Scott Benner 1/22/26 Scott Benner 1/22/26

#1744 Life Coach: Getting Older

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

Scott Benner (0:00) Hello, friends, and welcome back to another episode of the Juice Box podcast. (0:13) This is part two of a two part episode. (0:16) Go look at the title. (0:17) If you don't recognize it, you haven't heard part one yet. (0:20) It's probably the episode right before this in your podcast player.

Scott Benner (0:28) Nothing you hear on the Juice Box podcast should be considered advice, medical or otherwise. (0:33) Always consult a physician before making any changes to your health care plan or becoming bold with insulin. (0:44) My diabetes pro tip series is about cutting through the clutter of diabetes management to give you the straightforward practical insights that truly make a difference. (0:53) This series is all about mastering the fundamentals, whether it's the basics of insulin, dosing adjustments, or everyday management strategies that will empower you to take control. (1:03) I'm joined by Jenny Smith, who is a diabetes educator with over thirty five years of personal experience, and we break down complex concepts into simple, actionable tips.

Scott Benner (1:13) The diabetes pro tip series runs between episode one thousand and one thousand twenty five in your podcast player, or you can listen to it at juiceboxpodcast.com by going up into the menu. (1:31) This episode of the Juice Box podcast is sponsored by Omnipod five. (1:35) Omnipod five is a tube free automated insulin delivery system that's been shown to significantly improve a one c and time and range for people with type one diabetes when they've switched from daily injections. (1:46) Learn more and get started today at omnipod.com/juicebox. (1:51) At my link, you can get a free starter kit right now.

Scott Benner (1:53) Terms and conditions apply. (1:55) Eligibility may vary. (1:56) Full terms and conditions can be found at omnipod.com/juicebox. (2:02) The podcast is also sponsored today by US Med, usmed.com/juicebox, or call (888) 721-1514. (2:12) You can get your diabetes testing supplies the same way we do from US Med.

Scott Benner (2:17) I said, here's what I really think. (2:18) I think if you go on an algorithm, you'll be able to sleep better. (2:21) And I think and I think you won't know how much that's gonna change your life until you've had it for a month.

Liesl (2:27) Yeah.

Scott Benner (2:27) And then I I and I stopped myself and I said, and here's another thing. (2:32) Let's be more honest. (2:33) I said, there are days, chunks of my daughter's day where she boluses for her food, and then she goes off and does something. (2:41) She goes to class where she sits with her boyfriend or she, you know, goes out with her friends. (2:47) And because an algorithm is making changes to her insulin during that time based on her data, she doesn't really pay that close attention to her diabetes.

Scott Benner (2:57) Mhmm. (2:57) And and it's not that she's not aware of it. (2:59) It's not that she won't do something if, you know, if something really comes up or whatnot. (3:05) But she doesn't have to, like, go, oh, no. (3:07) It went to one twenty.

Scott Benner (3:09) I got a bolus or it's gonna go to one fifty. (3:12) Like like yeah. (3:12) Like, you know, she goes to one twenty, and the damn thing gives her insulin. (3:16) Then and then it stops. (3:18) Right?

Scott Benner (3:18) And and then, you know, and then if she tries to get low, it stops again. (3:21) I was like, so in my mind, when you're asking me, should I get a pump? (3:26) I think yes because Mhmm. (3:29) Of what it lifts from you that you can't really quantify, and you won't know until it happens. (3:36) Anyway, I wonder

Liesl (3:38) what Some it shoulders some of the burden for her, doesn't it?

Scott Benner (3:41) Oh, I mean, I'll it it when you sit in a conversation like this and go back to 50 calories today, a 100 tomorrow so that you'll die more slowly, well, it's doing more than shouldering the burden. (3:53) Right? (3:54) Right. (3:54) Like like, right, if you if you have if you have that kind of context when you're thinking about it, it's magic. (4:00) If you were diagnosed a year and a half ago, it's shouldering the burden.

Scott Benner (4:04) Yeah. (4:05) So your perspective has a lot to do with what you see it as a part of these con what I like about these conversations is that I hope to alleviate some of the the mental anxiety that people have and the burden that they have Yeah. (4:17) Because they live in a modern society where they're accustomed to everything kinda working the way it's supposed to and, diabetes then feels like it's not. (4:24) But I'm telling you just and say to yourself, holy shit. (4:29) I'm getting away with something here.

Scott Benner (4:31) Yeah. (4:31) You know? (4:32) Yeah.

Liesl (4:32) I I still think it's important for me as a health care professional and just as a person to recognize that I need to be careful that it doesn't come across as, well, I know you've got type one, but you should be grateful you've got the tech because there was a time when it wasn't available.

Scott Benner (4:49) Yeah. (4:49) I know. (4:49) I don't I wouldn't say that to somebody, but I do think it's important that they understand it.

Liesl (4:53) Yeah. (4:54) Yeah. (4:54) And and I and I know that you wouldn't do that, but I I just just say that people understand that just because the tech's there doesn't mean that I would expect somebody with type one diabetes to be a whiz at it just because the tech is there. (5:05) Yeah. (5:05) The tech is great.

Liesl (5:07) And as we've said, it takes some of the burden away, but you've still got that wet towel draped around your shoulders.

Scott Benner (5:13) Yep. (5:13) And you still

Liesl (5:14) have earlier. (5:15) So

Scott Benner (5:15) You also still have the rest of what Daphne's doing for people because that technology is basically useless if you don't understand glycemic load, glycemic impact, how to change your settings, you know, how to bolus for fat in your food. (5:28) Like, if you don't have those ideas, it's still gonna seem chaotic. (5:32) Yeah. (5:32) Yeah.

Liesl (5:33) Yeah. (5:33) And I think that's a really good point, Scott, because when we look at our data every year, we've looked at our we look at our that we call it our key performance indicator data. (5:42) So it's what happens to people's h b a one c when they've done a Daphne course a year later, their severe hypo rates, their DKA rates. (5:50) And I guess I thought that once people had the CGM and the tech that they would have a lower h b a one c before they did the course anyway, or they wouldn't have as much DKA. (6:02) There wouldn't be so many severe hypos.

Liesl (6:04) But what we're seeing is that people are coming in with the advantage of the tech already, but they're still achieving the same degree of reduction in their h h b a one c than they were when everyone was doing finger pricking. (6:17) They're still seeing the same reduction in severe hypos, the same reduction in DKA. (6:22) So that just goes hand in hand with what you said, which is if you give somebody the tech, they can achieve a lot. (6:28) But you give them the tech and the education, and it's it's boundless what they could achieve. (6:34) You know?

Liesl (6:35) It it just at least can double what they can achieve if they're given the opportunity. (6:39) And part of my job is to try and make sure that they get given that opportunity.

Scott Benner (6:43) Mhmm. (6:44) No. (6:44) It's wonderful. (6:44) Also, I mean, to be completely candid that the the human condition still exists no matter what level of technology you have or what level of of education you have. (6:54) And the the feeling that, like, our bodies aren't supposed to work this way.

Scott Benner (7:00) Like, you're not supposed to have to think breathe in, breathe out, you know, or, you know, you know, you you imagine if I said to you, look. (7:07) Hey. (7:08) Here's the problem. (7:09) Your heart's not gonna beat if you don't consciously think beat beat beat beat beat for the rest of your life. (7:16) You'd be dead in three minutes.

Scott Benner (7:17) You you you know what I mean? (7:18) Like and and the and you are asking people with diabetes to do that. (7:21) You're asking them to be to be a pancreas, to be aware of how a number of different systems work and how food and and exercise and stress and all, know, and everything else impacts those systems. (7:34) And the truth is is, like, none of us really understand it well enough. (7:38) No.

Scott Benner (7:38) And, you know, so you give them what what I have found is that there's there's, like, kinda hallmarks. (7:45) And if they have the hallmarks, they can do well. (7:47) Like and I mean that very simply, you know, understanding the impacts of their food, understanding how to time insulin against those impacts, understanding seriously how fat and protein impact their blood sugars, the you give them the autonomy to make changes to their settings that they don't feel like they have to wait for someone to tell them that their basil's not strong enough or not weak enough that they, you know, that they should bolus again. (8:13) That you don't saddle them with the idea that every if they bolus without food, it's stacking when that's not always true. (8:20) Like, great.

Scott Benner (8:20) Like, if you can give them those kinds of hallmarks, then most people

Liesl (8:25) Absolutely.

Scott Benner (8:25) Most people can make the rest of the leaps. (8:27) They can they can they can draw the rest of the lines themselves. (8:31) That's been my finding over and over again is that there's there's some basic fundamental foundational stuff. (8:38) And once you give it to them in a way that they understand it and hopefully they're motivated to do something with it, they have a lot of success after that.

Liesl (8:46) Yeah. (8:46) Yeah. (8:46) And I I had somebody on one of my Daphne courses years ago, and she said, look. (8:50) She said, I don't really understand how all of this works, but I don't understand how my car works. (8:56) She said, I just know where to put my feet and where to put my hands, and I trust it to get me from a to b.

Scott Benner (9:00) Perfect.

Liesl (9:01) So if I know what to do with Daphne, I might I don't have to understand the ins and outs of it as long as I know what to do when. (9:09) I know I'll get to where I want to go. (9:11) And I thought that was quite quite a good analogy of there's lots of things we do in life. (9:16) We don't understand how an airplane takes off the ground, but we trust that the pilot knows how to do it, so we just jump on board. (9:22) And she jumped on board with a Daphne course saying, I don't really quite understand, but I trust you, and I trust the process, and I'm just gonna get on board with it.

Liesl (9:31) And and I think that takes tremendous courage and a degree a huge degree of trust in somebody like me to be providing her with the right information.

Scott Benner (9:40) It's also thoughtful. (9:42) It's incredibly thoughtful. (9:44) And here's a secret that's not much of a secret if people are listening. (9:47) There's a lot about this I don't understand either. (9:50) And yet, there might be I I am I had to put this.

Scott Benner (9:56) I don't wanna sound like an asshole. (9:57) But, like, like, if there's a hierarchy to who's reaching people and helping people with diabetes, I've gotta be up in the top of it. (10:04) And there are plenty about it that I fundamentally, like, on a technical or scientific level, I don't I struggle all the time. (10:11) I say stuff all the time where I'm like, I don't really understand that. (10:14) But what I've learned is I don't it doesn't matter.

Scott Benner (10:17) Like like, what matters is understanding the fundamental stuff and being able to communicate it. (10:22) Yeah. (10:22) Yeah. (10:22) And and I don't need to be perfect or have, you know, a PhD level of understanding about, you know, a lot a lot of functions in the body, which by the way, I can't even pronounce little and explain to you. (10:35) Yes.

Scott Benner (10:35) And it and it and it it doesn't it doesn't matter. (10:39) Like, would matter if I was gonna be your surgeon. (10:42) Okay? (10:42) It would matter if I was gonna be teaching a course at at medical school. (10:46) It doesn't matter if I'm just the guy saying, like, look.

Scott Benner (10:49) When you eat a cheeseburger with french fries, there's fat in the fries. (10:52) And about an hour after you eat, you're gonna see a rise coming in your blood sugar, and that rise needs more insulin. (10:57) And there's a quick formula you can use to try to figure out about how much fat was in there and how that translates to insulin, and then you can put that bolus in Yeah. (11:05) And then the rise never happens. (11:06) Your blood sugar doesn't stay high for four hours afterwards.

Scott Benner (11:09) And you don't put in a bunch of insulin and get super low later and then take in a bunch of fast acting then it goes back up again, and then you lose your goddamn mind and you stop taking care of yourself. (11:18) Right? (11:18) Like

Liesl (11:19) Yeah.

Scott Benner (11:19) That that's the part I know for sure.

Liesl (11:22) And I think the frustrating thing when the thing that does frustrate people when they come on a Daphne course is there's so much that that we can't just say, do this plus that, and you'll get success with what you want. (11:34) Because it's so individual to the person, isn't it? (11:37) And you must know that in your experience that it's great to have a starting point and say, you know, try this for your fat, high fat, high protein meals. (11:45) But if that doesn't work and you see it doesn't work, you need to try a different proportion or a different ratio or something. (11:51) And and the same with exercise.

Liesl (11:53) Exercise is so individual that it's great to have a starting point, but there isn't a black and white set of rules that says do this and you'll be able to run a marathon or do that and you'll get through a game of football or something. (12:09) It it's so personal. (12:11) And I think that is it just shows that the more we understand, the more questions we have and the less we understand. (12:18) And if it wasn't that way, insulin would never have been discovered. (12:23) We never would have finger pricking.

Liesl (12:24) We never would have CGMs. (12:25) We never would have the tech that we have. (12:28) And I really hope that at some point I have a family member with type one diabetes. (12:33) And when she was diagnosed, I cried for twenty four hours. (12:37) And my husband said, I don't know why you're so upset.

Liesl (12:40) Why you know about all of this? (12:42) You can support her with it. (12:44) And I just said, she's 11 years old. (12:47) She will never go to a party again without thinking how much do I have to inject for that muffin? (12:53) How much do I have to inject for that pizza?

Liesl (12:55) I said it's the loss of that carefree living that I was mourning. (13:00) Mhmm. (13:00) And I really hope that in her lifetime, she's able to say, isn't it quaint? (13:07) My auntie used to teach people how to manage type one diabetes, and now we're just cured.

Scott Benner (13:13) Yeah. (13:13) Hey. (13:14) Listen. (13:14) I'll take anything from cured to this box and this box talk to each other, and I don't have to think and it just works. (13:20) Like because I don't it's not if we know for sure about fat, for example, then, like, that could be a setting.

Scott Benner (13:28) And and why is it not? (13:30) And then because it is in some of the DIY systems, by the way. (13:33) In some of the DIY systems, you can say there's this much fat in my in my meal, and it it helps it to layer more boluses out over the the future. (13:42) So, again, back to what I was saying earlier is you need the pump companies to admit that that's functionality that should be looked into and tried to figure out and put in. (13:53) I mean, so put a little effort into that.

Scott Benner (13:55) And and by the way, at some point, they will ceiling out on what they're doing, and they're gonna have to move to those ideas to keep getting better, to keep making their money, to try to beat the other guy, which, by the way, is the only thing that keeps innovation going. (14:08) I don't know if you're a capitalist or not, but that's pretty much what keeps people moving. (14:12) Yeah.

Liesl (14:12) Yeah. (14:13) So And I and having that as an optional thing on a pump would be great because some people, they really do have an impact with fat or high protein. (14:20) Don't they? (14:21) Other people, it doesn't affect them in the slightest.

Scott Benner (14:23) It's crazy. (14:23) It some people are like, I've never done that before. (14:25) It's never been a problem for me. (14:27) I'm like, yeah. (14:27) Right on.

Scott Benner (14:28) Like but at least you know. (14:29) Like, that to me is the idea behind the podcast is that I'm gonna put all these ideas out there. (14:36) They might not all impact you or be important for you, but at least you know about them now. (14:41) And if it did end up being important for you, that's awesome because you can do something about it. (14:45) And if it didn't, then right on, then that's the thing you don't need to worry about.

Scott Benner (14:50) I don't love the I don't love I I just think people deserve all the information.

Liesl (14:57) Yeah.

Scott Benner (14:58) You know? (14:58) And then they can do what with it what they want or what they're capable of doing with it. (15:03) But it it would be wrong to hide it from somebody.

Liesl (15:05) Yeah. (15:06) And you've just you've just reminded me. (15:08) You asked me a question almost at the beginning of this about what are the light bulb moments? (15:12) What are the Yeah. (15:13) The moments when the penny drops?

Liesl (15:15) And I think talking about information, basic information can be a real penny drop moment as a you know, yes, high fat, high protein, that can be a real game changer for a lot of people. (15:27) For me, one of the main learning outcomes for people with on a Daphne course is just understanding how long it takes their quick acting insulin to start working

Scott Benner (15:37) Yep.

Liesl (15:37) And how long it keeps working. (15:39) The number of people who have said, now I understand why I had a hypo because an hour after my meal, I was I'd got a glucose of 17, and it should have been less than seven. (15:50) And so I gave an injection of quick acting, but now I realized that my quick acting still hadn't even peaked from my meal. (15:57) And so that understanding how their insulin works in real terms, in that relationship with their glucose, their carbs, and their insulin, that is a big game changer for people.

Scott Benner (16:08) Definitely. (16:09) Yeah. (16:09) So I I I say to all the time that if you if you threw me off a cliff and told me, help people with diabetes before you hit the bottom, I would yell back up, it's all timing and amount. (16:21) Yes. (16:22) That's it.

Liesl (16:23) Yeah. (16:23) Yeah.

Scott Benner (16:23) That's the whole thing. (16:24) By the way, the podcast should be six seconds long. (16:27) Here it is for everybody again. (16:28) It's about insulin timing and the amount of insulin. (16:31) It's about how much insulin you use and when you use it.

Scott Benner (16:33) That's the entire thing. (16:35) Is it as easy as why the way I just said it? (16:37) It's not. (16:38) But that is at the core of the that's your entire fight. (16:41) Yeah.

Scott Benner (16:41) It's timing and amount. (16:43) So, you get that right, you'll be that's that's the a one c you're looking for. (16:48) That's the variability you're looking for. (16:49) Now you have to get it right at breakfast, at lunch, at dinner, at your snacks, you know, for your your settings, for your, you know, you know, that your Basil uses all day long, you know, for your, you know, for your adjustments, you know, it it's but it's all but, again, at the end, it's just it's the right amount of insulin at the right time. (17:10) It's matching the impact of carbohydrates or body function against the insulin's ability to fight it off.

Scott Benner (17:19) It's kind of it. (17:19) You know?

Liesl (17:21) It's like having another job on top of your normal full time job, isn't it? (17:24) Well, I mean, like it's like having to run two jobs at the same time.

Scott Benner (17:27) It it it reminds me all the time of this is gonna be out of context for you, but there's a, there's a movie now that's getting pretty old with Brad Pitt in it. (17:34) It's called Moneyball. (17:36) And it's a it's about, it's it's not it's a real story about, an American baseball team that eventually, like, kinda bucks the system and goes towards analytics. (17:48) And they start deciding to find the value in players that look valueless in in a normal, in a normal Okay. (17:57) Setting.

Scott Benner (17:57) Right? (17:58) And so they go to this player whose arm is shot, who used to be a catcher, and he needs to throw the ball out. (18:03) And they wanna move him to a position where he doesn't have to throw very much, but he's never played it before in his entire life. (18:09) And they say to him, you know, the the one guy goes, we're gonna move you to first base. (18:15) And he get and the guy says, well, I've never played first base.

Scott Benner (18:18) Well, the guy turns to the other coach and goes, it's very easy. (18:21) We'll teach you how to do it. (18:22) Tell him. (18:22) And he tells the other he tells the other coach. (18:24) He goes, tell him.

Scott Benner (18:25) The guy's name's Wash. (18:26) He goes, tell him, Wash. (18:27) And he goes, it's incredibly difficult. (18:29) And, like and so and and I and so while the one guy's going like, it's easy. (18:34) It's just we'll teach you how to do it.

Scott Benner (18:36) And then the other guy's like, I mean, I don't know, man. (18:38) Maybe we could figure it out, but probably not. (18:41) And I feel like that's how I'm talking about diabetes sometimes. (18:44) I feel like I'm the guy who's like, we'll just move you to first. (18:47) And then somebody else comes along and goes, it's incredibly difficult.

Scott Benner (18:50) But I think it's doable. (18:53) Like, I've seen it enough times. (18:54) And by the way, that was the leap for me. (18:56) I I I'd love to meet the person who figured out the Daphne thing one day because I I was like, look. (19:04) I'm not in this space.

Scott Benner (19:06) I'm not a doctor. (19:07) I'm not a I'm I'm in no way connected to the the technical or professional aspects of diabetes. (19:13) Right? (19:13) Yeah. (19:14) My daughter gets type one in 2006 when she's two years old.

Scott Benner (19:19) I am following what I am being told, and it is not working. (19:23) And I'm becoming overwhelmed, and she's becoming sicker. (19:27) And I'm a 100% sure I'm killing her most days, and I'm probably right. (19:31) And I I look to the people who are supposed to be telling me what to do, and I I come to the conclusion that I don't think they're gonna help me. (19:38) I don't think it's because they don't care.

Scott Benner (19:41) I don't think it's be I just think that whatever it is that they're programmed to say is not helping me.

Liesl (19:47) Yeah.

Scott Benner (19:47) So I dig into my daughter's health and become as much of an expert on all the aspects of it as I can. (19:54) And when I get to the edge of my understanding of it, and I start, like, interviewing other people and trying to find out their understanding of it to kinda, you know, bring together ideas. (20:03) And one day, it just hits me. (20:06) I've got my daughter's a one c in the low sixes now. (20:08) I've had it in the fives, and I know what to do.

Scott Benner (20:12) I'd never quantified it. (20:13) I never wrote it down. (20:14) I'm not as smart as your your grandmother who had the the or, you know, who had the had the list. (20:18) I don't I nothing was written down. (20:21) I just had come to the conclusion that there was a certain number of things that I did.

Scott Benner (20:24) And when I did them every day, her blood sugars were stable, and we had outcomes that we were looking for. (20:30) And so by then, I had the podcast, and I just sat down one day against my nature and wrote down the things that I thought helped people that helped us. (20:41) And then I said I I said, I think this is universal. (20:45) It's not exact. (20:46) Like, don't get me wrong.

Scott Benner (20:47) Like, you can't just do exactly what I do the way I do it, and it's gonna work for you. (20:52) But it's foundational enough that you can adapt it to yourself. (20:56) And Yeah. (20:57) When I started sharing it like that, get a lot of pushback from people, by the way, who said it was dangerous and it was gonna hurt people and blah blah blah. (21:04) And then just a lot of, like, you know, people, you know, toeing the company line.

Scott Benner (21:09) And, we don't talk about it like that. (21:11) I think back then, they were still aiming for an a one c that was eight. (21:14) Were They telling you if you had an eight a one c, you were doing well. (21:17) And and I was like, I don't think that's right. (21:20) You know?

Scott Benner (21:21) And so I shared my thing and then people actually, I you don't know this, but one of the you know, when I very first started writing a blog, like, one of the first pieces of correspondence I got back from a reader that said that the blog was valuable from them was from a person from England who said that Really? (21:38) Yeah. (21:38) She said her and her daughter have been finding a lot of value in the things I've been sharing on on my blog. (21:44) And, and then from there, it just kinda grew and grew and grew. (21:49) But it's not growing from my understanding.

Scott Benner (21:52) It's growing, I think maybe my my understanding is the seed of how it started, but then I had to keep bringing in other voices to try to add on top of it. (22:01) You you know? (22:02) Yeah. (22:02) And then making it and but then back to what we were talking about earlier. (22:06) That's all nice for me and my kid.

Scott Benner (22:09) But if you can't find a way to get it to other people, then if a tree falls in the woods, did anybody hear it? (22:16) Right? (22:16) So, like, then then Yeah. (22:17) Then your job becomes getting it out to people without letting it die. (22:22) Like, so you have to, like so right?

Scott Benner (22:24) Because at some point, that pump company was like, we got a pump. (22:26) This is it. (22:27) Now go out there and sell it. (22:28) Make sure people can get it. (22:29) Put it in their hands.

Scott Benner (22:30) And then they stopped innovating. (22:32) So if you innovate and sell and innovate and sell and keep doing that, that to me is the way you reach more people. (22:39) And I think I I'm sorry. (22:41) I think the more people that we reach, the better chance we have that doctors and and clinicians will will understand that there's a an elevated expectation from people and that they need to meet it. (22:52) Sorry.

Scott Benner (22:53) That was my whole thought.

Liesl (22:55) No. (22:55) No. (22:55) I and I think one of the things that you notice if you being a Daphne educator and being on Daphne courses is the relationship that that I have as a Daphne educator with the people that do the course is different. (23:09) It's changed then forever because they become more familiar with me as lethal and not somebody in a uniform sitting on a desk telling them what to do. (23:20) And I understand more about their lives, how they live with diabetes, what the the challenges are for each person as an individual.

Liesl (23:28) And then they get to meet a doctor on a Daphne course. (23:31) And where they will always say, I only come to clinic to get told off, suddenly they meet human beings who are health care professionals. (23:39) And so there's that mutual understanding and the realization that we're doing what we do not because we like to be bossy, but because we genuinely care and we genuinely have and are working hard to understand, to have empathy, to liberate people from that sense of guilt, and to give them information so they can live their best life. (24:07) Isn't that just what we want for everybody? (24:09) Whether they've got diabetes or not, whether they've got arthritis or not, whether they've got any other kind of life limiting condition or potentially life limiting condition.

Liesl (24:19) We just want them to live the best life they possibly can, and that's why we work in diabetes. (24:25) Because you either come and work in diabetes and you get spat out really quickly because it's not your thing, or you get sucked into work in diabetes and you realize you can't get out because this thing that I hated when I was a staff nurse on a ward suddenly became my be all and end all. (24:42) And that yeah. (24:43) I'm I'm in it for life pretty much.

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Scott Benner (25:09) You open up the email. (25:10) It's a big button that says click here to reorder, and you're done. (25:14) Finally, somebody taking away a responsibility instead of adding one. (25:18) US Med has done that for us. (25:20) An email arrives, we click on a link, and the next thing you know, your products are at the front door.

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Scott Benner (27:06) Can there not be or should there not be, or maybe there is, a Daphne course for doctors? (27:11) Because it occurs to me that any reasonably intelligent physician with a tiny bit of a heart who heard the last hour of our conversation wouldn't pull somebody into a room and and scold them. (27:24) And so, like, is is maybe that not a place where Daphne could could be valuable?

Liesl (27:30) We do that already. (27:31) So we've been training doctors to become Daphne doctors since Daphne started in ninety nine, two thousand when it was rolled out. (27:38) And that's what I was doing this afternoon before the podcast. (27:41) I was doing a a Daphne doctor workshop. (27:44) And so we get them to carb count so they understand what that's like.

Liesl (27:49) We will often talk about the language that's used. (27:51) And one of the doctors on the course today has been in diabetes for about a year, and her comment was, I'm already speaking to people differently. (28:01) I'm not telling people what to do. (28:03) I'm asking them how they are. (28:05) I'm asking them what they would like to be different about their life with diabetes.

Liesl (28:08) I'm asking them what their challenges are. (28:11) And she's only been in diabetes a short time. (28:13) And so everybody that she ever sees in the length of her career, which could be another thirty or forty years, is going to benefit from her having that different approach because she's done her DAFNI training, and she's out there now understanding a lot more. (28:30) I wish she very proud of that.

Scott Benner (28:31) Yeah. (28:32) I I would be as well. (28:33) I just had a 16 year old boy tell me the other day he wants to be an endocrinologist, and I thought, oh, he understands diabetes the way I talk about it. (28:40) He might be an endocrinologist one day and talk about it like that to people. (28:43) Yeah.

Scott Benner (28:43) And and I think that's just it really it's fabulous. (28:47) You know, there there's

Liesl (28:48) Yeah.

Scott Benner (28:48) It could be nothing better. (28:49) It's sad that, you know, it takes so long to change things in society, but there's nothing you can do about that. (28:56) So this is this is what you do. (28:57) You plant a lot of seeds. (28:58) You talk to a lot of people, and you wait for that stuff to grow.

Scott Benner (29:01) And and, hopefully, things move in a better direction, and, generally speaking, they do when people like you are out there doing what you're doing.

Liesl (29:07) Yeah. (29:09) I'm not perfect. (29:10) I have had a situation with somebody where I and, again, it's a family another family member with type one. (29:18) And I said to her, what's the one thing you could do differently that might make things different or might improve things? (29:27) And she just looked at me and said, why can people not just say, well done?

Liesl (29:34) Well done. (29:35) You're doing the best you can today. (29:36) And well done. (29:37) You did the best you could yesterday. (29:39) Mhmm.

Liesl (29:39) And well done because tomorrow, you'll do the best you can do tomorrow. (29:43) And I just thought, of all the people that per that she knows, I should be the one not to ask those questions of. (29:50) What's the one thing you could do differently that might make it better? (29:54) You know, really, I should have just said, well done. (29:57) You're doing your best every day, and I know that.

Scott Benner (29:59) Yeah. (29:59) You're So I you're trying to get still

Liesl (30:02) get it wrong.

Scott Benner (30:02) But but let me let me stick up for you for a second. (30:05) Right? (30:05) So you probably don't see this person that often, and you probably saw that they they made an advancement. (30:10) You thought, if I can get them thinking in this direction, they'll make another one. (30:14) Is that about right?

Liesl (30:15) It's it's because my personality is a fixer. (30:18) I like to be a fixer. (30:19) That's the thing.

Scott Benner (30:20) You know my I I hate to say that part one of my favorite things about this conversation is that when your voice gets a little higher, you sound like, Sharon Osborne when she was younger, which is delighting me. (30:30) Do

Liesl (30:31) you know the funny thing? (30:32) So that she's from Birmingham, isn't she?

Scott Benner (30:34) I don't know. (30:35) I just know that you sound like her sometimes.

Liesl (30:38) Well, I was born in Birmingham, and I haven't lived there since I was three. (30:41) But maybe I'm a bit like my mom, and when I get excited or passionate about something, a little bit of a brummy twang comes out in what I'm saying.

Scott Benner (30:48) Yeah. (30:48) I so much want you to yell, up.

Liesl (30:52) Aussie. (30:52) Exactly. (30:54) That's awesome.

Scott Benner (30:55) Oh, is there anything that we haven't spoken about that you want to? (30:59) Anything that we missed or skipped over?

Liesl (31:02) Goodness. (31:03) We've covered so much, haven't we, Scott? (31:05) We've talked about so much. (31:08) I just the value of education for people with diabetes. (31:12) It's what they deserve, and it should be an entitlement.

Liesl (31:15) That's what I believe very firmly if they if they want it if they want education, they should be able to have it.

Scott Benner (31:21) Yeah. (31:21) No. (31:22) I I agree. (31:22) I I think in any way we can get it to them is important. (31:25) I I will tell you that the, I was just having this conversation, with my actually, with my my nephew.

Scott Benner (31:34) He's in college. (31:35) And he needed to interview people about media, but he had to interview somebody over 50. (31:39) So it ended up being me. (31:41) I wasn't thrilled that I was the right one for that. (31:43) But but, you know, he's asking me about how things have changed about how I consume television or movies and stuff like that.

Scott Benner (31:50) And I found us getting off of a little bit of a he asked about the podcast a little bit. (31:55) And I said, you know, what's interesting is that before the cell phone, the podcast wasn't really possible.

Liesl (32:03) Yeah.

Scott Benner (32:03) Like, right? (32:04) So the cell phones came, and then suddenly there was a place to send the audio to. (32:08) But it really didn't take off until data became cheaper because Yeah. (32:13) People couldn't afford to download an episode of anything because you used to pay for your data by I forget how you did it. (32:18) But but it was expensive, right, to download something.

Scott Benner (32:21) And when data became kinda ubiquitous, then all of a sudden, people could share their their thoughts. (32:29) And I said, and then it and and then you think, well, that's great. (32:33) Until then everyone realizes that's possible, then they flood the area again with with, you know I mean, listen. (32:39) I'm sure everybody's podcast has value, but, like, a lot of information that maybe isn't as valuable, then it becomes confusing to the consumer, then they don't know how to parse through it. (32:49) And then I could hear him, like, getting a little, like, numb in his head, and I said, how many times have you sat down in front of Netflix and scrolled through it for an hour but never watched a movie?

Scott Benner (32:59) And he goes, a lot. (33:00) And I was like, right. (33:01) I was like, so is that much choice good or bad because you didn't watch anything? (33:08) And I he just froze. (33:09) And, and I was like, so I said, yes.

Scott Benner (33:12) Because he asked me how like, he asked me about the distribution of the podcast. (33:16) And I said, so, yes, the distribution is the only thing that made it blow up, but it also let everybody else who could figure out how to sit in front of a microphone do it too. (33:25) And then it puts me in a position of having to, like, persevere through that to get to the other side to continue to reach people. (33:32) I was like I was like, there and, anyway, my point to him was there's no perfect answer to your question. (33:37) Because he his question was, you know, should we all be going to the theater still or streaming better?

Scott Benner (33:43) Like, you know, what what do you find more valuable? (33:45) And I and I said to him, I was like, you're not that's not the question. (33:48) I was like, the question is what's gonna win? (33:50) What ends up being here when it's over? (33:53) You know, like, what is it that we end up settling on that we end up building on for the next thing?

Scott Benner (33:58) And I just I keep thinking about that since I've been talking to him about the, like, the diabetes aspect of it. (34:03) Like, what do we what have we settled on that helps people, and how do we build on it to try to get to the next thing, to get to the next fight, to see if we can fight through it, to see what perseveres comes out the other side. (34:15) How do we build again on that over and over? (34:18) I'm super excited for it to be I mean, I really I I don't know. (34:25) Like, I'm I'm the wrong person for this idea, but I'm seeing people right now using AI for their diabetes in ways that is really fascinating me.

Scott Benner (34:34) I don't know if you've seen people do this or not, but I'm starting to I've done it on the podcast once or twice. (34:41) I probably will do it a little more with people, but I watched somebody do it online recently where they were having trouble with their insulin, and they just they were at wit's end. (34:51) They didn't know what to do, and they just started feeding their their their graphs into, one of the AI models and then having a live conversation with the AI model. (35:01) And the I the person flat out said in their post online, I didn't even know if it was right, but I was so screwed I had to try something. (35:09) And then they tried it, it worked for them.

Scott Benner (35:12) And I was like, that's fascinating because I that I find that's how people get to the podcast. (35:17) When I was talking to my daughter's friend the other day and trying to help her through her thing, I said to her, try to imagine where a person has to be to say, I'm gonna turn a podcast on and listen to it about my health. (35:30) I was like, imagine how lost you have to be to make that decision. (35:34) Right? (35:34) Because that is not a that's not a on its face, that's not a reasonable decision to make for somebody who doesn't know me or doesn't know what's here or anything else.

Scott Benner (35:42) Right? (35:42) I was like, that's how lost people are when they're walking around. (35:45) They're like, maybe a guy will tell me. (35:47) Maybe my AI will know what to do with this graph. (35:50) And and, anyway, like, you're now seeing the AI does seem to know what to do with the graph.

Scott Benner (35:55) I don't know if you've done this, but I've had people go ahead. (35:58) Go ahead, please. (35:59) What were you gonna say?

Liesl (36:00) And I've not because I don't work face to face with, people with diabetes anymore. (36:04) I'm kind of more in the background. (36:06) So watching somebody use AI for their diabetes is not something I've seen, but I do know that there's more and more reliance on apps. (36:16) And one thing I like about your podcast is that it's people talking. (36:20) And if we're not careful, people are gonna lose that peer support from talking to other people who either have type one or have family with type one because it's all gonna be about an app on their phone and the technology.

Liesl (36:34) And I don't think you can divorce that personal connection.

Scott Benner (36:39) Allow me to be hopeful. (36:41) Allow me to be hopeful. (36:42) Maybe the technical side of their life will become so unencumbered or that they can spend more time on the community side. (36:49) Yeah. (36:49) That would be lovely.

Scott Benner (36:50) I hope so. (36:51) Yeah. (36:51) I saw, oh gosh. (36:53) What was I gonna tell you? (36:55) Jeez.

Scott Benner (36:56) The thing, the thing, the thing, the thing. (36:58) Oh, Scott. (36:59) This is terrible. (37:02) It was with an AI. (37:04) Oh, shit.

Scott Benner (37:06) Lisa, look what happened. (37:08) My age got caught up with me there.

Liesl (37:10) Oh, don't worry. (37:10) It happens to me all the time.

Scott Benner (37:11) Yeah. (37:12) Yeah. (37:12) I'm so disappointed. (37:13) I had one last thought, but that that's also a misnomer because I could just keep talking forever, so I don't really have one last thought.

Liesl (37:19) I could talk to you all night. (37:21) So

Scott Benner (37:21) Well, you're very good at this. (37:23) I was gonna say you're, you're you're chatty as hell. (37:25) It's awesome. (37:26) Do you have, you you've mentioned a couple of people in your life that have type one that are in your family. (37:32) Is there other autoimmune in your family?

Scott Benner (37:34) Do you have any autoimmune issues?

Liesl (37:36) No. (37:37) Nothing? (37:37) None at all.

Scott Benner (37:38) Celiac, thyroid, you don't see it through the family?

Liesl (37:42) Nothing. (37:43) No. (37:43) And and you know what? (37:45) I think the biggest lesson I learned when I got really upset when this family member was diagnosed. (37:52) And it just goes to show how you cannot however much you know, you can't divorce emotion from the situation because I was in tears talking to my husband, and he was a bit flummoxed as to why I was so upset.

Liesl (38:05) And through my tears, just said, thank god I'm not a cancer specialist nurse because then she might have got cancer.

Scott Benner (38:12) Oh.

Liesl (38:13) Now how irrational is that? (38:15) It doesn't make any sense at all. (38:17) Yeah. (38:17) But it was just this whole, oh my god. (38:22) This somehow, is this my fault?

Liesl (38:24) Of course, it's not my fault. (38:25) It's just bloody bad luck. (38:28) But it it just taught me the family members of anybody I've ever met who's got type one diabetes will perhaps have gone through emotions, irrational emotions, which I would have laughed at if I hadn't experienced it myself. (38:43) Thank god I'm not a cancer specialist nurse. (38:46) I'm a diabetes specialist nurse because she's got diabetes and not cancer.

Scott Benner (38:50) Well I

Liesl (38:50) mean, that just doesn't make any sense, but that's genuinely how I felt on that day.

Scott Benner (38:55) The unseen stuff, like, unseen psychological stuff is fascinating. (38:58) Like, imagine you you I go out to dinner with my family, and I sit down, and it is in the my daughter's 21 now, but it's still in the back of my head. (39:07) Like, is she gonna pre bolus for this? (39:09) Has she bolus? (39:09) And I haven't noticed because now it's on her phone, and I can't really tell.

Scott Benner (39:12) You you know? (39:13) And now you're all sitting there, and all you wanna say is, hey. (39:17) You bolus. (39:18) Right? (39:19) But you don't wanna put that on her because, a, if she forgot, that's on she doesn't need to feel like I'm watching her.

Scott Benner (39:26) And if she didn't forget, she doesn't need to feel like nobody trusts her. (39:29) But yet in the silence when nobody says, hey. (39:32) Did you bolus yet? (39:33) Everyone at the table knows that everyone else is thinking about it. (39:37) Yeah.

Scott Benner (39:37) And it's and it's in the background. (39:38) It's not right on the front of your head. (39:39) It's in the background, but there's an when I've noticed that every time I sit at a restaurant, until I know my daughter has bolus for food, I'm on some level a tiny bit uptight or or on guard or something. (39:54) I don't even know really how to put it. (39:56) And the minute I realized that she's done it, it's lighter.

Scott Benner (40:01) And I wonder if it doesn't feel that way to her as well. (40:04) You know what I mean? (40:06) Like and and that's the kind of little stuff that if we sat here long enough and talked and talked and talked, we could sit and make a list of a million things like that. (40:15) And Yeah. (40:16) And those things are happening to you all day long whether you're the person with type one or the or somebody that loves them.

Scott Benner (40:22) It just it it's unfair. (40:24) There's that it's the wet towel. (40:25) Like, I swear, I've never thought of that wet towel analogy before in my life, but now I realize it's like it's it's like, you know you know those, like, thin clingy, like, sarongs that you women, like, wrap around the the beach. (40:36) It's like that thin material, but cold and wet and just laying on top of you. (40:42) A little shitty.

Scott Benner (40:43) You know? (40:44) Like, and you can't make it go away. (40:47) But, again, I have seen people with diabetes get together in a room, and I watch that feeling. (40:52) It looks like it lifts off them. (40:54) So

Liesl (40:55) Yeah. (40:55) Yeah. (40:56) And and actually, until you said that out loud, I think I recognize that, and I'm conscious of it, but I'd never been properly conscious of that feeling of of sitting and waiting. (41:06) And once you know that they're bolus, the meal can start, and you can all enjoy it. (41:11) Yeah.

Liesl (41:12) And the other thing, you mentioned something. (41:13) We're talking about emotions. (41:15) One of the things that we ask our DAFNI course participants is about we ask them three very specific questions. (41:23) And we ask them to quantify how overwhelmed they feel by the responsibility of diabetes, how alone they feel with their diabetes, and how much they feel as if they're failing with their diabetes. (41:36) And what we see at the end of that five day course is they've gone from scoring a five or a six, which is what you don't want them to feel.

Liesl (41:46) A five or a six is that it's a serious problem or a very serious problem. (41:50) And at the end of five days, they're scoring a one or or a two, which is it's not a problem or it's a slight problem. (41:57) So to see that impact on somebody's psychological health in just five days is phenomenal. (42:04) But when they fill in the forms a year later, they've maintained that psychological benefit. (42:10) And I don't know any other intervention in health care, be it a tablet or physio or anything else that can achieve that improvement in five days and maintain it a year later?

Liesl (42:24) And even though as an educator, I always knew that was the case. (42:27) I never had the evidence to back it up. (42:30) Now we ask the participants to answer these questions. (42:34) They answer them on their own away from anybody, so there's no coercion. (42:38) And now we can quantify exactly what that improvement is.

Liesl (42:42) And that makes me emotional every time I look at that data because behind the data is a real person with a family who's living a different life because that emotional burden has got less. (42:56) And that to me is is truly what it's all about.

Scott Benner (42:59) You know what the data helps you with too is it helps you stop wondering if it's true. (43:04) It allows you to believe it's true and press forward.

Liesl (43:06) Yeah.

Scott Benner (43:06) I did a thing a few years ago that helped me a lot. (43:09) I did a, there was this really this lovely girl that people reach out to help me all the time. (43:14) They're like, I you know, the podcast helped me. (43:16) How can I help you? (43:17) And at one point, there was this grad student, and she's like, how can I help?

Scott Benner (43:22) And I said, I wanna do a survey to see if the podcast actually helps people. (43:26) And I don't know how I don't know how to do that, so you go ahead and do it. (43:30) And she put a survey together, and we actually got 1,200 people to take the survey. (43:34) 1,200 listeners to take it, which was is a pretty big data set.

Liesl (43:37) A great number.

Scott Benner (43:38) Yeah. (43:38) And, it turns out that the podcast helps them significantly more than their doctors do or anything that they found print online or etcetera for their diabetes. (43:47) And I don't I mean, it's somewhere the data somewhere that from the thing, but the point is that it didn't matter because it let me what doesn't matter is that that I can't quote it to you anymore. (43:58) What it did for me was what was most important. (44:01) It took this thing that I thought I was seeing, that I believed was true.

Scott Benner (44:05) It proved it to me enough that I could stop wondering about that part of it and just push forward. (44:11) And it really it really did allow me to to you know, because I'm not a I I mean, I I I joke around and hear a lot, and I think I try to keep this entertaining so that people will listen about their diabetes, which is not a thing I think most people are inclined to listen to. (44:24) And when I joke around, I think there are times that I can come off like a dumbass because I'm but I I'm not I'm not a I'm not a, like, a crazy narcissist who's just, like, every time I see something, believe it. (44:36) I'm like, yay. (44:37) I'm great.

Scott Benner (44:37) And, like, and I move forward. (44:39) Like, I really wondered, like, is this actually doing what I think it's doing for people? (44:43) Like, I believe it is, but I don't have the ability to just, like I don't know. (44:49) Like, to just take it on face and go. (44:51) And that data coming back was really helpful to me.

Scott Benner (44:54) And I think Yeah. (44:55) You know, same for you is, like, you can say, look. (44:57) Because when you said the thing about the first five days and their score goes up from day one to day five, my follow-up question before you told me about the year after data, my follow-up question was gonna be, but yeah. (45:08) But does that actually matter in the long run? (45:10) Like, or are you just talking them into believing they can do it and they get home and they can't actually do it?

Scott Benner (45:15) And Yeah. (45:16) You know, and that there's your answer. (45:17) And so beautiful. (45:18) Yeah. (45:18) Then run around yelling Daphne at people.

Scott Benner (45:20) You know what I mean?

Liesl (45:21) I do. (45:22) My friends that my friends will be, if if they if they listen to the podcast, they'll be like, well, she was in heaven because she was talking Daphne basically for an hour and a half. (45:30) So she's absolutely in heaven because, yeah.

Scott Benner (45:33) That's Very good.

Liesl (45:34) That's what they know me for.

Scott Benner (45:35) Well, it's like, can't I can't thank you enough for reaching out and for sharing all this. (45:39) I think this has been a really terrific conversation. (45:41) And, I I is there anything if people in The UK, if they don't like, how do they reach, like, a Daphne course if they Yeah. (45:49) If they want it?

Liesl (45:51) So we we delivered Daphne is delivered in a 117 different centers and over 200 locations in The UK. (45:57) So if anybody is interested in coming on a Daphne course, they just need to go to our website, www.daphne.nhs.uk, and it will show you where there's a Daphne centre in their area. (46:09) And it may be that they already have their diabetes care in a DAPHNE service. (46:14) And if they don't, they can ask their GP or their service to refer them to somewhere that does deliver DAPHNE so that they can access a course.

Scott Benner (46:22) Well, you asked before we started, like, said, before we started recording, you said, like, if I use any, like like, British colloquialisms that don't make sense, just stop me. (46:31) And I have to admit, like, I'm just gonna call this episode penny drop, but is that but I don't know I've never heard that before in my life. (46:37) So

Liesl (46:38) Have you not? (46:39) No.

Scott Benner (46:39) So, anyway, that's that's what your episode's gonna be called.

Liesl (46:43) Thank you.

Scott Benner (46:44) Yeah.

Liesl (46:44) I've really enjoyed talking to you today, Scott. (46:46) Thank you so much. (46:47) And as you know, I can as you now know, I can talk about diabetes till the cows come home. (46:51) And, having a conversation with somebody else who's in the same position is is really lovely. (46:57) I've really enjoyed my afternoon.

Liesl (46:58) Thank you so much.

Scott Benner (46:59) No. (46:59) Me too. (47:00) The feeling's mutual. (47:01) Hold on one second, please. (47:07) A huge thanks to my longest sponsor, Omnipod.

Scott Benner (47:11) Check out the Omnipod five now with my link, omnipod.com/juicebox. (47:16) You may be eligible for a free starter kit, a free Omnipod five starter kit at my link. (47:24) Go check it out. (47:25) Omnipod.com/juicebox. (47:27) Terms and conditions apply.

Scott Benner (47:29) Full terms and conditions can be found at omnipod.com/juicebox. (47:34) The conversation you just enjoyed was brought to you by US Med. (47:38) Usmed.com/juicebox or call (888) 721-1514. (47:44) Get started today and get your supplies from US Med. (47:58) My diabetes pro tip series is about cutting through the clutter of diabetes management to give you the straightforward practical insights that truly make a difference.

Scott Benner (48:07) This series is all about mastering the fundamentals, whether it's the basics of insulin, dosing adjustments, or everyday management strategies that will empower you to take control. (48:17) I'm joined by Jenny Smith, who is a diabetes educator with over thirty five years of personal experience, and we break down complex concepts into simple, actionable tips. (48:27) The diabetes pro tip series runs between episode one thousand and one thousand twenty five in your podcast player, or you can listen to it at juiceboxpodcast.com by going up into the menu. (48:51) Hey. (48:51) Do you need support?

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Scott Benner (49:16) American Sign Language. (49:18) There's a great sign language interpreter who did the entire bold beginning series in ASL. (49:23) So if you know anybody who would benefit from that, please send them that way. (49:27) Just go to juiceboxpodcast.com and click on support. (49:30) While you're there, check out the guides like the pre bolusing guide, fat fat and protein insulin calculator, oh gosh, thyroid GLP, caregiver burnout.

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Scott Benner 1/21/26 Scott Benner 1/21/26

#1743 Penny Drop - Part 2

Liesl works for DAFNE, a UK-based program teaching dose adjustment for normal eating, while discussing the evolution of diabetes management and the vital importance of peer support.

+ Click for EPISODE TRANSCRIPT

Liesl (2:27) Yeah.

Liesl (3:38) what Some it shoulders some of the burden for her, doesn't it?

Scott Benner (4:31) Yeah. (4:31) You know? (4:32) Yeah.

Scott Benner (4:49) Yeah. (4:49) I know. (4:49) I don't I wouldn't say that to somebody, but I do think it's important that they understand it.

Liesl (5:07) And as we've said, it takes some of the burden away, but you've still got that wet towel draped around your shoulders.

Scott Benner (5:13) Yep. (5:13) And you still

Liesl (5:14) have earlier. (5:15) So

Liesl (6:35) It it just at least can double what they can achieve if they're given the opportunity. (6:39) And part of my job is to try and make sure that they get given that opportunity.

Scott Benner (8:20) Like, if you can give them those kinds of hallmarks, then most people

Liesl (8:25) Absolutely.

Scott Benner (9:00) Perfect.

Liesl (9:31) And and I think that takes tremendous courage and a degree a huge degree of trust in somebody like me to be providing her with the right information.

Liesl (11:19) Yeah.

Scott Benner (11:19) That that's the part I know for sure.

Scott Benner (14:23) It's crazy. (14:23) It some people are like, I've never done that before. (14:25) It's never been a problem for me. (14:27) I'm like, yeah. (14:27) Right on.

Scott Benner (14:50) I don't love the I don't love I I just think people deserve all the information.

Liesl (14:57) Yeah.

Scott Benner (14:58) You know? (14:58) And then they can do what with it what they want or what they're capable of doing with it. (15:03) But it it would be wrong to hide it from somebody.

Scott Benner (15:37) Yep.

Liesl (16:23) Yeah. (16:23) Yeah.

Scott Benner (16:33) That's the entire thing. (16:35) Is it as easy as why the way I just said it? (16:37) It's not. (16:38) But that is at the core of the that's your entire fight. (16:41) Yeah.

Scott Benner (17:19) It's kind of it. (17:19) You know?

Liesl (17:21) It's like having another job on top of your normal full time job, isn't it? (17:24) Well, I mean, like it's like having to run two jobs at the same time.

Scott Benner (19:41) I don't think it's be I just think that whatever it is that they're programmed to say is not helping me.

Liesl (19:47) Yeah.

Scott Benner (22:53) That was my whole thought.

Scott Benner (28:43) And and I think that's just it really it's fabulous. (28:47) You know, there there's

Liesl (28:48) Yeah.

Scott Benner (29:01) And and, hopefully, things move in a better direction, and, generally speaking, they do when people like you are out there doing what you're doing.

Liesl (29:34) Well done. (29:35) You're doing the best you can today. (29:36) And well done. (29:37) You did the best you could yesterday. (29:39) Mhmm.

Scott Benner (29:59) Yeah. (29:59) You're So I you're trying to get still

Liesl (30:02) get it wrong.

Liesl (30:15) It's it's because my personality is a fixer. (30:18) I like to be a fixer. (30:19) That's the thing.

Liesl (30:31) you know the funny thing? (30:32) So that she's from Birmingham, isn't she?

Scott Benner (30:34) I don't know. (30:35) I just know that you sound like her sometimes.

Scott Benner (30:48) Yeah. (30:48) I so much want you to yell, up.

Liesl (30:52) Aussie. (30:52) Exactly. (30:54) That's awesome.

Scott Benner (30:55) Oh, is there anything that we haven't spoken about that you want to? (30:59) Anything that we missed or skipped over?

Liesl (31:15) That's what I believe very firmly if they if they want it if they want education, they should be able to have it.

Liesl (32:03) Yeah.

Scott Benner (35:55) I don't know if you've done this, but I've had people go ahead. (35:58) Go ahead, please. (35:59) What were you gonna say?

Liesl (36:34) And I don't think you can divorce that personal connection.

Scott Benner (36:50) I hope so. (36:51) Yeah. (36:51) I saw, oh gosh. (36:53) What was I gonna tell you? (36:55) Jeez.

Scott Benner (36:56) The thing, the thing, the thing, the thing. (36:58) Oh, Scott. (36:59) This is terrible. (37:02) It was with an AI. (37:04) Oh, shit.

Scott Benner (37:06) Lisa, look what happened. (37:08) My age got caught up with me there.

Liesl (37:10) Oh, don't worry. (37:10) It happens to me all the time.

Liesl (37:19) I could talk to you all night. (37:21) So

Scott Benner (37:34) Do you have any autoimmune issues?

Liesl (37:36) No. (37:37) Nothing? (37:37) None at all.

Scott Benner (37:38) Celiac, thyroid, you don't see it through the family?

Liesl (38:05) And through my tears, just said, thank god I'm not a cancer specialist nurse because then she might have got cancer.

Scott Benner (38:12) Oh.

Liesl (38:13) Now how irrational is that? (38:15) It doesn't make any sense at all. (38:17) Yeah. (38:17) But it was just this whole, oh my god. (38:22) This somehow, is this my fault?

Scott Benner (38:50) Well I

Liesl (38:50) mean, that just doesn't make any sense, but that's genuinely how I felt on that day.

Scott Benner (42:59) You know what the data helps you with too is it helps you stop wondering if it's true. (43:04) It allows you to believe it's true and press forward.

Liesl (43:06) Yeah.

Liesl (43:37) A great number.

Scott Benner (45:15) And Yeah. (45:16) You know, and that there's your answer. (45:17) And so beautiful. (45:18) Yeah. (45:18) Then run around yelling Daphne at people.

Scott Benner (45:20) You know what I mean?

Scott Benner (45:33) That's Very good.

Liesl (45:34) That's what they know me for.

Liesl (46:38) Have you not? (46:39) No.

Scott Benner (46:39) So, anyway, that's that's what your episode's gonna be called.

Liesl (46:43) Thank you.

Scott Benner (46:44) Yeah.

Liesl (46:58) Thank you so much.

Scott Benner (46:59) No. (46:59) Me too. (47:00) The feeling's mutual. (47:01) Hold on one second, please. (47:07) A huge thanks to my longest sponsor, Omnipod.

Scott Benner (48:52) I have some stuff for you. (48:53) It's all free. (48:54) Juiceboxpodcast.com. (48:56) Click on support in the menu. (48:57) Let's see what you get there.

Scott Benner (49:49) I'll be back tomorrow with another episode of the Juice Box podcast.

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Scott Benner 1/20/26 Scott Benner 1/20/26

#1742 Penny Drop - Part 1

Liesl works for DAFNE, a UK-based program teaching dose adjustment for normal eating, while discussing the evolution of diabetes management and the vital importance of peer support.

+ Click for EPISODE TRANSCRIPT

Scott Benner (0:00) Hello, friends, and welcome back to another episode of the Juice Box podcast.

Liesl (0:13) I work for an organization called DAPHNE. (0:15) So DAPHNE stands for dose adjustment for normal eating, and it's a not for profit part of the NHS. (0:22) And we provide education for people with type one and type two diabetes.

Scott Benner (0:28) Nothing you hear on the Juice Box podcast should be considered advice, medical or otherwise. (0:33) Always consult a physician before making any changes to your health care plan or becoming bold with insulin. (0:46) Have you tried the small sip series? (0:49) They're curated takeaways from the Juice Box podcast, voted on by listeners as the most helpful insights for managing their diabetes. (0:56) These bite sized pieces of wisdom cover essential topics like insulin timing, carb management, and balancing highs and lows, making it easier for you to incorporate real life strategies into your daily routine.

Scott Benner (1:07) Dive deep, take a sip, and discover what our community finds most valuable on the journey to better diabetes management. (1:14) For more information on small sips, go to juiceboxpodcast.com. (1:17) Click on the word series in the menu. (1:30) The episode you're about to listen to was sponsored by Touched by Type one. (1:35) Go check them out right now on Facebook, Instagram, and, of course, at touchedbytype1.org.

Scott Benner (1:41) Check out that programs tab when you get to the website to see all the great things that they're doing for people living with type one diabetes. (1:48) Touchedbytype1.org. (1:51) The podcast is also sponsored today by Tandem Mobi, the impressively small insulin pump. (1:57) Tandem Mobi features Tandem's newest algorithm, Control IQ Plus technology. (2:02) It's designed for greater discretion, more freedom, and improved time and range.

Scott Benner (2:06) Learn more and get started today at tandemdiabetes.com/juicebox. (2:12) Today's episode of the Juice Box podcast is sponsored by the Eversense three sixty five, the one year wear CGM. (2:19) That's one insertion a year. (2:21) That's it. (2:22) And here's a little bonus for you.

Scott Benner (2:24) How about there's no limit on how many friends and family you can share your data with with the Eversense Now app? (2:30) No limits. (2:31) Eversense.

Liesl (2:33) So, yeah, my name's Liesl. (2:34) I'm a diabetes specialist nurse by oh, there's my phone. (2:38) I thought I'd put that on silent. (2:40) Sorry about that.

Scott Benner (2:41) No. (2:41) It's okay. (2:41) It's a great intro. (2:43) Don't worry.

Liesl (2:43) I no. (2:44) I did put it on silent. (2:45) It was to remind me to log on to this if I hadn't already done it. (2:49) So that's what that's all about.

Scott Benner (2:50) Lisa. (2:50) Lisa. (2:51) Hold hold on a second. (2:52) First of all, I definitely think we have to call this episode Lisa Lisa cult jam, but that's a different problem for a different time. (2:58) What do you mean you put on a timer in case you forgot?

Liesl (3:02) Oh, well no. (3:03) Because I was I had to do some training before this that I wasn't expecting to do, so I was gonna have lots of time to prep. (3:09) Gotcha. (3:09) And it was if I got carried away with the training, but I left them early because I was so conscious I didn't wanna be late for you that I left the training early and left a colleague to take over from me. (3:18) So Oh.

Scott Benner (3:20) There a sick is there a sickly person in England now because you had to be on the podcast? (3:24) What's going on?

Liesl (3:26) No. (3:26) No. (3:26) No. (3:27) No. (3:27) It's fine.

Scott Benner (3:27) It's all good. (3:28) It's all good. (3:29) Tell me, Lisa, a little bit about, your job. (3:32) What is it you do?

Liesl (3:34) I work for an organization called DAFNI. (3:37) So DAFNI stands for dose adjustment for normal eating, and it's a not for profit part of the NHS. (3:44) And we provide education for people with type one and type two diabetes, which is free of charge. (3:50) And we also provide education for health care professionals who work in diabetes. (3:55) And we teach them about type one diabetes, type two diabetes, and also how to teach that education to the people they work with and support who have got diabetes.

Scott Benner (4:06) Would it fry your mind if I told you that today there's an episode up called sneaky chocolate bar? (4:14) And, sorry. (4:15) That part isn't what I thought would fry your mind, although I guess maybe it would. (4:18) And Danny, who is from England, is, telling his story in two parts. (4:23) And in the first part, it becomes completely clear to me that he does not know how to take care of himself until he finds the Daphne program.

Scott Benner (4:32) Mhmm. (4:33) Did that does that surprising to you?

Liesl (4:35) Not at all. (4:36) I have been involved in DAPHNE now for twenty years, I think.

Scott Benner (4:41) Wow.

Liesl (4:41) So I was a diabetes specialist nurse, and I was actively looking for a job outside of diabetes because I felt I had nothing else to offer. (4:51) And a new consultant joined the team and said, we've got to do this Daphne course. (4:56) We have got to do it. (4:58) And so I got sent to do my Daphne educator training, and I was really not that keen. (5:04) I thought everyone's going to eat pizza and chocolate cake and put weight on, and it's going to be dreadful.

Liesl (5:11) But I went to a Daphne center to watch a Daphne course in person for a week. (5:16) And as I sat there, I thought, this is so obvious. (5:20) I should know how to do this like I just know how to breathe. (5:24) I couldn't believe what I was learning and how much I hadn't known before even though I'd been a diabetes specialist nurse for, I think, six years at that time.

Scott Benner (5:34) So I wanna go back

Liesl (5:35) that surprise me now.

Scott Benner (5:36) You know? (5:37) Yeah. (5:37) Give me a second here. (5:38) So you you were a diabetes specialist nurse already for six years. (5:43) You felt disenfranchised or or just just maybe I don't how you felt exactly.

Scott Benner (5:48) We'll find out exactly. (5:49) But you're thinking about getting away from it. (5:51) A friend says, let's try Daphne. (5:53) And your first concern back then was that if we teach these people how to use the insulin, they're just gonna eat a lot of food?

Liesl (6:02) No. (6:03) Not that's not quite the way it is. (6:05) I think when we looked at the press and the media around Daphne at that time, the press focused very much on people can eat whatever they like. (6:13) And in The UK at that time, education was about healthy diet and not about carb counting. (6:20) Mhmm.

Liesl (6:21) So there was this disconnect even for health care professionals around the relationship between insulin and carbohydrate. (6:28) So that wasn't something I'd ever been aware of ever, really. (6:32) And I just thought, well, if people can eat whatever they like, if they've always been told you've got to eat a healthy diet, you can't eat sugary food, you can't eat fatty food. (6:41) They're just going to eat whatever they like, and this could be a disaster.

Scott Benner (6:46) Okay.

Liesl (6:47) But then I went on the Daphne course and properly understood that triangle between carbohydrates, insulin, and blood glucose, which I'm ashamed to say I hadn't fully appreciated for the six years that I'd been a diabetes specialist nurse.

Scott Benner (7:03) Characterize for me the kind of care you were offering in the first six years in hindsight.

Liesl (7:11) Changing insulin doses for people in very small amounts without really taking into consideration what they were eating. (7:21) So not really being aware of why they might wake up above their target glucose in the morning, and perhaps it's because they had to have a bowl of cereal before they went to bed so they didn't go hypo. (7:34) But that wouldn't really come into it necessarily. (7:37) So it was really very limited, and I suspect I was not very effective in that role at that stage.

Scott Benner (7:45) Mhmm. (7:45) Did you think during those years that everyone who you saw was just eating watercress and and drinking tea and not really taking him any carbs and they were super healthy? (7:57) Like, was that your expectation of what was happening, or is that is that what you were told is that what they were being told to do when you were just making the assumption they were doing it?

Liesl (8:07) That's what we were recommending people were doing, but I'm a realist. (8:11) And I knew that people were not doing it because I don't have diabetes, and I wasn't doing it. (8:15) Mhmm. (8:16) So, you know, I think I think it's very easy to give advice, but what I wasn't doing in those days was listening. (8:25) I felt I was a vehicle of information, and my job was to give information and tell people what they should be doing because that's what was going to benefit them in the long run.

Liesl (8:37) But doing the Daphne course and becoming a Daphne educator taught me to listen

Scott Benner (8:42) Mhmm.

Liesl (8:42) And to understand what it's like as well as I can with a condition that you can't have a day off from. (8:51) Yeah. (8:51) And I will never truly understand type one diabetes unless I get it, but I owe it to anybody with type one diabetes to listen and do my best to understand what it's like for them as an individual rather than try and put a population wide approach to it.

Scott Benner (9:09) So do you think that the, I don't know, the the establishment idea was eat like this, very low carb, and you should do that because you have diabetes. (9:20) And if you don't, then you're noncompliant, and we can't help you. (9:24) And if you do, then maybe you'll get lucky and have good outcomes. (9:27) Is that is that how they thought about it?

Liesl (9:29) I don't think even low carb came into it. (9:31) Carbohydrate wasn't anything for me as a qualify I qualified as a nurse in 1990, and then I went into diabetes in 1999. (9:40) And I don't think carbohydrate ever really entered our psyche or our training at that stage.

Scott Benner (9:46) In 1999? (9:47) I'm sorry. (9:48) I talked over you. (9:49) In 1999?

Liesl (9:51) Yeah.

Scott Benner (9:51) Wow. (9:52) Okay. (9:53) Alright. (9:53) Okay. (9:54) When did Daphne begin?

Scott Benner (9:56) Do you know? (9:58) It I can look if you don't know.

Liesl (10:01) Origins. (10:01) Yeah. (10:02) No. (10:02) No. (10:02) No.

Liesl (10:02) Its true origins are with a man called Michael Berger in Dusseldorf back in the eighties. (10:08) And Germany were having or achieving much better outcomes for people with type one diabetes at the time than we were. (10:16) And there were some very influential people in The UK, professor Stephanie Amiel, professor Simon Heller, and doctor Sue Roberts, who went out to Germany to visit Michael Burger and to see the education he was providing for people with type one diabetes. (10:31) And through a collaboration with him and his support, they brought his education back to The UK in the late nineties and called it DAFNI, dose adjustment for normal eating. (10:42) So we had a randomized control trial in the late nineties, which showed reductions in h b a one c, and then that was rolled out in 2000.

Liesl (10:53) So DAFNI's been going it's our 20 birthday this year. (10:56) We've just had in October our birthday month celebrations.

Scott Benner (11:01) I have here begun 1999, teaches adults with type one diabetes how to adjust insulin to match their lifestyle and food choices rather than restrict diet, adapted from a successful German model of structured diabetes education, usually a five day in person group course run by diabetes specialists, nurses, and dietitians. (11:19) It proves it has been proven to improve h b a one c, reduce severe hypoglycemia, increase quality of life, and confidence in diabetes management.

Liesl (11:28) Yeah. (11:29) And the other thing it does is reduce diabetic ketoacidosis because if some or DKA. (11:34) So when people have had DKA in the past, that usually, excludes them from any kind of research. (11:40) Mhmm. (11:40) But because we collect real world data, we can show real world reductions in episodes of DKA and also in the number of people who experience DKA once they've done a Daphne course.

Scott Benner (11:53) Is the Daphne course, akin to this podcast? (11:56) Does it have a lot of overlap

Liesl (12:00) or no? (12:01) Overlap with

Scott Benner (12:02) what like, with ideas of how to do things. (12:05) Like, the I mean, I I guess I should have started here. (12:07) Do you listen to the podcast at all?

Liesl (12:09) I haven't listened for a few weeks, but that's because we've had a lot of, we've had a bereavement in the family, and I just haven't been running. (12:15) But when I was running on my treadmill a lot, I was listening to a podcast while I was running.

Scott Benner (12:19) Okay. (12:19) And you and you've heard, I don't know. (12:21) Have you heard the pro tip series or one of those, like, management series?

Liesl (12:25) I haven't heard those. (12:26) I've heard a lot of people who have got either type one diabetes themselves or they have it in their family.

Scott Benner (12:30) Yeah. (12:31) You've been listening to the stories from people. (12:32) Okay. (12:33) So there are, a a ton of of, series within the podcast. (12:38) I was I was just wondering if you knew if there was overlap.

Scott Benner (12:42) But instead, I'm gonna talk to you about it, and I'll see if there's overlap. (12:45) So Okay. (12:45) Tell me, you know, in this five day course, like, what do you what do you tell people? (12:51) Like, how do you introduce the idea to them, and how do you help them understand it?

Liesl (12:57) Okay. (12:57) So before they join the course, we ask them if they want to do it. (13:00) And the way we do that is by saying, what do you want to be different about your life with diabetes? (13:05) Mhmm. (13:06) So there will be people who say, well, I haven't been running since I got diagnosed because I'm frightened I'm gonna have a hypo, or I really want to look after my grandchildren, but my my daughter won't let me because I had a really severe hypo.

Liesl (13:19) And so there are things in people's lives that they don't do because they've got diabetes or things that they do. (13:25) So they they may eat the same food every day because they feel safe, and they're anxious about eating something different. (13:34) So they want variety. (13:35) They want a social life back. (13:37) They don't want people to judge them.

Liesl (13:39) So we ask them, what do you want to be different about life with diabetes? (13:42) And then it may be that there's something within a DAFNI course that would be absolutely ideal to help them achieve what they want. (13:48) So we then say, actually, if you want to run safely, come on the Daphne course. (13:53) You can learn all about that, and then you can start running again when you feel safe. (13:58) Mhmm.

Liesl (13:59) And then when they come on the course, the first day is spent talking about carbohydrates. (14:04) So what is carbohydrates? (14:06) What does it do? (14:07) What is type one diabetes? (14:09) And why is carbohydrate important in managing your glucose?

Liesl (14:13) And then they go on to learn about carbohydrate the com the concepts build from very basic concepts to very complex situations over the five days. (14:23) So they start out by identifying what is carbohydrate. (14:27) So they have some food models on the table, and they split them into groups. (14:32) Those that contain carbohydrates, those that don't, and the ones they're not sure about, like burgers and sausages, baked beans, people aren't always sure about. (14:42) And then we talk about those foods so they can understand why some do and don't have carbohydrate in.

Liesl (14:48) And then by the end of the week, they're working out carbohydrate in recipes that they make at home, in their cake recipes or their scone recipes or their curry recipes or whatever it might be, they're able to work out what they're actually going to eat carb wise and how to match that with their insulin. (15:04) So they learn gradually over five days in this building of concepts. (15:08) And I have to say it was the best bit about being a diabetes specialist nurse is watching people's confidence grow and seeing their understanding just expand beyond what they'd expected and watching the penny drop. (15:24) It's it's like, it's a professional drug delivering a Daphne course. (15:28) Mhmm.

Scott Benner (15:29) Do you, find yourself in the beginning did you find yourself, astonished, or did you expect people's level of understanding about what's in their food?

Liesl (15:44) I think the Internet is a wonderful thing, but it's also a dreadful thing because when somebody is newly diagnosed with type one diabetes, they can often be in this state of shock. (15:56) There's a relief that all that sudden weight loss wasn't a life threatening diagnosis like cancer. (16:02) But then there's the realization that they've got this condition they can't have a day off from. (16:07) I can wake up in the morning and decide not to wash my hair, but you can't wake up in the morning and decide not to take your insulin. (16:14) And so sometimes they're like a rabbit caught in the headlights.

Liesl (16:18) And so even though we might give lots of information about carbs at diagnosis, how much actually goes in with the enormity of taking five injections a day and everything else they have to think about, I think it just doesn't stick. (16:30) So then they can look on the Internet, and there's so much conflicting information that I think people don't always know what to go with. (16:38) So when they come on a Daphne course, it's almost a relief that somebody is saying, this is what you need to know. (16:44) You're gonna learn it in a safe environment. (16:47) You can practice things.

Liesl (16:48) You can make mistakes. (16:50) We'll support you. (16:51) We won't judge you, and you are gonna become very much more confident and comfortable with self managing your diabetes in just five days.

Scott Benner (16:59) Yeah. (17:00) What what's the turnaround? (17:01) Like, I'm I'm gonna ask you just to quantify it somehow. (17:06) Do people come in at a confidence like, let's set confidence level between one and ten, 10 being the greatest. (17:11) Where do people come in at mostly, and where do they leave at?

Scott Benner (17:14) Like, what's the what's the build they get usually?

Liesl (17:16) Yeah. (17:17) So we do something called prom data. (17:20) I don't know what you call that in The States. (17:22) It's called person reported outcome measures. (17:24) And so those are questions that we ask people before they do the course, immediately when they finish the course, and then a year later.

Liesl (17:31) And we ask them very specifically how confident they are with insulin dose adjustment, how confident they are with carb counting. (17:39) And most people before the course for both of those will come in if one is not confident at all and 10 is supremely confident, most course participants will come in with a score of one to five Mhmm. (17:53) Before the course. (17:54) When the course is finished, they'll mostly be scoring between seven and ten immediately after the course. (18:01) And for insulin dose adjustment, it's still a majority seven to 10 score in a year's time.

Liesl (18:07) And for carbs, there's a slight dip maybe between six and ten at one year.

Scott Benner (18:13) Is there So

Liesl (18:14) it's huge.

Scott Benner (18:15) It's huge. (18:15) Yeah. (18:16) Is there a a wide difference between people's backgrounds in education, or do you find that there are certain people who don't need or or come for the course and there's groups that more so do, or is it across the spectrum?

Liesl (18:31) I think, on Daphne, we talk about health literacy. (18:34) So you can be very well educated. (18:37) You can have gone through university and got a degree, a master's, a PhD, but you may struggle with health literacy, which is applying the numbers to yourself. (18:46) Mhmm. (18:46) You might have left school at 14 with no qualifications but really strong maths ability, and you'll fly with it.

Liesl (18:54) So there's no I wouldn't have any preconceptions around whether somebody would manage to self manage their diabetes based on their education level because in my experience, that's not a good predictor.

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Liesl (21:08) No. (21:08) Not at all.

Scott Benner (21:09) Gotcha. (21:11) Do you find that there's one part is there an moment in the five days? (21:19) Like, I know you said it's it starts basic and it builds the more complex, but is there something that gets said that you you just see people's faces light up? (21:26) Like, is there a takeaway, a tagline you use, something you say over and over again that makes you can see it light people's eyes up?

Liesl (21:36) I think one of the main things which they learn on the first day is that they couldn't have done anything to avoid it. (21:42) And that's a big moment. (21:44) Because in the media, certainly in The UK, there's a lot of judgment around type about around diabetes, and there's a lot of judgment based on people's weight or lifestyle. (21:54) And whether you've got type one or type two, that stigma seems to apply. (21:58) And so often people have been told, well, surely if you just act differently, you wouldn't have diabetes.

Liesl (22:05) So the realization on the first morning of the first day that they were going to get it and there was nothing they could do to avoid it Mhmm. (22:12) It's not their fault. (22:13) That relinquishing of guilt for a lot of people is really powerful, and that happens within the first couple of hours of the course Yeah. (22:20) Starting.

Scott Benner (22:21) It is I mean, listen. (22:24) I've never been to England, so I'm guessing and basically going off of things I've seen on television. (22:30) But but are you are you guys, overall, societally not a warm fuzzy group who talks about their illnesses together a lot? (22:40) Or like, I'm wondering if this is also valuable because you get into a room with other people who know your story and and are living it as well.

Liesl (22:47) Oh, I think you've just hit the nail on the head. (22:50) I can walk through a waiting room in a hospital, whether it's a diabetes diabetes waiting room or people with broken legs, and you won't find people sitting there easily sharing their stories necessarily. (23:02) So when people come on a Daphne course, it's often the first time they've had a proper conversation with somebody else who lives with type one diabetes. (23:08) Mhmm. (23:09) And often they're quite reserved on the first day because everyone thinks they're going to be the worst in the room at managing diabetes, and then they realize that they're all as good as each other or they're all as bad as each other.

Liesl (23:23) And they all share the same problems, the same anxieties, the same fears.

Scott Benner (23:27) Yeah.

Liesl (23:28) And so I think that leveling of the playing field when you have a bunch of people together is the is the most powerful thing. (23:34) And I don't think we'll ever really know with Daphne. (23:37) Is it the Daphne principles around carb counting and dose adjustment, or is it the peer support? (23:42) And if you took the peer support away, would people achieve so much? (23:46) I don't know.

Liesl (23:46) I wouldn't like to have that guess.

Scott Benner (23:48) I'll tell you that, so the podcast, you know, in its entirety, it's it's been around for almost eleven full years now. (23:58) And at the end of this year, it'll be the end of the eleventh year. (24:03) And I'm gonna start right back up again, year 12 on, you know, January 1. (24:07) But the of the 20,000,000 total downloads that have happened over the last eleven years, a a number of million of them happened this year in 2025.

Liesl (24:16) Mhmm.

Scott Benner (24:17) And I I just looked and by, you know, by country, and I don't think this is surprising. (24:23) Obviously, it is most popular in The United States. (24:25) Canada's second. (24:26) The UK's third. (24:28) And there there are a significant number of downloads in The United Kingdom.

Scott Benner (24:32) From there, for people interested, it goes Australia, India, Germany, Ireland, Sweden, New Zealand, and China. (24:38) Those are the top I think those are the top 10. (24:42) I and I and now I'm sitting here wondering if I did a deep dive on people's national ability, I'll say, to be open and and and to talk to other people about stuff like this. (24:54) I do think I I don't think I'm incorrect to say that Americans are probably uniquely seen as really willing to talk about things that other people don't talk about. (25:03) Is that true, do think?

Scott Benner (25:04) Mhmm. (25:05) Do you do you think of us that way? (25:07) Well,

Liesl (25:09) my, my niece is half American, and and she's very happy to talk about almost anything. (25:15) So I think just going on that personal experience, I would say yes, and I adore her for it.

Scott Benner (25:20) Yeah. (25:21) I I had there's I won't tell you now because it has nothing to do with anything we're talking about, but I found myself a few weeks ago in the middle of a conversation that I did not think would go a certain way and somebody brought something up. (25:32) And the next thing you know, was a half an hour later, and I I got done and I thought, why do I share any of that? (25:38) Like like like, how did how did that even and I and it just would have made more sense for me not to. (25:43) But, you know so and I've seen, like, on this side of it, Lisa, I don't know how much of, like, I of the little ecosystem I've built here you're aware of, but I have a a Facebook group that has it's coming up on 80,000 members, and, it's incredibly active.

Scott Benner (26:00) Right? (26:00) Like and I mean, average one twenty to 160 posts every day. (26:08) Like, eight eight thousand comments, likes. (26:10) Like, there's at any point in time in any day, there's at least 40,000 of those people are active. (26:16) And I was not I haven't I haven't talked about this in a little bit, but, like, I didn't start that Facebook group on purpose.

Scott Benner (26:24) Like, the the listeners sort of made me. (26:27) And it was not it wasn't a thing that I really was interested in doing. (26:30) Meaning, I I I I don't not like the community aspect of it. (26:34) Like, I was scared of the idea of, like, well, I I don't wanna be in charge of a Facebook group. (26:37) That seemed like a problem to me.

Scott Benner (26:39) And it hasn't been. (26:40) It's been lovely overall. (26:42) But it it really has given me the opportunity to just sit back and watch what happens when people get to meet somebody else or get to ask a question that there's nowhere else to ask it of or to say something that they would have felt judged by in one place but but don't get to feel judged by there. (27:00) It's a a revolution for them. (27:03) Really, really truly is.

Liesl (27:05) I think and I think as Brits, we have a reputation for being quite reserved. (27:10) But I think with diabetes, there's so much stigma around it that people are afraid to talk about it because they're afraid that if they say anything, they're going to be judged. (27:18) Mhmm. (27:19) And so when you get a group of people in a room together and say, you're free to talk, and they've got type one diabetes, then they're fairly shy to start with, but not for very long.

Scott Benner (27:29) Yeah. (27:30) Happens pretty quickly.

Liesl (27:31) And in fact, I think that's I my second ever Daphne course was way back in 2006, 2007. (27:38) And the people that were on that Daphne course still get together every couple of months on a Saturday for lunch.

Scott Benner (27:46) No kidding.

Liesl (27:46) So we're now talking nineteen years later. (27:49) When I stepped away from being a diabetes specialist nurse and I joined the Daphne organization full time, they reached out to me and said, now you're not our nurse. (27:58) Would you like to come to lunch with us? (28:00) So I get to have lunch with them whenever I can several times a year on a Saturday. (28:04) And they might talk diabetes for a few minutes, but they talk about life like any other bunch of friends.

Liesl (28:09) Yeah. (28:09) But they have that irreplaceable, innate understanding of each other without saying a word of what it is like to navigate those life situations with type one diabetes. (28:22) And sometimes I am usually, I am in awe of them because they manage all the normal things of life that the rest of us manage, but they manage it while also living with type one diabetes. (28:35) And I don't think you can ever underestimate the effort that that actually takes. (28:40) And I take my hat off to them, and and I adore them.

Scott Benner (28:43) There's something about the way you just described that that made me feel like if if I don't have, you know, if I don't have a thing excuse me one second. (28:55) If I don't have a thing that's that's invisible, but yet I can kinda feel it, like, right, like and it's always with me, then it's then it's always with me. (29:06) And no matter where I am or what I'm doing, I have that feeling and no one else has it. (29:11) And and the way it hit me, like, visually was almost like if you could imagine, like, a thin towel a thin wet towel laid over top of you. (29:17) How uncomfortable that would be, right, if you were just living like that.

Scott Benner (29:21) But nobody else could see it but you, and nobody else could feel it but you. (29:25) But you still had to go to school, go to work, drive a car, go grocery shopping, and you always had that little wet towel over top of you. (29:32) And and somehow when everybody has the towel, it then it disappears. (29:36) It's gone. (29:37) Yeah.

Scott Benner (29:38) Yeah. (29:38) Yeah. (29:39) Yeah. (29:39) Oh, that's awesome. (29:41) I and listen.

Scott Benner (29:41) I it's just a different way to think. (29:43) It's not lost to me. (29:44) I I I do a lot of in person stuff, and I've done more of it in the last couple of years than I have in the past. (29:49) But I've you know, just this year was at a an event with two thousand people who had type one diabetes. (29:55) I you know, it was and I I don't know how to quantify what you've just said, but I know it's true that when they're all together, that that there's a lightness about them that I don't know exists when I see them in other places.

Liesl (30:11) And it's a sense of safety, isn't it? (30:13) They're not gonna be judged. (30:14) I think a few minutes ago, you used a word which is my absolute bugbear of a word and I wish it didn't exist, but there's a word noncompliant. (30:23) Right. (30:24) And that is used in medical terms to describe people with diabetes, particularly people with type one diabetes.

Liesl (30:32) So if somebody comes to a clinic and they see a health care professional and they've not been carb counting very much, they might be labeled as being noncompliant. (30:41) But actually, if that health care professional was to listen to them and find that they've just had to move house or they've just had a bereavement or they've got a sick child or they're working as a carer, they do shift work, and how difficult it is to be a carb counter and manage type one diabetes in those normal but frenetic situations. (31:02) If you understood that, you'd never label somebody as noncompliant. (31:06) And one of the things that we ask our Daphne educator trainees and our Daphne doctor trainees to do is to count carbohydrate in their day to day life for five days in a row. (31:18) Not because we want them to be perfect, but because we want them to have some shared experience with the people that they're supporting who live with diabetes all the time.

Liesl (31:28) Yeah. (31:28) And the number of doctor trainees or educator trainees who manage to do that completely 100% for five days is really small. (31:38) And that's not a criticism. (31:40) It's just a reflection of Well life.

Scott Benner (31:43) Yeah. (31:43) Lisa.

Liesl (31:43) Impact it has on people's managing ability.

Scott Benner (31:46) Isn't it true that those people were noncompliant with the task? (31:50) Right? (31:50) You asked them to count cards for five days in a row. (31:52) They became noncompliant. (31:53) Yeah.

Scott Benner (31:54) And and Yeah. (31:55) I listen. (31:55) I use that I use that word in the same way you you use it. (31:59) I I hope you could hear the underpinnings when I was speaking about it. (32:01) But Yeah.

Scott Benner (32:02) I don't think anyone I I've been doing this a very long time. (32:06) Okay? (32:07) And, by the time this year ends, I'll probably have had 2,000 separate conversations with 2,000 different people. (32:15) And I will have probably 300 more next year and and, you know, if everything keeps going the way it's been going, I probably have two or 300 more for the next coming years. (32:25) I I I hope really by the time I'm done this to have had 3,000 or more, maybe 4,000 conversations with people with diabetes.

Scott Benner (32:32) And I don't think any of them, no matter their situation or their outcomes, I don't think I'd be comfortable pinning noncompliant on any of them.

Liesl (32:44) Gosh. (32:45) No.

Scott Benner (32:45) Right? (32:46) No. (32:46) I think it's just life is hard, and and being, you know, a body system is hard, and it's unrelenting. (32:55) It doesn't stop. (32:56) It's not you know, it's so easy to say, like, you know, Christmas, Easter, 02:00 in the morning, doesn't matter.

Scott Benner (33:03) You still have type one diabetes. (33:05) And and Exactly. (33:06) You know, and it's just the peep those people have to make those people have to make a decision between their mental health and their physical health, which is unfair. (33:16) Like, right there's it that shouldn't there should be no situation where I say to you, you have to make a decision right now. (33:23) We're gonna make it again 20 times today.

Scott Benner (33:26) And you have to air on the side of making yourself crazy or making yourself physically sick every time. (33:33) And there's no win. (33:34) You can't win. (33:35) There's some people I I'll take that back. (33:37) There are some people who have such a specific personality that the taking care of the diabetes scratches an itch for their, like, type a personality.

Scott Benner (33:47) Does that make sense?

Liesl (33:48) Yeah.

Scott Benner (33:48) Yeah.

Liesl (33:49) Yes. (33:49) It does.

Scott Benner (33:49) Those are the perfect people to have diabetes. (33:51) And, like like, because they they can treat the management as, a reward system for themselves. (33:58) And I see it work for them incredibly well. (34:01) But everyone else is going to be on this very slow swinging pendulum that's going from center to left and center to right, and they are just, what's that thing? (34:12) We you ever see those people on the pole?

Scott Benner (34:14) They go up on a top of a real tall pole, and they just, like, they go back and forth and keep it from falling. (34:18) Do you know what I'm talking? (34:19) It's like a circus trick. (34:20) Right?

Liesl (34:20) I do.

Scott Benner (34:21) That's what those decisions are like. (34:23) Like, I can't fall one way, and I can't fall the other way, and I can't get the damn thing to stay steady. (34:28) So I just have to decide, like, what side do I give this to so that I don't either lose my shit or lose my sight. (34:36) And, that's not a and and when that's your situation, anyone who would understand that situation fully and then call being perfect is an asshole. (34:48) And anybody and anybody who would do it without understanding, it is just misinformed.

Liesl (34:52) Yeah. (34:53) And I think I I think the other thing we've to be careful of is even people who you I think you said type a personality, they, you know, they're the people to get it because they have a specific personality to manage it. (35:03) But I still think we have to be fully aware of diabetes burnout. (35:07) And now with the advance of technology, so most people with type one diabetes in The UK or in England now have got CGMs. (35:17) And that's brilliant.

Liesl (35:18) However, there's a risk of tech burnout, and sometimes they give you too much information, and that can be overwhelming. (35:25) And as a health care professional and as a human being, I need to understand and be mindful of that. (35:33) But, also, I think the one thing that tech has done is it's made type one diabetes visible, which it never was before. (35:40) So especially in the summer, you see somebody at the pool or someone at the beach or somebody out walking in a sleeveless top, and you see their CGM, or you might see their pump on their arm. (35:51) And so it's it's a bit like spotting a when you see people with type one diabetes and they meet each other and you can see they're looking and thinking, do I say anything or do I not?

Liesl (36:02) And I think, oh, do I go up to them and say, well done. (36:05) You're doing a blinder because I know they've got type one diabetes, or do I not because they might not want me to draw attention to it? (36:11) Yeah. (36:11) So it's making type one diabetes visible, which it never was before.

Scott Benner (36:15) We need a Jeep wave. (36:16) That's probably not something you know about. (36:18) But everyone who drives Jeeps in

Liesl (36:22) That's what we need. (36:23) Yeah. (36:23) Need a type we need a type one wave.

Scott Benner (36:25) We need a type one wave. (36:26) Yeah. (36:27) That way, you don't have to be right up some on somebody, but you can still give them a nod, you you know, and they'll and they'll know where it's coming from. (36:33) You you said two things I wanna go back to. (36:36) Type a thing.

Scott Benner (36:38) I again, I I not that I think I was taken that way, but, like, I'm not saying it's awesome for those people. (36:43) I'm just saying they're more perfectly suited for it. (36:45) But they should still be said, they are still giving an amount of effort and time and focus to something that nobody wants to be focusing on. (36:54) It's still unfair to them. (36:56) They just have Yeah.

Scott Benner (36:57) You know, they just their outcomes seem to work out a little better sometimes. (37:00) And maybe they don't go as bonkers about it because it it leans into whatever their, you know, whatever their wiring loves for them. (37:09) About the tech stuff, you know, it I take your point. (37:15) I really do about the beeping and the buzzing and etcetera. (37:19) But I'm really hoping that gosh.

Scott Benner (37:22) I'm really hoping that in a reasonable amount of time that the the trade offs are still I mean, I I believe now the trade offs are still valuable. (37:31) But I think in a reasonable amount of time, the it might get easier and easier again. (37:36) Like, hopefully, this technology will continue to grow. (37:38) I'm I'm I talk a lot about on here that, you know, I like that there are a number of different companies. (37:46) I like that they are aggressively trying to make their algorithms, more accurate and, you know, give them lower targets because it keeps it keeps those companies trying.

Scott Benner (37:58) You you know? (37:59) Like, I think

Liesl (37:59) Yeah.

Scott Benner (37:59) I I think when you saw, you know, the back in the day when there was one big pump company, you know, I'll tell you that I think they innovated and then they kinda sat back and were like, oh, we did it. (38:12) Here's the thing. (38:13) We gave it to you.

Liesl (38:14) Yeah.

Scott Benner (38:14) Right? (38:15) And I just, by the way, interviewed the CEO of that of that, company and and and put it to her. (38:22) I I was like, the what happened to you guys? (38:24) Like, it feels like you made the thing and then spent so much time selling it, you stopped worrying about whether it could get better again. (38:30) And she was very candid and said, yeah.

Scott Benner (38:33) I think that happens to a lot of businesses, and I think that happened to us too. (38:36) And and so that's not gonna happen again now because now you have No. (38:41) Medtronic and Tandem and Omnipod and Yeah. (38:44) You know, and now Twist and iLET. (38:46) There are more and more companies coming.

Scott Benner (38:48) If they wanna stay alive and make their money

Liesl (38:51) Yeah.

Scott Benner (38:51) They gotta make the thing better. (38:52) I think there's that's nothing but good news for people with diabetes.

Liesl (38:55) Yeah. (38:56) And that well, and it's similar with us in Daphne. (38:58) We're not we're not tech manufacturers, but we are developers of education for people with diabetes. (39:04) So Mhmm. (39:04) We haven't just got the Daphne course for people that use multiple daily injections.

Liesl (39:08) We've got the pump Daphne course for people who use a pump. (39:11) We've got the closed loop essentials course for people who are gonna be going onto a hybrid closed loop so that they've got an understanding of what it can do and what its limitations are. (39:21) So they don't so they go into it with realistic expectations and a confidence that they'll be able to manage it. (39:27) And we've just this year, we launched a course for people with type two diabetes who use multiple daily injections, And that's a very different focus. (39:35) That's about increasing their insulin sensitivity, decreasing their insulin resistance, and simple activities they can choose on a daily basis that is gonna help them with that.

Liesl (39:47) So rather than being stigmatized, judged, focusing on the fact that, oh, type two diabetes is always somebody who's overweight, which is not the case, understanding there's so many other reasons why somebody has type two diabetes. (40:03) And so we're trying to evolve to suit diabetes in the twenty first century rather than just sticking with most people in this country are still on multiple daily injections if they have type one diabetes.

Scott Benner (40:15) Sure.

Liesl (40:15) There's a big move to get people on closed loops in England, and there's a big move to get people on pumps. (40:20) We've got most of our people with type one have now got CGMs, but there's still a majority of people with type one in this country on multiple daily injections, and so that education is absolutely crucial.

Scott Benner (40:31) Mhmm. (40:32) You know, it's funny as you're talking, it occurs to me that you Daphne knows it works. (40:37) Right? (40:38) But it still has to innovate and continue if it wants to keep going because things can get stale and stagnant and die even when they're valuable. (40:45) Yeah.

Scott Benner (40:45) And I I it's funny how this is all gonna tie together because that happened to the pump company. (40:49) Right? (40:50) And it it you're they didn't defend against it, and now they're making they're making their comeback. (40:56) And you guys have the same thing. (40:58) Like, you know this thing you're doing works, but you still have to get it out there.

Scott Benner (41:01) You have to find people. (41:02) You gotta put it in their hands. (41:03) You gotta make sure they understand it so they go tell somebody else about it. (41:07) And not dissimilar, I'm telling you, that's what I have to do. (41:12) Like, there's Yeah.

Scott Benner (41:13) There's a value and this is gonna sound crazy, but, like, to some people. (41:18) But I know the I know how valuable the podcast is. (41:20) I get a lot of feedback. (41:21) Right?

Liesl (41:21) Yeah.

Scott Benner (41:22) And Yeah. (41:23) But just like I I I always say, like, I don't know what the what the old timey, like, British version of this is, but, like, if if things didn't need to be new all the time, then we'd all just be still watching MASH because that was a really good TV show, and why did they have to make another one? (41:36) Right? (41:37) And Right. (41:38) Yeah.

Scott Benner (41:38) So, you know, so why do you have to keep innovating and being modern and being in people's faces so that they're aware that something's there and happening that they should be looking at? (41:47) It's because that's how people's minds work. (41:49) So, like, I am constantly being forced to try to find new ways to have conversations or to say something to continue to help people. (41:58) And the only way I can accomplish that like, the only reason I can put that much time and effort into it is because this podcast also takes ads and it pays my bills. (42:07) And if it if it didn't, I wouldn't I I would go, well, I made the thing.

Scott Benner (42:12) Here it is. (42:13) And I can't keep going because I gotta go I gotta go find a way to turn my power back on. (42:18) Right? (42:19) And you guys ahead and take it, and then it would just die. (42:21) Would wither on the vine.

Scott Benner (42:22) It would it would be gone already. (42:24) Right. (42:24) Right. (42:24) So there's

Liesl (42:25) But I

Scott Benner (42:25) Go ahead.

Liesl (42:26) No. (42:27) I was gonna say, so a hundred and two years ago, I had a great aunt who was nursing in Liverpool, and I have her old notebooks. (42:34) And she has one side of paper on diabetes, and it's a diet to keep people alive with newly diagnosed diabetes. (42:44) And it starts off they can have 50 calories to eat on the first day, 75 on the second. (42:50) And I think over the course of two weeks, it goes up to 250 calories in the day, and then it goes back to 50.

Liesl (42:57) So she would have been looking after people and nursing them to their death when insulin suddenly appeared. (43:03) And a doctor said to her, give this injection to the child because this will save the child's life. (43:09) And so insulin, what was nineteen twenty two, twenty three when insulin became widely available. (43:14) So we went from having a fatal condition to something that people could live with. (43:19) And then in the nineties, I looked after somebody who'd had diabetes for seventy years.

Liesl (43:24) So he'd been diagnosed just at that time when insulin was made available. (43:29) Mhmm. (43:30) And I think he had lived all of those years measuring and weighing his bread and having so many grams of carbohydrate for breakfast, midmorning, lunch, midafternoon, evening, and going to bed. (43:44) And then suddenly, urine testing came in for him in the sixties and seventies, and that was an eye opener to him. (43:51) He could see that he had glucose in his urine.

Liesl (43:54) And then I was a student nurse in the late eighties when finger pricking came in on the wards. (44:00) That was just mind blowing. (44:02) We could still took three minutes to get a glucose reading, but, you know, it was still innovative and it was amazing. (44:07) Mhmm. (44:08) And then when I became a diabetes specialist nurse, that was when blood glucose meters were available to people with type one diabetes and particularly the pregnant women who had type one.

Liesl (44:19) And that was a big innovation, and that was twenty five, twenty six years ago. (44:24) So to think in the last twenty five years, we've gone to pumps and CGMs, rapid acting analogue insulins, ultra long acting basal insulins. (44:33) We've we've seen so much develop in twenty five years that if DAFNI as an organization doesn't keep up with that, then we're not providing what people with type one diabetes need.

Scott Benner (44:44) Yeah.

Liesl (44:45) And we're not here for shareholders. (44:47) We're not here to make money. (44:48) We're here so that a person that we've never met who has type one diabetes has a better quality of life, better psychological health, better long term health, and better confidence day to day with their type one diabetes. (45:01) And those are the people I'm thinking about when I'm doing my job is how is this going to impact them? (45:07) Because if it's not gonna have a positive impact, I need to do it differently.

Scott Benner (45:11) Yeah. (45:11) And it shouldn't be lost that that effort happening over and over again day after day is what what drags you into the next part. (45:19) Right? (45:19) Because there will be a time. (45:21) I am confident saying based on just the story that you just told, I'm confident saying that there will be a time that people will look back on 2025 and say, oh my gosh.

Scott Benner (45:29) Those algorithms were nice. (45:31) I mean, I see how it changed people's lives, but look what we have now. (45:34) You you you know? (45:35) And that's look how many times that's happened just since the the twenties. (45:40) In in a hundred and you know, what is that?

Scott Benner (45:42) A hundred and five years, maybe not even quite. (45:44) Like, look how many times you said, and then this came along, and then this came along, and then this came along. (45:50) Like and I realized at some point, it feels like, well, it'll stop, but I don't know that. (45:57) I you don't you have no idea how someone's gonna apply AI learning to diabetes over the next five or ten years. (46:05) And, you know I yeah.

Scott Benner (46:07) Yeah. (46:07) And my daughter already can may I? (46:10) Can you hold your thought one second? (46:11) Would you mind?

Liesl (46:11) Yeah.

Scott Benner (46:12) I I just got done speaking with a friend of my daughter's yesterday. (46:16) So they're the same age. (46:17) Her friend has had type one for ten years. (46:20) And she asked me, I just got a CGM last month. (46:23) This is the first time she's had a CGM.

Liesl (46:25) Wow.

Scott Benner (46:26) Do you think I should get a pump? (46:28) And and what would a pump do for me? (46:30) And I found myself telling her the stuff I say all the time. (46:33) I said, well, you know, with a you know, first of all, you don't wanna disregard somebody's care. (46:38) She's doing a very good job.

Scott Benner (46:39) I'm like, there's not much that you can't do with, MDI that you can do with a pump that's different. (46:44) Here are the differences. (46:45) You can do temporary basal increases and decreases. (46:48) Yeah. (46:49) You know, you could shut your insulin off.

Scott Benner (46:51) You could, you know, change your ratios very quickly without having to, like, do math again. (46:57) You know, blah blah blah. (46:58) But I said, here's what I really think. (47:00) This episode was too good to cut anything out of, but too long to make just one episode. (47:05) So this is part one.

Scott Benner (47:06) Make sure you go find part two right now. (47:08) It's gonna be the next episode in your feed. (47:18) Touched by Type one sponsored this episode of the Juice Box podcast. (47:22) Check them out at touchedbytype1.org on Instagram and Facebook. (47:27) Give them a follow.

Scott Benner (47:28) Go check out what they're doing. (47:29) They are helping people with type one diabetes in ways you just can't imagine. (47:34) The podcast you just enjoyed was sponsored by Tandem Diabetes Care. (47:38) Learn more about Tandem's newest automated insulin delivery system, Tandem Mobi with Control IQ plus technology at tandemdiabetes.com/juicebox. (47:48) There are links in the show notes and links at juiceboxpodcast.com.

Scott Benner (47:52) The podcast episode that you just enjoyed was sponsored by Eversense CGM. (47:57) They make the Eversense three sixty five. (48:00) That thing lasts a whole year. (48:02) One insertion. (48:03) Every year?

Scott Benner (48:04) Come on. (48:05) You probably feel like I'm messing with you, but I'm not. (48:07) Ever since cgm.com/juicebox. (48:12) 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. (48:25) Each episode will dive into the setup, features, and real world usage tips that can transform your daily type one diabetes management.

Scott Benner (48:32) We cut through the jargon, share personal experiences, and show you how these algorithms can simplify and streamline your care. (48:38) If you're curious about automated insulin pumping, go find the algorithm pumping series in the Juice Box podcast. (48:44) Easiest way, juiceboxpodcast.com, and go up into the menu. (48:48) Click on series, and it'll be right there. (48:59) Hey, kids.

Scott Benner (48:59) Listen up. (49:00) You've made it to the end of the podcast. (49:02) You must have enjoyed it. (49:03) You know what else you might enjoy? (49:04) The private Facebook group for the Juice Box podcast.

Scott Benner (49:08) I know you're thinking, ugh, Facebook, Scott, please. (49:11) But no. (49:11) Beautiful group, wonderful people, a fantastic community. (49:15) Juice Box podcast, type one diabetes on Facebook. (49:18) Of course, if you have type two, are you touched by diabetes in any way?

Scott Benner (49:22) You're absolutely welcome. (49:24) It's a private group, so you'll have to answer a couple of questions before you come in. (49:27) We'll make sure you're not a bot or an evil doer, then you're on your way. (49:31) You'll be part of the family. (49:33) Thank you so much for listening.

Scott Benner (49:35) I'll be back very soon with another episode of the Juice Box podcast. (49:38) If you're not already subscribed or following the podcast in your favorite audio app, like Spotify or Apple Podcasts, please do that now. (49:46) Seriously, just to hit follow or subscribe will really help the show. (49:50) If you go a little further in Apple Podcasts and set it up so that it downloads all new episodes, I'll be your best friend. (49:57) And if you leave a five star review, oh, I'll probably send you a Christmas card.

Scott Benner (50:02) Would you like a Christmas card?

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