Scott Benner 2/8/26 Scott Benner 2/8/26

#1765 Tandem Kids: Riley

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Riley, who was diagnosed with Type 1 diabetes 12 years ago, discusses the unique experience of having her brother and father both diagnosed with the condition within the last year.

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

Scott Benner (0:00) I attended my first ever Friends for Life conference in July 2025. (0:05) And while I was there, I interviewed eight children of various ages, all who wear a Tandem pump. (0:10) I wanna thank Tandem Diabetes for sponsoring this short episode of the Juice Box podcast. (0:16) Check them out at tandemdiabetes.com/juicebox. (0:22) Nothing you hear on the Juice Box podcast should be considered advice, medical or otherwise.

Scott Benner (0:28) Always consult a physician before making any changes to your health care plan. (0:35) The episode you're about to listen to is sponsored by Tandem Moby, the impressively small insulin pump. (0:41) Tandem Mobi features Tandem's newest algorithm, Control IQ Plus technology. (0:46) It's designed for greater discretion, more freedom, and improved time and range. (0:50) Learn more and get started today at tandemdiabetes.com/juicebox.

Scott Benner (1:05) Hi. (1:05) How are you?

Riley (1:06) Good. (1:06) How are you?

Scott Benner (1:07) I'm excellent. (1:07) Thank you. (1:08) What's your name?

Riley (1:09) Riley.

Scott Benner (1:09) Riley. (1:10) How old are you?

Riley (1:10) 15.

Scott Benner (1:11) And where are you from?

Riley (1:12) Marysville, Ohio.

Scott Benner (1:13) Awesome. (1:13) Do have type one diabetes? (1:15) Yes. (1:15) How long ago were you diagnosed?

Riley (1:17) Twelve years.

Scott Benner (1:18) Twelve years ago when you were three?

Riley (1:20) Yes.

Scott Benner (1:20) Do you remember anything about that?

Riley (1:23) It was on my brother's birthday, So

Scott Benner (1:26) Go ahead.

Riley (1:27) We were at, like, Chuck E. (1:28) Cheese or something and I just no. (1:32) We were not Chuck E. (1:33) Cheese, that's where we went after I got released from the hospital. (1:36) We my mom, she was like, I need to take my daughter to the doc to the doctors because she's, like, wetting the bed and she's always thirsty and she's just, like, she's just, like, sleeping all the time.

Riley (1:49) Mhmm. (1:50) So she took me to the doctor and he's like, you need to take her to the ER right now.

Scott Benner (1:56) Right.

Riley (1:56) So but I was really hungry, so we stopped for Burger King. (1:59) So when we got to the hospital and I remember, like, we were in this big room, but there were, like, like, bunch of toys in there. (2:08) So they gave me, like, a coloring book because I was just, like, sitting there and I was, like, crying because I didn't wanna be there. (2:13) Right. (2:14) And and I remember I was, like there was one time I was sitting in the room, I had Band Aids all over, like, all 10 of my fingers.

Riley (2:21) Mhmm. (2:22) And I was eating, like, the American, like, Kraft singles and baby carrots. (2:28) And I was just sitting there.

Scott Benner (2:29) Eating cheese slices and baby carrots? (2:31) Yes. (2:31) What were the Band Aids on your fingers for?

Riley (2:33) From all the times I had to poke my fingers check my blood sugar.

Scott Benner (2:35) Oh my gosh. (2:36) Yeah.

Riley (2:36) Because this was 2013, so Yeah. (2:39) They didn't, like, have Dexcoms or insulin So pumps I had, like, Band Aids all over me from where they had to give injections and stuff. (2:47) Right. (2:48) So and then after that, since it was my brother's second birthday, we went to Chuck E Cheese and I remember crying because everyone was getting like the triangle slices of cake, but I had to get the two by two square.

Scott Benner (3:03) They don't the different carbs?

Riley (3:04) Yeah. (3:05) Oh. (3:05) So I could actually count the carbs to make sure I got enough insulin.

Scott Benner (3:07) So you've grown up with type one Have there been moments where you've, like, felt like you've overcome something? (3:14) Have there been moments where it's been hard?

Riley (3:16) Yes. (3:17) There are like so I play lacrosse for my school, and there are many times where I've had to, like, sit out because I'm too low or I have ketones, so I can't do anything, but I still have to be there.

Scott Benner (3:30) Yeah.

Riley (3:30) So I'm just watching everyone play or practice or something.

Scott Benner (3:34) How does that make you feel?

Riley (3:35) I I feel like people are like judging me because I'm sitting out, but there's nothing I can do about it.

Scott Benner (3:40) Okay. (3:40) So do you feel supported by some friends and others so not you have a, like a good Yes, circle of I

Riley (3:45) amazing friends.

Scott Benner (3:46) How did you make that happen? (3:48) Did you, like, tell them about your diabetes? (3:50) Did you

Riley (3:51) Well, they kinda already knew

Scott Benner (3:52) Okay.

Riley (3:52) Because, like, I went to, like, a smaller elementary school, you're the kid with diabetes, so everyone knows.

Scott Benner (3:58) Oh, I see. (3:59) There's no other kids. (4:00) It was you.

Riley (4:00) It was me until third grade.

Scott Benner (4:02) And then somebody else showed up?

Riley (4:04) Yeah. (4:04) Well, she was already there, but she

Scott Benner (4:05) She was diagnosed. (4:06) Yeah. (4:07) Crazy question, but did it make you feel better when somebody else was there with type one? (4:11) Yes. (4:11) It did.

Riley (4:12) Because we were, like, best friends. (4:13) Like, we shared, like, the stories and Yeah. (4:17) We're just there.

Scott Benner (4:18) You know her still today? (4:18) Yes. (4:19) Oh, that's awesome. (4:20) So you're here today at Friends four Life? (4:22) Yes.

Scott Benner (4:22) There's a ton of kids here with type one. (4:24) What does it feel like to be around so many people who are in CGMs, Moby pumps, stuff like that?

Riley (4:29) I I think it I feel more like since most people here have type one that we're, like, not such a smaller group, it's like the majority of people here have it. (4:40) Yeah. (4:40) So it's like

Scott Benner (4:41) Is it like I don't know. (4:43) Does it make you feel lighter?

Riley (4:45) Yeah. (4:45) Like, if I I say something and someone's like, oh, yeah. (4:48) I have that too. (4:49) So It's

Scott Benner (4:50) just easy. (4:51) Yeah. (4:51) Other people beep, nobody acts like it's crazy. (4:53) Right? (4:53) And you're just like and it makes you feel like normal is the wrong word, but, like, there's what what is it?

Scott Benner (4:59) Like, there's a thing that's happening when you're around other people who don't have type one.

Riley (5:02) Like, there's a stigma. (5:03) There is, like, you have to be like, you're always high or you're, like, always beeping and they're, can I catch it?

Scott Benner (5:10) Yeah.

Riley (5:11) And then but everyone here is like just like it's normalized here, so they, like, know what's going on.

Scott Benner (5:16) Yeah. (5:16) So when you say the things you say all day long, nobody thinks, hey. (5:19) I'm high or your mom's yelling do something. (5:21) You're high or that kind of thing.

Riley (5:22) Yeah.

Scott Benner (5:23) Yeah. (5:23) I understand. (5:24) Okay. (5:25) So you told me about the day you were diagnosed. (5:28) That's crazy.

Scott Benner (5:28) Is that from stories that you were told from your parents or do

Riley (5:32) you actually But I remember some of

Scott Benner (5:33) them. (5:34) You have a mix of

Riley (5:34) it. (5:34) Yeah.

Scott Benner (5:35) Okay. (5:35) And then growing up, you've got friends, they're supporting you. (5:38) What has been tell me about a moment, I guess, where you thought, like, I can't believe I accomplished this, and you had, like, a big accomplishment despite diabetes.

Riley (5:50) I don't know.

Scott Benner (5:51) Is it tough? (5:52) Do you have a lot of things that you feel like you're working against that are

Riley (5:55) Yes.

Scott Benner (5:56) Yeah. (5:56) And you are you still working your way through those things? (5:58) What are they?

Riley (6:00) So I have a bunch of, like, scars all over my stomach and my legs. (6:04) Yeah. (6:04) So I can't really go out and, like, wear, like, a swimsuit because everyone's gonna be like, what's on your stomach?

Scott Benner (6:10) You're worried about that right And it makes you feel self conscious. (6:13) Yes. (6:13) Yeah. (6:14) I bet you that gets better as you get older. (6:16) I hope it does for you.

Scott Benner (6:16) I've watched it with my daughter. (6:18) Like, she's, like do you hide your devices? (6:21) Sometimes. (6:22) What insulin pump do you wear?

Riley (6:23) I'm currently on injections.

Scott Benner (6:25) You're doing injections right Are you getting a pump?

Riley (6:28) Eventually. (6:29) Well, I'm gonna try the Mobi here.

Scott Benner (6:31) Oh, okay. (6:32) So you're gonna do a what what are they calling it? (6:34) A try on? (6:35) Or

Riley (6:35) A trial or something like that.

Scott Benner (6:37) So you're gonna check out the Mobi here. (6:38) You're thinking about trying that? (6:39) Yeah. (6:40) Okay. (6:40) And do you think that would make a change for you?

Riley (6:42) I hope so.

Scott Benner (6:43) Yeah. (6:43) What is it about injections that I mean, you've you've been injecting for how long? (6:48) Because it sounds like you've worn pumps in the past.

Riley (6:50) I have. (6:51) So I did injections for about two years when I was first diagnosed, and then I started an Omnipod. (6:57) And then a few years after that, I started a Tandem. (7:00) Mhmm. (7:00) Like, I was on the t slim, and I did that for, like, two or three years.

Riley (7:05) Yeah. (7:05) So then now I'm on injections.

Scott Benner (7:07) What makes you switch?

Riley (7:09) It's just, like, sometimes I just need, like, the reset so I can, like

Scott Benner (7:14) Feel like you need a break? (7:15) Yeah. (7:15) So you just go back to injections for a while. (7:17) How long have you been doing them now?

Riley (7:19) Two or three months.

Scott Benner (7:20) Okay. (7:20) Yeah. (7:21) What pump was prior to that?

Riley (7:22) T slim.

Scott Benner (7:23) T slim. (7:23) And you're thinking about going back to and using the Movian? (7:25) Yes. (7:26) Is that a decision you're making or something your family decided together?

Riley (7:30) We I I decide when I wanna go back on the pump, but I talk with my parents about which one I wanna go back on.

Scott Benner (7:36) Okay. (7:36) And Moby is the one you're thinking about? (7:38) Yeah. (7:38) Tell me the difference between wearing a pump and injecting, like, what do you gain by having a pump on?

Riley (7:43) It's just, like, easier sometimes.

Scott Benner (7:46) How?

Riley (7:46) So instead of, like, having to go to, like, the nurse's office at school to do the injection because most most teachers won't let you do that in class.

Scott Benner (7:53) Okay.

Riley (7:54) But if I'm in class with, like, an insulin pump, I can just press a few buttons and no one would know.

Scott Benner (8:00) Yeah. (8:00) Okay. (8:01) So keeping that kind of anonymity that you want, like, you wanna be a little private Yeah. (8:07) The pump helps you stay private.

Riley (8:08) Yes.

Scott Benner (8:09) Alright. (8:09) And so because you don't mind the injections, it doesn't sound like. (8:12) Right? (8:12) So it's more about, can I keep this hidden? (8:16) Oh, is that why you're interested in the Mobi now?

Scott Benner (8:18) Because it's more

Riley (8:20) Yeah.

Scott Benner (8:20) Concealable? (8:21) Yeah. (8:22) That's why it's attractive to you. (8:23) Okay. (8:25) Tell me how, I guess, when you make that decision to go back and use the pump again, what what do you think like, what do you think is gonna happen?

Scott Benner (8:34) Like, do you know what I mean? (8:35) Like, you have in your mind, like, I'm gonna get a pump and then this is going to change?

Riley (8:39) Sometimes, like, when sometimes at the, like, the end of when I decide to go off the pump, my blood sugars are a little higher.

Scott Benner (8:47) Mhmm.

Riley (8:47) So then I go on the injections, and then when the injections are, like, keeping my blood sugar a little higher, that's when I go back on the pump. (8:55) So I'm hoping that'll keep them lower.

Scott Benner (8:56) You see more stable a one c's when you're pumping? (8:59) Yeah. (9:00) Do you like the Control IQ?

Riley (9:01) Yes.

Scott Benner (9:02) Yeah. (9:02) How come? (9:03) What does it do for you?

Riley (9:04) I it's easier to, like, understand from, like, other insulin pumps. (9:08) Mhmm. (9:08) It's I I like how sometimes I don't have to put in carbs and or not carbs, like, a correction because it, like, it's already, like

Scott Benner (9:17) Correcting for you. (9:17) Yeah. (9:18) Yeah. (9:18) So if you maybe miss on a meal and you start rising up, you have that comfort that it's gonna jump in and and do it for you. (9:25) Yes.

Scott Benner (9:25) That is relieving or

Riley (9:27) Yes. (9:27) It is.

Scott Benner (9:27) Just makes your day easier?

Riley (9:28) Yeah.

Scott Benner (9:29) Yeah. (9:29) How much of the day do you think you think about diabetes, like, normally, and how much less do you think about it when you're pumping with Control IQ?

Riley (9:40) I feel like it's, like, fifty fifty right now. (9:42) So, like, sometimes I'm thinking about it and other times I'm not. (9:45) Yeah. (9:46) But with Control IQ, it's way less.

Scott Benner (9:49) Awesome. (9:50) Okay. (9:50) Do have any heroes, people who have type one that you look up to or you follow in their careers or anything?

Riley (9:55) My dad.

Scott Benner (9:55) Oh, Your dad has type one? (9:57) Mhmm. (9:57) Do you know, when he was diagnosed?

Riley (9:59) He was diagnosed last year.

Scott Benner (10:01) No kidding. (10:01) So you've had type one for, what did we say, thirteen years? (10:04) Twelve. (10:05) Twelve years, sorry. (10:05) And your dad was just diagnosed.

Scott Benner (10:08) How old is he?

Riley (10:08) He's 43.

Scott Benner (10:11) Is there is there any other type one in your family, like aunts, uncles, cousins?

Riley (10:14) My brother.

Scott Benner (10:15) Your brother? (10:16) How old is your

Riley (10:16) brother? (10:17) He's 14.

Scott Benner (10:18) How when was he diagnosed?

Riley (10:19) Also last year.

Scott Benner (10:20) Wow.

Riley (10:21) Yeah. (10:21) So it went me, then my brother, and then my dad.

Scott Benner (10:24) What makes it, I don't know. (10:27) That's the wrong question. (10:28) I guess my question should be is how does it feel to not be alone in your family anymore? (10:32) I've interviewed other people. (10:33) I'm super interested to hear what you say, but was it nice that they got type one?

Scott Benner (10:38) I know that's such a weird way of saying it.

Riley (10:40) Kinda because, I'm not the only one who's, like, doing this stuff. (10:46) Yeah. (10:46) So they're kind of there with me.

Scott Benner (10:49) You don't you feel less alone? (10:50) Yeah. (10:50) Do know I interviewed, a person one time and everybody in the family had diabetes except for this one kid, like the one that, you know, I think it was, like, the youngest boy, if I'm remembering correctly. (11:01) And I inter I interviewed him and he told me do you know what he told me? (11:06) No.

Scott Benner (11:06) He wished he had type one diabetes so he could be like the rest of his family. (11:09) And he was real sincere about it too. (11:12) So I just kind of reverse engineering that figured when they got diagnosed, you probably felt less alone. (11:17) Yeah. (11:17) Do you think your mom feels like on the outside now or do you have other brothers and sisters?

Riley (11:20) I have one other sister.

Scott Benner (11:22) Oh, is she like, oh, I hope I don't get diabetes?

Riley (11:24) Yeah. (11:24) She's she did the trial on that stuff a couple years ago, so that's how I found out my brother had it. (11:29) Oh. (11:30) So she's doing it again this year just to make sure.

Scott Benner (11:32) Do have other autoimmune issues? (11:34) Yeah. (11:35) Hypothyroidism? (11:36) Yeah. (11:36) Do other people in your family have it too?

Riley (11:39) I don't think so. (11:40) Celiac? (11:41) My aunt has celiacs. (11:42) Both of them do.

Scott Benner (11:42) People have eczema in your family?

Riley (11:45) I don't think so.

Scott Benner (11:46) No? (11:46) It's just different. (11:47) That's not actually autoimmune, but it's a thing I see when I talk to people. (11:51) Anxiety?

Riley (11:52) Yeah.

Scott Benner (11:52) Yeah. (11:53) A lot of people have anxiety? (11:54) Yeah. (11:55) That's the other, I don't know, connector I see a lot when I'm talking to people. (12:00) Do are you anxious?

Scott Benner (12:01) No. (12:01) No. (12:02) But other people in your family are. (12:03) Yeah. (12:04) Okay.

Scott Benner (12:04) So your hero is your dad.

Riley (12:05) Yes.

Scott Benner (12:06) How come though? (12:06) What makes him your hero?

Riley (12:08) Because he's always standing up for me and when, like, insurance wouldn't cover something, he was, like, on the phone with them twenty four seven trying to get them to, like, approve the stuff.

Scott Benner (12:18) Right. (12:19) That's great. (12:19) Yeah. (12:19) So he's got your back. (12:21) Mhmm.

Scott Benner (12:21) And that feels what? (12:22) Like, what is it like, what does that give you when you

Riley (12:24) It's, know like, relieving because sometimes I don't wanna do it, but he said he'll always be there and do it for me.

Scott Benner (12:30) Yeah. (12:31) No. (12:31) I see that too with my daughter. (12:32) I think it's really valuable. (12:34) Let me see what else I got here for you.

Scott Benner (12:35) So you had type one diabetes for a long time before your dad was diagnosed and then your brother.

Riley (12:40) Yeah.

Scott Benner (12:41) Do you think they knew how to take care of themselves already from helping you? (12:46) Was it different for your dad? (12:47) Was your brother like, you know what I mean? (12:49) Like, did he go, oh, I've seen this before? (12:51) Do you think that made them more comfortable having watched you grow up with it?

Riley (12:54) I feel like my dad, he knew how to do it pretty good because he was taking care of me for so long, but there are some things that I had to teach my brother.

Scott Benner (13:01) Okay. (13:01) Like what?

Riley (13:03) He had, like, he has some trouble sometimes about, like, putting his, like, Dexcom into his insulin pump. (13:08) So Mhmm. (13:08) I had to remind him how to do that.

Scott Benner (13:10) What pump is he using?

Riley (13:11) He's on Omnipod five.

Scott Benner (13:12) Okay. (13:13) And he uses Dexcom?

Riley (13:14) Yes.

Scott Benner (13:15) G seven. (13:15) What about you?

Riley (13:16) I'm on g seven.

Scott Benner (13:17) G seven too. (13:17) Do you like it? (13:18) Yes. (13:18) Awesome. (13:19) Good.

Scott Benner (13:19) That's cool. (13:22) You count your own carbs, take care of your own meals? (13:24) Yes. (13:24) Yeah? (13:25) Do does your brother?

Riley (13:26) Yes.

Scott Benner (13:27) Yeah. (13:27) Who taught him that, do you think?

Riley (13:29) I think just from watching me and my parents do it, I think he, like, knew how to already. (13:35) Yeah. (13:35) But there are some things where I'm like he's like, I don't know about how much this is.

Scott Benner (13:39) Right.

Riley (13:40) Because, like, sometimes we go out and he doesn't know.

Scott Benner (13:42) Okay. (13:42) And your dad is your mom like, would you call your mom your primary diabetes caregiver or is it your dad?

Riley (13:48) It's both.

Scott Benner (13:49) Yeah. (13:49) So it's been split pretty Yeah. (13:50) The whole time. (13:51) So they both knew how to handle things.

Riley (13:52) Yes.

Scott Benner (13:53) What's your a one c right now? (13:54) Do you know?

Riley (13:56) Eight point something.

Scott Benner (13:57) Okay. (13:58) Yeah. (13:58) And does it change when you're on a pump?

Riley (14:00) Yes.

Scott Benner (14:01) Does it goes down?

Riley (14:02) Sometimes.

Scott Benner (14:03) You think because of the correcting? (14:04) Yeah. (14:05) Okay. (14:06) I had a question. (14:07) I just lost it.

Scott Benner (14:08) So I know that it was, like I know that you said that it was kind of nice when other people had type one, but initially when your dad and your brother were diagnosed, what was your reaction?

Riley (14:18) I kind of didn't want them to have it because it's like a little bit extra steps. (14:23) Yeah. (14:24) Like, we can still do everything else that everyone else can, but it's just extra steps and I didn't want them to have to do that.

Scott Benner (14:29) Yeah. (14:29) So it wasn't like a sadness about the diabetes, it was about the work. (14:32) Yeah. (14:33) Oh, that's interesting. (14:34) Okay.

Scott Benner (14:35) And when you're deciding between different pumps, what made you think about the Mobi?

Riley (14:40) I just wanted to try something else. (14:42) So because I was on Omnipod for so long. (14:44) It was just, like, something new, so I thought it would work better.

Scott Benner (14:47) Okay. (14:48) Alright. (14:48) Well, you're try it on today. (14:49) Hope you love it.

Riley (14:50) Thank you.

Scott Benner (14:50) Excellent. (14:51) Was really great talking to you.

Riley (14:52) You too.

Scott Benner (14:52) Thank you. (14:53) The podcast you just enjoyed was sponsored by Tandem Diabetes Care. (14:58) Learn more about Tandem's newest automated insulin delivery system, Tandem Mobi with Control IQ plus technology at tandemdiabetes.com/juicebox. (15:08) There are links in the show notes and links at juiceboxpodcast.com. (15:12) If you'd like to hear about diabetes management in easy to take in bits, check out the small sips.

Scott Benner (15:18) That's the series on the juice box podcast that listeners are talking about like it's a cheat code. (15:23) These are perfect little bursts of clarity, one person said. (15:27) I finally understood things I've heard a 100 times. (15:30) Short, simple, and somehow exactly what I needed. (15:33) People say small sips feels like someone pulling up a chair, sliding a cup across the table, and giving you one clean idea at a time.

Scott Benner (15:41) Nothing overwhelming. (15:42) No fire hose of information. (15:44) Just steady helpful nudges that actually stick. (15:47) People listen in their car, on walks, or rather actually bolus ing anytime that they need a quick shot of perspective. (15:53) And the reviews, they all say the same thing.

Scott Benner (15:56) Small sips makes diabetes make sense. (15:59) Search for the Juice Box podcast, small sips, wherever you get audio.

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Scott Benner 2/8/26 Scott Benner 2/8/26

#1764 Tandem Kids: Leah

Scott interviews 8-year-old Leah at the Friends for Life conference. Leah was diagnosed with Type 1 diabetes in August 2024 and shares her perspective on transitioning to life with a pump and CGM.

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Scott Benner (1:06) Are you nervous?

Leah (1:07) A little bit.

Scott Benner (1:08) Yeah. (1:08) I'm a little nervous, though. (1:09) Don't worry about it. (1:10) It's okay. (1:10) You ready?

Scott Benner (1:11) Okay. (1:12) Hi. (1:13) Hello. (1:14) What's your name?

Leah (1:15) My name is Leah.

Scott Benner (1:16) Leah. (1:17) I'm Scott. (1:18) It's nice to meet you.

Leah (1:20) Nice to meet you too.

Scott Benner (1:21) Thank you. (1:22) How old are you?

Leah (1:23) I'm eight years old.

Scott Benner (1:24) Eight. (1:25) And you have type one diabetes?

Leah (1:27) Yes.

Scott Benner (1:28) For how long?

Leah (1:30) I've had it since 08/26/2024.

Scott Benner (1:35) Oh, wait. (1:36) Not even a whole year yet? (1:37) No. (1:38) Wow. (1:38) That's pretty new then.

Leah (1:40) How are you doing? (1:41) Good.

Scott Benner (1:42) Yeah? (1:43) You you're just okay? (1:44) It's no big deal? (1:45) Do you check your blood sugar or do

Leah (1:47) you Yeah. (1:47) I check my blood sugar by myself. (1:51) Sometimes I dose by myself Yeah. (1:53) When I'm home alone with my sister.

Scott Benner (1:56) Oh, wow. (1:56) That's awesome. (1:57) So do you remember anything about getting type one? (1:59) Do you remember about being diagnosed or what it was like?

Leah (2:02) I remember laying I remember waiting what felt like forever in in the emergency room waiting place. (2:13) And then

Scott Benner (2:15) I just get called in, and we just go into the small room and take some tests. (2:20) And then I have to go into this big room with this large bed, and they tell

Leah (2:25) me to just pop on the bed.

Scott Benner (2:26) Right.

Leah (2:27) And then they take a finger prick, and it hurt it and it hurt so much.

Scott Benner (2:33) Yeah.

Leah (2:34) And then it it was already past lunchtime, so I was pretty hungry. (2:40) And so I was just waiting there Yeah. (2:43) While watching TV on a big hospital bed. (2:49) And eventually they put an IV in.

Scott Benner (2:51) Yep.

Leah (2:53) But before they did that, they put on numbing cream and told me to wait there for thirty minutes.

Scott Benner (3:00) And then they They

Leah (3:00) kept me there for an hour.

Scott Benner (3:02) Did they how how many days did you spend at the hospital?

Leah (3:04) I didn't spend any days. (3:06) I spent hours.

Scott Benner (3:07) Wait. (3:07) So you went into the hospital, got diagnosed, and then you left the same day?

Leah (3:11) I left the same day except I was there for so long.

Scott Benner (3:15) Wow. (3:16) I know it is.

Leah (3:17) I was there for maybe four hours.

Scott Benner (3:18) Gotcha. (3:19) Wow. (3:19) That's pretty short for most people. (3:21) I know some people were in the hospital for five days after they were diagnosed. (3:23) Wow.

Scott Benner (3:24) Right? (3:24) They had to be they had to live there. (3:26) So when you left, what was your understanding of what your new situation was?

Leah (3:30) I had no clue what was happening. (3:33) My mom and my dad didn't tell me I had type one diabetes. (3:37) They just they just took me to my Gigi and Papa's house, and so and it's helpful because my papa's a doctor Mhmm. (3:48) And my DD used to be a nurse.

Scott Benner (3:50) Okay.

Leah (3:51) So

Scott Benner (3:51) Did they help explain it?

Leah (3:54) I didn't really get explained to it

Scott Benner (3:57) Yeah.

Leah (3:57) By the next day.

Scott Benner (3:59) Okay.

Leah (3:59) And so I just ate mostly just, like, carb free foods for dinner and breakfast. (4:08) And then we just drove to UVM. (4:12) Mhmm. (4:13) And they just kept me there for most of the day.

Scott Benner (4:19) And This is your biggest problem with diabetes, the time it takes,

Leah (4:22) Yep.

Scott Benner (4:23) Yeah. (4:23) I see this.

Leah (4:24) It just takes time.

Scott Benner (4:25) It takes time. (4:26) It does take time. (4:27) So what do they give you to manage with it first? (4:29) Is it like pens? (4:31) Do you get needles and vials?

Scott Benner (4:32) Do you remember how you got insulin in the beginning?

Leah (4:36) They didn't give me insulin at the hospital

Scott Benner (4:38) No.

Leah (4:38) The day when I got diagnosed, which why didn't they give me insulin

Scott Benner (4:43) I don't know.

Leah (4:44) If I needed it?

Scott Benner (4:44) I think they probably wanted you to get training before they gave you insulin maybe. (4:48) You think?

Leah (4:49) Yeah. (4:50) I think so. (4:52) But the but at the day of Nuvian, I learned I had to take shots. (4:58) I had to take my blood sugar, and they even gave me this little eel meal for breakfast to eat.

Scott Benner (5:03) Yeah. (5:03) So that you could bolus for it?

Leah (5:05) No. (5:06) I didn't have the pump.

Scott Benner (5:07) Oh, but did you

Leah (5:08) So I had been I

Scott Benner (5:10) I said bolus. (5:11) I should have said inject. (5:12) You had to inject for it. (5:13) Right?

Leah (5:14) Yes.

Scott Benner (5:14) Yeah. (5:14) Okay. (5:15) And that was your first time?

Leah (5:16) Mom and dad how to do it. (5:18) And, eventually, I got to go down there. (5:22) And and then I got I got to go down there with mom and dad, like, to the Bottom Floor. (5:29) And we went to we went to this little, like, shop, and I got this little Barbie diary. (5:37) I still have it in my room.

Scott Benner (5:39) Yeah.

Leah (5:40) And on one end on some of the first pages, I wrote down stuff, but I couldn't really understand it when I read it the next time.

Scott Benner (5:49) Come because you couldn't read your writing?

Leah (5:51) No. (5:51) I could read it. (5:52) Oh. (5:53) It was just like a lot of, like, nutrition words.

Scott Benner (5:55) New words.

Leah (5:55) One of the words I really understood when I read it again one time was carbs.

Scott Benner (6:01) Carbs. (6:02) Because you count your carbs all the time now. (6:04) Right?

Leah (6:04) Yep.

Scott Benner (6:04) Yeah. (6:05) And you take you said sometimes you bolus for yourself now? (6:07) Yeah. (6:08) But how did you get from injecting to bolusing? (6:10) What did you do?

Leah (6:11) Okay. (6:11) So first, I had so I spent a couple maybe a month or a couple weeks with injecting and finger pricking.

Scott Benner (6:23) Right.

Leah (6:24) And then I got told I didn't have to do the finger pricking anymore. (6:28) I could just get a Dexcom.

Scott Benner (6:30) So you have a Dexcom now, but you're still doing injections? (6:33) No. (6:34) No. (6:34) You moved to a pump?

Leah (6:36) I moved to the Tandem pump. (6:39) I go onto my phone, open up, and then I type in my passcode, open up the Mobi thing, and then there's this little, like, thing of, like, words down at the bottom. (6:51) And so the words are dashboard, which I'm usually at to see my blood sugar Mhmm. (6:58) And and and some stuff. (7:00) And there's then there's bolus, which I just press, put, and then there's two and these three boxes.

Leah (7:08) The top shows you the insulin. (7:11) The bottom right one shows you your blood sugar.

Scott Benner (7:16) K.

Leah (7:16) And then the bottom left one, you can just type it. (7:24) You just push it and then type in the carbs. (7:28) So say I'm eating Pringles and I want 15 chips.

Scott Benner (7:32) Real quick. (7:33) What kind of Pringles? (7:34) The sour cream? (7:34) Original. (7:35) Original?

Scott Benner (7:36) Red ones? (7:36) Okay.

Leah (7:37) Because I did this just yesterday. (7:39) Mhmm. (7:39) I I took the Pringles, looked at the nutrition facts. (7:42) It said 15 crisps, and then it said 16 carbs. (7:48) So I just went into my phone, put in 16 carbs, and it took showed me the amount of insulin I needed to get.

Leah (7:58) And then I just press next, confirm, and then you drop this little, like, droplet. (8:05) You push that little droplet, and then it uses face ID, and it just

Scott Benner (8:10) Makes your bolus. (8:11) Yeah. (8:11) It's awesome. (8:12) Is it easy?

Leah (8:14) Pretty easy.

Scott Benner (8:15) Do you like it differently or better or worse than injections?

Leah (8:18) I like it a lot better than injections.

Scott Benner (8:20) How come?

Leah (8:22) I can't really feel it.

Scott Benner (8:23) You don't feel it? (8:24) No. (8:25) That's awesome. (8:25) That's right. (8:26) I think you're gonna grow up to be a technical writer, by the way, because when you explain something, it is very thorough and I understand everything while you're talking.

Scott Benner (8:33) So thank you very much. (8:34) I appreciate that. (8:35) Do people find that they understand you when you're talking, do you think?

Leah (8:40) Pretty sure.

Scott Benner (8:41) Pretty sure?

Leah (8:41) But I know some I know a lot of non diabetics.

Scott Benner (8:46) Okay.

Leah (8:46) And they are all like, so how's your diabetes going? (8:50) Like, it's my pet. (8:52) And I'm like

Scott Benner (8:53) Wait. (8:53) They treat your diabetes like it's a pet?

Leah (8:55) Like, how's

Scott Benner (8:56) how's Fido?

Leah (8:57) They're like, how's your diabetes going? (8:59) And I'm like, it's going good.

Scott Benner (9:01) It's going good.

Leah (9:02) I'm just trying to hold back my anger.

Scott Benner (9:05) Why? (9:05) You don't like do

Leah (9:06) you not? (9:06) Doesn't understand at all.

Scott Benner (9:08) So you would like it if she understood it better? (9:09) Yeah. (9:10) Do you

Leah (9:10) I want people to understand it better.

Scott Benner (9:12) Yeah. (9:12) Do you explain it to them or do you find that they're not interested?

Leah (9:15) I just I just know that, people are, like, trying their best, so I don't say, hey. (9:24) You're wrong. (9:25) It's actually, how have you been since you've been die how have you been with your diabetes?

Scott Benner (9:34) Mhmm.

Leah (9:34) And I could just say, I've been pretty good handling my diabetes.

Scott Benner (9:42) Yeah. (9:42) You're doing well? (9:43) Do you know what your a one c is?

Leah (9:45) No. (9:45) I can't remember.

Scott Benner (9:46) No. (9:47) That's okay.

Leah (9:47) I don't pay attention to all that stuff.

Scott Benner (9:49) All the numbers.

Leah (9:50) Mom and dad do.

Scott Benner (9:51) They do that stuff? (9:52) Yeah.

Leah (9:52) What do you what

Scott Benner (9:53) do you do at the doctor's office when you have an appointment though? (9:55) Do just sit there and hang out?

Leah (9:57) I just sit there, and a lot of times I bring my sister. (10:00) She's the only entertainment I've got when I go there.

Scott Benner (10:03) How many brothers and sisters do you have?

Leah (10:05) I have one brother, Joey, who is six years old, and then I have an older sister, Juliana, who's 11 years old.

Scott Benner (10:15) Does anybody else have type one diabetes in your family?

Leah (10:19) Not type one.

Scott Benner (10:21) Okay.

Leah (10:21) There is someone in my family with type two, though.

Scott Benner (10:24) Okay. (10:25) And how about you you have friends at school, but do any of them have diabetes?

Leah (10:31) My principal and school nurse have diabetes. (10:35) Oh, wow. (10:36) Type two, though.

Scott Benner (10:36) Type two, not type one. (10:38) Gotcha. (10:38) So you are you the only have you ever met another person with type one? (10:42) I mean, you're gonna meet a lot of them here, but where where did you meet that person?

Leah (10:47) At dance class. (10:48) Dance class. (10:49) Yeah.

Scott Benner (10:49) So is that something you like doing, dancing?

Leah (10:51) I like dancing. (10:53) Dancing and theater are my hobbies.

Scott Benner (10:55) They're your hobbies. (10:55) You don't play sports. (10:56) You do dancing in theater?

Leah (10:57) I do do sports. (10:59) I play, like, soccer

Scott Benner (11:01) Mhmm.

Leah (11:02) And dance and theater. (11:06) Those are my three main hobbies.

Scott Benner (11:08) How do you manage your diabetes with soccer and dance? (11:13) Is there stuff you have to do that's special or

Leah (11:16) anything? (11:16) Parents are always there every time I go to soccer.

Scott Benner (11:23) Yeah.

Leah (11:23) But with dance, they just drop me off and say goodbye.

Scott Benner (11:26) Story out of car.

Leah (11:27) We'll call

Scott Benner (11:28) Did they

Leah (11:29) Heather we'll call either you or miss Heather if we need it.

Scott Benner (11:32) Yeah.

Leah (11:33) But I usually have my watch on me. (11:35) Mhmm. (11:35) So I can just be like like this.

Scott Benner (11:38) That's where you see your blood pressure.

Leah (11:39) Open up my watch, just go down, and then I go into sweet dreams. (11:46) Fetching my readings or things for And then looking 64 right now.

Scott Benner (11:50) That's a nice steady line you have there.

Leah (11:51) Yeah. (11:52) That's awesome.

Scott Benner (11:53) So you don't have to do any special settings to go dancing

Leah (11:55) or to I do. (11:57) They, the pump has exercise mode, which actually lowers my insulin that I get while I'm doing that.

Scott Benner (12:07) Yep.

Leah (12:07) And they and the people at UVM actually decided to make me a profile for exercise.

Scott Benner (12:14) Okay.

Leah (12:15) And we call it dance profile because whenever I'm exercising, it's usually dance.

Scott Benner (12:22) Yeah. (12:23) And your buncher tries to go down so they put in a different profile and it doesn't happen like that.

Leah (12:27) Well, it goes down, but

Scott Benner (12:30) Not the same way.

Leah (12:31) Not the same way. (12:32) What if I didn't have that stuff?

Scott Benner (12:33) If you get low, what's your favorite, food to make your blood sugar go back?

Leah (12:37) Sour Skittles.

Scott Benner (12:38) Sour Skittles?

Leah (12:40) Yeah. (12:40) Sour Skittles are delicious.

Scott Benner (12:42) How often do you have sour Skittles? (12:44) Is it a daily thing? (12:46) No. (12:46) No. (12:46) Not every day.

Leah (12:47) It's not daily. (12:47) Oh. (12:48) Don't get many loads.

Scott Benner (12:50) Mhmm.

Leah (12:51) But if I do, I usually have gummy clusters.

Scott Benner (12:55) Okay. (12:55) Nerds gummy clusters. (12:57) That's the squishy in the middle and then the Nerds stuck to the outside. (13:00) Yeah. (13:01) They're not bad.

Scott Benner (13:02) They're not bad at all, but sour Skittles. (13:05) What do you do when you're sleeping and you're low? (13:07) Like in the middle of the night when your mom or dad comes up?

Leah (13:09) My mom my mom probably either put some Nerds gummy clusters in my mouth Mhmm. (13:17) And doesn't wake me up.

Scott Benner (13:18) You chew them up in your sink?

Leah (13:19) Or she just wakes me up, and she's like, hey. (13:23) Can you take some she and she's like, hey. (13:26) And then she just keeps, like, giving me nerds, going to question, and I'm like, what's my blood sugar?

Scott Benner (13:32) You ask? (13:32) Do you ask? (13:32) You wanna know

Leah (13:33) what's I ask what's my blood sugar.

Scott Benner (13:35) Right.

Leah (13:36) And then they just tell me a a number that it's either not low, but drops, like, a lot of points Mhmm. (13:44) Or it's just low.

Scott Benner (13:47) Just low, and you have to take care of it.

Leah (13:48) Yeah.

Scott Benner (13:49) Yeah. (13:49) How does it how does it feel to know that your parents are helping you all the time? (13:55) Do you like

Leah (13:55) Feels great because then I don't then I don't have to do all the work.

Scott Benner (13:59) Yeah. (14:00) What's the part of the diabetes that you don't like the most?

Leah (14:02) Sometimes I I just I'm like, hey, mom. (14:06) Here's my phone. (14:07) Can you polish me, please?

Scott Benner (14:09) Oh, my daughter does that sometimes, but

Leah (14:10) Even even if my dad told me the carbs, not my mom, I'm like, can you bully me, please?

Scott Benner (14:17) Do you like it when somebody takes care of it?

Leah (14:19) Yeah. (14:19) I don't wanna I don't wanna bully myself.

Scott Benner (14:21) What do you think the biggest change in your life has been since you got diabetes? (14:25) Has anything changed?

Leah (14:27) A lot of things have changed. (14:29) Sometimes I have to sit out because I'm low. (14:32) Yeah. (14:34) And then sometimes eventually my dad's like, hey. (14:40) You have to sit down because you're low, and then he just gives me stuff.

Leah (14:46) And, also, kids say that they're, like, jealous of me because they're like, I wanna have diabetes.

Scott Benner (14:54) To get the Skittles?

Leah (14:56) Just for the candy.

Scott Benner (14:57) Just for the candy. (14:58) Yeah.

Leah (14:58) And I'm like, you don't wanna be, like, shoveling candy in your mouth.

Scott Benner (15:05) It's not fun. (15:06) Right?

Leah (15:06) Wait. (15:06) I could just tell him.

Scott Benner (15:07) You yeah.

Leah (15:08) You're not always gonna have to eat it. (15:10) Sometimes you're gonna have to take the stinky stuff, and it's really, really stinky.

Scott Benner (15:16) What is stinky? (15:17) Wait. (15:18) What's that?

Leah (15:18) The the insulin.

Scott Benner (15:20) Oh, really?

Leah (15:20) I think the insulin's stinky.

Scott Benner (15:22) You don't like the way it smells?

Leah (15:23) I don't like the

Scott Benner (15:24) way People say they think it smells like Band Aids. (15:26) Do you think that?

Leah (15:27) No. (15:27) That's not true.

Scott Benner (15:28) That's not what it tastes like smells like to you? (15:30) What's it smell like?

Leah (15:31) It smells like something that'd be in a scientific project.

Scott Benner (15:34) Yeah. (15:35) Like a hospital? (15:36) Does it smell like the hospital? (15:37) Yeah. (15:38) I've heard people say that too.

Leah (15:39) Well, the hospital more smells like alcohol pads.

Scott Benner (15:42) Yeah. (15:43) How did you decide to get a tandem pump? (15:45) Did you see a bunch of pumps and pick? (15:47) Did your mom tell I

Leah (15:48) didn't get to pick. (15:50) My mom and dad were just like, my no one told me I'd get a tandem. (15:55) I just found out the name and I'm like, okay. (15:57) I have this pump now.

Scott Benner (15:58) Yeah. (15:59) And you like it? (16:00) Yeah. (16:00) I like it. (16:01) Awesome.

Scott Benner (16:01) That's a good review.

Leah (16:03) I like it.

Scott Benner (16:04) Yeah. (16:04) You like it? (16:04) You like not giving yourself shots. (16:06) Right?

Leah (16:07) Oh, I hate giving myself shots.

Scott Benner (16:09) You didn't like that?

Leah (16:10) But sometimes even when my brother or sister are like, I don't wanna get my shots. (16:15) I don't wanna get my shots. (16:16) I'm like, I'll I'll get your shots for you.

Scott Benner (16:18) Yeah.

Leah (16:19) So that way they don't have to take the shots.

Scott Benner (16:21) What do

Leah (16:22) you I like

Scott Benner (16:23) Can you tell me one thing you really love about the pump?

Leah (16:27) I got a choice. (16:29) Push in or pop in.

Scott Benner (16:30) Pushing or pop in. (16:31) So you like the choice of how it goes in? (16:33) Yes. (16:34) Awesome. (16:34) That's right.

Leah (16:35) I like knowing that I get to decide what I want.

Scott Benner (16:39) Yeah. (16:39) I like that too. (16:40) I've been married a long time, so I haven't made a decision in a while, but I remember it and it is fun. (16:44) Do you have any heroes that have diabetes? (16:46) Anybody?

Leah (16:47) Who? (16:48) Stacy McGill.

Scott Benner (16:49) Stacy McGill? (16:50) Who is she?

Leah (16:50) From the babysitter's club.

Scott Benner (16:52) Oh, from the babysitter's club. (16:54) That's your that's your hero? (16:55) That's awesome. (16:55) How many times do think you've read that book?

Leah (16:58) A lot.

Scott Benner (16:59) Yeah. (17:00) Do you read it yourself? (17:01) Does your dad read it to you?

Leah (17:02) I don't like my dad reading to me. (17:04) Oh, tell me what super tired, I'm like, I'm about to fall asleep. (17:09) I like my dad reading to me if that happens.

Scott Benner (17:12) Do you ever do sleepovers or go to your friend's house? (17:14) And how do you handle your diabetes with that?

Leah (17:17) My mom usually calls me when I'm at a friend's house.

Scott Benner (17:20) Mhmm.

Leah (17:21) Except I haven't had my first sleepover.

Scott Benner (17:24) No? (17:25) No. (17:26) Are you so is that a thing you used to do that you don't do anymore or just just haven't had a chance?

Leah (17:30) I just haven't ever had a chance.

Scott Benner (17:33) Okay. (17:33) Would you like to do that?

Leah (17:36) Yeah.

Scott Benner (17:36) Who are you more like when it comes to

Leah (17:39) I feel like daddy.

Scott Benner (17:41) Really? (17:41) Interesting.

Leah (17:42) Yeah. (17:43) Because daddy's always in control.

Scott Benner (17:44) He's in control?

Leah (17:45) He's always telling you, like, what to do.

Scott Benner (17:51) Well

Leah (17:52) He's always like, you have to make your bed.

Scott Benner (17:54) Oh my gosh. (17:55) Make your bed? (17:57) Yeah. (17:57) Does he make you pick up your dirty clothes too? (18:00) Yeah.

Scott Benner (18:01) This is ridiculous. (18:02) You don't have time for that. (18:03) What what do you wanna be doing?

Leah (18:05) Watching TV.

Scott Benner (18:05) Leah, this was really nice of you to do with me. (18:07) Thank you very much. (18:08) I appreciate this. (18:09) Thank you. (18:10) Did you have a good time?

Leah (18:10) Yeah.

Scott Benner (18:11) Me too. (18:11) Awesome. (18:12) Good job. (18:13) Thank you. (18:14) The podcast you just enjoyed was sponsored by Tandem Diabetes Care.

Scott Benner (18:18) Learn more about Tandem's newest automated insulin delivery system, Tandem Mobi with Control IQ plus technology at tandemdiabetes.com/juicebox. (18:28) There are links in the show notes and links at juiceboxpodcast.com. (18:33) If you'd like to hear about diabetes management in easy to take in bits, check out the small sips. (18:39) That's the series on the juice box podcast that listeners are talking about like it's a cheat code. (18:44) These are perfect little bursts of clarity, one person said.

Scott Benner (18:47) I finally understood things I've heard a 100 times. (18:50) Short, simple, and somehow exactly what I needed. (18:53) People say small sips feels like someone pulling up a chair, sliding a cup across the table, and giving you one clean idea at a time. (19:02) Nothing overwhelming. (19:03) No fire hose of information.

Scott Benner (19:04) Just steady helpful nudges that actually stick. (19:07) People listen in their car, on walks, or rather actually bolus ing anytime that they need a quick shot of perspective. (19:14) And the reviews, they all say the same thing. (19:17) Small sips makes diabetes make sense. (19:20) Search for the Juice Box podcast, small sips, wherever you get audio.

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Scott Benner 2/7/26 Scott Benner 2/7/26

#1763 Defining DIabetes: Sliding Scale

Scott and Jenny define "Sliding Scale" in this Defining Diabetes episode.

+ Click for EPISODE TRANSCRIPT

Scott Benner (0:00) Friends, we're all back together for the next episode of the Juice Box podcast. (0:03) Welcome. (0:14) Managing diabetes is difficult, but trying to do it when you don't understand the lingo, that's almost impossible. (0:21) The defining diabetes series began in 2019, and today we're adding to it. (0:25) Go to juiceboxpodcast.com up in the menu, click on defining diabetes, and you'll see a complete list of all the terms that we've defined so far.

Scott Benner (0:35) Check out my algorithm pumping series to help you make sense of automated insulin delivery systems like Omnipod five, Loop, Medtronic seven eighty g, Twist, Tandem Control IQ, and much more. (0:48) Each episode will dive into the setup, features, and real world usage tips that can transform your daily type one diabetes management. (0:55) We cut through the jargon, share personal experiences, and show you how these algorithms can simplify and streamline your care. (1:01) If you're curious about automated insulin pumping, go find the algorithm pumping series in the Juice Box podcast. (1:07) Easiest way, juiceboxpodcast.com, and go up into the menu.

Scott Benner (1:11) Click on series, and it'll be right there. (1:14) While you're listening, please remember that nothing you hear on the Juice Box podcast should be considered advice, medical or otherwise. (1:22) Always consult a physician before making any changes to your health care plan or becoming bold with insulin. (1:29) Jenny, we're gonna define sliding scale, and I'm probably gonna ask you to go back into your way back machine back till you were how old? (1:37) When do you think is the last time you did that?

Jenny Smith (1:39) Oh my god. (1:43) Sliding scale use was trying to think. (1:48) I was in college when I stopped using sliding scale because rapid acting insulin Humalog

Scott Benner (1:57) Mhmm.

Jenny Smith (1:57) Came out. (1:59) So it would probably have to be trying to think I was working. (2:04) Funny of the memories that come in. (2:05) I was working at a plasma donation center when I read an article on my break about Humalog. (2:11) Really?

Jenny Smith (2:11) It's really interesting. (2:12) Yes. (2:13) And then I had a doctor's visit coming up very soon, and I went to him with the article. (2:18) You know, like, Internet and stuff was very Yeah. (2:21) Microscopic at that time.

Jenny Smith (2:22) So I brought him the article so I wasn't, like, the crazy person. (2:25) Mhmm. (2:25) You know? (2:26) And I was like, this

Scott Benner (2:27) Yeah.

Jenny Smith (2:27) This is what Jenny needs right now because RNL is not working very well for Jenny.

Scott Benner (2:33) So And please ignore that I stole this magazine from the plasma center. (2:37) Right.

Jenny Smith (2:38) You know, it's all okay. (2:41) Sliding scale probably until I was a sophomore in sophomore junior in college, I think

Scott Benner (2:51) Okay.

Jenny Smith (2:51) Is where I was using that. (2:53) And it's really it's the best that you could have had outside of using a pump eventually that was programmable in a way that could manage better. (3:04) Really, it's just you get a set amount of insulin for a meal. (3:08) Mhmm. (3:09) Breakfast is three units.

Jenny Smith (3:10) Lunch is five units. (3:11) Dinner is six units. (3:13) That's your dose for the food, and it's given to you with the expectation that your education included, your meal will consist of this much food. (3:22) Don't veer from this because your insulin is dosed according to what we told you you needed to eat. (3:28) Right.

Jenny Smith (3:29) And then if your blood sugar sliding scale corrective was also another math part to add to that. (3:36) If your blood sugar is here to here, add one unit. (3:39) If blood sugar is here to here, add two units or three units. (3:43) And so it was really it was management that was very wide.

Scott Benner (3:47) Yeah.

Jenny Smith (3:48) It was not the precise that we can have today.

Scott Benner (3:51) Do you remember back I know you're you're a particular eater. (3:55) I don't mean that, like, in a in a finicky way. (3:57) Just mean you're you do a good job with your with your intake. (4:00) So I imagine your sliding scale for your food worked pretty well. (4:03) Am I right?

Jenny Smith (4:03) It did. (4:04) Yeah. (4:04) And because my parents, especially my mom, was kind of the controller of the food until I went to college

Scott Benner (4:10) Yeah.

Jenny Smith (4:11) Everything was weighed and measured. (4:13) And, like, we had a bouncy scale that sat in the kitchen table Mhmm. (4:17) And it everything got measured. (4:18) Everything got weighed. (4:19) And it was thankful that I had really good educators too that made it it made it workable in my brain at that age too.

Jenny Smith (4:27) Like, this is just the way that it works. (4:29) And look. (4:30) With all the activity, I mean, I danced. (4:32) I was in volleyball. (4:34) I was a cheerleader.

Jenny Smith (4:35) I did a I biked with my dad. (4:37) I did a lot of things. (4:38) And so with those variables, I saw that if I just stuck with the schedule that I was given Mhmm. (4:45) It worked out pretty well. (4:46) Now what happened in between finger sticks?

Jenny Smith (4:48) I don't know. (4:49) Like, there was no CGM to say, gosh. (4:51) This dose really is the right one for you. (4:54) But

Scott Benner (4:55) Is it fair to say that most see, I don't think this is true because I talked to so many people who are on a sliding scale right now. (5:02) Like, it happens it happens to Canadians a lot depending on what province they live in. (5:07) And I am surprised more and more about Americans that I hear who are like, oh, no. (5:12) I'm on a sliding scale. (5:13) I'm like, how's that possible?

Scott Benner (5:14) It's like hearing somebody uses a fax machine. (5:16) You're like, what? (5:17) Right? (5:18) But but is that still pretty common?

Jenny Smith (5:20) It can be. (5:21) You know, we especially what I do with the clients that I am able to work with

Scott Benner (5:26) Yeah.

Jenny Smith (5:27) I see a lot of people who have access, really, I think is what this speaks to. (5:31) It's access to technology. (5:33) It's access to a clinical service that has encouraged you to to be able to be better because they're providing you the ability to have technology. (5:44) And many people don't have that. (5:47) So sliding scale is what it is.

Jenny Smith (5:49) It's you're told to have, you know, a dose of insulin. (5:53) And I what I've come to see too with some sliding scale people that I've worked with is they're not even given as much detail as I was given when I was using sliding scale. (6:04) Right? (6:04) It's eat breakfast, take three units of insulin. (6:08) There's not as much detailed your meal has to consist of this much food because we're expecting three units to cover your food.

Jenny Smith (6:17) Okay. (6:18) But if Right?

Scott Benner (6:19) If if you met somebody today who had access to insurance and they could get what they needed and they were on a sliding scale, would you tell them, I think you shouldn't be doing that? (6:29) Or would you say I I mean, is it different now that there are CGMs? (6:33) Like, are there people out there on sliding scale who are in a CGM? (6:36) Probably. (6:37) Right?

Jenny Smith (6:37) I would say that it defines sliding scale in a little bit of a different way Okay. (6:42) So those people are MDI still. (6:44) Right? (6:45) They may have a CGM, which gives them more access to information about what their doses that are set doses provide in control.

Scott Benner (6:57) Right.

Jenny Smith (6:58) I would even say that there are some people that might be using their pump as sliding scale instead of carb counting. (7:05) They may actually just be dialing in a manual dose of insulin, and then potentially, they might have a correction factor put into their pump so the pump then automatically gives correction. (7:18) That could be another way of navigating sliding scale with a little more precision.

Scott Benner (7:23) Mhmm.

Jenny Smith (7:23) But in general, sliding scale is usually multiple daily injections with a set amount of insulin and then a corrective factor that's a set dose based on blood sugar value.

Scott Benner (7:34) You think there's a lot of yo yoing that goes on for people who are managing like this?

Jenny Smith (7:38) Very likely, unless they're willing to get you know, I have a couple of friends who use MDI and do very well with it. (7:44) Mhmm. (7:45) But theirs is a precision they've learned how to look at their CGMs. (7:51) They've learned how their insulin works for them.

Scott Benner (7:54) Mhmm.

Jenny Smith (7:54) They've learned the timing of their dosing. (7:57) Even though they are using kind of a sliding scale, most of them have also found that their most common foods, they've just figured out the dose for it. (8:07) They don't necessarily have an insulin to carb ratio. (8:09) They've just been able to say, well, gosh, you know, my bowl of cottage cheese with pineapple always takes four units.

Scott Benner (8:16) Mhmm.

Jenny Smith (8:16) I'll take four units and my blood sugar's high. (8:18) I add a little bit more to this. (8:20) Right?

Scott Benner (8:21) Okay. (8:22) I've never had cottage cheese in my life.

Jenny Smith (8:23) You've never had cottage cheese?

Scott Benner (8:25) And as you're talking about it, it makes me feel I just wanna say that.

Jenny Smith (8:27) Well, that's okay. (8:28) It's not I yeah. (8:29) It's all good. (8:30) I don't know why it even came to mind. (8:32) I was just trying to think of, like

Scott Benner (8:33) It was nice. (8:34) I just was like, oh, I've never had that.

Jenny Smith (8:36) There you go. (8:36) I did make you eat a tomato, though.

Scott Benner (8:38) I did. (8:39) I did have a tomato. (8:40) Where was

Jenny Smith (8:40) I? (8:40) Tomato.

Scott Benner (8:41) I was a that was we were on vacation, and the tomato came out. (8:44) Was like, alright. (8:44) I'll eat it. (8:44) And I did, and I sent Jenny a picture of it. (8:46) I said, look.

Jenny Smith (8:46) I ate the tomato.

Scott Benner (8:48) I don't know if that episode's out yet or if people have context for that yet or not. (8:52) So sliding scale is like like, put it, like, real black and white for me. (8:56) Take all the the the nuts and bolts out of it. (8:59) Like, I'm at the doctor, they're just gonna say, hey. (9:01) Put in this much insulin at this time.

Scott Benner (9:04) Eat at this time. (9:05) Eat this much food. (9:06) If your blood sugar is one fifty to one ninety nine, I want you to do this much. (9:09) If it's 200 to two fifty, I want you to do a little this much. (9:12) That's it.

Scott Benner (9:13) That's a sliding scale.

Jenny Smith (9:14) There's basal insulin behind it. (9:15) So usually the basal insulin is also once a day Yeah. (9:19) At this point. (9:20) Right? (9:20) And then mealtimes are covered with a sliding scale, which tends to work a little bit better at this point because many people, not everybody, but most people are using rapid.

Jenny Smith (9:31) They're not using the older r insulin, which took longer

Scott Benner (9:34) I was gonna say, are there I don't wanna muddy the two, so let's just say we're done talking about that now. (9:39) But, like, are there places in the world where people are still using, like, regular and NPH?

Jenny Smith (9:43) Oh, absolutely.

Scott Benner (9:44) Really? (9:44) Yeah.

Jenny Smith (9:45) Absolutely. (9:46) Yes.

Scott Benner (9:47) Well and then they're on a, like, an old school sliding scale at

Jenny Smith (9:50) that point. (9:50) And then they're on very old school sliding scale, kind of similar to mine. (9:54) It was just very structured. (9:56) There was not there was not deviation from time frames or where snacks were gonna happen or anything unless there was exercise in the picture that you

Scott Benner (10:04) I remember Mike always he kinda paused for a minute when he was drawing up his insulin, and I did ask him one day, what are you thinking about? (10:10) He's like, I'm trying to figure out how active we're gonna be today. (10:13) Mhmm. (10:13) And that was kind of the end of it. (10:14) Like, it was in the morning, and he was just it was weird to watch him.

Scott Benner (10:17) He'd, like, pull on that, and he'd like, and, you know, meanwhile, it wasn't obviously, his outcome was terrible, so it wasn't working for him. (10:25) But that was, I think, the extent of his training. (10:28) I'm making air I'm making air quotes.

Jenny Smith (10:30) I mean, you know, the old school stuff again with even the the intermediate acting cloudy insulin, the n and r Mhmm. (10:37) Whatever. (10:38) Like, I had a very different snack in the afternoon depending on whether I was headed to a sport right after school or not. (10:48) So snack for sport was this type of intake so that I wouldn't drop because I was on the tail end of my intermediate acting insulin. (10:58) Mhmm.

Jenny Smith (10:59) And it would encourage me to have a low. (11:03) And I so

Scott Benner (11:04) And I did.

Jenny Smith (11:05) All those things that you kinda figure out.

Scott Benner (11:07) As you go. (11:08) Okay. (11:08) Thank you. (11:08) I appreciate it.

Jenny Smith (11:09) Sure.

Scott Benner (11:17) If this is your first time listening to the Juice Box podcast and you'd like to hear more, download Apple Podcasts or Spotify, really any audio app at all, look for the Juice Box podcast, and follow or subscribe. (11:30) We put out new content every day that you'll enjoy. (11:33) Wanna learn more about your diabetes management? (11:36) Go to juiceboxpodcast.com up in the menu and look for bold beginnings, the diabetes pro tip series, and much more. (11:43) This podcast is full of collections and series of information that will help you to live better with insulin.

Scott Benner (11:50) Hey. (11:51) Thanks for listening all the way to the end. (11:52) I really appreciate your loyalty and listenership. (11:55) Thank you so much for listening. (11:57) I'll be back very soon with another episode of the Juice Box podcast.

Scott Benner (12:02) If you have a podcast and you need a fantastic editor, you want Rob from Wrong Way Recording. (12:08) Listen. (12:09) Truth be told, I'm, like, 20% smarter when Rob edits me. (12:13) He takes out all the, like, gaps of time and when I go, and stuff like that. (12:18) And it just I don't know, man.

Scott Benner (12:19) Like, I listen back, and I'm like, why do I sound smarter? (12:22) And then I remember because I did one smart thing. (12:25) I hired Rob at wrongwayrecording.com.

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