Scott Benner 6/17/24 Scott Benner 6/17/24

#1227 Weight Loss Diary: Twelve

The eleventh installment of my weight loss series. I've now switched to Zepbound.

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Scott Benner 0:00
Hello friends and welcome to episode 1227 of the Juicebox Podcast

Welcome back, this is my 12th installment of my weight loss journey. I hope you enjoy it. Please don't forget that nothing you hear on the Juicebox Podcast should be considered advice medical or otherwise, always consult a physician before making any changes to your health care plan or becoming bold with insulin. If you are a loved one has type one diabetes, the T one D exchange is looking for you go to T one D exchange.org/juicebox. And if you're a US resident who has type one, or is the caregiver of someone with type one, they're looking for you to complete their survey, it should only take you about 10 minutes, and it's going to help greatly with type one diabetes research it'll probably help you as well. T one D exchange.org/juice box. 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, go to cozy earth.com and use the offer code juicebox at checkout to save 30% off of your entire cart that goes for the shorts I'm wearing now the sheets I'll sleep on tonight and the towels that I'm going to dry my butt off with in the morning. Cozy earth.com use the offer code juice box at checkout this show is sponsored today by the glucagon that my daughter carries G voc hypo Penn Find out more at G voc glucagon.com. Forward slash juicebox Welcome back to weight loss diary number 12. Okay, so if you heard the end of number 11 I had a small stroke because I had one salty meal that put a bunch of weight on me, pissed me off, and I do get a little pissy about it. I apologize about that. Anyway, what are you gonna do was that the Sixth Day is the 13th that would have made that the sixth, right? Yeah. So on the sixth. You heard me crying of a weight went from 180 4.8. The the day before on the fifth to 187 on the sixth. And I think it's just because I ate air fried chicken that had a breading on it. That was really salty. I know how crazy that sounds. But I really believe that's what happened. Anyway, I can kind of prove that. So on the seventh, I didn't weigh myself too pissed on the eighth 180 6.2 On the ninth 180 5.6 on the 10th 180 4.8 the 12 185. And last night as a little test because I ate the chicken on a Friday night. And I inject on a Saturday. And then I gained all that weight. And I really thought it was the salt not just the meal. Because I I can eat a little more on Fridays because it's the end of the injection cycle. I think I think that's why so last night, I ate pizza for dinner. Really good pizza by the way. Sausage and pepperoni. And I it's very thin crust, but I had many slices as many as Scotty could eat. And I sat around to watch a baseball game by the way I took off last night. Anyway, yesterday morning. I was 185 this morning, after all that pizza. I made a bowl of Cheerios yesterday. Yesterday was not a great food day for Scott as far as good nutrition goes. I weighed today 180 5.2 It was the salt. It's crazy. A pizza by the way, not salty. Anyway, I'm going to inject my zap bout now. And maybe tell you one more story and then I'm gonna get going. That story is going to be about bloodwork I had done yesterday. But first, zap bound and down 7.5 milligrams cap off. That was the that was me missing the trashcan. That was me putting down the pen and pulling up a shirt. Let's see if I can find a place to put no I'm just kidding. There's plenty of places to put it. I'll just grab this little real estate of chubby right here. And I gotta miss my incision from my appendix. I

Speaker 1 4:15
don't want to get near that. And jiggle jiggle jiggle. Don't want to hit a stretch mark there's a pro tip for you. It's like a little black and blue mark from last week. That interesting.

Scott Benner 4:27
Still there. I'm gonna go to the other side and turn off the lock. Lock is off. Squeeze fat bad squeezed. Pen touching skin and woohoo. We are done. Was that came out there. That's a little liquid. Don't go back in. Don't wanna waste get in there. Do the work. Alright, pen in the trash. Made it that time. Here's the story. Got blood work. done because I have a doctor's appointment coming up next week. Is it actually next week? It is next Saturday. Oh, well, this is interesting. Next Saturday, maybe I'll record this after the doctor's appointment next Saturday. Anyway, that's neither here nor there. I got a bunch of bloodwork done. And my numbers all came back really good. But the one number that was fascinating, was my ferritin, which if you listen to the podcast, you'll know that I've had trouble for years with low ferritin. So much so that I've had to go multiple multiple times to get infusions like I'll get an infusion and like six months later, I'll be out of ferritin again, and I've tried everything to get my body to absorb iron, but now that I'm on a GLP, it just works. My firt was 188 I almost cursed crazy. I haven't had an infusion over a year and my third one is 188. That's because my digestion is working better now and my body has time to absorb the nutrients that I'm eating. So it wasn't that I wasn't eating them. It was the prior to the GLP I couldn't absorb them. And that crazy. Makes me wonder what else is going right? Should I tell you anything else this time around now and that was enough, I'm zip bound and down. I'll see you next week after my doctor's appointment. 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 store G vo Capo pen and how to use it. They need to know how to use G Bo Capo pen before an emergency situation happens. Learn more about why G vo Capo pen 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. Hey everybody, it is April 21. I'm a day late. Actually, I'm pretty much two days late. It's like 11 o'clock at night, I had a crazy weekend, I did not shoot myself bound this weekend like I should have. And actually noticed that I eat more last night than I normally would have. Which I don't find crazy at all. But I'm going to share something quick with you and tell you I don't even have my weight today to tell you I'm sorry. I'll do better next week. But I've had this experience that I was going to share very quickly. If I eat till I get all like really full. The next time I see myself in a mirror while I'm feeling full. I expect to look back. I don't know another way to explain that to you other than when I feel full. When I go see myself, I think oh, I'm gonna be back to where I was. And it's not like a real conscious thought. It's just what's not fair. It is a conscious thought. It doesn't stick with me. I don't believe it or anything like that. It just feels that way. It's very strange. Anyway, I don't have a wait for today. I don't have anything for you. Just going to shoot this upbound 7.5. Also suppose that my doctor's appointment on Saturday like you guys know except she was exposed to COVID. So it got pushed back a week. So I don't have any reports back from my doctor's appointment, although like I said, I've got my bloodwork back and it looks great. Anyway, here we go. A lot of pressure on that one. All right. We're all done. I will do better for you next week. Hey, everybody, it is April 27. Saturday. I've had my doctor's appointment today. Very exciting. And I've got some good news to report some good news and some not great news, but you know, mostly good. So my bloodwork was fantastic. The doctor is thrilled she took my vitals and said My God Scott, you're like a kid, you know, with my blood pressure and everything. She talked a lot about health and just overall how I was feeling. She was super excited for me. But my weight this morning was 189. So this 7.5 of zap bound doesn't look like it's doing the job. And she's going to move me up to 10 So we're gonna go to 10 milligrams, but of course I've got to get that filled. My wife is where we get our insurance from and she's actually in between jobs. Right now she starts her new job on Monday, so I have to wait a little bit. So for today, we're going to shoot the 7.5 into my 189 pound body. So I'm up a number of pounds from my lowest weight, I was 183 at my lowest. Honestly, I don't know what to tell you about the six pounds, I'm not exactly sure I don't feel like I'm doing anything oddly different. But the doctor is very, very confident that a lot of weight loss on zap bound is seen at 10 milligrams and 12. She thinks I'm gonna have success at 10 I'm sorry, there's a cricket in here. I'm not sure if you can hear that or not. Anyway, I'm gonna shoot this that bound. Try to get the 10 as fast as I can. I don't know if I will be able to get to it this week or not, probably not till next, if I'm lucky. So I might end up doing this 7.5, another couple of weeks, not a big deal. I'm added some dumbbell work. And I'm seeing improvement in the muscles in my arms, my shoulders, my chest. And My shoulders feel better, like I'm regaining strength that I just wasn't lifting weights before. So that's helpful. I'm very content, not happy, obviously still have weight to lose. It's in my midsection. Maybe the 10 will do it. I'll try to add some other stuff on my side. I really don't know what else to change. I guess I could restrict calories, but I already don't eat very much. So not sure what to do here. We'll say anyway, they're going off the cap. Is that cricket? Hopefully, get that thing. unlocked the pen. I mean, obviously I put this in the right side of my stomach. Yes, last week, and I didn't lose any weight. So not that that has anything to do with anything, but I'm gonna go superstitious here and move it to the other side. And here we go. Alright guys, I will see you next week.

So today is not may 4, like it should be. Because I just did not have the energy to record last week, I still shot the set bound 7.5. But this is going to be a little talky for a minute on my button this episode up after this make it shorter. Because I think I'm starting over today. Let me tell you what I mean. through the entire process, thus far, the medication has just worked. And there were gaps of time where it wasn't working. You know, there was like slow downs, but I never gained weight. And people tell you like you know, there'll be times you don't gain weight, or don't lose weight, excuse me, like just be patient. So I was patient and then it kept going or there's times that you had to work on, you know, elimination stuff like you get a little constipated at some points, etc. Like in there were things to pick through. Big Picture a week didn't matter. Weeks doesn't matter. Big picture. However, last week, I woke up and I was so disappointed with my weight that I was like, I have nothing to record. Like I just don't. I'm like I'm not losing any weight. I keep like gaining. And last week, I started having a real panic that I was just gonna keep putting on weight. I don't know why. My eating again, it's not. It's not any different than it's been through the whole process. So perhaps I'm at the end. I don't know, maybe I'm in a maintenance space with a GLP. But my doctor doesn't think so. I mentioned that last episode. I've spoken to her since then. She genuinely doesn't think so. So she's moved me to this 10 milligrams that bound, which I have here today. Finally, I didn't have it last week. And I shot the 7.5 Like I said, and my weight is just doing this dance, you know? Let me see from one 90.2 this morning. Yesterday. I was 188 for I mean, what did I do yesterday I got up what I eat? I don't know if I didn't eat enough. I mean, I had pasta at the end of the day. Maybe I eat too late. Had a little bit of sorbet. I mean nothing that I hadn't eaten, you know, weeks before. I mean, there was this there was a time six eight months into this you guys will remember I lost my mind. One night I ate a pint of sorbet and lost the pound the next day. So you know I had a small dish of it. It's a call it dishes maybe too much. I had a few scoops little scoops of it last night. Yeah, I'm gonna go all the way back to 180 3.8 that was on April 1. Now here we are male leaven. What are we 40 days later? And I'm seven almost seven pounds heavier. Even then I thought I was a little dehydrated. I didn't I didn't think the know But it was real because I went on ad for for a few days that 187 180 680-584-8580 580-687-8780 680-887-8888 Yeah, maybe this is just where I was perfectly honest. Anyway, whatever. I've gotten out of the medication so far that made my weight drop doesn't exist at the moment. Hopefully it'll exist. But this is 10 milligrams. Doctor seems very sure that if it doesn't, she'll push me to 12. In probably four weeks, I will report this on seven and a half milligrams of zap bound. I don't fill up as quickly as I did on the weego V. So I guess that feeling full thing, I mean, obviously does slow you down from eating. But I can eat a little more on zap bound than I can on we go over and it does happen sometimes. Like, I'm not gonna lie to you. I have also had more sugar cravings the last week and a half. And I have had some simple sugars. That I mean, I wasn't thrilled with that. You say Oh, well, there's your answer, Scott, you can't. But I don't think so. Because before that I was still 187 188 Don't be mean like these couple of pounds here are different. Also, I should point out my clothes, they'll fit relatively the same, my shirts a little tighter in the front. And moreover, even though people are coming up to me and saying like, Oh, my God, you look terrific, or I can't believe it, or how are you doing this? Or tell me how to get that stuff like all that. I don't care about what people think about how I look, I've learned that that doesn't matter at all. Almost doesn't matter how I feel about how I look. It's body composition and health, right? And I've got got these three handfuls of fat on the front of me, and they gotta go. I'm not going out like that. Okay, I'm sure I'll die some other horrible way. But it's not going to be from a heart attack. Because I carried fat around on my front. I'm just not doing that. I want my knees to hurt when I run up the stairs. I don't want to feel out of breath like these are the things that I am concerned about. I travelled recently, and it was just so much easier. Just being thinner. And I have no other way of talking about it. Other than that, absolutely fantastic. I still haven't been able to fully talk to you about the gut health stuff that I'm doing because I don't have all the answers yet. But there is part of me that thinks that a supplement I'm taking is what stopped my weight loss. And I'm not certain so I've tried to dial that back to see I'm in the middle of an experiment to figure it out. You know, I said to my wife the other day like I haven't lost weight and she was where you eat that pack of cookies and I was like this pack of cookies like so I brought it up here so I could tell you about it. This is a little snack pack of cookies that I get from Costco. They're called thin and crispy chocolate chip cookies the package holds one ounce of cookies. And on the front it says Made with simple ingredients which is why I bought it originally. semi sweet chocolate chips sugar, unsweetened chocolate cocoa butter soy let that's what's in the chocolate, right? Wheat flour, niacin, reduced iron thiamin riboflavin, malted barley flour, butter, sugar, brown sugar, it's Listen, it ain't great. It's an ounce, like you know what I mean? Like an ounce of hard chocolate chip cookies every day or every other day or whatever like to like satisfy a sweet tooth. This is not some crazy thing I shouldn't be you know, gaining weight and calories wise I mean this one ounces 140 calories. I'm not exactly like you know Horkan it down. I still see over and over again salty foods, like we'll put water weight on me very simply happens really easily. Anyway, I think all this to say that I haven't eaten as well as I have in the past year in the last week and a half or two weeks. And maybe I should be thrilled that my weight is where it is. I'm not not thrilled at all I can tell you is that I got to look at myself at 183 and I thought my body if this fat leaves here, my body will be right around 175 Probably like for me I don't know what the you know, the apps gonna say about my you know, obesity level or you know what all the other stuff it tracks but I feel like I'll be good with my weight at that around right around there. I have put some like I told you before a little muscle on my arms, my chest. So I mean I'd like to say that that's some weight but it's certainly not six or seven pounds. It's certainly not six or seven pounds. Anyway, my weight today is one 90.2 I am starting over today with this 10 milligrams BMI 28.2 where I started at 34.6 still high body fat 20 4.9 Still Hi, my hydration body water hold steadily. Skeletal muscle mass has gone up a little bit in the last couple of weeks. BMR steady. That free bodyweight? Well, that's interesting. My fat free body weight. Yeah, it's pretty. It's all steady. subcutaneous fat, steady, visceral fat steady at 11. muscle mass, steady. bone mass steady, protein, steady, metabolic gauge 55. Okay, so let's just say I'm starting over. And I don't mean starting over, like I gave up in the middle. But starting over, like, maybe this is act two. You don't I mean, like, maybe act one was lower, you know, amounts of the medication, helped me lose weight, and now the medication needs to be jacked up a little bit to get to the rest of this fat. And if this isn't it, then the answer has to go some other place, like it's going to have to be pretty intense exercise and targeting of my midsection. Trying to lose more weight, so my back would feel better, before I started doing that kind of stuff, but maybe that is just what it's gonna have to be. But anyway, let's not call it starting over let's call it beginning act to Scotts weight loss journey got the 10 milligrams was a lot of liquid in there. 10 milligrams of zap bound, a pop it in my belly, I'm assuming I'm gonna feel a little pressure from all that liquid going in, I'm sure that'll be fine. And then I'm gonna go downstairs, have my breakfast of, you know, two eggs. Maybe in a wrap

with a little steak or chicken. That's been what I've been eating for breakfast for, you know, forever now. And let's hope that I come back on here in the next episode, because I am going to button this one up early. But let's hope I come back on here in the next episode to report to you that you know, it's been six weeks I've been on the higher dose and you know, I've lost 10 pounds, and I'm at 180. Now, that's my hope. If I get the 180 in a month or two. Obviously this would be working. If I dropped weight, slowly, I'd be thrilled. Even no matter what the number is. If I stay at this weight, I'm gonna think we're not in a good spot. Now well, we move to the 12 then, and see my doctor is very confident that most weight loss on Zep bound or Manjaro is seen at the 10 and 12 milligram level. So I trust her she's been rock solid for me since the day I met her. It's pop off the cap. Unlock the doohickey. I guess it's a lock. I up my multitude of options where my fat is on my stomach go a little lower down here because it looks a little softer. That makes it better? It does. Let's see if 10 milligrams feels different pressure wise, it was easy. I gotta go down that soft spot again. I just had to go down like another inch. Absolutely no pressure at all went right in there. Alright, kids, listen, I appreciate you doing with this with me. I was telling somebody the other day. They said you have a weight loss diary in your podcast. And I was like, Yeah, I said it really helps me. It's hard to know what you know what value talking about it gives but really does make me feel better after I talk about this and the replies I get from you guys. It's one of those things. It's funny. Um, not a lot of people want to go online and say, Hey, I listen to your weight loss stuff, because I think it makes you feel like you, you know, a little too seen. But a number of people have reached out to me to say how much they're enjoying these and I'm glad they're helping you guys as well. So 10 milligrams into the trash. And I'll see you guys in the next episode. I don't sound excited, but I I feel excited about what just happened there were those 10 milligrams. So let's cross our fingers and live seven days and see what happens. I did it I live seven more days. Today is in fact may 18 It is Saturday. And let's go over my Wait, shall we? Okay, I've got the app here. Go to the trends. Go back here a little bit to find where things went off the rails. Wow. Damn, how about that? Okay. So it's October kind of just following through a little bit here. Give me a second December 2023 When I start dropping out 190s Oops, sorry, February I got a 187 in there, it's may now I'm doing this for a reason. Hold on a second. pretty steady, pretty steady 187 and all sudden I get to 185. So I got real motion there on March 30. I hit my lowest weight ever on April 1, unless the scale was messing with me because it was April Fool's Day, but I was 180 3.8 That day, you've heard me say, I think I was dehydrated. It hung it hung, it hung for three or four days and then all of a sudden I was 187. Again, I figured okay, 183 wasn't real, that's fair, 180 sevens about my weight. I got into the one that you faiz pretty stably. But then I started bounced around 185 187 and all sudden when 88 And one day I was 189. And then on the 29th of April 190 1.4. I was like, Oh, this is going the wrong way. So we danced with that devil for a while and started talking to the doctor, as you know about moving up on the medication which I did shot my first one last week by go back to that day, one 90.2 As a week ago today. And today, well, let's step through it one 90.2 Next day, on the 12th 180 9.6 on the 13th 180 8.2 Then 180 7.2 Then 180 8.4 Then 187 180 7.8. And today 180 7.23 pounds, three pounds in a week. Let's call the 10 milligrams working. I'm going to tell you very briefly I recorded this fantastic episode. The other day with a gentleman and endocrinologist Tom Blevins, he's from Austin, Texas, he's going to come on and do a short GLP series with me knows a lot about TLPs very clear about it when he speaks. So we're gonna have him on to talk about it through a small series that'll come out soon. Ish. I don't know when honestly. But for now 10 milligrams of Manjaro I'm going to shoot this go have lunch, go to a party for a family member and continue to live my life. I also spoke out today spoke out strong but I made a post today on the private Facebook group letting everybody know that there are going to be conversations about GRPs in that group and on this podcast. And I know that there's varying opinions and perspectives and complexities but we are going to have that conversation. Because I think that one day this stuff's going to help a lot of people. And I think we need to start talking about it now. Anyway, I'm going to shoot this what I do in the bottom remember the embarrassment of rolling my fat around and finding the soft bottom of it last week to inject into well that worked great and it didn't hurt at all. So I'm doing it again. cap off. Cap on cap off. Can I hit the trashcan? Nope, I was left handed. I just missed or embarrassing. So I can unlock the lock. That soft underbelly. Oh, I guess that's where that phrase comes from. Stay away from my scar from my appendectomy. Say what I lost three pounds. I'm going back to the same side. I don't really think that matters. But what the hell? Here's another hit. I said God damn, I went right in nice and smooth. The silk, no blood. If I go right handed, can I get the trashcan. I really missed it that time. I'm like two feet from that trashcan. In fairness, I'm shooting around like a mic stand and a light and stuff but still feel embarrassed.

Back No, May 25. Saturday. So probably time for me to start talking a little bit inside of this diary about something else that I'm doing, which is I'm seeing kind of a gut specialist about like lifelong issues I've had with my my GI tract, right. So we're doing some things. And one of the things we're doing is taking something called slippery elm bark. And it seems like it's stopping me from losing weight. I'm not exactly sure how to put all this yet. It's a stop gap to get rid of some of my symptoms while testing goes on. And I try some other stuff which I'm not going to talk about in here but I will have an episode about maybe a couple of episodes about anyway for the moment. I'm not expecting a ton of weight loss. I guess also I don't know if maybe this 10 milligrams is going to take a little longer to work. I honestly I want to try to be really honest here. I don't know exactly what's happening right now but What I can tell you is that last week when I was 180 7.2, on the 18th, I went to 180 6.8 on the 98th. And I thought, oh, maybe this 10 milligrams is working. Then on the 20th, I was 188. On the 21st 187, six, on the 22nd 188, eight. I was 188. ate yesterday. And today, I'm 189 Eight. So, I mean, listen, I'm in the middle of something here, you know what I mean? So I don't have a ton of answers. My total weight goal is, you know, in limbo, but I'm trying to get this one thing done. So I'm going to be doing a kind of like a, like a flush, like a gallbladder liver kind of like detox thing over the next four weeks. So we'll see what's going to happen. And then after that, I'll be doing another step, which I'll tell you about later. But anyway, Mike, my urinalysis came back. And I had a couple of issues like Candida, which I think is yeast and a couple of other things that my gut, I'm trying to get that all worked out. Anyway, I'm going to keep going. Obviously, I'm not stopping with this. But I just don't know what's going to happen with my weight over the next couple of weeks, I guess we'll find out together. Not a lot to say, I'm not disappointed. It's just, I mean, I mean, I'm a little disappointed, like, you know what I mean? Like, I want to get to my goal weight, and I want to see the rest of this belly fat go and stuff like that. I just want to be healthy, honestly. But it seems like it's a bit of a process. So this is part of the process. And today's part is taken off this camp. Or the trashcan would actually went the trashcan. That's exciting. unlocking it, finding a soft, jiggly place to put this pen needle is looks good right here.

Okay, it's in. It's gonna be a bit of a ride here for the next few weeks, I have no idea what this wash is going to do or how it's going to make me feel or if I'm going to lose weight or not lose weight, or? I don't know. We'll find out together. Hey, everybody, this is going to be the last installment for this episode. It is Saturday, June 1, and I finally got back on track. Let me tell you about it. So today is June 1. Last Saturday would have been may 25. And I'm gonna go back in the app to May 25 189.8 pounds on May 25. Then I decided to take a tiny, maybe a different tactic this week. What am I two full weeks into the 10 milligrams now I think. And I'm finally getting the impact from the medication that I got previously. So it looks like going up in the dose was the right thing to do. 525 24 I was 189.8 pounds. The next day, I was one 90.2. And I made a decision then I was like, Okay, I'm not weighing myself that much this week, just because it was starting to bum me out. And I'm like, I just have to wait for this medication to start working again. So I don't want to not going to burn myself out every day. And I was able to eat less this week. And I think that's because the medication was back up to a strength that was working for me. I want to tell you what I mean by eating less. The sugar cravings I've been having the last couple of weeks are gone. So I guess I probably just didn't eat as much stuff with sugar in it. Which, by the way wasn't to say that I was having a lot of stuff we should grant but basically almost no sugar this week. It's still eating eggs, protein, steak, chicken. All that, you know at breakfast time. I have to be honest with you. I have I've been so not hungry this week. I think I've had chicken soup a couple of times for dinner. Just has not been a lot of calories this week. And we saw the impacts and how did we see them? The next time I jumped on the scale after the 26th sighs I mean, I was one 90.2 on the 26th I jumped back on the scale on the 30 If that's me 30 Couple days ago. So in between the 26th and the 30th. I went from one 90.2 to 180 5.6. And I was like Okay, that'll work. I didn't even need the scale. I could see it in my T shirt. And my face. It felt like my face looked more like I remembered it from when I was like 184 and my shirt fit the same way as I did when I was 184 So not a big surprise when I jump back on the scale 180 5.6 On the floor Already it was a little shocked on the 31st when I was one at 4.6 Because now we're looking at Friday, right like end of the month Jarno halflife is it's waning, basically in the in the sixth and seventh day. I thought all 180 4.6 There's no way when I get on the scale tomorrow on the first so that I can weigh in for the recording that I'm going to have that number. And then I was working for a while. Yesterday afternoon. My wife comes to me and she goes, would you come out to the bar with me and I have a french fry. I think she wanted a french fry. So we went to, you know, like this restaurant bar that we go to. And what did I have last night? Shrimp in a thin sauce. But man hours ago, it's salty. Like I thought for certain I'm waking up today like three pounds heavier. I had the shrimp actually had a couple of pieces of bread. I had a chicken wing from her dish. And something else. I'm thinking well Oh, she got a wing. It's so funny when you eat on GLP. Like she got wings and a cheesesteak and ate like an eighth of the cheesesteak and three of the chicken wings, but still, you know, that's what we ate just the amount is not great. I had a chicken wing. I mean that's deep fried, right. And then I picked some of the steak out of her role. So basically I had a pound a pound of shrimp now is a half a pound a half a pound of shrimp, couple of small pieces of bread small like two, three inches across, maybe a half an inch wide. The chicken wing, and what I'm gonna guess is like two ounces of like, you know, thin steak, and I'll be damn I was 180 4.6 this morning still. So anyway, um 180 4.6 Today, not bad. I'll give you my BMI 27.3 still over the threshold. Body fat is down to 24.1 it had been as high as 25 or 25 and a half at the beginning of the month. My body water increases as I lose weight, skeletal muscle has increased. Not a full point, but almost a full point in the last month. BMR is down 1743 fat free bodyweight is now one 40.2 was as much as 142 and a half at the beginning of the month. And my subcutaneous fat. O 21 Even. That's nice but not record breaking for me. visceral fat now my visceral fat is at a 10 a 10. It has only ever been at a 10 once before, and I guess it would not surprise you it was back when my weight was more like it is now. My muscle mass is a little down. Huh? Yeah, it's down to 132 from 134. I'm gonna want to do something about that bone mass nice and stable. Protein rising metabolic gauge at its lowest. But I've done this age before at this weight, metabolic age 54. No doubt I feel better about the process. I think this 10 milligrams that I'm going to shoot right now is I'm so excited about it. And I'm going to read you something someone sent me before I go and talk about it for a second. So cap off. Cap on cap off the capper. I hit the trashcan today. It's because I moved the light that was blocking it. That's pretty smart to me. I thought Mila unlock the pen. Definitely going back in a spot from last week and I call this the lucky spot. The lucky spot, nothing to do with anything. All right, actually, I'm going to move a little over more. A little soft piece of Scott right here. I'm going to use your ID stung a little bit at the end. Am I gonna see a drop of blood? Nope. No drop of blood no loss liquid. 10 milligrams is in the trashcan because things are going well. You think I was missing the trashcan because I was upset before as possible. All right. So I'm going to finish with this. And then I'm going to button up this episode. Somebody out there listening. Send a note as a person with type one that has struggled with body image issues, listening to Scott talk about how great he looks and feels because of weego V is getting really annoying. If only We all could just take a shot to lose weight. And it says check your priveledge. Now, I'm not going to tell you sent it or anything like that. But I am going to talk about it for a second. If you think that a decision to make a GLP diary and put it on a podcast was an easy decision to make, if you think I was just like, oh my god, I'm losing weight, I'll just tell people about it and celebrate, that is not what this is. So I have a significant feeling that GLP medications are going to be important to people moving forward people with type two people with weight to lose people with things that we might not even be thinking about yet, like PCOS, other metabolic issues, insulin resistance, and yes, I think it's going to be important for type ones as well. Now, the only way to spread that word, of course, is to talk about it. And then I make myself the target, because I know people like this person are gonna feel not good about this. And you're gonna hear from people are like, well, I can't afford it, or my insurance doesn't cover it. I hope you have, you've got privilege. And I mean, listen, you start saying, check your privilege. I started thinking you have other goals. But I understand. I have insurance that covers this. And that is a privileged situation.

Absolutely. And I accept that. And I absolutely agree. But you want people talking about this stuff. Because the way you're all gonna get covered by your insurance, is by showing that people are having great success with this by making it undeniable that it's necessary for people to have these if they want them. If people like me don't push, if we're not out and open about it. They're just gonna say, whatever. And you have to understand that type two is not a huge market. You know, a couple of million people with type two diabetes is not, you know, that's not what they're looking for when they're they're making drugs, they're looking for stuff that covers hundreds of millions of people, they're trying to make real money, you don't mean like money, like we can't imagine money. So you have to show them why it's important to put the effort into the studies that will lead to the insurance coverage. So a person with type one diabetes can use Manjaro, or we go V or ozempic. Or, by the way, why they also might want to get behind this little ditty here. biosimilars, lots of companies making biosimilar GLP medications, and they're being in some cases, they're having trouble, because of the mechanism of delivery that a couple of the companies chose. So they patented, I don't know all of this yet, I'm gonna have someone on to talk about it. But a couple of companies patented that pen that I just threw in the trash, not the medication. That's janky. So the Federal Trade Commission has been involved recently. And again, I'm going to have somebody come on to talk about it. Because if these biosimilar companies can make GRPs that are biologically similar to the ones that are available on the market now, then they can make viable medications and flood the market with them at lower prices. And then this person here who says, you know, if we could all just take a shot to lose weight, you might actually have that option. Now, the next thing I got to say is, if I only said things on this podcast that I knew 100% Everybody could agree with, that no one would be upset by or no one would feel like, Oh, I've been left out here. If I only spoke about those things, you wouldn't even listen to the podcast. It wouldn't be valuable. It would be what they call milquetoast, it would say nothing. It would be something everyone could agree with, which is not normally something that's going to help anyone that you can tell when I'm talking this is off the top my head, but point being, we have to say things that are happening. This is really happening to me. I didn't start making this diary. Once I knew it was working. I went on day one. I didn't know if this was gonna work. Do you think I'm excited to tell you I have diarrhea? You think I'm super excited to tell you how much I weigh. I hate this. This is not fun. It is not fun at all. But I think it's important. I think that if I look at the impacts, I'm seeing type ones who are getting a hold of GLP medications. If I look at the impacts, they're having a quality impacts on their life. And I want these conversations to keep happening. Well, then somebody's got to have them and even though I know that there gonna be people out there who are either disappointed because, you know, for just any number of reasons that this has been aren't about, I think it's important. If it hurt this person's feelings, I certainly don't want that. But my God, if you're going to be triggered by the conversation of a 50 year old guy who can afford insurance, whose insurance covers GLP, talking about his weight loss, and I have to ask this person, if they were here, I would ask them this. Why the fuck? Are you listening to this? Like, why would you listen to something that makes you this upset? That I don't understand. There are so many things in the world I don't like and so many things that make me sad and upset. I wouldn't listen to them. And if I did listen to them, and found myself not surprisingly sad and upset, about the last thing I would do was take my time to reach out to that person and say, Hey, there's a thing you're doing a thing that I knew I wasn't going to like, but I involve myself in any way. And turns out, you're going to be so surprised. I didn't like it. So now I'm gonna take the time to write to you, and try to make you feel good about it. So to this person, I feel terrible that you feel this way. But you made me feel exactly the way you feel. So you want to sit here and discuss what came first the chicken or the egg? We absolutely can. But I say, stop looking for things that make you upset. That's all I got for this one. I'm going to keep making this diary. Because despite this one note, so many of you have written to me to say, hey, this has been really inspiring for me or it's comforting to hear how the medication works, or thank you for drawing attention to this to this person doesn't realize that their opinion is, as far as I can tell, so far in the minority, that if they could see the balance of their note versus the other ones, I genuinely think they'd be embarrassed. Now, having said that, again, I am so sorry that it made you feel poorly. I did not want that. But I mean, it's getting really annoying. What does that mean? You're annoyed by it and you continue to listen to it. Like, stop listening if you don't like it? Seriously, I mean, things that I've heard and I go, I don't agree with that. It makes me upset so I don't do it again. I don't know. I might be wrong, but it's how I feel. Anyway, I'm zap bound and down to one ad for something and if I have a fine enough wood to knock on, I hope to be a couple pounds lighter. Next time I talk to you, I still have a significant amount of weight to lose so that I can be healthy. So to that person, I'm trying not have a heart attack, not just look good. That is literally a bonus. Trying to stay alive and be healthy while I'm doing it. You know, you think you have body image issues? So why so does everybody?

A huge thank you to one of today's sponsors, G voc glucagon, find out more about Chivo Capo pen at G voc glucagon.com. Forward slash juicebox. you spell that GVOKEGLUC AG o n.com. Forward slash 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. The group now has 47,000 members in it. It gets 150 new members a day. It is completely free. And at the very least you can watch other people talk about diabetes, and everybody is welcome type one type two gestational loved ones, everyone is welcome. Go up into the feature tab of the private Facebook group. And there you'll see lists upon lists of all of the management series that are available to you for free in the Juicebox Podcast, becoming a member of that group. I really think it will help you it will at least give you a community. You'll be able to kind of lurk around see what people are talking about. Pick up some tips and tricks. Maybe you can ask a question or offer some help Juicebox Podcast type one diabetes on Facebook. If you have type two or pre diabetes, that type two diabetes Pro Tip series from the Juicebox Podcast is exactly what you're looking for. Do you have a friend or a family member who is struggling to understand their type two and how to manage it? This series is for them seven episodes to get you on track and up to speed. Episode 860 series intro 864 guilt and shame episode 869 medical team 874 fueling plan episode 880 diabetes technology episode 85 GLP ones metformin and insulin and in Episode 889 We talk about movement. This episode is with me and Jenny Smith. Of course you know Jenny is us Certified diabetes Care and Education Specialist. She is a registered and licensed dietitian and Jenny has had type one diabetes for over 30 years. Too many people don't understand their type two diabetes. And this series aims to fix that. Share it with a friend, or get started today. 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

#1226 Defining Diabetes: Glucagon

Scott and Jenny Smith define diabetes terms In this Defining Diabetes episode we define glucagon.

+ Click for EPISODE TRANSCRIPT

Scott Benner 0:00
Hello friends and welcome to episode 1226 of the Juicebox Podcast.

In this episode Jenny and I are going to define glucagon. 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. If you have type one diabetes, or are the caregiver of someone with type one and a US resident, please go to T one D exchange.org/juice. Box and complete the survey. Your answers will help to move type one diabetes research board that may help you to T one D exchange.org/juicebox. If you're living with diabetes, or the caregiver of someone who is and you're looking for an online community of supportive people who understand, check out the Juicebox Podcast private Facebook group Juicebox Podcast type one diabetes, there are now 50,000 members who are sharing stories and ideas. Go check out this amazing private and free Facebook group. Today's episode is sponsored by Medtronic diabetes, a company that's bringing together people who are redefining what it means to live with diabetes. Later in this episode, I'll be speaking with Mark, he was diagnosed with type one diabetes at 28. He's 47. Now that at the very end of the episode, you can hear my entire mini interview with Mark to hear more stories from the Medtronic champion community or to share your own story. Visit Medtronic diabetes.com/juice box and check out the Medtronic champion hashtag on social media. Why don't we do glucagon? So you all might know listening the defining diabetes series as well over 50 terms. And every once in a while I get a note from someone that says I can't believe that this isn't on here. No kidding. We didn't have like, I think Basal insulin wasn't on there for a really long time. Like we just missed it, you know, they made that's

Jennifer Smith, CDE 2:32
really interesting, because we define terms even like the symbol V effect, which I think was humorous, because I think you tried seven times to

Scott Benner 2:39
I don't know how to say yeah, Smokey, whatever. You're making fun of me, and then we need to find it. But apparently, I mean, we you and I've talked about glucagon a number of different times in the podcast, but we've never just defined it for the defining diabetes series. So let's do that now. So I think we when someone hears glucagon, and they have type one, my expectation is that they're thinking of the manmade stuff that they got through a prescription. I don't even know if do you think people even think because Ghunsa thing my liver makes?

Jennifer Smith, CDE 3:13
It's interesting because I think so but quite honestly, it's not made.

Scott Benner 3:20
No it's the alpha cells. Okay. All right. Yes, he in Korea. So there you go. Like I as I said it, I'm like, that's not right. Your pancreas makes glucagon, right? But what so what does your liver have to do with the release of it?

Jennifer Smith, CDE 3:32
So essentially, glucagon is involved in your livers, sort of fat metabolism and amino acids, which are like protein metabolism, it helps in how your body uses energy, all of that stuff, which is the reason as I mentioned, that other hormone that we talked about, right, Amylin, and how its action helps to actually sort of suppress glucagon, because we don't want as much of it output in the aftermath of actually taking in a meal. So when we look at where kind of you know, the liver comes in, what else is the liver stores? Glycogen, okay. So when we take in glucagon, right? We are using it for specifically in diabetes, hypoglycemia, okay. So we want to get a release of glycogen from our bodies, stores, liver, fat, muscle cells all store glucose or glycogen. So in order to get a release of that, in an episode of hypoglycemia, what we're going to look at is glucagon,

Scott Benner 4:48
so, okay, so it's, it's made by the pineal

Jennifer Smith, CDE 4:53
Yep, it stimulates hepatic or liver glucose. Production.

Scott Benner 5:01
Oh my god, I we have to do this more like street level Hold on a second so

Jennifer Smith, CDE 5:05
it helps. Oh go ahead. Go ahead.

Scott Benner 5:09
Glucagon is made by your pancreas. Glucagon

Jennifer Smith, CDE 5:11
is made by the alpha cells, not the beta cells. And there are multiple different types of cells in the pancreas. That's why we are not owners of a dysfunctional, completely dead pancreas doing

Scott Benner 5:21
stuff. So the alpha, the alpha cells are making glucagon. It's being stored.

Jennifer Smith, CDE 5:28
Is that right? So glucagon isn't stored so to speak is made in the alpha cells. Yes. It's pushed out as your body kind of needs it. The liver stores usable. Glucose, okay, glycogen glycogen is that that word? Alright.

Scott Benner 5:51
So the glucagon that the pancreas is making has nothing to do with the glucose that's stored in the liver, right in a way that they work together. All right, but they're not the same thing. Not the same thing. Okay. And then, if I have type one diabetes, I've used too much insulin, I get low and I use an emergency glucagon thing, it signals to my liver to release the glucose that's stored there.

Jennifer Smith, CDE 6:15
Yay. Yes, because glucose or glucagon essentially acts like a mobilizing kind of thing, right? It goes to the transporters like, hey, let's get some let's move it out into circulation. But it's not moving. Glucagon isn't what it's the stored glucose in your body stored glycogen that gets released. And that increases your blood sugar,

Scott Benner 6:35
don't you? Don't you imagine that most people just think that the emergency glucagon you shoot in and what's in there makes your blood sugar go up. But that's not it just signals your liver to let go of the glucose, which is why you can't do it over and over and over again, to some point because eventually your liver will run out of glucose

Jennifer Smith, CDE 6:52
back to your glycogen stores put essentially be depleted enough that it's not going to work

Scott Benner 6:58
work. And you'll get diminishing returns to the very least. Yes. Okay. All right, hold on. As you're listening right now, this is why I didn't like go to college. This is just some

Jennifer Smith, CDE 7:10
this is this is great. We're gonna get to break it down.

Scott Benner 7:14
Yeah. All right. So glucagon made by your alpha cells, glucagon, also the man made thing that you get as an emergency kit both have the same name. Your liver is storing glucose. If you have a low and use an emergency kit, the emergency kit signals to the liver to release the glucose that's there, which brings your blood sugar up. Yes. Yes. I feel tired from that. I'm setting because you understand it. So clearly, I'm looking at you look at me, and I'm like, I feel bad.

Jennifer Smith, CDE 7:49
Because this is I mean, even my understanding is a very, like, it's, I'm clearly not like, no, like, you know, biology. Like I understand all of the little transporter I beat I couldn't tell you the enzymes that release blah, blah, blah, and what happens but right in the gist of things, this is this is essentially how that works for you.

Scott Benner 8:10
Okay, are we going to mention here that if you're drunk, emergency glucagon might not work as well. And why? Because your liver is busy trying to get rid of all that booze you put in there? Us? Yeah,

Jennifer Smith, CDE 8:22
her likes to focus on. I mean, it's our detoxify. It does a lot of other things, you know, besides detoxifying? Your liver is an amazing, it's an amazing Oregon. Really. It really, honestly. But you're right. If you have a lot of toxins such as alcohol in your body, then your body's liver is working on taking that and kind of getting it out of the system. Yeah. And so it's it's less likely to focus on what's happening with your blood sugar.

Scott Benner 8:52
Okay. All right. I was the wrong person to lead this, obviously. But do you think we were clear about what glucagon is?

Jennifer Smith, CDE 8:59
I hope so. Yes, I do think that we were clear, and

Scott Benner 9:03
the glucagon that my alpha cells are making is not the same thing in the emergency kit. Right? Where is it? It's a synthetic version of it. It's,

Jennifer Smith, CDE 9:16
that's I think that's the easiest way to go. Okay.

Scott Benner 9:20
All right. So I see. And so glucose, your body's using glucagon to keep kind of like a homeostasis with your blood sugar.

Jennifer Smith, CDE 9:30
Correct. So even in somebody who doesn't have diabetes, right, their alpha cells are still making glucagon and they're making them in there it's making it essentially in order to allow a fasting state in order to allow some navigation through especially more endurance exercise, all of those kinds of things right. So the the human body has this, like

Scott Benner 9:54
a float valve almost like if I try to get too low, my body, my alpha cells, let out some glucagon and keep me stable.

Jennifer Smith, CDE 10:01
Correct. Right. So and remember in terms of our own body's glucose output, and this homeostasis kind of point. Why do we use Basal insulin?

Scott Benner 10:14
The same thing? It's it's this to hold down this the natural rise of what happens in your body? Yes.

Jennifer Smith, CDE 10:21
Okay. Correct, which is coming from this drip, drip, right? We're supposed to be getting, we're supposed to be getting insulin, we're supposed to be getting a little drip of glucose, especially in fasting states. So if we have no insulin coming in, our bodies still gives that drip, drip, drip, drip, drip, drip, but doesn't know it's that good.

Scott Benner 10:40
So you, Jennifer, you without Basal insulin, get the your body goes, Oh, here's a little glucagon, your liver goes, here's a little glucose and your blood sugar just keeps going up and never stops. If I don't take Basal, and we put it in manmade insulin to stop that from happening for me. My body is going here's some glucagon, that gives me some glucose. And then as I get too high, my body goes, here's some insulin, and they're just playing ping pong back and forth with my blood sugar. Yes. Ah, now, our bodies

Jennifer Smith, CDE 11:13
are a beautiful system. Our bodies are the most complex computer ever. There it is. It's amazing what it does.

Scott Benner 11:22
That's insane. I don't know why I've never thought of it like that before. That's really interesting. Okay, well, now I understand it. So if you look at we did it. And Jenny has to go. And it's Friday. Oh, so you only have a couple of minutes.

Unknown Speaker 11:38
Alright, well have a great week. Yes. Was way fun. No, we're

Scott Benner 11:41
gonna do more. Listen, we're gonna come back. The next time we do it. You and I are going to do total daily dose of insulin total daily and some are going to do duration of insulin action or insulin action time. We're going to do I might be it for that list. Oh, I don't know. Also, I've been told by the powers that be, which is Isabel who tells me what to do. She said that we need a bulb beginning to episode about correcting mistakes. Like if you were to inject the wrong insulin, that we should have a conversation about how to handle that. That's a great one. She thinks we should do a bold beginnings episode about CGM accuracy. Okay, she thinks we need a part two of the diabetes pro tip for fat and protein. Okay, she thinks that we need by the way, Isabel, thank you so much. She said we need a diabetes variable for men and not being able to finish. Okay, and they have type one and it's maybe not well controlled.

Jennifer Smith, CDE 12:41
So we're talking about erectile dysfunction. That's what

Scott Benner 12:45
we're talking about there. And okay. Yeah, she's got a whole list of stuff. Like, basically you and I work for Isabel is what I'm looking at her. She she tells us what to do. And we do it. Fabulous. Thank you. She's like, I don't even know that was happening. Okay. All right. Thank you very much. I'll talk to you soon. Awesome, thank you.

diabetes diagnosis comes with a lot of new terms, and you're not going to understand most of them. That's why we made the finding diabetes, go to juicebox podcast.com, up into the menu and click on defining diabetes, to find the series that will tell you what all of those words mean. Short, fun and informative. That's the finding diabetes, the diabetes variable series from the Juicebox Podcast goes over all the little things that affect your diabetes that you might not think about travel and exercise to hydration, and even trampolines. juicebox podcast.com, go up in the menu and click on diabetes variables. And now my full conversation with Medtronic champion, Mark. Mark, how old were you when you were diagnosed with type one diabetes? I was 2828. How old are you now? 4747. So just about 20 years?

David 14:11
Yeah, 19 years?

Scott Benner 14:13
What was your management style when you were diagnosed?

David 14:15
I use injections for about six months. And then my endocrinologist at a navy recommended a pump.

Scott Benner 14:21
How long had you been in the Navy? See eight years up to that point? Eight years? Yeah. I've interviewed a number of people who have been diagnosed during service and most of the time they're discharged. What happened to you?

David 14:33
I was medically discharged. Yeah, six months after my diagnosis.

Scott Benner 14:37
I don't understand the whole system. Is that like, honorable?

David 14:39
Yeah. I mean, essentially, if you get a medical discharge, you get a commensurate honorable discharge. I guess there could be cases where something other than that, but that's that's really how it happened. So it's an honorably discharged with but because of medical reason,

Scott Benner 14:51
and that still gives you access to the VA for the rest of your life. Right?

David 14:55
Correct. Yeah, exactly.

Scott Benner 14:56
Do you use the VA for your management? Yeah, I

David 14:58
used to up until Few years ago, when we moved to North Carolina, it just became untenable. Just the rigmarole and process to kind of get all the things I needed. You know, for diabetes management, it was far easier just to go through a private practice.

Scott Benner 15:12
Was it your goal to stay in the Navy for your whole life, your career? It was,

David 15:15
yeah, yeah. In fact, I think a few months before my diagnosis, my wife and I had that discussion about, you know, staying in for the long term. And, you know, we've made the decision despite all the hardships and time away from home, that was what we loved the most. So that's what made it that much more difficult was

Scott Benner 15:31
the Navy, like a lifetime goal of yours or something you came to as an adult,

David 15:36
lifetime goal. I mean, as my earliest childhood memories were flying being a fighter pilot and specifically being flying on and off aircraft carriers. So, you know, watching Top Gun in the 80s certainly

Scott Benner 15:48
was a catalyst for that you've taken off and landed a jet on an aircraft carrier, hundreds of times. Is there anything in life as exhilarating as that?

David 15:57
No, but there there's a roller coaster I wrote at, I think it was at Cedar Rapids up in Cleveland Sandusky, and they've got this roller coaster rotation from zero to like, it's like 80 or something, you go up a big hill and you come right back down. So the acceleration is pretty similar. I would say to catapult shot,

Scott Benner 16:16
I'm gonna guess you own a Tesla.

David 16:18
I don't I I'm a boring guy. I got a hybrid rav4 I get made fun of I get called. You know, my wife says I drive like a grandpa. I'm a five miles per hour over the speed limit person. No more than that. So yeah, in the car, I'm boring

Scott Benner 16:33
guy. So you've never felt a need to try to replace that with something else.

David 16:37
You can't replace it. It's irreplaceable. That's what I thought. So up until the point where someone you know, buys me an F 18. Or allows me to get inside a two seater and fly it you can't replace it.

Scott Benner 16:47
How did it make you feel when you saw or maybe you haven't seen? gentleman named Pietro has his large aircraft license. He's flying for a major carrier. Now he has type one diabetes. Does that feel hopeful to you? Yeah,

David 16:58
it does. You know, when I when I was diagnosed, that wasn't a possibility. The FAA prohibited commercial pilots who had type one diabetes, but I think it was 2017 when they changed their rules to allow type one diabetics to be commercial pilots. And part of the reason I did that was because of the technology advancements, specifically in pump therapy, and pump management. So I don't have any aspirations of going to the commercial airlines. But one of my sons who has type one diabetes very much wants to be a commercial pilot. So, you know, in that respect, I'm very hopeful and thankful. Yeah.

Scott Benner 17:30
Do you fly privately now for pleasure?

David 17:33
I do. Yeah. One of my favorite things to do is fly my kids to the different soccer tournaments they have all over the southeast us. So last week, my wife and I and two of our boys flipped to Richmond for their soccer tournaments up there. And Charlie, who's my middle child has type one diabetes, so you know if I can combine flying family and football and one weekend to me that's I think I've just achieved Valhalla. So

Scott Benner 17:56
then it sounds to me like this diagnosis was a significant course correction for you. Can you tell me how it affected your dream?

David 18:04
Well, I you know, if I guess three words come to mind first, it was devastating. Everything I had done in life, everything I'd worked up to up to that point was just taken away in an instant. And I was not prepared for that at all. The second emotion was, it was scary. I hadn't thought much about life outside the Navy, certainly not life as anything else, but a fighter pilot. And Heather and I were getting ready to move to France, I was going to do an exchange tour with with the French naval air force. So we were taking French classes. So pretty quickly, I had to reinvent myself. And then probably the most important thing at the same time that all that was going on, I had to learn how to how to deal with type one diabetes, and how to manage it effectively. The third thing that pops into my mind, I guess, is challenging, you know, new daily routines, I had to establish first with injections, and then eventually, you know, through pump management, and then learning how to count carbs and recognize highs and lows, how my body reacts to blood sugar trends based on exercise and stress and those types of things. And my goal at that time, and it still is today is to leverage technology and make sure my habit patterns are effective so that I take diabetes management from the forefront to the background.

Scott Benner 19:11
Have you had success with that? Do you feel like you've made the transition? Well,

David 19:15
I have I mean, I believe in continuous improvement. So there's always more to do. I will say the technology since I was diagnosed specifically with pump management, it's just, it's just incredible. It takes less of me intervening, and it's really done by the pump itself and by the algorithms through the CGM comes in to me again, that that should be the goal for everybody is to not have to focus so much on the daily aspects of type one, diabetes management, you know, we should let technology do that for us.

Scott Benner 19:44
What else have you found valuable? I've spoken to 1000s of people with type one diabetes. The one thing that took me by surprise because I don't have type one myself and my daughter was very young when she was diagnosed. I didn't really understand until I launched this podcast. And then it grew into this kind of big Facebook presence. I heard people say, I don't know anybody else who has type one diabetes. I wish I knew more people. But until I saw them come together, I didn't recognize how important it was. Yeah,

David 20:13
I think similarly, I didn't know anyone with type one diabetes growing up as an adult up until when I was diagnosed. And then all of a sudden, people just came out of the woodwork. And when CGM is first hit the market, certainly within the last five years, it's amazing to me and my family, how many people we've noticed with type one diabetes simply because you can see the CGM on their arm. I mean, I would say, a month does not go by where we don't run into someone at a restaurant or an amusement park or a sporting event or somewhere where we see somebody else with type one diabetes. And the other surprising aspect of that is just how quickly you make friends. And I'll give an example. We're at a soccer tournament up in Raleigh, this past Saturday and Sunday. And the referee came over to my son Charlie at the end of the game and said, Hey, I noticed you're wearing pomp. And he lifted up a shirt and showed his pump as well and said, I've had type one diabetes since I was nine years old. I played soccer in college, I'm sure that's your aspiration. And I just want to tell you don't let type one diabetes ever stop you from achieving your dreams of what you want to do. And this gentleman was probably in his late 50s, or 60s. So just having that connection and seeing, you know, the outreach and people's willingness to share their experiences. It just means the world to us and just makes us feel like we're part of a strong community. Yeah.

Scott Benner 21:33
So would you say that the most important things are strong technology tools, understanding how to manage yourself and a connection to others? Yeah,

David 21:42
technology for sure. And knowing how to leverage it, and then the community and that community is your friends, your family, caregivers, you know, for me to Medtronic champion's community, you know, all those resources that are out there to, you know, help guide away, but then help help you keep abreast on you know, the new things that are coming down the pike. And to give you hope for eventually, you know, that we can find a cure, you

Scott Benner 22:04
mentioned that your son wanted to be a pilot, he also has type one diabetes, how old was he when he was diagnosed,

David 22:09
so Henry was diagnosed when he was 12 years old. That was just at the start of COVID, we are actually visiting my in laws in Tennessee, we woke up in the morning and he had his bed. And several years before that, we had all four of our boys tested for trial net. So you know, predictor of whether or not they're going to develop type one diabetes, and whether or Henry and one of his brothers tested positive for a lot of the indicators. So we always kind of had an inclination that there was a high degree of possibility he would develop it. But we always had at the back of our mind as well. And so when that event happened, at the beginning of COVID, we had him take his blood sugar on my glucometer. And it was over 400. And so right away, we knew that without even being diagnosed properly, by endocrinologist that he was a type one diabetic, so we hurried home, to get him properly diagnosed in Charlottesville. And then we just started the process first grieving, but then acceptance and, you know, his eventual, becoming part of the team that nobody wants to join.

Unknown Speaker 23:12
How old is he now?

David 23:14
He's 15 years old. Now,

Scott Benner 23:15
when's the first time he came to you? And said, Is this going to stop me from flying

David 23:21
almost immediately. So like me, he's he always had aspirations of flying. In fact, he out of all four boys wanted to be in the military, that was a difficult part of the conversation and maybe something that we don't talk about as a community. But there are some things you cannot do as a type one diabetic, and that's a hard fact of life. And unfortunately, joining the military is one of those hard and fast things you cannot be you cannot join the military as a type one diabetic. So it was very difficult for him and for me and my wife to get over. Then we also started talking about being a commercial pilot. So I saw that same excitement in his eyes because like me, you know, he can be an NFA teen or a 737 or a Cirrus SR 20 That I fly and be just as happy. So he still has that passion today and still very much plans to eventually become a commercial pilot.

Scott Benner 24:07
I appreciate your sharing that with me. Thank you. You have four children do any others have type one?

David 24:12
They do? My oldest twin Henry has type one diabetes and my middle son Charlie has type one diabetes as well. The boys are twins. The oldest two are twins. One has type one diabetes. My middle son, who is not a twin has type one diabetes.

Scott Benner 24:26
I see. Is there any other auto immune in your family? There

David 24:28
isn't I'm really the only person in my family or my wife's family that we know of with any sort of autoimmune disease certainly type one diabetes. So unfortunately, I was the first to strike it rich and unfortunately pass it along to to my sons,

Scott Benner 24:43
but celiac thyroid, anything like that. Not nothing. We're

David 24:48
really a pretty healthy family. So this came out of nowhere for myself and for my two sons.

Scott Benner 24:53
That's really something. I appreciate your time very much. I appreciate you sharing this with me. Thank you very much. Anytime, Scott. Learn more about the Medtronic champion community at Medtronic diabetes.com/juice box or by searching the hashtag Medtronic champion on your favorite social media platform. 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

#1225 Defining Diabetes: Duration of Insulin Action

Scott and Jenny Smith define diabetes terms In this Defining Diabetes episode we define duration of insulin action.

+ Click for EPISODE TRANSCRIPT

Scott Benner 0:00
Hello friends and welcome to episode 1225 of the Juicebox Podcast.

Today on defining diabetes Jenny Smith and I are going to define duration of insulin action. 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. If you have type one diabetes, or are the caregiver of someone with type one and a US resident, please go to T one D exchange.org/juice. Box and complete the survey. Your answers will help to move type one diabetes research board that may help you to T one D exchange.org/juicebox. If you're living with diabetes, or the caregiver of someone who is and you're looking for an online community of supportive people who understand, check out the Juicebox Podcast private Facebook group Juicebox Podcast type one diabetes, there are now 50,000 members who are sharing stories and ideas. Go check out this amazing private and free Facebook group. Today's episode is sponsored by Medtronic diabetes, a company that's bringing together people who are redefining what it means to live with diabetes. Later in this episode, I'll be speaking with Mark, he was diagnosed with type one diabetes at 28. He's 47. Now that at the very end of the episode, you can hear my entire mini interview with Mark to hear more stories from the Medtronic champion community or to share your own story. Visit Medtronic diabetes.com/juice box and check out the Medtronic champion hashtag on social media. Jenny, let's define duration of insulin action. That's the I A is that right? Yes. All right. People want to know how to figure it out, depending on different insulin types impacts on boluses, manual pumps versus algorithms, etc, and so on. So first of all, duration of insulin action, is it something that is it's not quantifiable specifically to the insulin? It's got to do with you as well, right?

Jennifer Smith, CDE 2:34
Yes, it could, because in terms of, as you said quantifiable to the insulin, anybody who opens up those little paper packets inside of your insulin, which nobody does, that all goes in the garbage, right, you'll actually see what the, you know, the manufacturer has in terms of the duration of insulin action, its profile, it's sort of a bell curve of action, right? And that's tested and true. But that's coming out of a lab that's not in the individual body. And as everybody in the diabetes community knows your diabetes may vary. And that includes how long insulin may act in your body. We're talking about rapid insulin here, right?

Scott Benner 3:15
Yep. So, okay, so it's not as easy just to say, I pulled out the package insert for FY ASP, and it says it peaks here and it dissipates here and blah, blah, blah. And that's gonna work the same for everyone. That's not the case.

Jennifer Smith, CDE 3:29
It's a guidepost. It's a guide. Right. That's the starting place.

Scott Benner 3:33
So I don't want to freak everybody out. But could the duration of insulin action for you change from day to day, week to week? Not necessarily, not

Jennifer Smith, CDE 3:42
necessarily, I wouldn't say that I would say person to person is much more the case that it could be a little bit longer here or a little bit shorter there. I think scenario also changes things. Again, working with a lot of women in pregnancy, we find that not only is insulin need increased as pregnancy progresses, especially into the third trimester, but also that the clearance of insulin is faster in pregnancy. So it kind of it goes in a bit slower in action to begin with from a resistance factor, but the end effect kind of has almost a clearing effect a bit faster. Okay. I mean, a lot of that has to do with right, we're taking insulin by injection or by a pump, and whatever in that. There are sort of pieces of that that get moved out by the kidneys, and they get kind of flushed by the body. Right? So there are parts in that end of action time that could change but it again is based on scenario or where you are not on day to day. Today. It works for three hours tomorrow. I don't know it looks like it worked for five

Scott Benner 4:53
hours. So if you're having a bad experience, very likely you've not used enough insulin or timed it well or something to that effect. Correct. Okay. But in the is it this specific case of pregnancy? Or like? Are there other spots that can like chew it up and there are other spots,

Jennifer Smith, CDE 5:09
those who have any sort of degrees of kidney disease, okay, that can also change insulin action time. All right. So those are some of the very specifics that could change in one person. But again, it's not a night and day change, or it's not an hour to hour kind of, Oh, it's here. Now tonight, I have to consider it's three hours instead of five hours. Gotcha.

Scott Benner 5:36
For most people, once they see it, I injected it here, I pushed the button here, it started to work. 20 minutes later, it really started to pick up steam, 30 minutes in 45 minutes, it felt like it was at its full power. hour and a half later, I felt like it was trailing off whatever those numbers are, once you start seeing it, you should see it with some consistency.

Jennifer Smith, CDE 5:55
You should okay. And that's again, there are always some variables in the picture. One has your Basal insulin bend evaluated, right, because if it has, then wherever a Bolus of rapid acting insulin leaves you, your basil should hold you nice and stable in that time period, after you expect that that rapid has stopped working, right. But if your basil hasn't been tested, then you can't really test the duration of insulin action for your rapid dose. Because the Basal might be pulling or not giving enough strength in that latent part. If that makes sense.

Scott Benner 6:36
You have to hold this in two different places in your mind. Yeah, the insulin action works as it works. But the result you see could be different if your Basal is not correct. And other factors.

Jennifer Smith, CDE 6:49
Yeah, the other one would be fat, right? Okay, your high fat intake or a high protein type of meal. Those are not the meals if you're going into understanding this term, so to speak, you're really not going to test this out in a scenario where you sit down to, you know, a 12 ounce steak with butter all over your potato.

Scott Benner 7:14
Potato journey with some sea salt on it, maybe and some craft pepper, you're hungry. I mean, now that you're talking like this. Sorry, no, no. So that's important because, yes, alright, let's let's talk about it specifically, like I once heard somebody who really, really understood loop as an example, who told me insulin action is six hours in loop. Uh huh. Right. We're sure we see it so many times bah, bah, blah. And I thought and then somebody else would come along, go, I have my insulin action set the four hours and loop. But that's all just about like wanting the algorithm to be more aggressive. There, you're kind of falsely manipulating the insulin action to talk the algorithm into believing that the insulin is gone. Is that right? Correct.

Jennifer Smith, CDE 8:00
And that is ages old, even years ago, with no algorithm types of pumps. People realize that what the pump was calculating as I OB or insulin on board, which is another term that kind of goes along with this duration of insulin action, right? So people would say, well, by two hours after a meal, I'm still high. Why is the pump not suggesting anything? Well, if your duration of insulin action is set for four hours, the pump thinks that at noon, you're four units, two hours later, there's still two units left, right, you've got two hours before the rest of that finishes, it's not going to offer you anything. So those who were smart, were thinking I can I can fiddle with this system, I can set my duration of insulin action at two hours, because then at two hours if I'm high, now the pump will give me more insulin and ooh, this definitely is what I want to do. But all you're really doing is you're tinkering

Scott Benner 9:00
you're talking to Bolus calculator into believing there's no insulin there so that it will suggest more insulin based on the on the blood sugar. Yeah, I during my most aggressive times, just using a manual Omni pod with Arden. I think I had her insulin action set it three hours at one point because no matter what I wanted the Bolus calculator considering the carbs that were there and no matter because I knew our settings were good. And that wouldn't be stalking if I did that. Yeah, I hope people understand. What we're saying here is that that insulin on board in your pump is really just a calculation made based on what you tell. The pump your insulin action time is now some of the algorithms I would imagine you can't manipulate that nominee pod five for example. It believes what it what it believes. Yeah.

Jennifer Smith, CDE 9:51
Omnipod five is interesting tandems control like you. It's a hard set five hours with the algorithm enabled. Okay. Omnipod five has an allowance for duration of insulin action to be adjustable by the user. Okay, it's only going to reflect boluses that the user drives. So if I take via Omnipod, five suggestion to units right now for the food that I'm going to eat, that has, with a calculation, let's say I have my duration of insulin action set in the system at two and a half hours. So at noon today, two units, two and a half hours later, by 230, I should technically have no iob left from this driven Bolus. However, as we know, algorithms have their own output. So at 230 in the afternoon, maybe I was higher, and the system accommodated and gave me a little extra nudge of insulin. There might at 230 still be iob. Coming from what the system is driving out, but no longer from that nude Bolus. Does that make sense? Yes, it does. They are manipulatable in some of the poems. So

Scott Benner 11:05
if you don't want to get into all of this, and you just want to understand duration of insulin action? Are they different from like is Novolog and a Piedra? Are they different? Or do you you don't think about that you just think of faster acting as faster acting right? Right,

Jennifer Smith, CDE 11:19
rapid acting, the Nova log, the Piedra and the human log, those three which are all classified, just normal, rapid acting's, they do have a similar enough profile of starts here, peaks here finish action by about, they say three to five hours, which is, I mean, two hours is a good difference in time, right? But by about five hours later, the expectation is that those are cleared from the system, the more rapid acting insulins, like fee ASP and the loom job, those tend to have not only a faster onset, but because so they end up having when I used to be asked by loved it, it had a really nice, flat, complete, very visible finish. There wasn't this little trickle action, kind of nearing to the end, when it was done. It was done, it was very easy to see, in terms of a P dry No, their initial when they came to market, their big thing was that you could really, it seemed to be almost like they were saying it was a much more rapid insulin, because you could take it either at the start of the meal or 20 minutes into the meal. And you'd have the same blood sugar management. Now there.

Scott Benner 12:25
I tried that. Yeah. Arden you said I don't I don't find that to be Charles now. Yeah. I mean, in fairness, if you mean and knock over 200 It does that pretty well, you know. Sure. Right, right. The way I've always described a pager is that it's very consistent and stable. Throughout the Bolus. I don't see any like crazy hot moments where it's burning, like extra unit. I mean, like is like, Wow, it's really working right now. Like it just it starts to work. And it continues to work like that. And I don't have any trouble bolusing then for the next thing, and seeing some crazy, like hot flash where it makes you super low out of nowhere. It's very consistent and stable for Arden. Yeah,

Jennifer Smith, CDE 13:08
I was gonna say and it was the complete opposite when it came to market. I really wanted to try it was not that way for me at all. Funny, it seemed to work well, initially, but if I used it at I was using a lot of extended boluses. It did not work well in extended Bolus is for me at all. That's interesting. It almost it was like the extended portion that was getting dripped in had not the right amount of action. I gotcha. Compared to my long term used homologue. So again, person to person

Scott Benner 13:39
person, but yeah, okay. But we understand what duration of insulin action is. Did we miss anything there was well defined. I mean, I feel like we talked way more about it than most people do.

Jennifer Smith, CDE 13:51
One thing people are probably considering it, we talked about some of the variables were you wouldn't really want to expect to need to change it, right. But one way to test it out if you're kind of curious, because our rapid insulin is really meant to cover what, what macronutrient carbohydrates. That's it? Yeah. So if you really wanted to test and see with a known nice Basal setting, you could certainly just eat the way out, get a 15 gram portion or a 10 gram portion of carbohydrate, take whatever the dose is supposed to be for that expect by about 90 minutes, you're probably going to be peaking. insulin action should have kind of a bell curve where your blood sugar goes up, you peak at a certain place my plateau for about 30 minutes and then it should curve back down to get you close to where you started. Before you ate whatever it was. That's a good way to kind of see where does it finish? And does it stay stable then Right.

Scott Benner 14:47
Okay. Very nice. Thank you. Yes, excellent.

diabetes diagnosis comes with a lot of new terms, and you're not going to understand most of them. That's why we made the finding diabetes, go to juicebox podcast.com, up into the menu and click on the finding diabetes, to find the series that will tell you what all of those words mean. Short, fun and informative. That's the finding diabetes. The diabetes variable series from the Juicebox Podcast goes over all the little things that affect your diabetes that you might not think about. Travel and exercise the hydration and even trampolines, juicebox podcast.com Go up in the menu and click on diabetes variables. And now my full conversation with Medtronic champion, Mark. Mark, how old were you when you were diagnosed with type one diabetes? I was 2828. How old are you now? 4747. So just about 20 years?

David 15:56
Yeah, 19 years?

Scott Benner 15:58
What was your management style when you were diagnosed?

David 16:00
I use injections for about six months. And then my endocrinologist at a navy recommended a pump.

Scott Benner 16:06
How long had you been in the Navy?

David 16:08
See eight years up to that point?

Scott Benner 16:10
Eight years? Yeah, I've interviewed a number of people who have been diagnosed during service and most of the time they're discharged. What happened to you?

David 16:18
I was medically discharged. Yeah, six months after my diagnosis.

Scott Benner 16:22
I don't understand the whole system. Is that like, honorable? Yeah.

David 16:25
I mean, essentially, if you get a medical discharge, you get a commensurate honorable discharge. I guess there could be cases where something other than that, but that's that's really how it happened. So it's an honorably discharged with but because of medical

Scott Benner 16:37
reasons, and that still gives you access to the VA for the rest of your life. Right?

David 16:40
Correct. Yeah, exactly.

Scott Benner 16:41
Do you use the VA for your management? Yeah,

David 16:43
I used to up until a few years ago, when we moved to North Carolina, it just became untenable, just the rigmarole and process to kind of get all the things I needed. You know, for diabetes management, it was far easier just to go through a private practice.

Scott Benner 16:57
Was it your goal to stay in the Navy for your whole life, your career? It was? Yeah, yeah.

David 17:01
In fact, I think a few months before my diagnosis, my wife and I had that discussion about, you know, staying in for the long term. And, you know, we made the decision despite all the hardships and time away from home, that was what we loved the most. So that's what made it that much more difficult

Scott Benner 17:17
was the Navy, like a lifetime goal of yours or something you came to as an adult,

David 17:21
lifetime goal. I mean, as my earliest childhood memories were flying being a fighter pilot and specifically being flying on and off aircraft carriers. So you know, watching Top Gun in the ad, certainly a

Scott Benner 17:34
weight was a catalyst for that you've taken off and landed a jet on an aircraft carrier,

David 17:38
hundreds of times.

Scott Benner 17:39
Is there anything in life as exhilarating as that? No, but

David 17:43
there there's a roller coaster I wrote at, I think it was it's Cedar Rapids up in Cleveland Sandusky, and they've got this roller coaster rotation from zero to like, it's like 80 or something, you go up a big hill and you come right back down. So the acceleration is pretty similar. I would say to catapult shot, I'm

Scott Benner 18:01
gonna guess you own a Tesla.

David 18:04
I don't I I'm a boring guy. I got a hybrid rav4 I get made fun of I get called. You know, my wife says I drive like a grandpa on the five miles per hour over the speed limit person. No more than that. So yeah, in the car. I'm boring Scott. So

Scott Benner 18:18
you've never felt a need to try to replace that with something else.

David 18:22
You can't replace it. It's irreplaceable. That's what I thought. So up until the point where someone you know, buys me an F 18 or allows me to get inside a two seater and fly it you can't replace it. How did

Scott Benner 18:32
it make you feel when you saw or maybe you haven't seen? gentleman named Pietro has his large aircraft license. He's flying for a major carrier. Now he has type one diabetes. Does that feel hopeful to you?

David 18:42
Yeah, it does. You know, when I when I was diagnosed, that wasn't a possibility. The FAA prohibited commercial pilots who had type one diabetes, but I think it was 2017 when they changed their rules to allow type one diabetics to be commercial pilots. And part of the reason I did that was because of the technology advancements, specifically in pump therapy, and pump management. So I don't have any aspirations of going to the commercial airlines, but one of my sons who has type one diabetes very much wants to be a commercial pilot. So you know, in that respect, I'm very hopeful and thankful. Yeah.

Scott Benner 19:15
Do you fly privately now for pleasure?

David 19:18
I do. Yeah. One of my favorite things to do is fly my kids to the different soccer tournaments I have all over the southeast us so last week, my wife and I and two of our boys flipped to Richmond for their soccer tournaments up there and Charlie who's my middle child has type one diabetes so you know if I can combine flying family and football and one weekend to me that's I think I've just achieved Valhalla.

Scott Benner 19:42
So then it sounds to me like this diagnosis was a significant course correction for you. Can you tell me how it affected your dream?

David 19:49
Well, I you know, if I guess three words come to mind first, it was devastating. Everything I had done in life, everything I'd worked up to up to that point was just taken away in an instant and I was not prepared for that at all. The second emotion was, it was scary. I hadn't thought much about life outside the Navy, certainly not life as anything else, but a fighter pilot. And Heather and I were getting ready to move to France, I was going to do an exchange tour with with the French naval air force. So we were taking French classes. So pretty quickly, I had to reinvent myself. And then probably the most important thing at the same time that all that was going on, I had to learn how to deal with type one diabetes and how to manage it effectively. The third thing that pops into my mind, I guess, is challenging, you know, new daily routines, I had to establish first with injections, and then eventually, you know, through pump management, and then learning how to count carbs and recognize highs and lows, how my body reacts to blood sugar trends based on exercise and stress and those types of things. And my goal at that time, and it still is today is to leverage technology and make sure my habit patterns are effective so that I take diabetes management from the forefront to the background.

Scott Benner 20:56
Have you had success with that? Do you feel like you've made the transition? Well,

David 21:00
I have I mean, I believe in continuous improvement. So there's always more to do. I will say the technology since I was diagnosed specifically with pump management, it's just, it's just incredible. It takes less of me intervening. And it's really done by the pump itself and by the algorithms through the CGM comes in to me again, that that should be the goal for everybody is to not have to focus so much on the daily aspects of type one, diabetes management, you know, we should let technology do that for us.

Scott Benner 21:29
What else have you found valuable? I've spoken to 1000s of people with type one diabetes, the one thing that took me by surprise, because I don't have type one, myself, and my daughter was very young when she was diagnosed. I didn't really understand until I launched this podcast, and then it grew into this kind of big Facebook presence. I heard people say, I don't know anybody else who has type one diabetes. I wish I knew more people. But until I saw them come together, I didn't recognize how important it was. Yeah,

David 21:58
I think similarly, I didn't know anyone with type one diabetes growing up as an adult up until when I was diagnosed. And then all of a sudden, people just came out of the woodwork. And when CGM is first hit the market, certainly within the last five years. It's amazing to me and my family, how many people we've noticed with type one diabetes simply because you can see the CGM on their arm. I mean, I would say, a month does not go by where we don't run into someone at a restaurant or an amusement park or a sporting event or somewhere where we see somebody else with type one diabetes. And the other surprising aspect of that is just how quickly you make friends. And I'll give an example. We're at a soccer tournament up in Raleigh, this past Saturday and Sunday. And the referee came over to my son Charlie at the end of the game and said, Hey, I noticed you're wearing pomp. And he lifted up his shirt and showed his pump as well and said, I've had type one diabetes since I was nine years old. I played soccer in college, I'm sure that's your aspiration. And I just want to tell you don't let type one diabetes ever stop you from achieving your dreams of what you want to do. And this gentleman was probably in his late 50s, or 60s. So just having that connection and seeing, you know, the outreach and people's willingness to share their experiences. It just means the world to us and just makes us feel like we're part of a strong community.

Scott Benner 23:18
So would you say that the most important things are strong technology tools, understanding how to manage yourself and a connection to others. Yeah,

David 23:27
technology for sure. And knowing how to leverage it, and then the community and that community is your friends, your family caregivers, you know, for me to Medtronic champions, community, you know, all those resources that are out there to, you know, help guide the way but then help help you keep abreast on you know, the new things that are coming down the pike. And to give you hope for eventually, you know, that we can find a cure. You

Scott Benner 23:49
mentioned that your son wanted to be a pilot. He also has type one diabetes, how old was he when he was diagnosed,

David 23:55
so Henry was diagnosed when he was 12 years old. That was just at the start at COVID. We were actually visiting my in laws in Tennessee, we woke up in the morning and he had his bed. And several years before that, we had all four of our boys tested for trial net. So you know, predictor of whether or not they're going to develop type one diabetes and whether or Henry and one of his brothers tested positive for a lot of the indicators. So we always kind of had an inclination that there was a high degree of possibility he would develop it, but we always had at the back of our mind as well. And so when that event happened, at the beginning of COVID, we had him take his blood sugar on my glucometer and it was over 400. And so right away, we knew that without even being diagnosed properly by endocrinologist that he was a type one diabetic, so we hurried home to get him properly diagnosed in Charlottesville. And then we just started the process first grieving, but then acceptance and, you know, his eventual becoming part of the team that nobody wants to join. How old is he now? He's 15 years old now,

Scott Benner 25:01
when's the first time he came to you? And said, Is this going to stop me from flying? Almost

David 25:07
immediately. So like me, he always had aspirations of flying. In fact, he out of all four boys wanted to be in the military, that was a difficult part of the conversation and maybe something that we don't talk about as a community. But there are some things you cannot do as a type one diabetic, and that's a hard fact of life. And unfortunately, joining the military is one of those hard and fast things you cannot be, you cannot join the military as a type one diabetic. So it was very difficult for him and for me and my wife to get over. Then we also started talking about being a commercial pilot. So I saw that same excitement in his eyes because like me, you know, he can be an F 18, or a 737, or a Cirrus SR 20 That I fly and be just as happy. So he still has that passion today and still very much plans to eventually become a commercial pilot.

Scott Benner 25:52
I appreciate your sharing that with me. Thank you. You have four children, do any others have type one?

David 25:57
They do? My oldest twin Henry has type one diabetes, and my middle son Charlie has type one diabetes as well. The boys are twins. The oldest two are twins. One has type one diabetes. My middle son, who is not a twin has type one diabetes.

Scott Benner 26:11
I see. Is there any other autoimmune in your family? There isn't I'm really the

David 26:15
only person in my family or my wife's family that we know of with any sort of autoimmune disease, certainly type one diabetes. So unfortunately, I was the first to strike it rich and unfortunately, pass it along to to my sons with celiac, thyroid, anything like that. Not at all. Nothing. We're really a pretty healthy family. So this came out of nowhere for myself and for my two sons.

Scott Benner 26:38
That's really something. I appreciate your time very much. I appreciate your sharing this with me. Thank you very much. Anytime Scott, learn more about the Medtronic champion community at Medtronic diabetes.com/juice box or by searching the hashtag Medtronic champion on your favorite social media platform. 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