#1622 Thick Thighs Save Lives - Part 2

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Laura, 55, was diagnosed with type 1 in March 2024 after months of missed signs, DKA, septic shock, and necrotizing fasciitis. Now on a GLP, she’s honeymooning without insulin. Part 2 of 2

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

Scott Benner 0:00
Friends, we're all back together for the next episode of The Juicebox podcast.

Speaker 1 0:14
Hi Scott. My name is Laura, and I was diagnosed with type one diabetes at the age of 54 in March of 24 which I didn't even know was a thing. Adelon said, type one until I was diagnosed with it. Who knew?

Scott Benner 0:31
This is part two of a two part episode. Go look at the title. If you don't recognize it. You haven't heard part one yet. It's probably the episode right before this in your podcast player. If this is your first time listening to the Juicebox podcast and you'd like to hear more, download Apple podcasts or Spotify, really, any audio app at all, look for the Juicebox podcast and follow or subscribe. We put out new content every day that you'll enjoy. Want to learn more about your diabetes management, go to Juicebox podcast.com. Up in the menu and look for bold Beginnings The Diabetes Pro Tip series and much more. This podcast is full of collections and series of information that will help you to live better with insulin. Nothing you hear on the Juicebox podcast should be considered advice medical or otherwise, always consult a physician before making any changes to your health care plan.

A huge thanks to my longest sponsor, Omnipod. Check out the Omnipod five now with my link, omnipod.com/juicebox you may be eligible for a free starter kit, a free Omnipod five starter kit at my link, go check it out. Omnipod.com/juicebox Terms and Conditions apply. Full terms and conditions can be found at omnipod.com/juicebox us med.com/juicebox you can get your diabetes supplies from the same place that we do. And I'm talking about Dexcom, libre, Omnipod, tandem and so much more, usmed.com/juicebox, or call 888-721-1514, today's episode of The Juicebox podcast is sponsored by the ever since 365 the one year where CGM that's one insertion a year. That's it. And here's a little bonus for you. How about there's no limit on how many friends and family you can share your data with with the ever since now app, no limits ever since. Tell me about your integrative medicine experience, though.

Speaker 1 2:41
Oh goodness, Scott, if somebody would have just told me that what I was going through was perimenopause, menopause, I would have saved a whole lot of money and felt better sooner. What I knew was I was having trouble sleeping. I was sleeping only two to three hours at night. I was having terrible stomach pains that would wake me up in the middle of night, and bad acid reflux, brain fuzz to the point where, Scott, I couldn't remember the make and model of my motorcycle. Interesting, like

Scott Benner 3:12
if somebody asked you, you just couldn't come by the way, what's the make and model if you're in a

Speaker 1 3:17
motorcycle at the time, it was a buoy blast. My current one is a, Oh, geez. And I'm for, am I forgetting it now? It's a V rod muscle. Oh,

Scott Benner 3:29
wow. I used to write a GSX r7 50. Nice. Yeah, go ahead. I'm sorry. So your brain fog, you're having all the classic perimenopause symptoms,

Speaker 1 3:38
yeah, and, and weight gain, and so my gynecologist said, Oh, that's normal. That's all he said. That's normal. Awesome.

Scott Benner 3:49
What does that mean? And how long is this fan gonna be pointed at me while I'm sleeping?

Speaker 1 3:54
Yeah. And if you would have just said that's normal because of this, and this, and here's what we can do about it, would have changed everything. Yeah, so I went to so many doctors. I don't feel right. I'm exhausted, I can't think clearly. So I finally, I don't even remember how I heard about integrative medicine, but I started looking into that and found a practitioner. It's about a not quite an hour drive from me. I started seeing her. She only took cash, by the way, she was a former ER doctor, and decided this was kind of her retirement next stage job. She had lots and lots of supplements to sell. Did blood work once a quarter, and when I finally stopped going to her, it was my prescription for thyroid was running out. It needed to be renewed, and I had three days left in my package with her, and she wouldn't renew it. Renew. My my prescription, unless she knew I was going to re up with her. Okay, that's it. I've spent so much money I don't feel any better. I'm not doing this anymore.

Scott Benner 5:12
Yeah, I'm gonna tell you that I've seen a number of different doctors over the years trying to figure out what was going on with people in my family. And I've used two different integrative medicine doctors. One of them is awesome. She's been on the show Dr Benito, who came on in Episode 413 to talk about thyroid stuff. She remains maybe the I'm drawn to hug her every time I see her, just to say thank you, right? Like she's like, that meaningful. And there was another one who you walk in the office, and there's just a table full of supplements that she's happy to sell you from her online store. Yes. And you know, like, well, we should try this and this and this. And I'm like, I think you're full of like, I really do. Like, I'm not, I don't think supplements aren't I take some supplements too. There's things that I've needed that are helpful. There's people in the house that are using it, but like, they start with, like, well, there's this, and the next thing is just 10 things, and you're $500 deep in this. And, like, have you tried fish oil? Don't, don't just take fish oil. Take this exact one. It has to be refrigerated. It's the best one. I'm like, I don't know. Like, I took your fish oil for like, six weeks. Nothing changed. Like, I don't know. Like, I kept going for the second month, nothing changed. I don't I don't know what I'm doing here. And when you ask them to quantify it, it's never quite a quantification that makes sense. Is was with my experience with this one person. So sounds like something similar happened to you? Yes, now I have to say, I have to ask you, did she try to sell you a water filter for your house? She did not okay, that's the one that got me. I was like, A what now?

Speaker 1 6:47
No, I, I have to say, though she was the first time I felt heard. It was, it was the first time it felt like a doctor was really listening, and they had an answer and a path. She even had this really neat laminated sheet showing how different hormones react with each other and how the body processes it. So she didn't just say it's normal. She said, This is what normal looks like, and here are the things that we're going to do to try to bring you back

Scott Benner 7:14
into balance. And that was valuable, but it was not the sales. I didn't feel better, yeah, but you didn't Well, but you okay. So feeling heard was valuable to you, even though it didn't help you feel

Speaker 1 7:25
any better. That's interesting. Those two things are connected. Yeah,

Scott Benner 7:30
I have to say, I feel lucky with Dr Benito, like she has a great balance of thoughtful. She's willing to look into things, she's accessible, and she's not just trying to make a bunch of money. She seems to just really genuinely care about people, and which is awesome, but I don't know how you find that that's that's just dumb luck. It is just dumb luck that we ran into her, to be perfectly honest. Yeah, gotcha.

Speaker 1 7:53
We talked about judgy providers, but I also want to acknowledge that I've got some really good people on my team now I see pain management, and they've been amazing. They're very compassionate. And, yeah, not just saying, Okay, you're, you're this old, you're gonna hurt. Well, let's, let's actually treat the pain. Yeah, and I'm doing

Scott Benner 8:15
better. It's nice to know that this is maybe normal, but do I have to suffer with it? Is there something we can do? And exactly, yeah, not just told you, like, right? Well, with the 30 pounds all the way back, you're like, Oh, you lost 30 pounds. That's great. Get out of here, right? Yeah, but I have a lot of other issues. I don't know. We're not talking about those today. You got to go,

Speaker 1 8:33
I don't know how that happens, quite large. So my good, my endo is good, and I have a rheumatologist, because, as we know, autoimmune they tend to have friends. Yeah. So we're still trying to work out exactly what's going on, because I'm new to that process, but I am happy to say that while I've had some very judgy providers, I've got some really good, caring, compassionate ones.

Scott Benner 8:58
Now, okay, what are the other things that you're working through that you're trying to figure out, like, what are some of the things you're suffering with that you don't have quite hammered

Speaker 1 9:07
out yet? It's a lot of available personal energy and lots of aches and pains that are not related to the back fusion. So an example is, if I go to an event, which I've gone to a couple events recently, it'll take me a good three to five days to feel like I can get back to my normal routine. Okay, I just don't have the personal energy

Scott Benner 9:33
I have four fingers up. Ready? Have you checked your thyroid? Yes, your TSH is, you know what

Speaker 1 9:41
it is. It is on the low normal end. I just had it checked last week.

Scott Benner 9:46
Okay, under two, Yes, awesome. Do you have any thyroid symptoms? You do

Speaker 1 9:52
dry skin, dry, dry skin, brittle hair, fatigue, fatigue,

Scott Benner 9:57
okay. Have you had a full iron panel? Do you know if. You're anemic.

Speaker 1 10:01
I am not anemic. In fact, I have too much iron. Okay, have you had covid? I did before it had a name. Do

Scott Benner 10:11
you have any I do you think you might have long covid? It's possible. Yeah, the perimenopause. There are some things you could take to, like, kind of help you with your your energy for that as well. Yeah, yeah. Did your hippie doctor with you? Oh, full on your menopause now? Yes, awesome. I mean, those are my thoughts around that, like, I don't know. And did any of this get better with the GLP?

Speaker 1 10:33
Oh, that's a really good question, because I have not, I've not put thought to that. So I was so focused on GLP with the reducing inflammation and supporting my my diabetes, that I don't know I'd have to think about

Scott Benner 10:47
it. I'm only bringing it up because my, I think my wife, firmly believes that the GLP helped with her perimenopause and, Most assuredly, with her long covid symptoms, like probably just inflammation type stuff. If you go out on a Saturday and you're, like, really active, do you have to rest the next day? Yes, yeah, I don't know. It's tough, because all this stuff sounds like nebulous, you know, long covid perimenopause, like, like, you know, how do you, like, put your finger on exactly what it is. But I can tell you right now, if I brought my wife up here right now and said, Hey, do you have long covid, she talked for like, an hour and a half, you know, she has, she's researched the hell out of it, done a lot of different things to help herself, and been generally successful with it. I will tell you that. I think I've said this on here before, but she got sick, somehow, I forget she had sick, and she went to the doctor, and the doctor said, stop taking your GLP for a week. She came home and told me that I was like, I wouldn't do that if I was you. And she was like, No, I'm gonna listen to what he said. So she does it. And a week later, she said I should not have stopped taking that GLP. And it was around her like fatigue and pain and stuff like that. So it's interesting. Anyway.

Unknown Speaker 11:59
Okay, now she

Scott Benner 12:00
knows. Yeah, so Laura, the rest of the time is yours. You want to interview me? You thought you said some stuff before we started recording, I said, stop talking. We'll do it while we're recording the podcast, right? So go ahead. I'm here. You want me to introduce myself a little bit? Hi, I'm Scott. I'm 54, years old. I just had a birthday, and I make a podcast called Juicebox. I'm the father of two. My son is 25 my daughter is going to be 21 in a few days. She's had type one diabetes since she was two, and I've been married to Kelly for a long time, like almost 30 years.

Speaker 1 12:34
Oh, happy birthday, and congratulations on your longevity.

Scott Benner 12:38
Oh, thank you. I just believe that she's too tired to throw me out. But right on, she's, you know, I said recently, I was like, I don't have enough energy to sell this sofa. So you get to say, so do you have questions? I have answers. Maybe. Let's see. Why would you settle for changing your CGM every few weeks when you can have 365 days of reliable glucose data. Today's episode is sponsored by the Eversense 365 it is the only CGM with a tiny sensor that lasts a full year sitting comfortably under your skin with no more frequent sensor changes and essentially no compression lows. For one year, you'll get your CGM data in real time on your phone, smartwatch, Android or iOS, even an Apple Watch, predictive high and low alerts let you know where your glucose is headed before it gets there. So there's no surprises, just confidence, and you can instantly share that data with your healthcare provider or your family. You're going to get one year of reliable data without all those sensor changes. That's the ever sense. 365, gentle on your skin, strong for your life. One sensor a year. That gives you one less thing to worry about, head now to ever sense, cgm.com/juicebox, to get started. I used to hate ordering my daughter's diabetes supplies. I never had a good experience, and it was frustrating. But it hasn't been that way for a while, actually, for about three years now, because that's how long we've been using us Med, US med.com/juicebox, or call 88872115, 887211514, us. Med is the number one distributor for FreeStyle Libre systems nationwide. They are the number one specialty distributor for Omnipod dash, the number one fastest growing tandem distributor nationwide, the number one rated distributor in Dexcom customer satisfaction surveys. They have served over 1 million people with diabetes since 1996 and they always provide 90 days worth of supplies and fast and free shipping us med carries everything from insulin pumps and diabetes testing supplies to the latest CGM like the libre three and Dexcom G. Seven, they accept Medicare nationwide, and over 800 private insurers find out why us med has an A plus rating with a better business bureau at us med.com/juicebox, or just call them at 888-721-1514, get started right now, and you'll be getting your supplies the same way we do.

Speaker 1 15:24
A few months ago, you did an Ask Me Anything on Facebook, and the question that I posted for you was, what are you most looking forward to in this new year? But what I really wanted to ask you is, how are you doing you put a lot of time and and your personal into the podcast and the cruise and all of these other things. I listened to your podcast for hours on end in the very beginning, and it's more sporadic now. Sure, we get glimpses of you and your personality, but I just, I just wanted to know, how are you doing, and take an interest in you as a person, and not just a voice of somebody who says and knows really smart things. Okay,

Scott Benner 16:12
well, I'm gonna try to shut off the part of me that makes the podcast and just answer your question. Generally speaking, day to day, I'm good. My health is much better. My energy is much better. I am happy. I mean, there are things about my life that I wish were different, there were things there are things about my relationships that I wish I would have done differently. I wish that, you know, would go differently. But I see all of that as a process, not as like I would not tell you that anything in my life is broken beyond repair. I wouldn't tell you that anything in my life is sad. I just think that, much like when I talk about the different timelines, like I'm like, Oh, if you're gonna Bolus and then 45 minutes later you're hungry again. You try to think of the boluses on different timelines. I think about, like, all of the all of that the same way, my relationship with my children and with my wife, with people who I'm friendly with, like with my health, like, I think about all that as, like, there's a movie screen size, black sheet in front of me, and all the things I care about and that I'm thinking at are existing on different timelines. Some of them are farther along. Some of them are are newer. There are some things I'm just becoming aware of. There are things that I do differently than I used to do, and everything's a work in progress. Does that make sense? It does. It does okay. So that's all happening for me personally. That's all happening with the podcast. It's happening with the online space, with things I'm trying to accomplish for the future. You know, I have texts here from somebody that's like, look, we have to get going on, like the cruise for next year. You know, I've only been off the cruise for three weeks. I've had new experiences in the last couple of weeks, meeting people in person that has changed me. But at the same time, I can't come home and like, be that like, Oh, I'm, you know, trying to be more thoughtful about maybe this podcast is more just about people's stories than it is about, like, the downloads. But the downloads have to happen so that people's stories can keep happening. There's a lot to balance. I mean, I'll, I would tell you that I'm very happy doing this, and at the same time, I can imagine that when it's over, I'll be very happy that it's done. Does

Speaker 1 18:35
that make sense? I hear you, okay,

Scott Benner 18:38
yeah. But day to day, I'm, I'm happy, like, I'm doing well. I like, we're actually going to go on vacation in a couple of weeks, and that will now be, like, a vacation last year and a vacation this year, which I don't think is something I don't think we've done since the kids were little, like, actually going on concurrent vacations year to year. So we're trying to spend more time together, especially as our kids get older and we get older, I am personally worried about, like, I want to get stronger as I get older. Like, that's the thing I want to put more effort into. I have a little medical issue that I probably wouldn't share here, but I should get taken care of that I need to focus on. It's not like anything. It's not like a big deal. I have a friend who was sick recently that I'm worried about, and they just explained to me their their ordeal yesterday. I'm sad to know that that happened to them, and I'm hopeful that they'll be okay. I think they will be. But much like your thing, like, just kind of out of nowhere, just was okay, and then wasn't. And then that makes you feel like, like we all talk about, like, I could get hit by a car at any time, but like you don't think like at any point, a potato could start growing on my thigh, and it might be flesh eating, you know, bacteria. You become more aware of the world and and what may or may not happen, especially as you get older. I like my chameleon, but when I look at him, sometimes I just worry that he's gonna like, outlive my ability to take care of him. But overall, for me personally, the thing I'm trying to do right now is Arden and I are in the middle of, like an, like an uncoupling about diabetes, which is, you know, obviously, was obviously going to come and and is here now, and we are shifting so that she and I are going to just purposefully not talk about diabetes between us, and if something has to be said to her, we're going to shift it to her and my wife, because we've just gotten to this thing. And I'm sure I'm going to go through it on the podcast over years trying to figure it out. But you know, what starts out as, you know, I learned all about this so that I could help you, and it's really valuable. At some point when kids and I've been talking about this for a couple years, it's not a surprise, like, but as kids get older, like, like, it's very natural, right? Like, they want to push away from their parents. And, you know, normally it's over things that are kind of benign, or, you know, like, you know, I'll go out and stay out if I want to. Or, some kids use drinking, right? I'll drink if I want to. I'll smoke weed if I want to. Like, I'll do the thing. I'll grow my hair or cut my hair. I'll do whatever I want. You're not in charge of me, as I noted in today's episode, talking to somebody in an episode called Catholic guilt. Like, you know, when your kid's looking for something to push away from, like, what better than the diabetes? Like, that's a thing they don't want to be doing. It's not their fault. Nobody wants to be talking about it. I certainly don't want to be talking about it. But we've gotten to a point where, you know, Arden's, you know, getting older, and she's asserting herself as she should be, and yet there's still that balance between, like, health and harmony that you're always trying to strike, it's difficult to strike when you know, I want our relationship be harmonious, but you know, and if we were talking about cleaning your room, then I would just say, hey, you know what kids like a sloppy room? It's, but who cares? Like, let that go, but if it's, it doesn't Bolus for a 250 blood sugar, then I can't let that go, like something needs to be said. But there is a moment where it's, it's over, you just can't do that anymore. And Arden and I are going to have a different relationship moving forward. It's been, like, I said, slowly happening over years, but it just, it's gotten to the point where she just came to me and she was like, I just don't want to, like, I don't want to do it like this anymore. And I was like, right on, like, cool. Like, we'll, we'll find a different way to make sure that there's harmony and health for you. And so we set up a different plan, and we're, we're putting it into practice. Nobody's feelings are hurt or nobody's mad. It's just, it's on that timeline. We're just up to that part now. That's it. Like, the one thing I was sad about as we were talking about it, was, she said, You talk about this too much. And I thought, I don't want to be talking about this at all. And then I and I look at our time, and I really, I really looked at it, I really assessed it as best I could. I don't talk about it much at all, but to her, I think she's gotten to the point where almost any conversation about it is too much, so we're just gonna, like, just shift how we do it now. And I'm sure it'll shift again and again and again. And I'm sure my life will keep shifting, and so will everybody else's, until I throw a potato on my thigh and drop dead. I don't know. That's how I am. 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Speaker 1 24:29
it does very thoughtfully and sounds like a very challenging stage of your evolution together.

Scott Benner 24:35
It is, I mean, it is, the whole thing is, right? I tried to be reflective about it. I said to my wife, I was like, what if we would have just picked harmony, you know what I mean, like, what if she would have run around with anyone seeing the eights or the nines, and we would have just said, like, it's okay. Like, you know, like that. I was like, we would just be in a different situation right now. That would be unpleasant. It really brings me back to the. Idea that I think that once you once you interact with another human being, you know what I mean, whether you're married to them or dating them, or you have you're the parents of or you're talking to your parents like, everybody's got a different way of thinking. Everybody's brain is different. The interactions create different experiences. And in the end as a parent, I think no matter what you do, and I really do mean this for everybody to hear, no matter what you decide, the person is going to want the opposite. Like, I just think that's a very human thing, like, we want what we don't have. And for some reason, the last person we listen to is our parents at some point. Like, you know, not for some reason, I think it's pretty obvious why it works that way, right? But so no matter what you decide to do, if you, if you're one of those harmony people, and you're just like, Oh, it's okay, we'll ignore the diabetes, and this will be fine, eventually it's going to come back to bite you in the ass. And if you do the other way, where you're like, oh, let's worry about the health, like, eventually it's going to come back to bite you in the ass. Like, if you pick the middle then someone's going to one day say to you, why didn't you do more of this, or why didn't you do more of that? No matter what you do, someone's going to ask you, why didn't you do something else? And I think that's for every one of us in all walks of life. It's not me telling you I'm having some horrible problem in my life. I'm not. I just am trying to be reflective about it. I think you're all going to get to that point where you're going to say I should have done it differently, but if I would've done it differently, we'd just be in a different situation now that I don't wanna be in. So nothing's perfect, maybe, and accept that, except that's not how your kids are gonna see it until they're older, which is why your mom said, Why do you get older and have kids? You know what I mean, like a lot of truth in all those little isms and sayings, etc, all right, well, you're doing well. Do you have more? Do you listen to podcasts I do? Am I going to tell you which podcast I listen to that's interesting?

Speaker 1 26:57
Yeah. What topics do you? Do you tend to gravitate

Scott Benner 27:01
towards, Okay, fair enough. I listened to a few years ago during covid. I listened to and thoroughly enjoyed the West Wing weekly, which was a West Wing re watch podcast with a guy named Rishi and one of the actors from West Wing, Josh, Josh Molina. Josh Molina, who, by the way, I think, has done good work, but was awesome in Sports Night. If you've never seen sports thing, nevertheless, I thought that was awesome. I during covid. I actually watched it along with the podcast, which was really fun, and it was a well done podcast. I thought, I don't listen too much anymore, but think that Kevin Smith is an awesome podcaster, the director of movies like clerks and Chasing Amy and things like that. I would credit him to some level with this podcast, because he was an indie filmmaker who kind of figured out the internet before the internet, and he had a message board where people could talk to him and talk to each other. He was very active with the people watching his movies. And I think a lot of how I do this reflect is reflective of that, because I saw him build like a real relationship with people like I've met Kevin Smith a number of times, and the last time I saw him, he knew who I was when I got there, like he didn't go, Hey, your name is Scott, and all these things, but he looked me in the face, and he went, Oh, hey, man. And then he said something to me that made me realize that he remembered the last time we spoke. Anyway, he was very connected to the people around him, which I thought was good. I've also seen it be hard on him as he's gotten older. So I'm trying to, I try to be reminiscent of that. I think I've said, you know, a million times over on here. I'm a huge fan of Howard Stern interviewing capabilities and the long form way that he talked to people before there was podcasts. So I think all of us have podcasts probably listen to Howard Stern at some point or another. He probably doesn't get enough credit for that. Credit for that. But actual podcasts, I think I've shifted more towards YouTube lately, for like, creators who are still building their thing, but are talking about something interesting to me, I like that. I like to be in that space with them once they're two. And I try, here's the thing, I try to keep in mind for myself, once they're too ingrained in the business and they're just doing their thing, I think sometimes they get repetitive, and I try to be very cognizant of not letting that happen, even though I realize on some level, the things that I think to say are the things that I think to say so I can't be myself and not be a little repetitive sometimes, but I'm comforted by the idea that people don't listen forever anyway. So if you were a person who listened to me from 2015 to 2018 I may have re said those things between 2020 and 2022 but those people aren't going to. Know that because they weren't listening in 2015 so my thought is, is that the way I deliver this? People find valuable, and so I make it because I enjoy making it, and because I think it finds new people all the time. I'm sure that that is the case. I know about how many new subscribers I get every day, and the number is pretty significant. It's kind of crazy, actually. So I'm good with that. Other than that, as I'm older, I don't take in as much content as I used to, especially visually. It was just such a weird way to say it. I don't watch as much TV, is what I should say. If the TV's on in the house, I'm probably watching a baseball game, or it's in the background or something like that. And I'm some things that I enjoy, but podcast wise, I try to be really agnostic about podcasts. So as an example, I guess I've listened to all different kinds of podcasts that if I said the names of them, someone would go I knew he was conservative, or I knew he was liberal, or, you know what I mean, like, like, like, you know, like, I try to have like, a wide range. I try to find people that make that seem like they make some sort of grounded sense about the thing they believe in. And I try to listen to them to see, like, Well, what do they think about this topic that I don't intrinsically like gravitate towards, and is there any real value in what they're saying. And sometimes I'll listen and I'll be like, Oh, that makes a lot of sense. And sometimes I'll listen and think that person's out of their mind, and I assume that's how people are listening to me as well. Not a lot of politics. I don't particularly gravitate towards a lot of politics. I think politics is just like a version of fear porn, which I don't enjoy. I watch content about reptiles, even though I don't have them, because I find that some of the keeping Tips and Tricks help me with my chameleons. You know, I've seen somebody pop up on like a, like a bro podcast that I wouldn't listen to, and I'm like, I'm gonna try that anyway. I What did I recently heard Bernie Sanders on the flagrant podcast, and I was like, this isn't really my vibe, but I thought they did a good job of talking to him. It was interesting to hear him in that and then trying to keep in mind that he's got a thing he's presenting. They have a vibe they're trying to present, like everybody's trying to do a thing, but I thought they did a good job speaking to him. I listened to Joe Rogan interview Donald Trump, I didn't think he did a particularly good job of speaking to him. Speaking to him. I've heard Joe Rogan talk to other people, and I thought he's done a good job talking to them like, you know, I'm sure I've made an episode where people are like, Jesus Scott. That was, man. You didn't ask him any decent questions. And I'm sure you've listened to me and you thought, wow, that was insightful. So even that's interesting to see, because just because you're popular doesn't mean you're good at it. Every time, I actually think I made an episode yesterday that wasn't great, I felt my energy was weird. Now I don't know if it'll come through or not, but for me, I was like, I didn't feel right when I was doing that. There is a political podcast I'll listen to that has one person on one side and one person on the other. And when I'm trying to figure something out, it helps me to hear both of them, because they're both leaning pretty far to their their sides. And so I try to pick through and take out of it what makes sense to me? I don't know, though I tried for a while, here, here's a here, here's the thing. What's the podcast? Smartless,

Unknown Speaker 33:16
right? You know that one?

Scott Benner 33:19
I do not Jason Bateman, Sean Hayes, and the guy with a deep voice, who's the Lego Batman Will Arnett. And individually, I like something about each of them, and I love it when they interact with each other sometimes, and then sometimes I don't. One time one of the people said something that was weirdly political, and it turned me off to it. And one time, one of the guys was like, super mean to the other one, and it didn't feel fun. And I was like, Oh, I wonder if that's real. So I listened more to hear if he really hated the guy or not, but he didn't. And then, like, but that was it. I was okay with that one for a while. I don't listen to it anymore. I don't know. I guess I listen to podcasts the way everybody else does too. Does that make sense?

Speaker 1 34:05
It does. It does. How about you? Mel Robbins has been getting my attention recently, okay, yeah. She's very popular. Inspires in me self reflection of okay, that makes sense. And I've had this thing that I've said for a while. It's not exactly let them, but it is if somebody is behaving on brand, if they're behaving the way that we know they behave and we get upset that's on us, not on them.

Scott Benner 34:35
Yeah, it's a good point. Yeah, I am who I am. If you're listening to me, you know that, and you're still pissed at me, you should just stop listening. Don't be mad at me. I'm just being myself, by the way, the best I can be, knowing I'm being recorded and that, you know, and everyone's doing that, by the way, you can listen to somebody else and go, Oh, they stopped short of saying something there. Yeah, of course they did. Because they're married, or they have kids, or like they were about to say something that they can hear, that you're judging. Ass was gonna pin them down on that. They don't mean, like, you know what I mean? Like, that's even just saying out loud. Like, I've, you know, I've heard Joe Rogan's podcast. Like, some people are like, Oh, I knew you were an asshole. And some people are like, Oh, I knew you were awesome. You know what I mean? Like, so, like, like, what do you do with that? Exactly, like, when, when, no matter what you say, someone's gonna judge you. You got to give people credit who are willing to say things at this point, like, you know, like, I think that's why I'm grateful to have listened to Howard Stern through the 80s, because nobody tried to cancel people in the 80s, nobody heard you say something that they didn't like and said, Oh, I'm gonna, you know, tell my friend not to listen to this or something like that. Like, the guy said what? He said you liked it, or you didn't. You thought it was funny, or it wasn't, and then you went on with the rest of your life. He didn't think about it again. But then we opened up the internet so everybody feels like they have a megaphone and like, well, I feel this way about it, like I have to change it, like I'm gonna fix this. Like, Howard stone doesn't need to be fixed. He's who he is. Joe Rogan's who he is. Like, I'm who I am. Like, Mel Robbins is who she is, right? Like, be grateful someone's willing to open up a microphone and say what they think and record it so that you can be reflective about it and decide that I hate, that I love, that that helped me. It didn't help me. I'm going to stop listening. These people are giving you an opportunity to to be reflective in a life that doesn't really allow for a lot of reflection, but definitely needs it. And so I think that's what podcasts are doing right now for people like I think you can quietly listen to me prattle on about any number of things, and while I'm sitting here, willing to open myself up emotionally for you, I'm not doing that for me. I'm doing that for the podcast, and you are the podcast if you're listening like I'm doing that so that you can think, Oh yeah, that is scary. I wonder if I'm am I leaning more towards harmony, or am I leaning more towards health? And what is going to happen based on that decision I make, you know? And is my 20 year old one day going to say to me, like, please? I mean, I've been talking about it for 10 years. I knew this day was coming. Like, you know what I mean? Like, we've been walking towards it and and thoughtfully. It doesn't make it easy when it shows up for her or for i or for anybody else, instead of me being the person who's figuring it out and recording it, it would have been awesome to listen to this before it happened to me. In the end, this podcast is going to end up helping you guys in ways that it'll never help me, because a lot of the way it helps me is reflectively, and for you, it can be something that you can make a decision about before it happens. So I'm opening myself up and my life and everything for that, so that hopefully you guys can be healthier and happier moving forward, or at least be better prepared, or, I mean, at the very least not a Bolus for pizza, like you know, or what anything in between that it may or may not do for you. But if you're listening to this right now and you don't like me, or you're angered by this. Like, I believe you have a mental illness. Like, I don't know why you're subjecting yourself to that over and over again. Like, let it go. I've listened to plenty of things that I don't like, and as soon as I get done, I go, is that me or is it them? If it's me, I stop listening. And I will always use the example of talked about Howard Stern a lot, but he came into Philadelphia when I was in high school, right as Walkmans that had radios in them were, like, really popular. So everybody had on that, like little metal band over their head with the two foam things their earphones that sucked. You know, everybody could hear them and it had an FM radio in it. So I think I started listening to Howard Stern when I was a junior in high school, maybe 88 8780 8788 I'm not sure exactly when he came, but around that time, and all I know is like he was just saying stuff like, and he was telling you that he was fighting with his wife, and he was telling you when he was excited, or, you know, thoughts he had about sex, or, you know, like he was just telling you how he felt. And I thought that was, like, revolutionary at the time, like, who was doing that? A couple of people, maybe, but as far as I knew, he was the first one. So, you know, I listened and listened, and I watched him change over the years. He would have said something on the daily in 1992 that I don't think he'd say now, and wouldn't mean anymore. And people would come at him and say, Oh, you've changed. And he'd say, like, what would that say about me if I didn't like, what if I was just running around acting like I was, you know, 25 all the time, or 30 all the time, like, we have to keep growing together. Like, I have to keep growing and I thought it was brave that he shared it with people. He told people he went to therapy. You know what I mean? Like, this is way ahead of the curve, like, and then, you know, I think if you listen to any number of like, popular podcasters, they'll all say the same thing, like, I grew up listening to Howard Stern. He was making a podcast before like that show would come on Laura at 6am and it would sometimes not end. Till 11 or noon. He just talked till he was done. They didn't even have like, an end time. The DJs that came on after him were pissed because they'd sit around sometimes for hours into their shift, and he wouldn't stop talking. I think he made the first podcast like that. It just had a bunch of ads in it, and now people are like, Yes, Scott, your says ads in it, too. And to that, I say, if you want to send me a bunch of money, I'll sit here and make a pot. Make a podcast for you, but otherwise I need somebody to pay for it. I don't know where I was even going with that. I talked myself into a circle. I apologize. Do you remember?

Speaker 1 40:30
No need to apologize. You're being in the moment and you were being authentic.

Scott Benner 40:34
Yeah, no, I think that's what these things are. And like some people will listen right to the end of this one, and some people 10 minutes ago were like, oh, Scott's telling us how he feels. I'm good. Seems like the lady's done with their diabetes story. And they off. Then they go do something else. Like, that's fine. Like, that's what it's here for. You know, somebody asked me last week, how do you turn out five of those a week? And I said, The how is not as important as the why. So it's easy. If you're me, it's, I could talk all day, so like, I'm fine. You know what I mean, I'm I'm not encumbered by how I feel, like I'm happy to share, etc. It's the why. It's because this week, five episodes will come out, and one of them is going to strike your fancy and keep you connected to your diabetes. That's my that's my goal, is to keep you connected to taking care of yourself, and if it's through listening to you tell your story, or someone else telling theirs, or an interview with a company, or me prattling on about this stuff like whatever keeps you connected. I'm telling you, I've never done a study on it, but when people are connected, somehow they do better. Their health is better. And it's my goal to keep you connected without keeping you focused. Meaning, I don't want you to burn out on this. I do want there to be a little part in the back of your head that's like, going, like, Oh, I'm gonna Pre-Bolus now. Or I ate two hours ago. I should really take a look at my blood sugar, that kind of stuff. Like, I know I'm going to be low in 20 minutes. I'm not going to wait 20 minutes. I'm going to take, you know, a couple of like, little somethings now, stop this low in his tracks. And I think that's what this does. So I told the person, I said, right to them, I was like, Howard Stern didn't come on on Mondays. I said he gave you five episodes. I didn't listen to every one of them. I certainly didn't listen from six to noon every day, five days a week, and sometimes I did, right? And I don't think I've heard his show in a year. Now he's still making it. I could pop it on right now if I wanted to. I think it's there for you when you need it, how you need it, that's what's important. And then I answered their other question, which is, I record every day. That's how I that's how I stay ahead. I also have a I record ahead. So I don't know what it is right now, but I'm gonna guess I can open up a folder for you and tell you, let's go on Rob's server. I have 123456, there's seven episodes that Rob has done ready to go for me. And there are 25 episodes that he hasn't touched yet, and there are one, two, counting yours, three, four that I haven't sent him yet. So what is that? 2930 37 we usually have, and I'm a little behind right now because I've, I've gone away so much, but we we try to have 40 to 50 episodes that are ready to go all the time. We work from a backlog. And I got that down from I used to when I edited for myself. I used to have my number was 70. I wanted to have 70 episodes that were always done. And that's why people would like not be on till like, six months after they recorded, but now it's more like two months, because Rob's editing. I'm never gonna be in a situation where, like, what if I got sick for a week? You know what I mean? And even if Rob got sick, like, we're ahead, and if he got really sick, I could jump in and do stuff. But when it was just me, I was always worried that I'd be, I'd be screwed up somehow, anyway, other questions.

Speaker 1 44:06
I want to say my part of the the narrative we covered, but you're still part of my diabetes story, so that my questions to you and you being your authentic self here, that is part of my story, and I thank you. You've you've been amazing at providing guidance and perspective from people who have a common situation but uncommon life events.

Scott Benner 44:38
Well, thank you. I appreciate that is another thing that came up this week. While we're talking to people, there's so much time to meet people with type one. They said, how do you think, like, how does it work for like, such a wide kind of collection of people? I said, I think I've done a good job of distilling it and that so that it's these. Like. Like, pieces of a recipe, and then you take it and you go apply it to yourself. From, like, the simplicity of how I talk about pre bolusing, or when I say, like, you know, I don't know any of those, like you said, those small step episodes, right? Like, you know, I'd rather stop a lower falling blood sugar than, you know, fight with a high one. Doesn't mean I want anybody's blood sugar to be low or falling. It just means that, you know, it's easier to work down in those numbers than it is to work up in those numbers. And like you then take that idea and you apply it to your life. And I think the person was a little confused while I was explaining it, but what I ended up saying was, is that, you know, I don't know who I'm speaking to, actually, this person was a C was a was a CDE, that I'm remembering the conversation better now. And I said, you have the opportunity to sit down in front of a person, get to know them. You can look them in the face, you know how they're accepting what you're saying, or confused by what you're saying. I was like, I don't have that ability, so I had to turn what I was saying into something that's so kind of basic that no matter who heard it within reason, they could understand the bigger idea around it. And I said, and I think by doing that, and I originally did it because I thought not to tell you to be honest, like I used to think like, oh, well, there'll be all levels of intellects that are listening, and so you got to make it so everybody can understand it. But in the end, I think that helps everybody. I think even people who are walking around, you know, with crazy IQs and are super bright and have 13 different degrees, still benefit from hearing things in their simplest form, and then they can, like, translate it in their head to how it makes sense to them. So I think people who listen to this podcast and are successful with these things, I think they're using the ingredients I gave them, but I think the cake they make probably doesn't look anything like the cake I make. And that was the thing that was hard, not hard for me to learn, but it was interesting when I learned it, because I used to imagine that everybody was just doing exactly what I was doing, and that's why it was working. And then after talking to people, I realized, no, I just gave them flour, sugar, butter, salt, and they decided what to make with it, and their thing came out, and it was tasty. And so, like, that's kind of how I think about it now. So that that happened for you is really awesome, and I appreciate you telling

Speaker 1 47:19
me yes, to the point where once I finally got my endo appointment that took almost four months to get when I met with the CDE, I'd already been listening to your podcast for two months, and I didn't learn anything from her, and that's because I already had a pathway for education thanks to the podcast. So that's what my one of my notes to you was learning to say thank you to providers. So everything she shared with me that I already knew, I just said thank you for them. Yeah, yeah. No. Need to tell them I already know that. Right, right? They're doing their jobs. Give them the space and the grace and just say thank

Scott Benner 48:01
you. Yeah. You know, as time goes on and on, on a gut roll level, it's disappointing that somebody could go into a provider and not get decent information from them. But it hurts me, you know. But the more of them I meet, the more I think, like it's not their fault, like it's just really is how the whole thing works. It's how their education works. It's how the system works and how insurance works and appointments work, and that their people and your people and all these things together. Everybody always says, like, we have to fix the healthcare system. How? How would you do that? Exactly? And they'll say, like, things like, Oh, the appointment should be longer. I don't know if that's I don't know if that would help anything, you know, like, maybe this is just what it is, and things like this, then end up on the people, unfairly, who are living with them, and they got to go figure it out on their own. And maybe we should just be grateful that the technology exists where people can go listen to a podcast or read a book, or, you know, go ask, I mean, you should see what I'm seeing with people like I'm not saying to do it, but I'm watching people drop graphs into chat GPT, and it's given, you know, in some cases, some great tips for what you might want to look into. So you know that stuff's going to keep happening. I spoke to a number of healthcare providers this past week. I'm just gonna say this here and they'll hear it, and I apologize to them in advance. I had a lot of people say the same thing over and over again. Oh, I tell everybody about your podcast. So helpful to them, blah, blah, blah, and then I would try to say to them, here's why I think the podcast is valuable. They don't see it that way. And so even people who were standing in front of me telling me, I know why the podcast is great, like, I share it with people all the time. As they were talking, I kept thinking, you don't understand why the podcast works. And I tried to explain it to them, and they still didn't understand. And I was like, their experience is just so much different than mine is. And. They don't see this side of people like trying to say, like, you know, a lot of people go into like, I talked to some bright people who are good providers at great institutions, more than one, more than five. And I was like, This is what people need to know. This is how they have to hear it like, this is what you should be saying to them, from my perspective, because, again, I found a way to talk to people at every entry level, at every age reading level, like people, like all different people, and they all report back the same things over and over again about the podcast. There's also some people I told them like that hate me and or don't want to listen to things or whatever, like I'm not saying everybody, but the for the people it works for this is how it works for them. And they don't know what I'm talking about. They only see their perspective of how they do it. And when I said, no, these people are coming to you and they're leaving, and they don't understand any better than when they got there, I don't think they think that like I don't know what it is they think or whether they're able to how honest they're able to be with themselves, or whatever. I'm not exactly sure what gets in the way, but they don't see what I'm telling them, and even after saying it out loud, they don't follow. So I told them, like, you know, like, people need to be comfortable making changes to their settings. So they need to know how insulin works, and they need to understand how to use it. They need to understand how their food impacts that insulin. And I just said to one person, like, just listen to the Pro Tip series. I'm like, That's it. I said, You have no idea. I've lost count of the 1000s of 1000s of people who have said to me, listen to the Pro Tip series. My a 1c got into the sixes. That's not because I explained it perfectly in there. It's because I left bread crumbs all over the place, and they went and took them and and they put it together into their own concoction and made themselves an A 1c but you're not telling them that. You don't explain how insulin works. You don't talk about the connection between this and that. You don't talk about how to Bolus for things. I've been to great institutions when my daughter was younger. No one ever said to me, like fat might need more insulin. Never, ever, once, ever, ever, ever, no one's ever said it to me. And I even found myself talking to a person who I think is lovely and I love, who is Mike Arden's like second MP. And the only thing I didn't say to her was I didn't really learn much from those appointments. I didn't have the heart to say it to her, because she's lovely and really dedicated and a good person. She's helping a lot of people. But for me, I was in there, and I just heard the How are you feeling? Let me see your sights. Have you been low? How low? How are things going? How do you feel? Do you have any questions, like the stuff that they ask over and over again? I was like, not helpful. It just isn't like I had to go out and figure it all out for myself. And you put everybody else in that situation too, but not everybody goes and figures it out. So you know, where are those people? And once you start asking them, like I said this in an episode recently, like asking a person who doesn't know what they're doing if they have any questions about what they're doing is the silliest thing I've ever heard in my life. Like, if they knew what to ask you, they wouldn't have to ask you they don't know enough to know what they don't know, and you're asking them to lead you into what they need to hear about, like you should know what they need to hear about. Their response would be, everybody's different. My response would be, no, they're not on some basic level. We're all the same, and we all have the same issues, and the same 15 or 20 ideas would make a foundation for us that would really lead us to success. That's what I think the podcast is. And I don't think that's the I think that's the thing that a lot of them don't follow, and some of them do, but a lot of them don't follow it, so I don't know Anyway, sorry, that was all from you saying thank you to me, William. I got it today. I can podcast today. Oh, Rob's gonna be so mad. We've been talking for like, an hour and 40 minutes. Sorry, Rob. Awesome. Anything else we good.

Speaker 1 54:00
I just want to give a acknowledgement to how wonderful My husband was through that emergency situation. And he's no longer polite and gentle when he's concerned. He makes his point, and I listen to him, and we take action. He also he was my wound care, my primary wound care for over 100 days. He was changing my dressing, taking care of my wound, sometimes up to five times a day. But the poor guy, so my incision from the surgery went from what they call in yoga, the sits bones on my left leg all the way up to top of my pubic bone, following the seam of the leg. Okay? So the poor fellow had to look at my goods up to five times a day for over 100 days. Thank you, honey, for taking care of me.

Scott Benner 54:52
That's a very kind thing to do for somebody. Also, what was he gonna say? Is he gonna go? No, figure it out for yourself. Yeah, cuz I I couldn't do it. Yeah, no kidding, not, not an accessible place, right, right? Something. Well, I'm so glad you're doing better. That's a crazy story about your diagnosis. Infections are no or no, uh, no joke, it easily could, that infection easily could have gone somewhere else and ended you. It ended up in your thigh. And, you know, seriously, it's almost dumb luck that that's where it landed,

Speaker 1 55:21
yes, and it was an incredibly aggressive variety. The surgeon said that that particular flavor can kill people in one to three days. No kidding. And I had it for a week.

Scott Benner 55:35
Scared the hell out of you, I bet, when they said that, huh? Yeah, yeah, no kidding. God, diabetes would have been the least to your problems, right? Wow, wow. That's so I'm, I'm so happy for you that it, uh, that you found the answer in time. But I do want to implore you, next time you feel sick, like, maybe tell somebody don't be like, this will probably be okay. I'll just tough my way through it. Yeah, invincible, yeah. And I know, I know a few you people. I'm not That's not me. I get sick. I'm like, Hey, someone help right now. I need help. All right. Thank you so much, Laura. Hold on one second for me. Okay,

the conversation you just enjoyed was brought to you by us. Med, us. Med.com/juicebox, or call 888-721-1514, get started today and get your supplies from us. Med, a huge thanks to my longest sponsor, Omnipod. Check out the Omnipod five now with my link, omnipod.com/juicebox you may be eligible for a free starter kit, a free Omnipod five starter kit at my link, go check it out. Omnipod.com/juicebox Terms and Conditions apply. Full terms and conditions can be found at omnipod.com/juicebox Are you tired of getting a rash from your CGM adhesive? Give the ever since 365 a try, ever since cgm.com/juicebox beautiful silicon that they use. It changes every day, keeps it fresh. Not only that, you only have to change the sensor once a year. So I mean, that's better. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox podcast. If you're not already subscribed or following the podcast in your favorite audio app, like Spotify or Apple podcasts, please do that now. Seriously, just to hit follow or subscribe will really help the show. If you go a little further in Apple podcast and set it up so that it downloads all new episodes. I'll be your best friend, and if you leave a five star review, ooh, I'll probably send you a Christmas card. Would you like a Christmas card? Check out my algorithm pumping series to help you make sense of automated insulin delivery systems like Omnipod five loop, Medtronic 780, G twist, tandem control, IQ and much more. Each episode will dive into the setup, features and real world usage tips that can transform your daily type one diabetes management. We cut through the jargon, share personal experiences and show you how these algorithms can simplify and streamline your care. If you're curious about automated insulin pumping. Go find the algorithm pumping series in the Juicebox podcast. Easiest way. Juicebox podcast.com, and go up into the menu, click on series, and it'll be right there. Hey, what's up, everybody? If you've noticed that the podcast sounds better and you're thinking like, how does that happen? What you're hearing is Rob at wrong way recording, doing his magic to these files. So if you want him to do his magic to you, wrong way recording.com, you got a podcast. You want somebody to edit it. You want Rob.

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#1620 Thick Thighs Save Lives - Part 1

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

Laura, 55, was diagnosed with type 1 in March 2024 after months of missed signs, DKA, septic shock, and necrotizing fasciitis. Now on a GLP, she’s honeymooning without insulin. Part 1 of 2

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

Scott Benner 0:00
Friends, we're all back together for the next episode of The Juicebox podcast. Welcome.

Speaker 1 0:15
Hi, Scott. My name is Laura, and I was diagnosed with type one diabetes at the age of 54 in March of 24 which I didn't even know was a thing Adelaide said type one until I was diagnosed with it. Who knew

Scott Benner 0:33
if you're living with type one diabetes? The after dark collection from the Juicebox podcast is the only place to hear the stories that no one else talks about, from drugs to depression, self harm, trauma, addiction and so much more. Go to Juicebox podcast.com, up in the menu and click on after dark there, you'll see a full list of all of the after dark episodes. Please don't forget that nothing you hear on the Juicebox podcast should be considered advice medical or otherwise, always consult a physician before making any changes to your healthcare plan or becoming bold with insulin. Summertime is right around the corner, and Omnipod five is the only tube free automated insulin delivery system in the United States because it's tube free, it's also waterproof, and it goes wherever you go. Learn more at my link, omnipod.com/juicebox, that's right. Omnipod is sponsoring this episode of the podcast, and at my link, you can get a free starter kit. Terms and Conditions apply. Eligibility may vary. Full terms and conditions can be found at omnipod.com/juicebox, the episode you're about to listen to was sponsored by touched by type one. Go check them out right now on Facebook, Instagram and of course, at touched by type one.org, 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 touched by type one.org I'm having an on body vibe alert. This episode of The Juicebox podcast is sponsored by ever since 365 the only one year where CGM that's one insertion and one CGM a year, one CGM one year, not every 10 or 14 days ever since cgm.com/juicebox

Speaker 1 2:30
Hi Scott. My name is Laura, and I was diagnosed with type one diabetes at the age of 54 in March of 24 which I didn't even know was a thing, adult onset type one, until I was diagnosed with it. Wow, who knew?

Scott Benner 2:46
Yeah, this was just a year ago. And prior to that, not even a year, little over a year, little over a year. And never, once in your entire life, did somebody say diabetes.

Speaker 1 2:58
I did have gestational diabetes with both of my pregnancies, but I didn't know there was such thing as an adult onset type one

Scott Benner 3:04
I see, I see, and you didn't know anybody else with type one in your family? None, none. How about other autoimmune issues?

Speaker 1 3:12
My grandmother had myasthenia gravis. What is that? It's an autoimmune that attacks the smooth muscles of the body,

Scott Benner 3:21
okay, how did that affect her through her life? I

Speaker 1 3:25
don't know, because we didn't talk about it, and I didn't realize that was autoimmune. I just knew she was a very loving old lady that I looked like a lot like, and she took a lot of medicine, but she lived into her early 80s, and ultimately, it was strokes that took her

Scott Benner 3:43
out. Okay, early 80s, I could deal with that, I think, you know, unless they change something like awesome in the next 10 or 15 years, where like being older isn't like being older is now. You know what I mean, right? Yeah, it's not a bad run at all. Well, I guess. Are you married? Do you have kids like? What's your family structure look like?

Speaker 1 4:04
So I'm married. Just had my seventh anniversary two days ago, and I have two grown children. They're both in their 30s, and one grandson.

Scott Benner 4:14
Okay? This your second marriage. It is, it is, okay. Well, congratulations on your anniversary. Very nice. Thank you. And your your lovely family, tell me a little bit about being diagnosed as an adult out of nowhere. You know how it showed up, and how did you figure your way through it?

Speaker 1 4:33
Well, the story Scott is, I worked myself to the edge of death, and when my husband took me to the ER I was in DKA, I had necrotizing fasciitis, and I was in septic shock.

Scott Benner 4:47
Wow. So how long do you feel like looking back, how long were you ill before you did something?

Speaker 1 4:53
I was very symptomatic for probably about three weeks. And. Yeah, in the ER, my blood sugar was somewhere around 500 and my a 1c was 12 or 13. I had gone to the doctor a week prior to the ER visit because I had a cough, a long cough that I just couldn't shake. So I went to the doctor, and I told him during that visit that I had lost 30 pounds without trying, and I was concerned about that, but he wasn't concerned

Scott Benner 5:32
30 pounds that you were happy to lose, or that were concerning

Speaker 1 5:37
I was happy to lose. However, it was very concerning. For years, I had tried losing weight and couldn't lose more than three to five pounds at a time, and suddenly 30 pounds just melted off over the course of about two

Scott Benner 5:49
months when it was happening. How did you think about it?

Speaker 1 5:53
I did have diabetes in mind, but I didn't have any concept of how dangerous out of control blood sugar could be.

Scott Benner 6:03
So were you doing? Because other people have said this to me, and it's okay if that's not what you were thinking, but were you doing the like, oh, I might be getting diabetes, but I have needed to lose this weight, so I'll just ride this a little while before I look into it. Or was it not occurring to you like that?

Speaker 1 6:18
Honestly, it crossed my mind a couple of times, but I did seek medical help. I just wasn't I was blown off.

Scott Benner 6:27
Oh, so when you went to that doctor and you said, I've lost 30 pounds, did you say I've lost 30 pounds? I'm wondering if I have diabetes. I didn't say diabetes, okay, but they didn't think it through to that degree,

Speaker 1 6:39
correct? And that's part of my with self reflection. What could I have done differently, or what could I have done better? Because I actually did have a glucose meter, because I worked with a dietitian about a year and a half prior, and she prescribed me one, but my thought processes, they just weren't clear during that time. It didn't, it didn't occur to me that I had a tool that I could check on myself. I see I was relying on a medical professional to say, to take my hand and say, Oh, that is concerning, right? What? Let's do something about

Scott Benner 7:13
it. So when he's he or she's not concerned, does that shut off your concern, or does it just make you think? Like maybe the thing I was thinking, isn't

Speaker 1 7:22
it? It Back burner, the concern, okay, okay, because my mother was diabetic, and one of my sisters too, I see,

Scott Benner 7:29
well, you know, to tell the doctor I tried, I've tried to lose weight throughout my life. It's never worked. That wasn't part of the conversation. Wasn't part of the conversation, okay? So you think the doctor just got fixed on the idea that losing 30 pounds was probably good for you. So we're not going to think not going to think about

Speaker 1 7:43
it any deeper than that, right? And my chief complaint going in was a cough, and he prescribed a very strong dose of prednisone, which apparently will make even a healthy person's blood sugar spike.

Scott Benner 7:57
Yes, actually, it very well could about that. That's all I did. That's interesting. Didn't look to see if you had, like, an illness that caused the cough or anything like that. No, is it just a GP? Nurse Practitioner. Nurse Practitioner. Gotcha. Okay, so that happens, how long before you end up in the hospital? Like, how? Like, when's that doctor's appointment timeline wise,

Speaker 1 8:23
that was on a Tuesday, and the next week, on Wednesday was when I was in

Scott Benner 8:28
the ER, wow, that quickly. And I'm sorry, I feel like I heard you mention that flesh eating disease, yes, when did that? Okay, hold on, because this came on so quickly now that I understand the lay of the land, and it came on so quickly. In less than a week from like, Hey, Doc, something's wrong, I've lost 30 pounds to I'm in the hospital. What does that week look like? Like, walk me through that week. At first, I noticed this on top of this, on top of this. I kept ignoring like, show me the timeline there.

Speaker 1 8:57
So the doctor's visit was on a Tuesday, on Thursday, I noticed some discomfort on the back of my leg, and frankly, I had I had new undergarments, and I thought it was causing just a little friction rub. So Thursday, I started noticing the discomfort. Friday, I noticed that there was a bit of a growth and protrusion at that spot,

Scott Benner 9:26
skin tag. You were thinking something like that, maybe something like that. Yeah,

Speaker 1 9:30
I knew I had a dermatologist appointment the next Wednesday, so I wasn't concerned about it. Oh, just another thing for that doctor to look at. Yeah, Saturday, it looked like a small potato oozing just a little bit, and again. Well, I already have an appointment to see the dermatologist so they can look at it on Wednesday,

Scott Benner 9:52
russet or yellow potato. I'm just kidding. So that thing's growing exponentially.

Speaker 1 9:58
It's growing quickly. Yeah. Okay. Okay, and during this time, I am so exhausted that I can't go for more than an hour without laying down or taking a couple of naps during the day, but, but I had work to do. Scott so as as a career, I'm a corporate trainer, and I was the head of a sales enablement team, and sales kick off, which is the largest internal event of the year for any company that does it for most companies, okay? And I had a team that my predecessor hired really amazing people. Most of them, however, had never done sales enablement or sales training before they were hired. So there was a lot of burden on me to deliver this event. So I was working as hard as I could, non stop, hours on end and and that's, that's the part where I said I worked myself to the edge of death, including doing executive readouts that I didn't have any of money on my team that could do them, so I was pushing myself to get the job done. As I've said for years, pain may slow me down, but it never stops me. So I am working and napping and working and napping and working in napping, had to do an executive readout on Tuesday, Tuesday night, my husband is so concerned. We were out of town for his work. We were driving back, and it's about a two and a half hour drive between where we were for his work. Excuse me, yeah, and our home. I was so tired on the way home that I actually asked my husband to park his truck at a one of his work locations and drive my vehicle home. Scott, I don't let him drive my vehicles.

Scott Benner 11:55
Why not? What? What bothers you about how he drives your cars? What is it? Is it just that it's

Speaker 1 12:01
yours? It's not that it's because it's mine. We have very, very different driving styles, and it makes and I get uncomfortable when you don't

Scott Benner 12:11
like it when he's driving, right? Is it that he stops late, accelerates too quickly? Stuff like that

Speaker 1 12:17
doesn't necessarily stop late, but the way he uses distance and lane usage and speed, yeah, he's an excellent driver, by the way. He has a CDL, makes you janky, makes you feel weird, yeah, just be, just be a little more respectful with my baby, please.

Scott Benner 12:35
I understand you love that car I got you. So point being is, you guys are trying to make this ride. You can't do it, you can't stay awake. You're exhausted. I mean, listen, you're in fairness, you're giving birth to a potato, and that can't be easy, right? Listen, if everybody feels like, I'm now talking to my wife, but not to you, I'm sorry. But, like, what is it about you people that you can't just, like, admit like you're tired, or that, you know, I heard you say something so corporate. It just made me upset. Like you owned it, like, I know you mean you own the process, or you own the thing, like, it's your responsibility. I see my wife, you know, saying stuff like that all the time. Like, why does everybody think that they can just live forever through anything? And nobody ever stops to say, like, I'm exhausted or I can't do this. What do you think stops you? Like, from that business side, what is it that stops you from saying, Hey, I'm in trouble. I

Speaker 1 13:21
go until I can't, and that's that's what I do, not just in corporate life, but good example is, I live in the mountains, in the woods, and our primary heat source is firewood, and so chopping, stacking firewood is a huge task, especially at my age, and I work myself to the point of exhaustion. I go until I can't go anymore. And where did that come from? I really don't know, but it's just it's part of my MO

Scott Benner 13:54
one of your parents real demanding, or never give praise. Are you Catholic, anything like that?

Unknown Speaker 14:01
Neither of them were demanding. They were mostly absent.

Scott Benner 14:03
Oh, okay. You felt like everything was on you. Yes. Ah, we found it okay. All right, okay, so you're gonna kill yourself by ignoring flesh eating disease, type one diabetes and a few other things. So he pulls over. I mean, you act us. Let him drive the car. Where does it go from there. Today's episode is sponsored by a long term CGM that's going to help you to stay on top of your glucose readings, the ever sense 365, I'm talking, of course, about the world's first and only CGM that lasts for one year, one year, one CGM. Are you tired of those other CGM the ones that give you all those problems that you didn't expect, knocking them off, false alerts not lasting as long as they're supposed to. If you're tired of those constant frustrations, use my link ever since cgm.com/juicebox to learn more about the ever since 365 Five, some of you may be able to experience the ever since 365 for as low as $199 for a full year. At my link, you'll find those details and can learn about eligibility ever since cgm.com/juicebox, check it out. Today's episode is brought to you by Omnipod. It might sound crazy to say, but Summertime is right around the corner. That means more swimming, sports activities, vacations. And you know what's a great feeling, being able to stay connected to automated insulin delivery while doing it all. Omnipod five is the only tube free automated insulin delivery system in the US, and because it's tube free and waterproof, it goes everywhere you do, in the pool, in the ocean or on the soccer field, unlike traditional insulin pumps, you never have to disconnect from Omnipod five for daily activities, which means you never have to take a break from automated insulin delivery ready to go tube free. Request your free Omnipod five Starter Kit today at omnipod.com/juicebox Terms and Conditions apply. Eligibility may vary. Full terms and conditions can be found at omnipod.com/juicebox type that link into your browser or go to Juicebox podcast.com and click on the image of Omnipod right at the bottom. There's also a link right in the show notes of your podcast player.

Speaker 1 16:20
So we get home and I'm having trouble with my motor functions. So my husband actually I've had two back surgeries, Scott, I have four rods and 12 screws in my back. And from my back surgeries, I still have a walker from my recovery time. So my husband pulled the walker out of the closet and made me use the walker in the house because he was so afraid I was going to fall Wow. Yeah, yeah, but I had a doctor's appointment the next day, Scott,

Scott Benner 16:51
so we don't need to go to the hospital. This will be fine, even though I'm now a fully mobile person using a walker and can't stay awake. Yes, you hear it when you were talking about it,

Speaker 1 17:00
yes, yeah, okay. At the at the time, not only were my motor functions failing, I couldn't think straight. I didn't know that I was not being smart.

Scott Benner 17:10
I see you thought you were just managing the situation.

Unknown Speaker 17:14
Yes, I got that. There was a plan, that's all I knew. Got it

Scott Benner 17:18
okay? And your husband, is he pushing you, or even retrospectively telling you, like, you know, I thought we should have gone. Or where was he in that moment,

Speaker 1 17:26
he was respectfully expressing his concerns, but not pushing

Scott Benner 17:32
second marriage. In his first marriage, he would have drugged your straight to the hospital. Probably, the first marriage teaches you to be more respectful of people. Yeah, I got you Okay, so he's worried, but he's he's leaving it to you, but he doesn't know that you're not exactly making great decisions, and you don't either exactly scary, right? A scary thinking back on that it

Speaker 1 17:55
is, I am really fortunate to to be alive, Yeah, no kidding. But that's, that's kind of a, it's kind of a weird super power, power. And the women in my family,

Scott Benner 18:05
they don't die. It takes a lot. Yeah, hey, did you end up baking the potato? Did you mash it? Okay, so you go to bed, and then what happens? Sorry,

Speaker 1 18:18
yeah. So in the morning, I'm getting ready to go to the doctor's appointment, but I'm so exhausted, I can't do five minutes of standing just to do my skincare, yeah, brush my hair, get myself dressed. So I had to rest so many times because I was I was out of breath, and I'm very concerned at this point. But again, I had a doctor's appointment. It took me so long to get ready that we were late and the doctor couldn't see me. So my husband just said, that's it. We're going to the ER, your

Scott Benner 18:51
doctor blew you off because you were late, because you were so sick you couldn't get there in time. They didn't know that. Oh, okay, you live in the mountains. Are you telling me? Yes. Also, we're gonna have to get back to that at the end, because that sounds attractive to me, but I wanna make sure that I'm understanding all the downsides. So okay, so you right off the er, sorry, go

Speaker 1 19:09
ahead. Couple of other things that, again, not thinking straight, my vision was really blurred, and parts of my vision were dropping out. I don't know if you've ever had a migraine, but when I get migraines, my vision drops out, but it's replaced by more like white, but this time it was replaced with black. I had frequent urination, which I just thought because I'd had a hysterectomy a few months before. I thought, Oh, I'm having bladder dysfunction because of my hysterectomy. That's what happens when you're an old lady. I was having a lot of digestive distress. I was having a lot of heartburn. Well, Scott, turns out that wasn't heartburn. I was vomiting while I was sleeping.

Scott Benner 19:55
Oh, my God, yes. Digestive distress, constant. Patient or diarrhea, mostly upper digestive upper okay. So you thought, oh, I have heartburn, but you're vomiting into your into your mouth.

Speaker 1 20:08
Oh, my gosh. I just thought it was really bad acid reflux,

Scott Benner 20:13
yeah. So technically, speaking, you were dying.

Speaker 1 20:16
Yes, yes, got it. I even coded on the table.

Scott Benner 20:20
Wait, okay, hold on, so you get into the ER and how did they I mean, you remember how you presented yourself and what they started doing.

Speaker 1 20:29
I told my husband, as we're getting just out of the out of the vehicle, but I couldn't walk in. I needed him to get me a wheelchair. I took a few steps, and it just wasn't working. So he gets me in. I'm in and out of consciousness. I remember answering some of the questions, and they seemed a little accusatory, and saying her blood sugar must have been like this for a very long time. No, it hasn't.

Scott Benner 20:56
Why not that, you know, but you know, they have you pegged as DKA. Is that right? Yeah, okay, so,

Speaker 1 21:05
and then my husband tells them about the the growth, the infection on my leg. Immediately get into surgery, and I remember thinking they're moving too fast. They're going to kill me. Every line, everything that they hooked up to me.

Scott Benner 21:22
I ripped off. You were worried they were doing it wrong.

Speaker 1 21:25
Yeah, that was one of my last thoughts before I went under. You

Scott Benner 21:29
were backseat driving. The was, do you do that while your husband's driving your car

Speaker 1 21:36
too? I stay politely respectful. Look at you. Okay,

Scott Benner 21:40
all right? So you're freaking out in that hospital, feeling like something's wrong. They feel like they're moving too quickly, they're doing wrong things. So you look combative. Then, yeah, yeah, got

Speaker 1 21:50
it, but that's, you know, the fight or flight. That's what I felt in the moment, right? Right? Yeah, wow. And so I had two surgeries. What was the surgery for? It was to cut the infection out of me. Okay,

Scott Benner 22:05
back of your leg, thigh, back of your knee, back your calf, upper thigh, upper thigh. Okay, yeah, you said you thought your underwear was dropping it. By the way, when you said that, it made me super excited that I ordered new underwear and it's arriving today. Oh, yay. I don't know why. Like, I think it's because I grew up so broke like when I replaced my underwear, I feel like I'm really winning. I know that's probably ridiculous, but I love that. I have two packs coming today, nevertheless. So they cut out. How much of your thigh did they have to take away?

Speaker 1 22:31
Oh, goodness, I don't have a number for you, but I can tell you that it was kind of spider shaped because the infection tunneled and it took an entire roll of gauze. So what is that? Four yards that's three inches wide to pack the wound? Oh, gosh, okay, the only time in my life, Scott, that I have been happy that I had a thicker thigh, because it only got into the infection, only got into the fatty tissue, and not into any any muscle or any connective tissue.

Scott Benner 23:12
Wow, that's so you were lucky enough it didn't make it to a place where it could run more deeply. It was in, it was in the fatty tissue at that point. Exactly, exactly. All right, how do you end up with that? Did they tell you later, like, how did you get the flesh eating

Speaker 1 23:25
disease? That's something that we haven't been able to figure out. Okay, well,

Scott Benner 23:29
you do live in the woods. I do. And then you said you had a second surgery. What was the second surgery

Speaker 1 23:34
for the second surgery was to go back in and make sure that they got all of the infection. I see was that days later? That was the next day, the next day,

Scott Benner 23:44
okay? So they did what they thought was like saving, life saving and then get somebody else to come back and be more meticulous about it. Yes, okay, yes. And they're getting you out of DK at the same time. How do they put you into surgery when you're coming out of DK? Is that not dangerous? I have no idea. So you're pretty out of it during this time. Yes, okay, when's the first time in the hospital stay that you start like coming out of it, realizing what's going on?

Speaker 1 24:12
Oh, they had me so heavily medicated. So heavily medicated. Scott, I was, I was hallucinating in anime.

Scott Benner 24:20
Oh, well, that's kind of fun. Yeah, do you watch anime? I don't. Oh, that's awesome,

Speaker 1 24:28
yeah. And then at one point, somebody had come into the room to empty the trash and and whatnots, and I had a conversation and said, You know, I can tell things are getting better now because my hallucinations are more

Scott Benner 24:43
realistic. Geez, did anybody ever tell them back to you? No, no, that's

Speaker 1 24:50
and my husband doubts that I actually had that conversation. Oh, it was probably a hallucination too. That

Scott Benner 24:56
might have been a hallucination also. You were really, you really were close to death, huh? Yeah, yes, wow. I coded. Oh, yeah, oh, I'm sorry. During which one of the surgeries, the first of the second, the first one? Wow. They have to, like, do the thing, like in the TV show where they yell clear, and then they shock your heart, perhaps, oh, you're not sure, oh, I would have definitely asked about that one. Wow. No kidding. When did they tell you that? They didn't tell me. I heard it when they were doing the rounds. Oh, oh, yeah. So somebody said she coded during the surgery, and you heard them, but you don't. But is that possible that that didn't happen to like, how hallucination heavy were

Speaker 1 25:34
you? No, I heard that every day that I was in ICU six days. It's

Scott Benner 25:39
a part of the thing that they were passing from nurse to nurse to make sure that they knew, because they wondered if it was going to happen to you again, probably, and they wanted to use a teaching hospital. Oh, I see, I see, wow. So how long you're in the hospital for? How long after all this, nine days total? Well, nine days. And then does one of the problems supersede the other? Like, does somebody ignore talking to you about your diabetes because they're so worried about the other thing, or vice versa.

Speaker 1 26:02
In ICU, they were heavily focused on the wound and the infection. Then once I got to out of that onto the trauma floor, that's when they very closely. They were ready to release me after the surgery, but not until my diabetes was under control, so that's where I had two extra days in on the trauma

Scott Benner 26:24
floor. Gotcha, wow. So what's your expectations for how to manage diabetes leaving on day one? What do you what do they tell you like? What do you I mean, because you said it was out of nowhere, it's later in life. It's not a thing you were expecting. So you know, when you left, what did you think management looked like compared to what you feel like it is now

Speaker 1 26:42
when I left so I had prescriptions for a long acting and a fast acting, and I had instructions of once a day to take the long acting, but not when they gave me instructions on how to prepare for The injection, how to store the insulin using the glucose monitor, which I had done previously, they sent a nutritionist to talk to me about what my plate should look like. And that was, that was pretty much it, yeah, okay,

Scott Benner 27:16
so start looking into it on your own. Like, I imagine you're exhausted after this experience. So like, you're not like, or did you go right back to corporate, Laura mode as soon as you got home? Like, or did you, I mean, had to have taken you time to recuperate, right?

Speaker 1 27:30
I was in corporate mode before I left the hospital.

Scott Benner 27:33
Okay, Laura, I see so you're already looking into like, how to take care of your diabetes on your own,

Speaker 1 27:39
right? What'd you figure out early on, because I had gestational diabetes 30 plus years ago, I had a bit of a baseline. And then, because I had worked with a dietitian a year and a half prior and already confirmed that I understood nutrition and understood carbs and proteins and all of that, I felt like I was in a pretty good place there. It was more about understanding is, is the insulin, the right insulin and the right amount of insulin and when to take it? So I was just told take it before you eat. So I'd sit down to eat jab and then eat, not waiting the 15 minutes beforehand you

Scott Benner 28:21
have a CGM on at that point, not at that point, not at that point. So what do you how far after the meal? Did they tell you to test again? They usually say three hours, but two hours, two hours. Okay. So what were you seeing at the two hour test? Usually 150 or less. Okay. Do you think you were honeymooning at all? Oh,

Unknown Speaker 28:41
I'm completely honey. Many you are, okay, yeah,

Scott Benner 28:43
all right. So that doesn't seem, I would imagine that doesn't seem bad, right? Like, I gave myself insulin, my blood sugar's 150 a couple hours after, I probably felt like you were doing well, yeah, I wasn't concerned. What happens that makes you feel like I need to understand more and more. Like, how do you start digging into it to get to where? I mean, you are now

Speaker 1 29:01
going back to sales kick off. And by the way, I was in the hospital for 11 days. I only missed, or excuse me, nine days. I only missed 11 days of work. Oh, geez, I had sales kick off to deliver. Yeah. And so in January, flew to headquarters to do sales kick off. And one of the executives, she was one of my keynotes, and when she walked into the room where I was producing the event, I saw that she had a CGM on, and I asked her about it, and told her that I was recently diagnosed. And she just she looked horrified, and she said, You know what? I was 35 when I was diagnosed. It was was scary. It came out of nowhere. And she recommended a Facebook group for me to join and a book

Scott Benner 29:48
to read. Okay, when I was I do audio books.

Speaker 1 29:53
And so after I finished that first one, which was bright spots and land mines, something like that, Adams book. Yeah. Right, yeah, yeah. I was searching through audible for other resources so I could really educate myself. And that's when I found your podcast. Oh, your podcast is, is what gave me the, the complete confidence that, okay, this is, this is the best resource. This is real world, and it's, it's consumable in a way that feels personal.

Scott Benner 30:27
Oh, I'm glad that's awesome. Also, how crazy is it that somebody wrote a book that's inaudible, and that's how you found the podcast? That's, I feel so random. I've been surrounded by random things this week, so I'm paying a little closer attention to them. Oh, that's awesome. Can you help me for a second? Because you're a very clear person. Very clear person. You find the podcast. There's a lot of episodes, I realize that. But how do you figure out what to go listen to? Or do you just start and then eventually hear about like the Pro Tip series and go find it? I'm interested in the process of picking through and getting settled with the show.

Speaker 1 30:59
I started with most recent episodes, and just started working backwards. Okay?

Scott Benner 31:05
And then, did you get to like management series somehow? Yes. Did you find that through the Facebook group, or just by listening through the Facebook group? Okay, because we have them up in the feature tab, and there's like, all those lists up there. Is that how you found out it or because people share them in the group? You don't recall. I'm not recalling at the moment. That's fine. Also, I'd like to tell everybody Juicebox podcast.com/lists, with an S. I've taken all those lists that exist in the Facebook group and I put them online for you so you can find them on a web page too. So if you want to go look at them there, that's where they are, and they're shareable and usable from there,

Speaker 1 31:44
right on. Yeah, by the way, I think that your snippets, your smaller ones, oh, the

Scott Benner 31:50
small sips, they're brilliant, awesome. I'm glad, brilliant. I'm glad, yeah, we're gonna work on how to make more of those. But they were, they were more difficult to make than you might imagine, like, you know, like, take, like a big idea and jam it down into 10 minutes somehow, but it seemed important to do. So glad you like those basically, you found the podcast, you figured out what to do, and you're doing well. Where are you at now? What's your A, 1c how's your variability?

Speaker 1 32:12
My a, 1c is 5.8 and I don't know what my variability is, other than when I received steroid injections for my back in December. I haven't needed insulin since October.

Scott Benner 32:24
Oh, so you're on, like, a honeymoon that where you don't need insulin. I'm also on Manjaro. Okay, hold on, let's pick through that you're using insulin. Then you go to a GLP, and then you don't need insulin again,

Speaker 1 32:39
correct? So when I started, I was on 32 units of long acting and five units of fast acting. And then every time we titrated up for the mangero, my insulin needs reduced. And then once I was on 12.5 that's when I was controlled without insulin.

Scott Benner 33:02
Okay, so for all the people who are gonna say you don't have type one diabetes, now, did you do C peptide? Do you have markers for type one I do. Okay, so you're honey mooning pretty hard. And you know that if you listen to the podcast, just other people have come on and talked about this, you know, in the middle of probably some sort of a latent, like a lot of diagnosis that they jump on a GLP for weight, usually. And then, I've only heard the story a few times, but it's a few people who've come on and told it, and you start to your insulin needs go down and down, and some of them end up on almost almost none or none. But your expectation is, I imagine that one day that's the GLP is not going to be enough, and it's going to it's going to come back the need for the insulin. Is that how you're thinking about it precisely? Yeah, okay, wow. I wonder how long that well, how long has it been going for?

Speaker 1 33:52
Already? We started the bonjoro last year in March,

Scott Benner 33:56
April. Oh, like 16 months now, yes, that's incredible.

Speaker 1 34:04
Wow. We've also reduced my thyroid meds twice,

Scott Benner 34:08
really, after the GLP correct. So inflammation, you think, what do you think? I mean? Is there anybody guessing why that is weight? Has your weight gone down?

Speaker 1 34:18
My weights gone down. So I'm down about 45 pounds.

Scott Benner 34:23
I mean, that's why you less body mass. You need less medication for the thyroid. I would end plus, wait, 45 plus the 30 or 45 total, plus, Oh, so you've lost 75 pounds since the day you started growing a potato, or the couple days before you started growing the potato, a couple months. Yeah, wow. Do you have more to go? Are you interested in losing more you like where you're at? Where does that sit? Probably about 15. Okay. Oh, okay. Can you talk about if, if there have been any other benefits from the GLP that you're that you see

Speaker 1 34:53
massive reduction in inflammation. So the benefits, so, number one benefit. To fit glucose control. So my blood sugars have been improving from the very first shot. I didn't start losing weight, substantial weight, until I got on to 10, the 10 dose, but I lost so many inches because of all of that inflammation.

Scott Benner 35:20
Wow, that's crazy. So you weren't exactly dropping a lot of weight, but your body was, like, tightening, you feel like, like, visually tightening up.

Unknown Speaker 35:29
Yes, okay,

Scott Benner 35:32
that's a good way to say, yeah, yeah, you were shrinking, but not losing weight, correct? Okay, that's interesting. Did you ever, in the past, have any like, GERD or any other digestive issues, or is that just during the diagnosis, part

Speaker 1 35:46
years of acid reflux and a history of peptic ulcers,

Scott Benner 35:50
and how about the reflux? Is it gone? It flares up.

Speaker 1 35:55
And here's one of the things that I want to share as a tip for anybody on a GLP one, if you notice you have anything digestive before the medication, it's probably going to be magnified when you're using the medication. Interesting. So I love barbecue sauce, and especially a tangy one, not a sweet one. But I get heartburn when I have it that's going gone on for years. Okay? Now, if I have anything that I know that previously would have caused a little bloat, a little discomfort, a little acid reflux, it's guaranteed to do

Scott Benner 36:30
it. I had acid reflux and it's gone now.

Speaker 1 36:35
Oh, good, yeah. But food triggers, very specific food triggers. You

Scott Benner 36:40
had specific food triggers. You do. I don't know what mine was, if it was weight or if it was just my poor digestion, like my digestion was terrible. It's so much better for the GOP. I'm not sure exactly what it was. I can still get it minorly. If I eat too late at night, then I might overnight. Notice it, but very mildly. But I used to, like, I used to be it was constant for a while, like I was taking something to try to, like, you know, quell it for quite some time. So that's interesting. Okay, anything else? Sorry,

Speaker 1 37:13
I'm also much more sensitive to sodium. Now, how so extra water retention. I've heard you talk about this when you're doing your your segments on how's it going with your GLP, one and extra sodium. Scale goes up for a couple of days.

Scott Benner 37:31
Okay, yeah. I tried, yeah, chicken wings. I tried chicken every time I tried to eat chicken wings. My I gained, like, water weight. It's crazy. That was pretty common for me to begin with. So that's just one of the things that hasn't gone away. Going away, I'll tell you my the GLP, where it's helped me recently is that I've been traveling more. So I did a cruise with a bunch of listeners, and I was on, you know, it's on the ship for six days, five, six days. I was very busy, like, super, super busy. I just didn't have a ton of time. It's gonna sound crazy if you're not in my situation, but like, you know, when you're just on the cruise, you live your life. You eat, you go to the bathroom and you go to the bathroom, but etc, when you have no free time during the day, you actually do eat. So that you won't be in a situation where a bathroom visit is a surprise. Does that make sense? Like, so, 100% Yeah. So you, like, you probably know, you go on work trips and stuff like that. Like, you get up in the morning, it's more like, Oh, I'll have some fruit, I'll have an egg, I'll have this. Like, you kind of like I was eating, like, hard boiled eggs for my protein, chicken for my protein. More lettuce, like, than I normally have, little more fruit than I usually have, like I was simplifying my diet so that I could decide when to use the restroom. Like Simple, right? But what made it easy was that I was never hungry the entire time I was on that ship. Now, what made it difficult was is that part of me being on the ship was that I had two dinners tonight, because it was my goal to have dinner with everybody that was there. So I would have like, a 5pm dinner with 10 people and a 715 dinner with 10 people, and I was already exhausted, like, so there's so much talking, and I was already beat and everything, but the menu would come and I eventually got like, a rhythm, like this young server, which basically turned into my mom. Like, she'd be like, just get this right now and we'll get you this the second meal. And I was like, that's a good idea. Like, so we were, like, spreading the food out and everything, but that, GLP, like, I would have been voraciously hungry without it that entire time, and I still would have had to have done what I did. It's interesting how it shuts off. I don't. It's not probably the same for everybody, but like, I don't get head or stomach hungry, usually ever. It's very interesting, although on day six and seven, I can eat a lot more than I can on days one through five. With the injection. I don't know if that happens to you. It does. Yeah, exactly the same. I think it's novo. I might. Nova and Lily, but like they're both trying to come up with a daily pill that replaces the injection, but still has the impact that the injection has been having for people. So I'm wondering if that will spread out the impact a little a little better for people in the future. I don't know how long it'll you know, if they actually work it out and get it to work and get it to market, on how long that something like that would take, but would take, but I'm interested in that too. I don't mind the injection, but I want the coverage to be more even, is

Speaker 1 40:30
my goal. I'd also see the benefit for a pill would be shelf stable without

Scott Benner 40:35
refrigeration. Yeah. Oh, is do you have too much GLP in your refrigerator?

Unknown Speaker 40:39
I wouldn't say too much.

Scott Benner 40:42
I mean, my wife and I are using it for weight. We have it here for Arden, for, you know, you know, for, you know what you're talking about, inflammation and blood glucose control and stuff like that. So, like, there's, like, a, he feels like there's a GLP section in the refrigerator. A little weird, actually, but Okay, so the GLP has been really valuable for you. I'm looking at your notes here. Can you tell people a little bit the difference between managing with and without a CGM? How does it change?

Speaker 1 41:10
Oh, it is. It is a complete game changer. A good example is for a quick breakfast. Just had a frozen breakfast sandwich, and I thought I was doing well with that sandwich, because two hours after eating, I'd be under 180 so that okay, I'm golden. Well, once I got a CGM, I had that same breakfast sandwich. Didn't realize I was going up over 200 Yeah, so then I started taking off one piece of bread to make sure I wasn't going over 180 and is it, you know what? I can't do this. This is not healthy enough for me, yeah. So just having that awareness of how how I respond to different foods, yeah, but also knowing I better get up and take a walk, or I better start pedaling on my little elliptical peddler. Yeah, yeah, to bring the numbers

Scott Benner 42:07
down, the CGM is more about you understanding how the food's hitting you and how the insulin and but also how the insulin is working. But what you saw first was, this is not a thing I should be eating. Is that right? Correct? Yeah, yep. How did you change? What did you do to you didn't just keep modifying the sandwich. You changed what you eat for breakfast.

Speaker 1 42:28
I changed so a Greek yogurt with some low carb granola. Or what I did especially early on, the Manjaro with the constipation, chia seeds in a protein drink. Oh, and make a pudding out

Scott Benner 42:44
of it. Yeah, that's a lot of fiber, right? And, boom, yes, yeah, I just went to the magnesium oxide. It's like, I also have gone through, like, seasons on the GLP, my wife and I were talking about this the other day that, like, I think there's a difference between tolerating it but having side effects that are expected and having something serious happen. Like, I want to say there's, I think there's a difference there, but, you know, I've gone through GLP, constipation. I've gone through GLP, like, I wouldn't call it diarrhea, but I would call it like, like, very like, loose stool, and it's not a day or two, like, it's a season, like your body is clearly adjusting to something as it goes along, at least was for me. And now I'm two years into it all that's like, straight now, like, I don't have what you would call like distress, like in the bathroom, unless I go eat something that, like, I know I shouldn't eat to begin with. And for me, that's a lot of, like, any anything fried, like crappy restaurant food, stuff like that is gonna send. It's gonna make my stomach go, oh, I don't know what this is, but I want it gone. And other than that, like, if I go through my normal day on that even on the ship, like people, I know this is crazy, but like, I lost five pounds on that ship. And I know people like, oh, you go on a cruise, you'll gain so much weight. Like, I had to be more careful about it, and it was a little more difficult. But there was good food there. You just had to, like, you had to pick through it, like, you know, everything's not chicken fingers and french fries if you're, if you're careful enough. And then this week, at children with diabetes, I was in a hotel all week long, and I came back, I think I lost a couple pounds that week too. So, like, I you can do it, you can find that food in the world. But like I say, if I, if I just, like, I mean, I think it was a few weeks ago, my wife and I were out one day, and we were both hungry. And, you know, it was Saturday, so we were both at the end of our injections and everything, and we were like, oh, there's this diner we used to like to go to. We went to that diner. I'm gonna tell you like we left that diner, went home, and an hour later, I was like, Excuse me, I gotta go. That food did not jive with me at all. If I eat purposefully, I don't have that problem at all anymore. But there were months at a time where I was. Are struggling with some of the side effects, but I don't know I the way I explain it to people is, I don't know if I'm right about this, but I figured it took me a lot of years to get in this situation. It wasn't just going to change on a dime, and then there was going to be some adjustments, like, literally, like on a cellular level, that have been happening. But in the end, I just, I count myself as somebody who probably just does not have enough GLP in my system without it being added as a replacement with this injection. That's, in the end, what I think is happening to me. Sounds like a fair assessment, good awareness. Best I can do. I've been trying to pay attention. All right. So listen here, I have two things left on your list here, I feel like we've covered we covered judgy providers, CGM, glps, your DKA experience, you just say here, integrative medicine experience, which I want to hear about, but then it feels like you want to interview me at the end, so we'll save that for the End. Tell me about your integrative medicine experience, though you

this episode was too good to cut anything out of but too long to make just one episode. So this is part one. Make sure you go find part two. Right now it's going to be the next episode in your feed. This episode was sponsored by touched by type one. I want you to go find them on Facebook, Instagram, and give them a follow, and then head to touched by type one.org where you're going to learn all about their programs and resources for people with type one diabetes. I'd like to thank the ever since 365 for sponsoring this episode of The Juicebox podcast, and remind you that if you want the only sensor that gets inserted once a year and not every 14 days you want the ever since CGM, ever since cgm.com/juicebox one year, one CGM. Summertime is right around the corner, and Omnipod five is the only tube free automated insulin delivery system in the United States because it's tube free, it's also waterproof, and it goes wherever you go. Learn more at my link, omnipod.com/juicebox, that's right. Omnipod is sponsoring this episode of the podcast, and at my link, you can get a free starter kit. Terms and Conditions apply. Eligibility may vary. Full Terms and Conditions. Can be found at omnipod.com/juicebox, hey, thanks for listening all the way to the end. I really appreciate your loyalty and listenership. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox podcast. You

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#1619 Bolus 4 Oatmeal

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Jenny and Scott talk about bolusing for Oatmeal

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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 Juicebox podcast.

In every episode of Bolus for Jenny Smith and I are going to take a few minutes to talk through how to Bolus for a single item of food. Jenny and I are going to follow a little bit of a road map called meal bolt. Measure the meal, evaluate yourself. Add the base units, layer a correction. Build the Bolus shape, offset the timing. Look at the CGM tweak for next time. Having said that these episodes are going to be very conversational and not incredibly technical. We want you to hear how we think about it, but we also would like you to know that this is kind of the pathway we're considering while we're talking about it. So while you might not hear us say every letter of meal bolt in every episode, we will be thinking about it while we're talking. If you want to learn more, go to Juicebox podcast.com. Forward slash meal, dash bolt. But for now, we'll find out how to Bolus for today's subject, please don't forget that nothing you hear on the Juicebox podcast should be considered advice medical or otherwise, always consult a physician before making any changes to your healthcare plan or becoming bold with insulin.

This episode of The Juicebox podcast is sponsored by Medtronic diabetes and their mini med 780 G system designed to help ease the burden of diabetes management, imagine fewer worries about Miss boluses or miscalculated carbs thanks to meal detection technology and automatic correction doses. Learn more and get started today at Medtronic diabetes.com/juicebox All right, guys, listen to Jenny and I fumble through figuring out how to tell you to Bolus for a specific item. And you'll know, this was the first one we recorded, because it's probably going to sound like it. But Jenny, my idea is, is to create, like a food library of basic, simple foods. And then once we feel like we have that library, kind of like completed, I want to go to menu items like, I want to start like, oh, I want to go online and be like, I have like, examples from people, they've already sent, like, one, you have no idea how many people want to know how to Bolus for the roles at Texas Roadhouse, like, something simple like that. So, like, we're going to start, and you won't know. So we're gonna, it's gonna

Unknown Speaker 2:34
be very like, I should ever been to Texas

Scott Benner 2:37
Roadhouse, Roadhouse, but I think that'll be interesting, because what we can do is just pull up the menu, pull up the nutritional information, and just take, try to apply as much science to the random known information, yeah, and then, like, release people out into the world and see what they do. So

Jennifer Smith, CDE 2:55
no, it's kind of a progressive build. Then really the idea of taking single items like an orange, and then saying, Okay, now that you've got all the simple single food and the potential way to work them, now let's build in something that's more of a complete meal. Is the idea, right?

Scott Benner 3:16
I somehow oddly believe that these small episodes will teach people to swag better in the end? Great, yeah, I think, because, I think that's the most reasonable way, long term, to have type one and have to manage food, right? You can't. I mean, in the beginning, you know that you see the people like, I got a scale. I got this is there an app that you can take a picture of something, it'll tell you how much it weighs. Like, you know, like that. Mania hits you in the beginning, but at some point years into it, you're like, ah, it looks like 45 grams. So I'm interested to see if this helps people. Okay, all right, so let's start with something simple. How about oatmeal?

Unknown Speaker 3:53
Oatmeal? Yeah, okay, never have an oatmeal.

Unknown Speaker 3:57
Yes, okay,

Jennifer Smith, CDE 3:58
and I think we need to define oatmeal. I know. Are we defining quick oats, like the little bags of Apple Cinnamon, not real apple, and probably lots of sugar and not much cinnamon? Or are we defining old fashioned, thick, rolled oats? Or what are we defining here? Because there's a difference.

Scott Benner 4:18
Let's go with what people probably eat and Yeah, how about Quaker? Like, instant oatmeal, Chinese. Like, I don't know what it is, but I got it here. Okay, you ready? So there's a box you can buy on Amazon. It has four different flavors. It has maple and brown sugar, cinnamon and spice, apples and cinnamon, peaches and cream. So let's just like, let's say we chose the maple and brown sugar. Serving size is one packet. Okay? There is half a gram of saturated fat, no trans fat, half a gram of polyunsaturated fat. There's 260 milligrams of sodium, 33 grams of carbs

Unknown Speaker 4:58
in a single. Packet, right? Packet, 33.

Scott Benner 5:01
Grams of fiber, one soluble fiber, sugar. You want to guess, fiber, fiber, dietary fiber, three grams. Oh, it's pretty good. Three, look at that. He's like, Finally, but total sugars, 12, there's protein in it. That's interesting. Four grams

Jennifer Smith, CDE 5:20
grains have protein, and the more unprocessed they are, the more fiber as well as the more protein they retain.

Scott Benner 5:26
Okay, so, so this one's interesting. I've never wait. We're gonna really find out that the foods I've never seen in my life, I've never had oatmeal in my life. Are you kidding me? No, I've no idea like it really you've never had oatmeal. Oatmeal looks like small pieces of cardboard in mush. To me. Is that not what it

Unknown Speaker 5:49
is? Sorry, that that's what you think they look like.

Scott Benner 5:52
But you would turn me onto like, what like steel cut oats or something like that. If you were telling

Jennifer Smith, CDE 5:58
me dislike steel cut oats, I know that there is a world of people out there who love their steel cut oats. I do not like, I don't like the consistency of steel cut oats. And I'm not really a texture person, honestly, but steel cut oats just are gross to me. I much prefer old fashioned, thick, rolled and then do kind of I do like an overnight Oat. So it's where you put the fluid in of whatever kind you're going to use. You let them sit overnight with the liquid in them so that they get it gets absorbed, they get soft. And then you could technically cook them a little bit to heat them, but, but they're soft enough that you could eat them cold, which changes the glycemic nature of them.

Scott Benner 6:43
What taste was it? What I almost said, What tastes like? What does it taste like like? Describe it to me. Today's episode is sponsored by Medtronic diabetes, who is making life with diabetes easier with the mini med 780 G system, the mini med 780 G automated insulin delivery system anticipates, adjusts and corrects every five minutes. Real world results show people achieving up to 80% time and range with recommended settings, without increasing lows. But of course, Individual results may vary. The 780 G works around the clock, so you can focus on what matters. Have you heard about Medtronic, extended infusion set? It's the first and only infusion set labeled for up to a seven day wear. This feature is repeatedly asked for, and Medtronic has delivered. 97% of people using the 780 G reported that they could manage their diabetes without major disruptions of sleep. They felt more free to eat what they wanted, and they felt less stress with fewer alarms and alerts you can't beat that. Learn more about how you can spend less time and effort managing your diabetes by visiting Medtronic diabetes.com/juicebox

Jennifer Smith, CDE 7:56
oats are pretty, they're pretty, I don't know. They're a little bits. They're a little bit not sweeter, but I don't know. They're more breakfast foodie tasting than something like plain rice that has not been flavored with anything as well. And if you have cooked them or soaked them the right way, they're pretty soft, so they're not like the cardboard that you're envisioning. I just realized

Scott Benner 8:20
I'm gonna sound like an alien while we're talking about this. So why do I eat them? It's not for flavor. Is it for Well,

Jennifer Smith, CDE 8:27
if you eat again, that's the difference. That's why I asked, What are we talking about? Quick cook versus old fashioned, and especially the old fashioned thick roll. The difference being that the quick cook are really they're processed like they're they're broken down, they're more ground up. It's the reason that they cook really, really quickly, and they are like you're talking about, they're more like mush,

Scott Benner 8:48
but with enough sugar on them that I'm like, okay, I can do this. You could do it, yes, exactly, different flavors in one package, correct? All right. Well, let's assume that some people must throw these together, like in the morning, because it's quick and right? And so we're going to do for all these, we're going to keep it one unit covers 10 carbs. One unit moves you 100 points. Okay, that way, like, we can kind of keep the math simple. So if there's 18 carbs here, then what? It's one 1.8 units. And then there's,

Jennifer Smith, CDE 9:26
there are only 18 carbs in that little packet, really. Oh,

Scott Benner 9:29
no, 33 what was I saying? Sorry, 3.3 3.3 units. I saw the I was looking at the wrong number. And then and 12 of that is sugar. Like, how does that sugar impact that Bolus in your mind, because you know what I mean, like the oats themselves are probably a very slow breakdown. Is that not right?

Jennifer Smith, CDE 9:47
Yeah, correct. And with the sugar added now you've added in, what is that? If you do the math, it's about a third of the grams of total carb actually come from sugar, and that's. Added sugar. And so what we're looking at is a much heavier glycemic impact. And for definition, as I mentioned to begin with, we look at quick cook versus old fashioned, and they're both in the moderate glycemic index kind of number line. I think one is somewhere in the 50s, and that's probably that's the older old fashioned oats, and then the more quick cook flavored tend to be somewhere in the 60s. So they're not terribly different, but it's what you end up doing to them that can make the difference. And as we're talking about, Bolus strategizing, along with now adding in sugars, flavors, that kind of thing to it. You're adding in a third of the weight of this product is

Scott Benner 10:47
sugar. Doesn't seem like a good idea,

Unknown Speaker 10:50
right? Well, right? And, but it

Scott Benner 10:53
feels like, in my mind, it feels like you're getting a slow digestion material with a quick spike. So I'm gonna and when are we usually eating morning, when I'm already having trouble bolusing for things because for a number of different reasons, feet on the floor, maybe adrenaline about the day. Maybe you have a lower basal rate overnight that helps you not to get low. Overnights, you wake up, you have more resistance less insulin. Then you throw in something that's gonna take forever to digest, and hit it hard with sugar right away. So that's where you get a 320 blood sugar that lasts for three hours. Right? Okay, right, exactly.

Jennifer Smith, CDE 11:30
So you know, when you think through the strategy as you've defined a one to 10 ratio, a one to 100 correction factor. So we're giving some points of reference, and if we also say, okay, you've come into this meal, this breakfast at a stable in Target blood sugar. To just simplify the whole piece, right? You're not rising already. You're not low or having dropped or treated a low blah, blah, blah, or coming in nice and stable, let's say a blood sugar of 100 making it even easier. What would you anticipate, knowing what we've just talked about, in terms of the glycemic nature of this particular food,

Scott Benner 12:08
I'm anticipating a quick rise. I'd want a long, pretty aggressive Pre-Bolus, right? I would be, yeah, I used to talk about this more, but I'd be looking for like, an 80 diagonal down on my on a CGM before the oatmeal hit, because I'm thinking the oatmeal is going to hit you really quickly, like, the sugar that's going to hit you really quickly. Yeah, so, and

Jennifer Smith, CDE 12:34
we're also placing in we're not placing anything else addition to it. We're not saying, eat eggs first. We're not saying eat a add a load of butter to the dish, or whatever this is. You're just cooking these quick oats, and you're going to eat

Scott Benner 12:47
them. That's working these down, and you're leaving the house. And so, right, exactly.

Jennifer Smith, CDE 12:52
So the goal would be, if you know you're eating this, you're getting up in the morning, you've got this amount of time frame to leave the house, or get your kids out of the house, etc, that Bolus goes in almost as soon as you are getting out of bed, if you are the quick eat person in the morning, Bolus do your morning get ready thing. My previous experience in college with quick oats, because that was what they served in the cafeteria, until I started doing my own thing was like a 30 minute to get ahead of that, to get ahead of what was going

Scott Benner 13:27
to happen. I'm gonna I'm making notes for myself about other things to talk about, because I don't want to derail these but you're making me think of other stories that people have told me. Oh, great. So in case people aren't like following along yet, we did measure the meal. Evaluate yourself, add the base units, calculate the food, Bolus, carbs, etc, and now we're to the l layer a correction. So if we, you know, Jenny said, like you know, if you were, let's assume you're at 100 but if you weren't, if you were at 120 or 150 or whatever, that Pre-Bolus would include a correction to move that number to your target number, right? And now we got to decide, like, is this like, you know, we've talked, I think a big, long Pre-Bolus. Do you think it needs any extension, or extended Bolus, or a follow up? Bolus afterwards, or not, if you hit it hard enough up

Jennifer Smith, CDE 14:15
front, right? Not, if you do not, if you're really on top of the Pre-Bolus and that timing upfront. There's nothing sticky that doesn't have a lot of fiber in it. There's really nothing that's going to hold this food for a long time. It truly is a more carbohydrate type of food, which has an in and out clearance that mimic or goes along with, why we use rapid acting insulin, right? Rapid insulins have an in and out, and if there's nothing else in the picture to linger well beyond that three hours, like fats and proteins, your timing of that meal should coincide with the way that the insulin is supposed to

Scott Benner 14:52
work. If this didn't have sugar on it, you would Bolus differently for it. If this didn't have

Jennifer Smith, CDE 14:58
the added sugar. Factors too, if it was just truly plain, quick cook, quick cook. Oh, it's definitely less time, especially starting with all the factors that we defined already right, blood sugar, stable in Target, et cetera. But still at least a 15 minute, probably even 20 minute Pre-Bolus time.

Scott Benner 15:18
Yeah, so shorter Pre-Bolus, still not just five minutes, right? And because this stuff is gonna get in there and start hitting hard, it's just gonna hit a lot harder if there's sugar on top, okay? And then we wanted to look at the CGM maybe an hour later, see where we're at, and then just kind of spot check an hour, you know, three hours later, whatever you're comfortable with, and then take some notes for yourself and tweak it for next time. See, see if you got the outcome you wanted. Adjust your ratios, you know, adjust your Pre-Bolus time, maybe a little longer, a little shorter, and give it another whirl. I somebody said something online the other day that I love they somebody was trying to figure out how to eat ice cream. Oh, and this person said, My strategy for ice cream is I keep going back and eating ice cream until I figure it out.

Jennifer Smith, CDE 16:06
That's exactly what we're talking about here. Yes,

Scott Benner 16:10
try your oatmeal again. All right. Awesome. This was great. Thank you. Cool.

Thanks for tuning in today, and thanks to Medtronic diabetes for sponsoring this episode. We've been talking about Medtronic mini med 780 G system today, an automated insulin delivery system that helps make diabetes management easier day and night, whether it's their meal detection technology or the Medtronic extended infusion set, it all comes together to simplify life with diabetes. Go find out more at my link, Medtronic diabetes.com/juicebox. Hey, thanks for listening all the way to the end. I really appreciate your loyalty and listenership. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox podcast. You foreign.

In each episode of The Bolus four series, Jenny Smith and I are going to pick one food and talk through the bolusing for that food. We hope you find it valuable. Generally speaking, we're going to follow a bit of a formula, the meal bolt. Formula, M, E, A, l, B, O, L, T. You can learn more about it at Juicebox podcast.com, forward, slash, meal, dash, bolt. But here's what it is, step 1m. Measure the meal E, evaluate yourself. A, add the base units, l, layer, a, correction, B, build the Bolus shape, O, offset the timing, l, look at the CGM and T, tweak for next time. In a nutshell, we measure our meal, total carbohydrates, protein, fat. Consider the glycemic index and the glycemic load, and then we evaluate yourself. What's your current blood sugar, how much insulin is on board, and what kind of activity are you going to be involved in or not involved in? You have any stress hormones, illness, what's going on with you? Then a we add the base units your carbs divided by insulin to carb ratio. Just a simple Bolus l layer, a correction, right? Do you have to add or subtract insulin based on your current blood sugar? Build the Bolus shape. Are we going to give it all up front, 100% for a fast digesting meal, or is there going to be like a combo or a square wave Bolus? Does it have to be extended? I'll set the timing. This is about pre bolusing. Does it take a couple of minutes this meal, or maybe 20 minutes? Are we going to have to again, consider combo square wave boluses and meals, figure out the timing of that meal, and then l look at the CGM. An hour later, was there a fast spike? Three hours later, was there a delayed rise five hours later? Is there any lingering effect from fat and protein? Tweak, tweak for next time? T What did you eat? How much insulin and when? What did your blood sugar curve look like? What would you do next time? This is what we're going to talk about in every episode of Bolus four. Measure the meal, evaluate yourself, add the base units, layer a correction, build the Bolus shape, offset the timing, look at the CGM tweak for next time. But it's not going to be that confusing, and we're not going to ask you to remember all of that stuff, but that's the pathway that Jenny and I are going to use to speak about each Bolus the episode you just heard was professionally edited by wrong way recording, wrongway recording.com,

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