Podcast Episodes

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

Filtering by Category: Teplizumab

#485 Altered Minds

May 28, 2021Scott Benner

Scott and Jenny Smith, CDE share insights on type 1 diabetes care.

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

+ Click for EPISODE TRANSCRIPT

DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.

Scott Benner 0:00
Hello, and welcome to Episode 485 of the Juicebox Podcast. Guess who's on the show today.

Today on the podcast, I'm joined by Jenny Smith. Jenny, of course, is from all the defining diabetes episodes, and the pro tip series. And today she's here to talk about how people can be altered in their, in their minds when their blood sugars are high or low. Right. So if you're looking for an understanding of what high and low might make someone feel like or could make you feel like this is the episode for you. During this conversation, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan, or becoming bold with insulin.

Jenny holds a bachelor's degree in human nutrition and biology from the University of Wisconsin. She's a registered and licensed dietitian, a certified diabetes educator and a certified trainer on most makes and models of insulin pumps and continuous glucose monitors. One day when I grow up, I hope to be just like Jenny.

The T one D exchange needs 6000 people to join the registry. And I have to keep saying this to you until you do it. So the D one D exchange is looking for T one D adults and T one D caregivers who are us residents. They want you to participate in a quick survey that can be completed in just a few minutes from your phone or computer after you finish the questions. And they are very simple. I completed the survey in about seven minutes. You may be contacted annually to update your information. And they may even ask you a couple more questions. But this is 100% anonymous, it is completely HIPAA compliant. And it does not require you to ever visit a doctor or go to a remote site. See, this is interesting. This is a way for you in just a few minutes to help other people living with Type One Diabetes. Past participants have helped bring increased coverage for test trips, Medicare coverage for CGM, and changes in the ADA guideline for pediatric a one c goals. These are important behind the scenes things that people with type one diabetes need, and you have a unique opportunity to help them. These are not deep probing personal questions. They're pretty simple basic surface diabetes stuff, but they just need the data. Help them at T one d exchange.org. forward slash juicebox. And at the very least, if 6000 of you go right now, but I don't have to say this again. Do it for me.

Unknown Speaker 3:06
I'm kidding. Do it for the other people living with Type One Diabetes. But I mean, if you want to think of me while you're doing it, it's fine. This one's weird. But I will say

Unknown Speaker 3:18
it means it came from

Unknown Speaker 3:19
somebody came from somebody, but it's not

Unknown Speaker 3:21
from somebody.

Scott Benner 3:23
But it but it made a lot of sense to me when they said it. And then I left it on my list for a long time. And every time I look at the list, I'm like, yeah, we're gonna have to talk about that. I think so. Hopefully, I

Unknown Speaker 3:34
have something.

Scott Benner 3:37
So I'm posing this next question to you, Jenny. Because you have diabetes, and you would have you would have a real feeling for what this is? Maybe? We'll see. We'll see. Hopefully, I think you will. So I hear this from either parents or spouses usually. And it's something we make light of in communities and joke about, like I've said before, to my daughter, you know, when she was little, I'm gonna test your blood sugar. And if it's not high or low, you're in trouble. Right? You know, like, because you kind of can't, you can't tell, like, Is somebody acting a certain way because they're altered? Or are they acting a certain way? Because they're, you know, right a pain in the ass. So like, you know, which isn't, but that always makes me feel like what is the person with diabetes hearing when they're altered? And so that's what I want to understand. And when I'm we're gonna do both, but let's start with higher blood sugar. So I know there's no Mendoza line that you can point to perfectly, but I will. I've always said in the past that as ardent as active if her blood sugar starts to creep above 161 80. I could see her slow down, her reactions get slower, things like that. We know that people get cloudier. We've talked about on the podcast a million times as you get higher and higher, but what's it like to be in your head when your blood sugar's higher. Like, like, what if your kids are acting up? Or your husband's being unreasonable? Or you have to make dinner? Like and like, what does that feel like to you?

Jennifer Smith, CDE 5:14
Yeah, I think it to me, it feels one I'm just annoyed. Right? And it's not annoyance with them, it's annoyance for the number for why ever it is where it is, right? And it could be even worse, if it was like a bad site. Right that now, you know, like, fiddling with for a while actually get it. And I think then it the mental piece of that then comes when you're trying to manage this number that you're not happy with. And somebody interrupts that train of thought in that interrupt by, they're not like doing it intentionally to ask you, you know, can we have applesauce for dinner Mom, you know, like, it's just a piece in the mix. So I think mine is more like, it's just a mental struggle at that point. And I do also tend to, I get kind of headachy not so much when I have lows, but more so when I am higher, it's that like, mental that foggy kind of piece. And it makes me feel headachy I'm not the kind that's like a throbbing, but it's like that cloudy kind of headache that you get. Um, and again, that's just an irritating factor in and of itself, too.

Scott Benner 6:36
So there's a mechanical portion of it where it is, you know, for whatever reason, either you may be missed on a Bolus, or like you said, your site went wrong or something. So there's, there's a mechanical thing, I need to fix this thing, which becomes irritating as it would to any person, like, like, if I walked into a doorframe, I'd be like, I cannot believe I just walked into a doorframe like that. So you've got that going on. And then you have the actual act of having to fix it. And then you're focused on that someone else comes in. So this is still all mechanical, like, but then the headache happens. And that's not something like a like a, like a warning light on your palm doesn't go off and say Jenny's got a headache now, right? So when a five year old comes at you, you you can't say to yourself, I'm, I feel a pain in my head that I'm not even aware of yet. I'm going to react it you don't have like, that's not how thinking works. So then you're just level of irritation is, does it? Here's how I just went, here's how my wife puts it. around her period, she'll tell me, I'm not being unreasonable, I just have less space for bullshit is how she puts it.

Unknown Speaker 7:48
That's really great.

Scott Benner 7:52
I don't I think she's covering for herself, but I understand the intent of what she's saying. So there's a there's a ceiling in people before they get upset. Right. And there's all kinds of, of outside irritants that can limit that ceiling. But just your blood sugar being higher physically, can take away from your ability to, to abide both, basically, I guess, correct.

Jennifer Smith, CDE 8:16
And, you know, from my standpoint, too, you know, with the work that I do, and all of the data management that I do and interpreting things for people. I mean, the majority of my management is just because I want to be healthy, right? But the other piece of it is it also leads into my work. Can I get worked on really well, if I'm sitting really high, or if I'm sitting really low? My brain isn't functioning well on either level. So that management piece is always also there to benefit people.

Unknown Speaker 8:51
So I'm not typing out a message that's like, you know, I don't know why your blood sugar.

Scott Benner 8:58
Mary, why don't you just figure it out yourself? I paid this lady to help me with my blood sugar. And she yelled at me. Yeah, that wouldn't be great. No, but but I want people to understand that whether and I think they do. But if I do, I think they do understand that a higher blood sugar could be an issue. But the problem is, again, that you don't walk around as a person with diabetes with your blood sugar across your forehead. So what I come up to you, you're just Jenny to me. I don't know if your blood sugar's to Swanee, and you have a headache. And so how, what I guess what should those people be looking for so that they can back up and go, Oh, you know what, this could be that because even if I understand that your budget, say I come up to you, you react oddly. And I immediately understand it's your blood sugar that's high. If I say to you, oh, your blood sugar is high. I'm sorry. That's just gonna make it worse. Right? That's the, that's the diabetes equivalent of me saying, Oh, you have your period. I won't bring up the car payment right now. Right. Okay. Okay.

Jennifer Smith, CDE 9:58
Yeah, yeah, kind of and I think it does bring up a good. A good point, though, especially for I think this is goes more for adults who have a spouse or a significant other or partner or whatever. Because like Nathan, he follows he's got Dexcom follow, you know if it's got my stuff, but I mean, he doesn't keep it open and follow me all day, he's got the alarm set, and all of that for like, high and low. But other than that, I mean, he just, he lets me alone, honestly, which I'm very thankful for outside of counting carbs for me if he's like done dinner or something, you know, which is awesome. But in that regard, I think it also means that as the person with diabetes, you kind of also have to share more at times. Because as I do more often with my kids, I share with them, you know, this is what I feel like right now and go color in your color book for like 10 minutes while mommy changes her bad pod, or whatever it is, no, but I think it means that you have to express a little bit in order to decrease the chance that somebody is going to interpret your reaction to something in the wrong way. Because certainly, I mean, that's happened if the married a long time. And there's definitely been like blood sugar reasons for reactions that didn't really come out as response that I meant it to come out kind of sounding like. So I think sometimes you have to be open enough to be able to say, Hey, you know, I need this, like 15 minutes to manage around this, come back and like, ask me in a bit, but that's

Scott Benner 11:38
gonna come out as I wish I would have dated your brother and said, there you go. So I have a little context around this, which I've mentioned off and on in the podcast over like, the last year or so. And it's just that my, my iron level got really low. And I completely understand what you're saying, like saying words, not having the intention behind them that the words have, and also not being able to see that it's happening. Like, that's the interesting thing, like when you're saying something to somebody, even if it's a tone, you know, just the wrong tone. And you don't know what's the wrong tone, while you're saying it. Like when you're being sarcastic with somebody when you're, you know, when you're in an argument, you're like, I'm gonna ramp this up, right now, you're aware, you're going to do like, I'm going to say something now that's going to make you upset, but it's happening. And not only do you not know what's happening, but you don't think it's happening. And that's the that's the real fascinating part like is that you're doing this, it feels like it's you're doing it but it's just that there's a level of a trace element or something in your body. For me, it was iron, you know, for you, it's gonna be not enough insulin, and you're just you're not yourself. And it's, um, it's tough, because you're asking, you're getting you're an adult who's ultra where their blood sugar's, like really like your, you know, you do an amazing job for yourself. So maybe you can see it. We're all trying, right, one way or the other. But, but my point is that maybe you've been able to teach yourself over time to go my numbers up, like I won't get involved in an important conversation right now. Or I'll send my kids off the color for a second so that I don't tell them I wish I didn't have children. But But you know, when your kids 16, or you're 24, and you've had diabetes for a year and a half, and you're at work, you don't you're not gonna see that comment like that.

Jennifer Smith, CDE 13:38
No. And mine's more so in terms of like, like, spit out of things that I don't even know that I've like said the way that I've said is more so even when I'm low,

Unknown Speaker 13:50
honestly, yeah,

Scott Benner 13:51
let's switch to that idea. Now.

Jennifer Smith, CDE 13:52
It's, there's much more like the it's like a fragment of like thought in your brain. You're trying to manage how you're feeling with this low while you're probably waiting for the low to not be low anymore. And in that come the things of life. I mean, unless you're a single person and not interacting with kids or adults or other people around you. There's always someone you're interacting with. And that interaction, then in that time period where your brain isn't really firing off, right away. It doesn't you don't interpret it coming out in sort of the jagad way that it does. And then Aftermath is often Well, I'm really sorry, or, you know, I didn't mean that or I've Whoa, I felt like crap. And does it bother me?

Scott Benner 14:45
Does it feel like that afterwards, like after it's over and you're okay. Do you have the guilt that you did something wrong? Because it's not true. Right, you know,

Jennifer Smith, CDE 14:57
right. I mean, I'm only in the scenario that You know, we may have been potentially discussing something or whatnot. And that was the case during that discussion. Yeah, I mean that obviously every time by any means do I feel bad about, you know? Yeah. But yeah, it's a hard, it's a hard thing. And sometimes even with Lowe's, I think that I will have responded to something. And it's been in my head that I've actually and my husband will be like, Did you hear what I asked you? And I'll be like, I told you, whatever. And he's like, No, really,

Unknown Speaker 15:34
he didn't say it out loud.

Jennifer Smith, CDE 15:39
It's just like that muddiness that I think commented about before when I feel like I'm like, sort of like,

Scott Benner 15:45
that's the real low. There's a slide in there. There in the beginning, right. And numbers wise, doesn't really matter. But you know, if you're, the way I think of it with Arden is maybe between, I would say at 65, Arden maintains herself. Hey, Dad, I feel dizzy. You know, like, she's just like that. She's a little kind of jokey about it right there. It's almost like you could be like, hey, let's not do anything and see if you die. And she'd be like, Okay. Yeah. Yeah, right. She's elated for some reason, right there. Okay. And then it goes down and her energy drops away. But if you were to catch her there, somehow she got past the elated part into that part. And that's where you first intersected her. She'd be snappy, like L'Oreal short and nasty, right? And then I think after the nasty is what you were just talking about where the last, the last fragments or thoughts are, right? Yeah. Okay. It's almost like a and then there's, you know, falling over and not being able to help yourself. But as it's happening, are you able to consciously think, hey, my brain is trying to shut off and I'm the only one who's going to stop it. Right? Or does it turn into just a physical like, eat something feeling?

Jennifer Smith, CDE 17:02
I think it's probably a little bit of both. I mean, in my I can remember a specific time. Soon after my first was born, we had gone. I think it was to Kohl's, actually. And I was standing in, and I was nursing obvious at that point. So all the fluxes that can kind of come with blood sugar, and whatnot, mostly like lows, and my husband had gone off looking for something in like the men's department and I was standing like, in the toy department, we are looking for something specific for our little guy. And I can remember feeling low. And like, you can determine like those dropping lows. I was dropping. And so I sat down with my baby on the floor,

Unknown Speaker 17:48
the baby.

Jennifer Smith, CDE 17:50
And I get out, you know, my glucose tablets, and I'm eating my glucose tablets. And I, I had my husband found me, I mean, I was fine. But I was sitting there just like waiting for the load to fix itself, because I knew that I had taken care of it. But in that I had also gotten my phone out. And I was texting him to come to the kids department. Because I was low. Only I never hit send. Okay, I was just like, that's kind of that like, broken, like thought kind of that can happen. Well, do

Scott Benner 18:25
you ever get in a moment like that? is are you Cognizant enough to think don't fall forward on the baby? Like, do you? Like do you have those feelings? Like all the reason

Jennifer Smith, CDE 18:33
that I sat down? I mean, from my back thought to what I was doing, I would have thought, you know, I need to sit down. I've got a baby who clearly can't stand on his own yet, you know, I mean, it was I think he was probably like six months old or something. Yeah. And it's a sit down, treat your low blood sugar. I mean, I've always been able to treat so I've never had an issue with not being able to help myself. Outside of like, when I was a teen with my parents. So yeah, but it's, it is I mean, in those instances, sometimes there's not enough to like even like, be angry, you just can't even communicate

Scott Benner 19:10
quite right. It's interesting. It's super interesting to me the way that first of all, the way your body handles falling blood sugar, it's, it's when you start losing faculties, your it's your body shutting down, it's basically services. It's like, Oh, we don't need that one, like and it just, it just it has this finite amount of sugar in your blood. And its goal is to keep your brain running. Correct, right. And so it starts shutting. Right, stop sending sugar to this idea and this idea and so you're like, going down and it's your body going like, it really is it's like let's try to see how long we can stay alive until something intervenes. But you describe the, the actual actions you take very similarly. Like are like okay, I'm not okay, I'll sit down. I'll start taking these things down. It's more important than telling someone right now it's important to tell like you're doing the same thing. You're making these like,

Jennifer Smith, CDE 20:06
it's just that you're not like consciously. It's almost like your brain like those, like files in the back that were like, do this now, right? They take over, even though you're not really like, consciously aware that you're like sitting down and like drinking your juice box or whatever it is you do it because it's a habit. And you know what, that that's what you need to do with with the symptom?

Scott Benner 20:31
would, would you looking back on it a scenario like that, if that if the Jeeva hypo pan existed, then would you being with your baby, would that have been enough for you to be like, I'm not going to take tablets, I'm going to hit myself with glucagon. Or no, you still would have handled it that way.

Jennifer Smith, CDE 20:50
You know, possibly, with, with what I remember about that being such a quick drop in my blood sugar, I mean, it's not like we're running around the story. It's just like, I'd probably nurse before we went in the store to keep him happy. And like, there was enough to feed into the store. But,

Unknown Speaker 21:11
I mean, maybe,

Jennifer Smith, CDE 21:12
I mean, I certainly I've got like an extra bag Sydney, that I typically take out, especially when we're like traipsing around the neighborhood to the parks, and whatever. I mean, my eight year old knows about it. So I possibly I might have done that.

Scott Benner 21:29
Just because me with the back semi and like fit g vote now being like ready to go. But prior to that I only ever thought of glucagon is like, You passed out and somebody came upon you and gave it to you. Like that's how it felt. But now all of a sudden, like it's there, and it's easy to use. And like, I wondered about that, like how you would think about it?

Jennifer Smith, CDE 21:49
Yeah, yeah, you could, I mean, it's certainly not a bad thought by any means. Especially I've worked with a couple of women post well through pregnancy, and then postpartum who have had spouses who've been military. And so they have after a certain amount of time, postpartum, you know, their spouse goes back, you know, might be deployed again, someplace completely away from where they are, they're pretty much on their own. With a baby, they might have the support of friends or family coming in once in a while, but that's not at two o'clock in the morning. So you know, in a case like that, where you're dropping a really low and you're really worried about it not sure. That's what a product like that is therefore it's also the benefit potentially, of, you know, like mini dosing that age old red Lily glucagon.

Scott Benner 22:38
So, here's the question then, because I came at this from the idea of the people who are going to interact with a person who's either too high or too low. I have to be honest, when Arden in the past has been too low, where she's refusing I just go with like, a forceful because I think like, I've tried talking or like, you know, I've gone with the Come on Sweetie, drink it. It's really important. Like that stuff. That doesn't go it's almost like you're not talking to the complete her. Now, you know, and so you just you make these declarative, forceful statement, drink the juice, drink it, drink the juice, drink the juice drink, and I'm talking I remember I know, people say to me all the time, you know, you must know what it's like to raise a little kid with diabetes back before all the technology and I don't talk about it very much, but it's really bad. And so you know, like back before CGM and all that. There's, it's three o'clock in the morning. You're there with a six year old and you're like art and drink the juice, like drink the goddamn juice right now, you know, and because there also was no CGM, like at some point. So what's happening? Yeah, I'm like, you know, and you don't, you're not yelling, you're gonna die. But you're, it's how it feels in your head when you're talking to them. And I think that's much easier to figure out with a low blood sugar, right? Like, that's obvious to people, but it's the, it's always the high ones that make me I feel badly, like, I feel badly when I hear I've used this example over and over again, but it sticks with me, like right in the center of my heart so much that a woman found the podcast, it helped her daughter. And when she sent me a note, months later to thank me, she said, I really just thought my daughter was a bitch her words, and that we weren't going to get along for our whole life. And it turns out, my daughter's a lovely person. And I didn't know because her blood sugar was always high. And that makes me want to cry. And, you know, and and the, the idea that that could happen. Either at the beginning, right, you'll hear people say, Oh, I didn't realize you know, that that stuff happened, or I helped somebody recently with a baby, a young kid who has autism. And he end up talking, I said, Hey, you might see a difference in you know, just how reality personally and stuff. And that person was so sure that that wasn't going to happen. And then three days later said to me, you know, he is happier. And I said, Yeah, like you don't, you don't know. And then that's a sadder situation, because then the poor kid couldn't tell, you know, isn't right verbal to begin with very much. And but I just think about that for everybody else. Like, if you're running around with blood sugars that are 170, all the time your body gets used to it. So physically, you think you're okay, but you're not like you're not the person, you were going to be. Right without diabetes, you know. And so, there's just

Jennifer Smith, CDE 25:35
not even from a mental standpoint to even from performance, right? You may not be, you may not be putting out everything you possibly could putting things together, whether it's in school, or college, or job or whatever. Because your brain is really not working at the level of glucose that is healthy for it to work at

Scott Benner 26:02
this conversation is at the core, why I initially years ago, brusque, so hard at the idea of better high than low. I was like, I don't think that's right. Yeah. You know, like, I think that that that does not seem right to me, I've known people who through a lifetime, we're not who they were supposed to be, I just know it and it, you lose your you know, it's it every day you lose, it's gone, every hour you lose is gone. And then days turn into months to turn into yours. And before you know what people just think you're a prick. And you know, and that's just not,

Jennifer Smith, CDE 26:35
and you may not be at all.

Scott Benner 26:38
Yeah, maybe with another two units of basil all day long, you would have been an absolutely delightful person. And that, and, and then I think about the people on the other side who have to deal with you who love you. And then think, Oh, I love a guy who's just a jerk, but maybe isn't, or you know, vice versa, or your kids or I don't know, I just I want people to be very aware that outside of a normal range, that the lack of or addition of sugar in your blood is having a real big impact on your personality and your ability to live and make decisions and everything right?

Jennifer Smith, CDE 27:11
I mean, I've even had parents who have asked me, you know, how do you? How do you discipline your child with diabetes? When you're like, Do you always refer back to the blood sugar to begin with? Or, you know, do you just discipline them as if they don't have diabetes? And quite honestly, think if they require discipline, because they threw the stone through the front window? Because they were aiming and wanted to do it? I mean, really, unless their blood sugar's like 12 really loud are really high. Obviously, that was a that was like a decision on their part. They deserve to be punished right? away that your, if your blood

Scott Benner 27:52
sugar is 150, and you're breaking windows, you're just get Yeah, but but but I mean, but if you're a bunch of just been to 20 for your whole life, and you can't do well in math. It might not be because you're not good at math. Right. And you got to make that decision. Yeah, I mean, listen, I there are times there's been one or two times that Arden's been so low, that she has said horrible things to me. And I just I bear down and I think that's the blood sugar, and I just let it go. But you really have to be ready for it like because it's hard not to react. You know, I mean, Jenny, I'll bleep this out later. But when an eight year old calls your mother, you're, you know, you're like, whoa, hold on. Please drink the juice. I wasn't looking for this. I did. And, you know, I've heard adults talk about it too, in a married situation where one person is physically stronger than the other person. And you know, can get low and then get, you know, right, violent, like, not on purpose, right. And now you're, you know, a much different situation. Yeah,

Jennifer Smith, CDE 29:05
I actually had that when I was working in DC, a couple, an older couple had actually come into our diabetes clinic. And the man was complaining, he's like, sometimes I'm scared. I think she had gone to the bathroom or something. And they were just chatting. And I think it was on the topic of like, hypose. And he brought up he's like, sometimes I'm kind of scared of her. He's like, one day she threw a coffee cup and Okay, well, that wasn't really your wife. That was a low blood sugar.

Scott Benner 29:38
So I will tell you for blood sugars every 95 and she throws something at you. I don't think she likes you.

Jennifer Smith, CDE 29:44
Then there was something you did really nasty wrong

Scott Benner 29:46
to her so well. That's okay. I appreciate you talking about me. That was really good.

Could you just not talk to Jenny every day? I know I could. I wish I could actually just doesn't work out like that. Anyway, Jenny does this for a living it integrated diabetes comm and you can check her out there, there's a link in the show notes. What comes next is about the T one D exchange. If you heard it in the last episode with Johnny, and you haven't done it, let's get to it. But if you haven't, the T one D exchange needs your help. And the help they need is super simple to give. You just go to T one d exchange.org. forward slash juicebox. That's my link, use that link. And then when you get there, click on join our registering now. And after that you complete this simple, quick survey. It's for us residents only. But it's so easy. Like right now, if you did it right now look at your watch. Or you probably want to watch to pick up your phone, touch the face of it. If you did it right now, you'd be done in less than 10 minutes. It took me three hours to bring you this episode. And this is all I'm asking in return. One day exchange.org forward slash juice box. I mean, seriously, I the book Jenny, record the thing, edited it. I mean, you notice how there's no like pops and clicks and noises and nothing distracting while you're listening. You're welcome. That was me. Scott, click click click with the mouse. I fixed the whole thing for you. hours it took like you're just like, Oh, it was a quick 25 minute episode. It was nice. God said insulins important, blah, blah, no, no, there's more than that. It's deep. It's deep. It's building a narrative in your life about type one diabetes, giving you the tools and the access to information for the free. And all I ask is that you go to T one d exchange.org. forward slash juicebox. I only need 6000 of you to do it. I mean, there were hundreds of 1000s of downloads last month, I just need six of you. And I'm saying of the hundreds of 1000s of downloads. I need 6000 I'm tired of saying it too. I know you're tired of hearing it. I'm tired of saying it. But I mean, at some point one of us has got to pick up the manual and do their part. I can only do this I filled out the survey is easy. Alright, I'm gonna stop. I apologize. That was I that was too much, too much. I should just say T one d exchange.org. forward slash juicebox. You need to be a US resident who has type one or is the caregiver of someone with type one. Please go fill it out if you have the chance. I mean, that's that's how I should say it. But I mean, come on this podcast is amazing. And it's free. Free. And what do I say to you? You know, if you want to try out an omni pod, go to Omni pod comm forward slash juice box I say if you want to check out a Dexcom go to dexcom.com forward slash juice box I say want to get a great meter Contour. Next One comm forward slash juice box I say hey, my daughter's got this G Volk. hypo pen, you should check it out. That's it. I mean, you don't have to check it out. I'm not telling you to buy an ami. But it's not like if you don't buy an ami pad and I love to listen anymore. I'm just saying if you're going to go check it out. But this T one D exchange thing. I mean, you're on the internet constantly. I see the people in my life. I know you don't put the phone down. And I'm not judging you. I'm just saying while you're doing it. You don't I mean, p one d exchange.org. forward slash juicebox. Help a guy out a little bit. Make me beg you. It's embarrassing. I'll tell you what, if the T one D exchange contacts me at the end of the month, next month, the end of June and says we've added 1000 new people to the registry. Thanks to you. If they say that. What will I do? I will do an online talk about using insulin. Once a week, in July, once a week. Okay, I'll come on. I'll do it on zoom. It'll be free, obviously, because you helped me out with the D one D exchange thing. And I will answer everyone's questions as long as I can. If we reach 1000. Now if we reach 1500 I'll get Jenny on one of those calls. If you do 2000 I'll do the call. Right? Every day every what I say every week in July, Jenny wants and what else will I do? I'll do something else. That's cool. I don't know what yet, but trust me, I'll come through T one d exchange.org. forward slash juicebox. Use the link. complete the survey. That's it.

#483 Jessica No Longer has the Meats

May 24, 2021Scott Benner

Jessica is an adult living with type 1 diabetes

+ Click for EPISODE TRANSCRIPT

Scott Benner 0:00
Hello friends, and welcome to Episode 483 of the Juicebox Podcast. Today we're gonna be speaking with Jessica, and Jessica has the meats.

three, today's guest is an adult who has been living with Type One Diabetes for quite some time. And I have to be honest with you, I just want to say that this is her very interesting story. Like I could tell you a little bit about it. But I don't want to, you have to listen, if you want to know. I just don't like the idea, I guess of me offering cliff notes before the podcast. It's like, hey, in this episode, you're gonna hear about this and this and this, like you don't trust me by now. Just listen. I'm not gonna give me a crap. You get me to promise it's gonna be good. It's called Jessica no longer has the meats. Done. Right? Done. Get in there. While you're listening to the Juicebox Podcast, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan. were becoming old with insulin. And I just would like to say one other thing. If you have the opportunity, or the desire, or the need, please support the sponsors that support the show.

Okay, let's play a game you guess who the sponsors are? Ready? Think of it. Now find out if you're right. This episode of The Juicebox Podcast is sponsored by the Omni pod tubeless insulin pump, the Dexcom g six continuous glucose monitor and touched by type one.org. Now it's possible you can get a free a free trial, how long 30 days of the Omni pod dash, and to find out if that's going to work out for you. Right, because not everybody's eligible. But a lot of you are check out on the pod.com forward slash juice box. And to get started today with the but let's just say it's the best thing ever, the Dexcom g six continuous glucose monitor. Or to find out more about it, you can go to dexcom.com, forward slash juicebox. And let me finish this up by saying that touched by type one.org is it's just a landing space on the internet where you're going to feel good. You're just going to get there and you're like, Wow, look at all these people doing really cool stuff for people living with type one touch by type one.org where you can find them on Facebook or Instagram.

Jessica 2:44
My name is Jessica, I'm 32 years old, been a diabetic for like nine years now. And still trying to figure it out. That makes sense to me

Unknown Speaker 2:53
perfectly.

Scott Benner 2:57
Because it's something happens every day that you think, Well, that was no.

Unknown Speaker 3:03
It's

Unknown Speaker 3:04
I I still kind of beat myself up for not realizing how many things are out in the world. And then I'm like, you know, things that you learn every single day. That's how you get through life, right? You figure it out eventually.

Scott Benner 3:19
Yeah, if I understand your meaning, though, like once you see a bigger thing. There's almost unavoidable feeling that you should have found it sooner. And then you start you start going over what you've lost by not finding it sooner. But that's not how that's not how things work. So

Unknown Speaker 3:36
they always say it's last place. You look. So

Scott Benner 3:40
I thought that was about your keys. You mean that's everything?

Unknown Speaker 3:44
I mean, I guess To be fair, I continued looking and found more and more and more, because I'm a curious individual. But

Scott Benner 3:50
well, and that's a good point, actually. Because there are plenty of people who hit those roadblocks once, twice a dozen times. And then just they're like, Well, obviously this, there's no answer here and they stop. And that's and that's terrible.

Unknown Speaker 4:02
That's basically what happened to me when I was looking for some sort of reasoning to like figure out diabetes is I just kept looking. And then I kind of gave up I was like, all right, it just doesn't exist. I'm just gonna have to wait for technology to advance. That's all there is to it. And

Scott Benner 4:21
Was that your idea that one day, the magic machine will just come along and do all the things you didn't understand.

Unknown Speaker 4:28
There's a lot of so mostly surrounding, like blood sugars for a long time, my doctors would basically look at me and be like, I don't get what you don't get. And I'm like, Well, if I hear someone say, Oh yeah, I saw a spike. They're obviously looking at something that's much more in depth, or they're stabbing themselves in the figure 50 times a day. Like data points just don't come from nowhere. And that was one of the things that I struggled with. And finally I was like, you know, this is exhausting. I spend my days on Google Trying to find stuff and just get more and more confused. So I was like, okay,

Scott Benner 5:05
I'd like to know more about that. So tell me how old you were when you were seriously. How old were you when you were diagnosed?

Unknown Speaker 5:10
I was 22. I think I was. It was in 2011. November 2011.

Scott Benner 5:17
Done college, I guess.

Unknown Speaker 5:19
Yeah. I had just moved to where I live now in Colombia. And I just started college. I was in my second semester, and was running around and figuring everything out trying to finish up a bachelor's degree. And one weekend, I work at the local warehouse, and I was throwing some stuff around. I was like, man, I have to go to the bathroom for the 15th time and I've chugged like seven liters of water today. It could be diabetes. And my dad had been diagnosed with Type two, like, maybe eight months before that. And my mom was super on my case about you know, warning signs, and I was like, Nah, just chill. It's fine. If it happens to happens, it's no big deal.

Scott Benner 6:05
Wait a second. So your dad got type two that made your mom think you were gonna get type two.

Unknown Speaker 6:13
That was kind of the initial thought. Yeah, she was it was more like she was on alert, like her mind knew what the diet, what the symptoms look like. So now she was like, Oh my gosh, these are things I have to look for. And everyone. And especially for me and my brother. She was like, Wait, you're drinking a lot of water? Are you feeling okay? And I'm like, yeah, it's fine. Like, whatever

Scott Benner 6:34
her number sign her neuroses must have been thrilled. Because like, you know, I mean, like that, that that, that center of your brain that rewards you that reward center, he must have been like, I knew I'd find more things if I was diligent. I wonder, I wonder after your diagnosis, how much longer she was like, I wonder what else I can figure out.

Unknown Speaker 6:54
Oh, it was funny as I was like, a Sunday, Saturday or Sunday was over the weekend. And I had called into work because I couldn't even stand in the shower. Like I was so weak that taking a shower was sitting on the bottom of the tub, and literally like letting the water spray on me. And then I would stand up and like crawl out of the bathtub and get dressed to go to work.

Scott Benner 7:15
Oh my gosh, that's Thailand. I've been sat in the tub since I was a child. That's what, by the way, it wasn't the lack of your body control that I was upset by I was the sitting in the tub. Like, everyone stands though.

Unknown Speaker 7:29
It was

Unknown Speaker 7:30
it was one of those deals where like, I was throwing boxes that were 60 pounds. And I was struggling to pick up a box. It was like seven pounds. So I was like, All right, I'm gonna give in. Something's wrong. This is more than just me being super tired because I was slamming energy drinks. Like a kid in a candy store. Like nothing was happening. Yeah. And I was like, had this do anything. All these people run around like they're freakin doing drugs after they drink one of these and I'm over here. Like, I don't feel any different.

Scott Benner 7:58
I'm not getting the cocaine kick out of this energy drink that everyone else gets.

Unknown Speaker 8:02
I'm like, I got cheated in life. Apparently, I'm immune to this stuff.

Scott Benner 8:06
So okay, so you go when you get diagnosed? How does that give me just go to a doctor's office, I guess and be like, hey, something's wrong.

Unknown Speaker 8:13
It kind of tricked my way into a doctor's office. I had just moved up here. So I didn't have a doctor at all. I have

Scott Benner 8:20
a doctor and ever give me one second, could you? You said you're here in Colombia. I'm not sure if you're in a South American country. If you're in if you're in South Carolina, or

Unknown Speaker 8:30
Oh, Missouri, sorry.

Scott Benner 8:31
Well, I haven't even gotten to all them. I think there's a Colombian, Ohio. There's just like, and I started realizing I didn't. I'm like I don't know where you're at. But okay, we're in Missouri. And and I'm sorry. I don't know why that's important. But it is so keep going.

Unknown Speaker 8:47
But yeah, I

Unknown Speaker 8:48
I called a doctor's office. That was someone that I worked with who is pregnant, and they're like, Oh, this is a great doctor. And I was like, Sure, why not? So I called them and they're like, Are you an existing patient? I was like, Yeah, because she wasn't seeing new patients. So I got an appointment because the person working the front desk, didn't know very much. And I walked in and I was like, Hey, I think I'm diabetic. I haven't been able to eat anything for two days. And I don't really have the ability to like, do much. She was like, Okay, well, we'll do a urine test. And she walked back in the room. She goes, Alright, here's your prescription for insulin. And I was like,

Scott Benner 9:26
that saw Wait, that was it. Yeah, you didn't even get a like, oh, guess what? You do have diabetes. That's crazy.

Unknown Speaker 9:34
Nothing. No, she just handed me the prescription. And I was like, Okay, so what about right now because I kind of feel really bad and don't have any energy and she goes, Oh, yeah. Yeah, go over to the ER, they should be able to help you. And so she directed me to the ER which was literally all the way across town from from where her office was okay. And I almost got like three car wrecks going there was on the phone with my mom. Who was standing next to someone who is a type one diabetic at her work, like basically freaking her out by going, she's going into a coma. So through all of that I finally get there and they put me in a room hooked me up to an IV and I passed out like I just took a nap for like four hours, huh?

Scott Benner 10:21
Hey, there are other cars to hit Missouri.

Unknown Speaker 10:25
A couple.

Scott Benner 10:26
That's all I heard was that, wow, you almost had a number of accidents like what would you What were you gonna hit? Like, what is there once I've never been to Missouri, but for

Unknown Speaker 10:35
years, it's a college town. So there are lots of young college drivers that have better things to do than drive.

Scott Benner 10:43
So you have an answer, and you just ruin my stupidity. I was just being stupid. But

Unknown Speaker 10:46
I know. If you've ever if you ever come to Missouri, you should enjoy the college drivers that are in college towns.

Scott Benner 10:55
Listen, I've driven in Manhattan and Los Angeles. And if Missouri is taxing for me, I'm giving up. I'm just telling you right now, I will think that my skills have diminished and I'm too old to be in the game anymore. Have you ever been to have you ever driven like through the heart of Manhattan?

Unknown Speaker 11:11
No, I want so I went to Chicago and I've been down to the, like 14,000 get pump gas station in Texas. And both of those were like, Okay, so that's big.

Scott Benner 11:26
I'm forever reminded of my brother coming home with his wife for the first time from Wisconsin and they landed at the Newark Airport and I picked them up. And we were driving through the parking lot. And there's like, I don't know, there's a hotel in the parking lot. That's gotta be maybe 10 or 12 storeys high. And she just goes, that's the tallest building I've ever seen. And I was like, you're in for a hell of a shock. We get on the highway and you can see Manhattan just so you know. Thanks. And then we were out there in traffic, you know, on the New Jersey Turnpike. And she's just like, huddled in the backseat covering her head because, I mean, there were more cars than she'd ever seen. At one time. We were all going like 85 miles an hour there. You know, there's lanes and lanes and lanes of traffic and it was just so much sensory overload. Looking back, we should have given her a tranquilizer before. It was like just like taking a puppy and showing it like 1000 other puppies.

Unknown Speaker 12:25
I think I was 10 the first time I went out to California and we hopped in my cousin's like giant jacked up truck and got on. I think it was five, the main highway that runs through like San Diego and I remember sitting in the backseat, just like I know we're bigger than these people, but they could still hit us. Why are we going 300 miles per hour.

Scott Benner 12:47
Everyone who's got something like that going on the people of Atlanta right now are like oh my god, they they live with like nine lane racetracks down there. And it's all fascinating. But anyway, I'm so sorry. doctor's office, hospital pass out, wake up four hours later, and mom's there I imagined by now.

Unknown Speaker 13:07
So mom and dad lived three hours from where I am. And they my mom had called every hospital in Columbia and every doctor's office in Columbia trying to find me because my phone died in the middle of all this. So the nurse like politely wakes me up and goes, honey, your mom is calling. Can you please call her back? And I was like, okay, so mom got a little aggressive with the nurse because the nurse wouldn't tell her if I was there. Not due to HIPAA. And I was like, Okay, yeah, so I called her back. And I think the conversation basically went, yeah, I'm in the hospital. I don't know what they're doing. Okay, Love you. Bye. And I just hung up. Wow. And so they ended they got to Columbia as soon as they could. And I ended up in the ICU for a week and I learned lots of things about being in a hospital because I was the first time I'd ever been checked into a hospital.

Scott Benner 14:05
It was the first Have you ever been checked in a hospital? You're 22 It's not the first time you ever saw a hospital though, right?

Unknown Speaker 14:10
No, no, I mean, I grew up in Springfield, Missouri, so Oh, you're there. I was. Yeah, I was like six blocks away from one of the bigger hospitals there. But there's lots of I don't know me and my brother never really broken bones. We've always like scuffed ourselves up but we've never done anything so bad is that that's pretty funny

Scott Benner 14:33
by the way. Just never dropped the knife and caught it on the wrong side or you know something? Nothing.

Unknown Speaker 14:39
No, everyone else always did that. I was got to watch their pain. Oh, wait, I take that back. I did have stitches, but I don't remember because I wasn't old enough to, like recollect getting them. Have you

Scott Benner 14:50
said anything true in the last 15 minutes. What are we doing?

Unknown Speaker 14:54
When I was a kid I was on a rock or I jumped onto a rocking horse and the ears of the rocking horse. forehead, my forehead open, because I wanted to be like the Cowboys in the westerns that my dad used to watch and jump on a horse.

Unknown Speaker 15:07
So

Unknown Speaker 15:08
it's it's an image of that if you hitting that little rocking horse, the head coming back and slapping you while you're while your weight is still moving forward.

Unknown Speaker 15:17
Much and I would jump off my brother's bed like we were in his room and he was just like, Oh, my God, and I like I remember wanting to jump onto the horse, but I don't remember anything after that. Gotcha.

Scott Benner 15:29
So okay, so so we will let's get out of the hospital. So you, you know, I'm saying like, I want to find out about the rest of it. So blah, blah, blah, they bring your blood sugar down, they start telling you have diabetes, etc, etc. You get home, what do you have to manage when you get home?

Unknown Speaker 15:44
Um, let's see, they gave me so they showed me how to use an insulin pin in this like little dummy Silly Putty thing. And then they sent me to, I think it was a prescription with the needles and the 7030. I don't remember what blood meter I had or glucose meter I had, though, I want to say it was just like rely on or something like that. And it was basically take this, this many units are 7030 twice a day, and test your blood sugar like four times a day. So when you wake up after you eat breakfast after you eat lunch after you eat dinner before you go to bed,

Scott Benner 16:24
they have you eating at certain times certain amounts of carbs.

Unknown Speaker 16:27
No, they like I remember driving home because that was the week before Thanksgiving. So I went home for Thanksgiving break break after that. And I remember stopping at Sonic and eating my first hamburger without a bun. Because I was so paranoid of eating carbs.

Scott Benner 16:45
That that data that resonates with me Actually, the the being being afraid once you know that something can make your blood sugar go up. Like just avoiding it because you're like, Oh, I don't need that. That's, uh, that's not the right way. Dude, Sonic that's for sure.

Unknown Speaker 17:00
Well, that's,

Unknown Speaker 17:01
I remember the first like, probably three months because I think it was every three months that I had to go to the doctor then. And my agency was like, in the fives after that, because I was literally eating no food. I was just eating like chicken and green beans every day.

Scott Benner 17:18
Did the doctor know that's how you were achieving the five or did you not tell them that part?

Unknown Speaker 17:23
At the time, I was seeing a general practice doctor, and she was the one that just handed me the paperwork and said, Here's your insulin. So she was like, Oh, yeah, it's almost like you're not diabetic, and then dismissed me out of her room. I was like, Okay, cool. That sounds great. Well, and so how long do you live like that?

Unknown Speaker 17:41
It was,

Unknown Speaker 17:42
let's see, from November two, I had my first doctor's appointment. And then it was almost immediately after that she sent me to a diabetes education thing. And so I went into a classroom with almost exclusively type two diabetics, which was really confusing for me. And one of the people that was leading it actually figured out that I shouldn't be on 7030 because I handed her my journal, like our little food journal and blood sugar journal. And she goes, you had a 29 blood sugar at three o'clock in the morning. And I was like, yeah, that happens all the time.

Scott Benner 18:21
That's how I get this great. A one thing? Yeah.

Unknown Speaker 18:25
I was like, yeah, it was really amusing because I woke up the next morning, and I had chocolate, excuse me chocolate covered ramen noodles. And my kitchen was like how that

Unknown Speaker 18:33
happened.

Scott Benner 18:34
So they're just over, medicating you with insulin. And yeah, you're getting low, you're probably getting super high and other times and only Were you aware of spikes, or no,

Unknown Speaker 18:46
I could feel like I felt funky that I didn't know enough to like, associate it. So like I would test my blood sugar. It would be you know, in range, so to speak, because at the time, they wanted my range between like 70 and like 180. So as long as it fell between those two, I was like, Okay, cool. I'm doing great. And then I would wait until the next time I was supposed to check my sugar.

Scott Benner 19:11
And that was that. Wow, it was Tell me again. That was 2000 2011 1120. That's 10 years ago.

Unknown Speaker 19:21
Yeah,

Scott Benner 19:22
thank you speaking I'd like do we I was gonna make a joke about Missouri, but I won't because people listen there and I don't want to insult them. But I was thinking we like the doctor another like we add another 15 years of it to that for the eye anyway. It's frightening, by the way, because 10 years ago, you should not have been given that insulin or that lack of instruction or lumped in with a bunch of type twos and been like, hey, diabetes is just a word. So get in there. How long do you so they get you off the 7030 and they put you on what?

Unknown Speaker 19:54
So they put me on a Piedra and I I had it all written down and I'm like, I don't remember where I planned.

Scott Benner 20:03
It was a mirror.

Unknown Speaker 20:04
Yes, Lance's a patron Lantus, right. And so I took that for a very long time, it was like three or four years, something like that. No one still no one explained to me like how the sliding scale works, they just handed me a piece of paper with, like a form on it that had some calculations that I was supposed to like fill in the boxes, to figure out how much insulin to take. Yeah, and I may be math minded, but that got real old real fast. So I kind of just resulted to 10 units usually works, let's go with that. So my standard dose for pretty much every meal was just the same, like between five and 10 units. And that was just, that was it. Like, I didn't go higher or lower until I noticed that, like, if I tested my sugar, I felt funny that I adjust it, but they never really explained to me anything other than, like, here's your, your sugar. This is what it does. So food and have fun.

Scott Benner 21:09
I think this is much more common than I'd like to believe it is or that the, you know, immediate bubble around me, you know, meaning that people who end up listening to the podcast, believe it is I get there's this, you know, it's almost like anything else in the world, right? Like there are people who are lucky enough to have access to, you know, technology, or better education or doctors who are more thoughtful about how they talk about things, or even you know, finding a podcast means you're on a cell phone, it means you're like you don't mean like there's there's a lot of ways that you could be precluded from getting information. But I don't think I mean, if there's, I don't know what the number is now, it's something like 1.6 million people in the United States have type one diabetes, I forget what the number is it goes up, but number of hundreds of 1000s every year. But I think that most people get substandard direction around this. And it's shocking as you're saying it and at the same time. I'm not surprised by what you're saying. Can you talk a little bit about how it impacted your life during that time? Oops. Sorry, the Dexcom g six continuous glucose monitor is in fact, the greatest thing in the world. That's it. I know you're thinking like Scott isn't like water important. And air? Yeah, I mean, it is. But what fun is breathing if you don't know the speed, direction, and number of your blood sugar, I've picked up my phone, I've swiped up upon it. I'm opening the Dexcom g six application and to learn what, what have I learned? Arden's blood sugar's one to nine, and it is stable, you just need they're going up, we're going down. But if it was, I would know, I would know what direction her blood sugar was moving, and how quickly it was moving in that direction, not just the numbers, the numbers nice. But the other information. It's what makes the difference. Later, you can go back and see grass over three hours, six hours, 12 hours, 24 hours, and really begin to get a feeling for what's happening. We ate here and there was a spike. I wonder if a little more of a Pre-Bolus might not fix this, these kinds of things become evident when you can see the data that the Dexcom g six provides. It's also got a ton of safety features for you like it'll alarm wherever you want it to my my phone goes off at 70 and 120. You could choose at five if you want it and be like oh, I want to know when I'm getting down at five and it'll say a BBB. And you'll be like Oh, hello. And then you know you can do something before a problem arises. Same thing with highs. And not only that, but up to 10 people can follow on an iPhone or an Android device. 10 people that could be you a school nurse, your spouse, your sister, just somebody that wants to help dexcom.com forward slash juice box Do yourself a favor. Get there today. While you're out and about on the internet and the web's go to omnipod.com forward slash juice back, because you don't need to give yourself shots every day. And wouldn't it be nice to do an extended Bolus for pizza or Chinese food stuff like that? Oh, yes, it would. But wouldn't it also be nice, even nicer, in fact, to not do those things with a tube pump? Right? You understand that most pumps have tubing that goes back to a controller and you got to clip that on your belt or your bra or something and then you have an infusion set but the Omni pod is all in one. It's got this little tiny wireless tubeless design. It's amazing. It's probably could be difficult for you to picture so why why try. instead go to Omni pod comm forward slash juice box you have two options when you get there. You can see if you're eligible for a free 30 day trial of the on the pod dash, that's crazy. Or you can ask for a free no obligation demo pod. It's just one nonworking pod that you can wear to see what you think. So you can start slow with a demo pod if you want. Or just jump right in and get that free trial if you're eligible. It's up to you. Choice is important on the pod knows that. And so they'd like to give you a choice. And I want to make you lock into something before you know if you're comfortable on the pod comm forward slash juicebox dexcom.com forward slash juice box, links in the show notes, links to Juicebox Podcast COMM And when you get to those links, you know what you're gonna see, you're also gonna see a link to touched by type one.org. It's an amazing organization doing amazing things. For amazing people who have type one diabetes, click on the link, and be amazed.

Was that too much? It felt good in the moment. I was like, Oh, so many amazings like, I felt like I was like, Oh, this is fun. But now I'm not sure. I'm gonna leave it.

Unknown Speaker 26:27
I was super frustrated. I am a research person. I'm like math minded. So I want to see numbers, I want to see the reasons why. Like, I probably asked why more times, then my dad loved. He always used to tell me like you're thinking about it too hard. And I'm like, No, I need to understand it before I can actually like go through with it. So not understanding what I was supposed to be doing. It was just complete frustration to the point that I just started ignoring it like I completely, I would take insulin, I would eat to reasonable effect, like I would be aware of what it was doing. But to the degree that I look at it now, not even close, like not even 10% of the amount of information that I have now. I would search on Google for hours just trying to find stuff. And it was mostly that my searches weren't good, like I would put in just diabetes and just scroll through pages of results. And everything that I would get would be you know, science journals and stuff like that. I didn't know what a CGM was or what it was called. So anytime I tried to search for anything around that I couldn't find anything. I was told that insulin pumps were for people that were just really bad at managing their diabetes. So anytime someone said anything about an insulin pump to me, I immediately shied away and was like, No, no, no, it's fine. I'll get better. Oh,

Scott Benner 28:01
I didn't. Well, that's interesting. I don't disbelieve that. But I don't think anybody's ever said that before. The idea of insulin pump was if you're failing, you use an insulin pump.

Unknown Speaker 28:11
It was basically presented to me like it was if you can't take control of MDI, then they put you on an insulin pump, because you're just having too much trouble with MDI. And so I remember actually, like vividly remember being in an Arby's where it was like a little Arby's gas station unit. And I remember seeing someone with an insulin pump and my first thought was, oh, man, I feel really bad for that person, because they're diabetes must be really bad.

Scott Benner 28:40
You didn't feel for both of you for being in an RV that was connected to a gas

Unknown Speaker 28:43
station. No, I will say their curly fries are really good.

Unknown Speaker 28:49
What is what is the tagline of Arby's? We've got the what?

Unknown Speaker 28:53
I don't I can't even tell you more. I haven't seen an Arby's in years. Like there's two that are semi close to me. But they're such far ends of the town that I probably haven't driven by him in a month or so

Scott Benner 29:04
it's we have the meats.

Unknown Speaker 29:06
There we go. say like, I don't even listen to ads anymore. So

Scott Benner 29:10
here's the frightening way I know that I taped My gosh, I opened up a browser, I typed a RB. rb com popped up. I want to promise you a website I've never been to before in my entire life. And the like, you know how the URL like you can write like a message in and it says Arby's we have the meats and it's a registered phrase. They must be super proud of it.

Unknown Speaker 29:38
After you said that I definitely had the jingle like in my head and I was like, yep, that's it.

Scott Benner 29:43
I'm now starting to notice it. Wow, there's a lot of stuff about Hey, they do a good job of taking pictures this food. It looks like food.

Unknown Speaker 29:50
Like Arby's is not a bad food. It's I they used to have a BLT that I absolutely loved. I think they sound better than that. And

Scott Benner 30:00
while I believe you're confusing how things taste with how good they are for you, when you said I don't think they have for each slice of Turkey is exactly the same thickness, which is a problem for me. Because I will,

Unknown Speaker 30:16
I will say that my tastes have advanced since I did for you, they figured out, you know, food stuff

Scott Benner 30:23
for you. Okay, so you're in the Arby's ignorant of the fact that you should be scared for yourself. And instead, you're scared for someone else. Because they had a pump on. So Oh, my gosh, they must be doing terribly. And does that then give you a false feeling of I'm doing great because I don't have a pump.

Unknown Speaker 30:39
No, it I used to kind of have like this permanent, like petrified feeling of every time I would go to the doctor, I'd almost hide my meter and just be like, Oh, I forgot it today. Because I didn't want to be judged to be told that I was doing bad. And like, I knew I was doing bad. I knew that I wasn't doing the things that I should have been doing. But I always had that like it's okay, I can fix it. And like I had that like inner desire to just find a way to fix it. And that's why I would constantly be on Google trying to find something like just some piece of information that would tell me something more than what I already knew that would make it easier to do whatever it was I needed to do.

Scott Benner 31:24
Let me ask you the belief that you could fix it was baseless, though, right? It's not like you, it's not like you had, how do I put this, it's not like you had a tool box. And in the toolbox was a hammer and a screwdriver and some pliers, and some electrical tape and you looked at an outlet in your wallet needs to be changed. You've never changed an outlet before. But you said to yourself, I think I could do this. It wasn't like that. It wasn't like I have the stuff. And I know what I have to do have to take that out and put another one in, I'll just figure out how to turn off the electricity. And I'll take the wires off and match them back up and put them back on, which is how everyone, by the way changes their first socket. Hopefully, except for my father who didn't think that it was important to shut electricity off while he was working on it. But he was just, you know, one of those badass guys from another time was just like, how do I find enough this is hot, you just touch it real quick. I'm

Unknown Speaker 32:13
like, No stop batteries on the tongue.

Unknown Speaker 32:16
That's how you do things.

Scott Benner 32:17
You didn't put a wire in his tongue. But he would reach out he used his fingers, his electrical testers that's live. I'm like, Holy God, man, what's wrong with you? And but, but But nevertheless, like you didn't My point is you didn't have the tools or the knowledge or even understand the parts you had to move around. You just had the feeling of I'm going to figure this out.

Unknown Speaker 32:36
Pretty much. The only thing like I remember reading, like people, you know, have blogs and stuff on the internet. And I would read like the comments and they'd be like, man, my, my spike or my graph for like a Bolus and a basil. And I'm like, What are all these words mean? And I would you can't Google the word diabetes graph, by the way, in 2011, and figure anything out? Yeah. The only thing that comes up is just a graph and a person with diabetes.

Scott Benner 33:07
You're like, hey, that's all right. That is the graph. That is a guy with diabetes. I have properly googled diabetes graph. Now, what do I do with this information? And I don't know. And then you're done again. Yeah. It's the thing we talk about sometimes, about knowing that there's something that exists beyond your understanding, but having no meaningful way of getting beyond your understanding.

Unknown Speaker 33:29
And that's like, I didn't even warn a CGM for the diabetes education class. But the way that they presented it to me was they were like, Oh, this is the doctors. And that was all they would tell me it was it just a doctor tool,

Scott Benner 33:43
like a diagnostic tool that you no different than if you went in and they put a pulse ox on you. You don't get the lead with your pulse ox, they take it off and gotcha.

Unknown Speaker 33:50
And for that week, I actually I intentionally ate bad food. Like I remember going to McDonald's. It was the first time that I got to McDonald's in like four months. And I was like, this is the best hamburger ever. And I was like, I just like enjoyed every bite of it. And it popped up on the CGM graph, and they were like, What

Unknown Speaker 34:07
was this? I

Unknown Speaker 34:07
was like, that wasn't McDonald's cheeseburger. They're like, okay, and I'm like, Hey, I haven't been eating carbs for like four months. That cheeseburger was the best thing that happened to me in my small budget that

Unknown Speaker 34:19
day. Don't judge me.

Scott Benner 34:25
Oh, my gosh, yeah, I okay. All right. So how do you What's the first leap that gets you to a greater understanding?

Unknown Speaker 34:34
So I switched from the general practice doctor to an endocrinologist because the general practice doctor basically said, I don't know what I'm doing. Go see this person. So I wouldn't saw her. She's an amazing doctor. And she was like, hey, there's this new technology out. It's called a Libra a. It literally just came out. I think it would work really well for you. And I was like, Okay, cool. I guess and So I immediately hopped on Google started researching. And of course, I found out that Libra is, you know, a flash glucose monitor not a continuous. So I got the Libra and had it. See, that was 2018. I think I got it in. I think you may know it was it was right at the end of June.

Scott Benner 35:22
Well, you live seven years like that. Yeah, I'm sorry. No, seriously, how you just made me sad, dammit. You know, because like, Listen, here's the weird thing we talked about at the beginning of your notes. I told you not to feel bad about it. And then it happened. And I was like, Damn, I feel bad about that. Because if you and I would have bumped into each other at Arby's, and you would have said to me, oh, your daughter's wearing an insulin pump. Like I in four minutes, I could have like, set your brain right about how to like what you wanted to do. You know what I mean? It's

Unknown Speaker 35:54
Yeah, I found there's a lot of like, parts of me where I'm just like, man, if I would have searched this phrase, instead of this phrase, I would have found a whole plethora of information. Well, I just didn't know the terms. And I didn't know the, the right words to plug in to get to it. So. And then, for probably the two years before, my doctor suggested delivery, I had given up like, I don't think I googled a single thing outside of like things to carry your diabetes stuffing. Like I just gave up on I was like, this is the way it is technology will get there one day. And little did I know technology was already there.

Scott Benner 36:31
Yeah, what you need to do was find a doctor who understood things better, or a podcast or at mean anything like that, seriously. It's ridiculous. But it's so you understand that as I asked the questions, I'm a bit incredulous, because I know what I know. Okay. And it turns out that what I know about diabetes is fairly significant, over what you knew about it, you know, even at the same times, right, I didn't have a blog, I didn't have a podcast in 2011. But I had the knowledge. And, you know, so I'm thinking of a new person right now, who is, you know, the next, Jessica, who's being diagnosed right now. And I, it's hard for me, I have to, it's not hard to do, but I have to physically stop myself and do it to remember that my understanding of all this is not equal to most people's understanding of it. And and that you could get lost in with the, for the lack of a better term, the system and all the sudden just think, well look, this my meter, I need a bag to put it in, I take this insulin here, I count the car by do this, I hide my meter, because I don't want the guy to know I'm doing bad because I am doing bad, I feel bad about doing badly. I'm getting some bad information from people about what technology is, etc, etc. And then before you know it, you're so far down that rabbit hole. There's no way out. You're never in most people don't dig their way back out of it. And I'm I'm maintaining that your story is incredibly common.

Unknown Speaker 38:04
And that's, there's actually people that I worked with that were the same way. And when I found the library, like when she gave me the labor, I was like, Oh my gosh, look at this. And they're like was like, Yeah, like it's a thing and it shows you things.

Scott Benner 38:19
It's magic. I hold it to the disk, and it tells me a number.

Unknown Speaker 38:24
And, like I remember so prior to that there is twice that my now husband had to wake me up with an ambulance because my sugar got so low in the night. And I remember the first time that him and I like sat down and had a discussion about having the libri and you can just see like the relief on his face because going to bed every night was just I don't want to say horrible, but like it was so stressful for him. It was anxiety.

Scott Benner 38:50
Do you think he didn't want to go through finding another girl and starting all over again?

Unknown Speaker 38:56
I can't. I already got some time invested in this

Unknown Speaker 38:59
one. Like, you know how this girl likes it? I mean, like, I don't want to do it again.

Unknown Speaker 39:04
What's funny is we him and I started dating in the January after I was diagnosed. So our relationship is like literally the entirety of me being diabetic.

Scott Benner 39:16
So it was a break for him as well. Yeah. He was like, oh, finally.

Unknown Speaker 39:21
Yeah. And then once we found he It was funny because he was the one that was like, it doesn't have an alarm that tells you when you go low and I was like No, but wait. And that's when I found the next comment. I was like, Oh wait, let's do this. Wow. And so you sure instantly agree with it. But

Scott Benner 39:37
did they eventually?

Unknown Speaker 39:40
Yeah, I convinced them that I was just gonna use my phone. And they were just gonna send me the sensors and then I got it on the Costco cheap receiver. I don't even know why I spent that money but I have a receiver.

Scott Benner 39:55
That that's over now, though. I think I don't think that I'm not sure somebody would have to look at this It was a big push for Dexcom through Costco. And then I sometimes think maybe it's my fault. It doesn't exist anymore because I told people about it and the podcast has such a reach. I think it's possible they sold more Dexcom at Costco that they were ready for. I don't know where people might have been, like gaming the system about how to pay for it or something like that. I don't remember exactly what happened. But I do know that it was like, this is a thing. And then suddenly, it wasn't a thing. And that wasn't my fault. You know, so

Unknown Speaker 40:29
I know that Sam's Club still has a discount, but it's not as much of a discount. Like I think a receiver there is now like, to almost $300 like two or $300. Okay. But I think if you get it through, like, I want to say the number that I was told when I called Dexcom was like 600. And I was like, okay, $100 is substantially cheaper. Costco it is. I'll take that.

Scott Benner 40:53
Okay, so now you've got a CGM that actually tells you when you're leaving ranges and things like that. Is this is this the beginning is this where you're like, Oh, I could make different decisions to stop things from happening.

Unknown Speaker 41:06
It was,

Unknown Speaker 41:08
it was kind of one of those moments where like, the the lights, you know, everything lights up around you, the halo comes down, and you're just like, Oh, my God, it all makes sense. Because I was able to see all of those things that everyone was talking about. And like, I was able to see that when I ate, you know, a cracker, that I could see the spike, I could see what was happening. And I was like, wow, all of those little dots. Like I was absolutely convinced that there is just some people out there in the world, that prick their finger like 50 times a day and made their own charts on paper. Like that is how that has to happen. So me being able to see it in like a digital representation. I was like, it makes so much more sense. How was I so dumb not to think that this is a thing?

Scott Benner 41:57
I'm glad you said that. Because there are times when I'm doing the Dexcom ad. And I'm like, and I think to myself, people won't believe this, if they don't know about it, like like, just not that not that it does it but that it's such a big impact. And it is it's like it's that AD AD is easy to do. Because I genuinely believe everything I'm saying you see that data, and you start making better decisions about insulin, you start making better decisions about you know, carbs, and I don't even mean like better like not Arby's, I mean, you know, understanding that, I don't know, a Kaiser roll may say it's got 22 carbs in it, but it might hit you like it's got 35 carbs. So you use 35, you know, as the number for Kaiser or the doesn't matter what the what the package says like when you start learning things like that. It all just goes. It's magical. It's so easy. I just looked at Arden's last 12 hours. And her line is so flat for the last 12 hours, that I might be embarrassed to show it to you. Like you might be like, Hey, don't show off. You know what I mean? Like, but it's just, it's fascinating. And how do I and that was a lot of overnight time. And so how do I figure out that much? How do I figure that out? It's not because I was like, Oh, I know what I'll do. It's her basil is definitely point nine, five an hour overnight. It's not I didn't just make that guess. It's like, I got to look at this graph and say, Okay, this is too much. This is too little look at it over days, then finally come down like this is it right here? It's point nine, five overnight, it just absolutely is. And so unless something a variable comes up that I can't foresee, overnight, Arden is just super stable. And you know, therefore, during the day, I can make a mistake, she can you know, not Pre-Bolus or, you know, get something wrong. And I see a spike that goes to 150 or 160 and get it right back down again, again, with the data. And then you know, you still end up with us a one C in the fives. It's just you know what it is

Unknown Speaker 43:57
on that. Like, I remember when I first was able to like see the Libra graph, like I was absolutely in heaven. Like I was like, this is it. This is the thing that I have been like I knew it existed. I just didn't know how to find it. Yeah, like I couldn't figure out how to get this information. And finally having that was, I mean, it was literally like someone opened the doors to the biggest library in the world. Like I had all of the resources I needed, because that one key word to type into Google will literally open the gates to everything you need for diabetes. And it's so funny, because I actually went back and replicated some of the searches that I'd done because I have search history from them. And I was like searching those things still shows the same bad results. But if you add the word Dexcom to them, the search history or the search results is like so much more in depth than like what I was looking for. It's like man, one keyword that's all I needed.

Scott Benner 44:56
No kidding and everything was just suddenly the doors was thrown open and you're like, Oh look, there's the garden I've been looking for. It's bright and sunny and there are butterflies flying around and I'm eating. Now I'm now I'm eating Arby's, like a mad genius. And

Unknown Speaker 45:12
it's actually Pinera cinnamon crunch bagels. But

Scott Benner 45:16
hey, well not know why those things have about 80 carbs in them.

Unknown Speaker 45:20
No and I. So well, I tasked myself because they had the unlimited free coffee thing going for a little bit. So I was going in the morning to get free coffee. And every morning I'd be like, do you want to send him in bail? I'm like, stop app, you know my weakness. And finally, I was like, You know what, I'm gonna master this, like, forget it. I'm doing it. And so every day for like a week, I ate a bagel. And I finally figured it out. And I'm like the second to last day of eating them. I remember showing the graph to my boss and being like, look at this. You don't understand why this is so important. But I am like three shades of happy right now. I am so static.

Scott Benner 45:58
Who's the man? jumping around? You're like, calm down. Jessica. You don't understand a bagel? Look at this line. Everyone's like, I didn't think it would be her that lost it. But she's got to work by herself in a different room now. So

Unknown Speaker 46:16
yeah. Especially working at a like customer facing tech support. Type job. Yeah, there was a little bit of like, okay, and we're gonna go back to fixing this person's problem. People come in and like,

Scott Benner 46:29
tell me what's wrong with my, my Ram. And you're like, only after you look at my Dexcom grab it smell it, you could still smell the cinnamon on my fingers to get closer. Here, you can't smell I'll let them hold on. I'm sorry. Like my hand, you know, like, yeah, you're out of your mind. So excited. I understand. Like, the first time I realized I could, I could figure out a bowl of cereal. And then I didn't even have to measure it. I was just like, I want something. I don't know what it is. poor health, I guess for my daughter because she's eating cereal. But, but, but I figured it out. And the truth is, is that I took what I learned using, you know, on that really difficult to Bolus for item. And I use that information on more easy, you know, things on your system and more healthier things. And But the truth is, if you can do a bowl of Apple Jacks, there's a lot of things you know how to Bolus for all the sudden, you know, it's very cool. So so when you googled it, what did you find?

Unknown Speaker 47:32
There was so that a lot of the stuff was like ads from Dexcom. And I'm weird. And I do image searches because I'm a visual learner. So I was like, find graphs, find things that I can relate to. And it was actually funny because like the probably fourth or fifth line down the page was the Juicebox Podcast like the little excerpt from the ad that's at the bottom.

Scott Benner 47:55
I have terrific SEO. Very proud of it. I've been working on it for over a decade. Go ahead.

Unknown Speaker 48:01
So I remember like, I was clicking on all the images so that it would take me to the website and you know, tell me about dex calm and all that good stuff. And I remember seeing Omni pod and I was like, what this do. I started like, just basically searching for tubeless insulin pump because I was like, You know what, forget it. Like everything I forgot about or I learned about diabetes is wrong. I'm forgetting it all. And I'm just starting fresh. So I immediately started going out and just like diving into a deep hole of jargon. And then I ended up in the catalog for edge Park. And that was like day sell it. And I basically emailed my doctor was like, hey, this thing. I'm getting one. Thanks, bye. And she said the prescription and then in a matter of a month, I had all everything that I needed lots of insurance phone calls, but like it was a whirlwind when I really want

Scott Benner 48:58
to give up. That's excellent. necessarily. I'm being serious like this seven years is long enough to give up. And you really didn't like you saw one thing that like reignited you and you're like, Oh, I'm back in the game key. I can't believe keyword searches where your where your downfall and diabetes. Like your Google food sucked. Therefore you didn't know how to take care of yourself. That is a sad statement, by the way about the health care system, in case you're wondering, and why the podcast is so popular.

Unknown Speaker 49:30
When it was like I remember them sending me home with a folder that had a bunch of like community outreach programs, and they were all defined, like every single one of them. I'm closed down like some random lady and she's like, Oh, we don't do that anymore. And I was like, Oh, great. Okay.

Scott Benner 49:46
Again, if I can just bring this background to me. And I pause here so all the people are like, Oh, this is what he does. But, but seriously, when I say something like support the sponsors because when you support sponsors, the sponsors buy more ads. And when the sponsors buy more ads, Scott gets to keep making the podcast. This is what I mean by you know, besides the money part, this is what I mean, right there is that if you want the podcast to keep going, and if you have an eye on this being a tool for everyone, not just for you, like you can't look at this podcast, like, you have to look at it like a cow, right? And that makes milk and you need some milk, but you want there to be milk for other people, you don't take all the milk, and then kill the cow and have a steak and laugh about it. You know, I mean, like, you Milk the Cow for what you need, you make sure the cow has hay and water so that the next person that comes along can get a little milk as well maybe even make butter out of it. Who knows. But the point is, is that you have to, it's important to me to support the podcast and keep it going because you're not the first nor will you be the last person with your story. And the next person is going to come along what I don't want for them to do is to Google something and come along and find a defunct podcast, I want them to find a vibrant tool that that continues to exist and, and and help people. So yeah, I mean all that stuff. When I say it, I just you know, I wonder if sometimes people take it the wrong way. But But I need you to support the ads, you know, and I'm not saying I'm not saying buy an insulin pump you don't want but if you're going to get an omni pod, for the love of God, go through my blank, like like, you know, like that kind of an idea. Because it's helpful. And look, look how it found you. It's amazing.

Unknown Speaker 51:30
And he was like I remember listening to I couldn't tell you which episode was first. But I remember listening to it and just sitting there and being like, Oh my God, this guy thinks like I do. This is perfect. This will actually work.

Scott Benner 51:44
Although I think like you because I would need it Arby's

Unknown Speaker 51:50
it was I think it was the insulin. I think it was one of the ones about insulin, like how it works in your system. And the way that you were being like analytical but not overly analytical. And there is lots of like, is and Ms. And like, that's how I talk. So I was like, he knows it. I know what his ed is. And I know what his net is. And like, it makes sense to me.

Scott Benner 52:14
Yeah, I'm just smart enough to understand it not quite smart enough to make it hard to believe or understand. I can get it out just on my level. So I really, I'll tell you what I mean, I'm very happy about that. Because who I am is a very strange blend of how I grew up just like everybody else's. But I've said this in the past, I haven't said a long time, I'm adopted. And I was adopted by lovely middle class blue collar hard working people lived outside of Philadelphia. And I am probably this seems bad to say but my dad's dead. My mom's an older person who doesn't listen to podcasts, I'm probably somewhere in the 40 to 45 IQ points smarter than they are. Okay. So if had I grown up with other people who probably had my possibilities, I would probably be not who I am today. But they didn't look at education like that. They they looked at school as something you did before you went and got a job. And so I'm a crazy blend of, you know, bright, but grounded at the same time and my intellectual side has never really been fed. Honestly, you don't mean like or grown it had no real attempt to blossom. So I have the that's why I think your story is so interesting. Like there's a ceiling above me, I'm never going to get anywhere near in my lifetime. Because I'm married, I have kids and I have responsibilities. And it's not like I'm going to head back to college and you know, find out about stuff. So I get to like, wonder about things, diabetes being one of them. And then I get to build a narrative around what I'd learned. That is incredibly blue collar and incredibly middle class and very easy to understand. Because I don't know enough big words to make it not understandable. Trust me, if I knew more big words, I'd use them. And then everyone would be like, Ah, that's a sign. And that would be instead I talk like an idiot. And it's understandable. So

Unknown Speaker 54:19
it's always been amusing to me because my entire life You people are like, oh man, you're so smart. And you're like I just know how to explain things really well,

Scott Benner 54:30
if that makes sense. Is that is that one of your superpowers? You can explain things? Well,

Unknown Speaker 54:35
yeah, apparently I've been told that more times than I can count like that's basically how I got my current job. I had absolutely no IT skills and I was like put my customer service is on point. Like you want me to sell a phone to someone explained them how that phone works. I can do that

Scott Benner 54:52
in a way that's crystal clear to them in a way that they'll remember that it'll be valuable to them walking out the door and all that stuff. That's how I feel about this. And I've got enough feedback about it now that I believe it, you know, is that I'm just, I don't know, I'm good at talking about diabetes. So you know, and I understand how to do it. But I don't overcomplicate it. And I think that there are probably people out there who are talking about it, who were much more specific about it. And I think that at some point along the line, that's what makes their information less usable by more people. And so that's,

Unknown Speaker 55:30
there's definitely a personality that has to go with it. Like, I know, I've tried reading, like science journals, for instance, sitting down and trying to read, like even the piece of paper that comes with the insulin, I've sat down and actually read that. And I had, you know, it's one of those deals where it's like reading a textbook, you have to kind of force your way through it. But because there's something gold at the end of the, at the end of the rainbow, you're like I can make it through. And there I've seen other people that explain things in that same language. And you're just like, I have to pick my dictionary up five times. That's five times too many, like use words that are commonplace. And I think that's what you really accomplish is like making it easy to digest. So they don't have to go pick up a dictionary 15 times to figure out what a word means.

Scott Benner 56:19
I really appreciate when there's an intersection to a thought like, Terry comes to mind now if you've ever heard Terry lives on a boat, or or the or his follow up episode, I think it's called Tony lives in a house. Yeah. Anyway, I, I'm not gonna apologize to people about what the episodes are called. Just,

Unknown Speaker 56:37
you know, I enjoy it.

Scott Benner 56:39
Thank you. But Terry's a great example, an older gentleman, engineering background, really bright guy talks about diabetes in a way that I completely understand. But I could never do. Like I couldn't have, I would never think to put the words together that he puts together, but when he's talking, I'm like, Oh, this is brilliant. I completely understand this. And for some reason, no matter how smart he is, he likes the way I talk about it. So and that's, that's really, I find that, but I don't know what the word is. I am. Wow, I just lost the word. Jessica. Well, I'm making my own point aren't I goddamn Give me a second on push the microwave on my face? Well, I think

Unknown Speaker 57:24
I was really good with humble

Scott Benner 57:25
Yeah, humbles. No, you can't say humble because people don't believe that when you say it. It makes me feel. I don't mean proud. I mean, oh, my God, I'll edit it in later, I'll fall when I'm editing it back, the word will pop into my head. And then right here, you'll hear a future Scott say it, and then we'll go back into the conversation. But it It feels good to me that, that Terry vibes with how I talk about diabetes, when it is so different than how he talks about it, but it's not. But it's not really that different. I guess. It's just he just, he's smarter than I am. Like, I don't know another way to put it. You know what I mean? Like, everybody's still clear. And he's concise, and he's thoughtful. And he's not just bullshit. Like he, he, he knows that what he's saying is accurate. And I have that, for me through that part of it's very important for me, like I would never say anything on this podcast, or anywhere about diabetes. That wasn't at the very least tried and true in my daughter's life. You know, like that, just I like people who are patient with how they disseminate things. And

Unknown Speaker 58:35
I think that sincerity like that was one thing that pulled me in as well as there's a sincerity in the discourse that's very, like, you know that it's not Bs and like, you just have that feeling you have that trust with it. But I remember listening to the Terry's lives on a boat. And I don't remember what he was talking about. But I was like that man is that that's engineer all over. Like, you can just tell by the way he talks. Yeah. My father in law's does engineering. And I actually started school of engineering. I'm like, yeah, that's that trademark, that trademark speech of just enough analytics to get you by it and a little bit of humor to make sure that everyone's still following.

Scott Benner 59:18
It is a very specific way you know what I'm hoping one day and if anyone's listening, I'm looking for an actuary who has type one diabetes, because you people are so boring. I want to interview you to see what I can find out. I'm being quite serious and not insulting. I'm looking for an actuary who has type one diabetes who wants to come talk about it because I've had more conversations with more actuaries in my entire life. And there is something about how your all brains work. That is fascinating. So there is a certain kind of person who is drawn to that kind of work, please, Scott at Juicebox Podcast comm send me an email. I would just love it.

Unknown Speaker 59:58
There's a person that I work with I remember trying to explain to him, like the ins and outs of the Omni pod and Dexcom because I just gotten them and I was still, you know, like super jazzed about it. And he looked at me and just holds his hand up and goes, Okay, Jessica, I need to go back to work. And I was like, guy respect that you say that. But man, I really want to continue this conversation. And I hate that you're able to shut it off so easily. I just

Scott Benner 1:00:24
really want to tell you about how great this little tubeless insulin pump is. It's very exciting, guys. Like, I'm not excited by this at all.

Unknown Speaker 1:00:30
But anything that he's done with like, he literally just puts his hand up and says, I really need to go back to whatever it is. And like, I don't know how you have that power. Like,

Scott Benner 1:00:40
my wife has it, it's hurtful.

Unknown Speaker 1:00:44
I don't get it. And he's such like a, I don't want to say like a plain Jane. But he's very, like meticulous and he's very methodical. So things that he does are like, kind of like the actuary just very, like, analytical and they have a purpose. They're not done unless they have a purpose type person.

Scott Benner 1:01:03
I have so every bit above it on the podcast, like if I get bored with people are talking, there's like a alarm that goes off in my head. And it says it says this is boring. Change the subject like this is boring, keep moving. Do not like make people listen to this any longer. You know, it's just I and that voice in my head is screaming at me while it's happening as they move on. I'm like, Okay, all right, I hear you. And then sometimes I ramble on and on. And I don't even hear that the voices yelling at me. I'm like, shut up.

Unknown Speaker 1:01:33
It doesn't apply here.

Scott Benner 1:01:34
Yeah, but I'm the host, I get to do whatever I want. Stop it now. Now, the other times I talk too much. It's obvious, but you know, it's just what are you gonna do?

Unknown Speaker 1:01:46
Say My dad always made a joke. He's like, I swear to God, the owner's manual for you how to diagram where the off button was, but pretty sure that page got ripped out. So

Scott Benner 1:01:56
listen, I don't know about in your life. But in my life, if I can't speak, you know, forever. It's not my ever listen to a podcast where nobody knows what they want to say next. It's painful. I'd rather say something that's a little wordy, then just have everybody talking. And then well, what do you think, Jessica? And then you pause for 12 seconds before you answer. And I'm just quietly listening. Like I could never

Unknown Speaker 1:02:20
Oh, it's painful. Like I even listening to podcasts that have that I'm sitting there just like, if I hit the skip button, do you think it'll break into the conversation? Or will it like cut just right?

Scott Benner 1:02:31
I don't I like when people speed up podcasts. I think they can't possibly speed mine up. Like I understand why you might speed up another one. But mine, I don't imagine you could. And if you can, God bless that your brain works really quickly. But I don't know, I like I like it to keep moving. I wanted to keep moving. And I wanted to make points and I want it to be interesting, and entertaining, and thoughtful. And I want there to be some advice. I didn't mean advice, some information that's really valuable to you, you know, throughout the way, but I don't think an hour's worth of valuable information every week is something people would want you know, and ignores people who need community but very badly and don't know anybody else who has diabetes. And you know, for me, like your your your conversation is really interesting, because this is your person. Your story is interesting. And how you how you kind of made your way through it is interesting, but you're also like light and bubbly. And and there's a community aspect of this conversation as well. Like people will also listen to this and feel like oh, Jessica, I know Jessica, she's that really nice. I have a friend just like Jessica she's cool, you know and, and that makes you feel good about it. So I don't know.

Unknown Speaker 1:03:45
I'm down with being friends

Scott Benner 1:03:47
with her. That's me. No, I'm busy.

Unknown Speaker 1:03:51
Anyone I'm one of those people that's like okay, cool coffee as long as coffee is involved for fine.

Scott Benner 1:03:57
Everything go nuts. Go find her. Listen, she's sorry. There's like four things. There's no trees just yell out loud. And I know nothing about Missouri other trees there.

Unknown Speaker 1:04:05
There's more trees and buildings probably it'd be the other way around. There's like four buildings and all trees.

Scott Benner 1:04:11
The only person you're going to find when you get there, just go to an Arby's wait out front, leave your Omni pod exposed and she'll jump on you. It'll be easy. Will you buy the coffee just oh you'll you'll drag them to free coffee at Panera.

Unknown Speaker 1:04:23
say there's free coffee in the world. Why would I buy it?

Scott Benner 1:04:28
Just realize as I was saying it was like Jessica is gonna sniff out a free cup of coffee. You got to be on your way.

Unknown Speaker 1:04:33
Are you kidding me birthday coffee is like on your birthday. If no one knows this, you get free stuff from like every single restaurant so you sign up like two months before and then you spend your entire birthday day just going around to different restaurants or getting free pizza ice cream sandwiches, whatever you can eat for a week. That one day

Unknown Speaker 1:04:52
you go with a cooler and dry ice.

Unknown Speaker 1:04:56
No I usually I usually try to refrain from getting All of the things but I am known to go to firehouse and Andy's because those are my my cruxes and then Panera because a free cinnamon roll or a free cinnamon crunch bagel is kind of like giving someone happen. So

Scott Benner 1:05:15
let's, let's do something from it. Mr. Murray that's like two thirds left and two thirds up right or now I'm picturing a map in my head. I don't really know where it's it's not the it's Is it the West mid it's, it's where we are.

Unknown Speaker 1:05:32
So right above Arkansas and then right below Iowa and there's like Iowa and then Illinois and Ohio like that stretch.

Scott Benner 1:05:43
Oh, I think I think it's just you know, Minnesota, Wisconsin, Iowa like Illinois, Indiana. That's like the same place to me. So we're below

Unknown Speaker 1:05:53
that.

Scott Benner 1:05:54
You're below that. So you're like left of Tennessee?

Unknown Speaker 1:05:57
Yes.

Scott Benner 1:05:58
All right. So before I get to like the top of Texas in there do you think people are horrified that that's how I think of the map.

Unknown Speaker 1:06:08
My brain says I'm in the middle and everyone else was around me but who's touching again? Cuz I forget what states are actually touching the Missouri State line. I'm like, as in Nebraska, Colorado, so

Scott Benner 1:06:19
is Missouri is like Missouri, Kentucky, Tennessee, all about the same place.

Unknown Speaker 1:06:26
There's, there's actually a lot different like I we have family lives in Tennessee, and there's a second. It's like we're all the same place. But we are very different people.

Scott Benner 1:06:40
I don't mean what kind of people you are. I just meant like, generalized geographic location. Hold on a second. Oh, wow. I'm oddly off by a lot of this. Oh, okay. So where our console is. and Oklahoma is more like Arkansas, or Arkansas on the top of Mississippi is is where I thought Missouri is. But Missouri is above Arkansas. I guess it's Kansas that I don't really think about what I'm factoring all that's common.

Unknown Speaker 1:07:08
Yeah, Kansas and Nebraska are just like flat sheets of dirt. I've

Scott Benner 1:07:13
been to Kansas. I was in Kansas City. They had this like adorable little like, they called it a city but it was like a, like a town on steroids. And they were like, they're like this is the city and I was like you guys have never been to a city if you think this is a city, but I was like it was really nice there. I liked it.

Unknown Speaker 1:07:31
Were you in Kansas City, Missouri or Kansas City, Kansas?

Scott Benner 1:07:34
Hello there two different places.

Unknown Speaker 1:07:36
Yeah,

Scott Benner 1:07:37
I don't know. Are there Wait, there's Kansas City in Kansas in Kansas City, Missouri.

Unknown Speaker 1:07:43
So it's one town that's basically on the state line.

Scott Benner 1:07:48
I think it was in the Kansas side.

Unknown Speaker 1:07:49
Oh, that explains it.

Scott Benner 1:07:52
But I have not liked it as much if I was in the Missouri side. had to be the Kansas side because they took me to a barbecue. Oh no, that

Unknown Speaker 1:07:58
happened to both sides. Kansas City barbecue is a that's a thing. Kansas City and St. Louis. So where I met I'm the I 70. The interstate 70 that runs through Missouri goes from Kansas City to St. Louis and about midway is Columbia. So like we have the I 70 challenge where it's like Kansas City versus St. Louis on lots of things. Or Columbia versus Kansas City. So that stretch of highway is like the barbecue.

Scott Benner 1:08:28
I had BB everything seems so scary. I thought I was gonna die and up at the food was amazing. I have to tell you once when I was in Oklahoma, it snowed for a brief second and that threw me off because I felt like I was in Mexico so I didn't understand how it could snow that's how like, poorly I understand the geography of things. In Mexico, how's it snowing?

Unknown Speaker 1:08:52
I just had a debate because I was like it snows in Texas and they're like no only once every like 40 years I'm like no there has like it snows in California. Which is weird to me.

Scott Benner 1:09:03
They have mountains they're closer to the clouds. The mountains.

Unknown Speaker 1:09:07
Oh my I have family out there and they drive like two hours north from San Diego and they're like we found snow and I'm like it's two hours north I don't know that's still desert

Scott Benner 1:09:16
there's no way for me to understand any of this meaningful as I'm looking at this. I just saw Iowa and I was like oh Iowa yeah, I forgot about that. That's it's I really should look harder. And by the way it just so people don't think I'm like a like some sort of a northeast snob anything east of like Pennsylvania like you know all that like Massachusetts, Rhode Island, Connecticut, Maine for I don't know about any of that either. I basically know where I am and where New York is. And then even once I get South I'm a little confused, to be perfectly honest, like the North and South Carolina things nice because that's pretty easy to remember. So I know I know. It's like Pennsylvania, like Delaware wash. Virginia, North Carolina, South Carolina. But then if you made me bet money that Georgia was Next, I don't know that I'd be able to do that. Exactly. There's probably part of me who thinks that Tennessee is more like where the northern part of Alabama and Georgia is. I don't know anything about this.

Unknown Speaker 1:10:15
We were taught in geography that Iowa is the guy's head and the Missouri and Arkansas makeup like the guy's belly and then Louisiana his feet. So that's the only way that I remember that. It goes I was Missouri, Arkansas, Louisiana.

Unknown Speaker 1:10:28
What guy? What are you talking about?

Unknown Speaker 1:10:31
So if you look at a map of you know,

Scott Benner 1:10:34
like a god, Holy God in Minnesota looks like his big like, colonial hat. Yeah, I didn't realize that. Has anyone else ever seen this?

Unknown Speaker 1:10:45
And then Kentucky looks like a Kentucky Fried chicken leg.

Scott Benner 1:10:50
Tennessee looks like his penis if that's what's going on there.

Unknown Speaker 1:10:55
And we don't we don't say that out loud. We just kind of mockingly laugh at it and move on. Oh, so

Scott Benner 1:11:01
this is not something you've never thought of before because it's obvious once you see Wow, people listening. So Minnesota is the hat I was the head. Missouri's like the chest belly. Arkansas is like the belly pelvis. Louisiana is the feet Tennessee is clearly an aroused penis. And

Unknown Speaker 1:11:18
a chicken wing

Scott Benner 1:11:20
hitting on Texas. Holy, I've never seen this before. Alright, everyone who comes on if you have like a map thing you have to tell me about it from now on. That's alright. We're ending on that. Thank you, Jessica.

Unknown Speaker 1:11:33
That was great.

Scott Benner 1:11:34
That was absolutely perfect. Oh, by the way, is there anything about diabetes we didn't talk about that you

Unknown Speaker 1:11:37
wanted? I mean, I think we got it all. I can't remember anymore.

Scott Benner 1:11:42
I did a great job. I look back at your email. While you were talking. I was like, Damn, I had all this. I'm so good at this. And No, but seriously, I want to make sure we didn't skip anything.

Unknown Speaker 1:11:55
No, I I had notes as well. And like everything that happened. And I was like, Okay, I think we got them all. I stopped looking at it like 20 minutes ago.

Scott Benner 1:12:02
So I think we're good. I am really good at this. Did you want to say that out loud? Or

Unknown Speaker 1:12:06
that you're really good?

Scott Benner 1:12:08
Justin diabetes? No, no is making in the pocket just in your own words. Pretend I didn't say.

Unknown Speaker 1:12:15
I think we're good. I got everything that I can start over.

Unknown Speaker 1:12:20
laughing

Scott Benner 1:12:21
I know, it's fine, that we're good. And we got everything else how I talking about how good I am at this. That was what you were supposed to do one more time. Just go ahead real quick.

Unknown Speaker 1:12:32
I appreciate everything. And I'm really glad that you are doing everything that you're doing. Because if you weren't, I'd still be in a deep dark hole of MDI and not knowing what a glucometer was.

Scott Benner 1:12:43
You what you're supposed to say, You're really good at making this podcast. I can't count on you to disseminate. You know, my I forget it. Although what you just said was very nice. I appreciate that.

Unknown Speaker 1:12:56
I was just trying to be a nice person is, you know, a step above.

Scott Benner 1:13:01
I was just like, I was just looking for some baseless, like pandering. You know what I mean? Like, I was like, Scott, you're so good at making this podcast. And it's just, it's amazing. And they should probably give you like a peace prize or something like that. And then instead, you said something very heartfelt. And I was gonna say something dumb afterwards, and you ruined it by being nice. So that's just fine. All right. Thank you.

Unknown Speaker 1:13:22
parents taught me to give 110% I'm sorry.

Unknown Speaker 1:13:27
Did they really ever tell you that?

Unknown Speaker 1:13:29
That was a big thing. Like that was a steady thing. And growing up was like, it's always 110 100 is not enough. And I'm like, okay, that's not how math works.

Scott Benner 1:13:39
Because I want to ask a question, but I don't want to embarrass anybody.

Unknown Speaker 1:13:42
They're still here. They're not here, but they're in Springfield.

Unknown Speaker 1:13:46
Are they gonna hear this? They might depends on if I tell them about wondering what their 110% looks like. Yeah, I mean,

Unknown Speaker 1:13:55
so I can honestly say that my mom can still to this day run circles around me when it comes to manual labor as well as my dad, like, the amount of gumption that they have to do something because it just needs to be done. far outweighs mine. Like I look at something and I'm like, do we have to, and my mom's already halfway done with it. That's cool.

Scott Benner 1:14:17
I like that I love I'm a big fan of getting things done that need to get done because they need to get done. And for no other reason that somebody's got to do it. Might as well be you. Oh, look, I was gonna make fun Your parents are they probably given 150% you're probably the lazy one. In this scenario.

Unknown Speaker 1:14:34
I honestly think I am because I'm decently sure that nine times out of 10 if the dishwasher got loaded, I did it wrong so that my mom would load it right. And I didn't have to actually do it. I just told my wife the other day

Scott Benner 1:14:45
will end on this. I just told my wife the other day in all sincerity. I said hey, should I die before you at my funeral? Spend a good 30 or 45 seconds, telling people how good I was at loading and unloading this dishwasher. She's like, what am I, I spent so much time doing it, I want people to know, I took pride in it. I am proud that this stuff goes through the dishwasher once and it's clean, because I know where to put it. And I don't let things sit in there. So once stuffs dry, I take it out, and I put it away. I'm very good about that every morning, I make sure the sink is I think the house needs to start a morning with a open sink and clean dishes.

Unknown Speaker 1:15:27
You and my husband would have a very clean house, he does the same thing.

Scott Benner 1:15:32
It's important like what if I need to bring something off later and there's a pan, I don't want to get involved in that mess.

Unknown Speaker 1:15:37
You know, I'm saying take the pan, you set it aside for a moment, do your thing. And then you go back and you're wrong.

Scott Benner 1:15:42
That is 100% incorrect. That is not how you do it. You sound like a girl. Alright. My wife's like, it's fine. I'm like, it's not like she's like just peel the potatoes. I'm like, there are other dirty things. And the thing, I will clean the sink out first. And then the potatoes will go in and get washed. We are not animals.

Unknown Speaker 1:16:02
I will say before I start cooking, I clean the entire kitchen. So I will stand by that one.

Scott Benner 1:16:08
You need a nice palette to start over with. Alright, we said a lot of important things here tonight, and many things that have no importance whatsoever. So I think we're done. I really appreciate you doing this having such a great sense of humor. And seriously writing me that wonderful note, I am thrilled that this podcast found you and that it has been so valuable for you. It really is wonderful. It makes me happy. And I hope more people find it. I have to be honest. There's some times online, I see people jump into the Facebook group. And they're just like, what's the secret to this podcast? I'm like, huh? You gotta listen to it Really? Like, you know, you can't just you can't just ask for the the answer. Like it doesn't work that way or the next time you need the answer. You all know how to get it. And so

Unknown Speaker 1:16:55
it's very cool fish.

Scott Benner 1:16:57
teach a man to fish, right? Yep, you can teach them to not eat an Arby's. So although you've in fairness that you don't need Arby's anymore.

Unknown Speaker 1:17:07
No, I switched it out for Panera.

Scott Benner 1:17:10
So you don't have the meats any longer.

Unknown Speaker 1:17:13
I have the sliced turkey meats. If

Scott Benner 1:17:17
anything, I get my own Turkey and slice it. So I think it's possible that this episode will be called Jessica no longer has the meats.

Unknown Speaker 1:17:25
I will say that every single one of my friends would look at that and just absolutely know what it means.

Scott Benner 1:17:31
Tell you what, it's a strong contender.

I want to thank Jessica for coming on the show and telling an amazingly entertaining and fun story. I want to thank Dexcom on the pod and touched by type one for sponsoring Jessica's tail. All you have to do to support the sponsors is click on the links touched by type one.org omnipod.com. forward slash juicebox dexcom.com forward slash juicebox. That easy. If you're in the market, use my legs. If you're not in the market, don't feel pressure. I mean, do something else support a different sponsor, send me a lovely email and say, Scott, I love the podcast that will friend leave a great review. There are so many ways for you to support the show.

But if he gave me a choice, I'd say like, you know, click on the sponsor links, please. That's really, really helpful. And sharing the show with other people. I guess I'm being specific now. These are the things that would specifically really helped me share the show with somebody else. Let me add, subscribe or follow in a podcast app. And of course, if you're in the mood for some of the gear that we talked about here on the podcast, use my sponsor links there in the shownotes of your podcast player on there. Juicebox Podcast calm it's an extra click for you to get to the thing to help me but I mean, in the grand scheme of things right what's the click? Thank you so much for listening and for staying till the end at the end of my like bla bla bla bla stuff. I really appreciate that you love the show. I love you. I feel like that purple dinosaur right now. Which is weird because I've never seen that show once. But as soon as I said I love you made me think like, I love you. You love me. Where something something lots of words, I don't know. And then there's some thing and some thing and something else too. And then I think that's about the end of the song.

#482 Too Much Insulin?

May 21, 2021Scott Benner

Scott and Jenny Smith, CDE share insights on type 1 diabetes care.

+ Click for EPISODE TRANSCRIPT

Scott Benner 0:00
Hello friends, and welcome to Episode 482 of the Juicebox Podcast. Guess who's on the show today?

Today on the podcast, I'm joined by Jenny Smith. Jenny, of course, is from all the defining diabetes episodes, and the pro tip series. And she's here today to answer a question that I have based on watching people. I have a watching people question. I listened to a lot of people who use insulin. Some of them say this thing that doesn't make sense to me. And I wanted to ask Jenny, her opinion. And while you're getting her opinion, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your healthcare plan, or becoming bold with insulin. You know, I'm wearing headphones, and I can hear myself and my voice sounds amazing right now. Jenny holds a bachelor's degree in human nutrition and biology from the University of Wisconsin. She's a registered and licensed dietitian, a certified diabetes educator, and a certified trainer on most makes and models of insulin pumps, and continuous glucose monitors. And she just celebrated her 33rd diversity.

The T one D exchange needs 6000 people to join the registry. And I have to keep saying this to you until you do it. So the T one D exchange is looking for T one D adults and T one D caregivers who are us residents. They want you to participate in a quick survey that can be completed in just a few minutes from your phone or computer after you finish the questions. And they are very simple. I completed the survey in about seven minutes. You may be contacted annually to update your information. And they may even ask you a couple more questions. But this is 100% anonymous, it is completely HIPAA compliant. And it does not require you to ever visit a doctor or go to a remote site. See, this is interesting. This is a way for you in just a few minutes to help other people living with Type One Diabetes. Past participants have helped bring increased coverage for test trips, Medicare coverage for CGM, and changes in the ADA guideline for pediatric a one c goals. These are important behind the scenes things that people with type one diabetes need, and you have a unique opportunity to help them. These are not deep probing personal questions. They're pretty simple basic surface diabetes stuff, but they just need the data. Help them at T one d exchange.org. forward slash juicebox. And at the very least, if 6000 of you go right now, but I don't have to say this again. Do it for me. I'm kidding. Do it for the other people living with Type One Diabetes. But I mean, if you want to think of me while you're doing it, it's fine. This topic, absolutely mesmerizes me I could because I can't make sense of it. And I know I can't make sense of it. Because I don't have diabetes. I know this is one of those things that I can't wrap my head around because of it. And it comes mostly from adults. Although I've seen parents lean into it a little bit too. And I'm really want to kind of dig into this with you. Why do some people think that there's an amount of insulin that's too much insulin to use? And that they're actually embarrassed if they use that amount? Or feel like they're failing? Where does that thought come from?

Unknown Speaker 3:52
It's a good question. First off,

Jennifer Smith, CDE 3:54
I would think that it probably starts with some like, sort of off the cuff kind of comment from a doctor. Not that the doctor is really implying what the person takes out of it. Like doses of insulin usually go along with each other, you're not going to have a Basal rate of point two, and have an insulin sensitivity factor of 20, which is unbelievably aggressive, right? I mean, that's not going to typically happen. So in terms of like evenness of insulin distribution, they may have heard the doctor say, well, you're on a lot of insulin. So your ratios should be such and such. Right? So it may initially come from something like that, but um, you know, they even might compare themselves to another person with diabetes, who they maybe they work out together or maybe they are close enough friends that they're just comparing things and they say, well, gosh, you know, I eat really well or I follow this type of exercise pattern and Gosh, it looks like I use like twice as much insulin as you and you're like a couch potato or whatever, you know,

Scott Benner 5:08
the, um, the closest I can come up with listening to people, and I really mean that this isn't from one or two people. This is over the years, I hear this constantly, like, I'm a bad diabetic. I use too much insulin, I've heard those words come out of like grown people's mouths. And sometimes it feels like, it's I don't know if this is gonna sound crazy, but sometimes it feels like it's impacting them almost like an eating disorder, but it's a it's like disordered insulin use it feels like, and no matter how many times I talked to them, and I'm like, Hey, you just need what you need, or your body has a need meet the need, whatever I ended up saying to them. It doesn't feel like it's enough. Like it feels like it's psychological. And you know what I mean? Like it really it's sad to,

Jennifer Smith, CDE 5:56
I think some of it to probably comes from those who are trying to manage weight. Because if you know really what insulin is, it's a storage hormone, right? Its job is to move food from one place your bloodstream into a place to either get used or get stored. So, you know, if that's the fact then a lot of people also don't see what is insulin do if you don't have diabetes, if it's really still being made from my pancreas, its job is still the same thing. So in terms of weight management, you may find that, well, gosh, I use an awful lot of insulin, if I was just using less insulin, maybe my body wouldn't pack away as many calories. And thus, you know, my insulin use would go down. And I also wouldn't be, you know, heavier than I maybe want to be. And it certainly brings into the discussion kind of the, the whole thing's like eating disorders within the realm of diabetes specifically, yeah.

Scott Benner 6:56
So I get the idea. But I've seen it a side of people who are concerned about their eating, like like this, you know, like, if somebody comes to me recently, and wouldn't use their name, but I don't think they'd mind being an example here. So they come in, and they're like, Hey, you know, lately, my, you know, my blood sugar's have been going up, right? Like my, my resting blood sugars are more like 170, they used to be more like 100. and showed me the graph, and I look at it pretty hard. And I'm like, it just feels like you need more basil here. And you know, like, and then we could look at the meals. And, well, that's a lot of insulin, the person said, I don't usually use that much insulin. And I was like, Is there a problem with that? And the person said, It's embarrassing, but couldn't tell me why it's embarrassing that I'm using more insulin. And I

Jennifer Smith, CDE 7:51
guess I would feel like maybe it's the thought that they're not managing well enough. So they need more insulin to compensate for their lack of management, which shouldn't be

Scott Benner 8:03
right. Be the piece of like thought, that's how it feels to me too, that somehow, if I'm using more insulin, I'm doing something wrong. I didn't even see it connected to eating in this person's example. Although it's funny, because when it is connected to eating, it's the last thing people see, when you know, like, I'm using more insulin because I'm taking in more carbs. Insulin makes me gain weight. Although insulin didn't make you gain weight, the calories made you gain weight, the insulin was helping you keep your blood sugar down, they conflate the two somehow, right? You know what I mean? And then it gets, but they're tortured by it. Yeah, like really, really. And I didn't know if you would talk to anybody that this would come up for or if you felt personally,

Jennifer Smith, CDE 8:47
I would say that more. I mean, at least once a week, I have somebody both young and old, meaning both parents of kids with diabetes as well as adults managing their own diabetes. I I'd say you know, their, their typical question is, well, what does somebody else this age use? Is this the right amount of insulin? For me? Am I supposed to be on I guess, this much insulin or, you know, is this too little insulin? I mean, that's kind of the opposite with some kids or whatever. But it's always a question of, shouldn't it be specific to like, my age, or where I am in life or whatnot. And really, there's a physiologic personal physiologic need for insulin for every body. Good. Good point is that I've got a really good friend who is she's tiny, she's like three inches, and I'm not tall. I'm only five three, and she's like three inches shorter than me and probably weighs 10 or 15 pounds less than me and she uses more insulin than me. She's single and more active than I am. So, you know, from that standpoint, it kind of gives you a visual that the right amount Insulin for you as the right amount of insulin for you, as long as it's keeping your glucose where you want it to be, is it in the target that you're aiming for. And in the case of the person that you talked to, you know, their needs had gone up? Why? I don't know, some variable in the picture that was new and causing something to happen, but then just need more. And sometimes it's figuring out, well, is the more going to stick? Like, is there a, is there a body reason like is thyroid? Is there something going on that's causing the need for more? And will it be short lived, while this other thing is going to be taken care of and managed and gotten into control as well? But overall, you know, it is? It's a good question. I know the other piece of that too much insulin, sometimes also comes from people who have sort of been scarred by really like, low blood sugars, in the aftermath of what they deemed was a big amount of insulin for a meal. Yeah. Right. They're very wary of Gosh, I mean, I've worked with a number of adults who won't take more than like two or three units of insulin at a given time, no matter what, no matter what. And so, you know, then it becomes Well, okay,

Unknown Speaker 11:19
well,

Jennifer Smith, CDE 11:20
what's your ratio covering then? Because you can only eat this much at a time. The way that it works.

Scott Benner 11:28
So you see people who spread like little meals out throughout the day? No kidding. Jenny is nodding at me. No. Okay, so so that they won't have to take too much. That's what? So you said, I haven't I have a thought. But I want to go back to something you said. The comparison to others, is huge. And I always thought of it as looking for the answer through somebody else. But when you brought it up, I thought maybe there is just a comparison in their head, like I don't want to do more or less than other people do. Like maybe there's a real human failing in this, it has nothing to do with diabetes, that like comparison thing.

Jennifer Smith, CDE 12:04
Right? And I would, I would say that that's, especially with the teens that I talked to the teens themselves are not really so concerned, it's more the parents that are concerned god, he's using so much insulin, I remember when he was diagnosed, he was six, and he was on this tiny, tiny amount of insulin. Now he's got like, you know, Basil rates that are like 1.9 units an hour. And I'm like, well, he's a T and he's growing. And he needs a lot more insulin. I mean, so comparison wise, you do have to look at time of life. But even with, you know, this T and let's say, compared to his friend, his needs may be very different. His friend might be getting along just fine. On your point nine units of Basal an hour versus his 1.9. Right. So yeah,

Scott Benner 12:52
yeah, I get that. It's interesting, too, because I think my brain I know yours does, my brain kind of slips into that like, slip back, go macro, look at the whole picture. See, like, you were like maybe your thyroids out of whack, or like, I don't think mostly people think about stuff like that. Right, and the impacts of other things on your blood sugar, the one that you just brought up now, which I'm always fascinated by is, you'll get a note from somebody who says, I don't understand, like, kids had diabetes for two years. You know, all of a sudden, his blood sugars are high all the time. And my first question is, have they gained weight last, like three months? Oh, yeah, he's put on like, 10 pounds, I was like, Well, you know, a gallon of gas moves a car that weighs 1000 pounds this far, it moves, it moves a car that weighs 1010 pounds, a little less, you know, like that. And, but they don't see that a lot. Everyone's so locked in on making a number. Be right, and holding on to some hope that it's just going to be like that forever. Maybe that has something to do with this as well, I have no idea. I know, all I can tell you is that when I hear adults say it, there is sadness in their voice. And they feel like they failed somehow. And the other thing that, that I hear too, that I want to know if you've heard and wondered where it comes from, if you know is the idea that you can use too much insulin, and it's not healthy for you. Not that it will make your blood sugar low, but using too much. It's almost like you ever meet a person is like, has pain and you say take an Advil and I go, I don't want to put medication in me like and you go all right, right on, you know, I it feels like that a little bit like they're almost I don't want to say irritated but they're disappointed that they have to take insulin law. And somehow by using less of it, it's going to be healthier for them when that's of course, the opposite. But I do you know what I mean by that?

Jennifer Smith, CDE 14:50
I do and you know, in terms of too much insulin. If you need a certain amount of insulin you need it. I mean, that's the base fact right? But Getting into the fact of where I remember years ago, even before I was I was working clinically. And I started a young girl teens on a pump. And prior to the training, we always go through, like, what's your insulin dosing, so I could figure out like the strategy for the pump settings, right? When she was telling me her doses, and I was like, you're going to be going through a reservoir a day, like, serious, that's how much insulin this this team girl was using. And I was like, we need better insulin. Yeah, you, you 100. At that point, I mean, you 500 was on the market. But it was not at all something that was typically used an insulin pump, we had to actually go about, like getting a doctor's order to use it off label in her pump, in order for her to actually get enough insulin. But at that point, there, there are other reasons. I mean, that's significant insulin resistance, then, if you're not a growing teen, or a growing child, or maybe you know, a woman going through pregnancy, or some other type of like body, like health issue that might be impacting, yes, there are certain doses of insulin that typically you will need for your own body. But if you have all of a sudden, like climbed in need, for some reason, that's a reason to get a check in with your doctor to see if something else is going on. But then Thankfully, there are, there are other meds on the market now that, you know, they're starting to be used. Thankfully, in type one, they started out mainly as type two because insulin resistance is a hallmark of type two specifically. But it's kind of becoming more visible now in the type one community. And so some of those meds that help with resistance, can actually help you get back to a more normal need for your own body of insulin. Because, yes, exorbitant doses of insulin. At some point, you know, as I think we've talked before, like large depots of insulin under the skin take a longer time to disperse and get absorbed. So while that active insulin time of let's call it three to five hours, or whatever, from a single one shot dose of insulin, if you've got two units, probably over the course of that time, you're going to see its action, the way that it was meant to be, if you've got a dose, that's like 30 units in a shot. That's a huge amount of insulin to get dispersed. So in terms of decreasing resistance, especially if it's climbed for you, you may want to explore the other medications that are on the market that are very helpful for that.

Scott Benner 17:56
Well, as as we're sitting here talking, I do think that there's this one aspect that that's kind of creeping into my mind and making sense to me that I've just never thought of, which is, if my insulin needs are going up, I know I'm eating more food or eating less healthy foods maybe? And possibly, it could, it could, that could be I shouldn't say I should I know that could be one of the reasons like say, say for a person, that is the reason instead of wanting to face head on the idea that I'm eating in a way that I'm not thrilled about. I focus on Oh, I don't want to take so much insulin. And then like you said, you have a higher blood sugar, which then keeps your body weight down. hurting you in other ways,

Jennifer Smith, CDE 18:45
right?

Scott Benner 18:47
Correct. I'm trying to like put myself in someone's shoes there. You know what I mean? That whole like,

Jennifer Smith, CDE 18:54
it's a difficult it's, it's it is it's very difficult. And I think even in this past year, with so much change to people's schedules. And I mean, even the people I've worked with, in like cities where they were used to doing their their commute and getting on a train and walking and walking to the office and like that disappeared. And that might have been like 5000 of their 10,000 necessary steps in a day out of the picture. And now you're just getting up in the morning sitting at your desk and look at that you gained some weight and hey, you're going to probably need more insulin. In that time period,

Scott Benner 19:31
I would imagine plus the activity itself. Put your insulin requirement down. Yes. So now there's maybe you're going to gain weight because you're not moving as much and you're lost as much. Yeah, blood sugar. Well, that all makes a lot of sense. Like I it didn't not make sense to me. It's just that it's happened so many times and people seem so sad when they say it. And I just wanted to really like have a conversation and try to understand it because I really I'm at a loss Because I just come at it from like a clinical way when they said, I'm like, Well, I just put more in, you know, we're exercise more, eat a little less sort of like these your options. It's that one specific sentence that I need more insulin, I don't want to use that much insulin, or insulin is not good. Too much insulin is not good for you. I always expect they're going to say, because I don't want to get low. I don't want to have a ton of insulin in me. But right, that's not always the concern.

Jennifer Smith, CDE 20:27
It's just the actual dose. That's the concern. Yes, the number,

Scott Benner 20:31
it's the number that messes them up. It's got nothing to do with anything out like if you, if you, I don't know, let's say I put you in charge of the world. And you decided that a unit of insulin was actually equivalent to two units of insulin. So we started calling two units one unit, then they'd be okay with it. Then they'd be like, Oh, I'm only using three. Right? Right. But you tell them it's six. And they're like, Oh, it's still it's still like in I'm putting my fingers on. But it's still this much insulin in the syringes this much in a little tube. But if the number was different, they'd be okay with it. And that's got to be psychological, right? Mm hmm. Yeah.

Jennifer Smith, CDE 21:12
And I think it kind of goes back to what you brought up initially, is just that, that feeling of, I need so much, I must be doing something wrong. Like the feeling of just you're like beating yourself up. Because why else would I need this much insulin? And that that's not normal? Why should I have to take 50 units every single day? Should I be more on like 20 units a day. I mean, from a standpoint of like, overall weight management, sure, doses of insulin can make a difference. But there are other lifestyle pieces that go into that. It's not just the management of the dose of the insulin.

Scott Benner 21:55
So the way we do it here is is interesting, like are no go through swings of you know, there'll be a day or two where suddenly there's just like, way more carbs than usual. And you don't notice it when it's happening. But then you do notice that if you're especially if you're on an on the pot or something with a cartridge in it when you're like, Oh, I have to change my pumps sooner than I thought I was going to. And yes, and so she used to be like, why are we changing it now? And I was like, it's empty. And then you know, and she goes, Oh, why? as like, why do you think she goes, Oh, I got nachos at Mo's yesterday. And I and I had a milkshake today. And I was like, that is why so I you know, in a very, like, simple way, it helps her go. I am maybe I'm, maybe I'm carb crazy right now and don't realize that I'll pay a little more attention to it. I see it as a kind of a, it doesn't well, because it doesn't impact her adversely. in her mind. I see it as a positive thing. Because she she can kind of see like, Oh, you know, pay attention. Look what's happening to me. But anyway, okay. I appreciate you talking about this with me. Yeah, I really did not meaningfully understand. And I think this helped a little bit. And I want people like I let me ask you this, though. If there aren't outside influences. In general, you're comfortable saying more insulin is not unhealthy for people.

Jennifer Smith, CDE 23:17
As long as it's managing their blood sugar, and everything is in target and they have no other health concerns, then the dose that they're taking, is obviously working to help them maintain control. Yes.

Scott Benner 23:30
So when I say meet the need on the podcast, that's what I mean. I just mean there's an amount of insulin you need. Use it. Use it. Yeah. Okay. Thank you.

How about Jenny. I love Jenny. You love Jenny, who doesn't love Jenny? There's no one. No one law. I mean, maybe once in her life, she kind of guy off in traffic and that guy still like a person to cut me off in traffic, but they don't really know. It's Jenny. They knew this Jenny. They want that. They'd be like, God cut me off. You're fine. Anyway, Jenny does this for a living it integrated diabetes comm and you can check her out there. There's the link in the show notes. Alright, look, one last time in this 25 minutes that you've been with me, the T one D exchange needs your help. And the help they need is super simple to give. You just go to T one d exchange.org. forward slash juicebox. That's my link, use that link. And then when you get there, click on join our registering now. And after that, you complete this simple, quick survey. It's for us residents only. But it's so easy. Like right now, if you did it right now look at your watch. Or you probably want to watch to pick up your phone, touch the face of it. If you did it right now you'd be done in less than 10 minutes. It took me three hours. To bring you this episode, and this is all I'm asking in return one day exchange.org forward slash juice box. I mean, seriously, I the book Jenny, record the thing, edited it. I mean, you notice how there's no like pops and clicks and noises and nothing distracting while you're listening. You're welcome. That was me. Scott, click, click click with the mouse, I fixed the whole thing for you. hours it took like, you're just like, Oh, it was a quick 25 minute episode. It was nice. God said insulins important, blah, blah, no, no, it's more than that. It's deep. It's deep. It's building a narrative in your life about type one diabetes, giving you the tools and the access to information for the free. And all I ask is that you go to T one d exchange.org. forward slash juicebox. I only need 6000 of you to do it. I mean, there were hundreds of 1000s of downloads last month, I just need six of you. And I'm saying of the hundreds of 1000s of downloads. I need 6000. I'm tired of saying it too. I know you're tired of hearing it. I'm tired of saying it. But I mean, at some point, one of us has got to pick up the mantle and do their part. I can only do this I filled out the survey is easy. Alright, I'm gonna stop. I apologize. That was I that was too much, too much. I should just say T one d exchange.org. forward slash juicebox. You need to be a US resident who has type one, or is the caregiver of someone with type one. Please go fill it out if you have the chance. I mean, that's that's how I should say it. But I mean, come on this podcast is amazing. And it's free. Free. And what do I say to you? You know, if you want to try out an omni pod, go to Omni pod.com forward slash juice box I say if you want to check out the Dexcom go to dexcom.com forward slash juice box. I say want to get a great meter contour next comm forward slash juice box I say hey, my daughter's got this G Volk. hypo pan, you should check it out. That's it. I mean, you don't have to check it out. I'm not telling you to buy an ami. But it's not like if you don't buy an ami bike, and I love to listen to him. I'm just saying if you're going to go check it out. But this T one D exchange thing. I mean, you're on the internet constantly. I see the people in my life. I know you don't put the phone down. And I'm not judging you. I'm just saying why you're doing it. You don't I mean, p one d exchange.org. forward slash juicebox. Help a guy out a little bit. Make me beg you what's embarrassing? I'll tell you what, if the T one D exchange contacts me at the end of the month, next month at the end of June and says we've added 1000 new people to the registry. Thanks to you. If they say that, what will I do? I will do an online talk about using insulin. Once a week, in July, once a week. Okay, I'll come on. I'll do it on zoom. It'll be free, obviously, because you helped me out with the D one D exchange thing. And I will answer everyone's questions as long as I can. If we reach 1000. Now if we reach 1500 I'll get Jenny on one of those calls. If you do 2000 I'll do the call. Right? Every day every what I say every week in July, Jenny wants and what else will I do? I'll do something else. That's cool. I don't know what yet, but trust me, I'll come through T one d exchange.org. forward slash juicebox. Use the link. complete the survey. That's it.

contact us

JUICEBOX PODCAST

Podcast Episodes

#485 Altered Minds

May 28, 2021Scott Benner

Scott and Jenny Smith, CDE share insights on type 1 diabetes care.

+ Click for EPISODE TRANSCRIPT

#483 Jessica No Longer has the Meats

May 24, 2021Scott Benner

Jessica is an adult living with type 1 diabetes

+ Click for EPISODE TRANSCRIPT

#482 Too Much Insulin?

May 21, 2021Scott Benner

Scott and Jenny Smith, CDE share insights on type 1 diabetes care.

+ Click for EPISODE TRANSCRIPT