#1272 Chicken Coop Intrigue
Melissa unraveled a web of lies.
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Scott Benner 0:00
Hello friends and welcome to episode 1272 of the Juicebox Podcast.
Today's episode is with Melissa she has three children her middle child has type one diabetes, and today we're going to pick through her story of how her child was diagnosed and what made it so difficult to figure out and what else they found out about their lives while they were looking around. 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 decide that you want incredibly comfortable and quality sheets, towels and clothing, you'll be going to cozy earth.com If you've made that decision, you might as well save 40% off of your entire order by using the offer code juicebox. At checkout, surround yourself in quality for 40% off juice box at checkout at cozy earth.com. 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 just 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. today's podcast is sponsored by us med us med.com/juice box you can get your diabetes supplies from the same place that we do and I'm talking about Dexcom li Bray Omni pod tandem and so much more. Us med.com/juice box or call 888721151 for this episode of The Juicebox Podcast is sponsored by the ever since CGM. Ever since it's gonna let you break away from some of the CGM norms you may be accustomed to no more weekly or bi weekly hassles of sensor changes. Never again will you be able to accidentally bump your sensor off. You won't have to carry around CGM supplies and worrying about your adhesive lasting. Well that's the thing of the past ever since cgm.com/juicebox. 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.
Melissa 2:35
Well, I'm Melissa. I have three kids at home. And my middle child figured out how to get around middle child syndrome by developing type one diabetes in October of 2021. I am one of those weird chicken ladies. I have a husband like him. He's at work right now. But yeah, even children are running amok, I'm sure because we homeschool. And they our kids are 1411 and about to be five. And
Scott Benner 3:06
the 11 year old has type one for a couple of years. Right,
Melissa 3:09
Leah? Yeah,
Scott Benner 3:11
okay. Yeah. All right.
Melissa 3:13
That's why I like that episode. I choose Leah because I
Scott Benner 3:16
do. Oh, no kidding. Yeah, I guess you do that episode. Love that episode. For the moment. You're gonna be chicken lady if you're not careful. So you know. You don't I say do something better than that. Or you're stuck.
Melissa 3:31
Oh, I'm sure we can do better than that. Tell me
Scott Benner 3:35
about colons. You raise chickens for eggs?
Melissa 3:39
Yes. My youngest. So we started out doing it like just to be you know, hippie homesteader type deal. And then my youngest came out, apparently with like, major food allergies. She stopped gaining weight, that sort of thing. So having access to food that I control, the sourcing, the feeding that everything got really important. And she passed eggs when she was about two. But before that, like there was a period of time where to nurse her I was eating lamb from one local farm, tallow that I rendered from that farm and plantains and like sugar, salt and a specific random bottle water. You
Scott Benner 4:26
had these specifically just to breastfeed your youngest, who has food allergies, what kind of food allergies, does she have?
Melissa 4:32
Nothing IGE mediated, so allergy can't help us. And gi couldn't help us. It's really like only the hippie out there alternative stuff that's helped at all, and she's still on a pretty limited diet. So I kind of live in the kitchen. You know, it was really no big deal to add on. Maybe we'll cut some carbs. Because I already lived in the kitchen.
Scott Benner 4:53
I just I just get up a roommate and I make food. That's what I do. That's what I do all day. Wow. What happens to her if she gets Some food that she's allergic to. So
Melissa 5:02
when she was a tiny baby, she would stop gaining weight completely. Like she didn't gain weight at all, like not, I mean, I'd milk flying everywhere like, but she didn't gain weight for weeks on end. And then when I cut my diet down to almost nothing, and she started gaining slowly, and then when I figured out exactly what she could tolerate, which is very few things, then she gained like a newborn again. Here until the end, probably. I don't know. I see. Sort of inflammatory process. Yeah,
Scott Benner 5:33
that's what I'm saying. Nobody can help us with. And that's been. Thank you, everybody. That's been her whole life.
Melissa 5:41
Yes. She stopped gaining weight when she was about six weeks old.
Scott Benner 5:44
Okay. Yeah, that's her whole life. And then Leah is diagnosed at what age?
Melissa 5:48
She was nine. Okay, yeah, that nine and a half.
Scott Benner 5:55
And what was that present presentation, like, like
Melissa 5:58
a lot of people, we kind of mistook it for something benign and sell or easily resolving the story is, you know, she's always been sensitive to gluten. A year and a half before her diagnosis. She got gluten, and her pain was so severe that she ended up in the ER, like, mid COVID. She had to go into the emergency room because her pediatric nurse practitioner could not rule out appendicitis her pain was that severe. And so they did an ultrasound and did a CT scan and like the inflammation was visible, but it wasn't perfect. It wasn't her appendix, that was just just bowel inflammation. Okay.
Scott Benner 6:39
So
Melissa 6:40
then in October of 2021, we went to the annual Wildgame cookout on my husband's side, which is like a great time, I hate to miss it. Just a huge gathering of like the coolest people ever, and you have to bring meat that did not come from the grocery store. Okay, so that's really cool for us. And my husband is not as up on the whole dietary restriction thing. You know, he's used to, if it's at home, if it's if it's available, it's safe for the kid. So I just don't keep things in the house that aren't safe for them. So he allowed some desserts that were not safe. And so when she complained of belly pain, several days later, I thought, Oh, you got glute, you're backed up. This is par for the course. And she just kept getting worse. She was in pain. She didn't feel good. She was kind of sleepy. Like, you know, I mean, I don't feel great when I'm backed up either. And by that Friday, I was like, I don't like this at all. So I called the nurse practitioners office. And I was like, if she got gluten, I think this is what happened. Can I bring her in? Can you guys take a look at her and they were like, You know what, this really just sounds like something that needs a mural wax cleanup. So I with their blessing, gave my child who's going into diabetic ketoacidosis a half gallon of juice. I will take that gallon that half gallon of juice like that, the guilt of that to my grave. Oh,
Scott Benner 8:13
well, did that really change anything? Did it hurt anything? You know,
Melissa 8:18
I guess glucose at that point wasn't going to hurt anything. But we cleared any blockage but she still kept getting worse. And I really thought I need to take her to the ER and my husband's kind of like, you know, I'm sure this can wait till morning. You're just hysterical. Which you know, fair. Okay. Any other time he had been right? And so first thing, as soon as the places the urgent care walk in open in the morning, I had her in there. And by then she was doing what I now know is the Kussmaul risk. respirations Yeah, but I was thinking her belly her belly. She's got appendicitis. She's got something wrong with her belly Belly, belly belly. That's all I could think about. Cuz she'd been vomiting. I mean, Mike Scott. My kid was so sick. And I'm an idiot. It's, it's really hard to you know, the hospitalist in the PICU said to me, he was like he's like, do doctors and nurses miss this? You're not special for thinking that. It wasn't diabetes. I mean, I I really hadn't had that come across my brain. I know why you would think we take Yeah, we take her to the walk in.
Scott Benner 9:26
Hey, she got a great the day before, which a lot of people don't get that. That's nice.
Melissa 9:33
Yeah, yeah, there you go. Yeah,
Scott Benner 9:35
it's all you did something.
Melissa 9:37
I do feel like I tortured her. It's hard to shop that.
Scott Benner 9:42
My gosh, I'm now thinking I'd love a lovely clean out. What do you think of that? As you're talking about? I'm
Melissa 9:47
like, Are you off your Metamucil? Like take your magnesium Scott,
Scott Benner 9:50
don't worry, I took my magnesium. Everything's fine. But I'm just saying like, you know, that might be nice.
Melissa 9:56
Yeah, especially if you're going into the hospital. So You take her to a walk in the nurse practitioner. There's great listens to her belly. Yeah, her belly sounds funny. Yeah, she's a little altered. And she's like, I would like you to take her to the ER, like right now. And I said, Okay, can I take her to the one here in town? Or do I need to drive 45 minutes to children's? I'd rather go to children. She's like, Okay, go to children. And then, you know, I'm carrying my staggering five foot tall, you know, I don't know what she probably weighed 70 something pounds at that point down from 90 something she's a tall, solid girl. Um, you know, we're staggering out and the nurse practitioner goes let me get you your analysis cup. Let's let's get a sample before you get on the road. And I'm sure she was going to check you know now in retrospect, I think oh, that's what she was doing. She just wanted to confirm for glucose that the ER could be the ER cuz
Scott Benner 10:51
she could do that while you were driving. So she could call there and be like, Hey, I just sent a kid over with diabetes.
Melissa 10:57
Yes, she was like Do not stop for gas do not suck. Just go. Just go. And we were almost to Nashville when you ran out of gas. I'm just kidding. No, no, we're almost to Nashville and I the number pops up for her normal nurse practitioner like the one we see the one who has her primary care provider. That's weird. And so I pick it up and she says are you sitting down? I said I'm in the car. racing to the ER What do you want and
Scott Benner 11:26
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Melissa 13:52
She said Okay, so your analysis shows high ketones and high glucose in her urine. She is a type one diabetic. You need to get to the ER right now. And I was like I'm almost there. Can you guys call ahead? Can you let them know? And it's it's COVID Craziness. So I'm like grabbing the mask off the back of the rearview mirror and trying to figure out how I'm gonna get this child into the ER, and stuff like that. Nobody like in at the front desk. And we're just like, let me take your temperature and like nobody was matching my urgency. I was like, my kid is really sick. We need to get her in there. And I knew that type one diabetes, like a lifelong thing. I didn't. I didn't have any illusions at that point. I was like, Oh, this is this is a big deal and it's permanent. Okay. But first we got to, you know, figure out why she's so sick right now. I didn't realize I didn't know what decay was. I didn't know why it was dangerous or why she was this sick right now. Yeah. But they took great care of us in the hospital. I was I was a bit of a mess. She was barely conscious. I read over her First endocrinologist notes yesterday just sent they they kept saying severe DKA, severe DKA. So,
Scott Benner 15:06
I feel bad for the person at the hospital takes your temperature coming because people really don't appreciate that job. You know?
Melissa 15:13
You know, usually I can be philosophical about it like, Yes, this is what we have to do. I'm just thinking that
Scott Benner 15:19
this person if you ask
Melissa 15:20
them like my kids gonna die what's gonna let me I'm
Scott Benner 15:24
just saying I think in their personal life, people say to them, what do you do for a living like, oh, I approach people with thermometers and they yell at me. It's my
Melissa 15:33
might not be fun. Yeah, nobody's favorite person.
Scott Benner 15:36
Oh, my God, I just need to take your temperature. My arms broken. Yeah, I just need to take your temperature. You don't need my damage or my arm is broken. I don't know what to tell you. They hired me to take your temperature. Okay. I gotta do it. Okay. Oh, my gosh, how long have you guys in the hospital for?
Melissa 15:51
So we came in on Saturday morning. And she was discharged. I think Monday afternoon. She was in the PICU for like, a day and a half. And then on a regular floor for like a night you had
Scott Benner 16:01
home is two years. I mean, it's not that long ago, right. Two years ago. So you had home with what? Like? What is your what are your marching orders?
Melissa 16:09
Oh, let's see we had to Seba. And we had humor along those pins. I think they sent us out of the hospital on like nine units of receba. And I think by the time she got onto a pump, four months later, she was on like, I don't know, 2020 Something unit with receba.
Unknown Speaker 16:26
How tall is she?
Melissa 16:26
Right now. She's about 5455. She grew a ton. Like she just like she hit that like puberty growth spurt. Right after diagnosis. So she's, she's in women's clothing like she is. I mean, she's gorgeous. women's
Scott Benner 16:43
clothes. If you don't want the women's clothing thing, you don't want that. Just try to avoid that as long as you can.
Melissa 16:51
So, so much more expensive than going to once upon a child. Oh, my God. Well, that's
Scott Benner 16:54
not untrue. Yeah, it's more expensive. For sure. That's one part of it. So what makes you come on the podcast that I know you listen, and you've listened for a while? And and that's fantastic. But what made you think I should come on? Well,
Melissa 17:07
you actually put out a little call, you know, hey, it was right. You know, of course, when I was thinking about coming on, like a year ago, right? We're starting some of the type two stuffs. And shortly after my daughter was diagnosed, my husband's annual screening, pop the funky one, see, like he'd been writing in the high fives for a while. And I was like, This is not good. I don't like it. But the doctors were like, Yeah, that's normal. And like, Oh, my God. And he finally had an A one C approaching seven. And they were like, oh, that's type two, let's slap a Dexcom on you. Because our former insurance. At that time, they were super, super great for diabetes, I'm so sad that we don't have that anymore. Because they covered Dexcom under percent pump supplies 100% Like outside the deductible was amazing. So they put a Dexcom on him. And then with some diet modifications, mainly cutting out sugared soda, he brought that down to 5.3. Now, I'm sure it's creeping back up. But he hasn't gone to the doctor in a while. Because the man doesn't do anything really, except he cut out soda. Right. And he got a little more receptive to my bad eating burritos, you know, that sort of thing. Like stop eating wheat. I think being gluten free keeps us out of a lot of processed carb trouble. Because it's not as convenient to find it. You know, you have to go looking for the gluten free stuff.
Scott Benner 18:29
I find I mean, I've had a ton of experience driving from the north to the south on the East Coast. And you get to a certain part. I don't know exactly when to say it is but all of a sudden just even stopping at a gas station or convenience store to get you know, bottled water, use the bathroom or something. Drinks that don't have sugar in it start to disappear as you go south. You wouldn't notice that really because you live there, I would imagine. But like,
Melissa 18:56
I'm from the Midwest, I grew up in Illinois. Okay.
Scott Benner 18:59
Do you know what I'm talking about?
Melissa 19:01
No, I don't spend much time up with you Yankees. You can
Scott Benner 19:05
buy a lot of diet or low carb drinks here that once you get where am I gonna say? Virginia, North Carolina ish. They start to disappear.
Melissa 19:20
I believe that? Yeah. And then my husband was my husband was raised in Cleveland. So I don't know we go up there. And I'm like, oh my god, the food's terrible. It's like so like everything got a by not.
Scott Benner 19:32
Well, you guys, so how did you end up in your little hippie commune that you live in now? Where you're? I mean, what are you doing? You? Yeah, chickens. It sounds like you're teaching the kids, you know, at home, like what else you're doing there? Yeah,
Melissa 19:45
I have a big garden. Let's see. I went to school in St. Louis. And that's where my husband I got married and started out and then he was looking for jobs and I'm in by training. I'm an accountant so I could work anywhere. So it was like okay, let's find you a job that you like. It's not a traveling job he was he was traveling, first married. And he came down here for Nissan. There's a big car plant in Middle Tennessee. And we just ended up here and I was I first I remember I cried on my shoulder, we're gonna be from Tennessee, and I would leave it for anything. I don't I don't always love the politics. But I do love, like, being able to target practice in my backyard, and have chickens and homeschool and what are you shooting in the backyard? Melissa? You name it.
Scott Benner 20:31
We're talking about guns? Arrows. Yeah, good.
Melissa 20:36
Oh, yeah. Hello. My dad's a police officer. My husband was in the army. So I'm familiar. I gotcha.
Scott Benner 20:42
Okay, so you say you move there for a job? Did you end up working? Like you said you could work anywhere? Did you get there and start work? Yeah.
Melissa 20:48
I worked for a malpractice insurance company. But mostly for podiatrist, it's right. It's really pretty low risk. Unless you're working on diabetics,
Scott Benner 20:58
you like doing the accounting for podiatrist. Specifically, it's, it's good for
Melissa 21:02
you with the insurance it was selling it was selling the insurance for the podiatrist and some of them are surgeons like they actually do surgery. So okay. But yeah, it was it was a great place to work, not the least of which was that it was almost an all female department, amazing people, amazing people that work with. So I left there. I always knew like a hobby, and I had kind of decided I was going to stay home with the kid. You know, I wanted to do the cloth diaper, you know, all that kind of stuff. Yeah. People were like, What are you going to do? And I was like, we'll just be poor. It'll be okay.
Scott Benner 21:32
We'll just be poor.
Melissa 21:34
Well, you know, yeah, no, I understand. At the time, I was making the same kind of money that he was giving away, then. That's an adjustment, and then put, of course, having a stay at home wife, that's, I'm sure help him in his career. Although he's super, like, liberated and stuff. He does the laundry. I love him.
Scott Benner 21:54
I love that when guys do like one of the 500 things that I do. I hear their wives like, Oh, I love him. He does the laundry. And I look around my house. And I'm like, No one appreciates the stuff I do here. Like, I know my wife is so spoiled by it. Because we've been doing it for so long. That it just all feels like oh, that stuff Scott does. If I did half the things I do in another household. I would I mean, I think that I think I'd be carried around on a throne like I really do. But it's okay. I don't mind.
Melissa 22:25
No, to be fair, I'm a terrible housekeeper. The best I can say most days is like, but have you ever run out of toilet paper? Like I do take care of those sorts of things. But I'm no housekeeper. Let's, let's be real clear on that.
Scott Benner 22:39
You said your husband, I'm gonna stay home with the kids of please have very low expectations.
Melissa 22:46
High end to how it's worked out. But
Scott Benner 22:48
to try to lock the doors at night and keep the place at a reasonable temperature. If I can do that. I think you call it
Melissa 22:53
lucky. I don't know what the deal is. But he likes me.
Scott Benner 22:58
Well, God bless. Okay, so is there any, um, any other autoimmune stuff in the family?
Melissa 23:07
So there's a strong history of type two, I mean, an insulin dependent, you know, that like grandma, but like, younger people being insulin dependent? Type twos? Oh, yeah. As far as I know, his biological grandmother on his father's side, like, she had major type two complications. And then he also had, I don't know a ton about this. I just know of it. On his biological father's side, there was a half sister, who unfortunately passed away from, I think type one complication. Like, I know, she was a type one diabetic. And I know she passed away very young. I think she was like, in her late 20s, early 30s. And I know she had type one, but they were not raised together like I we never knew. Or we didn't find out my husband was adopted until he was 35 years old.
Scott Benner 24:06
So wait, is the half sister from anybody? He's actually related to?
Melissa 24:11
Yes, because as it turns out, he was adopted by his paternal grandfather and his paternal grandfather's wife.
Scott Benner 24:21
Let's go now we're getting to it. Okay. Are you talking about we this is how does that? I don't understand. So
Melissa 24:29
apparently everybody knew but Him the way I found out he was Scott he. He was in Japan for six weeks. Our son was like, not even two years old. And he was overseas with Nissan. And I was picking up some hammy down little boy clothes from a cousin of his and the the ages are all over the place. Big family so she had a grandson who's the same, same you know? either of our son was coming into it. She was like, Oh yeah, I'd love to give these to you. And I'd stopped by in between my folks house and home. And I know what she was thinking. She's like I'm terminally nosy right, but I also understand boundaries. So sometimes the nosiness is so painful, right? But she had this opportunity where she could ask a nosy question without being hurtful to the person that was actually about right. So she was like, so is Brian, in touch with his biological parents? And I looked at her like, oh, shit, what? And like the color drained from her face. I mean, there are people who think what she did was malicious. She did not know we did not know about she had no idea. Interesting. I
Scott Benner 25:43
like a little family drama. That's nice. Okay, so he is related to somebody else who had type one diabetes, right.
Melissa 25:50
So his his adoptive father, his biological grandfather passed away. When he was seven. He was much older than his mom. And I'm going to call his adoptive parents, his mom and dad without any qualifiers. We're gonna put qualifiers on the bio. Does he
Scott Benner 26:05
know his actual parents? Well, he
Melissa 26:08
was raised to think that his biological father was his half brother. All right, now, but I'll tell you what, you want to hear my gripe when that when that dude passed away? Brian was not mentioned in the obituary, as a son or a brother. And I was like, why that night. I was salty about them.
Scott Benner 26:25
Love this little entry you guys have going on here. This is from Ohio intrigue.
Melissa 26:31
I guess like Ohio and Kentucky. There's like people that are still in Cleveland. There's people that are in Kentucky, various cities in Kentucky. And we actually we reconnected with one of his brothers. So I guess biologically his uncle, when my middle kiddo was very small. I was actually looking over his shoulder. He was surfing on Facebook, and was like, hey, you've got a message request over here. And it was his brother, who had been looking for him. Like, and I, Mike, I love you. And I get choked up my kids. So lovely. So accepting. So you know, when that stuff, the stuff about finding out your adopted was new, we actually didn't know who he like, who were his parents was he was our last name. Our last name was we didn't find out the part about Oh, you were adopted by your biological grandfather. We didn't find that out till a couple years later.
Scott Benner 27:29
Were you put in a position where you had to go home to your husband or he was in Japan? You had to in Japan? over Skype? It gets home, right? And you say he's
Melissa 27:40
taking a nap and you go, what I did though, what I did first I was like, Okay, how can I confirm this? Like, I'm not going to tell him some wild story, you know that I can't. So there's, of course, this was what? Well, 13 years ago. This
Scott Benner 27:57
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Melissa 29:21
you know, internet chat rooms were a thing and forums and stuff like that. So I went on to an adoptees forum and I was like, Oh, my God help me. What do I do? Do I need to have like a therapist waiting at the door? Do I need to like what do I need to do? keeping this secret? I'm not participating in any of the secrecy.
Scott Benner 29:39
Oh, no. I mean, I gotta tell him, right, right. What did the internet say?
Melissa 29:43
The internet says there's such a thing called Search angels. And we will put you in touch with one who can search the public records in Ohio and tell you what you can find out and they were like, yes, he's adopted. Because what they do is they match up the birth date. Like all the children born on this day But they kept his first and middle name the same. So that was helpful and then like, okay, none of these people have any other public records. So they were a baby and then their name change and then we have this going forward so you could get a birth name you know, I did what I could on the internet, you know, even face like people do not let down their Facebook's
Scott Benner 30:20
Facebook snooping people. I totally did.
Melissa 30:24
I totally did. You know, I
Scott Benner 30:26
know what I'm gonna call this episode. So, a couple of minutes ago, I thought I'm gonna call this episode Palace entry. But now I think I'm going to call it chicken coop entry.
Melissa 30:36
That's great. That's great.
Unknown Speaker 30:39
Um, write that down. I love it.
Melissa 30:40
We did not have a chicken coop at that time, we still lived in a neighborhood with sidewalks. This is
Scott Benner 30:45
my this is my way of being humorous. This is why I'm going with you is it's not a goddamn thing to do with diabetes. And I'm still very happy you told me about it. That's it. And so now you're picking your,
Melissa 30:55
for me it is wrapped up in the diabetes. The family history is all from his side. And like, I mean, when I'm in the hospital, it's all I can think about is like, oh my god, she died.
Speaker 1 31:11
Oh, I'll see you. Because you went through like all this set at the time. Yeah. So you're in the hospital with your kid. You're like, this is what killed somebody else in the family? Correct? Oh, my gosh, well, that's upsetting.
Melissa 31:25
One and I kept because they're like, Does anybody else have it in the family? I was like, Well, my husband's half sister, but she died. And I was like, Oh, my God. Did
Scott Benner 31:33
you say, Listen, my husband's deceased? Father's father adopted my husband. I think that his grand weights thought or I'm not sure but some
Melissa 31:49
to try to explain his family. So confusing. Oh, my God. And the thing is like he didn't know from birth, this was just you know, people made, quote unquote, jokes to him about finding him in a Cabbage Patch. Apparently they weren't jokes. Oh my god. I know. Peyton
Scott Benner 32:08
was this I hate to ask, but his father had like drug issues. I
Melissa 32:11
honestly don't know. I could not speculate.
Scott Benner 32:16
How old was he? When he passed away?
Melissa 32:17
I think he was in his 50s or 60s. Oh, wait. His
Scott Benner 32:22
father was How old was your husband when he was adopted? His
Melissa 32:26
his adopted father. He was 54. And then his bio father died just died in the last five or 10 years?
Scott Benner 32:35
What At what age? Did his grandfather adopt him? What age for your
Melissa 32:39
husband? Honestly, it depends on who you ask. And, you know, and everybody involved is getting up there in age. So I
Scott Benner 32:53
mean, I'm I'm this close to singing the song of the Beverly Hillbillies. So I don't know what to say right now. Wasn't
Melissa 32:59
really like that. Now we have had contact with his bio mother.
Scott Benner 33:03
Okay. Does he did he ever know her? He knew the Father. He knew the bio father as a brother. But did he know the bio mother?
Melissa 33:11
Yes, she was a friend of the family. And we have like photos of the bio mother and his older half sister from his mom, like at birthday parties. Listen,
Scott Benner 33:21
here's what I'm gonna say to everybody. birthday party. This is what I'm gonna say to everybody listening. When you find yourself lying. Stop yourself, because this is where it goes.
Melissa 33:30
30 years later. A real nobody's that slick. Nobody's
Scott Benner 33:33
that's like, exactly. You're not that slick. I used to tell my mom that my mom would like, you know, try to like, trick me into doing something. I'm like, Mom, do you feel like you're tricking me into this right now? It's like, that's not happening if you think it is, but But when did she think it was she thought she was so smart. And she was you know, like, writing this story. And everybody was buying into it. I'm like, Mom, no one believes that. Like, and people do it all the time. Just tell the truth. I mean, honestly, what truth could have been worse than what you just explained?
Melissa 34:01
Series? Yeah, I mean, nothing. And it feels like there's a really socially acceptable story for adoption. We chose you You are wanted and loved. It feels good. Like, why would why would people hide that? And yeah, I think there's probably some fear from his mother that he wouldn't love her anymore. I don't know why she would think that. And he wouldn't let me ask her about it for years.
Scott Benner 34:28
Yeah, I'm just sure you're outsmarting yourself and nobody else and it just it's gonna go poorly. If they if you get all those people together and ask them do you wish at this time, doesn't matter what the story was, like, let's just it doesn't matter. Let's say the father was in jail and the mom was on heroin. Okay, and so the grandfather had to step in and do something. I think it's better to just know that. You know what I mean? Like, whatever the truth is, I think it's better to just know the truth and live with it than it is to make up all these stories that no way are going to Like, you're not going to keep this story forever. This is why in every movie when three guys rob a bank, one of them kills the other two. Because Because you look at the group and you go, they're gonna crack. Like that's it like nobody. You know, like you said, somebody told you one day and you think, okay, they weren't being malicious, but other people think they were being but who doesn't matter if they were they weren't? It came out eventually. So I don't know like it to me this whole story tells me just be honest. That's Yes.
Melissa 35:30
Well, then, I mean, and with the advent of 23andme, 23andme is not keeping y'all secret. I did it as part of fertility study, years and years ago, we had a hard time having our youngest. And then I got it, you know, didn't want those half price deals for my husband to have it. And then, a few years ago, he popped up this first cousin match that made the euro cent. No, nine, zero, zilch. And, you know, she got in contact with us. She got in contact with him. And first then I took over because I mean, nosey Hello. With his permission, he was like, Oh, do you want to handle this? And I was like, Absolutely.
Scott Benner 36:08
I would love to get involved with this. Well, listen,
Melissa 36:13
listen, she was like, list doesn't make any sense at all. And I was like, I know. I was like, Well, my husband's adopted. So but we're, we're quite sure who's who, like we have, you know, his mom helped me clear some things up. And then we've been in contact with his bio mom and some other family members, stuff like that, like it all matched. And she's like, well, maybe you've got something wrong. And I was like, I don't think so. And it did come out eventually. That who she was told her bio father was not her bio father. And it was somebody on my husband, bio mother's side. And that was like a whole like, 23 and me not keeping your secrets, what
Scott Benner 36:51
you people do? And I don't just mean your family. I mean, everybody listening, what has happened?
Melissa 36:55
Like we, we you look at people and you think, oh, everybody's normal and average, right? I mean, and this is a recurring theme on the podcast in general, too, right? People are interesting, even like a normal, boring, ordinary life
Scott Benner 37:11
does how to dig far.
Melissa 37:15
twists and turns and stuff like that happens all the time. And she's lovely, like, Thank you, 23. And me for putting us in contact. Yeah. Listen,
Scott Benner 37:22
I'm adopted. And I've done 23andme and gotten nothing out of it. Like it's not a guy, I thought like one person would pop up. And I'd be like, Oh, my God, this is great. I guess somebody's nothing. You know, years ago, Kelly made me contact an attorney. And I got contact with my biological mother's sister. And after an hour and a half on the phone, I hung up and I said to Kelly's, like, How'd it go? And I'm like, I am never contacting those people again. Because the same thing, it's just like, the stories you like, go, you know, if your uncle this calls, don't listen, he's gonna want money. And I'm like, Oh, hello. And this happened here. And this. And I'm like, I'm trying to ask these questions just to get enough answers for myself. I get a little bit of, you know, a little bit of answers for some things that I cared about. And then I never, ever, I so I'm disconnected from that idea that if you asked me, my mother, my biological mother's name, I'd have to search for it for a second my head. Like, that's how far I pushed it out on myself. Because I was like, these are not people I want to be involved in. I think that's sort of the lesson, which is you tolerate the family you have, right, like, we're all related to somebody who's a lunatic, and we're all related to somebody who's not. And everywhere in between. There's lovely people in my family. And there's crazy people in my family. And I grew up around them. So they don't seem crazy to me. Like I know they are intellectually, but I can make allowances for them in my head. You bring another person into my life, who is whacked out of their skull or making bad decisions. And I don't have any personal connection to them. I'm done. Like, I don't want to be involved with that. So like, it's all very, I don't know, I don't care what somebody else did with their 52 years ago. That doesn't make me related to you. Like, I don't care that there's a bloodline there. It's meaningless. I'm related to my, you know, my biological mother and father, they're my parents. I have two brothers who I'm not biologically related to at all who I would step out in front of a truck for and you know, and I don't, I really don't want to know about the rest. I really don't care. Because I think that this is all that's gonna happen. I believe everybody who's adopted just thinks like, oh my god, you know, my mom was obviously like a supermodel and she had to go to a photo shoot in France and so she couldn't take me with her. And so I got put up for adoption. She's probably the Princess of Monaco now, but no, your parents are this. This is what you got away from. I I hate to say that, but I really believe it's true. So good luck for you. I feel lucky that I'm adopted. When I heard when I talked to those people, I talked to those people. And I was like, Thank God, they gave me away. Anyway, this thing's adopted, though. I love this. It's very,
Melissa 40:16
very interesting.
Scott Benner 40:18
Yeah. Because you're you know why it's interesting is because you're raising three kids. And you have like a nice nucleolus and a little family, you're growing, your husband works, you're taking care of the stuff that you're taking care of. And you don't, I'm assuming you don't have children with somebody else he doesn't know about, I'm assuming your husband hasn't made 16 Babies somewhere else that you're not aware of like, you're just just being, well, you're just being a normal person. Like, just be normal. For God's sakes. Is it that hard? Is it all sex?
Melissa 40:46
Apparently it is?
Scott Benner 40:48
I mean, how hard can it be to just like, life is so short, and it's tiring to begin with? Find one person will have sexy, that one that's good, get a house? Buy some food and drop dead? Like, what are you doing?
Melissa 41:05
I can get there because I am super content with my little life. I like it. I don't think I'm important. I'm important enough to my kids and my husband like that. That's enough for most, I
Lija Greenseid 41:18
don't think you have a little life at all. I think you have a lovely life. And your kids will go off and make their own life. Like what is it people expect is gonna happen? Do you really mean? Like, what are you trying?
Melissa 41:28
It's like a thing, you know, where everybody's trying to become? Like, the goal is to become famous to be no.
Scott Benner 41:34
So you know, like, so in a small town existence where you're not on television or have fame somewhere or professional sport. You can be the person who has all these stories about them. And people everybody knows about me. Do you think that might be it? Like they're just looking for connection with people? I don't know. Maybe it doesn't matter if it's good connection? I don't know. I don't think you have a little life. I think you have a lovely life. And I think that I do too. I get up. Right? I say good morning to my wife. I try to catch a look at her before she gets her brown. That's fun for me. And then I grab some eggs. And then I make a podcast. And then I talk to my kids and I help them with stuff. I do the laundry i the other day. Well, I had a gutter break. I went out bought a piece for gutter. What is it? I should be doing? Like I should be impregnating six women. Like you don't I mean, like creating chaos in people's lives. Like I don't, I don't understand. I really
Melissa 42:25
are just lucky to have gotten through our, you know, teens and early 20s. Without making big mistakes. You think it's luck? Some of it? Some, it's good decisions, but some of it's just there. But for the grace of God go I you know,
Scott Benner 42:42
I think if I told you what I think it is, people wouldn't like me.
Melissa 42:47
I tell my husband that all the time. I'm like, You think I'm a nice person? That's because I just don't say what I'm thinking. No, I
Scott Benner 42:52
think it's the 20 IQ points. Some people are missing. That's what I think it is. Seriously, because you call it a good decision. But what what's the root of a good why do I sound angry? I'm not angry, I'm just talking about the root of a good decision is being able to think through something. That's all
Melissa 43:07
like, didn't you mean like, wait and delay that impulse? Like not kill someone?
Speaker 1 43:12
What's that saying? Those who know don't say? And those who say don't know, right? Like, you got to know when to keep your mouth shut. Like you have to know what's important to articulate, and what's not. These are impulses that people have. And I don't know, I'm sorry, go off the rails completely. But
Melissa 43:33
like, Well, I knew I knew the family stuff was gonna take us off the rails a little bit. But it is it's, it's part of our story, because it involves how the type two came about how the type one came about, like, and it's, you know, I'm glad we got reconnected with his father's side of the family because I wouldn't know about some of this stuff otherwise, like, Mike has made things a lot easier for us by helping us know these things.
Scott Benner 43:59
My best advice to anyone, if things are always going wrong for you. You don't know what you're doing. I know you're blaming everything else. But it's, it's probably you. And I don't mean that like it's like you're,
Melissa 44:14
it's at least worth considering.
Speaker 1 44:18
Consider for a second that the first thing that pops into your head might not be the best idea. Go look at other people who are having successes and say, how did they handle this situation? Oh, it's funny. I thought this and they did something completely different. I wonder what would have happened if I did that. If you have trouble eating? Here's one for you. I swear will work. If you're overweight, and you don't know why go to the grocery store and follow fit people around. Just go to the aisles they go to notice that they don't go into the aisles you go to notice that they're picking up something different than what you would pick up by the food they're buying. Eat that that's how they got there. Life's not some unknowable thing, if you're constantly having money troubles, and your brother doesn't have money troubles, call your brother up and say, I have money trouble all the time. But you don't? Can you tell me what you do? I'm going to tell you what I do. And you could maybe make some suggestions to me because I like, why would you just, it's always I don't know what happened, or somebody else screwed me or like, just I don't know, shame
Melissa 45:24
is very powerful and avoiding it is a powerful motivator, I think, screw
Scott Benner 45:30
all that. I want people to have a happy life. And I hate to say it, sometimes you're not the right person to decide like, and that's fine. There's no shame. I don't think there's any shame in that. Like, there are so many things I don't understand. So many things I don't know the first thing about, and if they are something I need to be involved in, I go find somebody else that understands it. That's it. Like I do not run around pretending that I know how to do something I don't know how to do. It would be stupid. I'm going to make mistakes. I'm going to screw it up. I'm going to put us in a deficit. I'm going to cost us money. I'm going to, you know, I'm going to waste time. I know it's not something people think about. But all of you don't know what the hell you're talking about. I don't know what I'm talking about. Sometimes. I'm good at this thing. Like, do you mean like I have some things I'm good at? I have some things I look at my wife and I go help me. I don't know what to do. I'm dumb. Like, I you know, like, it's, I don't know, there's no harm in it. Mostly, it made me very upset. I don't even know why. How's the kid? How's the diabetes is orange.
Melissa 46:30
You know, you mentioned us in episode, it was like 922, one of the myths. Oh, real. Minute 17. You said this lady's putting in a massive amount of effort. And I was like, Thank you for staying because Part A one C has been 5.4 to 4.9 for the last year plus, wow, we use we use Control IQ. You sleep mode around the clock. You know, Christina Korea's advice has been really helpful for us. As far as like how to gain that. So it can let us ever be below 110 puberty. And you know, the advent of periods have been kicking my butt. So that's why we went because we we held for point like 5.1 4.9 we held that for a long time.
Scott Benner 47:18
This is a pretty low carb lifestyle, too. Right? lower carb,
Melissa 47:22
you know, low Earth, lower, but sometimes we go nuts. And you know, she's always been my fruit that like literally since she could have food that wasn't boob. She's always been my fruit back. So I don't like to not let her have fruit. So that is something you know, I have read Bernstein. I like it. I get where he's coming from. But I'm not going to count my kids salad. And I'm not going to say she can't have fruit. I'm not counting out for berries. I'm just not I'm not going to forbear. Honestly. That's why I like you so much. I could be a fence straggler in the Juicebox Podcast Facebook group. And maybe I get criticized but I don't get a lot of because it's not really tolerated. And everybody's encouraged to do what works for you. So we straddle that fence, like we're we're in both sides we're in, you know, where's that aim small Miss small, like small dose and have you use the insulin that you need? Or what you're going to eat? Like, I don't care how you eat, just learn how to dose insulin. So that's kind of where we are. I will say puberty is kicking my butt. And they have these these first cycles where, like, I know how the female hormones in general affect things. But since cycles are not regular yet, I don't know when that's gonna happen. You know what I mean? Like, okay, so we're super insulin sensitive, like, right after the period starts and maybe some really great sensitivity, like right at mid cycle. And we do well like, oh, we'll have more carbs stay because it'll be easier. Yeah. And then, you know, toward like, right, like, right before like PMS time, major insulin resistance, you know, and we've always heard Basal to Bolus ratio has always been more like 7030 the 5050 stuff I read in books like I read pumping insolence, a great book I read, think like a pancreas, but I found your podcast like, weeks, 123 weeks in. And so I really feel like the podcast spoke to me because I knew I was responsible for it. And I wanted to direct it if I'm responsible for it. If I'm accountable for it, I have to have control over it. So when the doctor like I'm saying, I'm calling into the doctor asking for new pump settings, we got a pump like we had a Dexcom I'm sorry, I'm jumping around. We got a Dexcom a week she was discharged on a Monday we had on Friday. The our first endocrinology since left to make a concierge practice and we don't have that kind of money. So whatever takes insurance, that's where we're going. In our in our city. It's one practice now so We're with them now. But the first one she was like, get that technology, get it, get it, get it. And we have a high deductible plan. She was diagnosed you know, in a pick you stay in October. And I said to them, I think we know we want to pump. This is what she's decided she wanted. We need to get it before the end of the year before the deductible right?
May love you took up for us. She even said to me, this is how vain I am. Right. So I remember she said to me when I was saying okay, so this is what I saw on these the adjustments I made to her MDI, insulin, she was like, this is the kind of critical thinking we're looking for. And I'm like, ooh, ooh, I'll take those aspects all day long. Because, you know, it can sometimes be a little thankless caring for children in general. And, you know, MDI was,
Scott Benner 50:54
that was harder, nice to hear somebody say, I'm doing a good job.
Melissa 50:56
I do love a pump. I do love a pump of those algorithms. I wish everybody could have them. So you
Scott Benner 51:02
brought a lot of stuff up here. I think that it's worth talking about, that most people listening, don't know that online. There's, you know, small wars that go on over, you know, between low carb and people who eat carbs and type ones, right, like, and it's not everybody, it's a small faction of people who are very specific about their eating styles. And if you try to get involved with them, and and then you say, Oh, I'm gonna add fruit to this, there'll be like you are, you know, a bastard. Like your kid. Yeah, yeah. But I want to say something that I've learned recently. This is gonna sound disconnected for a second. I have for my entire life. wanted a chameleon. I know that's a weird thing. I'm an older person. And we were having a conversation around the house recently. or somebody's like, what is the thing you don't do that you could do? And I said, I could have a chameleon. And people I know, they looked at me weird. I'm like, my whole life. I thought, I'd like to have a chameleon. But I've never done it because they're not easy pets to take care of. There's responsibility, a lot of responsibility. I feel very responsible for living things. I don't sometimes I don't enjoy that. Like that feeling of, it feels like I that thing now comes before I do, like, I that's how I deal with things like my kids come before me. My wife comes before me. If I get a chameleon, I'm gonna actually it's gonna come before me. But I thought I could do this. Right. And I saw I said it out loud when we were talking about this thing. And my kids go out and get me a chameleon for Christmas. Like they buy the habitat, learn all about it, set it up, go find one, get it like this whole thing. And as soon as I see it, I have this feeling of dread. I'm like, no, no, no, no, no, I don't want to be, I don't want this. Like, I don't want the responsibility that comes to this. But because they did it. I smiled. And I was like, thank you. This is really wonderful. Thank you so much for making your dream come true as far as they're concerned, exactly. And so now I'm teaching myself all about it right. And I listened, I'm lucky I have a little bit of time, I could do some reading, while I'm editing and stuff like that, I figure some stuff out. I know what I need to do to take care of this thing so that it's healthy, and you know, etc. But at one point, I go into a Facebook group about chameleons. And I'm struck immediately with the juxtaposition between some of the people in the chameleon group and low carb people in type one diabetes online. And it's really interesting. And then I realized, it's not diabetes. It's not chameleons. It's not anything, it's people. Some people believe they have the end all be all answer. There is only one way, there is only one way. And if you don't do these things, you are the devil. Like immediately, and not just You're the devil, and you're gonna kill that chameleon. But you're gonna say you did this thing out loud. And other people are gonna kill their chameleons, too, because you have spread bad information. And then I was like, oh my god, this is the same thing about COVID. I was like, this is just people. This is not a COVID argument. It's not a chameleon argument. It's not a low carb diet argument. It's just how people's brains work. Some people grab on to something so firmly, and they say to themselves, my way the highway. And now because of the advent of the internet, they are able to make passionate pleas to you, but they never come off as pleased. They always come off as telling. Like, you have to do this and you have to do that. And if you don't use the enclosure that you're supposed to use, the chameleon is gonna die. And I'm like, and then you go to another person that says, hey, you know what, it turns out if humidity in your house is one way well, this kind of enclosure would work for you and if humidity in your house or where you live is another way this one might be more appropriate. But I go Back to the first person that like, no, it absolutely has to be this one. If you don't do this one, you're a monster. And I think that's how I see some people talk to people about low carb in diabetes, but it's not everybody. Their voices are so loud. And they're so I don't know what the word is vicious very sure. Yeah, yeah. Yeah, very positive. And sure. And I've thought about it in the past. And I was like, you know, specifically around low carb and type one. And I thought, they just feel like they found an answer to something and they want you to be okay, the way they're okay. Now, because let's know what you're saying here. Kids, they want to ease between like, what four, nine and five, four. Amazing, you know, but that doesn't mean it's the only way to do it. And, you know, it's not because they're bad people. It's not because they're anything, it's because they're, they're trying to help. They're really trying to help them they feel passionate about
Melissa 55:56
it, I feel lucky that I can take it for I can take ideas from everywhere and just do what I want to do.
Scott Benner 56:02
Well, that's what I ended up doing with this. That's why I brought this, I was gonna say this to the community, that's my brother chameleon up because I looked, what I did was I first I looked, and I saw the people yelling, and I disregarded them, like, Okay, I'm not gonna listen to the yelling people. And then I listened to everybody else. And I paid attention to what they were saying, I applied it, you know, to real implications in my life, and my home. And what I'm gonna do here, and I'm like, I know, these are, these seem like healthy ways to deal with the situation. And as I'm having that experience, I think to myself, This is how I set up my Facebook group for diabetes. And that's why it works so well for you. Or for somebody who's gonna, you know, like, literally not eat low carb, you take the bits that work in your situation, and you apply them and you have a nice outcome. That's all you're looking for.
Melissa 56:55
The other thing that I think that the faith the juicebox group gives is a place to belong, even if you don't belong in any other, like, smaller slot. Yeah, there's a lot of room for people to belong there.
Scott Benner 57:07
Oh, it's a big tent idea for sure. Like, I want everyone to be there. I don't care if you have type one, if you have gestational, if you're the parent, I have grandparents in their school nurses that have no connection to diabetes. Other than that, there's a kid that comes in their office that has type one, parents and adults, there's 70 year old people in there, there's 20 year old people in there, and they all talk to each other just fine. It just turns out that, you know, being led by common sense, is really the is really the key to success, I think. And I think that's the one thing that I have is common sense. So, you know, it's, it's the way I run the thing. And basically don't even do anything. I mean, secret time. You know what I mean? Like there's not a lot to do. You set up the expectation. And then the people follow the expectation. Like you don't I mean, like and like you said, I don't like if somebody starts yelling at somebody or acting crazy, I take care of that right away. I'm like, we're not doing that. Like I want you here. I want you to be able to benefit from this. But if you're a crazy person, you gotta go.
Melissa 58:13
That's that no pain in the pool.
Scott Benner 58:15
There's no, exactly right? I treat those people in the Facebook group the same way I treated my extended family when I found out where my adopted family is like, no, no, no, thank you. You go ahead and go. You tell me someone's going to ask me for money. I'm done. I was like, Okay, I'm not doing that. You know, they start telling you some crazy stories. And I'm like, That is not a story I want to be around. And that's not that doesn't bring harmony to my life. And so that's what I want for that Facebook group is harmony. And it obviously works. Because it grows so fast. It's just fascinating how quickly it adds people 150 every four days.
Melissa 58:55
It's really solid. I mean, yeah, they're still like diagnoses are still happening. Gonna keep coming.
Scott Benner 59:02
Have you ever seen craziness? And thought, oh, Scott's gonna come take care of this, right? No,
Melissa 59:08
like, most of the time I missed it. By the time I get there. Somebody's referencing the craziness that's already been taken care of. Like, oh, man, it
Scott Benner 59:17
gets taken care of very, very quickly. Yeah, I'm not I'm not screwing around with that. So anyway, control IQ aggressively with over and you're always using sleep mode with it. Dexcom G seven,
Melissa 59:29
six. No GS six so far. You know, I'm sitting in a parking lot right now because the Wi Fi neither the Wi Fi nor the cell signal in my house will support a reliable like zoom call. So I'm afraid to try and do the update for G seven and I love that it's backwards compatible and you could apparently you can use libre now to
Scott Benner 59:53
Oh, I saw that yesterday. Yeah.
Melissa 59:57
And but you know what? I'm dying them to partner with tidal like I know that Omni pod said they weren't going to do it. So I'm like who's left? Who's going to do tide pool? I want tandem to get a lower target through the FDA of typo could do 87 Do it, do it. That's
Scott Benner 1:00:15
an interesting problem. I don't know that many people know what you're talking about. But tide pool Oh,
Melissa 1:00:20
see, I'm, I'm there because I, I like control IQ. I would love it. If I could set my target 9590 Even I could, that would be so great. Because a lot of the time I'm fighting the algorithm and I think who on them are just continuing Basal IQ? Like, does that mean? Like, does that mean? Like the pump isn't going to be for people under six anymore? Because they don't that control IQs out approved you
Scott Benner 1:00:48
just right off label. That's what they'll do. The doctor will write for it off label, I'm gonna tell you that I don't expect that that thing will ever happen. I was
Melissa 1:00:58
thinking maybe after the g7 integration that
Scott Benner 1:01:01
I just it doesn't seem like from a business perspective. It doesn't seem like an idea that people would do like that. There's just an algorithm out there. And you can use it on our pump. If you want to
Melissa 1:01:12
know why doesn't it doesn't seem like a good way to keep your market share and keep your this and keep your that it's also
Scott Benner 1:01:18
another thing you can explain to people like like every most people, they don't want to know about this. They want to go to the doctor and be like, hey, Pump. Pump me. When the pump comes, they go, Hey, don't use it. Use it like this. Great. Goodbye. That's it. They don't want to know. They don't want to know, me
Melissa 1:01:38
like I had my babies at home because I'm a control freak. Right? Like, yeah, I
Scott Benner 1:01:42
need to feed your chickens. I
Melissa 1:01:44
want to be in control of it. Yeah. Why can't I pick my number? Let me pick my number. You know, I can do it. Like I said I did for 4.9 with, darn it. There's a train coming. I'm sorry. Don't
Scott Benner 1:01:56
worry, let the train happen. It'd be very authentic. This sounds like the Tennessee two to Chattanooga. Oh, that. I'm gonna tell you something right now. Chattanooga, I don't care if we can hear that train. This is going to be Chattanooga Choo Choo. But if we can't hear the train, you're stuck with chicken coop? Entry? Yeah.
Melissa 1:02:23
Well, that's the problem. I bought a microphone that said, Oh, they can't hear me on my Zoom calls when my wife is bumbling through the house. So too bad
Scott Benner 1:02:30
chicken coop intrigue it is. But I just don't think that companies really want to be involved in that.
Melissa 1:02:37
And there's probably a I'm probably part of a small enough subset, like Basal IQ people. They don't, they don't care. It's not a big enough group for them to worry about. I mean, I don't know. And that's what I have to keep remembering about diabetes. Like not everybody is like the Juicebox Podcast group where everybody shooting for five and a half. Yeah, nobody is. It's it's, it seems like everybody because that's the only place I really hang out diabetes wise. And then I go out, it's kind of like parenting stuff. You know, I go out into random like, oh, oh, okay. Not everybody. A hippie, like, okay for God, but had been insulated enough?
Scott Benner 1:03:16
Yeah, no, listen, most people are not doing that. Like most people are just trying to get by, like you don't I mean, like, that's why I'm proud of building it up. Because it means you're bringing in more and more people, those people go back to doctors, they tell doctors, I listen to a podcast. And guess what, here's my one, say it's 5.3. It's six, it's, you know, I don't work that hard. And it's six or I work a little harder, it's five and a half or whatever. And then eventually, doctors should be able to get it their heads like, oh, there might be ways to do this that aren't as difficult as I thought they were. And, you know, maybe that spreads. But the truth of it is, is that for most people, they're going to have middling a one sees middling success, there are going to be a lot of people who have complications, like that's not new, you know. So I think from a technology standpoint, companies are thinking, if that's who we're helping, then let's try to get this stuff in a place where it's plug and play, and you put it on them, it's going to keep their a one C lower is going to keep their stability, you know, lower, and they're gonna have a better chance to good outcome. Like you're thinking about it, like, I can learn this, I can do this, I can change my reality. Whereas I don't think a lot of people think that way. I think a lot of people think oh, a thing happened to me. And now I have to like use this device. And what's going to happen is gonna happen.
Melissa 1:04:41
Now our first endo told us when I was asking, I was like, we're having trouble with Hi, can you help me adjust? And they gave me a they gave me pump settings that reduced her insulin delivery when you needed more insulin. And I said, What about the highs I'm experienced? We're not experiencing lows. We're experiencing high eyes. And the CD told me, Dr. So and so will not give pump settings that increase insulin delivery unless and until her average glucose is above 200. Yeah, well, that's a problem. That was where I got angry. And it wasn't. It wasn't the CDs fault, but I was like, then clearly we have different goals. Yeah, for my daughter's help.
Scott Benner 1:05:23
Yeah, that's insane. So your doctor wouldn't give you orders to increase insulin until average blood sugar was 200.
Melissa 1:05:32
Yes. And so I was like, Okay, I'll do it myself. And I had the podcast that point. So I could, like I had read things like a pancreas. I had read pumping insulin, I had these tips and like, here's what, here's the variables I'm working with. Here's, you know, the things that could affect it. Here's, you know, not saying we never have to catch lows we do. I mean, I'm not perfect. But we're very, just always trying to keep it under 2%. I don't like loves to go over 2%. I know. 4% is like the ADA standard. But that's not what we're shooting for. I
Scott Benner 1:06:04
mean, I don't care about the ADA standard. I care about what your standard is. Just do what you can do. You
Melissa 1:06:09
know, I feel like mine is reasonable. And I think that's where I was butting heads with the Endo. Like, just support what I want. Because I can tell you why it's good.
Scott Benner 1:06:20
Yeah, that's not gonna happen. With some doctors, it's not gonna happen with some doctors, it will, you'll get you'll get ones that understand it on a bigger scale, and you'll get ones that don't. That's the thing that people I want people to understand. Is it a doctor that's willing to manage it with a 200 blood sugar is saying extensively, I will trade problems down the road for not being low right now.
Melissa 1:06:45
Is that common among pediatric endocrinologist because they don't see the complications? Like it's, it's not their problem,
Scott Benner 1:06:53
it's common with everybody. Because they just they don't, I mean, doesn't exist, I'm turning around to get to another computer. So they don't have the thing I have. And that thing is access to you. I don't have a pressure of having to say everything. Today. I can say something in one episode and something in another episode and a third thing and a fourth thing, and you can take six months to listen to those and listen to them and make sense of them and coalesce it together. And I used to work cold last time twice. And take your time and build a narrative for yourself. The doctors don't have that. I couldn't tell you everything you needed to know in 15 minutes, four times a year. It's unfair. And so maybe they've decided it just won't work. And so we'll shoot for you know this because the ADA says it's okay. And if the ADA says it Okay, then I'm not doing anything wrong. I don't have to feel bad about this. You don't I mean, like, who knows? I'm not in their heads, I can tell you that an average 200 blood sugar isn't a one C of 8.6. It she
Melissa 1:07:57
actually argued with me, she said kids who have an A one see under seven are having significant hypo episodes. And I was like, here's the Dexcom data, show me the hypose. And she was complaining when we were a 6.1.
Scott Benner 1:08:11
By the way, a seven a one season average blood sugar of 154. Yeah, or 8.6. If you're in Canada and other places, and see,
Melissa 1:08:20
that's one thing I really like about the strident low carb people is they're like, this a one C is not good for you. We're not really we're not really hearing that from many other places.
Scott Benner 1:08:33
No, I completely agree with them. Yeah, on that, on that topic. I don't agree with yelling at people. That's, and I also think that this is very manageable, down on the farm. But if your daughter goes off to Ohio State one day and has to eat in the cafeteria, she might not know how to Bolus for that if you don't teach her how insulin works. And then you're gonna put all this effort into this 4.95 to a one sees her first 18 years of her life. And then what happens to her when that food doesn't exist anymore. And she doesn't know how insulin works because she's been so low carb that she's using, you know, I don't know, regular an MP regular wood, a low carb, some low carb people still use like regular insulin right to like, like for their protein rises, which is cool. If you know how to do that. It's amazing. And if you're an adult living in a house, you have control over your food, go for it. That's cool. I think it's cool. But like, you know, off in the world, 21 years old, 18 years old. Good luck. You know what I mean? Like so like my point is know how insulin works, be able to use it, and then apply it to the lifestyle you have. That's all
Melissa 1:09:45
yes. And that's why I call us Ben stragglers because we eat fries. We we leave taco shells. We have a brand of taco shells that are really at a dose where
Scott Benner 1:09:55
I'm sure you can figure a lot of stuff out I would imagine like I'm not I'm not against people eating low. card at all. I'm not certain that it's doable for everybody. And you can't just tell people it's doable, and then send them out into the world. You're not there anymore. You know, you and your little in your Facebook avatar gone. That kids at college, I don't know what they're gonna do. And you know, I've heard people say, Well, you can meal prep, and you can do that. And like, yeah, I see your fancy lady in your kitchen with your $95,000 worth of like cabinets and countertops telling me how easy it is to meal prep. Your kitchen costs more than some people's homes. And you know, like, you're telling me how easy it is. I'm not saying anybody specifically, I've seen a lot of these. I've seen a lot of these ladies on the internet. All you have to do is you just set it by the way you spend your life in the kitchen. Yeah, right. So all you have to do all you have to do. I'm at Walmart trying to make a living. I don't have this. Like it strikes me like when I'm famous people tell me that all I have to do is work out three hours a day.
Melissa 1:10:56
So simple, Melissa,
Scott Benner 1:10:58
I get up in the morning, I go for a walk, then I cold plunge. And then I like to get into the sauna. And then I have a nice breakfast of meats and cheeses that I've made myself. And then I'm like, where do you think my time and money comes from? I don't have a contract with like Warner Brothers. Like like they're not paying me to be in a movie once a year. I can't do the things you're doing. I love it when famous people do that. Like all you have to do all you have to do shut the fuck up. Like I don't have your money. I don't have your time. I don't have your access.
Melissa 1:11:32
It's so simple, though. It's just a matter of prioritize.
Scott Benner 1:11:36
You don't know cold shock proteins, Melissa? Cold shock proteins. You need them? They're gonna save your life. Yeah. Would you like to live forever? Getting some cold water?
Melissa 1:11:48
Oh, thank you. So all
Scott Benner 1:11:50
I'm saying around diabetes is that people need practical advice. You're not saying anything wrong, that other person, your variables aren't the same as theirs. You know, like, you know, today I did this, I look at the plate. I'm like, This lady's grocery bill must be $1,000 every two weeks. She's like, Oh, all I have to do. It's just have you ever done this? No, I haven't. Because I'm at work. Because my grandfather is my dad, like I got going on, like, so like, I want those people to be able to use insulin to and it bears out. I see it bear out online all the time. You know, you take again, like we talked about earlier, you pick and choose from the podcast, the things that work for your life. And people are really able to keep low stable a one sees that are going to lead to good health. And, you know, their ability to actually navigate the world that they live in. So anyway, I'm not against anybody's i Whatever works for you, I think is terrific. I'm very clear about that. How do
Melissa 1:12:50
we get the NGOs to stop giving us a hard time for wanting an agency under six? I mean, smiling, not giving a is definitely you know, like option number one, but they stop hassling us. No,
Scott Benner 1:13:02
they're not gonna stop hassling us because they're just doing the thing they're supposed to. They're the lady with the thermometer or the guy with a thermometer at the emergency room. Okay, somebody paid me to be here with this thermometer, open your mouth. Like that's it. Like I'm the doctor. This is what my practice does. I am now going to say the thing do we say? So, you know, it's up to you to be able to do the I always call it like the Madagascar penguins from that movie. You get a smile and wave. Just when they're like, You know what their problem is? You go Uh huh, uh huh. Yeah, okay. Yeah, no problem.
Melissa 1:13:33
Right. My prescription, please.
Scott Benner 1:13:34
Yeah. Oh, don't worry, I'll turn it down. Thanks. Bye, bye. You know, either just get the heck out of there with your prescription and keep going. I feel like I'm
Melissa 1:13:43
gonna set my daughter up to not care as much what they think when she's on her own. But it's sometimes it feels like judgment when you're the parent and a pediatric endo office. That's not just your health, it's your kids health. If you're not doing it, right, then
Scott Benner 1:14:00
I don't know how to pass that part of my of myself on to people either tell you like I don't I don't give a what other people think about what I'm doing. So yeah, that's pretty much it. Like I am happy to listen to outside, you know, ideas all the time. And I integrate things people say to me constantly, but if if you're wrong, you're wrong. And so I mean, I'm not going to give it any weight at that point. A person who would tell you hey, your kids a one C is 5.8. It's too low. I'm going to I'm gonna take away some of their basil. Like II talking about, like, No 2% lows. Are you kidding me? Is that what you have?
Melissa 1:14:39
Yeah, we keep it less than 2%. A lot of times it's less than 2%. No one should be telling you anything. Yeah, you know what the last endocrinologist appointment we went to they apparently they only look back two weeks when they check our Dexcom data. And I was telling about something that had happened so mom of the year. My husband was on the road For work, and I had not slept in two days, because various things that had happened, diabetes and Babywise, she had turned control IQ off, which we sometimes have to do for dinner because it's always taking away basil. It's a specific problem that I can't get tandem to help me with. Her basil gets stuck at three, even though she needs more, which is a whole other thing. But we had turned control IQ off and then forgot to turn it back on. And she was low at night, and I slept with the alarms. And she slept through the alarms. And her dad is several states away getting urgent, and he had to send the police, he could not get anybody on the phone, right. And he had to send the police to wake us up. And I said that I of course brought that up thinking I was gonna get help at the endocrinologist office. And they basically documented it like they were gonna document to turn me into CPS. Yeah, nothing about anything else we talked about is like you are treating with insulin for normal glucose levels. And you need to not do that, and blah, blah. It was it was very upsetting to read those notes. And they wouldn't have known about it if I hadn't called if I hadn't brought it up and asked for help. Like if the algorithm like were bolusing for these corrections, and it in turn takes away more and more and more and more basil because it's perfectly happy to let her sit at 200. So now I now I just have an alarm to turn control IQ on every night at midnight. Melissa,
Scott Benner 1:16:29
I want you to imagine what would have happened if you went into a doctor's office and told people who had 15 More points of IQ, that same story. And then said I just need help with this one problem. The dumb they don't know. They don't know how to think the hero thing and they go scared run. Some people have trouble thinking. I don't know what to say. It just was.
Melissa 1:16:53
It was horrible. I asked for help. And instead they documented it like I had done something criminal. Yeah. I'm telling you. I felt very defeated by that.
Scott Benner 1:17:02
I bet you did. I'm sorry for that. I'm sorry. You went through that. You're not a smooth criminal. Well, I
Melissa 1:17:06
can't wait till our next appointment, which we have to camp because we don't have insurance right now. But we'll see. We'll see how the new insurance is. Oh,
Scott Benner 1:17:14
can you sell some of those eggs that Aetna and trade or something like that? No,
Melissa 1:17:19
those eggs are for my baby.
Scott Benner 1:17:21
How hard is it to make it to feed a chicken every day? Oh,
Melissa 1:17:25
not hard at all. Do you know what I have set it up? So I don't even have to feed them every day. So I went on the internet. Everything's on the internet as
Scott Benner 1:17:33
the chickens and
Melissa 1:17:34
ozempic I'm just kidding. God. No, no, no. But hey, you're about to get me on it because I'm tired of being chubby.
Scott Benner 1:17:43
I just switched, actually. Anyway,
Melissa 1:17:45
yeah. Good. I'm carrying I'm like comparing menopausal it's, I'm sure there's other should I should be doing but no, I made like great big feeders with giant plastic trash cans. Like got a like a you know when those circle bit things and cut a hole out and put in some PVC elbows. So they don't spread it everywhere. They just get their head then. And I can put two 350 pound bags of food in there. And I don't like I always check it like I check on them every day. And I gather the eggs and I shoveled it and stuff like that. Yeah, I don't have to. And I did the same thing with waters. My husband helped me with that in great big barrels and you know drilling holes and putting in little automatic cup waters. And so, like we check on them every day, but we don't have to haul water in whole food every single day. And that makes it so much nicer for us.
Scott Benner 1:18:37
A little bit of ingenuity. That's all you need. Yeah,
Melissa 1:18:39
and an automatic coupe door. lets them in and out. I mean, we can go on vacation now. It's great. And this is why we don't have a dog like with first you know, we had our you know, one the dogs that you get when you get married. You don't have kids yet? Well, you know, we've been married a long time. So they're dead. And they die before the baby. The youngest was born. She's gonna be five. By the time we were ready to think about getting a dog again. Her food allergies were such there was no way that we could have even crumbs of dog food anywhere. Mind you. I'm not a housekeeper. So that was a legit concern.
Scott Benner 1:19:14
How to get this off the floor? Yeah,
Melissa 1:19:17
I mean, there's there's many times like the kids, you know, get food on the floor. I'm like, Oh, if only we had a dog. But you know, we've been dogless long enough now that I'm, I'm reluctant to jump back in. Now the chickens don't tie us to the house the same way a dog would. So I know kids need pets and stuff like that. But they're gonna have to settle for chickens right now.
Scott Benner 1:19:35
I'm just gonna get a chameleon. And oh, I already have one. Nevermind. I'm good. Yeah,
Melissa 1:19:39
my sister has a house full of reptiles. And she has a much cooler mom than me because I'm like, Absolutely.
Scott Benner 1:19:44
I'm not getting any more. This is just this one thing. It's good for me because I find keeping the chameleon to be a lot like raising a cactus, which is they are so slow that they really teach you how to be patient. And I need more patients always Smart patients so I can sit and watch that thing, move a half an inch in 15 minutes and think, okay, I can slow down. Get it. I mean, so I'm good with it. Anyway, I appreciate you very much doing this. I don't know what we talked about. It doesn't matter to me. I love the podcast. We just sometimes we chit chat and things go one way or the other. I'm looking here people are thrilled with an episode that went up the other day. I'm getting a lot of notes about episode 1100. So maybe yours will be one of those that one day I'll look online and be like, Oh my god, I was listening to Melissa on episode 1500. No, I had such a good time where we're so thoughtful or whatever. But I really appreciate this. Thank you so much for doing this with me. Yeah, thanks for having me. Of course. Thank you for sitting in a parking lot to get your Wi Fi.
Melissa 1:20:46
I appreciate that. Well, I mean, pros and cons are living.
Scott Benner 1:20:57
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#1271 Bold Beginnings: Using a CGM
Bold Beginnings will answer the questions that most people have after a type 1 diabetes diagnosis.
You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Spotify - Amazon Music - Google Play/Android - iHeart Radio - Radio Public, Amazon Alexa or wherever they get audio.
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DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.
Scott Benner 0:00
Hello friends and welcome to episode 1271 of the Juicebox Podcast
Welcome back everybody today Jenny Smith and I are adding to the bold beginning series with this episode about using CGM. 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 was just diagnosed with type one diabetes, and you're looking for some fresh perspective. The bold beginning series from the Juicebox Podcast is a terrific place to start. That series is with myself and Jenny Smith. Jenny is a CDC es a registered dietitian and a type one for over 35 years. And in the bowl beginning series Jenny and I are going to answer the questions that most people have after a type one diabetes diagnosis. The series begins at episode 698 In your podcast player, or you can go to juicebox podcast.com. And click on bold beginnings in the menu. If you'd like to help with type one diabetes research right from your own home, and you're a US resident who either has type one or is the caregiver of someone with type one, go to T one D exchange.org/juicebox. and complete the survey. It's that simple to help. type one diabetes can happen at any age. Are you at risk, screen it like you mean it because if just one person in your family has type one, you're up to 15 times more likely to get it to screen it like you mean it. One blood test can help you spot it early. And the more you know, the more you can do. So don't wait. Talk to your doctor about screening. Tap now or visit screened for type one.com To get more info and screen it like you mean it. This episode of The Juicebox Podcast is sponsored by the Omni pod five, learn more and get started today at Omni pod.com/juice. box. Check it out. The episode you're about to listen to was sponsored today by ag one. You can drink ag one just like I do by going to drink ag one.com/juice box. Check it out. Jenny. Good morning. How are you?
Jennifer Smith, CDE 2:27
I'm well how are you?
Scott Benner 2:30
Good. Thank you. I'm excited to add to the bowl beginning series. Yay. I think that it is maybe the most popular series, certainly among newly diagnosed people. But in general people seem to really like it. It made me think a little bit. And by the way, this is a little tease about a way to kind of refresh the Pro Tip series, which Oh, yeah, when we're done here, I'll actually run my idea. I mean, make a note here to myself to tell you
Jennifer Smith, CDE 2:58
what I was talking about this a while ago just because of all of the new technology. And the algorithms that have really shown up compared to when we did majority of that.
Scott Benner 3:09
No, it was a handful years ago. Yeah, I think there's a nice way to refresh it. But the whole beginning series, we're just going to add to it today. I'd like to talk about basically wearing CGM, the accuracy best practices, that kind of stuff for people because I think you get diagnosed or you have a child who's diagnosed and all of a sudden you're wearing a device. This is obviously very new and different for somebody. Right? And then there's some quirks about wearing technology that aren't obvious in any mean and and ways to manage. That's a good way to say it, right?
Jennifer Smith, CDE 3:42
Yes, they are kind of, I guess quirks is a good? Yeah.
Scott Benner 3:46
So you know, I think no matter what you're talking about here libre ever since Dexcom. CGM is right. They're going to tell you Look, put them on. And it's going to tell you what your blood sugar is. And it will and they're great. They're absolutely fantastic. But you might then take your meter out, check your blood sugar and say, Oh, my meter says I'm 96. And my CGM says m 115. Which is it. So let's talk a little bit about how CGM work first versus how blood blood finger or excuse me about how BGM 's work. And then we'll, we'll lay it out for people so they understand give them some tips and tricks to get through and set up some expectations forums, that make good sense. Sure. Okay. So I'm gonna start by asking you some technical stuff that I don't understand as well as you do for certain. I use my, my blood sugar meter, and I check a drop of blood from my finger. And it says, I'm 96. Why is it possible that my CGM doesn't read the same? It's
Jennifer Smith, CDE 4:52
possible because your blood glucose meter is reading the glucose in your blood? which is, technically the more accurate it is the more real time right now. So your glucose then kind of shifts out, moves through our interstitial fluid that surrounds the tissues in the cells and everything in our body in order for the glucose to kind of move into cells. That's a very simplified explanation, right. But sensors, CGM EMS do not measure blood glucose, they measure the glucose that is in that interstitial fluid. And that's the reason that you can see a difference between a blood glucose and a CGM value, because they are not reading glucose in the same fluid in the body. And that glucose again from the blood has to kind of move out transport through the interstitial fluid. And so many people know the term or the thought of leg. In CGM data, a lot of people talk about that. And that data can leg then finger stick is here. CGM is higher than this or lower than this. The reason is because there's a lag in that glucose, sort of transport, if you will, into the interstitial fluid. And as we'll probably talk, it's another reason that hydration very important, really, really important.
Scott Benner 6:28
So very high level, not technically, someone one day said, Hey, there's glucose in your interstitial fluid. We can measure that and help people with diabetes using insulin. I'm going to read this interstitial fluid is the fluid that surrounds the cells in your tissues. It plays a crucial role in transporting nutrients and waste products between blood and cells. Yes, when you're using a continuous glucose monitor, it is important understand how the interstitial fluid relates to blood glucose monitoring. And Jenny's already brought up there's a lag, right? And that's lag could be five to 15 minutes from a finger stick. Okay? Correct. So somebody figured out, probably not that hard to figure out if you're like, you know, a scientist or you went to college or something, that there's glucose in there, we can measure it and we can help people not have to poke their fingers all the time and still get close enough to what's happening that it's really valuable for them. Okay, so interstitial fluid similar to blood plasma, it says, but without the high concentrations of proteins found in plasma contains water, electrolytes, glucose and other small molecules. Correct. So then, if you're dehydrated, then that fluid is not where it needs to be volume wise, I imagine. So Right. Why does that mess with the reading. I partnered with ag one because I needed a daily foundational nutritional supplement that supported my whole body health. I continue to drink ag one every day because it works for me. Ag one is my foundational nutritional supplement. It gives me comprehensive nutrition and it supports my whole body health, drink, ag one.com/juice box. When you use my link to place your first order, here's what you're gonna get a free welcome kit that includes a shaker scoop and canister, five free travel packs, a free year supply of vitamin D, and of course your ag one. So if you want to take ownership of your health, it starts with ag one. Try ag one and get a free one year supply of vitamin D and five free ag one travel packs with your first purchase. Go to drink ag one.com/juice box that's drink ag one.com/juice box. Check it out. My daughter is 20 years old, I can't even believe it. She was diagnosed with type one diabetes when she was two. And she put her first insulin pump on when she was four. That insulin pump was an omni pod. And it's been an omni pod every day since then. That's 16 straight years of wearing Omni pod. It's been a friend to us, and I believe it could be a friend to you, Omni pod.com/juicebox Whether you get the Omni pod dash or the automation that's available with the Omni pod five, you are going to enjoy tubeless insulin pumping, you're going to be able to jump into a shower or a pool or a bathtub without taking off your pump. That's right, you will not have to disconnect to bathe with an omni pod. You also won't have to disconnect to play a sport or to do anything where a regular tube pump has to come off. Arden has been wearing an omni pod for 16 years. She knows other people that were different pumps, and she has never once asked the question, should I be trying a different pump? Never once Omni pod.com/juice box, get a pump that you'll be happy with forever.
Jennifer Smith, CDE 9:50
Well tell me what happens when you have a really teeny tiny amount of water that you try to put a whole bunch of sugar in Does it stay fluid or what happens? Oh, it gets more viscous concentrated, right? It gets kind of sticky it gets. So not only are you impacting everything else that needs to be transported in your body in the right way, which, I mean, that's a whole just physiology discussion. But honestly, electrolytes play a big role in transport of even glucose and other sort of nutrients in the body. So when we're dehydrated, that concentration of all of these can kind of get slow in movement, as well as more concentrated, right. And so that can shift glucose readings. It's also the reason on the opposite, where people again know this term, it's like a compression low, right? Where you're laying on your sensor, what you're doing is compressing that sensor so much that all of that all but a good majority of that interstitial fluid gets shifted away from the sensor. And so what ends up happening is glucose levels drop. And not until you roll the child or the person over or they get up and kind of things get moving again, fluid comes back to normal, you know, levels that it should be at, then that glucose number jumps up, and is actually where it should be. So as you can see, hydration and proper hydration in the whole body can make a really big difference in
Scott Benner 11:22
so like a compression low as an example, almost like putting your foot in a puddle and you displace the water. So if you press hard on the sensor, you're displacing the interstitial fluid, which contains glucose, you're pushing that away from the sensor. And then that's why all of a sudden, you look low out of nowhere, because you technically push the glucose away from the sensor. And now suddenly, there's less there than actually exists in the body. Right? Interesting. Hey, here's a little side note that you'll probably pletely agree with. Only about 30 to 40% of adults meet the daily recommendation for water intake. And the remaining 60 to 70% may not be adequately hydrated with varying degrees of mild to moderate dehydration. So, my point bringing that up is is I think most people hear that and think I'm not dehydrated, but you very likely could be especially kids to who you know, correct.
Jennifer Smith, CDE 12:18
And honestly, you know, having worked with a good percentage of athletes in the past very heavily. Our biggest recommendation for hydration is that when your body finally gives you the signal that you're thirsty, you are definitely dehydrated,
Unknown Speaker 12:34
okay? You should not
Jennifer Smith, CDE 12:36
have thirst so to speak. That's like oh my gosh, I have to get a glass of water right now. You are not hydrated. Well, you're under hydrated at the point that your body is giving you signals right?
Scott Benner 12:51
I'm just gonna say here your urine like should be what? Oh, yeah, how do we measure our hydration by the color of our urine?
Jennifer Smith, CDE 12:58
Your urine should be like very light pale lemonade.
Scott Benner 13:03
Makes me want to sing lemonade. A cool refreshing drink. Clear or light yellow typically indicates good hydration, pale yellow. Also a sign of good hydration suggests that you're well hydrated but not overly so bright yellow can indicate mild dehydration and the presence of excess vitamins. Oh yeah, that's true too. If you take a multivitamin your your pee could get bright right and
Jennifer Smith, CDE 13:25
especially B vitamins. So I always recommend Do you know that you're really doing a good job of hydration and you've just taken like your multivitamin or a B complex or something like that. And your pee is like this golden color.
Scott Benner 13:39
dark yellow often indicates dehydration and that your body is currently conserving water. It's interesting and amber or Holly, honey colored, strong or sign of dehydration important to drink more water orange dye to people's Wait a minute. Orange can be the sign of severe dehydration and brown could indicate severe dehydration or the presence of certain medical conditions such as liver disease. pink or red is blood in the urine. Wait a minute, Jenny. This has nothing to do what we're talking about but blue or blue or green. unusual colors can result from certain medications or food dyes rare genetic conditions bacterial can and then cloudy or murky could indicate a urinary tract infection or kidney stone.
Jennifer Smith, CDE 14:21
Okay, but and from the color that even that pink it may not definitely be blood. If you have had a fair intake of bees recently. Beets or berries a fair you know an intake of those can definitely discolor the urine. Beets can also really discolor sort of poop. So just as an FYI.
Scott Benner 14:43
What color does beets make my poop? Kind
Jennifer Smith, CDE 14:47
of like? It's almost like a reddish color. Yeah, so there you go.
Scott Benner 14:52
Sorry. We go over it like this because being hydrated is super important for your CGM working by It's also very important for your insulin working as well. So we might as well talk about it here, because you're getting a double benefit. If you're wearing a CGM, you're gonna get more accurate readings. And if you're using insulin, which if you're listening to this, you're very likely are your insulin is going to work better. So can we take two seconds on that tell people why well hydrated body uses insulin more effectively?
Jennifer Smith, CDE 15:20
Absolutely. Again, it's a transport component, right, we're injecting or infusing insulin into what we call the sub q tissue. So the layer that sits like right underneath the skin, which is why your little cannulas or the even the insulin needles on your pens or your syringes, they don't really go in very far, they're not terribly long. The idea is that with proper hydration, and fluid movement in the body, that that insulin along with the chemicals that help it to get used in an appropriate timeline, it works along with the hydration of the body. And again, if you're under hydrated, things are not gonna be moving as easily I, I considered dehydration, especially like in circulation, it's kind of almost like molasses in winter, right, things move really slow. Once you get hydrated, things move and flow the appropriate way, your insulin, all of the nutrients, all of those things, they get moved to the right places in the body, in the timeframe that the body is meant to do it.
Scott Benner 16:24
I was going to mention that extreme temperatures can affect the rate in which glucose diffuses into your interstitial fluid. So that is a potential impact for your CGM, right things are also different, like blood flow. So like sedentary versus exercise again, increases. Yep. Right. So some best practices, first of all, be aware of lag time. Right? And that's an interesting one, because here's a real world example. Arden's blood sugar will, you know, dip down to 63? And I'll send her a text and I'll say, Hey, did you do something about this? And she'll say, Yeah, I'm good. I did, you know, I drank this, or I ate this or whatever. And then five minutes later, the CGM will still say 63. Or it'll go down again. And then I get the tap, tap, tap. It's my wife. She's low. And I'm like, no, no, I know. But she's already had something. Well, this thing still beeping at me. Right. And I'm like, Yeah, I know. But I think we did enough. Like, I think we did enough. It's gonna come back. You gotta wait. I find sometimes you need to wait 10 minutes? At least Yeah, to see. Yeah. And if you go, go ahead. Well,
Jennifer Smith, CDE 17:29
I was gonna say, and it could also be longer depending on what you've used to treat that with, right. Thus, the reason that we really recommend dextrose are really simple sugar, something that's going to get in get moving fairly quickly. Because if you don't, then not only is the CGM potentially lagging, but it might be also even behind further because of what you ate not being fast enough to reliably start bringing that blood sugar
Scott Benner 17:58
up. But in a case when you have done that, when you've taken in that simple sugar, and it's bounced like, say you're 63 and CGM says 63. You wait a couple of minutes after you drink your juice, and you test and you get a 75 test. And you think, Okay, this hit, it's coming, right? The CGM is not suddenly going to say 6075. As a matter of fact, that next time it it reads, you could end up being 1520 points higher than the last time, right. And so I just want to say here, you really still need a really accurate blood glucose meter, and you should use it. I know. And listen. Dexcom is a sponsor ever since as a sponsor, I think CGM are fantastic. I don't know what I would do without them. You still need a really good meter, and you should test your blood sugar. That's
Jennifer Smith, CDE 18:45
100%. Yeah, I 100% disagree. And I Oh,
Scott Benner 18:50
you just said I 100%. Disagree.
Jennifer Smith, CDE 18:52
I 100%. Agree. I 100%. Agree I was what I was gonna say. In terms of, you know, like disagreement is, I disagree with the fact that people are really heavily relying on only their CGM. And that they're really only waiting to do a fingerstick when their own body symptoms are telling them something that seems off compared to the CGM value. I mean, I think if I were the one setting up any of the sensor systems, my recommendation doesn't get into calibration because there's a whole strategy with calibration and that kind of stuff as well if it's needed, but my best practice is doing a finger stick when I get up in the morning. Yeah, just to see because just to see it because it gives me a visual of the CGM has been here all night. I have no food in my system. I have no excess of insulin from boluses or anything that could really be impacting right now. I do a few You're sick before I get out of bed. So I don't have that quick shift in blood sugar that could happen for many people, right that foot on the floor. And they compare. And if it's off with, you know, within this set comparison, I may calibrate, but 99% of my mornings I'm not calibrating. I'm just comparing and saying, yeah, it looks great, fabulous, even
Scott Benner 20:24
like, but what you don't want is to get out of bed with a blood sugar of 140. And your CGM is like, Oh, you're 95. And then rack, then the whole day just 45 Points off everything that you do that the first Bolus you make, you know, leads to probably arise, you know, because you didn't have enough insulin. And this just doesn't, this doesn't stop. And even if the CGM comes back in line eventually great, but it just throws it. I'm just a big fan of testing once a day, at the very least,
Unknown Speaker 20:56
yeah, yes.
Scott Benner 20:59
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Jennifer Smith, CDE 22:01
You know we have Dexcom Hello, and I know the other systems have something else but Dexcom has clarity reports, right? And so clarity reports will give you an estimated what they it's not an agency but an estimated average, right? They call it a GMI. A glucose management indicator and that gives you a value close to what a one C would represent from an actual blood draw. And in comparison, some people get really frustrated. Well, my agency came back at this but my GMI according to clarity was telling me that I should be here or here. And it's frustrating. My first recommendation is or a question is, are you doing finger sticks,
Scott Benner 22:46
right?
Jennifer Smith, CDE 22:47
If you're not doing finger sticks, let's start doing several finger sticks a day. Because I would almost say that in the majority of those cases, the CGM is what's off. The CGM is not on with the finger stick enough. And so your GMI is then reporting an average. That's not actually what's really represented in your blood. Yeah, right. So I think they're in the case of things being really different. It's just a good strategy to do even more than one test a day for even if it's just a week, if
Scott Benner 23:24
I'm listening to this, and I'm more newly diagnosed, what I would want you to take away from this is, this is maybe some of the best technology that's ever existed for people with diabetes, agreed that and algorithm pumps are going to change people's lives with type one. And you should not walk around bemoaning, oh my gosh, I'm 95 and it says 110. That's astounding, be very happy. Okay, right. But the next thing they're going to think, is, well, if I'm really 95, and it says I'm 110, and I'm on an automated system, is it not going to give me insulin based on 110? And, you know, like, should I be fearful that I've never come up with a better answer other than to say that my daughter has been on different algorithms for a long time. This has never been an issue. And I know that is not a comforting statement. Right? To me, it's the same question. It's the same answer as back in the day when somebody would have, you know, four different meters. And they would like take pictures they'd like they test their blood sugar with one meter. Then with the next one that would the next one, the next one, they get four wildly different numbers. And they say great, now which one of these should I use? Right? I'd pick the most accurate one. You know, like, go look online, see which one of them they have is most accurate and go with that. But at some point, do you don't remember that moment? Probably because you were a kid when you were diagnosed, but I remember the moment of like swallowing hard and going, this is the meter. I don't know if it's right or not, but I gotta go with it because I gotta go with something. Like I'm not in the hospital. She doesn't have we're not using a $10,000 blood glucose meter. and I really mean like, this is the one I have. And if you know what I'm saying like it's a real big leap to make
Jennifer Smith, CDE 25:05
it is and unless you really know, as you already said, you can look up accuracy online, right? There are charts and in diabetes daily, there are a whole bunch of different places that have accuracy chart by different brands even have the off brands right that are on there for an evaluation. I always say choose the one that is not only on your insurance plan coverage wise, but also choose the one that's on that list that is the highest accuracy according to this chart.
Scott Benner 25:36
Yeah, there's like three meters at the top of the chart, listen to contour next gen is a longtime sponsor of the podcast, and it's the one we use, it's a very well ranked and rated meter and
Jennifer Smith, CDE 25:47
and they've rated top of the charts for years. Yeah, particular meter I kind of right up there with it is, I wish I could use that one. My insurance doesn't cover that one. It prefers accucheck brands. So I use the guide or the guide me that one has very similar to the contour accuracy readings. So again, look, because that also translates into if you're going to be calibrating as you brought up, I checked one this meter and then I checked on this meter, and I checked on this meter, and I have three varying results. And this day, you're using this particular brand and this day you're using this particular brand at work to calibrate your CGM. Don't Don't do that. Pick one, pick a meter and use that one to always calibrate just
Scott Benner 26:32
freaks you out in the beginning. Like it just does. Like you know, you're fairly newly diagnosed. You're like, well, this meter says my blood sugar's one thing. The CGM says another thing, then you start going well, which is it? And right, I always tell people I'm like, I don't know. Is it a $4 meter and an A Dexcom? I'd probably trust the Dexcom more, but like I don't think it's a more or less it's an understanding of once you have as accurate as you can blood glucose meter CGM. Then understand the lag time really seriously. Look at your hydration. You know, you know, are you in an extreme temperature situation? I listen, I'm wearing a CGM. Today. I got in the shower and my blood sugar went up 45 points. I have a working pancreas. Do you really think my blood sugar went up? 45 points. Right, right. So there's that stuff to remember it also, when you put it on is really important. So going back to CGM Jenny, I talked about this before we started. Again, I want to say again, I don't want to scare anyone away. Definitely get a CGM. Okay, but the first day ain't as good as the second day. Ain't as good as the third day. And then all of a sudden, when you get to the end of the sensor, it could trail away again, some people have great luck. Some people's physiology works great with them. And some old time Oh, my God, yep, just boom, all good. Yep, I saw Arden had a g7 go bad in the last three hours last week. And other than that I've seen they go right, she wears them right out to the end every time. And the longer she's wearing them, the better they look for her, like accuracy wise. So but keep that in mind, too. If you're in a 10 day window or a 14 day window, it's boring. But there's that little sensor is under your skin. And it's in there. And it takes a little time to what's the word people use marinate,
Jennifer Smith, CDE 28:13
marinate,
Scott Benner 28:14
again, yes, right? Like get set, who cares what's actually technically happening. Dexcom added what to the g7. It's a like a grace period.
Jennifer Smith, CDE 28:25
There is so after the 10 days, you have a 12 hour grace period that the sensor will continue to work before it's fully expired. And in that grace period, it will continue giving alerts and alarms and all of the regular stuff. They've just given, you know a period of sometimes life is what it is, and you planned to be home at 2pm to change it and your train got stuck or you're just stuck in traffic or you had to go pick up your dog or whatever happened. And now you're either without a sensor because it has fully expired or now with g7, you've got 12 hours beyond that 2pm that it's still going to help you until you can really get home.
Scott Benner 29:07
And so I'll tell you what I tried to get Arden to do and she fights me all the time about it. But you know, I'm always like, look, put a new one on now while the old ones still working. And just let that thing sit in there for a while and get accustomed to its surroundings. And you know, because if it if it doesn't work as well, in the first couple of hours of the first day for some people, then let's try to buy some more time there and then we'll swap it back on the end by taking the free 12 hours on the backside if we can, right that makes sense to me. So people call that like marinade era needing a new sensor right you just you all you do is you open up the g7 pop it on and then you don't do anything else. You don't start it up often hold on to the box hold on to the sensor then when it's time to switch you scan that one and jump to the other one. And you might very well see better numbers coming back from it the longer it's been in. We try to do it for a couple of hours at least but she's just He's just tough. She's young. You don't I mean, I'm like, I'm like, it
Jennifer Smith, CDE 30:02
doesn't mean a million other things. Yeah, it's
Scott Benner 30:04
hard for to get but it's a great, it's a great tip. Is that something you can do with libre? Do you know? That's
Jennifer Smith, CDE 30:10
a really good question.
Scott Benner 30:12
No, if you can, I don't think so.
Jennifer Smith, CDE 30:15
I don't know. Okay, I would honestly because Libre is similar in that the device also is like G seven that it just pops on. There's no additional transmitter to pop in, or it's like a one and done kind of habit on it. I think it could be possible because you still have to enable that CGM to get started with the app. I would expect but I don't know for sure. I. Honestly, the majority of people that I get the opportunity to work with are either Dexcom or you know the small number who get really good accuracy with Medtronic Guardian system, which is nice.
Scott Benner 30:53
How do you find the predictive alerts work for CGM? Like the ones who tell you you're going to be low in a while? Do you notice that they are helpful?
Jennifer Smith, CDE 31:03
I think that they can be helpful what I've seen the best though, and it goes back to hydration. It really goes back to the reliability of your fluids moving the way that they're supposed to through the body. And that data that then gets transmitted from blood into the interstitial fluid, it's going to register a shift that's going to trigger however, you've had that predictive alarm set. Either you get you have it set really conservative or really aggressive to alert your alert you sooner or later to that drop happening that could predispose you to the low. Where
Scott Benner 31:40
are you at on calibration? Do you calibrate?
Jennifer Smith, CDE 31:44
I calibrate if necessary? Yes. The majority of my centers, I've had really, really good luck, if you will, with my Dexcom. For a long time,
Scott Benner 31:58
I'll have ordered and calibrate once in a while doesn't come up that often. I think you really have to pick through what works best for you. Like some people will say, look, I put that thing on six hours into it. It says I'm 65. And I'm 90. And I calibrate. And some people will tell you like don't calibrate on the first day. And you know, in Dexcom, all the CGM companies, they don't really talk about how to best do that. So I would say this,
Jennifer Smith, CDE 32:21
they do tell you that you can calibrate. And most of them, if you've read the fine print in their owner's manual, there is a defined strategy to what they recommend for calibration. And how far outside of that could actually create sort of a setup or where the sensor is just going to fail itself. Because you have over given it information. And the algorithm that's changing that sensed goes to a number to tell you what it is, it gets all messed, you could just
Scott Benner 32:54
confuse it. You could confuse it you find sensor placement because you know, there's the places where they've tested the sensors. So they can say you can wear it here, but people move them all over the place. Do you find that you have better sights some than others for accuracy?
Jennifer Smith, CDE 33:08
I do. You know, again, leg sight isn't technically approved. I don't wear it. I also don't wear my pumps on my thighs either. Neither of them work ever for me. But people find special places that do definitely work. Many times. They're the approved sites. And the majority of the time. They are not technically approved sites. My recommendation is tested. This is another opportune time to use your glucose meter. And make sure that it is actually really serving you. Well there. And then if it is great, keep using it. I mean, we all have limited real estate on our body. Yeah,
Scott Benner 33:50
I don't know that Arden has ever worn a Dexcom on our arm. Seven gees. Oh, nice. You bring them on or like size for hips or budget, upper body kind of thing. Yeah, like there. So let's talk a little bit about the quality of your management is also going to add to the quality of your CGM accuracy. So if your blood sugars are not constantly bouncing up and down or super high or super low, you are going to see, I think more stable accurate readings back from a CGM, correct. Yeah, yes. Okay.
Jennifer Smith, CDE 34:21
Absolutely. And with the difference between those coming again speaking Dexcom, specifically, those coming from G six to G seven, where there is no longer smoothing of the data. Right. That balance could get worse, visibly in the data points with somebody who has a lot more Rise Fall happening looking a lot more like a roller coaster. Those numbers again, data points on the CGM graph, they could look a lot more jagged and up and down even as the glucose is going up and down compared to somebody who has a lot smoother trends. addition from data point to data point.
Scott Benner 35:01
Yeah, that and then my point is that if you do simple things, like we talked about in the diabetes Pro Tip series, like Pre-Bolus, your meals, you know, have your settings closer, you're not going to see as much variability. And you're going to see more accuracy out of your CGM as well also do not calibrate while your blood sugar's moving. So correct. If you're rising very quickly falling very quickly. That is not a good time to calibrate. No, this thyroid have impact on CGM accuracy at all? Or do you think it just has impact? Because right, like, as I looked into it a tiny bit like, so you can have like, an overactive thyroid, right, which would maybe speed up your metabolism as an example? Like, would that maybe move glucose through you differently? You know, it's an interesting, I just, I don't know if it's right or not it just like it popped into my head. I'm like, I wonder what medications people are taking that might have an impact on this as well? Well,
Jennifer Smith, CDE 35:54
I do you know, obviously, and most people who are Dexcom users know about acetaminophen. And in fact, while they cleared that push to avoid acetaminophen, I think it was once G six came out, they still will ask you, if you are trying to return a failed sensor, if you had used acetaminophen, my expectation is that they're looking potentially maybe for a dose, that's more likely going to fail a sensor comparative to just using you know, 500 milligrams of something once a day, and you had no effect whatsoever. I know Vitamin C is another one, you know, higher doses of vitamin C can certainly affect the accuracy. I think it's a FreeStyle Libre, too, for vitamin C, and you know, a lot of people might not even realize that they're using a large amount of that. If they're, if they're taking some type of a powder that includes a high amount of vitamin C, they're not technically just taking a chewable or a daily might vitamin, they may not think that they're really going to have a problem. They may not realize it's in something else that they're eating. Okay, those are the two things I definitely have impact. So with
Scott Benner 37:10
overactive underactive thyroid, I'm just kind of picking through some of the notes I made earlier. It's gonna more change like, like underactive thyroid, slower metabolic rate could delay glucose uptake into cells, which could affect how quickly changes in your blood glucose are affected. All I'm saying is that if you have hypo hyperthyroidism, it's not crazy to think that you might see Genki readings from your CGM. Or maybe it's a little different for you than it is for other people. Maybe listen, if I'm wrong, that's fine. You have to imagine there are other things impacting this, it's not as easy as I put the thing on and the thing don't work. You don't mean like it right. And that's what I think always happens with people's they just kind of don't see the bigger picture. And I understand why. Right? Because you don't buy tires, and think, oh, they were out faster. But I drive faster than other people like you just think I bought more than other more or like the roads are worse or whatever. Like you just think like I bought the thing they said 30,000 Miles 60 It didn't last, like you know, there's reasons why things happen. I don't know what they are sometimes. Yeah, you just need to think bigger when you're trying to decide how to make this thing work the best because this is going to be a very important part of your life with diabetes until they come up with something different. And I don't know if there's something different to come up with. A CGM might be the greatest advancement for people using insulin, you know, in the last 20 years.
Jennifer Smith, CDE 38:34
Absolutely. Yeah. Yeah, absolutely. In terms of that accuracy to, you know, and calibration and whatnot. There are strategies, like I said, in the fine print of the books to if it's this far off, this is one to add a calibration. I know in the realm of people with diabetes, there are so many conversations about when to calibrate how to calibrate how many calibrations to put in, should I change the number from this to this to make it closer to the actual to put into the system so that I don't confuse it. I mean, there's so many different things. My first recommendation is always go by what the system is telling you as allowable for a calibration and try that
Scott Benner 39:15
first. Right. Follow the advice from the company about how to handle it.
Jennifer Smith, CDE 39:19
Correct. Exactly. And then, you know, Bob on the corner who has his own proven strategy? You know, what, if you've tried the strategy, they don't seem to be working, maybe try Bob strategies, but I, I wouldn't necessarily rely on them. 100%
Scott Benner 39:35
working for you, you have a second over adhesive stuff. Sure. Okay. So some people are going to have adhesive allergies. And it's not crazy to say that everyone sort of while some of you are going to have significant adhesive allergies must be no big surprise. You have autoimmune issues and your body tends to overreact to things. So skin preparation, doctors, so it's tough, right? Because they're going to tell you to clean your skin The alcohol. Yes, and for some people may be a person with very oily skin that might be really important. But for some people who have more sensitive skin taking out those oils could lead to, you know, dry skin, that kind of stuff. We are more like light soap and water, pet dry people. We don't use alcohol to clean the sights. In that idea somewhere might be something for you. So if you're noticing your skin getting very dry, bumpy, scaly, I the first thing I would do is I'd get away from alcohol, if you're using it to see what happens, not a doctor not advice, etc, and so on. It's what worked well. For us. There are skin barriers. There are skin tag, Tara DERM. What's the other one IV?
Jennifer Smith, CDE 40:43
Well, there are a couple that help with stickiness. So if you're having a problem on the end of things not staying stuck, okay, there's some things that are patches for that, or perhaps IV prep, all those kinds of things that actually help at here. But then there are more patches, IV 3000. And those types of barriers that are hypoallergenic, they're typically clear, they come in multiple different sizes. And essentially, you would clean your skin with whatever method you're going to do, let it dry with that on the skin, creating a thin barrier. Upon which then you're going to apply the sensor you're gonna pop the sittin sensor on over so the sensor adhesive is not technically touching your skin, right.
Scott Benner 41:31
So you're just trying to create a barrier between you and that adhesive because some people, some people are never going to be bothered by it. Some people are terrible, they can't wear it, you feel horrible for them. Some people can't get it to stay on, some people can't get the tip come off. And you're gonna you're gonna, you're gonna hear people online like well, I don't know why they don't make it more like this or they're trying to make it down the middle. So everybody helps most people. And you might have to make some, some adjustments. hypo allergenic tapes, adhesives are a way to get around sensitive skin. There's these holders like some 3d printed like holders I've seen people use Yep.
Jennifer Smith, CDE 42:10
And that's actually for the people who really can't do an adhesive. So what happens is they'll put a dressing on, the adhesive will essentially not be on their skin. And in order to hold especially like the pad or in the infusion set, or even the sensor on the skin. That sort of 3d printed is almost like a it's like a cage that sits on top. Yeah. And then there's a band that goes around to actually hold that in place
Scott Benner 42:41
where you can use different adhesive that doesn't come on your device that maybe you can deal with. Yep, keep moving your sites, if you're having reactions is can be helpful. hydrocortisone creams and histamine, stuff like that. Like if it gets to that point for you. You know, there are ways to manage it. And for those of you who can't, I mean, I'd say if you absolutely can't figure it out, like if your skin just doesn't work then I think you got to look at ever since for the implantable CGM right because they have their transmitter is on a silicone based I think I'm saying that right silicone based adhesive, which I don't think causes much. dermatologist. dermatological. Is that dermatological? Is that right? issues. If not make up a word. A good
Jennifer Smith, CDE 43:27
word. A great works for me. Yeah, good.
Scott Benner 43:31
Okay, so anything we're not talking about here that you can think of anything we must. I think
Jennifer Smith, CDE 43:37
the only thing that I would say in the same line of thought that we're just talking about would be really make sure that after you remove any adhesive, whether it's a CGM or a pump soldering, you really clean that site. Well, they seal a lot of times just a basic like, clean over it with like, again, like an alcohol or something to kind of get the sticky stuff off, but you never really completely getting off all of that residue. And there are some really good residue removers there even some that are more like essential oil type, you know, or homeopathic that work really well that are just good for the skin. I also think keeping skin really, overall, people with diabetes can tend to have drier skin, and so making sure that you're overall really well moisturized as well. But does that sound
Scott Benner 44:31
weird? Either on the cocoa butter or whatever. Yeah, coconut
Jennifer Smith, CDE 44:35
oil actually. I mean, it's great for a million wonderful things and it is you know, it's a wonderful
Scott Benner 44:44
kid, you know, you can refinish leather products with coconut oil. I did not know that. It did it with an ottoman once it worked very well. Treat yourself like an ottoman Jenny is saying and moisturize your skin
Jennifer Smith, CDE 44:56
and moisturize your skin and especially those sites that get used and used and used, really make sure that they get nicely cleaned and hydrated. How about from
Scott Benner 45:06
your perspective, nutrition or vitamins that would help with that? Anything that pops the mind? That's an outside of the box question, but because I'll point out that hypothyroidism could lead to dry skin as well. So if you're under medicating your thyroid and you're experiencing dry skin, that would not be crazy if your TSH was if you're one of those people walking around with a four and a half TSH, your doctors like it's fine, which probably isn't you probably want to push it under 2.1. But like that could be a thing. But I mean, are there like when people take multivitamins? Are there foods that help with with skin? Health? Or am I just making that up? Um,
Jennifer Smith, CDE 45:48
well, I'm quite sure I'd have to go to my skin health kind of guide. But I mean, there are certainly things that are very good overall, even in the in terms of aging, which is not what we're really talking about, but it kind of goes right along with keeping your skin healthier, more stretchy and keeping things more elastic. Rather than getting paper thin kind of skin. There are definitely nutrients and food in terms of supplemental, I'm always wanting to save try to eat it in food as much as possible. Rather than pulling out a whole bunch of expensive stuff that you may not actually be in need of. Jenny,
Scott Benner 46:30
I asked our chat GPT overlords. They said that benefits of vitamin A produces cell production helps repair vitamin C boosts collagen production. Yep, vitamin E acts as an antioxidant. omega three fatty acids reduces inflammation keeps skin moisturize supports skin barriers, function. Zinc can add in skin repair and reduce reduction of inflammation. Bio 10 B seven supports healthy skin by improving the skin's hydration collagen, protein essential for repair. Vitamin D plays a role in skin cell growth and repair. So yeah, I mean, eat well. Always a good advice, but you know, all these things could be valuable for you.
Jennifer Smith, CDE 47:15
And interesting, a very valuable thing about all the rest of those is that they are highly recommended and people with diabetes anyway. Yeah.
Scott Benner 47:23
If you're taking care of yourself, you might be taking care of your skin by mistake already. Right. Cool. Yep. All right. Well, I want to thank you, I'm gonna let you go. But then I'm going to tell everybody to hang on for a second because I'm going to go over some things that I have in my notes that I'm not sure if we hit or not so fabulous. There'll be more right after this. Okay, thank you. Alright, guys, Jenny's gone she had to get going. But I put together so much like stuff to talk about in this episode that I just wanted to kind of roll through it very quickly. And make sure that it's all highlighted for you. So very, I'm gonna go through very fast. These are things you should be researching maybe on your own. Super simple stuff, right. Sensor insertion, clean the site, use proper placement. Rotate your sites, calibrations, like Jenny said, Follow the manufacturer's guidelines for calibrations, and try very hard only calibrate during stable glucose levels. Do your best to keep the sensor dry. I know you can be in and out of water with them. But you know, the better you keep them, maybe the better the adhesives going to stay, you know won't be moving around that could end up helping you stay on top of when the sensor expires, right? You want to know when it's going to shut off? Are you noticing janky readings and you're more towards the end? Maybe that's why take a look at maybe swapping it out a little sooner. If you don't know what's happening, all the company ask questions go online, find Facebook groups, go to the Juicebox Podcast Facebook group, ask other people who are users, you might get some great information from them. Skin Health hydration superduper important a balanced diet. Now just not just a balanced diet for your skin but a balanced diet so that your blood sugars aren't bouncing all over the place. You're monitoring your blood sugar with the CGM, which just works better. If your blood sugar is not super variable. You're always going to need adequate sleep. Keep your stress down, get mental health support. Remember that alcohol consumption moves your blood sugar around CGM is going to bounce around with it. Now you're a little loaded and the things jumping around might be harder to pay attention to. I'm not saying that alcohol changes its ability to work. I'm saying alcohol can have impacts on your blood sugar. And now you are trying to decide what you're seeing on your CGM when you're inebriated, and it's bouncing around a little more. Scrolling down super important. I know we went over it probably felt boring to you but understanding how interstitial fluid works, what it is and how the CGM is monitoring it really important especially for understanding lag time. And that's impact on what your readings might be versus your blood glucose meter. I can't suggest enough a quality blood glucose meter contour next.com/juicebox Great, great, accurate meters. There are other medications impacting your readings Jenny mentioned acetaminophen, also beta blockers could have an impact. Check into that with your doctor or online. So regular monitoring consistent medication use regular endocrinology visits. Some other stuff to keep in mind the Dexcom G seven has a shorter warmup time of just 30 minutes, you can plan your sensor changes to give yourself some marinating time very helpful. Between me and you. I don't care what the company says about never needing a calibration. You need your meter, you should be checking your blood sugar and seeing if there are drastic differences. Just so you know. Okay. And then you can make a decision about calibrating but you want to make sure that you understand what's going on. That's libre three Dexcom all of them adhesive skin prep barrier methods, hypoallergenic adhesives, rotating your sights, making sure you get all the adhesive off, and managing reactions if you have them. Finding a health care provider to help you with this may be necessary. If you're having significant allergies to adhesive. You can consult a dermatologist, look for barrier creams, non adhesive alternatives, medical grade silicone tapes, all these things might be possible. This would be a time to get online find other people who have this issue and see what's working for them. That's it.
Did you know if just one person in your family has type one diabetes, you're up to 15 times more likely to get it to screen it like you mean it. One blood test can spot type one diabetes early tap now talk to a doctor or visit screened for type one.com. For more info. The conversation you just enjoyed was sponsored by Omni pod five. You want to get an omni pod five you can you wanted to make me happy, do it with my link, Omni pod.com/juice box. I'd like to thank ag one for sponsoring this episode of The Juicebox Podcast and remind you that with your first order, you're going to get a free welcome kit, five free travel packs and a year supply of vitamin D. That's at AG one.com/juicebox. Are you starting to see patterns but you can't quite make sense of them. You're like, Oh, if I Bolus here this happens, but I don't know what to do. Should I put in a little less a little more? If you're starting to have those thoughts? You're starting to think this isn't going the way the doctor said it would I think I see something here but I can't be sure. Once you're having those thoughts. You're ready for the diabetes Pro Tip series from the Juicebox Podcast. It begins at episode 1000. You can also find that at juicebox podcast.com up in the menu and you can find a list in the private Facebook group. Just check right under the feature tab at the top it'll show you lists of a ton of stuff including the Pro Tip series, which runs from Episode 1000 to 1025. If you're not already subscribed or following in your favorite audio app, please take the time now to do that. It really helps the show and get those automatic downloads set up so you never miss an episode. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast. The episode you just heard was professionally edited by wrong way recording. Wrong way recording.com
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#1270 Weekly News 7/29/24
For the week of July 29, 20024
You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Spotify - Amazon Music - Google Play/Android - iHeart Radio - Radio Public, Amazon Alexa or wherever they get audio.
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DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.
Scott Benner 0:00
OmniPod. Hello friends and welcome to Episode 1270 of the juice well. Did you hear them? 1270 of the juicebox Podcast.
Today I'm going to go over the news stories around diabetes that jumped out at me for the week of July, 29 2004 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. Don't forget, if you use my link drink AG, one.com/juicebox, you'll get a free year supply of vitamin D and five free travel packs with your first order. And if you go to cozyearth.com and use the offer code juicebox to check out, you're going to save 40% off of your entire order. The juicebox podcast is full of so many series that you want and need after dark, ask Scott and Jenny algorithm pumping bold beginnings, defining diabetes, defining thyroid, the diabetes Pro Tip series for type one, the diabetes variables series, mental wellness, type two diabetes pro tip, how we eat? Oh, my goodness, there so much at juicebox podcast.com head up into that menu and pick around. And if you're in the private Facebook group, just go to the feature tab for lists upon lists of all the series. Always free. Always helpful. What's up? Everyone? This is the news that caught my eye for the week of July, 29 2024 let's get started. So there's a recent trial investigating the use of ozempic to manage kidney disease in individuals with type one diabetes. The study aims to determine if ozempic can reduce insulin needs and improve blood glucose control in people with in people newly diagnosed with type one diabetes. I can only talk from my perspective here with my daughter, but I don't think we need to study for this one. The answer is yes. Study Details participants and dosage. The trial involved 10 adults aged 21 to 39 who started taking semaglutide With three months of within three months of their diagnosis, they began with a weekly dose of point 125, milligrams, which was gradually increased to a maximum of point five per week. The mealtime insulin doses were reduced based on continuous glucose monitoring data, key findings, it says, After three months, participants no longer required mealtime insulin. And after six months, seven out of 10 participants no longer needed basal insulin. Additionally, there was a significant improvement in glycemic control, with a 1c levels dropping from an average of 11.7 at diagnosis to 5.9 at the six month mark, and 5.7 in one year, most participants achieved a time and range of 89% some participants experienced mild hypoglycemia. Sounds like they gave them too much insulin while the semiclutide dose was being increased, but no severe side effects like diabetic ketoacidosis were reported once the dose stabilized. I'm just going to jump in here and say all the people who came to me and said, You can't share stories of people who are using less insulin on glps, because type ones will get confused and think they don't need insulin. First of all, I don't think type ones are easily confused like that. I still know you need insulin if you have type one diabetes, but to all you people who mercilessly, mercilessly, mercifully, mercifullessly Ram your hot poker up my ass for spreading news that is absolutely legitimate. Let me just go say to you now yourself. In addition to these findings, a separate trial starting in March 2020, will investigate the use of karadia for preventing kidney disease progression, adults with type one. This study, known as the fine one trial, will enroll 2220 participants, and compare the effects of finaroni. I mean, how do they F, I N, E, R, E, N, O N, E, against the placebo. Over six months, if successful, finaron could become the first new medication for managing kidney disease in type ones in 30 years. That's very cool. I got this information from a number of different places, but one of them I really enjoy is diatribe. The rest was kind of cold over the internet and I asked, of course, our chatgpt overlords, the carodemia trial for preventing kidney disease is actually accepting participants. It must be 18 years old, diagnosed with type one diabetes, have an A 1c of less than 10% diagnosed with chronic kidney disease, meeting specific criteria for estimated Glomar, really. I mean, why do they these words? Fill? Rate, EGFR and urinary albumin. I know this one, albumin, creatine ratio, UA, CR, I don't talk so good. Sometimes must be on a stable dose of an ACE inhibitor or an angiotension receptor broker for CKD exclusions. Individuals with type two or those taking SGL t2 inhibitors or GLP one receptor agonist, they're not eligible for more information or express interest in the participant. You can contact the study directly, 888-842-2937, and to add some clarity to what I was poo pooing a minute ago. I've had two conversations so far with type ones who have used the GLP and their insulin needs have significantly decreased. Episode 1136 is called 15 year old type one using GLP. You should check it out. Episode 1230 is called off insulin with Manjaro. That's an adult with type one. Listen, does he have Lada? Probably, but he's not using insulin right now. Go listen to his story. Jenny and I talk about glps as part of the diabetes pro tip for type two series. That's episode 885, actually, that whole series is terrific if you have type two diabetes, or know somebody who does or even has pre diabetes. It's great for them to know what's about to happen to them, so that they can tackle it well. But in the end, today's story is about kidney disease and looking at glps and how it might help. It's a big deal. I hope you check it out. Looks like I've received an email from OmniPod today, most of you have probably received it as well. I'm just going to read it to you. Hey, Arden, you insert your name there. We're excited to share the latest information on the OmniPod five integration with Dexcom g7 launch and limited market release of OmniPod five app for iPhone with Dexcom g6 sounds like things are moving. OmniPod five, Dexcom g7 you will receive a free over the air update to complete on your controller starting July 30. That's today. OmniPod five app version 3.0, point one will add the option to pair your system with Dexcom g7 you can choose to install the update immediately, or delay it until a time that is convenient to you. It's important to know that the software update requires 15% battery level and should only take a few minutes, depending on the strength of your WiFi connection. During the update, you will not be able to navigate with the OmniPod five app, including the ability to bolus Bazel insulin will continue to be delivered in the background. There's a link here for where you can find out more, but I am not going to be giving you that link so you can do some Googling. Let's see here there's more. The new pod. Oh, the new pods compatible with Dexcom, g6 slash g7 may be at your current pharmacy as early as August, with full availability expected in the fall continue using your Dexcom g6 supplies until you see this is going to be written right on the box, the words compatible with Dexcom g7 right in the top right corner of the face of the box. It'll say that you don't need a new pod prescription. Oh, this is nice, but a new Dexcom g7 CGM prescription will be required if you decide to change your CGM, which I think makes sense. If you have g6 and you want to go to g7 you're going to need a script to go to the g7 that's got nothing to do with OmniPod now iPhone control with Dexcom g6 the limited market release of OmniPod five app for iPhone with Dexcom g6 is underway. The first version of the app will integrate with the Dexcom g6 only if you prefer. And so ends the part of the show where Scott reads you his email. This last thing here. I mean, it's not news, but I keep seeing people talking about it in the Facebook group, so I thought I'd go over it with you real quickly. You can get a free lifetime national park pass if you have diabetes. I don't know if you knew this or not. Eligibility US citizens or permanent residents with diabetes qualify as it is considered a disability by the ADA. The pass, called an Access Pass, grants free entry to over 2000 federal recreation sites. Apply in person for free, online for $10 or by mail for $10 you have to provide evidence, a physician statement or document from federal or state agencies are needed. I don't love reading URLs, but www.nps.gov/sub, s.gov/subjects/accessibility/interagency-access-pass.htm
There you go. Have fun with that. One tickets for the 2025 juice crews are limited. I'm not just saying that they actually are. Limited. We have a certain window to sell them in, and then that's it. Juicebox podcast.com, scroll down to the juice cruise banner. Click on it. Find a cabin that works for you and register right now. You are absolutely limited by time on this one, I'm so sorry to say that. It sounds pushy, but it's the absolute truth. Juice cruise 2025 I hope to see you there. We're gonna get a tan, talk about diabetes and meet a ton of great people who are living with diabetes. It's kind of gonna be like floating diabetes camp, but you won't have to sleep in a log cabin. You'll get a tan. And it's not just for adults or kids. It's for everybody. 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.
If you or a loved one was just diagnosed with type one diabetes, and you're looking for some fresh perspective. The bold beginning series from the juicebox podcast is a terrific place to start. That series is with myself and Jenny Smith. Jenny is a CD CES, a registered dietitian and a type one for over 35 years, and in the bowl beginning series, Jenny and I are going to answer the questions that most people have after a type one diabetes diagnosis. The series begins at episode 698, in your podcast player, or you can go to juicebox podcast.com and click on bold beginnings in the menu. You.
Please support the sponsors
The Juicebox Podcast is a free show, but if you'd like to support the podcast directly, you can make a gift here. Recent donations were used to pay for podcast hosting fees. Thank you to all who have sent 5, 10 and 20 dollars!