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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
Martin is 62, years old. His wife (type 1 30 years) asked him to come on in hopes that he might learn something about diabetes.

Friends, we're all back together for the next episode of The Juicebox Podcast. Welcome. 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. Don't forget to save 40% off of your entire order at cozy earth.com All you have to do is use the offer code Juicebox at checkout. That's Juicebox at checkout to save 40% at cozy earth.com if you or a loved one was just diagnosed with type one diabetes and you're looking for some fresh perspective, the bold beginning series from the Juicebox Podcast is a terrific place to start. That series is with myself and Jenny Smith. Jenny is a CD CES, a registered dietitian and a type one for over 35 years, and in the bowl beginning series, Jenny and I are going to answer the questions that most people have after a type one diabetes diagnosis. The series begins at episode 698, in your podcast player, or you can go to Juicebox podcast.com and click on bold beginnings in the menu.

Touched by type one is excited to host their first ever walk steps to a cure. This is going to happen on March 8 at Lake Eola Park in Orlando, Florida. You can join touch by type one as they walk united with their community to elevate awareness of type one diabetes, to raise funds to find a cure and to inspire those with type one diabetes to thrive. Learn more at touched by type one.org Go to the Programs tab. This episode of The Juicebox Podcast is sponsored by touched by type one.

Martin 2:09
Hi, Scott, so my name is Martin. I'm from the UK, as maybe you can tell from my accent, and I'm married to a type one diabetic. You're married to, I'm married to, yes, excellent, excellent. So I don't have diabetes or anything like that. I My experience is purely second hand. Oh, this is

Scott Benner 2:32
gonna we don't get a lot of this. This is excellent. And I love your topic, by the way, that you that you included when you signed up. I can't wait to get to that. No, okay. Well, do you

Martin 2:41
have kids? We do have kids so they don't live with us anymore, because we are that old, we are both retired, and the kids have moved away and live in different parts of the country. One is married and has their own family, and one is just dating at the moment, but happily in relationships, happily working, going really well. Daughter did. She's pregnant again at the moment. Daughter did have gestational diabetes during her first pregnancy, but so far, that hasn't reared up during the second pregnancy.

Scott Benner 3:23
Has there been conversation that that might mean diabetes in the future?

Martin 3:28
There has indeed been conversation around that, yeah, and the NHS here is keeping a close eye on it. She was, in fact, tested yesterday. She's at 24 weeks.

Scott Benner 3:40
Well, congratulations on being a grandfather again. Is that difficult that like you and your wife sitting down with your adult daughter and saying, hey, you know gestational could mean diabetes in the future, not so

Martin 3:53
far, no, she knows the sort of risks. Frankly, we don't come with just diabetes as a health background. I'm asthmatic, so that's something that the kids occasionally suffer from. I had eczema when I was younger. The kids both suffer from that now. So we come along with lots of health problems. They're used to that kind of inherited health danger, I suppose you could call it or or risk.

Scott Benner 4:23
So what about your wife? Besides the type one, does she have anything else? No, nothing, no thyroid or celiac or anything like,

Martin 4:30
oh, apologies. Yep. Good. Good. Prompt, nicely done. She does have if it or she's regularly taking stuff to keep the thyroid under control.

Scott Benner 4:39
Hypothyroidism, she takes, uh, Synthroid. Maybe

Martin 4:43
you're going into way more detail than I know. I'll be Martin. I'll be honest. Tell me. How long have you known her? So we are not now. You're really asking tricky questions that I hadn't expected and hadn't prepared for. We've been married over 30 years. Let's put it

Scott Benner 5:00
that way, 30 so you've been married over 30 years, and if I said to you, does she take a little white pill every morning? You're not 100%

Martin 5:06
certain he does take a little white pill that comes in a really nice cardboard box. But what the name is on the outside? I have no idea. I love that you said

Scott Benner 5:15
it's a very nice cardboard box

Martin 5:18
that's just keep them fresh, isn't it?

Scott Benner 5:21
That's listen. I only asked not to embarrass you, but to point out that, you know, you could live with somebody for 30 years and be like, I don't they do take a pill every morning. I mean, if I'm being honest, I'm asking you, because if people are listening who are just starting their journey with hypothyroidism, for example, I'd like them to know that 30 years from now, their kid, or they might be with a person who loves them very much, is like, yeah, it's not that big of an impact for them. You know,

Martin 5:46
agreed, now that it's under the control of the drugs, it doesn't actually impact her. She occasionally has to get assessed to get the dosage adjusted, sure. But actually, that is working out

Scott Benner 5:58
fine, excellent. No, that's great. Yeah, yeah, it's a big problem if you're not taking the medication. I agree. And I actually have a personal friend right now who's fighting with the doctor, you know, who wants to just point at everything except the obvious. They have a TSH that was five and a half. They tested it again. It was 2.6 it's bouncing all over the place. And the doctor is like, what could be your liver? It could be this, it could be that. And the person goes back and says, Well, elevated liver enzymes are common when TSH is elevated. And the doctor goes, yeah, it's not, it's not your thyroid, but it's just, like, but my hair is falling out and I'm tired and I have, like, like, just lists all these thyroid system the doctor goes, you know, maybe you have fatty liver. Maybe it's this, like, Can I try this generally harmless medication to see if, like, you know, it helps me doctors like, ah, we might want to test you for fatty liver. Like, oh my god. Like, just trying to make money, you know, like, I don't know. But anyway,

Martin 6:50
that sounds such a tricky situation when you're suggesting to the doctor based upon my symptoms. It could be this, but I suppose it does fit in with how the world works at the moment, we do a lot of diagnosis by Google. It's

Scott Benner 7:04
an interesting problem, you know, nevertheless, so your wife had diabetes when you met her, or was diagnosed during your relationship?

Martin 7:13
No, she'd had diabetes for quite a while. When I met her, she was at that point, because it was quite, quite such a while ago. She was obviously just injection controlled, but it's now become, as with all the technology, she now has a CGM on her arm, and she's still injection based, but it she's changed insulin several times during that

Scott Benner 7:40
so when you start dating, how prevalent is the idea that she has diabetes? You're really testing a memory now, a long time ago. But do you remember being like, I like this girl, but or do you remember not thinking about it? I remember not thinking about it frankly. Okay, it was an interesting aspect of her, but it wasn't a risk or a don't go there type flag, nothing like that. I have my daughter's dating a boy, and I resist every time I see him from asking questions that are meant to lead to are you judging my kid because of this? Are you worried about it. Like, are you scared? Would you flee if she had a problem? Like, like, I don't do any of I don't do any of that, and it doesn't overwhelm me when I'm seeing him, but I would be lying if I said I wasn't interested in where his mind was. And then there's part of me that thinks he probably doesn't even notice. Like, she barely you'd be hard pressed to know that Arden has diabetes if you were looking at her, you know what I mean? And interesting? Yeah, and she's, I mean, she wears her stuff out. But people get used to that very simply, like, I don't think it takes long for someone who's around you not to see your pump. For example, she's not overly involved in it. It goes very well. So there's not a lot to do, is what, I guess, is what I should be saying, not that she's she's involved in it. She's giving herself insulin every time she needs it, etc. But it's going so well that, you know, there's not, like, a lot of pit stops, I guess is my point. No, that's great. Good. Good for her, yeah. But I do wonder, what's that? I'm sorry I'm good for him as well. Actually, yeah, yeah, no, I hope so i It seems like that. I guess if I was worried, I'd probably open my mouth, but I must not be anyway. So you start dating, there's no notice of this or anything. But then through your life, like, what are the stories that stick out in your head that were diabetes related, maybe things that you were like, Oh, I didn't realize this was going to happen. Or, you know, that stuff like that. So

Martin 9:40
significant steps are definitely as you are changing your insulin regime as because as you move from one injection to another injection, that has always seemed to disrupt her and it takes several weeks to get through and. A new regime and to settle and to be under control again, pregnancy was, at times a little bit tricky. We always had to keep a set of chocolate biscuits on hand, as things would change quite rapidly when she was actually pregnant, those are probably the major things that that actually stick out now, she's obviously, most of the time, well controlled, looks after herself. At the moment, we're having a bit of a discussion, and I'm interested as to what your experience around this is, because I think you know a lot more about the the situation than me, obviously being my experience being second hand around a diabetic. I've not read through a lot of the background to diabetes, and I I'd be honest, I don't understand the dosage. And you quoted TSH at me earlier. I think your medical background is much deeper than mine, because I didn't actually understand that phrase. So I don't actually understand, I think, the mechanics of diabetes and the dependence upon the injections for the provision of insulin. And we're just having a discussion around that at the moment as to whether I should become more versed in that in order to understand what's going on with, you know, the amount that she's eating, the amount that she therefore needs to be dosing, the amount of exercise, and all those other factors that that come together to keep someone balanced with type one diabetes. What are your thoughts around that? Earlier,

Scott Benner 11:40
I told you about touched by type one and their steps to a cure walk, which is happening on March 8, 2025 you can go to the website touched by type one.org, and register now. But guess what? This weekend, there's a special steps to a cure kickoff event. You can join touch by type one for a light breakfast at their walk kickoff, come meet fellow participants, learn more about the walk and get excited for the big day. Then you can enjoy a complimentary day at the Orlando Science Center. Get out of here for free. What the heck? Touch by type one.org Go to the Programs tab, get registered. Now. This thing's happening on Saturday, January 18, at 8am you gotta go register right now on the website. Get going. I have to ask first, do you not know about it, because you were busy working, and she was raising a family, and you had two separate kind of lives around that, and now you're, are you guys retired now? We are indeed retired now, and now you're retired. Is she starting to think about, what happens when I get older? What if I can't do this for myself? Is that the concern? Or is she or did she look up and go, How did this jackass make it this far without understanding my diet? What's the um, the onus together? Think about, I'm gonna

Martin 12:47
go with the second one, frankly, that she really thinks I ought to be understanding some more of the situation in order to be under probably more of a sounding board as to whether she is actually going the correct way with the regime. Yeah.

Scott Benner 13:04
Can I ask you, like, a slightly personal question, did you when this came up? Did you have any hindsight? Did you think, wow, why didn't I think about this sooner? No,

Martin 13:14
that wasn't the thought that occurred to me. The thoughts that have occurred to me around this are, frankly, we have a relationship, which does work really well, but can be just a little bit prickly at times when we don't agree on something. And I just feel that if I knew more about the diabetes, then I would be saying, Why are you giving yourself three units at the moment, you've just run around the park. Shouldn't it be two? And I could see that creating more tension than actually providing the value that she feels. It might do

Scott Benner 13:54
is everyone hearing a wise man who's been married for 30 years, speaking very carefully. This is wonderful, Martin. Thank you. What Martin is saying is there were times over the years I thought to speak up, but I imagined it would end with the resolution of my marriage and me living above a donut shop, so I kept my mouth shut.

Martin 14:17
Maybe the donut shop is questionable, because we don't know many of those in the UK. But the general gist is there,

Scott Benner 14:23
yeah, of course. And by the way, I want everyone to know, my brain struggled for a more British centric food. It didn't find anything, and I just decided to move on the thing. Ah, have you not been to the UK? We said crumpets, fish and chips would be the one that would come out in the UK. Yeah, I don't know. I was looking for a baked good for some reason. Now the reason is, is that that joke here in America is that every guy I've ever known who ended up divorced lived above a pizza place for a while, while they were getting back on their feet, and I wasn't certain if pizza was a was a delicacy in England or not. Oh yeah, went off to come sometime and try it. But anyway. I hear what you listen, I get what you're saying. Like people don't want to be alone. They want someone to help, and they want support. But when that support comes from someone who's too close to you, a lot of times, your reaction is, leave me alone. I don't need your help, and nobody's looking to fight. So you guys probably settled into a space where you kept your distance on this, and she quietly resented that you weren't helping her. And had you helped her, she probably would have quietly resented that you were involved. But now you're now, you guys are together all day long. You're seeing the reasons why it would be helpful if everybody, if there was a sounding board, somebody to just run through it, I'll tell you, simply stated. I think the Pro Tip series in the podcast would be really helpful for you. Okay, yeah, no kidding. Episode 1000 to like, 1025 and there's even stuff in there about pregnancy, and just, I have a whole series about gestational stuff, and if your daughter should run into the problem, again, the diabetes part, you could figure out easily, right? Especially because she is she using a pump with an algorithm.

Martin 16:12
No, no. She was using the T slim, and that just completely didn't fit her lifestyle. It was making way too many assumptions about if this happens, I should do that, and it was either allowing her to go too high or pushing her too low. So that didn't last very long. At the moment, she is long term injecting once a day, and then since where I start become hazy and probably need to learn more, I think it's three times she injects on the rapid acting stuff. She's

Scott Benner 16:52
doing what they call MDI, multiple daily injections. And once a day she's using her her long lasting insulin, her basal insulin and Yeah. Then at meals, she's shooting for for carbs. Is that why it ends up being three times a day? Yeah? Does she ever shoot in between a meal to adjust down a high blood sugar? Occasionally? Occasionally, she does. Do you know what her a 1c is no, no. When she goes to the doctor, they give her that report about what her average blood, Yeah, agreed. Interesting. Have you ever gone to the doctor with her? Not about diabetes, because she doesn't want you there, or because you've just never thought to go. I've

Martin 17:34
just never thought to get. Been honest with you, how old are you?

Scott Benner 17:38
6262 Okay, so I have no medical background at all. Martin, I want to be clear. I barely got through high school, everything I know I know from I'm not kidding you, I didn't go I imagine I've said this on the podcast, but I missed 53 days of my senior year of high school, and I did that because I was poor, and I went to work instead. And, gosh, I look back on it now, and I realized I would work an eight hour day to make $40 before taxes. I'd skip school all the time to go to work. I got done with high school. There was no expectation of college. I grew up like in a very blue collar family, they just wanted me to go work, and I went off and did that. What I know I know because of having these conversations on the podcast, I know because of paying attention to my daughter's health and wanting better for her. And then my wife, who has hypothyroidism, you know, and she's 50 years old, she's had, you know, problems along the way, paying attention i My son has hypothyroidism. I couldn't process iron for a lot of my adult life. So my ferritin levels, my iron levels, were always very low. If you grab me right now and pointed at me, at one of my family members, and said, Tell me about their health background, I would know all about it. I have, like, a very deep caregivers mentality. I hate saying this out loud, because I think some people might hear it as sounding sad, but I don't think of it that way, I genuinely care more about the people around me than I do about myself, and if I'm not doing that, I'm not happy, generally speaking. So I'm very aware of everyone else's life and their situations, where they are the medications they take when they need to be doing it. And I'm going to tell you that for the most part, some people appreciate it, and some people are like, I don't want you involved that much. And there's like, a whole spectrum of the responses you get back from people. I understand that I'm unlike most people like in that regard, that if I interviewed 100 spouses, forget men or women, and asked them about their spouses medical stuff, I generally think they wouldn't know that much about it. I don't think that's uncommon the situation you're in, but I think it's really uncommon that you stand up and try to, like, figure it out. And I think this is, that's why this is a great conversation, because you're, I mean, you lived a long time not doing a thing, and now you're trying to figure out how to do it. The

Martin 19:59
fact. Myself just a little on that in the not doing anything. Obviously, I'm around whenever there is signs of a hypo or trying to help with a Hypo. But you're right. I've not got involved with the mechanics of how that hypo came on. About, yeah, so I didn't really know the background. I don't know the background. Yeah, my

Scott Benner 20:22
wording was poor there, like not being, yeah, yeah. But what I'm saying is that I don't think that's uncommon. I think the person with diabetes probably, like, if I got your wife on here and said, How come you didn't pin Martin down earlier on this, she might say, I didn't want to, I didn't want to burden somebody. I didn't want people to see me as sick. I didn't like she probably have her own reasons why she was more private about it, and allowing you to feel like, I don't need you to be involved in this, and then that's a pass for you. Then you're like, Okay, she's got it, and that's the end of it, you know what I mean? And then you go live your life and do all the other 8 million things you had to do with the last 30 years. This is so interesting, Martin, because I've never gotten to talk to somebody about it from this perspective. But I will tell you that I think the management of type one diabetes is at its core about the timing and amount of insulin, right? So whether that's the basal insulin or the meal time insulin, if you're making a correction to a high blood sugar, that's the timing and amount. You have to time it well. You have to measure it well. You can't measure it Well, if your settings aren't good, there are pretty reasonable ways to figure out what your basal should be, what your insulin to carb ratio should be, what your correction factor is, your insulin sensitivity, meaning, like, you know, a unit moves me exactly how far you know how many carbs are covered by a unit of insulin. These numbers are super important. If your wife got onto a pump, especially an algorithm based pump that was making decisions without her settings being pretty solid, that's why the pump probably felt like it wasn't working, because control IQ is a great algorithm, and if it was crashing or low or letting her get high all the time, you have to remember that that pump only knows what she told it or what her physician told it on the day they set it up. This is how much basal you need. This is your sensitivity factor. This is your carb ratio. And then beyond that, if no one's ever taught your wife that, for example, going off and having a salad, you know will, and let's say she has a salad and there's 20 carbs in it, that's different than having 20 carbs of French fries chips, because, yeah, the absorption, right? Is completely different. And you know why that happens? No, I wouldn't like to say, oh no. It's the fat in the fries slowing down your digestion and keeping the carbs impactful for a longer amount of time. It's not, yeah, that it's so it's so much about your digestion, because if you think about the timing of it, the timing is, whatever the carbs are, they go in. They're absorbed a couple of different ways, right beginning right away with the lining of your cheeks, which is why you would, if your wife was having a low blood sugar, put gel in her cheeks, or ask her to, you know, take one of those hard glucose tablets or something like that, because your body absorbs right through your that simple sugar, right through your cheeks lining, if you have, You know, I don't know a burger. That burger doesn't really get absorbed so much through your mouth. It goes down into your stomach and your body, for the lack of a better way of talking about it, your body kind of prioritizes things, and it breaks down. So if that burger went down there with cheese and bread, the bread is going to hold your blood sugar up. The fat in the in the ground meat will slow down digestion. The fat and the cheese will slow down digestion. And the entire time that digestion process is happening, that bread is kind of leeching off those carbs and it's and her body's picking that up in her bloodstream and raising her blood sugar if she eats that same burger and cheese without the bread. Well, there's not many carbs in there, so it doesn't really matter how long, although at some point, 45 minutes later, with this burger, this pretend burger with cheese, with no with no roll, your body starts to store the protein as glucose. So as it's breaking down the protein, it stores it as glucose. So you'll get even if you ate very low carb, you'd see some sort of a bump, 45 minutes an hour later, where your blood sugar would start to go up. And that's another thing. So my point is, is that if people don't understand how food is impacting their blood sugar, then they can't figure out where to put the insulin. That all makes sense. Yep,

Martin 24:38
understood. And yeah, I have come across aspects of that before. Because definitely, for example, when she eats a pizza, it hits several hours later, right?

Scott Benner 24:47
It's exactly why. And if the pizza has protein on it, like a sausage, for example, even longer. And so even a plain pizza versus a sausage pizza would be different. Yeah. And that all is just bonkers, because most people, no one tells them that. They tell them, count your carbs, push the button, you know, inject and go live your life, right? Yeah, that is not helpful when you're trying to make big decisions, and that puts your wife or and other people like her in that situation where they're making decisions which are driven by doctors. And, you know, Doctor says, Look, do this. And you get home and it doesn't work, and you're like, Well, I did the, you know, it was almost cursed. But it's like, yeah, yeah, I'm thinking I was told to do and it's not working. And then you're over their shoulder from the other room going, Honey, what's wrong? She's and she's probably thinking, I don't know. I you know, like, instead it turns into like, leave me alone. I'm trying to get this like, and I think that's how this gets sideways. Seriously. Yeah, that that fits the situation. So, what do you want to do? Like, what is your what is your goal? Like, what kind of a sounding board Do you want to be?

Martin 25:55
Oh, that's an interesting one. There are several ways I could play it. I could try and be a know it all, but I don't think that would actually work very well within our marriage, we don't tend to work like that and get on it would be much more a listener and then, in effect, an advice giver, as in, yep, That's the right way to do it, or no, have you thought of X, Y, yeah, whatever it is. So much more the gentle background sort of person, rather than the Oh, hey, it's time for you to three units,

Scott Benner 26:35
dear. Yeah, she's, she's not looking for you to, I mean, she's been doing a long time. I wouldn't, no,

Martin 26:39
she'd been doing it a long time. She's still alive. She's doing really well. Oh, by the way, I don't know how you think of it, but I don't think of diabetes as a sickness. You mentioned that earlier, and I was just wondering if that was your phrasing, or whether that was very interesting. Yeah,

Scott Benner 26:55
I don't think of it that way, either. But what I'm saying is that I've talked to enough people who say, I don't want to feel like I'm XYZ, like whatever the phrasing is that they use, yeah, I don't want people to see me as broken. I don't want people to see me as sick. I don't want it's not necessarily what they think of themselves. It's what they're worried other people will think that's kind of how it seems to me. Okay, understood is that, you know, and listen, fair enough, I've also spoken to people who see themselves as those things, and, you know, like so a lot of it is perspective. And you know, how people see the world. What I've heard from people is either don't see me as broken, or don't see me as a problem, or they're just frustrated that this thing is interfering with their day. Forget. They don't give a shit. You think about it. They don't want to be involved in it either. You know, like it's it's difficult to remember sometimes that this person who's doing this thing and making it seem so effortless is constantly thinking about it, burdened by it, doing their own work, mental gymnastics, to not be thinking about it. And they they very much wish none of this was happening, too. And that's an experience I've had to have with my daughter, where, like, not that you forget, but she just does such a good job that you're just like, Oh my God. You know, like, it feels effortless, and it's definitely not, you know, it's just definitely not. Yeah, agreed. Did you live at all any time worrying that your kids would get type one? Did your wife ever talk about it? Yeah, that's

Martin 28:34
been a conversation, and that's obviously a risk we're still aware of luckily, that hasn't happened so far. Yeah, could still happen, but hasn't happened so far. So

Scott Benner 28:47
it's interesting, because you're a generation B, I'm 50. I turned 53 a couple days ago. Okay, it does feel like a crazy thing, you know what I mean? Like, like, you're just like, I can't believe I'm this old, but I'm happy I made it. But my point is, is that you're, you're, you're a generation beyond me. So even this thing about like, being more involved, like, it's not common, it wouldn't be common for you, right? Like, this interlapping, like, you guys are kind of learning to be new people as you're retired, I guess is my my thought,

Martin 29:20
exactly, yeah, yeah. It's one of those new phases in life.

Scott Benner 29:24
Is that frightening? Is it something you're looking forward to, like getting away from the diabetes idea?

Martin 29:29
Yes, it is definitely something to look forward to and enjoy. We have plans for travel playing with the one existing grandson. That's great fun. So yeah, we have lots of good things to do. I mean, I'll I'll be honest, I also one of the reasons I retired was I wasn't actually very well. I had to have open heart surgery back in end of November. So things are a little bit different than they were. But yeah, we're enjoying. It so far. How did you come through the surgery that took a while to get back to feeling how it was before? I wouldn't like to say my stamina is back yet. And I wouldn't like to say that my stamina was back at those pre levels, because the even last year, I was skiing quite a bit, and that that was only sort of six or eight months before the actual surgery, but looking forward to getting back to it next winter. What

Scott Benner 30:30
did they tell you, like, what led to the need? Were you? Was it diet, weight, just genetic? I'll admit,

Martin 30:37
again, it shows my sort of disinterest in medical things, but I don't really know what the cause was. It was much more. I thought I was feeling ill. Started to go to talk to some doctors about it, and they said, Oh, it's not your breathing, it's your heart. That's what's slowing you down. And it just sort of snowballed from there through to you need to have some heart surgery. You need those three of those replaced. Okay,

Scott Benner 31:05
wow. Martin, that is so of your generation. It's fantastic. It really is,

Martin 31:13
in which way is that my,

Scott Benner 31:14
I don't know, man, like, I'm so involved in my own health. Like, if I like, if I get up and I'm like, Oh, what was that? I might do something about that? And you're just like, I don't know I was going along. And then Doctor told me my heart was falling apart.

Martin 31:28
But these things happen. You deal with them. When they happen. You get over it. No Inkling prior to that my breathing wasn't doing so well. But I've asked them anyway. So I was, I was used to that

Scott Benner 31:42
your breathing wasn't, well, yeah, and you had asthma. Oh, see, so there you go. So you had asthma. So you're like, Oh, this is something I'm accustomed to

Martin 31:50
exactly. So it was the symptoms didn't really push me down that heart route at all. And it was only when I started talking to some doctors, they said, Oh, by the way, this breathing thing may not be breathing at all. It, it may be your heart, and it's got a problem. Let's do some investigation along that route. And that was

Scott Benner 32:10
the right one. Interesting. That is very interesting.

Martin 32:14
See, whereas you would have been there with the I need to find out on this. I need to work out what could be causing this is that, oh

Scott Benner 32:21
my god, I would have Martin. I'd sit down in front of chat G P T and tell it a whole story about my health, and let it tell me what it thinks and and the whole thing. Oh yeah. I'd be like, I'd be like, first of all, I gotta tell you something. I've had some of the most thoughtful conversations with chat G P T in the last couple of months. So I know that sounds ridiculous, but you sit down in front of an AI thing, I do it over my phone, and so it actually talks back to me. I will literally say to it here, watch. I'll do it for you right now. Let me see if I can load it up for you. I'm having some medical issues, and I'd like to chat with you about it. If I sat down here now and talked you through some of the things I've experienced in the past, would you help me work it out? Listen to this, Martin. It's thinking, Okay, give it a second. Oh, now it's gonna let me down. Chat. GPT, what are you doing? You're always Martin, how embarrassing is this for chat. GPT, 4.0 hold on. A second. Let me start over again and not

Martin 33:22
they. These large language language models are not my fault. Hold on a second.

Scott Benner 33:30
I'd like to talk about some medical issues I've been having. If I went over some symptoms, would you help me figure out what might be going on? Absolutely, Scott, please tell me about the symptoms you've been experiencing. I'll do my best to help. Lately, when I eat greasy food, my bowel movements aren't firm and my stomach hurts. It sounds like your body might be having trouble digesting fats. Do you think that has anything to do with my previous problems not being able to absorb iron, because previously, I've been having trouble absorbing iron. Sorry about that. I got a text in the middle that messed it up. You're right, but so I now I've put on this big show about it, and I'm like, and now I'm it seemed like, but I'm swear to you, I had a 20 minute conversation with it, a 20 minute conversation where it actually helped me think about things that I hadn't considered before. Yeah, is so it is not it isn't crazy. I know just now it didn't go as well as I was hoping. It's not like that normally. So I literally just like talked it through, and it gave me this idea, and I thought, Oh, I hadn't considered that. And it led me down a road. I went and talked to my doctor about it, and my doctor was like, Yeah, that makes sense. And so then we worked on it, really crazy, but not just that. Like, seriously, I would think about all of that, but tell me why you wouldn't. Like, what is that idea like? Just that life is what it is. And it ends when it ends, and I'm not in that much control of it. I'm

Martin 35:04
intrigued that you think you do actually have that that much control life can be planned, but only to a certain degree. There are a lot of things that that happen that are completely out of your control, that you have to react to and do the best you can your health, I thought, and would still think, actually, is one of those factors. You don't know the DNA that you're born with, and therefore you can't, at any point say, Oh, well, 2025 I know I'm going to get that in growing toenail. Now, if I start to wear the right socks, I can deal with that. That sort of thing doesn't occur to me. Doesn't make me want to do the research. When I get the ingrown toenail, I'll get the right socks.

Scott Benner 35:53
It's so simple. So all right, so I'll tell you a story. Okay, okay. There have been a number of people on the podcast just recently. And those people are lot of they have lot of diabetes, so type one, but, you know, just getting going and okay, you know, they maybe had it for four or five years. They've been using insulin. They've got auto antibodies that indicate they are definitely type one. On their way to type one, but their body's probably still making some insulin. They have a very slow onset of type one, and they're taking one of those GLP medications that are for type two diabetes or for weight loss, like ozempic or Manjaro, that stuff you hear about all the time in the news, right? Some of them are almost either completely off or completely off insulin right now, now, like that's not a thing that anyone would consider in the past. That is a new idea. So because they were paying attention to the world and what was possible. Now, I interviewed a man who's literally, at this moment, not using insulin. Now, isn't that fantastic?

Martin 36:59
I agree that's tremendous. But isn't that the I have the in growing toenail and now founding, there are sock options. I could have a blue set. I could have a red set. I could have a pink set. And he works really well. His feet work really well with the pink set. Is it not that kind of situation? Rather

Scott Benner 37:17
than, I'm not following you, I'm not finding exactly like, so, like, he's paying it, he's paying attention to cutting edge technology, and it's working for him, yep. And so if he wasn't paying attention, he'd never find out. Like, never. A doctor wouldn't tell you about this. You know what I mean? Okay, yep, you're coming from restoring. A doctor wouldn't tell you about this. Never, ever. I promise you, by the time a doctor thinks to talk about this, it's going to be, it's going to be too late. It'll be 10 years from now. You know what I'm saying? It'll be 10 years from now, and they'll be like, You know what we're finding out, we're finding out, and like, and I'm going to be the guy running around going, is that what you're finding out right now? Because Scottie knew about that 10 years ago. And like, and that's the thing that I'm interested in. Like, I'm interested in, why not just do it like, you know what I mean? Do it? Do it right now. Pay attention to it. Get out there and and just like, try something. Like, I'm not talking about, like, bio hacking exactly, which is even probably a term you're not completely at ease with, but it is that simple. Like, you know what I mean? Like, it's if you're very low in vitamin D? Well, there might be a real reason for you to take extra vitamin D, like, why not try it? Like my my friend who, right now can't get a doctor to give them medication for a high thyroid stimulating hormone value, even though they have all the symptoms of it, my argument to the doctor is like, look, this medication is fairly benign, right? If I take it for a week or two and I didn't really need it, then you know, it's not going to kill me, but if I start seeing my symptoms go away, then can't we say, Wow, this is working. And would that really hurt to try it? Would a person that I'm seeing now who has type one diabetes, who's taken this GLP medication completely off label, and they're micro dosing it, giving themselves little bits of it every day, instead of the whole thing once a week. It's impacting their insulin needs and not causing them not to be hungry like that's a thing that I guarantee you Martin that five years from now, someone will say, we've done a study, and what we've learned is, and that woman will have lived the past five years of her life happy because she figured it out now and and so that makes me wonder, like, what else could I be paying attention to to benefit myself? Like, that's why, like, I'm not just saying to you, like you should have known something was going to happen to your heart. For it happened, but by staying kind of ahead of the curve, the opportunity is there. At the very least, that makes sense. Yep, that does indeed make sense. I see where you going. I'm just still a little bit nervous about that as an approach, because we are talking healthier and

Martin 40:22
trying, as you say, something new with your health doesn't feel to me a safe way forwards. Frankly, there haven't been a study if you don't know what those longer term effects can

Scott Benner 40:35
be, I take your point, and that is definitely a way that I would think you would think about it. But here's the thing, right? How much longer do you think you got? What do you think so? So if you try something like, like, I'll let you into my life a little bit. Okay, so it's interesting, because you, you don't listen to the podcast that much, I imagine, not at all. I'm afraid. How did you end up on it? I was volunteered by your wife?

Martin 41:01
Yeah? Oh, she listens. Send us to talk to you. I

Scott Benner 41:06
sit in front of you today virtually, yep. 53 years old. I weigh this morning. I weighed 184 pounds. Oh, my God. What is that in like, what do you got pounds? Like, that's fine. You understand what I'm saying? Yeah, I'm just understanding, okay, okay, a year and a half ago, I weighed 236 pounds. That's a bit much, right? It certainly was. I am not nine feet tall, Martin, so it wasn't working on me. Yeah, now I have a fairly sedentary job. I'm not gonna lie about that, but I do not eat poorly. I as I you and I talked before I started, I don't even I don't drink caffeine, I don't smoke, I don't drink alcohol. I've never had a cup of coffee like I'm a pretty clean eater. I'd made all these changes to my life over the years. No oils. I don't eat oil. I don't do all these things. None of it would impact my weight, nothing. No matter what I did, if I really, like, really starved myself, I could maybe lose like, 10 or 12 pounds, but generally speaking, I couldn't lose weight, and I was unhealthy. At times, my body would not absorb iron. I was at the in a position where, twice a year, twice a year, I had to go to the hospital, and I had to have them infuse me with iron, because my body was like shutting off. No lie, like I my ferritin level was nine at one point should have been a minimum of 70, and I would bend over to pick something up off the floor and almost pass out like I was that from this low iron, I said to myself, there are people losing weight on this GLP medication. I'm going to try it. And I tried it, and lo and behold. Now I'm, I mean, gosh, 3646 I'm laying like almost 50 pounds lighter than I was. My life is fundamentally changed. My knees don't hurt. I'm not creaky and achy. As crazy as it sounds, even though a doctor would never have told you this was going to happen, my body now absorbs the iron by itself through my nutrition that I take in. I don't have to take supplements for it just to keep me from dying. I don't have to go to the hospital and have interventions. And no one would have told me that that medication was going to do that okay, but now the research on just this medication alone in the last couple of years is saying that it is alleviating PCOS symptoms for women that a ton of women who for their whole life haven't been able to get pregnant, are suddenly getting pregnant because of this medication. Now a doctor will tell you, Well, yeah, well, they lost weight, but it feels like it's more than that, like I've seen plenty of overweight people pregnant. Do you know what I mean? Yeah, and and then now there's a study out that says that it might impact dementia and it might and there's on and on and on, because this medication, among other things, is eliminating inflammation in people's bodies like Fascinating, right? And people with type two diabetes are taking it, and some of them are not needing insulin anymore, or they're my brother is a type two is a one c1 from the mid sevens to the fives. He didn't change anything else, except he's taking ozempic once a week. My point is, they're even talking about heart health and ozempic and weight and etc and like, you don't know. Man, we're so close to figuring things out, and you're still you're young, 62 right? Yeah. So if you look at chat, GPT, 4.0 versus 3.0 3.0 was garbage, compared to 4.0 and 5.0 is going to be insane. And five years from now, I think what you describe is kind of scary, like, how am I just going to know if this is okay without a doctor? I think that's how people are going to interact with their health. I think they're going to pull their phone out of their pocket and tell the phone. Own. Hey, this is who I am. This is my weight, this is my height. Here's my medical history. Don't forget that. Keep that in memory, and then it's going to know all about you, just like you imagine your doctor does now, but they really don't. No, you know, the doctor stops outside the door, opens up, the chart, reads it, you know what I mean, like, uh, like, and meanwhile, you're in there with this, this warm feeling like of the last time you met, and the guy really likes me. He's a good guy. He knows that. He don't know anything about you, but that algorithm will. And then you can wake up one day and say, Hey, algorithm who remembers everything about my medical history that I've ever told it I woke up this morning, and on my lower right quadrant, I have a pain that feels like this, blah blah blah, and it might say, oh, Scott, you are having blah blah blah. That's where this is going. Now, there'll be a person on the other end to make sure, but I think that's what's going to happen. I think it's going to happen with diabetes and with health in general. That's my thought. And I think you could pay attention to that stuff and help yourself in little ways that would build up and be bigger ways eventually, it's an interesting future. What do you think, though, at your at your age, what do you think of all that? What

Martin 46:09
of all the the large language model stuff? Yeah, yeah. Oh, that's a absolute longer conversation at this point. Well, I can, I can summarize into it's a superb way of using the currently collected information that is available on the internet. However, I don't trust all of the information, or quite a lot of the information that's on the internet, and therefore, I'm not particularly trusting of those large language models. I

Scott Benner 46:42
don't disagree with you. You know, the question becomes like, how? How does it know what it should be paying attention to and what it shouldn't be? But when we're exactly, but when we're just talking about Martin, and it only knows about Martin, what we told it about Martin. Now you have a large language model for your health, and you're not going to and even if, even if you end up telling it something that's specious, something that you like, you know, was a ghost for you. You thought it was one thing, but it was actually another thing. Over time, you'll be able to weed that out and go back in and tell it, hey, you remember, like six weeks ago when I told you, I thought this was what was going on with me. I don't think that's what was happening. And just like that, it

Martin 47:20
won't think about that anymore, personalized, focused items, it could be very effective.

Scott Benner 47:24
I would agree. Yeah, it's going to do all the things that human beings can't do, keep, like, competing ideas in their head, but don't judge them based on bias. It's going to be able to remember things you told it six months ago about, like, you know, I got up in the morning and my toe really hurt. Just really, really hurt. Then it stopped hurting. But it'll remember six months later that your toe hurt six months ago, there in is where, like, you know, it might be able to put block, like puzzle pieces together and say, Oh, had you considered this? You know, if you said I was out of breath today, and it was after I went for a walk. And then you forget about that six weeks later, but it happens to you again. It would say, Hey, weren't you out of breath six weeks ago? I wonder if we shouldn't go to a cardiologist or maybe visit your pulmonologist, who would have then said, Oh, it doesn't look like it's this. Let's take a look at your heart, like that kind of stuff. Man, I'm super excited about that kind of stuff. You know, it's a good it's a good future, yeah, and imagine your wife even, like, as you guys get older, like, because this is the thing we don't talk about. Like, type one diabetes is just going to keep happening, like, for her, and she does if she does a, you know, a good job, and keeps her her stuff where it belongs to live a long, happy life and etc, but one day, it'll be harder to push the buttons, or it'll be harder to inject the medication or to do the math or that kind of stuff. But just imagine if you could, you know, say, you know, Alexa, can you tell me I'm about to eat a ham sandwich. I think you know about how many carbs you think are in this ham sandwich, and then it comes back and tells you, I think it's 23 carbs. And you go, great. I don't remember, but what does that mean for me? How much insulin do I need right now? And have it come back and say, Oh, that's two units for you. That might be very comforting as people get older, you know, agreed, hey, it might get you out of having to understand all this diabetes stuff. Martin, don't think that was gonna happen. No, no, no. So your wife sent you on here to learn something, to get schooled. What do you think her her onus was?

Martin 49:36
Oh, to talk about my experiences with her type one diabetes, to hear your opinion on that, because there are some parallels to our situations. You learned about diabetes because of your daughter, yep, but you're definitely getting it all secondhand. And frankly, would that persuade me that I should. Be more involved or not. What do you think? Do you think you should be? I did, actually, when you said expert series from Episode 1000 on, I did write that down. Good. I do need to start listening to you. Scott. Good, well,

Scott Benner 50:15
I'm glad, honestly, it that series is myself and Jenny Smith. Jenny is a nutritionist. She's a CDE, a certified diabetes educator, and she's had diabetes for over 35 years now. And I'll tell you what, what had happened. So I'll tell you what you're gonna get. Some background on me is that my daughter was diagnosed when she was two, but today she is 20. Actually, she's gonna be 20 in a couple of days. Couple of days. She's had an A, 1c between five, two and six, four for probably the better part of the last 10 years. And a long time ago, gosh, a very long time ago, after she was diagnosed, she was diagnosed in 22,006 and in 2007 about almost the exact year later, I started writing a blog about being the parent of a child with type one, and I was as lost as everybody else and her a 1c was, you know, in the mid eights, and I didn't know what I was doing, and just, you know, I was following what the doctor was saying, and it wasn't going well. But over time, I realized, like, if this is on me, like, if I don't figure this out, she's not going to live as good a life as she could have. And so I start, you know, putting pieces together and figuring things out. And one day I said to my wife, like, one day after I got her a 1c down into the fives, I was like, I said to my wife, I was like, I have a system. And she's like, What are you talking about? I'm like, it's not obvious. I don't call the steps that I take a thing. It's not written down like bullet points, but I know there are things, and if I do these things, Arden's a 1c. Is lower and stable. Her blood sugars are lower and stable. There's a system in here somewhere, and I started writing about it on the on the blog. But then one day, I launched this podcast, 2015 in January. I was making it for a while, couple 100 episodes, and people would get back to me all the time and say, I listened to the podcast, and my a 1c, goes down. I don't even know why. They'd say, like, I don't know. I'm just listening. I guess I'm doing the things I'm hearing you saying, because I don't like, most of my conversations are, like, the one I had with you, right? Like, it's not a lot of like, do this, then this and this, it's more big ideas. You pick out of the ideas and figure out for yourself. I would tell people all the time, listen, if you want your a 1c to go down, if you want your blood sugars to be more stable, just listen to the podcast. It'll happen. And people would have that experience. But then one day, I was like, God, there's 200 episodes. Like, How long am I? Like, how much should I expect these people to listen to, you know? And so I went to this girl, Jenny, who I know is now a very good friend of mine, and I said, I love the way you talk about diabetes. You have a more medical background, plus you have type one. I think I have a system. Would you sit down with me and talk about it one episode for one idea? And she was like, I'd love to so we did that. And then we could say to people, go listen to the Pro Tip series, if you don't have time to listen to the whole podcast. And then people would come back and say, I listen to the Pro Tip series. And a month later, my a 1c was down to six. Or I get notes all the time. My ANC went from eight and a half to six. It went from 12 to seven, and then it went to six and five and and, you know, all I did was listen to this. That's all you really need for your desire. You can keep listening if you want to. Yeah, you can go back and hear stories of God. I have after dark series where people will tell you anything from about their eating disorders to being bipolar and having type one. One girl came on here and told me she was diagnosed with type one on a heroin Benner, like, literally out on the town, scouring the town for heroin. She diagnosed with type one during that. And when you hear people's stories, you will pick things out of them. You'll hear little bits, and you'll think that's important, I should remember that. Or, my gosh, I didn't realize. Or you start to have, like, a community feeling, where you recognize you're not completely alone, and then other people have other ideas that are maybe even more valuable than the ones you have about an idea, and you can adapt and borrow from me and borrow from them until you have a, you know, a plan and a family that that kind of keeps you more shielded and protected. And that's that's how the podcast ends up working for people. No, that's really good, you know. And I'm not 62 but I'm 53 and I gotta tell you, this wasn't in my wheelhouse when I started doing this, and I was surprised by a lot of what happened. I really thought I know how to use insulin. I'll jump up on this microphone and tell people how I do it, and then hopefully they can get some success right. But instead, I learned about community, which is not a thing I really understood back then. I knew it was nice to know you weren't alone, but I didn't realize how important it was, and then to see that everyone basically has the. Same set of problems. You know what I mean? Like, basically has the other set of problems, and nevertheless, like, your story impacts my story impacts someone else's, and it makes your burden lighter as you go. And so it's not just about the nuts and bolts of diabetes and how you could have felt better, etc. It's really about a lot more than that. I hope you find some value in it, and that it's helpful, and that, you know, you and your wife can, uh, you'll have something else to talk about, and it'll be about me and my conversations I had with somebody the other day, that'd be crazy. That'd be that'd be insane, even literally, where are you at right now? You're in what I don't want you to tell me, like, what street you're on, but where do you live?

Martin 55:44
I live in Guildford, which is about 30 odd miles outside London, 3045,

Scott Benner 55:49
and I'm in New Jersey. Isn't that crazy? That's great, and I don't have diabetes, and your wife is finding value in a thing I'm saying in a spare bedroom in my house into a microphone. Yep, like the world's crazy. Now, I tell people all the time they have a private Facebook group I think has like 52,000 people in it now, and by the time somebody hears your conversation with me, it'll have 1000s more in it. And this podcast, which has now reached I'm getting close to 18 million downloads in the time that it's been recording and available for people in over 40 countries, the podcast charts like, well, like people listen to it in mass in 40 different countries. It's all because of the cell phone, because without the cell phone, people couldn't get podcasts. And people used to talk into microphones, and they'd sit down at browsers and try to listen through the internet. But it's not, really not, not a great way to take in audio, right, like until you could have it portable and with you and in your ears. It really blossomed at that point. So somehow, a guy in New Jersey who doesn't have diabetes is helping a lady in London who's had diabetes for 30 years because of cell phone technology in part. And I think it's going to keep happening like I think that as AI doubles on itself, and as technology gets faster and better, you're going to be able to get information to people in different ways. For example, I um allowed a company called Vision AI to absorb, absorb my podcast. So they took the transcripts from my podcast and absorbed it into their large language model for people with type one diabetes, and when you not only does it attach itself to your CGM data like I have it set up with my daughter's data. So if I go into this large language model right now and just say, what's my blood sugar, even though this thing is not attached at all, you know, to anything my daughter is wearing, it comes back and says, Your latest recorded glucose levels, 129 the trend is stable, and if I just asked it, what should I Bolus to get to 99 when it answers, it'll explain the whole thing to you, but it'll also break it down. Tells me what my insulin sensitivity is. It shows me the formulas and everything else. But then it just clearly says, you know, here's how much you should Bolus to do. That gives you like, you know, that kind of stuff. It also says tip from the Juicebox Podcast. And one of the Juicebox Podcast episodes, Scott mentions the importance of monitoring trends and making adjustments based on real time data. And Jennifer suggests using cautious approaches, starting with smaller adjustments and observing glucose responses for future fine tuning, and then it gives you follow up questions that would be smart to ask and that kind of stuff like, and that's just going to get better and better. You know, I don't know, man, like, I'm so interested in how to help people. I think all of this has something. It all has a place in it somewhere, because I've put so much information into this podcast that that idea of like, just go listen to it, you'll understand one day might be just go ask the prompt. It'll know, yeah, you know, super exciting. Anyway, I spoke way too much today. I apologize.

Martin 59:20
You're okay. No, no, no, no problem. Really

Scott Benner 59:22
good. When you leave today, what do you think you'll go tell your wife? We had a

Martin 59:27
good conversation. I thoroughly enjoyed the conversation with you that you are definitely passionate about the large language models and that that is a future approach, and the one thing that I will be doing is listening to some of your expert expert podcasts, which were 1000 on, I believe the episode number was,

Scott Benner 59:50
it's called the diabetes Pro Tip series. And okay, and that would be, and that's going to be dug down, but I'll tell you what to Martin, there's an app. There's a series called Bold beginning. Things that's for newly diagnosed people. So if you think I'd like a little more elementary lead into it, go bold beginnings first, and then go to pro tips. Okay? And there's also a series called defining diabetes that takes everyday terms around diabetes, in case people are, you know, throwing terms around and you're like, I don't know what that means. Those will help you understand Bolus basal, all the way up to things like feet on the floor, things you've never heard of before. But believe it or not, when people get up in the morning, when the world hits them that adrenaline, sometimes their blood

Martin 1:00:34
sugar goes up. Yeah, agreed. Now that one, that one on you, yeah. And

Scott Benner 1:00:38
so there's all kinds of different terminologies that I think get thrown around that stop people from understanding their diabetes well and all the rest, man, like there's a world of information. There's 10 years worth of conversations in there. I hope some of them help you and and your wife. And I really impressed with you guys, because I know some people who've retired and they don't talk to each other anymore, and so I am super impressed that you guys are so excited to to know each other like this. Yeah, new face, yeah, good for you. You excited to it? You excited about it? Yeah, yeah, yeah. How often you get to see your grandkids?

Martin 1:01:19
At least once a week. We look after him for a whole day once a week. Oh, that's really cool.

Scott Benner 1:01:25
That's lovely. Good for you. I bet you wait. I bet you wait for it every for the other six days, you're just waiting for him to come back, right? Oh, yeah, chatting about him. Don't you worry. That's wonderful. All right, man, it's really nice to talk to you. I appreciate it. Cracking to talk to you. Scott, yep. Hold on one second for me,

I'd like to thank touched by type one for sponsoring this episode of The Juicebox Podcast. And I have to remind you again about this steps to a cure kickoff event that's happening this weekend, january 18. Man, if you're in the Orlando area, I'm talking about a big day for you. Join touch by type one for a light breakfast at their walk. Kick off. You come meet fellow participants, learn more about the walk. You get excited, but then you're enjoying a complimentary day at the Orlando Science Center. I'm telling you, you're not going to get a better deal anywhere anyhow. Touched by type one.org Go to the Programs tab, head over there now. Man, you're lucky to be in Orlando. Are

you starting to see patterns, but you can't quite make sense of them. You're like, Oh, if I Bolus here, this happens, but I don't know what to do. Should I put in a little less, a little more? If you're starting to have those thoughts, you're starting to think this isn't going the way the doctor said it would. I think I see something here, but I can't be sure. Once you're having those thoughts, you're ready for the diabetes Pro Tip series from the Juicebox Podcast. It begins at Episode 1000 you can also find it at Juicebox podcast.com up in the menu, and you can find a list in the private Facebook group. Just check right under the featured tab at the top, it'll show you lists of a ton of stuff, including the Pro Tip series, which runs from episode 1000 to 1025 if you're not already subscribed or following in your favorite audio app, please take the time now to do that. It really helps the show and get those automatic downloads set up so you never miss an episode. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast. 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 you?