#1329 Unpixelated

Jon is the creator of the Sugar Pixel. 

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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
We are all together again friends for this next episode of The juicebox podcast.

Some of you may know John as the creator of the sugarpixel, and some of you might know him as John from episode 9081 way or the other, he's returning to have another titillating conversation with me about type one diabetes. Nothing you hear on the juicebox podcast should be considered advice medical or otherwise, always consult a physician before making any changes to your healthcare plan. If you are the caregiver of someone with type one diabetes, or have type one yourself, please go to T 1d exchange.org/juice, box and complete the survey. This should take you about 10 minutes, and will really help type one diabetes research. You can help right from your house at T 1d exchange.org/juice, box. When you place your first order for ag one with my link, you'll get five free travel packs and a free year supply of vitamin D drink, ag one.com/juice box. Don't forget to save 40% off of your entire order at cozy earth.com All you have to do is use the offer code juicebox at checkout. That's juicebox at checkout to save 40% at cozy earth.com

this episode of The juicebox podcast is sponsored by us Med, usmed.com/juice box, or call 888-721-1514, 87211514, get your supplies the same way we do from us med. This show is sponsored today by the glucagon that my daughter carries, gvoke hypopen. Find out more at gvoke glucagon.com, forward slash juice box.

Jon Fawcett 1:59
Hi, thanks for having me, Scott, this is John Fawcett. I'm the creator of sugarpixel, and then also loop follow app that many are using, and even the loop patches that a lot of loopers are using. So thanks for having me on the

Scott Benner 2:12
show. And John, you've been on the show before, right?

Jon Fawcett 2:15
Yes, I have. We talked about my daughter, Lily's change from being a looper for four to five years over to the OmniPod five. That's

Scott Benner 2:25
right, and your episode is smartly called from loop to OmniPod five. Episode 908. These people find you compelling and want to hear more. Thank you. Yeah, please. I enjoy talking to you very much. Now today, my my schedule's a little tighter, so I don't think we're gonna be able to go on and on like we did last time, John, I made a I'm going to tell you about it, because it's got to go somewhere. I don't know what happened to me, but a few weeks ago, I was like, I'm so tired of waiting for some of these other companies to contact me. Like, I get the idea that, like, OmniPod, for example, has been sponsoring the podcast since, like, you know, the very beginning. But I, I've always been baffled that, you know, tandem has never reached out. And been like, can we have somebody on your show? And I don't know why that is. And so I was like, All right, like, I'm just gonna put the call out. So I put up a post that was just like, hey, listen, if you have any kind of tech, or if you're helping people with diabetes or whatever, you can come on the show and tell people about it like, you know, contact me. Well, I think I've got an insulin coming, another device that reached out, which I thought was great, but mainly it was just like, more like entrepreneurs and people like you when I'm thrilled for you know what I mean. But anyway, so the last time you were on, we didn't really talk about the business of what you do very much. So tell people, give them like, a quick catch up. Like, how do you find yourself in this position?

Jon Fawcett 3:49
Yeah, so Lily was diagnosed when she was 12. She's 18 now, within weeks of her diagnosis, I had night scout up and running. We were using the spike gap at the time to get better alerts. And so I just dove in head first with all of the Hey, what's out there? What can I implement on our, you know, in our house, to make things easier for us managing this new diagnosis? So we were even tracking rudimentary, rudimentary tracking. Io be and see would be using night scouts built in decay just from manually entering that so we were using night Scout instead of that paper log book that they sent you home from the hospital with. And at the time, I also owned a company that made smartphone accessories, so I had all kinds of tech and product background, and at some point it just hit me that we're still waking her up for alerts overnight, and this was when she was 16, so she would sometimes wake up, but Mom and I still have. And our alerts set, and our alerts were going off all the time to get up and make sure she would have low carbs or take a correction for a high and I realized we're potentially only two years away from her moving out on her own, living in a dorm room, first time on her own, anything like that. Yeah, and I needed to solve the ability for her to wake up on her own, her alerts every single time. So that's how sugarpixel got started. I used my background in designing and manufacturing tech products to basically create a better alert system for her Dexcom, and it has so so a couple things that we added to it is the audio alerts peak around 105 decibels, so it's drastically louder than your alerts off the Dexcom app. But it also randomly creates the audio as it plays in real time. So there's a lot of studies. It's called Brain habituation. Clinically, we call it alert fatigue, where your brain hears the same sound repeatedly and then just literally starts to ignore it and you it just basically won't wake you up anymore because your brain has heard the sound too often. So we implemented that. And then we also have haptic alerts. So there's a vibration talk that you can put underneath your pillow to give vibration alerts also. And sort of like we're trying to combine as many things as possible to ensure that you're going to wake up to your alerts every single time reliably. So that's sort of the high level of what sugarpixel is and how I created it.

Scott Benner 6:45
That's amazing for people who may not know that you can, you know, like, how could this blaring alarm from your phone go off and it not wake you up? I will tell this brief story. I, as I've highlighted on the podcast, number of times, grew up very broke, and we lived in this place that was the front door was 12 steps from the sidewalk that butted up against a five lane highway. All right, so prime real estate, John, everybody was clamoring to be there, trucks like semis all day long, cars all. It's one I was literally 75 yards away from one of the top 10 most deadliest intersections in Pennsylvania when I grew up. Okay, that literally, I'm telling you. There was never not traffic moving, but every once in a while, that would go, and it would come and everything. But you lived there for a while, the trucks would go by, the building would shake. But I met my wife, and I was dating her, and she came over one time, and we were all sitting sort of in the living room watching television, and it was later at night, so the traffic had died down, but then a truck came cruising by, and the house shakes and does the whole thing, and the windows are rattling and everything. And she literally stands up off the sofa, like, what is happening? And I looked and my rest of my family, we didn't know what she was talking about. We had no idea what she was talking about. We're like, are you okay? What's wrong? She's like, why is the house shaking? What's that noise? And we're like, oh, that's a truck. Like, we never would have heard it. So I take your point. And you know, from my kid having diabetes, I've slept through an alarm or two, so yeah, yeah,

Jon Fawcett 8:32
not even just audio that your brain does that with. It's any stimulus. So a lot of people feel this is like phantom vibrations from their phone in their pocket where the phone didn't go off. It's because they're just so used to feeling that same vibration that it's tricking them. So even with the the vibration just it randomizes the vibration pattern, because your brain can get used to even the haptic alerts or the house shaking, or just about anything that it's a constant, repeated

Scott Benner 9:03
stimulus, that's amazing. And so you just have, like, I don't want to call it an algorithm, because everybody says everything's an algorithm, but it just randomly. It just randomly goes through and and makes changes to the vibration and to the sound, into the pitch, to the bot, like, the whole thing. If you take insulin or sofanylurias, you are at risk for your blood sugar going too low. You need a safety net when it matters most, be ready with G vo hypo pen. My daughter carries G vo hypo pen everywhere she goes, because it's a ready to use rescue pen for treating very low blood sugar in people with diabetes, ages two and above that, I trust low blood sugar. Emergencies can happen unexpectedly and they demand quick action. Luckily, jivo kypopen can be administered in two simple steps, even by yourself in certain situations. Show those around you where you store GEVO khypoped. How to use it, they need to know how to use GVO kypopen before an emergency situation happens. Learn more about why GEVO kypo Pen is in Arden's diabetes toolkit at gvoke, glucagon.com/juicebox, gvoke shouldn't be used if you have a tumor in the gland on the top of your kidneys, called a pheochromocytoma, or if you have a tumor in your pancreas called an insulinoma, visit gvoke, glucagon.com/risk, for safety information. I don't know how you guys order your diabetes supplies, like CGMS, pumps and testing equipment, but at our house, we use us Med, and I'm gonna walk you through the entire process. Right now, I'm looking at the email from us med. It says it's time to refill your prescription, dear Arden, please click the button below to place your next order. Then you click the button that was it. Two days later, I got this email, thank you for your order from us. Med, we wanted to let you know that your order and it gives you an order number was shipped via UPS ground. You can track your package at any time using the link below, and then there was a link, and then it showed up at our house. Now I'm going to walk you through the entire chain of events. On the 29th which was a Saturday, I clicked on the email. On that Monday, the first I got an email that said the order had been sent four days later on the fifth the package arrived. If you can do it easier than that, you go get it. But if you can't, us, med.com/juice, box or call 888-721-1514, get started today with us. Med, get your diabetes supplies the same way we do.

Jon Fawcett 11:45
Yeah, every time. So sugar pixel runs on a millisecond loop, basically as it's doing the alerts, and every time it hits that, it says, Okay, pick a new tone, for instance, a new pitch for the audio and pick a new duration. And obviously we have some top and bottom parameters that it can choose from, but it's, it's sort of like saying, every time it loops, pick a random number from one to 10,000 okay, and you're never, you know, you're never going to get that same number, like same pattern of numbers, sequences matching in any repetition. That's

Scott Benner 12:26
pretty cool. We've done two things already. We've just said night scout out loud, as if somebody understands what that is. And so let's start with that. What do you think of night Scout as being like, I'm, people know I'm I'm tech savvy, but I don't understand back end stuff. So I know that night scout is on my phone. I know that Arden has a night Scout URL. I can tell you that Arden's vision AI, which is not a thing I've told people about, yet, runs off of her night Scout link. And yet, I don't honestly know what night scout is.

Jon Fawcett 12:58
Yeah, so night scout is, there's two pieces to it. One is just a database behind the scenes, running on a server somewhere. And when I say database, you can think of just like an Excel file to greatly simplify it. And this Excel file has Your blood glucose reading every five minutes that it's grabbing from dexcomber libre or wherever. Loop even uploading it and then it has your carb entries, your bolus entries, your basal changes, depending on what system you're using. Night scouts flexible from the database back inside to utilize all kinds of different capabilities. So for the DI wires, using a loop, it can grab all the data possible to the very simplest form that I mentioned. We were using it just with MDI. We were just manually going to the night Scout web page for my daughter and clicking a form and typing in 30 carbs and hitting submit, and it would save that. So it's not really on that end much different than just an Excel file sitting in the cloud that has all of the data and then the other half of it is a front front end, and the front end can vary drastically. So night Scout, in and of itself, like the open source project has a web based front end, so you just open the website link that's for your night Scout site, and it shows you, sort of like looking at your Dexcom graph or the follow after libre graph, but it has a bunch of other data with it, such as little dots for your carbs and dots for your boluses. But the ecosystem with night Scout has gotten pretty large to where you really don't even necessarily need to deal with the front end anymore, the website running and only looking at it in a browser most of the apps out there and download the night Scout data and display. Them in a different app. You can display them. You can sync your sugar pixel up tonight. Scout, to display it. You can sync the loop follow app that I mentioned earlier, that I wrote up tonight. Scout, not sure about like the sweet dreams app. Guru, I know you can sync up tonight. Scout, so there's this big ecosystem of all kinds of things that can sort of plug in and utilize all this data. That's your data sitting in the cloud for your back and night Scout site.

Scott Benner 15:33
So you just did a thing where you just mentioned a bunch of other like, I'm assuming, like third party apps or that kind of stuff. They come and they go. I don't mean the ones you just said, or anything like that. I mean, over the years, I've seen people say, I've have, oh, my God, such a good idea, right? I'm gonna do this. And some stuff takes off, and some stuff doesn't. The apps, especially, they come, they go, they come, they go. It's constant. You came and you stuck. So that's my next thing. Is, like, we say sugar pixel, sugar people, again, they're like, a sugar pixel. I know you explained what it does, but like, visually, it's this little, let me see, is it about six inches long?

Jon Fawcett 16:11
It's, yeah, it's six inches long, two inches tall and two inches deep. It's about the size of an alarm clock.

Scott Benner 16:18
Okay, yeah. And it's time. It's smaller than that, I think, but, but, and then there's a screen on the front, and it just tell me everything that that screen shows me.

Jon Fawcett 16:28
So we have 25 or so different screen display options to choose from. So I won't get into all of them, but

Scott Benner 16:38
you can choose how and

Jon Fawcett 16:42
what you want to display on that the default things are going to be your blood glucose reading, the trend arrow, and then your delta, which is how much your blood sugar change between the last two readings. So did it drop by five? It would list the negative five, or did it raise by 10, it would list plus 10. But we have all kinds of options for you. Just don't want your blood sugar shown to the world sitting on your kitchen or in your dorm room. You can just display it as a clock, so it'll show the current time. And the clock is color coded, so green means you're in range, you know, red means you're urgent, low, things like that. So the time, the color of the clock just changes all the way through to we have full emoji and icon sets. So you can we have a lot of parents that that's the one they use. It shows a picture on the left, and then your blood glucose and the trend arrow, so if they have toddlers that might not even going to read, they can start associating a picture with how they feel, and the parent can still look and see the exact BG value. And we actually just had a parent email us a few weeks ago with a story where she said the pictures are absolutely fabulous because her three year old, I think, came up and said, Mommy, it shows a thunderstorm. That means I need to wait an extra 20 minutes before I eat. So the kids started associating the thunderstorm with lightning. Is one of the icons that we show for a high blood glucose value. Now

Scott Benner 18:21
here's the downside, John, that kid can't eat it's raining. Did you know that? They haven't figured it out yet, but whenever it's cloudy, she's not hungry. That's amazing how old I think the kid

Jon Fawcett 18:36
was three, and it was just a really interesting story. And we had thought of that, but that was sort of the first parent that reached out and said, you know, my kid learned to do this on his own just by, you know, the parent child communication of, no, you should wait to eat. And then the child associated that with the pictures that they were seeing on their sugarpixel,

Scott Benner 18:58
yeah. Terrible. Postscript, they eventually moved to Seattle, and he starves to death. So when you hear that story, can you tell me on a personal level, like, forget the business for a second. What's your reaction to that when you hear that? Because I have experiences like that, and I'm wondering how they strike you,

Unknown Speaker 19:16
well, and how it strikes

Jon Fawcett 19:18
me is, that's why I'm still here doing this. And he sort of back to your point about the app, you know, come and go and things like that. So I came out of consumer technology as the company that I was running, and that is, I got to see the worst parts of everything from corporate greed with competitors down to just absolute fuming customer support requests to us. So you flip the script here to making a product that's helping people, and that's quite frankly, the reason I'm still doing it is because. Is of how many times people just send us a note and say, oh my gosh, this, you know, my kid is now learning how to understand his blood sugars. Or last night, this saved my life, because my phone alert didn't go off, but this alert did go off, so all of those, that's the reason I do this, and that's the reason, you know, every morning, I get up and I basically

Scott Benner 20:23
search the 200

Jon Fawcett 20:27
Facebook type one groups that I'm part of to see if there's anybody that's having a problem or needs help with setup, or, you know, has a question

Scott Benner 20:35
about it, because

Jon Fawcett 20:38
it's, it's so gratifying just to be able to know you're doing something that's truly making a difference in 1000s of people's lives. John,

Scott Benner 20:47
that's customer service. You don't wait for them to come to you. You go find them. I mean, I do

Unknown Speaker 20:52
it, sort of a weird thing. No, I

Scott Benner 20:53
do it. I know what you're talking about. Yeah,

Jon Fawcett 20:56
I know you do it. If you look at people having Dexcom problems and you know, or pump questions. None of the major companies seem to do that, but you're a great example too. Is you hopped up on there all the time when there's stuff that needs addressed from your end,

Scott Benner 21:15
I answered a woman's question last night at 2:48am I was I was asleep, and I got a text from Arden that said, I need help. I'm working on a finals project, and I don't understand something. I said, Oh, I'll get out of bed. So I got out of bed, I came into my office, and I FaceTimed her, and I helped her work through it, which reminds me, by the way, in two minutes, I have to wake her up, but that'll be the end of the story. And when I got back in bed, I just, I was awake, and I opened my phone up, and I went to my mentions, and I just went through and answered people's questions about diabetes stuff for a couple minutes. And, you know, I take your point about the companies not doing it. They can't, like, they're they're restricted by the FDA, they can't give medical advice. And so no matter, like, you know, when it's you or it's me, I'm just a guy, I get to go on and say, hey, look, you know, here's what I would do. But you know, I'm not a doctor, like I'm nobody's, nobody's counting on me to be right. As soon as you put a company in that position, they, they have, they'd have to be correct, and everything would have to go through legal. And it just they, it's not a it's such a it would be such a valuable thing. They'd have the most popular Facebook group in the world. But there's not a thing they can do. So yeah, you know well,

Jon Fawcett 22:30
and there would be ways I think they could do because there's even times where, no matter how much we ask people to contact us directly for customer support. We can't stop people from posting to the Facebook groups, so that's the reason I do it, is I don't want someone who maybe they forgot to click the help button and contact us through there to the post to Facebook. I don't want them getting upset and not having a sugar pixel work because of a setting that needed changed or something. So that's why we do it. But there are times where I even have to say, Please, email supported custom type one.com because I'm not about to ask them to post their you know, Wi Fi information on juicebox podcast, Facebook group, you know, things like that, where we have to even

Scott Benner 23:22
take caution with

Jon Fawcett 23:24
confidential information that might be on the sugar pixel that we need to see in order to assist them so we we still direct them over

Scott Benner 23:33
you have this little ritual where you go around on on Facebook. Let me ask you a sincere question that you please feel free to answer me honestly about, Do I have the best diabetes Facebook group? Yes. Is it the most active? Yes, yeah. Okay, so I don't look at the other ones,

Jon Fawcett 23:53
so you definitely from what, from what I see, because I I am probably on at least three or four dozen,

Scott Benner 24:03
oh, my god, horrible. Globally

Jon Fawcett 24:05
there, there's, we're in ones that are, you know, in a Facebook group for Norway where I can't even read any posts on it. I have to click through to translate. Okay, try and catch, you know, they'll still write sugarpixel in in English. So I'm talking worldwide. We're on these groups, but by and large, we see the absolute most posts from juicebox group. And I think a big reason for that just sort of as not the guy who runs it like you are, that I don't know if you get the same feeling as the guy who's overseeing it is your users seem to be very, very passionate, compared to some of the other groups like they're not only passionate about sharing what they learn, but about helping people and knowing. That this is a safe space to come to, where I know I'm going to get the help I need. These questions, where there's some groups, where it's just it gets out of hand pretty quickly with, you know, very unhelpful comments. I smacked

Scott Benner 25:14
somebody on the hand the other day digitally.

Jon Fawcett 25:18
Yeah, I saw that.

Scott Benner 25:21
Oh, I did it again since then. Actually, here, I'll tell you this, because it'll delight her when she hears it. Isabelle helps me run the Facebook group. And Isabelle is a lovely woman who lives in Canada, who has type one diabetes. She is maybe the kindest, like so good at, you know, seeing the things to point out to me. You know what I mean, like, check at this. Look at that. You're going to, you're going to want to see this. And she's so kind to everybody, but there's like, three people in the group, if I'm being honest, she really doesn't like and sometimes she'll be like, this one's at it again. And I'm like, okay, and I'll look and I'll be like, you just don't like them. And she's like, that's not why. And I read, and she's right, they're doing something they shouldn't be doing. But yesterday, one of those people kind of like, went off half cocked, and I stepped in, and then I sent a note, and I said, Hey, I got you a present. What's the present? I said, I told this person to, you know, you know, be a little kinder, or something like that. And she's like, Oh, I feel so good about that. And I was like, I know, but generally speaking, the group is fantastic, like, and I even think, like some of the agitatoring people, I think it's just what it is. But I do take your point about the veracity that people are helpful with and how knowledgeable they are too. And, I mean, I think they're knowledgeable from listening to the podcast, and then they come back in to help other people, which is beautiful. And then what you don't see is all the lurking, like they're, yeah, oh my god, 90. It might be 95% of people don't say a word, but they're there, and I can see the data that supports that. They're there and they're looking it's really interesting how it all works. You have a couple, like, a little list of things we could talk about here. This one seems like it'll be fun to dive into CGM outages. I'm assuming, when your sugar pixel works with Dexcom, does it also work with libre? Yes. So you

Jon Fawcett 27:20
can directly connect to your g6 or g7 account, and to be clear right here, because we get this question a lot, is sugar pixel downloads from the cloud servers in the same way that the follow up, like the Dexcom follow app or the libre linkup app work, so it doesn't directly connect by Bluetooth to the CGM or even to the phone running the CGM app. I can be in Ohio, and my daughter could be in New Jersey, and I would still have readings on the sugar pixel sitting here, as long as her phone has readings with the main CGM app. So with that said, Dexcom, G 67 libre three and the updated version of libre two. And this is just one of the things that drives me crazy. Is libre has released multiple versions of the libre two, and now they even have the two plus, which causes a little more confusion. So the original libre two, you had to manually scan the sensor with your phone to see the value on in the app on your phone, they updated that in numerous countries around the world. So like UK, now it's still called libre two, but it essentially runs like the libre three, where that connections in real, real time, without you having to manually scan the sensor. So right now, we work with both of those. I like to sort of tell people, if you don't have to manually scan the sensor to see the value in the libre app, sugar pixel works, okay, but some exciting news were in beta testing for sugar pixel functionality for the original libre version, version two that requires manual scans, so it'll run a little different, but I'm hoping within the next two months, we'll have that available where it will actually trigger alerts off of the libre to where those alerts send out to the libre app and the link up app, even if there's no BG value, it's like the sensor says, Hey, I know I'm low, send that Bluetooth ping to the phone to trigger an alert. So we're about to release that for beta testing right now, and then also in sync with night scout and glue Global Connect, which is sort of like glueru runs their own night Scout backend system that can run through their own app, and we can sync with that too. It's

Scott Benner 29:50
ponderous to me that the companies don't just do this themselves, by the way, like, I mean, I'm glad everybody else does, but you're like glueru, night scout. So this one that, like, just do it yourself. My God. Like, look how valuable it is. People would like talk about adding functionality that people would be thrilled about. I haven't talked a lot about this in the podcast yet, and I will at some point, but I'm involved with a company called Vision AI, and so I'm using the product right now, going to be talking more about it moving forward, but I'm hooked to Arden's account, right? So I just went into a prompt and said, Show me my last five boluses. And it said, bolus dose one may 13, gives the time and the date point six, units two time and date point one, units three time and date point two, units, like, just like that. I said, What's my current BG? Your current BG is 98 the trend is stable, like, stuff like that. I asked the question. It can answer like, what do you think my blood sugar's gonna be in 30 minutes? And it doesn't know. But it said, predicting future glucose levels accurately requires consideration various factors. Like, it gives you, like, you know, a great like, synopsis of your question, since your glucose trend is stable at 98 without additional influence factors like recent meals or exercise, it is likely that your glucose levels will remain relatively stable in the short term, and assuming no new variable, that's hook the Arden's night Scout, yeah, it's insane. If you ask it another medical question, it takes into account that you have diabetes. It's just like, where are we going, you know what I mean, like, because wherever we're going, John, I like it. I'm a fan of all this. I

Jon Fawcett 31:26
would like I see this long term picture off of AI stuff that I would like to see into the actual algorithms, yeah, because I think it can get there. I think we've got a long way to get there, because AI still not perfect, it's sure, based on data in but ultimately, if, if we could have a system, let's just, for example, use OmniPod five. Since my daughter's on that, I was thinking about this the other day so she had, she had a cold last week, and her insulin needs just work through the roof. Well, the one concern with OmniPod five is, do you change to the next pod and then she's having a lot of lows after she's passed her cold, because TDI was like, double AI could easily solve that. Literally, all you have to do is tell it you had a cold, and it can even look through and try to determine an appropriate adjustment of TDI. One of the things I did manually years ago with loop is I pulled in, like, a month's worth of data and made a calculation that would average out, not really average, but more the median of what her blood glucose was throughout the day and after meals and stuff like that, and then determine, based on her total daily insulin, How much to adjust carb ratios and basal spy. It's really not that difficult as a human to process just massive amounts of data like that, but for a machine, I don't think we're there yet with naturally think through all of these variables of sickness or stress or extra activity or anything like that.

Scott Benner 33:20
Arden's using Iaps, and we have the functionality on where it's, I don't know what they call it in the app, but it's like a dynamic insulin on board dynamic basal like, it makes adjustments to those like, and it's still, I hear what you're saying, because I still see the same thing, like coming out of her period, for example, or, you know, a time when she needs more insulin, like, you're almost like assured she's going to get a little too low once those that insulin need changes. But, man, it adapts very quickly. I

Jon Fawcett 33:50
actually just had a discussion with someone this morning about dynamic ISF. I'm torn on it. It's a

Scott Benner 33:58
it's, it's solving a

Jon Fawcett 34:01
different problem, in my opinion. So it's it while it works, and you can solve things with that. It can also introduce, introduce more risk, if you're not for someone that may not know exactly you know what the settings are doing. And it's it sort of comes back to, like our last episode, we, I think we talked a lot about fat and protein, and I know you have other episodes about that. Is so it's dynamic. ISF to me,

Scott Benner 34:31
there's not a lot of science

Jon Fawcett 34:35
that I've seen, and if you have some, I'd love to read it, or if you have had other people on talk about it, but there hasn't. I haven't seen a lot of science to me that has sort of shown that when blood glucose is high, there's more resistance, just period in and of itself, where everything I've seen sort of falls back on the the other things, the. The hormonal changes for monthly cycles, fat, protein, taking four to eight hours, those types of things, and it's always a tricky situation on you can solve that with a TEP basal. You can solve that with dynamic ISF. You solve that with dosing for whatever underlying causes. So I think there has to be something new out there on a way to solve that. I just don't I don't think we're there yet. I don't think dynamic ISF, is it? I don't think temp basals are it. I don't think having to manually go in and dose, because even then, it's just they're all guesses in many ways. Well, what

Scott Benner 35:46
do you see as the answer? AI to put something else in charge. Be like, Look, you figure it out. Because you know, even like, considering fat as an example is not something people do, you know, and even if you were to do it now, you're asking them to know the fat content of a cheeseburger and french fries and like, you know, I'm wondering if these other fixes are while maybe not at the root of the problem. Does it not maybe? Does it just not matter, because it's doing what it needs to do, well and

Jon Fawcett 36:24
to some degree. But I mentioned there's more risks, and ultimately it comes down to the greatest low blood sugar risk is from a bolus, no matter what. So if you're so dynamic, ISF is essentially just adding automated bolusing when you're high dosing, trying to dose and time fatter protein doses. That's adding a bolus. And there's just so many variables that the risk to me, that I see with all of those is that

Scott Benner 37:01
you misjudged the

Jon Fawcett 37:03
reason for the high. So if it, if it is fat and protein, you're going to work out dynamic ISF is going to work out, an extra dose is going to work out, if it's a timing issue, and I know that, you know, a lot of people post that chart, but I don't know if you made it or someone else, but I see it all the time on juicebox of sort of, how do you determine, is it timing or ratio, or what of the dose based on what the graph does after you eat? So if it was a timing issue, you could already have way too much on board, but you hit 250, or 300 because the bolus timing was off from the carb time, and

Scott Benner 37:48
it goes again, yeah, that dynamic

Jon Fawcett 37:50
ISF could cause a major low, or doing an extra fat protein dose too soon could cause an extra low. So that's sort of my concern from both of those so

Scott Benner 38:02
far, what I'm seeing with Arden while she's at college, because her her pre bolusing isn't great. At college, she'll spike to like 202 20 if she doesn't pre bolus, but it hits her pretty hard. It brings her back. It does not normally make her low. That's good. So yeah, the last few months, she's been completely all of her settings in Iaps have been the dynamic version of those settings, and I have not touched it at all. She's doing well, that's great. Yeah. Now I don't know that the stability, like the the rises, are the same. It's, they'll be once she's, you know, not up, you know, overnight, three days a week, trying to get work done. Yeah, right now. It's making her life manageable, and it's allowing her not to think about diabetes while she's so busy. And I'm taking that as a win in the moment, and I'm also counting on the people who are working on this to continue to work on it. You know, that kind of thing, actually, can we, John, can we just take a second here? Arden was up all night working on a project, and I'm in charge of waking her up so she can keep working. So hold on. One second for me, you're gonna hear, hey, it's 1145 you want to get up now, or you want me to call you back in a little bit. 10 minutes. Okay, bye, by the way. Could you hear? Yeah, the Hello was this and 10 minutes, by the way, I already called her 15 minutes later than she wanted me to. So she was up all she did an all nighter, Friday night. So on Friday she went to the lab at one a 1pm they worked there all day. Came home at 8pm ate something, went back at 930 and then left at 11:30am the next day. Then she slept, then she slept through the day, then she got up in the evening, worked all night, again, I think, went to bed at like three or four o'clock and. Got up at 11 or 12, worked all day yesterday, all night, last night, and went to sleep this morning. At time did she go to sleep 10:15am and asked me to wake her up at 1130 so she's been asleep now for an hour and a half after doing well, she's got one more thing that has to be in by five o'clock tonight, and then she's got to go to class all week. So is this the last week? No, this is the last two weeks. Somehow, John, I don't understand this, and maybe it answers a lot of my questions in my cold wind episodes, have you heard those? Don't remember? Oh, there are healthcare workers. Come on and tell you how shitty their jobs are and how bad everybody is at what they're doing. If you haven't heard it, it's really eye opening, and it'll scare the living out of you, while Arden's friends who are becoming teachers and nurses and all these, you know, other things are already home and like, you know, out at parties on Friday night and everything, my daughter, who's learning how to make clothing, is being treated like she actually works in a sweatshop at college. Basically, she went somewhere where the instructors are like, ex, you know, industry people, and they're basically like, tell them, like, look, this is this is it? If you can't do it here, you can't do it there, and I'm going to give you something to do, and I'm not really going to tell you how to do it and get it done and be right. And so that's the situation she's in. So she had to make a pattern from nothing. They gave her a piece of clothing that is already made and told her, deconstruct this, make a pattern for it, and then remake the thing she calls us. She goes, what the AM? I supposed I'm like, I don't know you wanted to do this. Not me. I was like, it was like, go figure it out. Right now, she finally met a really good friend that's in the same track as her, and ironically, that person is a type one from New Jersey. Oh, wow, yeah. So they were there. That's great, and then insane. So they become very fast friends, and they're helping each other and doing great and everything. Yeah, no kidding. Like I'm not lying to you. I very close with all these other girls who are in these other, you know, like tracks in different colleges all over the country. And we talk all the time, and they they say over and over again, it's insane, but Arden's college is way harder than ours is. So yeah, anyway, this is gonna kill her, for sure. She's

Jon Fawcett 42:36
like you said something really interesting that triggered something in my head that it's sort of all the dynamic studies that made it manageable so she doesn't have to think as much about diabetes, especially with how but you know how hard this program is for her right now, and I more and more see Facebook posts or questions where somebody is worried about, you know, hey, I had the same meal this morning that I had yesterday. And here's the two graphs, and they look different. What study should I change? And more and more, I think that the technology is getting there with, at least with loop, IPS, Android, APS, OmniPod, five and tandem. The technology is getting there to where you don't really need to worry about, well, why did it, why did it react different, unless you start seeing it, you know, for a week straight, obviously, because we're at the point with Lily where we almost never talk to her. Think about what she's dosing, how much she's dosing, what her blood glucose is, because the systems are so good at handling it with the algorithms. And even when you have a mistake, it's sort of just, you know, mistakes happen, either go small if you're high, or have some carbs if you're low, and then move on. And it's probably not going to be the same thing that happens tomorrow or the next. I

Scott Benner 44:14
think quality of life is becoming a focus, and as the as the technology expands and grows, and the companies have more time with it, and even the well as DIY people have more time with it, the focus is more and more on quality of life, like not just, can I keep my a 1c at 5.2 I mean, I'll go backwards, right? Arden's diagnosed. She's two years old. I don't know what I'm doing. I'm thrown into the same cement mixture that all of you are thrown into. I feel like I'm killing her. I might very well maybe her a 1c and the eights. I can't seem to affect it. I don't know what's going on. What happens next? Dexcom makes a CGM. All of a sudden, they have more context for what's happening. I'm like, Okay, I'm getting this. I bring her a 1c down a little bit. She gets a pump. I. Know, I'm using the pump just as an injection replacement. So it's not, I'm not getting any of the functionality out of it. Yet, all of a sudden I start learning about extending boluses. And, you know, temp basal increases and decreases. And you know, I'm bumping and nudging blood sugars. And all of a sudden I can bring a 1c down and down, down. It comes out of the eighths and the sevens, the sixes, the fives. And it takes a lot of effort in the beginning, especially a lot of effort now, as time moved on, I got better at it. It took less of my effort, but didn't let you sleep still all the time. You know, there was a lot of downside to it. OmniPod five comes along. And while they're even talking about it in the in the planning stages, the way they're talking about it is like, look, you know, it's not going to be loop, but people aren't going to need to understand all this to still live a nice life and have a good a 1c and some stability and all that stuff. And as they were saying that to me and to whoever they were saying it to, out loud, I was thinking, oh yeah, but my kids got like, a five, three, A, 1c A, five, five, a, 1c, A, five, seven, A, 1c, like, that's what I want, right until you sleep through the night the first time, yeah, and then you're like, hey, you know what? Maybe a six, one's okay. I was gonna die, and I didn't realize it, like, I was worried about her dying. I was the one that was dying. Like, you know? And now you're an adult, and you have type one, and your mom and your dad aren't helping you. You're burning your candle from six different ends. And, you know, and then you get into a situation like I said to Arden the other day. I'm like, Are you taking your vitamin D? And she goes, dude, after finals, talk to me about that. Like, I'm like, they're right next to your bedside. I put them in this little, like pill container, Monday, Tuesday, Wednesday, Thursday, Friday, just to open one and take it out, put it out, put it in your mouth and swallow it. You're sitting next to it right now. Can you see it? Put it I can't like, she's got no bandwidth. If she was taking care of her diabetes, like MDI, on top of all this, I don't know if she'd be, like, hanging the way she is and doing as well. And so I say, let OmniPod work on that OmniPod five algorithm, like, you know, sure, though I'm assuming they're gonna keep working on it. I like that. The thing what I find in diabetes, John, is that the thing that first scares people is the thing they end up loving at some point. My example is Dexcom came out and all the old head moms were like, you're gonna make these kids crazy. My kid's 35 and she's fine. We didn't have a CGM, like, these. Oh, I can, by the way, I got one in my mind right now. Old Cal just going on and on about, I don't mean that in a gender way, by the way, just, she's just doing anyway. I'm gonna go back to old Cal. Old Cal just mooing and mooing about CGM, and it's gonna ruin these kids and blah, blah, blah. And I'm like, OmniPod, you have never seen one. Your kid doesn't wear it. You've never had any experience with it. You sound like a lady going, get off my grass. You goddamn kids. Like, like, and I'm like, I'm like, you don't know what you're talking about. But then that becomes pervasive throughout the space. Oh, I don't know. People are too focused on their data. It's gonna give people anxiety. You know, who gives people anxiety? People have anxiety. People who don't have anxiety are very calmed by the whole thing. So it's not for everybody, but that initial panic, it's change. People hate change. Like, do you remember when Facebook was massaging its way to what it is now. There was a revolution online. Every time Facebook changed their their the way Facebook looked right, because people don't want to change. I get that. I understand the whole human thing about that. But anyway, a couple of years later, that cow stopped mooing. You know what she said this CGM is fantastic. My daughter's never had better blood sugars. Blah, blah, blah, blah, blah, Oh, good. I'm glad you figured it out two years later. For the last 24 months, you've been setting brush fires in people's minds on the internet, and all those people now believe that CGM data is a bad thing to have. And then OmniPod five comes out, and they say, Hey, look, we're not going to show you all the settings. We don't want you to think about this. We want you to just live your life. People like, I gotta see my settings. A year and a half later, I hear you go, I love OmniPod five. So I'm like, I think just wait. You know what I mean, like, and I can't wait to go. It's

Jon Fawcett 49:15
all of them, yeah. So it's, it's,

Scott Benner 49:19
we saw this

Jon Fawcett 49:21
when Lily started looping. So she started looping the week that loop added OmniPod arrows functionality, more than just their private just the private test group, and she actually that was her first bump. So she she got the OmniPod. One week later, I switched her to loop with OmniPod. I never even had time to learn extended bolus. Literally, I've never used it a single time, right? So you kind of look at that, though. And one of the things I hear from OmniPod five people, is, oh my gosh. How do you do extended bolus? How do you do extended bolus like we've never done that ever with her OmniPods now, in what, seven years, or whatever, six years, because she went right to loop. But with every system, see, then you had, you know, always saw the loop. People who were coming in from MDI, and, you know not, not necessarily understanding how loop handles things differently. It could be looped by APS, Android, APS, whatever is just, I tell a lot of people, there's no such thing in my mind as an empirical setting, basal, card ratio ISF, etc, nothing that's empirical, that works on every single system out there, because every single system out there handles those things in such a different way.

Speaker 1 50:48
But once you sort of, from

Jon Fawcett 50:52
our viewpoint of how it's happened in our family, is once you embrace how whatever system you switch to is different than what you used to be on, and start adjusting your management style to how to the strengths of that system. Yes, the quality, the quality of life, goes way up. And your point about the first time you sleep through the night. So we have, we have our alerts. I still have a sugar pixel in my room, even though Lily has one in her room. Mine is set at, I think, 50 and 300 like, I don't want woken up unless she hasn't handled it, and it's truly approaching an emergency level. But I've had people ask me like, you know, hey, I want my low alert on sugarpixel set to 120 but then I want to easily change it. If it goes off, I want to change it down to 100 and then change it down to 90. Like, if BG,

Scott Benner 51:51
like, that's just counterintuitive.

Jon Fawcett 51:55
It's counterintuitive. It's it's really degrading the quality of life. And so for us, we've started focusing more on quality of life. And I think her a 1c might have gone up a point one or point two, and that's fabulous, because everything else, the burden of management, has dropped, yeah, by 90%

Scott Benner 52:18
Yeah. I mean, I think Arden would have been sad if she had a five, three, a one scene, her father was dead. You know what I mean? So, because there were nights I laid in bed and I was like, oh my god, I'm going crazy. My head is shaking. I'm vibrating, you know, I need to sleep. The

Jon Fawcett 52:33
other thing that concerns me, and this was sort of back to me creating sugarpixel, I was concerned that, you know, Lily has to go to wake up to her alerts well. And then I started also thinking, okay, in two years now, she's also going to be managing this way more on her own, with way less involvement from her parents. And the one thing that started concerning me was, can an 18 year old shift from their parents handling everything and getting down to this 5.5 a 1c to then becoming an adult who's having to do that same stuff on their own, my fear was a swing of like 5.5 up to nine, a 1c just because a kid's going to get burned out. You and I, we sort of push through it over the years, and most parents do, but the fear is an 18 year old just going to get burned out in the first month of that, and then they're not going to those they're not going to bolus at all. They're just going to let the pump do whatever it does. And that's so I kind of felt that, you know, going from a 5.5 to a six or 6.5 that's way safer and healthier in the long term and not that much different in the short term than a swing up to sort of not managing your diabetes as a young adult and jumping up into the eights, nines, 10s, A, one CS, and

Scott Benner 54:01
you give her the opportunity to come to it on her own without it going wildly the other way. And so it's a thing she'll come to like, you know, I could probably put my a 1c back down under six if I tried it on her time, which will be important, you know? I mean, you can't force people to do things. Yeah, exactly. Those are the big picture ideas you have to keep in mind, when you're talking about stuff like this, like you're not going to be able to force people to just to do a good job. You can't. I mean, I don't know how many times I have to, like, have somebody on to make the point to people, mostly humans, just do stuff for other people, never for themselves. So like, you're doing that thing for your daughter. I'm doing that thing for my daughter. She's not going to do it for herself. She doesn't see the situation like that. She didn't watch her come out of my wife. She doesn't see herself the way I see her, like she's my most important like focus, her most important focus is learning how to put sleeves on a thing before the lady yells at her on Friday. Like, you know what I mean? Like she's not she's not prioritizing life the way I do. She doesn't have the same ability. To do that. She's not as far along in her career, in her life and her understanding, and she hasn't had enough experiences like if a six five, My God, what a great a 1c to have. You know, if a six five, a 1c is the price to pay, and I'm making quotes around that to get you through that part of your life. You know when, God bless that's fantastic. We never did go to CGM outage is when I brought it up, John, I'm going to run out of time for you, but it might seem like a left turn. I do just enjoy, maybe more talking to you about algorithms, stuff like that. I assume you see what happens? The Dexcom lost their but I don't know the technical term, but like, overnight, like people didn't have access to their stuff, unlike other people's phones, right? The share stuff.

Jon Fawcett 55:41
This one this time it was even on the main Dexcom app was getting logged out.

Scott Benner 55:47
That didn't happen to us, but, but okay, yeah, I did see it happen to some people, like people are getting kicked out of their app or something. Yeah.

Jon Fawcett 55:54
So, so they were getting kicked out of their app, having to being forced to re log in, being told they have to re log in, and then sometimes they weren't able to log in again. Lily was able to log in immediately, and everything was back up and running. But I know other people who, gosh, even this week, are still having issues with it with CGM outages. So the first thing is that we always tell people, because I have a lot of we've got 1000s and 1000s of sugarpixel users all over the world. So I hear, anytime there's any outage anywhere, basically, and

Scott Benner 56:32
they treat you like it's your problem. I bet,

Jon Fawcett 56:35
yeah, yeah, quite frequently that's okay, because I have enough experience to you know, even help them with it. Is the first thing everybody should do if they don't have readings in their follow up, or if they're Libra the libre link up app is check the main app. So check the Dexcom G 67 app, check the libre View app, because if you don't have readings there, you're not going to have readings on not only the follow app, but also every other app service device, whether it be sugarpixel or night scout or everything. So the first thing you always want to do is go see if the main app is running correctly, has readings, doesn't have any error messages, like the Dexcom will report a big red X on the server air error for the sharing page when they're having a lot of these outages. So that's the first step to always look at the main app. So as the main app is logged in and has readings, then you start looking at the follow up. And companies have status pages, so status.dexcom.com is you can easily check if they're having an outage. Now it does seem like they might update that page manually, so it's not like automated flip over when they detect outages. So it might not necessarily always be accurate, but it is a good place to check from a sugar pixel standpoint, is, obviously, we rely on those services.

Scott Benner 58:09
The one thing that we do that is different than like

Jon Fawcett 58:14
the Dexcom follow up, for instance, is sugar pixel handles, no data alerts locally on the device. So it doesn't matter why it has no data. It could be from a sensor warm up or sensor error, or a major Dexcom outage like they had last week, where the follow up is completely down, or even your home Wi Fi goes out, or your home internet is out, as long as sugar pixels has power. If it has no readings for any reason, it can trigger the no data alert. So one thing for our users specifically is you might not get readings, but you can still go to sleep knowing that if follow goes out in the middle of the night, you're still going to get an alert for no data if you have that set up

Scott Benner 59:07
nice and get your meter out like, like people used to do for years, check your check your blood sugar. Yeah, it's interesting. The girl that Arden met at school, she doesn't use any technology and yeah and, and Arden's like, you know, we, we were working, and she stopped and checked her blood sugar. And I was like, Oh, that's interesting.

Jon Fawcett 59:28
Well, and you know what's, what's really going to be fascinating in the next few years is so the rumors of Apple and Samsung both working on glucose monitoring, non invasive, just through the watch. If that gets to the point where it's actually reliable and accurate, rather than just a sort of a you're in range, you're high, you're low, not an actual Well, am I 70 versus 150 if those get to the level where. You can rely on them. What starts looking way and way more appealing is potentially some sort of hybrid combination system, where you might be doing a freza just for super simple meal times, or the weekly basal that's coming out, where it could potentially be like one injection a week of a weekly basal, and then that's it, that could potentially actually be a drastic quality of life improvement, because technology

Unknown Speaker 1:00:34
fails, sincerely,

Jon Fawcett 1:00:37
pods fail, pumps fail,

Unknown Speaker 1:00:38
your phones

Jon Fawcett 1:00:40
break and die. And so there could be the opposite swing from sort of add more AI and more technology to if we can get there with the insulins and the non evasive CGMS, where that could potentially be a much improved quality life all

Scott Benner 1:00:57
different pathways. How about there's I did an interview recently with the mother of a 15 year old girl who's had type one for three years. Was using 70 units of insulin a day, combined basal bolus. Mom has PCOS. Daughter started showing signs of PCOS. Mom got relief from PCOS, from wegovy. They put the daughter on the wegovy. And now that that I just talked to the mom again recently, when she was on the podcast, her kid was down to seven units of injected basal a day, no other insulin from 70, wow.

Jon Fawcett 1:01:30
And that's not, that's not the first story like that that I've heard, yeah.

Scott Benner 1:01:35
And now, by the way, they're thinking of moving it down to five units of basil a day, wow. So she's not bolusing for meals at the moment. Now, people hear that, they go, she doesn't have type one diabetes. She does. She does have type one diabetes, and, you know, and I'm, I'm sure, as time goes on, her insulin needs will increase. But that, it sounds to me like that kid was in the middle of Lada that looked worse for insulin needs because of PCOS, and now the GLP is helping with the PCOS symptoms and maybe bringing down her inflammation. I have a doctor coming on next week to really explain to me everything glps are doing for people. I have a family member. I won't say who they are. Again, PCOS Not, not somebody in my immediate family. She started wegovy On Saturday, and it was point two, five, not even what they would consider to be a therapeutic dose. Here is the text from her this morning, I lost five pounds in the first 36 hours. This is a miracle. I said, How did you do you know? Did change your appetite? Do you feel full? Etc. She said, I'd had a headache for the first bit, but I chugged a bunch of water and that went away. I've not thought about food once, and I had to consciously think about taking smaller portion sizes. So she so she, as she was getting herself for food, she she said, Oh, I here's how much I would normally take, but I'm not hungry like that. So she took less. So there's one way it helped her. I've eaten significantly less. I didn't think about breakfast until I got to work. I'm going to eat something now because you told me to, but I really I'm not hungry. I feel full faster, so that now you can say, well, she hasn't eaten as much. You don't lose five pounds in 36 hours by stopping eating.

Jon Fawcett 1:03:22
Yeah, so one pound is 3500 calories. Yeah, that, you know, there's no way to just, and

Scott Benner 1:03:30
I'm sure some of it's water weight. Like, don't get me wrong, I don't think she's like, reshaping herself, but look, look at how excited she is before that. She's a kid who works out all the time. She's an adult, works out all the time is eating it clean and just gaining weight. It has seemed frustrating to me. I think we're still, seems

Jon Fawcett 1:03:55
like we're at the early side of kind of what this whole classification of drugs can actually do for benefits for people, and

Scott Benner 1:04:03
it almost seems like back to your story about the other one who drastically

Jon Fawcett 1:04:09
reduced the insulin usage it. It almost seems like the press has caused some problems at a drastic disservice for the this class of drugs by basically just saying it's, you know, the from a public perspective in just a weight loss drug, but when you look at it from like, insulin resistance and things like that that may or may not be weight related, it seems like there's going To be a lot of benefits that I think people are going to start to see from it that aren't necessarily publicized very much today because of how the press has handled it, that you know just just because you have type one doesn't mean you can't have the same insulin resistance the type two. Have, yeah, and just because you have type two doesn't mean you can't have the same insulin dependency as type one can have. Now, I think from a truly clinical perspective, they've said you can't, you can't, essentially have type one and type two, but from an actual, real life perspective, just Google, they call it double diabetes, or things like that, where you have you have symptoms and signs of both. And I think a lot of those types of people, this class of drugs is going to really help, talking about insulin resistance, weight loss and even other things that, who knows what this drug's gonna be found to? Yeah, you know, other benefits right

Scott Benner 1:05:47
now we're having mostly an insurance designation problem because people talk about it the way it's covered by insurance. Yeah, you know, and that's one side of the issue, the other side of the issue. And I shared this with you before we started recording, I don't have any trouble saying it here. If you look hard at the people who are telling you, oh, my God, it's a crutch. You can do it on your own. Blah, blah, if you look real hard, there are people who are making a living selling that side of weight loss. Okay, so you can tell me that like, you know, I mean, I see people, I don't want to use people's names, but I see people online or on television shows and they're like, We don't know. There's a lot of side effects. It's killing people. Blah, blah. You know what kills people? Tylenol, way more than a GLP does. Okay? Now, I don't see that person on television going, you have a headache, don't take Tylenol. You're gonna die. It's a killer. That's true, by the way, Tylenol has killed more people this year than a GLP medication. Has people die taking medications all the time. It's not going to be right for everybody. If you're scared, don't do it like that's that okay. But I've lost 50 goddamn pounds this year, and I was not running around eating with both hands, with donuts around my fingers. Okay? My body doesn't, doesn't work right, and now it does. That's all I can tell you. I plateaued for a while. My doctor's like, here we'll just up your dose, up the dose. Two days later, I lost two pounds. I could literally feel it like somebody flipped the switch of me. I went to the higher dose. I got a little like, I've been on it for a long time now, like a year. So I went up to a higher dose, I got that weird nausea feeling. I was like, Oh, I can feel it like, I feel it in there. I don't know what it's doing, but it's doing something, and then bang right back. Like I was starting to have sugar cravings again. The sugar cravings went away. You want to argue about what's right way to do something? I'm 52 man. I was gonna die, like I was gonna have a heart attack, like, now I'm not going to I went to the doctor. My doctor says, My God, your your vitals are like your child. They're amazing. You look fantastic. You look 10 years younger. Your vitals are amazing. Good for you. If it's not working, I'll give you a little more. She said, I heard the real weight loss, like, heard she's seeing with her patients. I'm using zepbound now. The real weight loss doesn't even happen until the 10 to 12 milligram injections I was back on 7.5 so here's my point. If you're listening and you're like mad about it, you don't know what you're talking about. This whole like, I'm always scared of what's coming, and you don't know what this stuff's gonna do to you. They've been working on a GLP since in the 80s, I think by Eto was 2005 that's 20 years of data, but, but people are running around like it just came out five days ago, yelling, You don't know what this stuff's gonna do to you. They've been using it since 2005 they just they're turning the screws. They're making it work better. Now, you know, like, I don't know, like, in the end, you got to make a decision who you are in this life. Like, are you scared? Are you going to go for it?

Jon Fawcett 1:08:48
It's really no different than talking about omnipodify or bloom Joe or placebo versus basr. It's not everything is for everybody. We say that a lot. Of course, some people like my our OmniPod five and loom Jeff experience, which is what Lily's using. She's been using loom Gen for probably six months to a year now, absolutely fabulous. And I tell everybody that. But is it for everybody? No, might not work as well for other people, but burns

Scott Benner 1:09:24
Arden like a mother. She can't she can't get anywhere near it. Whatever the additive is it? It hurts her like literal pain.

Jon Fawcett 1:09:32
So, exactly, yeah, so, but there's no difference between talking about those versus how lugovi has helped you and 1000s and 1000s of other people, yeah,

Scott Benner 1:09:45
John, the difference is, I'm not a nudnick. I don't run around telling everybody loom Jeff hurts. It didn't work for Arden. Like you know, you have to ask yourself, I'm gonna have to let you go in a second. But you have to ask yourself, when someone comes online and says, I took. A look. I took a GLP, and now I have, like, you know, I have real problems, like digestive issues. It's I'm not even on it anymore, and I'm having problems. I'm having a real problem from it. That's horrible. Okay, I feel a ton of empathy for that person. You do not know where their body was when they started, and maybe a doctor should have said to them, hey, you've had a one season the nines your whole life. You might actually have gastroparesis. Maybe this isn't something we should try with you. Or let's wait till there's more data on this. But instead, you don't hear their whole story. You just hear, I took this and my foot fell off. Oh, my God, did you hear that? It makes your foot fall off? Like I'm hearing people's feet are falling off. That's literally how the Internet goes after that. I had to tell a woman online the other day. She goes, we're seeing catastrophic problems from this GLP medication, life threatening. And I was like, who's We? Are you a doctor? No, are you a research scientist? No, when you say we, who are you talking about? Well, I heard it on a project. Yeah, you heard it somewhere. Are you kidding me? That's who we. Is we? Is you heard it somewhere from WHO? What are their credentials? That's how the world works.

Jon Fawcett 1:11:16
But it's a reminds me of the all I probably see posts once a day about two things, actually, probably more like five times a day about two things recently. One is,

Scott Benner 1:11:29
Hey, first time flying. What do you guys do for

Jon Fawcett 1:11:34
for TSA, or whatever security in the country you're in, there are 1000s and 1000s and 1000s of people walk through whatever scanner they're required to put all supplies through the X rays, and have never had a single issue. I'm

Unknown Speaker 1:11:50
one of them. And so are we.

Jon Fawcett 1:11:53
Yeah, you get one person had a pump failure after going through security, I don't have to, you know, hear stories like this

Scott Benner 1:12:03
noise or beams aren't good for it, yeah?

Jon Fawcett 1:12:08
But, I mean, there's nothing saying that actually caused the pump failure. There's, you know, correlation is a causation, yeah? But then that, meanwhile, there's probably hundreds or millions, hundreds of 1000s or millions of individuals who have gone through that never had a single one, so one in a million. And then the other one I hear is, and this is my new favorite, is the insulin temperatures. So all the recent studies that are out there, there's, if you Google Cochrane, insulin, temperature, you'll find it on Google. But there been like a dozen different studies, one of them, one of them, put it in, I think, like a clay pot at 100 almost 100 Fahrenheit, for two months, and it had zero loss of efficacy in the in the study, yet, you know one person you know had insulin fail, right? You know, because it was in the car for an hour. That may or may not have been the case, but all the clinical stuff shows there's no issues at all. There's a risk with everything in life, though, and right? You know, you're going to have the outlier, people who this just didn't work for you, or, yeah, I'm starting to get a pat down at security, whatever. John,

Scott Benner 1:13:30
isn't it fascinating. People generally are distrustful of each other until they say something bombastic, and then they believe them completely. That's the thing. That's the thing that's fantastic. Like, Listen, if you and I got together quietly, I'd say, give me a list of people you don't trust in your life. You would be writing for a half an hour. Oh my god, this guy don't know what he's talking about. I've seen this guy and this guy lost three jobs. A guy don't know how to like, Oh my God. This guy refinanced this house six times. Like, you know, you'd be like, I wouldn't listen to him about this, but you could do that all day long. But someone gets online and says, Hey, I went through an x ray machine, and my T slim exploded like I knew it laser beams like and then, and then the next thing you know, you had 20 people going I went through it one time, and my blood sugar went up. Yeah, that might be adrenaline, because you were really worried about it. No, no, no, no. It's the pump. The pump stopped working after the X ray like no one knows what they're talking about. John, go listen to the cold wind series. Go listen to doctors and nurses tell you things like, my favorite one is an ER nurse who told me I'd be safer having a seizure in your living room, Scott, than in the ER I work in. Okay, one of those people who can't save her life, and that er is online telling you about something else, and you're going see I knew it. No one knows what they're talking about. I don't know what I'm talking about. I'm having conversations. I'm explaining to you my experiences. You don't hear me say, do a thing. I know for sure. I don't know anything. I barely got out of high school. You shouldn't be listening to me. You don't know who John is. Is he's just an even tempered guy with a good speaking voice who understands things. He could be at home kicking a dog right now. He might have a dog under his desk right now, and he says, kicking it, kicking it. Hates dogs. You don't know who John is like, right? So you listen and you make good you make good decisions. But you can't just blindly, just take what everyone says you want to watch a conversation get out of hand online. Go ahead and say, Hey, I got type one diabetes after covid.

Jon Fawcett 1:15:29
I knew you were going to say that, Oh,

Speaker 2 1:15:31
my God in heaven, it won't stop. And like, right? And so, like, by the way, covid is a virus. Type one diabetes is frequently diagnosed after a virus.

Jon Fawcett 1:15:43
The funny ones with those that get me are the ones that are like, I was diagnosed with type one a week after getting covid or a week after a vaccine or whatever, when, yeah, they don't really know, but it can be months or years. Even there could have been, there could have been a trigger five years prior that. Yeah, was it? None of us know.

Scott Benner 1:16:12
Of course, it. You don't know how it happens and then, but they do. Oh, you don't know. Oh, I know exactly what happened. Sure you do. You know exactly what happened? Everything else in your life is a freaking disaster. You don't know which way is up this You're right about like, Finally, seriously, I love people. People are terrific. Don't get me wrong. I sound like I don't, but I really do. I love humanity. I think people are amazing. We are not nearly any of us as smart as we think we are, and we see a lot of shadows and ghosts and believe that they're the cause. And if it checks out in our brain, we move on. And that's fine, because for most of your things, day to day, you really don't need to know why things are happening. You know, like, it's not important. But this drill down stuff, by the way, I could jump into any one of those covid conversations and argue both sides of it. Absolutely I could, I could argue both sides of it and but that's all people are doing. Is they're arguing from their perspective, in their or the way they're colored, you know, whatever bro podcast they heard. They're like, Oh, yeah, that's it. It's giving everybody diabetes. Like, look at the numbers diabetes. You're going, Well, yeah, the whole population of the planet got a virus. Viruses can cause your type one diabetes, not cause it like it flipped a diabetes switch, but you have an autoimmune issue. Your body attacked the virus. It got a little funky, confused, got into those beta cells. Now you have type one diabetes, same way my daughter got Hand, Foot Mouth, which is Coxsackie virus, which is a large that there's data that shows that a large amount of people with type one diabetes had Coxsackie before, like so, yes, the whole planet got a virus, and now more people have type one diabetes. This is not surprising, unless you don't understand that that. And then if you do, if you don't understand that, then, Oh, my God, I knew it. And then, and then, it takes four seconds for somebody to go. It was probably the vaccine that got them. Like, here we go. Like, I don't know. I don't have a thought about the vaccine one way or the other. I took two, two. No, I got the I got the J and j1 the one that everybody's like, you got that trashy vaccine? Yeah, I got the vaccine that was built on data from the last 50 years, I got a vaccine that was built from like, the basis of what they vaccinate the whole world with. To me, that seemed like a better move. Also, my wife could see the safety data of it, and I wanted to go with that one. But the point is, is that, you know, if my foot falls off three years from now, someone's gonna be like that J and J vaccine got his foot. We don't know what's going on. Like, just shut up and live. I don't know, John, you've made me very upset. Of

Jon Fawcett 1:18:48
people, I have a feeling we're gonna get some angry people yelling at us when you post this.

Scott Benner 1:18:54
Oh, maybe you don't, maybe you care. We won't mention sugarpixel again. But

Jon Fawcett 1:19:01
you know how often I type something in Facebook just to get it out of my off my chest, and then I delete it without posting? Is 99% of my Facebook posts never make it public. I

Scott Benner 1:19:15
want to be clear. If my foot does fall off five years from now, and it is because of a vaccine, I also won't go, No, it isn't like I'm not defending anything one way or the other. I don't know. That's what I'm trying to say. I don't know. You don't know. I don't know. No one knows. Everyone's just trying to get by the same nudnik that you stand behind in the grocery store who can't figure out how to key in their code for something in the little thing, and start going, I'm so bad at this. That person works at a pharma company. Sometimes, like, right? Yeah, that person's a congressman. Sometimes it happened, and people were like, What should we do? And then our dumb asses came up with the best thing we could think of, and then it got bastardized all over the place through media and people making money. And then. Thing, you know, they're like, you know, you just need 17 boosters. I'm like, I feel like you're trying to make money. And you know what I said? I said, No, thank you. That's all. I don't need a conspiracy theory. Hey, hey, you want to hear conspiracy theory? John companies try to make money selling the stuff they have. Oh, no, do they?

Jon Fawcett 1:20:20
Where's the worst? Ones are the the worst, to me, are the conspiracies over the insulin companies preventing a cure from getting released. Yeah, because of that, yeah,

Scott Benner 1:20:33
I have to tell you something. I know people, most of them, can't do anything. They're not they're not out there making like, great plans to, like, Stop, like, trust me, if there's money to be made, someone's going to make it. There's and right away, people go, there's no money in a cure. Yes, there is,

Jon Fawcett 1:20:50
yeah, there is. And it's potentially, not really any difference than what they're making today, because I have to imagine it. Well, maybe the pump companies, but the the CGMS, you're probably gonna still need CGMS, at least for a long time, to make sure that you know everything's working, and stuff like, let me be

Scott Benner 1:21:10
clear what I mean, John is a company making insulin, trying to find a cure for diabetes. Maybe not, but somebody else is. There's not one magic company, like there's people all over the place. There's people getting out of college every day going, you know what? I'm gonna try, I'm gonna try to do this like they don't work for the company that makes the insulin. I like to when there's a shortage, one person calls their pharmacy and they say, hey, no vlogs back ordered. They're online, dear internet. There's no insulin in New Jersey. We're all gonna die. Oh, my God. I'm like, Listen, your pharmacy goes to a distributor who, at the moment, doesn't have Nova log. 17 other people in New Jersey. I'm like, I live in Westfield. There's plenty of it. I'm here in orange New Jersey, plenty of insulin, but insulin here, blah, blah, blah, blah, oh my. My guy says there's the shortage. Your guy, you mean the 22 year old that works at the counter at CVS. That's who you're listening to. It's fascinating. I love you all. You're fascinating people. I enjoy every one of you. And you know why it's okay to talk like this. John, I'm gonna give the secret. Nobody listening thinks that I'm talking about them, but I am talking about something. You're

Jon Fawcett 1:22:28
sitting here talking about me. I know that talking

Scott Benner 1:22:33
about everybody like, like, there's, there's, listen, let me be clear, if there's an insulin shortage, and it really is, you're all gonna die. Just let it go. Like, my daughter's going, we're all going. Anybody who needs insulin is going. So what are you worried about that for? Like, that's literally not a thing. You can't stockpile enough insulin to live forever. Like, this is the world that we live in. This is how things work. Could everything fall apart and there not be any more insulin? Sure, there could also be no more fresh water. There could also be no more food. I mean, I think we saw how quickly during covid, people were willing to listen to anything. They were told, like it would only take one charismatic guy to make you all kill each other in like seven days, if they wanted to. It's not the point. The point is that there are companies who sell insulin. They're going to keep selling insulin. If they tried to stop the government would step in and force them to make it. There are plenty of drugs that the government makes. Pharma companies make. The pharma company says, Look, we don't make enough money on this anymore. We literally can't afford to do it. And the government steps up and goes, here, here's some money. Keep making it, shut up. That's how that works. Okay? I know you don't know that, but that's how that works. And so there's never, not going to be companies making insulin. That's just true. If that happens, you can come find me and tell me I'm wrong and slap me once across the face with your non dominant hand. Okay? And so, but I could not, by the way, even hit you in the face with my left hand. I don't think I'd be able to do it. I'm so uncoordinated with it. But there it goes, and I get where it comes from. By the way, like you're newly diagnosed, you're looking at your little kid. You can't get insulin. The place I get insulin from says it's discon, you know, it's back ordered, you know, we can't, we can't get it. Those are the words they use. You get very upset. I don't know you're going to Facebook, call your doctor. Like, call your doctor up and go, Hey, I can't get insulin, by the way. If you're really out of it, go to the emergency room. Walk in and say, Hi, I'm out of insulin. I need help. Like, right? Like,

Jon Fawcett 1:24:34
most of the doctors should have samples that they could give you immediately,

Scott Benner 1:24:38
samples of everything. Those doctors are flush with samples, flush with samples, everything gonna be all right. What did that go? Who is that? Bob Marley, every little thing's gonna be all right. It'll be fine. You got sugar pixel. You're fine. John, tell me something did I turn you down when you tried to give me a sugar pixel, like offer code or something like. That. Yeah,

Jon Fawcett 1:25:00
you said, you said your accountant wouldn't let you do one more affiliate.

Scott Benner 1:25:06
I'm gonna do it for people. You send me a link, I'm gonna put it in this episode. I love your device. I and I know we got pretty far away from it. Yeah, it's really fantastic. It's got a great feel. It feels like it sits in this space between like professionally made and DIY, which has this just great feeling. It's not junky. It's not working by the seat of its pants. It's a perfected device that works really well. Looks handsome, but the DIY part of it is kind of like the community part of it, where you're like, Hey, I'm gonna put emoticons in here. That'll be fun. Like, you know what? I mean? Like, that's the thing a company wouldn't do.

Jon Fawcett 1:25:41
One of the display choices is the emojis with slang. So Lily actually came up with all the slang. So one, just one example, is urgent high one of them is a dumpster fire icon, and it just says,

Scott Benner 1:25:58
perfect. It's absolutely perfect. Sugarpixel.com

Unknown Speaker 1:26:02
custom, type one.com. Custom

Scott Benner 1:26:04
type one.com. Wait, wait. Custom type one.com/juice.

Unknown Speaker 1:26:08
Box. It'll be,

Jon Fawcett 1:26:11
I could, I could make that happen, all right.

Scott Benner 1:26:12
Well, then let's just say it like that. How much money am I going to make every time somebody buys one, John, I'm gonna start planning. I might buy a rocket ship. How about we go, yeah, we'll chat off air. Now. I'm gonna make at least $1 everybody, all right? And then, and then you can get online and go, Scott just got that John guy on because he's getting rich off his sugar pixel. And at the end of the year, I'll make 200 bucks, okay? And then I'll go to my account to do my taxes, and they'll be like, What are you doing? Stop it. These are more lines I write. When I write more lines, I charge you more, you idiot. Oh, my God. I just want people to know about it. It really is fantastic. Thank you. No, no, it's quite a thing and and you're doing it over time, and I brought that up earlier. There's a lot of stuff comes and goes. People have good ideas. Sometimes they have big ideas. They get into it, they realize what it really is, and it goes away. And I hate that, because then some people in the community come along and they love the app, or they love the thing, or whatever, and then it's gone again, and you don't know where to jump in, because, you know, Jesus, how many of these things have come and gone. But you're a steady guy, John, I like you a lot. And to be perfectly honest, I like you a lot because you're smart and thoughtful and steady. I like that about you.

Jon Fawcett 1:27:29
Thank you, and we're not planning on going anywhere. This is my full time job, just like juicebox is yours, and

Scott Benner 1:27:35
we already have three release

Jon Fawcett 1:27:41
feature sets for the next three releases already planned out that we're going to be working on. Wow. So, yeah,

Scott Benner 1:27:48
that's cool. Listen, I noticed when I said something nice about you, you didn't reciprocate. But that's okay. I'm not gonna that's fine. I have no problem with that at all. I I love No Stop. Don't do that. Don't do that. Buy sugar, even though John doesn't like me, go ahead and buy sugar. Pixel. It's fine, because our our recordings feel like just BS, ing with

Jon Fawcett 1:28:14
a friend hanging out at your house, you know, which I think is the the way more personal. Is what cuts through everything. Yeah?

Scott Benner 1:28:24
Well, can we be friends? John, do you want to be friends? What does that mean? I'm not coming to your house to play Atari or anything. Not

Jon Fawcett 1:28:29
on. Don't send me a Facebook friend request, but anything else, yeah,

Scott Benner 1:28:35
all right, man, I appreciate you doing this. Thank you. Hold on one

Unknown Speaker 1:28:42
second. This

Scott Benner 1:28:44
the conversation you just enjoyed was brought to you by us. Med, us. Med.com/juice, Boxer, call 888-721-1514, get started today and get your supplies from us. Med, a huge thank you to one of today's sponsors, gvoke glucagon, find out more about gvoke hypopen at gvoke glucagon.com, forward slash juice box. You spell that, G, V, O, k, e, g, l, U, C, A, G, o, n.com, forward slash juice box. I can't thank you enough for listening. Please make sure you're subscribed or following in your audio app. I'll be back tomorrow with another episode of The juicebox podcast. The episode you just heard was professionally edited by wrong way recording, wrongwayrecording.com, the diabetes variable series from the juicebox podcast goes over all the little things that affect your diabetes that you might not think about, travel and exercise to hydration and even trampolines. Juicebox podcast.com go up in the menu and click on diabetes variables.

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#1328 IDU: Vanilla Diabetes Content

Scott and Jenny don't understand vanilla diabetes content.

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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
Friends, we're all back together for the next episode of The juicebox podcast. Welcome

everybody. Jenny is back. We're going to do another I don't understand today. Today, the topic is about entities, diabetes, organizations, companies, etc, and why the information that they kind of give out about diabetes and social media is so basic. Nothing you hear on the juicebox podcast should be considered advice medical or otherwise, always consult a physician before making any changes to your healthcare plan. Don't forget, if you're a US resident who has type one or is the caregiver of someone with type one? Visit T 1d exchange.org/juicebox right now and complete that survey. It will take you 10 minutes to complete the survey, and that effort alone will help to move type one diabetes research forward. It will cost you nothing to help when you place your first order for ag one with my link, you'll get five free travel packs and a free year supply of vitamin D drink, AG, one.com/juice box. Don't forget to save 40% off of your entire order at cozy earth.com All you have to do is use the offer code juicebox at checkout. That's juicebox at checkout to save 40@cozyearth.com%

Did you know if just one person in your family has type one diabetes, you are up to 15 times more likely to get it too. So screen it like you mean it one blood test can spot type one diabetes early, tap now talk to a doctor or visit screen for type one.com for more info, today's episode of The juicebox podcast is sponsored by the contour next gen blood glucose meter. This is the meter that my daughter has on her person right now. It is incredibly accurate, and waiting for you at contournext.com/juicebox, this episode of The juicebox podcast is sponsored by Eversense the Eversense CGM is more convenient, requiring only one sensor every six months. It offers more flexibility with its easy on, easy off, smart transmitter, and allows you to take a break when needed. Eversense cgm.com/ cgm.com/juicebox,

Jennifer Smith, CDE 2:23
I feel like we haven't talked in a long time. We

Scott Benner 2:26
haven't. But why is that? Because Arden's I went on vacation, and then Arden had to go to college, and then I had to cancel with you a couple times.

Unknown Speaker 2:35
Yes,

Unknown Speaker 2:35
that's my fault. I apologize. No, I

Jennifer Smith, CDE 2:37
hope your vacation was lovely.

Scott Benner 2:39
It was actually that was our first family vacation together in six years, and it was warm, and we did some cool things. We went out on a boat and did some like snorkeling, like out the sea snorkeling, that was cool. What else did we do? We did a paddle board. Well, not paddle boat, like, clear bottom boat tour through through these, like, mangroves. It was very, very cool. Arden's blood sugar really played nicely. That was great. So we had a good time. We really did. Yeah, thank you. I'm sure I said to Kelly this morning, like, we can't wait that long to go on vacation again, again, yeah? Like, you just worked too hard. So, but yeah, thank you. Good. Well, I want to keep going with the I don't understand fabulous, okay, and I'm going to bring the I don't understand today. Oh, yay. So this is blended from a couple of things that happened to me over the last couple of weeks involving diabetes. Okay, I don't understand why

Unknown Speaker 3:40
entities share

Scott Benner 3:41
such vanilla information with people, whether it's in their social media where they're teaching. And I'm not just saying companies now, I'm not saying like, I'm not specifically saying a pump company or a CGM company in general, pharmacom, not just saying in general, the content that people get is often like, Hey, here's a recipe for a cake that you can take to your July 4, blah, blah, blah, and diabetes. And, you know, like, does diabetes do this? And like, it's the same stuff regurgitated over and over and over again. And I'm always stunned, because they have an audience, and they could help them, but instead, they just churn out the same crap over and over again. I don't know why people do that.

Jennifer Smith, CDE 4:32
I think if we're talking in general statements again, not about a product in general, or, you know, in specific, or anything. I like the term vanilla. I really do. I

Scott Benner 4:44
usually say banal, but I think people don't know what that means sometimes, and then I throw off the conversation with

Jennifer Smith, CDE 4:49
them. No, vanilla is perfect in this I think it's because people are so scared to be what I think should be truthful and in the truth. Statement offending somebody. Okay, we are so worried in today's society that something you say, or the way that you tell somebody, the real, right way to do it, is gonna make them, Oh, my goodness, like you're saying this against me. My good. Do you know many times a day I could be offended if I really chose to be, come on, let it roll. I just

Scott Benner 5:26
come on. And so there is that, I think, that people's concern about making their content, you know, okay, for everybody, yeah, so that no one could possibly get upset ever. Does keep it very surface then, because you end up saying things that you're just like, well, this can't possibly make anybody upset. But I think the joke's on them, because, yes, someone's still going to be upset. What's

Jennifer Smith, CDE 5:52
still going to be angry? I mean, it's kind of like the whole concept you mentioned recipe, right? You can put a recipe out, and you could even put into it in terms of just the diabetes angle, right? You could say, and in this, I choose to use this product, and I choose to use this and it, it seems to do this for my blood sugar, but I think it's beneficial to follow up and say, but you know what? That's my n of one. You go ahead and you give it a try. And if you can't use this, or you don't do this, go ahead and do something else. I'm just telling you what works for me, right? But just be honest about it. Yeah.

Scott Benner 6:28
So what brings this up for me is that, 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 too. So 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. In a professional setting, a person asked me, but the conversation started with like, what are you most proud of about the podcast? And it was a business question, not a like a helping people question, because my answer is always going to be that it helps people. It helps people. But yes, they meant business wise. And I said longevity. I said that, you know, open your Instagram up today, see who's talking diabetes. Wait a calendar year, go back and see if you can find them again, right? Like that's, you know, keeping, you know, current and keeping your popularity up. And they said, well, then how do you do you do that? And I said, Oh, that's easy. I said, I genuinely get up every day, and I think what would help people with diabetes? Like, what could I offer them? What could I pull into the conversation that would help them? And they were like, Oh, okay. And I said that that's where the rest of you go wrong. I'm like, You're always saying things that are just like, I don't know. Like, oh, you know, insulin is too expensive. Great. Well, we all know that that doesn't help anybody's blood sugar be stable. You know what I mean? Like, here's a recipe. Have you tried this? I don't. I'm not angry about it. I'm just confused about it. Like, they never seem to say anything. And then I realized, as I was talking to them, a lot of doctors do the same exact thing, right? Just surface, always surface, never deeper.

Jennifer Smith, CDE 8:08
Yeah, I was just gonna say exactly that it's, it's almost like they're afraid to dig down and look for what do people really want a discussion about? And sometimes, I think you may not know until you hear discussion about something that, gosh, I had some of those questions too, yeah, and I wouldn't have even thought to ask, or they were subconscious, something like nicking at your brain to gosh, you know, but you couldn't put words to it, but somebody else did right? And you need to dig into people's life when you have conversations in order to get the wealth that can help somebody else, and it's not going to help everybody. I pick and choose things I listen to all the time, yeah, what

Scott Benner 8:57
I realized is I was doing this thing recently where I asked somebody to kind of expound on their experience, and it was a professional thing, and they just didn't, or they couldn't, I wasn't sure what happened. Like they defaulted to some pre written conversation that I could tell while they were saying it they had said 1000 times in their life, right? Like they went back to their script, and I re asked the question. I was like, No, how does it make you feel? And they couldn't, like, I was stunned. I was like, you don't know how you feel about this. And they're so professionally focused on, like, say these things, use these words, don't say this part. A lawyer told me not to do this, like, right? And I was like, I know there's knowledge inside of you. You don't even know how to let it out, right? And then I changed up the focus a little bit, and I thought I could get them to a moat, and they still could. And then I started wondering, like, is it just, are some people just better communicators than others? Like, if I said, Jenny, you and I have done this together. I know, you know, for people who don't like, maybe don't have context for. This, Jenny and I spoke together in Austin at a live event like last year, and we did, we speak for five or six hours to a group.

Jennifer Smith, CDE 10:08
The long time it was several hours before lunch, and then it was a couple of hours. It was a couple of hours after lunch as well. So I'd say probably six hours

Scott Benner 10:18
the extent of our preparation was standing outside of the door of the auditorium five minutes before it started, and I said, Hey, do you think we should talk about what we're going to talk about? Then we kind of like, giggled a little and went inside, and I was like, okay, diabetes, go. I never once looked at you and thought, oh, Jenny's stuck. She doesn't know what to say. She doesn't have anything for this moment, and it made me wonder, like, do people not have the information, and that's why they're not sharing it? Are they gatekeeping the information? I feel like I've seen both. I feel like I've seen people who find themselves. Today's podcast is sponsored by the Eversense CGM, boasting a six month sensor, the Eversense CGM offers you these key advantages, distinct on body vibe alerts when high or low, a consistent and exceptional accuracy over a six month period and you only need two sensors per year. No longer will you have to carry your CGM supplies with you. You won't have to be concerned about your adhesive not lasting, accidentally knocking off a sensor or wasting a sensor when you have to replace your transmitter. That's right. There's no more weekly or bi weekly hassles of sensor changes, not with the Eversense CGM. It's implantable and it's accurate. Eversense cgm.com/juice, cgm.com/juicebox, the Eversense CGM is the first and only long term CGM Eversense sits comfortably right under the skin in your upper arm, and it lasts way longer than any other CGM sensor. Never again will you have to worry about your sensor falling off before the end of its life. So if you want an incredibly accurate CGM that can't get knocked off and won't fall off, you're looking for the Eversense CGM. Eversense cgm.com/juicebox, the contour, next gen blood glucose meter is the meter that we use here. Arden has one with her at all times I have one downstairs in the kitchen, just in case I want to check my blood sugar, and Arden has them at school. They're everywhere that she is, contour next.com/juice, box, test strips and the meters themselves may be less expensive for you in cash out of your pocket, than you're paying currently through your insurance for another meter. You can find out about that and much more at my link, contour next.com/juicebox contour makes a number of fantastic and accurate meters, and their second chance test strips are absolutely my favorite part. What does that mean? If you go to get some blood, and maybe you touch it, and, I don't know, stumble with your hand and, like, slip off and go back. It doesn't impact the quality or accuracy of the test. So you can hit the blood, not get enough, come back, get the rest, without impacting the accuracy of the test. That's right, you can touch the blood, come back and get the rest, and you're going to get an absolutely accurate test. I think that's important, because we all stumble and fumble at times. That's not a good reason to have to waste a test trip. And with a contour next gen, you won't have to contour next.com forward slash juicebox, you're going to get a great reading without having to be perfect in a position where you would expect they know what they're talking about, but when you start talking to them, realize they don't have a lot. And I also feel like I've been around people who know the answer, but they want to be the ones to have the answer, so they don't want you to have it. Have you ever seen that like gatekeeping the information? Yes,

Jennifer Smith, CDE 13:56
absolutely. Like. But then who are they going to share it with? You can you can keep the information, but I mean to your beginning statement is, who's it going to help? Yeah, right. Well, that's not to help. Yeah, that's not their concern. But there are people who

Scott Benner 14:11
you would think that that was their concern.

Jennifer Smith, CDE 14:13
You would hope, yeah, right, aren't we in this too? I mean, my, my joy every day that I get to work with somebody is truly that I have given them as much as like at the end of my day, my brain feels done like because of all the little bits, the digging and the talking and the digging out the right information from what I know And what I can apply to that particular individual discussion and need, and it's different for every single person, right? But you have to be willing to say, why would I hold on to this information if it can help somebody else? Like, why wouldn't I share it? Yeah,

Scott Benner 14:55
I don't know that's for a psychologist to figure out for those people, but I've definitely seen. People gatekeeper information, like I'm the person of power. I want to stay like this, and I've always taken the the opposite approach. And you people have heard me say this on the podcast for years, like I actually believe that the hardest part about my job is that I have to find you, make you believe that I might know what I'm talking about, actually get the information to you, and then be willing to say goodbye at the end, right? Because you might not need this anymore, right? And, you know, in any other media situation, they get a listener, they want to hold on to them. My goal is for you to feel like, Man, I don't really need this podcast anymore. Like, you know, like, that big picture, that's what I'm hoping. I'm hoping you feel comfortable enough to your life and be happy and live, right? Yeah, yep, if you want to keep listening like, God bless you. Thank you. But like, you know, I I just find it. I don't know it's frustrating for me, because as much as that person who started that conversation with me was like, Scott, you're so your thing is so popular, tell me how you did it, I sit there and I think I'm stunned that more people can't figure out a way to do it. They either don't want to share it all or and then this is another part of it. I think it's possible. I want to be completely clear, like, I couldn't make this podcast if it didn't generate an income for me, right? Sure? Like, it just, it's just too much time, and it's all my time. Yeah, so I understand that if people are like, look, I can make this content, but I'm gonna also have to run a coaching service, or I'm gonna have to do something, because they're not big enough to draw in advertisers, and they're not small enough for it to be a part time thing. So they have to find a way to make money so they can't give you all the information, because they need you to pay them to give you the information so they can keep doing the thing, sure. So that's possibly part of it as well.

Jennifer Smith, CDE 16:46
And I think sometimes there is also just the want to be truly involved in a community effort of of bringing people together in maybe a different way and and that's okay, right? And I think your goals aren't truly to be successful for, hey everybody, look at me and look at what I did, but to be successful for the give to the to the broader community of people with type one and type two diabetes, truly to be able to gain information that they're not getting from someplace else, right? And so I think all the communities certainly have a pull for certain people, yeah, and I think there's value in all of the different avenues of getting it for sure. And the effort that you know the other you know, bloggers or podcasters or whatever their effort is, their own effort, for whatever reason they have behind what they're doing? Yeah,

Scott Benner 17:43
I don't listen. You make the point that if you want to reach a lot of people, you have to reach people. Yes, there's like, a I don't know. You have to strike a balance between not being a clown to get eyes and at the same time be entertaining enough that it draws in a massive amount of people so that it can help a mass amount of people correct. And

Jennifer Smith, CDE 18:02
though keep supplying enough information that is building on what's already there, it's not just rehashing it is getting more and getting deeper and having further conversation. Because despite having one same diagnosis, let's say type one diabetes. Everybody's life with type one diabetes is very different. We all have different diagnosis stories. We all have different experience with healthcare practitioners, medications, other conditions in life that we live with, crappy situations we've lived through. You know, you

Scott Benner 18:39
also have to have a vision for what I hope I say this correctly, but somebody asked me one time like they kind of insinuated that my job was to tell people what they wanted to hear. And I said, I think my job is to tell people what they need to know and might not know that they need to know. Yes, yeah, absolutely. They say one of the jobs in the future might be as much as chat GPT. Will you know as AI will know things, asking it the right questions in the right way is going to be an art, right? And so I ask myself, what are these faceless people who I know are listening like, what is it that I'm seeing in the community that they don't understand? And I don't need to make them comfortable. I need to give them good information or lead them down a road that they might not think to look down and and you also have to stay ahead of the curve, like, just thinking back quickly over the years, I take it hard when I do things and people don't like agree with it, so I've taken it over. Well, back in the day, I was like, these CGMS are amazing. And I know that seems really obvious right now, but there was a whole faction of old heads before who wanted to say, like, my kid grew up without a CGM and they're fine. And I'm like, Yeah, it's fine. Good for them. I'm glad you know this data seems really important. And so for the first two years, while I'm out there going, like, these CGMS. Are awesome. People are like, he's a shill. He blah, blah. I'm like, and now it looks like common sense, right? Present day, same thing's happening with GLP meds. I'm like, I think there's something here. And people are like, one guy, one, I swear to god, somebody said to me, you're pushing the GLP agenda. I don't know what, like, Looney, like, I don't know what you think. You know? I

Jennifer Smith, CDE 20:23
think that if there weren't enough people who are experiencing the benefit of this particular medication, right, that you wouldn't have people coming and saying, Hey, I'd like to tell you my story with this, right? You'd have silence. You'd have, okay, well, it sounds great, but I don't know anything because I don't want to try it myself, you know. So, yeah, I don't think that there's necessarily an agenda, I mean.

Scott Benner 20:47
But this person was like, saying, like, you know, basically, like, you're Strapping, you know, pharma to your back and carrying them on this. They're trying to sell this GLP thing. And I was like, Listen, what I'm telling you is, I'm seeing people with diabetes using this, and a lot of good things are happening for some of them. I think we should look at it more. And again, it'll be one of those things that two years from now, it'll see like common sense, and no one will remember this part. But again,

Jennifer Smith, CDE 21:09
what you're talking about is already, it's already being studied. So you're, you're not ready, like I want to make research out of this and put together all of this information to put out there as a whole, you know, whatever. If it wasn't actually happening, then they would not be studying the use of it in people with type one. Now, right? It's

Scott Benner 21:31
not like I took an aspirin for a headache in my toe nail screw fashion. I was like, I think somebody should look into this connection between nail growth and aspirin like, you know, am I the only one saying this? Like, plenty of people are seeing what's happening, but it's when you're talking about it out on the bleeding edge of of this community connection. Like, there's a couple people talking GLP, and other than that, everybody else is like, Are you sure? Like, does it make you sick? Should you be doing it? What about muscle wasting? Like, it's a lot of fear mongering around it, or being so careful that they're not willing to look at some of the positive things that are happening and, or

Jennifer Smith, CDE 22:06
even do their own research? Right? You can hear something about and, or you can hear somebody's 1n, of one, again, kind of story. If you really are concerned, then do your research. Look outside of this person's story. Look at what is actually in the research, what's being done, why they're considering the potential use of this, beyond just type two, and beyond the weight management, you

Scott Benner 22:33
got to pick through what you're what you're hearing like I listen, I'm pretty comfortable saying to you, I think if you pre bullish, your meals consistently, your a 1c, could come down a full point, right? Yeah. But I've had people come to me and say, Listen, I pre bolus, and I get low every time. So I'll say, Well, if your basal is right, if your settings are correct, if your insulin sensitivity is right, and that's happening to you, it sounds like you don't need to pre boss, yeah, you know, like, I'm not saying, like, do it anyway. I'm saying, This is what I've noticed. You go check into that for yourself. Is it valuable for you? Great. Is it like even with the glps, some people have stomach issues. They can't take it correct. It's not for you then. And yeah,

Jennifer Smith, CDE 23:13
absolutely. I have no need or desire to personally use it. I don't need it. So I can talk about it. I can tell people about it. I can talk through in the avenue of their individual could it be useful? Why are you considering it? And if you are, are there other things in place already that we haven't adjusted, or they're not in place yet, that we haven't adjusted? We could go those there first and then revisit this conversation, right? I mean, just like you're pre bolus well, you're pre bolusing for grilled chicken, that's probably why you're going home.

Scott Benner 23:47
Yeah, we don't need that. And that's the point, right? That's the bigger point around all this. This is there's an example of where you need more information, and it can't just all be dumped onto you in one second. So I'll make the point there, that maybe that's why people don't give more specific advice, because they can't give enough of it to make sure they've covered the whole thing. Whereas, if you have this platform that I have, it can be spread out, people can take their time to absorb it and hopefully get enough of it to put together that puzzle for themselves. Yeah, I would agree. I get frustrated when somebody says, like, I'm a professional, I know this stuff. And then you listen to them, and they speak for 20 minutes, and when they're done, I think they didn't even say anything. They just talked and talked and talked, and there's nothing left here. If I ask you five minutes from now what that person said, you won't remember anything from it.

Jennifer Smith, CDE 24:39
You know, how many conferences that I've gone to with the hopes of a topic being really, like, dug into, like, the nitty gritty of information that I want to pull more out of than the surface level, and I walk away thinking I could have read the PowerPoint presentation in five minutes.

Scott Benner 24:59
Yeah, I. Flew here for this. Flew here, and it feels like their presentation is made from a Google search that just returns the basic ideas of the of the thing, right? And when you go to dig down, they go, what? Yeah, we don't have time for that right now. Or

Jennifer Smith, CDE 25:15
they're constrained by some other disclosure, like they they have an association with somebody and they can't, as you were saying, they're sort of contained into what they can say, and they do know more that they can't say more because somebody told them that they can't.

Scott Benner 25:32
So I use chatgpt all the time, so I asked it this question, and it says that for reasons of professionalism and ethical standards, this might be one reason why a healthcare professional wouldn't give more, but also fear of misinformation and liability. It goes on risk of reputation and damage. Like, if I tell you something and you get it wrong, even if I'm right, and then you go off and you say, Oh, my doctor said this, and he doesn't know what he's talking about. And then you're screwed in the community, like, that's understandable. There can be institutional guidelines that they have to follow. But they also talked about a conservative culture in medicine. Traditionally, medicine is a conservative hierarchy with a strong emphasis on adhering to established norms and protocols. That's something too it's like, you know, as treatments move forward, you're still talking about whatever you heard in medical school and whatever, whatever the writings say. And I actually heard a doctor talking about this recently, like there's all these advancements, but the papers don't reflect them, like the paper and the papers reflect them, right? So the research reflects it, the papers reflect it, but it never gets moved back into the teaching at the medical school. The Medical School's teaching off of papers from decades ago. Sometimes,

Jennifer Smith, CDE 26:46
yeah, absolutely. And the unfortunate thing about teachings in medical school now, of course, we have so much that's being taught that's relative to medicine use and I'm trying to be careful. I'm trying to be vanilla.

Scott Benner 27:08
Well, you don't want to insult anybody, and it's not my, it's not my desire to insult anybody. Yeah,

Jennifer Smith, CDE 27:13
I don't want to insult but truly and completely, the majority of information that is taught and given and where they where they get their information that then gets fed into the patient, and what the patient is going to be provided with in terms of a medication. It comes from research that's been conducted by the companies that want their product to be the one that's put out there. I hate that, because I think medication is an important piece of of navigating health conditions in some circumstances. But if that's all you're using as your basis, and you're not going to the first step, the first line, which is more preventative, there are so many lifestyle things that could be being taught to incoming doctors in medical school to be able to say, this is the first step to teach the patients you work with, you want to care for people. You want to do no harm, teach them to live a healthy life. If that isn't working and they've put that in, then move into this researched potential use that could benefit their efforts that are already in place, right as

Scott Benner 28:28
you're talking, I thought, Is there just a way to, like, tax everybody, 50 cents per person, put all the money in a pile and then use that money to pay researchers and lawyers to be on the side of the people, not the side, not side of the government, not the side of a company, but but the people like, right? Just people, because that's what, that's what you need, is you need someone out there doing this research for you, yes, and then throw it all out into the world and let it shake out where. And then

Jennifer Smith, CDE 28:55
it would be honest, right? It would be not vanilla. It would be this. These are the ground rule facts. This is what you should know and move forward.

Scott Benner 29:06
Yeah, no, I just, I'm saying that

Jennifer Smith, CDE 29:08
live long and be prosperous. Yeah,

Scott Benner 29:11
get out though. Well, you made a point a second ago, right? Like, if you, if you can by eating well and exercising and living a life that your body needs, live healthy, then great. And if you have processes in your body that aren't working well enough that that's not enough for it, then let's see if there's a pharmaceutical or something else that can help you with it, right? So, I mean, it makes a ton of sense to me to start at that basic but as soon as you do that, you're going to get argued with by 17 different people are going to tell you the way to eat is everything you open your mouth with becomes some sort of a fight. I'm answering my own question, by the way, why companies don't get involved in specific? Yes, yeah, there's no way to win if you said hey, even if you said eat, well, someone go. Well, what does that mean? And then now we're arguing. About that for 10 years, and then that pisses away, and people finally stop arguing about that. And then you move on to the the next step, and then it starts all over again. There's five different opinions, five different financial perspectives, and everybody wants their thing to be the thing

Jennifer Smith, CDE 30:16
right? And I think what you know, what it honestly brings in that you're kind of skirting around is that we need discussions to happen. We should not shy away from discussion. We should not shy away from bringing up hard points, like uncomfortable discussion points. We should be happy to be able to talk about something that is not vanilla. Yeah,

Scott Benner 30:42
right. Let's have a deeper conversation and disagree. That's fine. Be nice, like, that's even like, I listen, I cultivate what I think is maybe the kindest Facebook group around diabetes that I've ever seen, but it's based on you're all adults. I'm not going to tell you what to say, just however you eat, however you feel, love, I don't even care. Like, go ahead and have your conversations, but then be nice. And it's interesting. I had this thing happen the other day. I can talk about this, probably right. So there was a post, there's a, I don't want to out anybody, there's a post that comes up and somebody says, this is one of the most controversial posts in diabetes. What would you bolus for this? Like, you know what I mean? And it's a photo, yeah, yeah. And eventually,

Jennifer Smith, CDE 31:23
in a million different places, not just Yes, people post all the time. Look at the bowl of ice cream and all the toppings, and it looks like, like a kitchen sink full of stuff. Like, well, that's a wide guess.

Scott Benner 31:35
A lot I'm guessing, but so, but somebody will come in and say, hey, well, you know, I see this in there, and that you're going to get an impact quickly from this. There might be some fat in there. You get a lot of thoughtful answers, but there's always one person that can't stop themselves from saying, I just wouldn't eat it. Well, no one asked you. That guy didn't ask you the question. Question wasn't, Hey, would you eat this? And so something like that happened where a person came in and said, like, yeah, you know, I just, I think that if you ate a different quality of food, and blah, blah, blah, and then someone got insulted by that. And I'm like, okay, that's legitimate. I have a one of my rules in my Facebook group is, don't tell people how to eat. And so this person gets very angry that this person told another person how to eat. Now we've got three people involved, and the person who gets angry about it then fires back at that person, very rude. And I removed the rude comment, and I said, please be kind like you know, I next time somebody does something like that, report that comment. I will take care of it. Because I would have taken that comment out and said, Please don't tell somebody how to eat. So all I would have done, right? Well, you know, that person left the group in anger because they didn't want to be told what to do. And I was like, you just got mad because that person was cruel. You were three times crueler to them in return. And now you're mad at me. I was like, and then I'm dumb enough to get on here and ask you this question when the obvious answer is, you can't win.

Unknown Speaker 33:04
No, you can't win. There you go.

Scott Benner 33:07
So Jenny, I think we're getting back to what you started with. If people want to know why they're not getting straightforward information from companies and entities, it's because they're scared to talk to you all,

Jennifer Smith, CDE 33:17
yeah, yeah, pretty much they're they're scared, and companies, especially, they're scared to be sued if they get back to you with an answer that's 100% the nitty gritty truth of what they're doing. I mean, it is the reason that today I am so not in love with all of the pharmaceutical commercials. I mean, I grew up with Band Aid and I think an aspirin. They are aspirin and band aids. Those were the commercials for medical care on TV right today. It's not this and not that, whatever it is, but they have to put in some of those sort of things that could be symptoms after because, you know what? They don't want to get ground out for not stating, well, you could have headaches with this medication because one person had it. In a study of 300,000

Scott Benner 34:06
people, yeah, if your eyes start bleeding and fall out your asshole, please, yeah. What did that happen to one person? But, yeah, so you have to disclaimer everything, which I'm not against, but, like, no, it's just very by the way, now I have the I am stuck on Band Aid brand because Band Aid stuck on me. That's got stuck in my head, and now I feel very old. But here's the problem, okay, so if, whether it's a diabetes website who's captured an audience and is feeding you information, it ends up being just this banal, vanilla information, or it's a company who's not willing to say, you know, maybe you should look at this if my our product's not working for you, what it ends up leading to is, people with diabetes are misered, right? They have a difficulty managing their blood sugars. They get increased anxiety. They're frustrated, they misinterpret things. They. Make self management errors and then misinterpret why those errors happened. Then it's just a tumble, right? You just you lose empowerment, you feel disengaged, and before you know it, you've got a nine, A, 1c, and you think, Oh, this is the best I can do. And so isn't it interesting, if that is that loop, which is people won't speak up and say what works because they're afraid of all the things that we discussed. In the end, it doesn't hurt those people. It hurts, it hurts the audience and those, those people have diabetes. It's the one thing like I know I've, I've told this story on the podcast before, but I wrote a blog for a long time, and it was popular. It was really, really popular. And one day I just realized I'm just saying what everybody else is saying. This is silly, like I'm gonna start sharing directly what's helping Arten, right? And when I did that, the blog got massively more popular. But I'm also, at that point, a blogger. I can say, hey, there's a disclaimer page on here that says, don't listen to me, anything you read here is for entertainment purposes, like that thing, right? A company, a company, can't come out and say, hey, you know this information is for entertainment purposes, but I would change your basal if I was you, like, like, that's not gonna work, right? But, but when I saw that help people, and then when I moved it to a different medium, where it's easier to reach people, and it's easier for people to, like, absorb the information. The amount of people I saw help with it exploded. And then that's what frustrates me. I'm like, I don't reach everybody, and some people don't like me, which is totally cool, yeah, but if you don't like me, but you still don't know how to pre bolus, I want someone else to be telling you how to do it, if it's not me, right? And that just doesn't happen. And then I get super frustrated about it, because I want people to be well, whether they get the information here or somewhere else. Yeah,

Jennifer Smith, CDE 36:47
I think the other piece, in terms of companies, especially diabetes companies, that is frustrating from the the coding of what you get told when you call in with a complaint is that they're choosing to use your product to benefit their life in a really significant way. Right? So if each individual person uses a product and has some minor things that are easy to overcome, but some people have more specific, really considerable issues, but you're still feeding them the same response. That's what also makes people really, really frustrated, right? You know, if you're going to replace something, replace it because you've said you're going to replace it, if you're not going to replace it, then you don't replace it for anybody, no matter what. But you can't, like cherry pick, so to speak, who gets something who doesn't get something? What you say to somebody, and I think that is where, on that end of calling into customer service, you get a little bit more. Get the tip of the iceberg. You get the person who's reading off of the form that says, This is how to answer this type of question that comes in. But in diabetes, especially with products, again, we need more than that, because this is impacting our life. If

Scott Benner 38:09
you're the one giving out that information, you have to understand that whatever is said is going to be received by the person on the other end of the phone, or the other end of your Tiktok, or wherever it is. As all of the information, they're not going to wonder if there's more. They're going to think if there was more to it, you would have said it. And so when you give incomplete answers, the person hearing them believes it's a complete answer, correct? That's why it works so poorly with management ideas, because if you can't give it all, then you're not going to be able to succeed. And even with like, the you know, like you said, with with how to use a device. And I listen, I understand device manufacturers are prohibited by the FDA. They're not allowed to tell you how to use them. That's not allowed, but they find ways to to get good information out into the world. And it can be done. Do? I did it with OmniPod for OmniPod five, we put together a three part series that very completely explains how to use OmniPod five, right? It's awesome, and they should be lauded for the amount of effort and time that a ton of people behind the scenes put into making sure that that content was valuable, right? You don't see that from a lot of places. And I'm not like, I'm not blaming like, another pump company or something. I've even learned to believe it. It's not just because they don't want to. They might not have the staff for it. The staff might not have the expertise for it. There's a lot of reasons why stuff like that doesn't happen, right? But mostly I think it's the stuff we've covered here.

Jennifer Smith, CDE 39:29
I think in what you just said, too, is that I think people get frustrated because they can see that the company isn't being openly honest about what they can tell you or what they know, right? You know, what? If you don't know how to answer a question or you can't answer it because you're bound by legal, kind of, you know, constraints, then tell me that. Tell me that so that I don't remain frustrated with the problem that I'm having. And I've called six times and I get six. Different answers, but the real answer is that you just can't tell me, because you really don't know yet. Miss Smith,

Scott Benner 40:05
I'm sorry, but the FDA precludes us from answering that question. The problem is that the next thing they're going to say is you should ask your doctor, and then apparently, if you're unlucky, you're going to get to your doctor and they're going to go, but I don't know, call the company. Call the company. You see people do that all the time. They bounce them back and forth, because nobody wants in the end. Listen, there are plenty of great people, okay? And this is not a blanket statement, but when you run into those people who aren't great in the end, what you're going to run into with people who are covering their own ass. And that's that like so and you do not know if that's who you're talking to or not, that's always my problem is, like, I don't know. Am I talking to an ass cover, or am I talking to somebody who doesn't know? Or Is there really no answer, you know, right? That's all right. You know, nothing you hear on the juicebox podcast should be considered advised medical or otherwise

Jennifer Smith, CDE 40:54
there No, yes, I have no affiliation for that. I

Scott Benner 40:57
don't know those people. But then you share your stories, and hopefully people can cherry pick and take things out that'll help them or resonate with their experience. They go, Oh, I never thought of it that way. I just helped somebody. The other day, a person emailed me and said, my kids on OmniPod five, they're in college. He's starting to take his health much more seriously. That's awesome. I was so excited, exercising more, eating better, but he's getting low a lot. And I was like, Oh, God, I know the right answer here. The answer is that that algorithm is working, is just over giving insulin based on his needs prior, and it's not shifting quickly enough in this case. So my thought was, you know, so I what I thought was, like, reset it, you know what I mean? Like, figure out what your total daily insulin is and start over. But I can't just email a stranger back and say, Hey, here's medical advice, right? So I have so I go. If this was happening to me, I would wonder if blah, blah, blah, and then I might look into making sure my settings are clear, and then maybe the algorithm could benefit from being, you know, reset with those new numbers. And as I was writing it, I felt ridiculous, because I'm still saying the same damn thing. You know what I mean, but like you are, but you're

Jennifer Smith, CDE 42:18
putting in a disclosure so that it can't come back to you. You're saying, if it were me, this is what I would do. I mean, I'm asked things all the time from a personal as well as a clinical perspective, and sometimes I give clinical perspective based on a professional stance, right? But my personal perspective is because of personal experience. And I can say, You know what, but that isn't what I do, because it doesn't work for you.

Scott Benner 42:47
In the end, I'm looking at my inbox and I'm thinking, Can I really ignore this and let this poor kid who's trying to pull his together? Am I gonna let him give up and live a life of poor health? Because I don't have the balls to answer this question, yeah, so, so I answered them, and I guess that's where my frustration comes from with everybody else. Like, just, like, what if we all just did the right thing? Like, going back to why I mentioned that the podcast is popular. The podcast is popular because it helps people, and then they tell other people I was helped here. Like, imagine if we were all doing that, how much more quickly people would be, you know, brought forward with their outcomes. That's just, I don't know it gets anyway. I understand why you guys don't do what I said an hour ago, but I get frustrated by it, and I'm so sick of seeing your freaking recipes for that cake that I can bring to my July 4 that won't make my blood sugar spike. It's just Jenny, by the way, the secret is using whipped cream for the icing. Oh,

Jennifer Smith, CDE 43:45
whipped cream for the icing. Lovely. So, because it's not real frosting,

Scott Benner 43:48
it doesn't have all that sugar in it and everything. And if I ran a website for type one diabetes, I would probably end up having to do what they're doing. But it still frustrates the hell out of me that that's how they do it. And, you know, I just wish people would just be more forthcoming if they know they should say, and if they don't know, they should stop pretending they know. That's pretty much what I think anyway,

Jennifer Smith, CDE 44:12
stop. Don't put the Fourth of July recipe out anymore. Yeah. I mean,

Scott Benner 44:15
just stop. It's so upsetting.

Jennifer Smith, CDE 44:20
I clearly have not visited whatever you're looking I'm

Scott Benner 44:22
so afraid that the website that does it's going to be like, Hey, he's directly talking about us, but I think they could figure it out too. And I feel badly. But it's so weird that that we live in a world where a person can have a medical question and be better off going to the juicebox podcast, Facebook group and asking a bunch of faceless strangers and come up with a better answer than if they went to their doctor, the company they bought the thing from, or it just, I don't know, I find it weird, like I'm almost here arguing against myself, like I don't think this is how it should work.

Jennifer Smith, CDE 44:54
I think with technology today, if it wasn't you, I think somebody else would have. Likely figured something similar out. Yeah, right. I mean, in whatever way. But I think because you were so quick to the move from just being a blogger into putting that voice specific connection, I think especially in the past several years where we've gone through a lot of poor social interaction, like True Seeing somebody. I think podcasts really have bloomed because it was the closest to socializing that you could get. And with you talking to so many different people all over the world, it was a great way to feel like you were almost having a conversation. No,

Scott Benner 45:43
I agree, but at the same time, it's only working because I'm being so authentic and honest while I'm doing it, because there's other people doing this, and they they run banal all the time as well. Listen, it went all the way back to when I was blogging. What I noticed that was that made me it was confusing is that people would get popular by being a blogger, which is to say that they're speaking to people very genuinely, right? And then when their popularity rose, the first thing they do was make over their website. Then all of a sudden it looked like a pharma website, like they put some money into it, they shined it up. And then they thought, then they took themselves too seriously, and then they stopped saying what they thought, and then they somehow turned into the thing that they were railing against the year before. And I was like, Oh, that was weird. I was I was like, you just stopped doing all the things that made you popular, like, because they wanted to look, I don't know, more

Jennifer Smith, CDE 46:37
professional maybe, or more like a more like a knowledgeable resource, trust

Scott Benner 46:44
me, they did the wrong thing. Jenny, my website looks like a five year old. Made it juicebox podcast.com, go check it out. But it works, and all the information's there. And I don't care if it doesn't look fancy, you know, and by the way, that website gets, it's really great traffic, so I'm sure it does, I don't know Anyway, all right, I appreciate you talking to me about this. Thank

Jennifer Smith, CDE 47:07
you absolutely.

Scott Benner 47:12
Thank you. A huge thanks to the contour next gen blood glucose meter for sponsoring this episode of The juicebox podcast. Learn more and get started today at contour next.com/juicebox your kids mean everything to you, and you do anything for them, especially if they're at risk. So when it comes to type one diabetes screen, it like you mean it, because if even just one person in your family has type one, your child is up to 15 times more likely to get it, but just one blood test can help you spot it early, so don't wait. Talk to your doctor about screening tap now or visit screenfortypeone.com to get more info and screen it like you mean. It a huge thank you to Eversense CGM for sponsoring this episode of the podcast. Are you tired of having to change your sensor every seven to 14 days with the Eversense CGM? You just replace it once every six months via a simple in office visit, learn more and get started today at Eversense cgm.com/juicebox. 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 bold beginnings 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'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, wrongwayrecording.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. It is completely free, and at the very least, you can watch other people talk about diabetes. And everybody is welcome, type one, type two, gestational loved ones. Everyone is welcome. Go up into the featured tab of the private Facebook group and. And there you'll see lists upon lists of all of the management series that are available to you for free in the juicebox podcast, becoming a member of that group, I really think it will help you. It will at least give you community. You'll be able to kind of lurk around, see what people are talking about, pick up some tips and tricks. Maybe you can ask a question or offer some help. Juicebox podcast, type one diabetes on Facebook. You.

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#1327 Beaver Tail

Charlie had gestational diabetes with all three of her pregnancies and now has type 1.

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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
Welcome back to another episode of The juicebox podcast.

Charlie had gestational diabetes with all three of her kids, and she probably actually had type one during the third pregnancy. We're going to talk about that and a lot more on this episode of the podcast, nothing you hear on the juicebox podcast should be considered advice medical or otherwise, always consult a physician before making any changes to your healthcare plan. When you place your first order for AG, one, with my link, you'll get five free travel packs and a free year supply of vitamin D drink, ag one.com/juice box. If you are the caregiver of someone with type one diabetes or have type one yourself, please go to T 1d exchange.org/juice, box and complete the survey. This should take you about 10 minutes, and will really help type one diabetes research. You can help right from your house at T 1d exchange.org/juice box. Don't forget to save 40% off of your entire order at cozy earth.com All you have to do is use the offer code juice box at checkout. That's juicebox at checkout to save 40% at cozy earth.com you OmniPod.

This episode of The juicebox podcast is sponsored by OmniPod five, and you can learn more right now at my special link, omnipod.com/juicebox this episode of The juicebox podcast is sponsored by the Eversense CGM. Eversense is going to let you break away from some of the CGM norms you may be accustomed to. No more weekly or biweekly 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

Charlie 2:11
My name is Charlie. I am from Canada, and I was diagnosed with Lata diabetes type one and a half in march of 2023, after the birth of my third child. But I didn't become insulin dependent until seven months later. So it was a bit of a shock, because I had two gestational pregnancies before that. I thought the third was gestational, and I was expecting type two, like I was fully prepared for type two

Scott Benner 2:41
let me, let me ask you that question. So then you have, you have two pregnancies. So you have, you get pregnant. You have gestational diabetes. It pass, passes, goes away, isn't impacting you anymore. You get pregnant again. It happens again, passes again. Yeah, that leaves you with the expectation that one day you will have type two diabetes, yeah,

Speaker 1 3:01
and we have family like, there's family history of type two on both sides of my family, and they told me with gestational like, the more gestational pregnancies you have, the more like you are to develop Type Two later in life. So I was just that was on my radar.

Scott Benner 3:16
So you're like, hey, let me see if I can get this going, and I'll make a third baby and see what happens?

Speaker 1 3:22
Well, yeah, my sugars got crazy after my second when my second child was a year old, okay, my sugars were weird. I wasn't on I wasn't a diabetic, yet. I was getting lows. Was getting lows all the time, like I was hitting even the twos, like 2.8 after I had a snack, if I was late for a meal, I was crashing. I was hitting, like, threes all, all the time. I was hitting threes if I missed, was late for a meal or missed the snack, and I just kept I feel it like I'd feel the drain, I'd start shaking, I'd start sweating. And I test that I'm in the threes. And I'm like, why am I in the three and then even in the twos after eating, and like, what is going on? So I went to my doctor

Scott Benner 4:08
real quickly, Charlie, for people listening, 2.8 is a 53 is, like a 54 just for like, context for everyone, yeah, yeah,

Speaker 1 4:15
which I mean, and I so I also knew really nothing about diabetes, because I'd only had two gestational pregnancies, and I never saw the twos when I was pregnant like because if I was in the fours, I'd have a snack to come up above five.

Scott Benner 4:32
Can I ask during the pregnancies with the gestational what was the management plan like?

Speaker 1 4:37
My first two was different than the third, because we did move. So just a different team altogether. So it was quite different. So the gestational for my first two, they had me record. I had to write down all my sugars, like so fasting, and after each meal, I had to record it on paper and then take a picture and email it to them on Sunday, and then they'd. On Me Monday and say, these are your adjustments. And I did it. I mean, I knew nothing else. They and I already had a big baby with a big head. And they did tell me in the in the education class, they said, if you don't manage your sugars, then that can cause your baby to have a larger head, or just be larger in general. I'm like, great. I'm already there. If you're telling me this can get worse, yeah,

Scott Benner 5:26
Charlie, when they tell you that, how do they shape that statement? Is it like, Hey, careful your hoo ha, is going to have a problem? Or is it like, it's an actually, actually a problem for the baby itself.

Speaker 1 5:37
It was for the baby, like, the health of the baby was the main concern, I mean, and then in turn, I mean, it was my first child, there's already fear of, how does this thing get out of me? Right? Like, is your first pregnancy, and you're like, Oh my goodness. So they did say, like, and this was pre covid. So there was, like, 10 ladies there for this gestational education Yeah, class, it was like an hour long. I was already in shock that was diabetic, because I know gestational diabetes was even a thing, okay, until the lady called me like I knew I was getting a glucose test done and had to drink the sugar and wait the hour and and then a lady called me a week later and said, I'm calling to book you in for the diabetes education class. And I said, Does that mean I'm diabetic? And she froze, and she said, Well, I'd assume so, because I've been told to call you to book you in for the diabetes education I said, Okay, I just nobody told me that my blood work was done and I was diabetic, so I was confused. I guess I just had never heard of it.

Scott Benner 6:45
The OmniPod five automated insulin delivery system is available now and waiting for you@omnipod.com forward slash juice box. OmniPod five is the only tubeless automated insulin delivery system that integrates with the Dexcom g6 CGM, and it uses smart adjust technology to automatically adjust your insulin delivery every five minutes, helping to protect against highs and lows without multiple daily injections. OmniPod five is also available through your pharmacy, which means you can get started without the four year Durable Medical Equipment contract that comes with most insulin pumps, even when you're currently in warranty with another system to get started today, go to omnipod.com, forward slash juicebox. Now, for those of you who aren't in the market for an automated system but still want an insulin pump and love the idea of tubeless you're looking for the OmniPod dash. Head over to my link, omnipod.com forward slash juice box. While you're there, you'll be able to learn everything you need to know about the OmniPod five and the OmniPod dash, and you can also find out if you're eligible for a free 30 day trial of the OmniPod dash. My daughter, Arden, has been wearing the OmniPod since she was four years old, wearing an OmniPod every day, and it has been nothing but a friend in this journey with insulin. Because the OmniPod is tubeless, you can wear it while you're showering, swimming or participating in your favorite physical activity. It's a big deal to not have to disconnect from a tubed pump to do those things, head over now to omnipod.com forward slash juicebox to find out if you're eligible for that free 30 day trial of the dash. To learn more about the dash or to learn more about the OmniPod five, get started today. OmniPod five full safety and risk information as well as a list of compatible phones and clinical trial claims data are available at my link, and at that same link, omnipod.com forward slash juicebox, you can also find terms and conditions for that. OmniPod dash 30 day trial. Lot of assumptions made like so the doctor says we're going to send you for a glucose test, and they assume that you know what that means, and then the results come back. Nobody tells you, until the person calls you to say, hey, coming in for your diabetes training.

Unknown Speaker 9:08
Yeah, I'm

Speaker 1 9:09
like, Okay, I'm I'm diabetic. What part of you know what that meant? What part

Scott Benner 9:14
of the Great White North Do you live in? What um? What province there? Ontario? Okay, yeah, when you become a type one, I know I'm gonna jump ahead for just a second. What's the management structure? Like, what insulin do they give you? How do they talk to you about technology for

Speaker 1 9:30
my type one? Like, for my type one? Yeah, dependency, um, they put me on basal R and long acting and novoropping with meals, okay,

Scott Benner 9:38
all right, that's all I wanted to know. If not, we can go back to the pregnancy. Okay, so she gives you the call, Hey, you give diabetes, and you're like, Well, what now and then? Where does it go from there?

Speaker 1 9:46
So I go to this class with all these other pregnant ladies, and they just, they gave me the glucometer, and they're like, this is how you test your sugars. And I'm just like, I was so scared that I was started to shake when I had to use. The Lancet. I just couldn't believe how to do this. And then they told me how to do it, like, five times a day, and I just couldn't believe it. I'm like, that, that's a lot of work. And I'm like, I'm already busy, and it just seemed like such an inconvenience. But I did it like, I followed all the rules to a T because I didn't want my baby to get any bigger, sure. And they told me that, like, once baby's born, you stop your insulin. We'll test you make sure you're not diabetic. And that's what happened. He was born. Stopped my insulin like six weeks later. Did the blood work? Everything was fine. And I'm like, great, glad that's over with I hated the needles. I got pregnant again, and they tested me early because of the first pregnancy, because the first gestational Sure. So they tested me a lot earlier, and I was borderline. So then they made me do it again, but with more sugar, and then I was diabetic again, and that was for even longer. That was like for five months, four to five months, whereas the first one was like two months, okay? And then so second diabetic pregnancy, then after my second was born, I never got tested. I just never found I just didn't do it. I don't know. I never went

Scott Benner 11:11
back for that postpartum follow up. Can we talk about the kind of this psychological aspect of all this, the Hey, this is horrible. I can't believe I have to do this. I don't like needles. I'm not following up after my second pregnancy. Is there a reasonable expectation that that gestational diabetes is just a momentary thing and it just goes away and it went away last time? So why should I possibly need to follow up the second time it's gonna happen again the same way? Yeah.

Speaker 1 11:42
I mean, there was also covid, okay, which I didn't want to leave the house. I had a baby that was, I mean, a minor factor, I suppose. No, I just didn't do it. I mean, I had my glucometer, so I was able to check every now and then. And I'm like, my sugars are fine. I'm like, I I'll be fine. So I never did it. Babies a year now. So this is March 2022, and that's when I started getting weird sugars,

Scott Benner 12:11
all these lows. By that, you mean lows. Okay, so, so I just want to be clear, and not that I'm questioning you, but because this has been in my head lately as I've been watching people in my personal life ignore their significant health issues. That's not what you were doing. You weren't doing out of sight, out of mind. I'll whistle and it won't nothing like that. Okay, no, okay,

Speaker 1 12:32
they went away the first time, and like I said, I was checking my sugars. I would randomly check, yeah. And then I just reached a point I just, I just didn't go back because I'm, like, my sugars are fine. I wasn't being ignorant about it. I My sugars were okay when I tested them. So I just, I mean, I know I should have gone. It's not that big a deal. It's just another blood work test. But I didn't,

Scott Benner 12:54
no, I'm not breaking, listen, Charlie, I'm not breaking your snowballs or anything like that. Yeah, I just, I just got to watch somebody recently walking around with like, 350 blood sugars, a type two, and they're just, they've lost like 100 pounds in the last 12 months, and they're just not doing anything about it. No, yeah, it's, it's, I'm genuinely fascinated by every sign points that I'm dying and I'm just not going to do anything. It's, it's and, you know, and the person knows, by the way, they're not doing anything to lose weight. They're actually eating voraciously, which, of course, makes sense, because they're probably in and out of or on the verge of DKA with this type two all the time, and now they're finally going to a doctor. But as I spoke to them about it, like face to face. Could really see in their eyes. I couldn't tell. That's why I asked you. Like, I couldn't tell. Was it just, like, blissful ignorance, or was it, yeah, you know, or was it I just don't understand this? No,

Speaker 1 13:51
if I, if I've had numbers that high, like with my pregnancies, I don't like, I rarely went over 10, which is 180 Yeah. Like I just 10 was bad, like that was above target for pregnancy. And so I never even knew how high blood sugars could get until, until I became insulin dependent. Were

Scott Benner 14:12
you using insulin during the pregnancies? The first two, yes, I was, yeah. Did they have you shoot, like a FAST Act thing for a high blood sugar? Were you taking a basal?

Speaker 1 14:21
So the first two was different, like I said. So they had me on humlin N, which was my long acting that, but that was like an eight hour duration, so I had to do that. It was gradual. At the end of the first pregnancy, I was on five units of human end in the morning, four units at bedtime, and then Humalog with breakfast, lunch and dinner. Okay, six, six units at breakfast, two at lunch and six with dinner. Did they

Scott Benner 14:49
have you eating a certain amount of carbs?

Speaker 1 14:51
Oh, yeah, there was a specific this many carb choices. So you had to have like, breakfast snack, lunch snack, dinner, snack. Boo

Scott Benner 15:00
boy, was it too much its points? Were you like, Oh, my God, I can't believe I'm eating all this food. Or was that okay? Yes,

Speaker 1 15:05
did I already No. Was not okay. I already naturally ate lower carb, okay? Like, I was not following by any means, a strict low carb diet, but I just ate,

Scott Benner 15:17
like, whale meat, seal, Penguin, stuff like that.

Speaker 1 15:19
Yeah, the norm, you know, Moose

Scott Benner 15:24
right? You're probably moose jerky, am I right? Yeah, wash that down with a nice glass of crude oil. I don't, I don't know a lot about Canada.

Unknown Speaker 15:35
Good old beaver tail.

Scott Benner 15:38
So too much food for you, but you're keeping up with it. Oh,

Speaker 1 15:41
man, it was so hard because so I already, like, I said, already low carb, and then my baby was huge. I didn't have room in my stomach for that, like,

Scott Benner 15:48
for the baby, and the food I didn't,

Speaker 1 15:51
the indigestion I had, and I I struggled. I'm like, Look, I can't eat this volume of carbs. Yeah, like, it's because and then you can't just eat the carbs, so you have to pair it with protein. And I

Scott Benner 16:03
forget exactly how big were the babies Charlie when they came out. The first one, the second

Speaker 1 16:07
one, my first born, was eight pounds 13 ounces. Okay, the second was six pounds 14 ounces. And I I cried when I saw her on the scale, because part of me, I felt some guilt with my son, which is silly, because, I mean, 813, is a big baby, but not

Scott Benner 16:24
crazy. I know lady had a 10 pound baby, she still limps 20 years later. Oh, my God, go ahead. Yeah.

Speaker 1 16:31
Just wondered, like, is he that big? Because he was also he was 11 days early.

Scott Benner 16:36
So you thought, oh, I, I did this with the blood sugar thing. You felt like, yeah, and

Speaker 1 16:40
because I was looking back with what I knew then, looking back in my blood sugars, they were high, like I was 12 after that sugar drink. And like, how long did I go without managing my diabetes? Like they caught it there. But was I already diabetic for a month before? And we didn't even know because, because with your first pregnancy, they don't test you till the third trimester. Today's

Scott Benner 17:00
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Speaker 1 18:42
told me, like it can affect their development, if it's really bad cognitive development, just overall, I suppose, okay, and then it just makes them larger, like they're just bigger. They just put on more weight, is my understanding. As far as unmanaged goes, I don't know, because I was managed. I managed it very well, and it was easy to just avoid sugar, because it was they told me, like, this will be over once you deliver. So it was like, Okay, I just won't eat

Scott Benner 19:15
dessert. It felt like a momentary thing, like I could cut this out for now. Yeah, it

Speaker 1 19:19
was momentary. It was easy to say, No, I'm not going to eat that. I'm diabetic and I'm caring for my baby like it was not a struggle to watch everyone else eat cake and I ate nothing. It was, it just mentally was fine. Well,

Scott Benner 19:32
yeah, listen, if you, I gotta be honest with you, if you're, if you're planning on raising a kid for its whole life, and you can't cut out like snacks, you're probably not cut out to be a parent. I mean, seriously, or at least you're not ready for the the amount of that probably sounded harsh. You're probably you're not ready for the amount of things that you give up to be a parent. Because that's no that's next. I mean, honestly, if the top 10 things I give up every day, if someone just said sugar in. That of this, I'd be like, Oh, is that it? That'd be terrific.

Unknown Speaker 20:02
Yeah, all right, I'm

Scott Benner 20:03
gonna try something here. How does elevated blood sugar in a pregnant woman impact fetal development? That's a pretty good right? My Google.

Speaker 1 20:25
Let's see what I never Google. I never googled that, and,

Scott Benner 20:30
yeah, we just always talk about, like, don't, don't do that. Why that isn't good? What? Why not? Yeah, listen now, I feel like we're all curious. So if we're not, you probably shouldn't be listening to the podcast. If this doesn't have your curiosity peaked, you should probably get out of this episode. Okay, so I'm gonna put it. I'm so interested to see where this comes back, because the place I put it, I put it into my vision AI app. Elevated blood sugar levels during pregnancy, particularly in cases of gestational diabetes or pre existing diabetes, can have significant impacts on fetal development. Here's a detailed look at how high glucose levels can affect the developing fetus. This is Scott reads the Internet to you, but hold on a second. Macrosomia, large birth weight, high blood sugar in the mother can lead to higher blood sugar levels in the fetus. The fetus then produces extra insulin. I get it to process the glucose, which can lead to increased fat deposits and larger body size known as micro microsomia. This can complicate delivery and increase the risk of birth injuries. So your blood sugar goes up, the baby's blood sugar goes up, and the baby makes more insulin. Ooh, okay, that's interesting. Hypoglycemia at birth. Babies born to mothers with high blood sugar levels can have very high insulin levels at birth. And then once the umbilical cords cut off, and the and the maple tap is, I guess, in your situation, is, is cut, the glucose supply from the mother stops, but the baby's insulin levels remain high, which can lead to dangerously low blood sugar levels shortly after

Speaker 1 22:01
birth. So they did explain that to me, okay, like the week before, like the week before delivery. Yet I sat down with the they called her the diabetic doctor. I don't think she was an endocrinologist. And basically that was explained to me, like, you need to monitor your sugars up until, like,

Scott Benner 22:17
the baby's born. Don't give up now, because we're close, yes, because

Speaker 1 22:22
some woman, apparently some woman, will wake up the morning of their induction, and like I made it, I'm having fruit loops for breakfast, and then your sugars are high. And then yeah, baby, sugars are high. Their pancreas doesn't know what to do, because it's been leaning on my pancreas. And then, yeah, sugars drop.

Scott Benner 22:39
So baby's making a ton of insulin. It comes out, the umbilical cord gets cut, then the baby's glucose level is not being fed by your high glucose level anymore, and the insulin crushes the baby. Here's the third thing. It says preterm birth and respiratory distress syndrome, high maternal blood sugars can increase the risk of early labor and delivery. Premature infants are at risk for many complications, including respiratory distress syndrome, a condition that makes breathing difficult. There's more. Did they tell you about that one? By any chance, no developmental delays. There is some evidence to suggest that children born to mothers with poorly controlled diabetes may face a higher risk of developmental delays. These could affect cognitive, motor and social skills. And then there's congenital malformations, elevated blood sugar levels, especially during the first trimester, when the baby's organs are forming, can increase the risk of congenital malformations, this includes heart defects and defects of the brain and spine, and the last thing is increased risk of obesity and type two diabetes. Children born to mothers with high blood sugar levels during pregnancy may have a higher risk of becoming obese and develop type two diabetes later in life. They told me about that one. They did tell you about that one. Yeah,

Unknown Speaker 23:53
they did tell me about that one.

Scott Benner 23:54
Then there's some direction here. I want to tell people I used my vision AI app, which is an AI platform that I've gotten involved in, because they are, at the moment, integrating a ton of content from the podcast into the knowledge of the AI. So I'll be telling people more about that in the future. But that's I've never done that before, because there are going to be those of you listening who are like, Oh yeah, Scott's got a piece of this vision AI company, and he's trying to get us to use it. Well, let me be clear, you're 100% right, but I'm actually using it because instead of googling it and getting back, kind of like a high level answer and then having to dig through to get all this, this thing knows why you're asking. It actually knows I'm using Arden's account. It knows Arden has diabetes, as interesting is that is, although I think it wouldn't answer the question the same for anybody who is using it. You don't have to have diabetes to use the app anyway. Okay, so they told you some of that, not all of it, now that you've heard the rest of it, does it freak you out more? Or are you like, okay, no.

Speaker 1 24:55
I mean it makes sense. I mean it certainly is scary. But then I. The bit that they did tell me was enough to have me Listen,

Scott Benner 25:05
take it real seriously. I'm

Unknown Speaker 25:07
yeah, this is serious. This is for my baby.

Scott Benner 25:10
Yeah. May I say, Charlie, still, even though you took it very seriously and did what they told you, you're still at the at the, I was going to say, the whim, that's not quite right, but you're at their direction constantly so you're not making adjustments. Like, can you look back with your type one diabetes mind now and say, Oh, I would have done differently when I was sure, okay, oh, yeah,

Speaker 1 25:30
like I did. As they said, I knew nothing about insulin. They said, inject this much at this meal. And I did. But then what happened with my second pregnancy is my A friend of mine had gestational diabetes, like I had my first child, then she had hers, and then I had my second. So for her, her pregnancy, I was watching her, she was on the sliding scale, and she could adjust her insulin, and I was never allowed to do that. I didn't even know it was an option. I never even thought to ask, because it was never brought up. It was inject this at this meal and this at bedtime, and, yeah, that was it. So watching her manage her diabetes, I

Scott Benner 26:12
was like, huh, like, that looks that

Speaker 1 26:16
looks easier. That looks nicer. So for my second pregnancy, I remember asking them on like, Christmas, I'm like, What can, what can you do for me? Like, help me get through Christmas? Like, I want to eat more sweets,

Scott Benner 26:32
yeah? Like, I want this kid to be healthy, but I would also like a chocolate chip cookie.

Speaker 1 26:35
Yeah, I want the Christmas treats within reason. I hear you. How can I increase my insulin to accommodate that? And they said, they said, No. They said, You just have to be careful. Just try and, like, balance it out.

Scott Benner 26:47
Okay, so Charlie, are you and her going to different doctor's offices?

Unknown Speaker 26:51
Yeah, we were in different we had different clinics.

Scott Benner 26:54
Were you in, I just like to say province, but were you in different provinces? No, same problem. Okay, all right, so it's literally, yeah, the reason I ask for people who don't know is that you can get wildly different healthcare depending on what Province of Canada you're in. I just It's something I've learned from making the podcast is about diabetes specifically. And I was wondering, was this just like, literally a different doctor? Because so would you consider now that she had a more progressive Doctor than you did.

Speaker 1 27:22
I don't even know like, I wonder if my team like everything I know now, if my team was a bit dated, I suppose, and even just the insulin they used. I had heard later that what was it? Humolin and hemolog were kind of older insulins, and then over rapid love of mirror, kind of newer. I mean, I don't know if that's true. I never looked it up, but I had heard that from my third pregnancy team, because that was a different team.

Scott Benner 27:48
The thing that throws me off is that you had the first baby. Would you say 810, eight pounds, 10 pounds,

Unknown Speaker 27:53
13 ounces. How

Scott Benner 27:54
much is that in kilograms? Why don't you guys? Why do Why do you guys do some things in in kilos, and so thank goodness,

Speaker 1 28:00
because we are influenced by the UK and and the US, so we're all mixed up.

Scott Benner 28:08
I apologize anyway. But my point was, you had an 810, baby that was pretty like, not premature, but came 1010, days early,

Speaker 1 28:15
right? Which is early. I was induced. I was induced because of the diabetes, oh, because

Scott Benner 28:19
they were like, We got to get this, this Zeppelin out of you, is what they were thinking. Right, right. Okay, apparently

Speaker 1 28:24
induction. So induction is normal with the gestational because the last week or two is when your sugars get really hard to manage. So they just don't even let you go there. So

Scott Benner 28:35
then what I wonder is, when you come to them with your second baby and say, Hey, I got a friend over here seems to be doing a more adaptive thing, using more insulin, more targeted. How do they not look and go? Well, she did have an eight pound, 10 ounce baby. We had to induce her, like, worth a worth a roll. But then your, then your daughter was the other way, though. How was that like? How do you she

Speaker 1 28:55
was smaller? So I did wonder, okay, my third child was not even smaller, but she was eight, four, I think. But yeah, when my daughter, when my first daughter, was born at 614, I remember just the relief of, like I did it, yeah, like I did it. I grew a small baby, and now she was early too. She was two weeks early, but she came. She came on her own. She came two days before her induction date, so she was a solid two weeks early. I believe.

Scott Benner 29:27
Can I share with you? I almost cried when you said that, that feeling that you I did it. It feels,

Speaker 1 29:32
yeah, yeah. It's making me emotional, remembering because, well, because I experimented a bit with that second pregnancy, because I'd witnessed my friend do her adjustments and whatnot with my second pregnancy, when they said, No, you can't increase insulin for Christmas, I did it anyways. You were like,

Unknown Speaker 29:49
I bet I could.

Speaker 1 29:51
I'm like, I think I can. Just gonna push this a little

Unknown Speaker 29:55
harder.

Speaker 1 29:56
And then I just, I never wrote it down. I just lied on. My on my sheet because I had good sugars after Yeah, I bet you did like or like, or like, date night. Like, if we had pizza night, guess what? I actually had pizza night. I just increased my insulin a little bit. You have pizza base it off of like, I had no carb ratio. I none of that. It was just, yeah, this many units for this meal, so I would increase. Now this was not, I didn't do this daily. I was still quite strict with my like I did what they told me. But when we went out for dinner, took a bit more insulin, but I wrote down the the units they wanted me taking, and then everything was fine. What

Scott Benner 30:34
did you base it on? The extra a gut feeling, and just a little more, I guess, and

Speaker 1 30:41
just a little more. Yeah, yeah, that's what it was. I mean, I would kind of eyeball it, and know, okay, I'm generally eating three carb choices. This looks like five, so I will almost double. Like, I just it was an eyeball

Scott Benner 30:56
on the old OmniPod PDM, which they don't call it a PDM anymore. They call it a controller. But there was, like, this rubber button you had to hold down to make the, like, the insulin go up, like, the numbers, like, you know, if you were going to choose how many carbs or something, I would like, I just push and hold it, like, say, I was trying to get to, like, I don't know, five units, and it would roll up, and it would like, go to, like, 5.25 and Arden would be like, go back. And I was like, ask, close enough, and then, how many times back then was I going, Oh, no, we've used too much insulin. But it was almost always, I don't have enough. So, yeah, it just hit me one day, like, once she got bigger, five units, 5.15 what the who? I mean, what's the difference? Like, you like, when it's down to, like, when you're little, and it's, you know, point one is, like, all the insulin, well, then obviously it's a lot, but where did you get the courage from

Speaker 1 31:49
my friend? Yeah, that's it. Okay. She she can go up for ice cream and increase her insulin, and she's fine.

Scott Benner 31:58
I like Charlie's, like, I want to be a good mom, but I would really like ice cream too.

Unknown Speaker 32:02
Well, yeah,

Speaker 1 32:05
and this was an even longer duration of diabetes because it was caught earlier, so it was kind of like, oh, man, I got to do this again, but it's even for longer. I mean, there's still a light at the end of the tunnel, which was the delivery of the baby, and then insulin will stop after, like it didn't last time, but I had a few. I treated myself a bit. So

Scott Benner 32:24
then what happened after she came out? Like you had an expectation, you were supposed to do a follow up. You didn't, and then I didn't.

Speaker 1 32:30
I checked, like I said, I checked my own triggers, and I didn't, but I didn't do the True Blood work. Yeah. And then when she was a year, is when my sugars went

Scott Benner 32:42
dizzy. Is that how low you got?

Speaker 1 32:44
Lightheaded, okay, but my so my fasting was high, like, my fasting was around nine, but then I would, like, I'd crash after meals. But I wonder if it just hit me harder because I was higher and then crashing, because in the moment, I'm like, I'm always low, but I learned later I was high, but then I was getting low, very fast, okay, I just was never catching the high, because I would go to test an hour after my meal, and I'm in the threes, but I would probably already hit the twelves, but Then within the hour, come back down to threes. So my doctor, I went to my doctor, and I said, like, I'm something's wrong with my sugars, and he just did a generic blood sugar test. Like, I don't know it was fasting. I think fasting and a 1c my fasting was 5.7 my ANC was 5.9 and you need to be under six. So he's like, You're fine, you're you're okay. And I went back and I said, I'm not like, I keep like, this was, if I went to get groceries, I had to bring snacks, like grocery shopping. Oh yeah, I couldn't go anywhere without bringing a snack or having fueled up with a meal beforehand, because I was getting low

Scott Benner 34:03
no matter what, even if you didn't matter what, like, you couldn't fast, right? No, no.

Speaker 1 34:08
Like, I would. So I was in like, a I wasn't managing diabetes because I wasn't diabetic, yeah, and I didn't. I was never diagnosed yet. So I was in a preventative, like, Let's prevent the lows,

Scott Benner 34:23
but you knew this was a problem, right? Like, you weren't, like, unaware. I

Speaker 1 34:26
knew it wasn't okay, and that's why I went to my doctor. And then I went back and I said, I can't, I can't live like this, like I'm I have two kids. I'm crashing every it felt like a crash in the threes if I don't eat enough food. And even, like, even a fully balanced meal, like, like, we had chicken curry with quinoa and, like, that's a filling meal. And I remember an hour after that, I was in the threes and shaking and sweating, and I didn't feel good. So he did even more blood work that I had to pay for. It wasn't covered. Covered. Why?

Scott Benner 35:00
When he said, Can you tell me why it wasn't covered? Because he didn't think it was necessary. No,

Speaker 1 35:05
it just not covered by OHIP. So it was, it's just a specialty blood work, I suppose, not A, not A common one I see so and he told me he's like, You need to come in for this blood draw during a low

Scott Benner 35:19
hell. You want me to do that? What? Like,

Speaker 1 35:23
how do I do that? And he's like, I know, I understand, you have two kids at home. I understand the complications, but this is, this is the blood work I want to do. So my neighbor at the time, like, we've moved since then, but her has, like, he's diabetic, type two. She's not, but I chat with her on the fence, over the fence all the time, because she was retired, and so she knew everything, and I told her, and she's like, well, if a low happens, just let me know. I'll watch your kids. It happened, it hit. I could kind of time it too. Like I knew if I'm late for a snack, I'll get low. So I just didn't have a snack. And then I got all shaky, and I tested and I was like, I think 3.8 or something. I holler, hollered over the fence and like, can you watch my kids? I gotta go to the doctor's office, and it was only five minutes away. I was nervous because I had to drive there, yeah, but I also knew I've been in the twos before and not passed out, so I should be fine. And I did it. I drove i She took the kids. I drove to the doctor's office, yeah, and I'm shaking, and I've got my sugar pills in my pocket, but I'm shaking and I'm sweating, and the lights are somehow brighter. I guess it was the one of the symptoms of the low and then I go in and I'm like, I need my blood drawn now. Like, I'm experiencing a sugar though. It needs to happen now. I'm uncomfortable right now. Yeah, and so she, she got it, and she's the lab tech. She's like, but she can't just draw the blood. She has to, like, take the requisition and do all that stuff. So I'm sitting with her, waiting, and she says to me, she's like, Oh, you're gonna have to pay for this. And just said, Okay, that's fine. She goes, but it's pretty expensive. I said, okay, just, and I'm like, I can barely think, yeah, exactly. I'm in a like, I'm I'm sweating financial decisions, and I'm nervous because I don't I've never passed out from a low but I, I mean, there's a first for everything, yeah, and I knew I was 3.8 at home, so I've got to be lower than that by now. 20 minutes later, she said it's going to be about $500 and I and I was shocked, but then I said, Just do it. Just Do It Like It's fine. I'll figure it out, because I need I can't live like this anymore. So she drew the blood, and then I shoved some sugar pills in my mouth. Right away, my doctor told me later that it was actually only in the fours, the low fours, whereas my glucometer had shown the high threes. The blood work result from that was that my pro insulin levels were slightly elevated. That's what he got from that. And then he referred me to an endocrinologist. He couldn't have

Scott Benner 38:00
just referred to the endocrinologist, and let you keep the $500 No, did you get the 500

Unknown Speaker 38:06
back? I and I did through my husband's work. I

Scott Benner 38:09
would like you should have asked him if I could pay him millimoles instead of dollars, because I think the number would have been

Speaker 1 38:15
lower than I'm not right. It's only through, it's only through the coverage with my husband's work that we got that

Scott Benner 38:23
doctor sounds like what they call a pill. You understand? Like, I don't understand why. I mean, you had gestational twice. It is not unreasonable to think you're going to develop diabetes. Like, why do they have to have you drive around Ontario with a low blood sugar? I know you know what I mean. I mean, what if you would have crashed the plow. Yeah, there's definitely a plow on

Speaker 1 38:44
your truck, right? Yeah, not now, but that was gone, but you have

Scott Benner 38:47
one, is what I'm saying, yeah. Okay, all right,

Speaker 1 38:51
so I get referred to. This is March. Now, this is end of June. I had that blood work done. So I get referred to in 2022 I get referred to the endocrinologist, but by the time I get to the Endo, I'm pregnant again. And I noticed right away, when I was pregnant, the lows stopped. It was immediate, because your blood sugars rose. They were high, yeah. So whereas before, my fasting was around nine, and then I was, like, I said, in the threes very often. I mean, sometimes fours and fives like it happened. It was just rare.

Scott Benner 39:22
Can I ask real quickly, the time between the first pregnancy and the third pregnancy? How long is that?

Speaker 1 39:28
So my first was born September 2019, and my third was born March?

Scott Benner 39:36
Are you making a hockey team? What are you doing over there?

Speaker 1 39:38
I know, right. We did we yeah, we committed.

Scott Benner 39:41
Are you done now? Are you just gonna go for like, a five or something like that? I

Speaker 1 39:46
love four. I've always loved the idea of four, okay, but the diabetes has certainly cooled down my baby fever, it kicked

Scott Benner 39:55
your ass a little bit. We shall see.

Speaker 1 39:59
We shall. See, I'm currently focused on me and my diabetes, and then we'll see. Okay,

Scott Benner 40:07
I don't know. Yeah, no. Priest, could you've added to the total? Well, don't worry, yeah, but Okay, I'm sorry. So now you're pregnant again. No low blood sugars, no

Speaker 1 40:17
lows, none. So I was my fasting was still around nine, but then I was like, 1011, 12, after my meals. So I went to the endocrinologist, and she's like, How can I help you? And I said, Well, this, these are the reasons why I was referred here, but I am now pregnant. And she said, Okay, so we need to ride out this pregnancy as a gestational and then after delivery, we will go back to what's going on. We'll see what happens. So I was three weeks pregnant when I had that blood work done, and my ANC was seven. So this is where it gets questionable. My random sugar at the time was 12.8 and my ANC was seven. And they said, Well, you're only three weeks pregnant, so your your pregnancy doesn't have much effect on your a 1c so your a 1c reflects that you are diabetic, but because you're pregnant, we can't truly diagnose you as a type two diabetic, even though it was only three weeks you're probably type two. We'll just have to wait

Scott Benner 41:17
for I mean, it doesn't matter. You're gonna manage it the way you're gonna manage it, right? Yeah. So,

Speaker 1 41:23
yeah. Well, I had my next end of appointment. It was a few weeks later, and I was thinking, I can't go a few weeks double digits here, like I need insulin. I know I need insulin. And she said, she

Scott Benner 41:38
didn't say we're gonna try to get your blood sugar down. Because for people listening, at 12.8 is a 230 blood sugar and an average, like, nine and a half a 1c so I don't understand, like they she knew that about you, but didn't say we're going to use more insulin and be more aggressive. Yeah,

Speaker 1 41:52
she didn't give me insulin. She sent me to the gestational she sent me to the diabetes clinic, whereas I was at her office, she sent me. She's like, Okay, you're pregnant. Here, go see the team. The team will look after your pregnancy. That's what happened. I understand. So, so then my team, I put on the team,

Scott Benner 42:09
yeah, what's the gap in time? Though, when once she i It feels important to me, she sees you, how long till you see the team?

Speaker 1 42:17
I think I didn't. I don't have that in my notes here. I'm going to guess I think it was two weeks part

Scott Benner 42:23
I don't understand it, really is the part I don't understand. Always Charlie about all these I didn't

Speaker 1 42:28
understand it either. So I phoned them. Now this is a new team, remember, it's not because we moved, so it's a totally they don't know me, right? Whereas my other team for the second pregnancy, they knew me. So I ended up phoning them, saying my appointments in whatever it was two three weeks, I want insulin now, because I know I need it. These are my numbers, and an endo, a different Endo, called me, and he's like, Look, I can't just give you insulin. I don't know who you are, but he asked me a bunch of questions, and I answered them all, and he's like, okay, yeah, here I'll give you. Here's your prescription. So he did give me insulin before I had my first gestational meeting with them, because I called and basically demanded it. I'm like, these are my numbers. I need insulin, and I know what to do. So he did give me insulin before I met him, and then I had my appointment a few weeks later. And this was different management, like they had me titrating, they had me adjusting my numbers, like they gave me the power, like I could do this, yeah, which was really nice, like, because my appointments, because before I had to email them every Sunday and they call me Monday with my adjustments first here, like I'd see them every three weeks, three four weeks. I mean, I could call them if I needed them. They were always there if I had questions, but otherwise, I was left to manage myself. And I really enjoyed that, like I knew what to do. Yeah, well, hell,

Scott Benner 43:59
you got enough practice you know how to make babies and take care of diabetes, that's for sure. Diabetes, that's for sure. Yeah. So that was hugely different for me. At what point do you think during your third pregnancy, if, if, during your third pregnancy, at what point do you realize I'm gonna have diabetes now, like this isn't going away again? Yeah. So that

Speaker 1 44:21
was honestly, I didn't fully get that until the insulin dependency, when, like seven months after she was born. Because what happened? Like it was managed really well. I think the biggest adjustment for me with the third was doing needles for the full nine months. That was a hard pill to swallow, because before it was such a short period, I'm like, Yeah, I can. It's only a few months. Like, it's fine. But so I had to ask my team, like I knew I'd do my insulin and whatnot, but I had to ask them, How do I have dessert? Because I never done that before. I just didn't have. Dessert. How do I do this? So, like, they gave me pointers on how to indulge it. That was one of the hardest things, was making this like a lifestyle, yeah, instead of like a strict regimen of I just don't do that, it was like, Okay, how do I do this safely? And then exercise, because I had two kids, so activity level was a factor, whereas it was not a factor with the other two. So

Scott Benner 45:22
that was, those were the hardest things, like things to hurdle, yeah, to figure

Speaker 1 45:29
out with the third, with it being the full pregnancy on insulin. So the signs for them was that I was going to be type one later was how sensitive I was insulin at the end of the pregnancy because my target, I think fasting, they wanted, I forget now I think it was under seven, so like, my fasting would kind of be creeping up to seven, and then I'd increase my 11 year by one unit, and then the next morning, I'm waking up at four or something like that, and they're like, Wow, That's a big jump. That's a big draw. So then they gave me half unit pens, but half units for 1111, half units for an over rapid because I had a similar issue with food, like with meals, but even then, a half unit would drop me quite a bit. That was, that was the biggest sign for my Endo. I mean, throughout that pregnancy, some people, they'd ask, they'd say, so you're gestational. And I'm like, Well, I don't, I don't know, because I was told. Some people were like, Oh, so you're diabetic and pregnant. I'm like, I guess so. And others are like, but your pregnancy are gestational? Like, I saw different people all the time, like, different, different dietitian, different nurse, different Endo. There was three endos in that clinic, so everybody had a different view as to what I was fantastic, but it was not type one. It was not type one like that was not a thing yet until the very end, like, it was two weeks before baby was due, and he goes, he's like, You need to get this blood work done now, because there's a chance you will need to continue your insulin after the baby's

Scott Benner 47:00
born. And I was like, what?

Speaker 1 47:04
Like, I didn't know that was a thing, right? I got the blood work done on time. I remember phoning the office, like, a few days before she was born, and asking, like, do you have these results yet? Because my baby is about to be born, they told me I might need to continue insulin. I need to know. What am I doing? I need to know so they did, like I had to dig for those adults, they called me and they said, they said, stop your insulin after baby's born. And now I know because I didn't know in the moment, but now I know that was the what is the anti gat like the antibody test, and I was high, like there was I had high antibodies, but my C peptide was fine, so they had me stop the insulin, but I had to continue checking my sugars every like every morning and every meal. And that was not easy to do with a newborn and two toddlers running around. So that was a shock too, because, like, I just had in my mind, this will end when the baby's born, yeah, and then baby's born. And now I need to remember to check my sugars an hour after every meal. So I have these timer set, and the timers are interrupting. Like, I want to have a nap I just had a baby. Like, sleep when the baby sleeps well, I would, but my alarm is about to go off because I had my lunch an hour ago, so I'd have to either skip a blood test, like Skip turn off my alarm, not test my sugars that time, have a nap, but then feel kind of guilty because I'm not collecting this data that my team needs to figure out. What the heck is going on with me is I did not want that those daily lows to happen again. And I knew I'm like, I need to give them this information so that they can diagnose me, like, what's going on? I need that can't happen again all those lows. So I was testing after every meal. Dinner was awful, because the dinner alarm, like the blood check for after dinner, was very often during bedtime with the kids. So it just stopped. It was just constant interruptions, testing, testing my sugars. And then they so she was born March 7. I had my first follow up in April, or the April, and that's when they said, You're type one and a half. And I'm like,

Scott Benner 49:20
what? Like,

Speaker 1 49:21
I never heard of that. Like, never.

Scott Benner 49:25
So they tell you Lada. And, yeah, yeah, right. And so do is that? Has that persisted? Like, is that what they tell you, today or today? Are they just saying you have type one?

Speaker 1 49:37
Well, they don't depend. Some people say, Lada. Some say, well, Lada is type one,

Scott Benner 49:42
yeah. I mean, do you have any honeymoon at all?

Speaker 1 49:44
I don't know. I wondered about that. I didn't know if I was like it was the first few months of being on insulin. Was just a blur. And I don't know if that was honeymooning or if it was just my monthly change from. Sensitive to resistance, like I just, I don't know my endo did at one point say, he said, You're not honeymooning, because honeymooning, honeymooning is when you go from eating insulin to needing no insulin. Well,

Scott Benner 50:10
less. He's like, Yeah, not none, but less so well, well,

Speaker 1 50:16
he said, because I do get quite sensitive on my period and resistant the week before. So he's like, you're not honeymooning. You're just sensitive. So I don't know. I mean, I don't know, just another gray area,

Scott Benner 50:28
yeah, no. I mean, listen, what I'm saying is, how long has it been since you have baby three a year? Okay? And do you forget, like, within the month, like, consistently over the last couple months, you use the same amount of insulin in a month. Yeah, yeah. I mean, I don't think you're honeymooning then, like, I mean, you you have hormonal impacts that ask for more or more insulin or less insulin, but that that does, that's not honeymoon. A honeymoon would be, like, all of a sudden for, you know, days or weeks with no other impact at all, using, like, sometimes significantly less insulin. Or, you know, or out of nowhere, in the middle of the day, all of a sudden, you bolus, and then it's like, oh, God, I didn't need to do this like usual. Like, that's more about, yeah, yeah, more of a, like, a sputter, and, like, a sputtering, you know, ending of your pancreas is its ability to give you insulin. Yes,

Speaker 1 51:22
I don't think. I don't think a honeymooned. I don't think so. Or maybe it was honeymooning through the pregnancy, and you wouldn't know, but it was drowned out by the pregnancy hormone. I don't know, but he told me he's like, You are type one and a half. He said, that starts out like type two, but then turns into type one. And he said, I don't want this to hang over you, but I'm going to give you a ketone meter. And he's like, because a a severe, like the bad, like a bad case of the flu could be what turns you to type one, something like that. And it didn't hang over me because I didn't know what type one management looked like. I had no idea like, if I could go back and tell me, then, hey, go listen to the juicebox podcast to learn how to use insulin while you're not pregnant. OmniPod, that would be so would have made my insulin dependency so much easier. Oh, no kidding, because I didn't know. Like, I just didn't know. I don't know any type ones. I had asked them before during the pregnancy, like, what does type two management look like? And they said, Yeah, you check your sugars a few times a week, and you generally, like, there's medications for it. So,

Scott Benner 52:35
like, that's also a fairly inaccurate description of how to, well, take care of type two diabetes. Yeah. Well, I mean, listen, you you get you're gonna get flung right into that world of nobody really knows what they're talking about, or if they do, they don't do a great job of explaining it. And you know now, here you are. But how are you doing today? Like, what's your management look like today? I'm

Speaker 1 52:55
pumping now. I've been pumping for a month. It was a blur, like, so they told me in April was I'm type one and a half, and they're like, type one can happen next week, next year, five years, they don't know. So, like, just keep to keep monitoring, is what they said. So that's what I did. I kept checking my sugars. They kept checking like, they kept doing blood work. They put me on Metformin in August, end of August, and I did ask for insulin. I didn't know, like, again, I didn't know that what type one management looked like. I just knew type ones used insulin and like, I didn't know. I'm, like, is it a like, is it a weekly insulin? Because that would be nice. Like, I'm, like, I could do once a week needles. Like, that's fine. Or, like, once, here's

Scott Benner 53:39
what I'm willing to do. Yeah, yeah. So

Speaker 1 53:42
I asked about it, because they put me on Metformin, and I'm like, Look, I already have a sensitive gut. I've heard it can have gut side effects. What about insulin? Because I was, I think I was hitting like, 14, 1314, after meals sometimes, but I was still hitting four at times. So they're like, you're not high enough for insulin. For sure, insulin will turn your 13 is into like, a 10 or nine or an eight, but then it'll turn your fours into a two or a one. So they're like, you're not high enough for insulin. They put me on Metformin. My sugar would definitely better on Metformin. I was even getting into the fours, like, especially if I went for a walk, it definitely was good for my sugars. I My gut couldn't handle it. Like, I couldn't, so I was only on it for a month, like, I I stuck to it for a month, because they did say, my pharmacist said, like, your stomach can adjust to it, like, get used to it. So I gave it a month and it, it didn't, you

Scott Benner 54:42
didn't feel better. No,

Speaker 1 54:44
I stopped the end of September, and I also stopped testing my sugars. I was usually testing because I felt funny, anyways, because I was getting lower, but for like that three weeks, I didn't test my sugars. And I knew I should have, but I wasn't, because I'm like, Ah, on my next I know they'll just give me a different pill. Pill. I'm, like, they'll just pick a different pill or something. Like, I'm

Scott Benner 55:04
gonna take a break. I'll take a break for a month till we get back to that. Yeah,

Speaker 1 55:08
like, I mean, I had a baby, my middle child in diapers, my oldest had just started school. Like, it was a lot, it's chaotic. And so I didn't, I didn't check unless I felt funny or whatever, but I didn't really check for the three weeks. So then I had, I had my annual appointment, and he's like, Well, what have your sugars been? And I said, Well, I haven't been checking, but like, this is what they were when I was on Metformin. And he's like, Well, check your sugars right now. And I was 19, oh, and I had never, ever seen a number that high, never, yeah. The dietician went, Whoa, insulin. And he and the endo goes, Yeah, insulin. And I said, But wait, like, I just had lunch,

Scott Benner 55:55
you don't know. And he's like, he's like, that

Speaker 1 55:58
doesn't he's like, Well, what do you drink? Because I drink because I drink water. I always drink water. He was like, No, 19, yeah, yeah. He's like, 19 means your pancreas are shocked, right? You need insulin.

Scott Benner 56:09
I could go drink a two liter bottle of soda, and my blood sugar might go to 160

Speaker 1 56:13
Yeah. So then he goes, so then they're talking, the dietitian, and the end over talking, he they're talking, they're saying, like, so basic alarm the morning and over wrap it with meals. And that's

Scott Benner 56:27
when it hit me, like, I diabetes, Yeah, no kidding.

Speaker 1 56:32
It was like, like, I'm getting emotional just thinking about it. Because I thought I was done with that, because I gave birth, right?

Scott Benner 56:40
I tried to, I pushed out the baby and the diabetes. I thought, Yeah, no kidding.

Speaker 1 56:44
So then it was like, oh my god, I'm on needles like, for the rest of my life. Like it was, I was in chalk, like, I think it was compared like I I couldn't believe it. So that I'm processing that of like a needle with every meal and the morning and like

Scott Benner 57:09
it was, I just wasn't. I didn't

Speaker 1 57:13
know. I wasn't expecting that. Like, even with the one and a half diagnosis, nobody had said, Hey, like they had said, it'll turn into type one. But no one had said he didn't really know what that meant like. And I didn't think, yeah, I didn't know what it meant. So they put a libre on me, right, and sent me home with a prescription. And he said, he said, start with eight units of basal glare in the morning. And I think it was three units of Nova rapid per meal. That's all your direction. That was it. And I remember thinking, maybe they have more trust in me, because I already have experience with this. No,

Scott Benner 57:48
that's not it. Charlie, what happens is, no one tells anybody. You know, I am never not gobsmacked and think to myself, how is everyone even alive? Like, here, just take some insulin. It'll work out. Like, okay, yeah,

Speaker 1 58:00
right. And I did, so I kind of, I went into this overconfident. I know that now because of my gestational so I thought, Okay, this like needles with every meal and every morning. That's what I did. So I can do this. I had this false it was false. Common is I would figure it out, because I what they told me when I'm pregnant is the

Scott Benner 58:25
pregnancy hormones affect your sugars, and I'm like, Okay, well, I'm not

Speaker 1 58:30
pregnant, so I won't have that roller coaster. I'll figure out my dose, and I'll be good to go.

Scott Benner 58:36
It still felt like taking a pill to you, but through a needle. Yes, yeah, exactly. Because

Speaker 1 58:41
I thought I'll just figure out my dose, like I will put my heart into this, like I was weighing everything, I was measuring all my food accurately, and I was trying to figure out the right dose, and I was never I couldn't get it.

Scott Benner 58:58
There's a reason for that.

Speaker 1 59:01
I mean, now I know like it's so much better now, but at the start of it and eight units was way too high, but I didn't know that. So then I'm getting low between meals, which was normal with pregnancy, so I'm snacking, and then I'm getting high before my next meal. And and my appointments are a few weeks apart, so I'm on my own for a few weeks, and I can call them if I want to, but I also thought, Why call them like I'm allowed to adjust. I'll do my own adjusting and tell them what I've been doing. So then at some point they said, like you're not you shouldn't snack on carbs between your meals. Type ones don't do that, like meat and like protein and veg between meals. Like, okay. I mean, I guess that kind of makes sense. So that was an adjustment. Like, I just went into this thinking, like, I know how to do this, but I didn't, like, no clue. But the pregnancy made me think I did. And the other thing he never told me, he just. Said, this is your target. You need to be between four and 10, so adjust your insulin until you're within target. While I was 19, no one told me, like, Hey, do this slowly. The next few days, I'm just doing my like, I'm going to target. And then I had, I guess, a sugar withdrawal. I don't know what it is, but my vision was so blurry I could barely read my phone. Oh, because

Scott Benner 1:00:27
you were bringing your blood sugar down so quickly. Yes, and,

Speaker 1 1:00:31
but I didn't know that in the moment. So I'm trying to Google like, is this a weird Is this a low? Like, am I going to pass out?

Scott Benner 1:00:42
Yeah, what? Why can't I see?

Speaker 1 1:00:44
Why can't I see? Oh, the other thing, when he gave me the insulin, he also gave me a prescription for Vax. Is it vaccine? Me thing? And I said, What's this? And he said, Oh, that's in case you're unconscious from the low blood sugar, someone else can spray it up your nose.

Scott Benner 1:01:03
What a description I was like, what like? Because

Speaker 1 1:01:08
I was on insulin before, when I was pregnant, nobody ever gave me this. No one ever like that wasn't a thing. So I'm leaving with like, Okay, I could pass out, and someone else will need to stay like, what? Like, I was just so confused, yeah. So then I'm scared, because I'm like, okay, the chance of me passing out must be high enough,

Scott Benner 1:01:32
because they've given gave me the squee, yeah, gave me

Speaker 1 1:01:35
this thing to fix that. I'm home with a baby and two toddlers. What am I? Who's gonna save me?

Scott Benner 1:01:45
Charlie? Which one of these kids Am I gonna put in charge of shooting powder in my nose?

Speaker 1 1:01:50
Yes. Well, so then, anytime I felt funny, my first thought was, if I pass out right now, are the kids okay?

Scott Benner 1:01:59
No, not if you fall, for sure, you're gonna squish one of them.

Speaker 1 1:02:04
I pass out on the floor right now. Is the baby? Like, where's the baby? Where the kids are they? Like, where are they? Yeah, you

Scott Benner 1:02:10
have this whole new fear, yeah,

Speaker 1 1:02:13
I was terrified, damn, right? Because I'm I'm home with the three kids. So

Scott Benner 1:02:18
where's your husband? By the way,

Unknown Speaker 1:02:20
he works for, for hydro,

Scott Benner 1:02:21
is that he

Unknown Speaker 1:02:23
fixed. He's a lineman. He's

Scott Benner 1:02:25
a lineman. Okay, all right, so he's gone, he's he works, yeah, he's gone all day, literally, up a pole, Yep, yeah, a lot of that's what got you in trouble, by the way, with the adjustation. But yeah, I hear what you're saying. I assume he's gone for long stretches then he comes back. You missed him? No, no, it's not like that. Okay, no, he's

Speaker 1 1:02:47
home every he works seven to three, Monday to Friday. Oh, you have time. He works a lot of overtime, but he's gone all day. Yeah, yeah. So the fear

Scott Benner 1:02:56
pay for insulin.

Unknown Speaker 1:03:01
The fear was huge. Yeah, I

Scott Benner 1:03:02
imagine I'm not No joking like, I mean, it's the idea that I could pass out and I have three little kids with me is overwhelming. Yeah,

Speaker 1 1:03:11
now, over time, I learned to trust the tools, and I knew, and like, I learned after a few weeks, I don't know it was such a blur, because I tried so hard to be perfect too, and then I was so hard on myself, so fixated on target, that's where I really went wrong. Is like four, four to 10. I need to be between four and 10 and under seven in the morning. So if I was over seven in the morning, I'd increase my basal glare, because that's all I knew to do. Like, Target,

Scott Benner 1:03:41
Oh, you were being too reactive. Yeah, the wrong thing.

Speaker 1 1:03:47
Like trying so hard to be perfect, and it was just causing this roller coaster. Yeah, I didn't know to connect all these dots. I didn't know. Okay, maybe my fasting was high today because we had a movie night last night. Like, I didn't know to analyze it that way. It was just, oh, my fasting was high. It's been high for a day or two or three. I'll increase my long acting well, then I'm getting low between meals and in the night, and then, because that

Scott Benner 1:04:11
wasn't the problem, your your long

Speaker 1 1:04:12
problem. But I didn't know it yet, because I didn't, I hadn't found the podcast yet. I was stuck on with my gestational experience, like that was the only experience I had. So I was kind of Yep. That's what was guiding me mostly. I mean, I had my team, but that's only a one hour ish appointment every few weeks. Yeah, and

Scott Benner 1:04:35
they're not all that helpful, let's be honest. Like, you know what? I mean, they only, well,

Speaker 1 1:04:39
they only look at the last week, let's say. But then there was two or three other weeks that I was struggling that they're not analyzing to tell me where I'm going wrong or not. And I didn't know about compression lows, like I'd pricked my finger a few times during the day, like, Hey, can I trust this thing on my arm? And it was accurate. I'm like, okay, I can trust. Said I didn't know about compression, though, so I'm getting these lows in the night. I'm just getting up and drinking juice because I didn't know to question it like a compression, though. Until the one morning I woke up and it's screaming that I'm like, 3.9 and dropping, and I'm like, I don't feel that. I

Scott Benner 1:05:15
don't think that's right. So

Speaker 1 1:05:17
then I tested on like, seven. I'm like, my god, like now I can't even

Scott Benner 1:05:23
now you feel like you can't trust that. No, no, yeah, there's a cascading thing that happens as you're learning. And I, I'm always fascinated when somebody thinks to grab a different meter and test their blood sugar again, and then they see the two different numbers, and that like, frozen feeling. It gives you of like, if that one said 83 and that one said 105 then what am I? And then, you know, these are all what they call come to Jesus moments when you when you start really understanding, you know what this is going to be, and you accept it. That's really the big part. It's just the acceptance of it. Charlie, I appreciate you sharing this story with me very much. Is there anything we didn't talk we didn't talk about that you wanted to because I'm up on time, but

Speaker 1 1:06:05
I was just looking at the time. We didn't even make it to my pumping.

Scott Benner 1:06:09
Yeah, see that? No. Well, you did a really. So it I don't know how interesting this is to people, but there are some people that I interview who are very leadable. They'll tell a bit of a story. I ask a question that takes the story in the direction that I'd like it to go in because it feels natural to me. And people like will answer. And then there are some people who know how they want to tell their story. I can affect it. You're one of those people. So so in the beginning, in the beginning, in the first 10 minutes, if anybody wants to listen back for a podcast lesson about how to interview somebody, I tried to do what is most comfortable for me. You didn't respond to it, so I adjusted to what's more comfortable to for you. So if you would have let me, I could have got us through it faster.

Speaker 1 1:06:57
But now I didn't even realize you were

Scott Benner 1:07:01
resistant, oh, but not in a bad way. I just, and I've learned that it's better for you to tell your story the way you want to tell it than for me to cram you into my style, because then every time I've tried to do that, it makes people they're on. I don't know what the word is, but it's not as smooth, so I don't do it anyway. No, I think you did a great job, you know. And then we'll say, and you move to pumping it happily ever after, not quite, but not quite. You're still getting it

Speaker 1 1:07:28
hopefully. Well, I'm only six weeks in. What are you using? A learning curve as well. You're

Scott Benner 1:07:33
using OmniPod, no tandem control, IQ, mobi, yes, regular. There's

Speaker 1 1:07:40
only, there's only three pump options in Canada, and so Medtronic tandem or omnipodge. So it's tandem teasing, okay, is what I'm on.

Scott Benner 1:07:49
And you're still, you're still figuring out. Tesla, have you tried the control IQ ninja episode?

Unknown Speaker 1:07:55
Not yet. You

Scott Benner 1:07:57
would want to find that one that's a good one. Yes. Okay, for sure. All right, so g6 control IQ, on on the on the T slim, and you're just getting into it now you're digging in and learning,

Speaker 1 1:08:10
yeah, so I'm following the rules of the pump to try and just see what the pump can do, testing the boundaries, like, hey, if I eat this, can control IQ, control it, that kind of thing. And then I know in time I'll start maybe, like, taking some carbs. I've heard people will do that stuff like that, like breaking the rules at the pump. I suppose you

Scott Benner 1:08:30
should check out that episode. I'm gonna tell you what episode number. Just hold on a

Unknown Speaker 1:08:33
second. I

Unknown Speaker 1:08:34
it's, it's on my to do list for sure. Okay. It's,

Scott Benner 1:08:37
um, 662, wow. I have four. I have three episodes with the word ninja in it. I have control IQ ninja. 662, somehow episode 290, from 2019 is called theoretical ninja. And then episode 800 is lazy control IQ ninja, which I remember this woman's like, I want to come on, like I heard control IQ ninja, and I really like, and as she was describing it, she's like, I'm more of like, a lazy ninja.

Speaker 1 1:09:05
That's hilarious. Yeah, I need to listen to more pumping episodes for sure. Yeah,

Scott Benner 1:09:10
understanding how, you know, even understanding how loop works, and OmniPod five works, and and all the different algorithms, like, just getting a vibe for how algorithms work helps you to understand how your specific one is doing, what it's doing, even if they're not like exactly apples to apples. There's you need to understand no matter how your system does it that concept of raising basal, lowering it, taking it completely away, giving it back again, like this constant dance that's going on with insulin, little micro boluses with some of them, bigger boluses with some of them, like, how is it like, you know, loop sometimes will put all the insulin in, like, for a meal, and then completely just take away the basal for hours and work off of just the bolus, and then suddenly start. Reintroducing the basal. It's, it's, um, it's, it's interesting. And you learn about a lot about diabetes, watching your pump do what it's doing. Yeah,

Speaker 1 1:10:09
I'm always going back in the history to see, like, what did it do? What am I what am I pump doing? How did I respond when

Scott Benner 1:10:16
Arden first went from just manual pumping to looping, and I had, and still have the night Scout app, and I was watching it, give her insulin, take it away and give it and take it away. I was like, Oh, my God, it's doing what I was doing. Because if you listen to the to the Pro Tip series, you hear me talk about, like, you know, temp basal increases. Temp basal decreases. Like, you know, create, like, black holes where there's no insulin for a little bit like, so there's a stop, a drop, and, like, I talk about all that stuff that I figured out completely on my own. And then I was, I'm watching the algorithm work, and I'm like, oh, it's doing what I was doing. That's so interesting. Yeah, how cool is that? So? And now I sleep. So, ha, ha, yes, yeah. Anyway, all right, Charlie, I'm gonna let you go. I think we're definitely calling this one Beavertail. Okay, otherwise, I just have to call it. There's no chocolate factory. And that doesn't make any sense at all. No, but, but I really do appreciate you doing this. And like, people don't know, but like, you had to set up, you had to set up all these raccoons to run on this thing to make electricity so that you could get online. And it's a lot of work to be on if you're Canadian, a lot of work. Yeah, so I appreciate you doing that very much. Thank you. Great. Way north. Oh, please. Hey, real quick, strange brew. Do you know the movie? Yes. Okay, I I'm now asking every Canadian that, like, you know how I ask, like, Are there any other autoimmune issues in your family? Which I didn't ask you. Are there any other autoimmune issues in your family?

Unknown Speaker 1:11:41
No, not

Scott Benner 1:11:42
that I know of. Okay. Do you have anything else? Celiac, thyroid, anything like that? No, okay, not

Unknown Speaker 1:11:48
yet. At least the last

Scott Benner 1:11:49
two Canadians I've interviewed have not known the movie strange brew, and one of them didn't even know who Rick Moranis was. So, oh, I am now going to try to remember to ask every Canadian, these questions, you should I'm going to I love you, by the way. You are so Canadian. That's fantastic, Charlie. I don't know if you know that or not, but I didn't know that. Oh, okay, you'll listen back and you'll hear it. You'll be like, Okay, I am very Canadian. I will listen for it. Nothing wrong with it. Just interesting. All right. Hold on one second. For me, I really appreciate you doing this. I want to thank the ever since CGM for sponsoring this episode of The juicebox podcast and invite you to go to Eversense cgm.com/juicebox to learn more about this terrific device, you can head over now and just absorb everything that the website has to offer, and that way you'll know if Eversense feels right for you. Eversense cgm.com/juicebox, the conversation you just enjoyed was sponsored by OmniPod five. You want to get an OmniPod five you can you want to make me happy? Do it with my link. Omnipod.com/juicebox if you're looking for community around type one diabetes, check out the juicebox podcast. Private, Facebook group. Juicebox podcast, type one diabetes, but everybody is welcome. Type one type two, gestational loved ones. It doesn't matter to me. If you're impacted by diabetes and you're looking for support, comfort or community, check out juicebox podcast. Type one diabetes on Facebook. Okay, well, here we are at the end of the episode. You're still with me. Thank you. I really do appreciate that. What else could you do for me? Uh, why don't you tell a friend about the show or leave a five star review. Maybe you could make sure you're following or subscribed in your podcast app, go to YouTube and follow me or Instagram. Tiktok. Oh gosh, here's one. Make sure you're following the podcast in the private Facebook group as well as the public Facebook page you don't want to miss. Please do not know about the private group. You have to join the private group as of this recording, it has 51,000 members in it. They're active, talking about diabetes, whatever you need to know. There's a conversation happening in there right now, and I'm there all the time. Tag me. I'll say, hi, hey. What's up everybody? If you've noticed that the podcast sounds better. And you're thinking like, how does that happen? What you're hearing is Rob at wrong way recording, doing his magic to these files. So if you want him to do his magic to you, wrong wayrecording.com, you got a podcast. You want somebody to edit it. You want rob you.

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

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