#864 Type 2 Diabetes Pro Tip: Guilt and Shame

March 8, 2023Scott Benner

A series for people with pre and Type 2 diabetes.

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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.

00:06:12 Addressing guilt and shame.
00:09:00 Stigma around Type 2 diabetes.
00:16:14 Lifestyle and genetics contribute to type 2 diabetes.
00:17:53 Emotional response to diabetes diagnosis.
00:24:17 Education is crucial for managing type two diabetes.
00:29:24 Misdiagnosis and stigma in diabetes.
00:35:57 Education is vital for diabetes management.
00:40:10 Type one and type two diabetes are related.
00:45:37 Take action for someone else.
00:53:00 Take care of your health.
00:59:57 Empowerment through education and action.
01:00:55 Successful type two community is possible.

Scott Benner 0:00
Hello friends, and welcome to episode 864 of the Juicebox Podcast

Welcome back to the Type Two diabetes Pro Tip series from the Juicebox Podcast today is the next episode in that series, and Jenny Smith and I will be discussing shame and guilt, and how those things may be tricking you into not taking care of yourself. While you're listening. Please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan. This is the spot in other episodes where I remind type ones to go to the T one D exchange and take the survey but instead because this is a type two centric podcast, I want to say this to the type ones that are listening. You love the podcast, you subscribe. That's why you got this episode. I bet you also know people in your life with type two diabetes that need help. Please pass these episodes on to those people. And if you're new to the podcast, and you have prayer, type two diabetes. Welcome. I hope you'll love this. I really think it's going to help you.

This episode of The Juicebox Podcast is sponsored by the contour next gen blood glucose meter. Learn more at contour next one.com forward slash juicebox. That's right, the contour next gen. What do you think the Gen stands for next generation, whether you have type one, or type two diabetes, or pre diabetes, and you need to check your blood sugar, the contour next gen is for you. Contour next one.com forward slash juice box. I'll tell you a little bit more about that meter later on in the program. But if you're looking for accurate blood glucose meter results, contour next gen is the way to go. Hey, Jenny, how are you?

Jennifer Smith, CDE 2:16
I'm great. How are you? Scott?

Scott Benner 2:18
Jenny's not great. Her dog ran away and she's trying to be

Jennifer Smith, CDE 2:24
doing this while my husband is

Scott Benner 2:26
out looking for the dog. Sure the dogs gonna be fine.

Jennifer Smith, CDE 2:30
You got a caller? He's got a number on it. You know, it's all?

Scott Benner 2:33
Yes. Let's just say the people just missed a nice five minute conversation about the responsibility of dog ownership.

Jennifer Smith, CDE 2:40
If you're going to own a dog, be prepared to take care of it like you prepare to take care of a child

Scott Benner 2:45
exactly, essentially. Yes. So we hit record here because I'm in slightly unsteady water for what we're trying to do here. So I think everybody who listens to the podcast knows that it is overwhelmingly it's a type one diabetes podcast, right? It's I think it helps adults and caregivers pretty equally, but it's mainly about type one. And then over the last few years, I've been thinking about, as I mentioned, in the first episode of this series, I wanted to figure out how to help type twos. And then I started seeing type twos come into the Facebook group and listen to the podcast. And then they were making these kind of really amazing, like improvements in their life. So we we asked the listeners of the podcast, you know, what would you like to know about type two diabetes. And it's going to be a little strange talking about it, because my conversation is going to come from kind of some anecdotal stuff and kind of my reflections of what I've seen people talk about you, of course, Jenny are not just the CDE. But you have a degree in nutrition. Yes. So you're going to be a great help here and Jenny, in a former life, why don't you tell people what you used to do?

Jennifer Smith, CDE 4:00
Yeah, so within the realm of diabetes education, and while I was working as a dietitian within a hospital care system, I was also helping to teach the type to accredited classes within the hospital that I worked at. And I was working with a nurse educator who was head of the education, the diabetes education department, and we coordinated the classes together on the angle of, you know, all things diabetes, in terms of the medications and monitoring and the nutrition part and the activity part. I mean, all the things that go into managing, so that is what I did, and it actually helped me as well. A crew, enough hours to sit what was the CDE exam certified diabetes educator exam, which now we are CDC, e ss, right? Everybody's still calls us CDs. shots. All right?

Scott Benner 5:03
Well, I so here's what I've been thinking forever. And I mentioned a little bit in the first episode, but I'll just say it here again, if you see behind the scenes, the diabetes space, people, companies, organizations, institutions are always trying to figure out why type ones are such a close knit group of people online. Like there's a real type one diabetes community online, as Yeah, it's just the reasons why I mean, you can all guess for yourself, but it just exists. It's a helpful community, it's a vocal community, they're not afraid to share what's going on with themselves. And anyway, these organizations, these companies, they've all they all use kind of behind the scenes about I wish we could, you know, build a community for type twos. And we tried, and it didn't work. And we tried this, and it didn't work. And, and I've had conversations in meetings where I've given my opinion about why I think it didn't work and how it could and people didn't take my advice. So now I'm just going to do it myself. And I'm going to do it here with this. And I thought I thought the way to start off was by addressing guilt and shame. So there were a number of different categories that people brought up medications, doctors, you know, die diets, which we're not going to call diets, Jenny, we're going to call fueling plan fueling plans, I'm gonna have to leave that written in front of me for a couple of weeks, the way I speak. But, to me, if we're going to start this conversation, I think we have to start it with why if you have type two diabetes, is it difficult to step up and say, I have type two diabetes, I don't understand it. I don't know what I'm supposed to be doing. I think it's killing me. And I'm not really sure how to stop it. You know, like, that's the insecurity I see with a lot of people with type two, like this thing is happening to them. And they, they don't seem to know what to do about it.

Jennifer Smith, CDE 7:02
There's absolute negative, there's a negative piece to having type two diabetes. From an from an understanding perspective, but I think that, that it lacks information. And I think that that's where it comes from, in a lot of a lot of that negative attitude can be because the majority of people who don't have diabetes of any type, type two, specifically here, there, there's a lot of missing information. And so there are there are silly statements that are made that are completely not true. And you never know, when you're seeing something that might be just an off the, you know, off the cuff, kind of like, Haha, joke, whatever you don't know if somebody that you're sitting around, has type two diabetes, and then that's taken, it's taken in or you

Scott Benner 8:11
internalize, no, and then you realize I need to keep this quiet, or I'm going to take, I'm going to take this from other people, or I'm

Jennifer Smith, CDE 8:17
going to be the brunt of the jokes, or I'm going to be the brunt of, Hey, did you know this could help you? Or hey, did you know you know, I've got this friend who's talking to this person? And don't you know, that this could really help you or, you know, we'll talk about all the supplements and all the funny things that people get offered help from. And I think that brings a lot of it in it's like, I'd rather maybe be quiet about it. And just

Scott Benner 8:41
Well, I think we always end up in this situation where we sort of talk around it because, I mean, obviously you and I don't want to insult anybody. And we don't have oh, we don't have those feelings. But it's I think it's worth, like just vocalizing right now that other people do that. And that's hard to hear. And you don't want to hear that. And I understand not wanting to hear that.

Jennifer Smith, CDE 9:03
Right. And I think a lot of it too comes from the people who may be making con comments or may be thinking what they know about type two diabetes, but it's completely false. It's it's from this idea. People have that it is self induced. Yes,

Scott Benner 9:19
exactly. Right. I did that to myself. I did

Jennifer Smith, CDE 9:22
something I have it or God there, they must have totally just not paid attention. Or they must have done something that created this problem for them. Yeah, right. Look

Scott Benner 9:34
at you, your body is whatever. That's obviously because you don't take care of yourself. And so you deserve somehow this thing that's happened to you. And that's I think that's the that's the path that minds can follow when they say stupid things like that. And it lets them off the hook to they get to say well, I'm, I'm okay being horrible to this person because look, they did it to themselves. And and then whether that's true or not, and we're going to talk about why it's not. But whether it's true or not. That's how you feel it. If you're on if you're on the receiving end of that, that's how you felt it. And now someone picks up and says, Hey, I've started a diabetes group that might help you understand your diabetes better. Or why don't you talk to your friends who have it and see if nobody, nobody's gonna want to do that then. Right? Yeah.

Jennifer Smith, CDE 10:21
Right. Absolutely. And I think, as you said earlier, the the type one world has a lot of has a lot of connection, they've, it's a very big community. That's like getting a big hug whenever you reach out for something, right. And people are very willing and open to talk about it. But it's the minimal percent of people who have diabetes as a whole. The bigger community has type two diabetes,

Scott Benner 10:55
by leaps and bounds numbers wise, right? Absolutely.

Jennifer Smith, CDE 10:58
And even now, and I think it's unfortunate, but now even includes children and teens, with type two diabetes, not type one. And thinking of that, and how they will grow. If they don't get the right information and the right way to feel about how to navigate this, they will get that same image that maybe their parent with type two has, or maybe their grandmother with type two has, and a lot of the older information, unfortunately, is kind of clouding what those with type two in the past 10 or even 20 years, could be doing differently, if they just got around that mindset of I clearly must have done something wrong. Well,

Scott Benner 11:45
in regards to being open about it, I guess, type ones are sort of protected, right? Because, and here's how I've seen it like that. Again, this is anecdotal from watching people talk about it for so long. But because it's an autoimmune issue, and your pancreas, you know, was attacked by your own body and doesn't make insulin anymore, you get to say, I didn't do this to myself, I don't you don't make an autoimmune issue. So you can you can shed, you would think you could be able to shed some of that, the guilt and the shame that could come along with it. So I guess we should first talk about what are the ways that people get type two diabetes? Like if you if you have an autoimmune disease that gives you type one? Can you eat your way into type two diabetes? Or is that? Is that just a misnomer? Is that the quality of the food? Is it like what? What's the real honesty of it?

Jennifer Smith, CDE 12:51
That's a deep rabbit hole.

Scott Benner 12:53
I don't want Listen, I don't wanna get anybody in trouble, because I know. But I mean, let we can't start talking about it if we're going to lie to people in the first 10 minutes. So you know what you mean.

Jennifer Smith, CDE 13:03
Right. So to be quite honest, in terms of lifestyle, absolutely, lifestyle does play a part in terms of the potential for somebody to have type two diabetes, you're more likely to develop it if you are overweight, or what you know, is categorized as being obese, which is a certain BMI level above being just overweight. extra weight can cause what we know is called insulin resistance, or the inability for for the body to utilize the insulin that is being produced by the beta cells in your pancreas. And initially, somebody with some dysregulation of insulin production in the body. In terms of potential for having type two diabetes diagnose, some of that comes from the resistance factor. The location of where the weight on the body is distributed, can make a big difference. activity level can make a big difference. Can food make a big difference? Absolutely. It can. Is it? You said quality? Could the quality of food make a difference? Yes, if you're thinking on the on the edge of preservatives and more processed versus more real food, let's call it right. Sure. There is a big difference. I mean, that's it's kind of a question that's in the air, regardless of what condition you have heart disease and all of those kinds of things. Could it be worse or could I have brought it on because I'm eating more of this processed, less real food than real real food? Sure, but those are some of the big pieces from a metabolic standpoint that somebody is more likely to have type two diabetes is does it mean that every person who might be overweight is going to have type two? No, it does not. Family history or genetics, we know play, it plays a very big part as well, in terms of the potential. So if you have a strong family history of type two diabetes, then some lifestyle things that you put into action for yourself. may very well be preventative. Yeah,

Scott Benner 15:28
I would say this too. I don't think I mean, yes, if you're an adult, you're in charge of what you're eating, right. But there are, there are other factors at play, like financial implications about the foods you can afford to begin with, how you grew up, what somebody put in front of you, when you were a child, and told you this is good food, this is not or in. And by the way, no one may have said to you, this is good, or this is bad. They may have just, maybe it's just giving you food, you remember, like, oh, like when I was a kid, we used to eat this. And so you become an adult and you make that, you know, like, it's, it's not, it's not, I don't think it's a malevolent issue. Like, I don't think that somebody's parents three generations ago, were like, I'm going to eat unhealthy, you know, and it's gonna cause all kinds of medical issues, and I will teach my children to eat unhealthy and they'll teach their children like, it's not like that. It's just you do what you do. And but to not understand that that's what's happening. I think that's the crime, right? Like, if and to not know how to get out of it, if there are actually ways and it turns out, there are a number of ways that you can help yourself, then, you know, that's a crime too. So we're not going to pretend like I mean, listen, this is straight from the ADEA. Type Two diabetes is generally caused by a combination of lifestyle and genetic factors, lifestyle factors, including being overweight or obese, eating a high, eating a diet high in carbohydrates, sugars, and fats and physical inactivity. Um, that's a, you know, that's directly from their website. And it's dated just last year. So, but that's all but the point is, is that that's, that's all both. Now, you've got type two diabetes, like, who cares how we got here, right? See what we can do now. But that becomes an issue because guilt and shame are real things. They are real things and they burden people. So I want to read you a couple of a couple of things. And I'm not going to tell you who they're from, until, until we're done. But I asked a group of people, if you struggle with guilt, or shame, and he found a way past it, can you please share your experiences here. And I told him that their experiences might be used anonymously on the podcast. So you know, everybody's first person just says, I went to therapy. And other person said, I connected with other people who were in the same boat and hearing their stories helped me, giving myself grace, being patient, focusing on my family, prayer, therapy, connecting with others. This goes on and on. My neurologist put me on an antidepressant for migraines, but that ended up helping me with my anxiety. You know, like that stuff. I was embarrassed. And I felt guilty for adult. Now, here's where the, here's where the secret comes in Jenny, because I think I've read enough now that anybody with type two diabetes is listening and said, Okay, I have felt like that, you know, here at the beginning of the onset, it was the realization that I'm often part of strategies, I went through a bunch of grief, you know, I, I went through the stages of grief, I had to get educated the education empowered me, I felt a lot of guilt. I felt like I brought it on myself. These are just over and over again, there are dozens of responses here, right? So if you're a type two, and you're saying yourself these sound like things, I have thought for myself, these are all responses from people with type one diabetes, type one or type two, type one. Because in the end, it doesn't matter how you got here, it feels the same once you're there. You know, like, how did this happen to me? Bargaining people talked about bargaining with God, I'll do something different. Please take it away, you know, and this person of course, said they'd bargain that they would eat better if their pancreas would start working again. And these are real real responses from real people who live with type one diabetes, but yet their responses I imagine mimic how anyone else would feel type one or type two.

Jennifer Smith, CDE 19:30
I would agree especially within the like I said, I I taught classes for type two diabetes and many of the people that initially came into our classes, which was like a four part series.

Scott Benner 19:48
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Jennifer Smith, CDE 22:31
Many of them appeared to just come because it was something their doctor required them to do or really requested for them to do or felt like they had enough questions to their doctor that they needed to go somewhere to get them answered. And I would say that many people didn't appear to really want to be in that first class. Yeah, they. And that was just my perception. Right? What I could see. But once once we got rolling, and they could see that information, the tidbits that would make sense in their life. This bit of information, that bit of information. Well, gosh, what? How many questions or how many times I heard, why didn't nobody tell me this? I've had this for you know, our classes were people who had had type two for a number of years, or who were newly diagnosed as everybody all together. And eventually in class those with type two for a longer period would bring in to the people that they'd get connected with the people who are newly diagnosed, I've tried this or Oh yeah, I was on that medicine, and ever worked for me, you know, kind of thing. So there was a sense of bringing people together that they felt comfortable to talk with others who had type two. And then by the end of class, the questions and the things, and they they would leave class, feeling like whatever portion of education or information they got, from what we gave them. There was a way to put it into action. Yeah, there was something that made sense. As their this is why I this is why I can try this, or this is why I can go back to my doctor and say, Well, I learned all this stuff. And I've been trying this and this isn't working. So I might need a medicine change. Would you talk with me about the other options? So in terms of education point for type two, that's one piece. I would definitely say if nobody's ever told you, you can have education. You can Yeah. And you should ask about it. If nobody's ever told you to go and see somebody. The classes for type two, I think are enormously beneficial. And if you can find one within your area, like I said, getting to be in class with others who also have type two, it brings in a sense of community that many People who've lived with type two for a number of years already have not ever had.

Scott Benner 25:04
What would you say that people lack the most? Like, what do they lack? That they're there to learn about? Is it basic understandings of nutrition? And that because I find, I find there are times that people say to me, I didn't realize that this food had this impact on a body forget my body on a body, I just didn't know. And then somebody told them, they're like, Okay, well, then I won't do that anymore. You know, and it's the, it's the feeling. To me, I think that the the implication from others can be that, again, you're doing it to yourself, but I just think that we're just doing what occurs to us. It's not like we're making a bad decision on purpose all the time. I'm sure there's some people are, but that's not my, that's not my point that overall, I find that people don't run around doing things to hurt themselves on purpose. Correct, you know what I'm saying, and so you just need to understand enough to get you going. And then you get a little momentum and you see a little, maybe you feel a little better, or, you know, maybe you lose a couple of pounds, and you'll have a little more energy and you start having a little more focus. And you think, Okay, well, I made this small change. Maybe I'll add a walk, you know, go for a walk now. And you know, if you can't walk outside, walk around your house, like work on your apartment, like, I don't care, like do something, you know, and then incrementally, you'll see change. And that change should draw you in that other direction. And but again, it seems like the problem is, I should go to a class to learn, but I'm embarrassed. I feel ashamed. Listen, the guilt and shame of not noticing made me sick. My initial gut reaction when my PCP told me that I had diabetes, was of shame. But people use the word shame constantly over and over again. And this is a very, I'm not a therapist, okay. But I have, I have a therapist that comes on. And this is a big thing that she talks about all the time that people just can, the feeling of shame and guilt are not exactly the same, and I'm not qualified to talk about it. But I do know that it holds you down. And it stops you from doing things you want to do. Because you don't want to feel it anymore. And then that is not a tenable situation like it's not going to you're not I mean, you're not going to pretend your way through this, basically,

Jennifer Smith, CDE 27:35
no, you're not. And in fact, if you if you feel that way, forgetting will, will will make it worse. Whether nobody again, as you said sets out for that to happen. But it's almost a will, if I just put it to the side, and I just take the meds that the doctor told me to take, that should take care of like, it's almost a convincing of yourself that they do this bare minimum thing. Yeah. And, again, I go back in terms of education. At diagnosis, it shouldn't be this rip off scrip of, well, this is what you have. And there's no education about even what Type Two diabetes means, like, physiologically, what's happening in the body? Why do I all of a sudden have this or, quite honestly, type two diabetes has been a progressive state, where initially your body tries to handle the glucose levels that are not contained in the normal range without diabetes. And so you know, your body needs more insulin to essentially get the glucose levels down, and to help that glucose get into the cells, right. So at first in type two, your pancreas actually kicks in, it's like I have to make more I have to keep up I have to give, give, give, give, give and eventually over time, at that point, many several years later, that's when you actually find out a diagnosis of type two after your body has already not been handling things well enough

Scott Benner 29:24
to tell me the the other side of it so it's a combination of lifestyle and genetic factors. So you could be I mean, people say it all the time on the on the podcast, right? I was I was diagnosed with type one as an adult, but I was first misdiagnosed as a type two, because they looked at my body style and they just assumed I had type two diabetes, but that can happen in the reverse for people too. You can be you know, I always use the example of when I was growing up. My neighbor's husband was tall and lean and fit, but he died of a heart attack. act really young. And when he passed, everybody was like, that doesn't make sense to them. That doesn't make sense. He's not fat, right? Like, because back in the day, I mean guy was the 70s and the 80s. Like, that's what we understood. You know what I mean? Like, heavier people have heart attacks, you know? Yeah, trust me, we didn't know a whole lot. And my best toy was like a stretchy doll. World was not as advanced. But, but he's a good example. This man is a good example. He didn't fit the bill visually. And so nobody paid attention to his heart. And right, and people in diabetes get kind of yanked around like this all the time. Oh, you're heavier, you have type two, they won't even test you. Like I've heard people tell stories. Like, look, I'm in the doctor's office, I tell them, my mom has type one diabetes. My grandmother has type one diabetes, I have diabetes, test me Give me a C peptide test. I think I have type one. No, no, we're not doing that. You're overweight. It's type two. Like, That's just insane. And so when that kind of stuff also exists, and you're already embarrassed, or you feel ashamed or guilty? How are you supposed to stand up in that moment and tell the doctor, I need help? Like, you're not explaining this to me? I obviously don't know. And I think, look, I can't speak for every doctor, obviously. But it wouldn't have gotten this far. If there wasn't a preconceived notion, hey, you have diabetes now. And now we're gonna write you off, like you're a lost cause we move you over to the other side of the ledger. And I really think that happens to people. And it doesn't need to be like that. But the doctors probably bump into so much what they consider to be God, that word. I don't even want to say, I want to talk around it. Okay, I assume they mean, I assume they bump into patients that they think, have no interest in getting better. But the doctors are going to call them non compliant. They're gonna say, they're gonna say, I gave them a diet. And I told him an exercise routine. And six months later, he came back, and he hadn't lost weight. And there was no difference. So I take you and I slide you right off here. And then that happens enough times that Dr. And my assumption is that they just begin to believe that people aren't going to try to change, or to do the things that they, you know, whatever. But it's never that easy. It just isn't like I, for some people, like your body's built the way it's built, like you ever see a real muscular person and you're like, I would like to be like that. But my body doesn't. It's not built that way. You know what I mean? Like, everybody's not gonna, I'm not saying people shouldn't get more exercise and eat better. Everyone should be doing that. That's just, I think that's obvious to all of us. But correct. But just changing something if you don't really understand what to change. Like, I watched it with my mom. My mom got type two diabetes should not have been a surprise. Your father had it. His father had it. This is not her brother has it? Like you don't I mean, like, everybody's got it. And my mom says to me, I have to start eating more healthy. That's what she said. That's what the doctor told me be more healthy. My poor mom in her 70s trying to decide what that is. I said, well make a list of foods you think of as healthy we'll sit down look at them together. There was not one valuable food on that for Lauren, her blood sugar. Not one. I'm sure oh my god, it was I wasn't mad at her. Like I was like, I'm like mom, like, like, Honey, listen, like, here's what we're gonna do. You don't eat meat. And I got her into a slightly lower carb situation. set her up with some like, my mom just thought a vegetable was a vegetable. You know, like, so I said, Mom, these are the vegetables that are actually lower in carbs. Your vegetables

Jennifer Smith, CDE 33:44
were corn and peas. Because she comes from that she comes from that era. Yeah, it does. Yeah, great. Well,

Scott Benner 33:49
we'll throw a potato in. It'll be lovely. Man, we're not gonna have a potato for a while. Okay. And so it was just very interesting. That when given the task of why don't you write down things that you think would be less impactful on your blood sugar? She couldn't she couldn't for the life of her think of any of them?

Jennifer Smith, CDE 34:11
No, I'm sure she couldn't. And again, I bring in Oh, my dog is back. By the way not to interrupt. Oh, no,

Scott Benner 34:17
that's a good thing to say. Everybody's probably been worried.

Jennifer Smith, CDE 34:20
Yeah, sure. They're not. Yeah.

Scott Benner 34:23
You have no idea. I'm gonna get emails about your dog. I'm glad you said this.

Jennifer Smith, CDE 34:28
So anyway, there you go. Okay. All dogs back. But in general, you know, my dad also had type two diabetes. And were it not for the fact that I had had and lived with type one diabetes prior to his diagnosis, and I think he was diagnosed when I was in like the end of high school probably like my senior year in high school. And I had, you know, been living with type one for a number of years already. And so my mom had, she had learned because of me. Yeah. However, had she not my mom being the primary like cook in the house. And my mom having grown up on a dairy farm, she would have continued to cook the very typical, I call it the meat and potato type of fair. Yeah, right. That would have been what she did. And we also wouldn't have known the things that we knew from learning from my experience. So my dad had a very different start with type two diabetes than somebody else, but he was of the same age as kind of your mom, who, well, goodness, what's wrong with like corn and peas? Right. And, in general, they're better than sitting down to a bag of Cheetos. Absolutely, from a nutrition, like, nutrient standpoint, they are. But from a blood sugar management standpoint, they're different. And that's where, like I said, I keep going back to education. But quite honestly, from a type two perspective, I think, some of some of the stigma some of the feelings of Gosh, I've got this thing now. And I don't know where to turn, or even know who to talk to. And maybe my, you know, my grandma had it, my dad had it. So I was gonna get it anyway, I saw how they navigated it was never really talked about. So I guess I'm just gonna go about and maybe I'll eat a salad every day, because that that's better, right? I mean, that's better, the doctor said to try to eat better. And there's there's not enough information. And that kind of boils down to the fact that majority of people with type two, they're being navigated in management, by primary care. Yeah. And thank goodness for health care, thank goodness for physicians, for general practitioners for PCP, thank goodness for them. However, type two diabetes is definitely it's a metabolic, right, it's much more metabolic. You can hear all the things we're talking about that are lifestyle that many people, they don't really think about too much, until Oh, my goodness, I have type two diabetes, and primary cares, or they are not. They're not educated, for lack of a better word. In terms of teaching the things that are needed for type two management, they are not, they should be referring for people to learn more, you've got this major thing that's going to be there 24/7 For someone now, you have to give them more tools than telling them to just eat better, and to get exercise. That is that's like speaking Greek. You need it to somebody

Scott Benner 38:06
you need a chance to you know, it's interesting. You told your story. And I told my story. Your father and my mother both had the same thing. Yes, they had the benefit of someone else's experience. It's exactly what they had. My mom was helped by me because I have a daughter with type one diabetes. And this podcast and I was like, I know how to. I have seen every food go in my daughter's mouth. And I've watched it on her CGM. And I was like, Mom, I don't know anything about nutrition, but eat these things. These things don't hit his heart. And that's it. I know you want a piece of bread. We'll get your bread. We're gonna make sure it doesn't have high fructose corn syrup in it. We're gonna make sure it does this. We're gonna do like little things, right? Yeah. Your father had a woman cooking for him who had to cook. Right? Because that was a long time ago. Your dad probably made a meal in his life. And

Jennifer Smith, CDE 38:51
oh, no, he was actually he was he was a he was a good cook. It was just that my mom. You know, they grew up the way that they grew up. And it was just that my mom. She was the cook and she was a really good cook. But yeah, my dad could. He could in fact, we have a hot dish. I don't know that. No, anybody even knows what hot dishes. It's like a casserole. Okay. He had a hot dish that on the nights that my mom had my mom was a teacher. And so on the nights that she had, like teacher, you know, teacher, he would make the dinners and that kind of stuff he had we still call it dad's hot dish. Now I make it with like, better thing. But it was essentially ground meat. And then they always did these canned jars of like was peppers and onions and tomatoes from the garden and my mom did all the canning and it was like a hot dish seasoned kind of thing that you'd put over elbow noodles and ground meat or ground beef. And it was mixed together. So

Scott Benner 39:51
why my dish is different because when I would get in a corner I would just take ground meat and then melt cheese over and I would put on a plate and my son was like What does it sound like? It's cheeseburger surprise. So what's the surprise? I'm like, It's not on a roll. I'm stuck. I guess all dads do something silly like that. But they do. But the point of it is, is that whether you're a person who has type two diabetes, who I've witnessed in the Facebook group, or come on the podcast and been nice enough to tell their stories, they all have the benefit of listening to someone else. And I know we want to stand around and like, some people want to argue that type one diabetes and type two diabetes like I don't want there, they don't have anything to do with each other. Okay? They're different diseases. And that's 100%. True. I'm not arguing that point. But both of them are about blood sugar management in Yes. And that's what they're about and the and the things that you can learn from watching a type one manage their blood sugar's whether it's about how you're fueling plan, or it's about using medication, or insulin, or exercise, or all of the other things that impact blood sugars, those same things are going to impact blood sugars, for type twos. So as I'm sitting around, trying to figure out how do I talk, type twos into creating their own community, what I realized was, they don't need their own community, this one's already here. It helps your dad, it helped my mom, it helped those people, it can help them as well. And they can deal with the guilt and the shame and the embarrassment in their own time and still listen to this. Because if you have to go to a therapist, and spend three years getting over the shame, just so you can walk out and go to a class. Well, that's too much. That's too long, it's too long to wait. So here's this thing, you can listen to it completely anonymously. And, and I at first I thought, Well, how am I ever going to get it into these people's hands? But there it is, right? People with type one diabetes, they all know people who have type two diabetes. And they already believe in the podcast, and they'll have no trouble sharing the series with them. And I thought this is this is it. Like, this is going to work?

Jennifer Smith, CDE 42:03
And I, you I think you bring in some things sort of behind the scenes here that, like jogged my brain, it's people with type one diabetes are very vocal. They are they they are very big advocates for themselves, or the person that they're caring for with type one. If somebody says something to them about, oh, hey, did you try this? Or, you know, if you did this more with your kid, you probably, they step in? And they're like, No, you are wrong, but they educate the person, they don't just blather a bunch of offensive words to the person because they're angry, they educate the person and they say, This is why you're wrong. This is what we do. This is how we do it. And maybe in broad sense, or maybe in a couple of sentences. And I think, in that respect, one, somebody with type two has enough information that they can spit back. That doesn't work, I will tell you why. But at this point, a good majority of the population with type two, unless they've done their own research, and, you know, people have they don't feel set with something to come back with.

Scott Benner 43:21
Yeah, how are they going to argue something when they think maybe they did it to themselves too, right? And type ones that this was my point earlier, at least what type ones have is they can they can stand up and go, I didn't do this to myself, right? I'm gonna argue, and they won't get hit with Well, you did it because they can go No, I didn't. And but a person with type two might actually, by the way, a lot of people think this, you could be a person who thinks this too, and then get type two diabetes. And now you, you believe you did it to yourself, because that's what you thought five minutes before it happened to you. Right. And this is just a, this is a unique opportunity to take something that already exists. Just adjust that a little tiny bit and make it work for a whole new group of people. And you don't have to get over I want you to get over the shame and the guilt because you don't deserve it. And it's it's misplaced, if you feel that way about type two diabetes, but in the but I think maybe the process of understanding how to help yourself might actually help you also get rid of some of those things. Like I don't think you all have to go to a therapist to get past that. Do you know what I mean? Right?

Jennifer Smith, CDE 44:26
And eventually may also help again, if it because of the large or the heavy genetic component to type two, you will impact somebody in your family's future. Yeah,

Scott Benner 44:40
I was gonna say, yeah, you will help

Jennifer Smith, CDE 44:42
if you're, you know, brother has type two now as well. Well, what you've learned, you can get them going in the right way. Right.

Scott Benner 44:53
So no, no, I mean, I the way I was thinking about it was much more ham fisted. But, I mean, if you've gotten your is off to a point where you think I'm never going to be able to get this back again, like, alright, I respect that maybe that would be difficult to do. Also, trying doesn't hurt anything, but at least you could put the people in your family on a better path. Like I mean, everybody talks about breaking circles all the time, there's an easy circle to break, you know, you feed your kid, the way you got fed, they're going to eat that way when they get older. And that's just

Jennifer Smith, CDE 45:25
and they may not, maybe that's enough lifestyle change from a genetic standpoint, that you've impacted enough that they won't have type two diabetes. Exactly

Scott Benner 45:35
right. And so, so this is gonna sound strange, if you don't have a podcast listener, this is your second episode, because somebody shared this with you. But what I've noticed, overwhelmingly after, after she's interviewing, like 1000 people is that it is a very common human trait, to not be able to do something for yourself, but to be able to do it for somebody else is a lot easier. So if it's not for you, if you have feelings of like inadequacy, or you feel beaten already, to do it for someone else, like do it for a kid or a loved one, or somebody who will benefit, you know, and you'll, and listen, you're gonna get the benefit, too. And you'll see six months from now a year from now, that, you know, wow, this is helping me as well, like, there's no secret here. Like, just, you know, there really isn't you, right is hiding

Jennifer Smith, CDE 46:21
something from you, you're just not getting the right information to start with.

Scott Benner 46:26
And my bigger point is that it doesn't matter how we all got here, I hope I'm being clear about that. It doesn't matter if I have an autoimmune disease, and my pancreas stops making insulin, and I'm a type one diabetic. It doesn't matter if I ate myself into this, and I have type two diabetes, it doesn't matter if my genetic predisposition put me into this type two diabetes, none of it matters. We're all here now. Time to do something, right. And so that I think ends up being it's why I wanted to talk about this as we were going into it, the impediment in those other people's minds about starting community for type twos and how to help people have type two diabetes, it's because they always get stuck on this piece, the like, well, how are we going to get them out of that mindset. And what I'm saying is, you don't have to get out of that mindset. Just we'll work on that over time, right now, let's do some simple things. And by the way, if one of those things ends up being insulin, not a failure, if it's an injectable, not a failure, we're going to Jenny and I are gonna go over all those different medications in another episode, if you need help getting out of your situation. There's just no shame in that whatsoever, you know, right? Like, you need to do what you need to do. I mean, for type twos we talked about with type ones, a lot of type ones will um, they'll feel badly if they're using quote unquote, too much insulin, they think the amount they're using is too much. Right? We have episode after episode, you need the amount of insulin when you're a type one that you need. And, and when you're a type two, if you've gotten to a point where your body just can't, it can't shoulder it anymore, then help it don't just go down with the ship and say, I got the sugars. I guess I'm done. You don't? I mean, like you're not, there's so many good things you can do.

Jennifer Smith, CDE 48:07
Right? Your ship still has lifeboats, yes, utilize one,

Scott Benner 48:11
there's things to do, and we're gonna, we're gonna and you'll be surprised how quickly you can get to them as well on how once you change those insulin issues, or metabolic issues, that things like weight loss can come along, like, it's very interesting. And a lot of these medications that will help you with your type two will actually help you with weight loss to begin with. So, my gosh, and to Jenny's point earlier, your doctor probably doesn't know. So. So we got to figure out what to do for ourselves. So that's going to be an interesting portion of this journey is that type ones are at their core, very independent in their care. And they're very accustomed, because the the one thing I wanted to mention that I haven't mentioned so far is that I think the benefit that you have, this is gonna sound strange. When you get type one diabetes, this is gonna sound really strange. So give me a second to get through it. I think the benefit that you have is that if you don't do something right away, it'll kill you. It forces you to do something, it forces you to learn about it, it forces you to it forces you to get in the game. When you get type two, the feeling is Ah, well. I got time. Yeah, you know,

Jennifer Smith, CDE 49:26
time. That's, that's a good word use because I think from a physiology standpoint, there is not there's a big difference in terms of one versus two. Right? And time is a big reason that, as we already know, with type one regardless of how you're managing, you don't get a complication on on day eight on day two of diagnosis. Right. And these are things that until there's enough issue long term. Finally, there might be some symptoms of something, right. But for both type one and type two, then diabetes, it is not a visible condition to live with. In either regard type one, you're right, if you don't do something about this right now, meaning take your insulin, you will have a very quick impact of that, a very quick visual impact. Whereas with type two, if you forget to take your oral medication of whatever kind it is, or even maybe your insulin, one, maybe you don't have enough test strips to monitor. Or maybe you don't know what the numbers mean, or where you were before. So who knows what difference this made. Maybe you don't have a CGM. So again, you're completely blind. And until you're really paying attention to how your body feels when you are in those target ranges where you should be. You may be able to, as you said, get away with

Scott Benner 51:01
Yeah, well, it's the strength in the immediacy of the implications. If they're not too strong and not too quick, then you can procrastinate because yes, because in your mind, you're like, Yeah, well, I've been okay, this long. Like, so what if I let me just get through one more Christmas season? Right? Yes. Oh, but to have cornbread stuffing one more time, LA, like, you know, like, who knows what the thought in your head is. But I'm saying that people the way people's minds work, it's like, oh, I have time I can I can do something about it. It doesn't mean they start necessarily doing something about it, it means they have time to do something about it. Like I think, oddly type two diabetes and the way I see people, even in my own life, decide or not decide to, I think the same attitude that put them in that situation is the same attitude that got my powder room needing a paint job three days, three years ago, because I was like, ah, nobody sees it that much. And I can get to it eventually, like the problem is, is then once it's too late, it's really, it's really good. And it becomes a real issue like act now, like do it when it's only a little touch up, I should have done that when I just needed a couple of touch ups in one hole filled in, I could have got it all done in a couple of hours. And now I'm looking at ripping out a vanity and doing the whole thing again. You know, anyway, I don't know if that makes sense or not.

Jennifer Smith, CDE 52:21
No, it doesn't. It also brings into as I said earlier, with type two, it's almost an accumulation over time. Right. And for some people who haven't, maybe you haven't really kept up with health care, because other than the average yearly cold that you have, or whatever it may be, you've been feeling fine. And so you skip your yearly visit with your doctor and you never get lab work done. So there are many things that can sneak up then if you haven't been at least going in yearly for a checkup. Those are mean they're important. Even I go in yearly to my primary care. I just write it's part of my checklist of things to get done. Not that my primary care for me, but I'm glad that she is there if and when needed. And if I've got questions to bring up in that visit, so you know, a checkpoint is just start going to your doctor yearly, at least. And if there are things that you're kind of, hey, I've got a history of type two diabetes in my family. If the doctor doesn't recommend checking, you know, an average glucose or even Hey, asked for an E one C, right? I get it checked if it's this range to this range. Well, goodness, Doctor, could you send me in for you know, some additional questions, I'd like to ask somebody about this. I think as adults, we get away from taking care of ourselves. Because there are so many things get loaded on as an adult. That until, until you're hobbling into the doctor. Clearly your leg hurts so bad. You're like, oh, well, it started hurting about six months ago. But now I can't walk on it. Well, oh, you know, it's too

Scott Benner 54:06
late now. Now it's broken. We got to do a whole thing. I we just we live in a different time. Like when do you know if you listen, I wasn't alive in the 50s. But my expectation is that if I got a Coca Cola in the 50s, it was a special thing that happened for me every once in a while. Yes. And now if I go to the grocery store, and I'm willing to buy 10 bottles, I can get them for $10 because they're $1 a bottle if I buy 10 bottles, and so I listen, I'm I want to say I'm not a judgmental person on this on this front. I'm not because I do believe and I do think the way I said earlier I think people just end up being carbon copies of what happened before them right? Sure. But I will walk down that aisle to get a sparkling water for myself. And I look in people's carts and I'm like you are leaving here with more soda than I will drink in the next 10 years of my life and you're going to be back here next week to buy more of it. Like that's not a thing your body's supposed to process. Right? Oh, I mean, I eat a burrito once in a while, but you shouldn't. And there's just there's there's food process. I know people hear this and they must be bored by it. Process food is difficult for your body to process. So. And it's not food, no. And it's everything everybody eats. Like, there's

Jennifer Smith, CDE 55:28
just it is, it's something with calories. It is not food, right?

Scott Benner 55:33
You'd be surprised how much better you feel when you get away from that stuff. And again, it's a financial thing. I understand. But, I mean, and now we're all like, I mean, we're gonna end up talking about as we go on, like, maybe people are thinking right now like, I can't break this cycle. I'm, I'm addicted to that food. Like, I absolutely know people who are addicted to food. Yeah, so it's, I understand all of that. But we'll talk about some things like maybe we'll talk about, you know, trying a intermittent fasting to help break some cycles, the foods that you're stuck to, or things like that feature,

Jennifer Smith, CDE 56:06
or budget. And you know, budget eating, honestly, is another thing to bring in. Because, unfortunately, type two diabetes doesn't care what you bring in monetarily. It doesn't. And it can be a major strain on many people, especially adults with families to take care of. And often as you know, as a parent, you're very willing to take care of outside of your own cell. Yeah,

Scott Benner 56:32
that's hard to write yourself. Yeah. No, I know, as soon as my it wasn't, as soon as my kids, my son went, got his own job. And my daughter went back to college. And the first thing I did was make a doctor's appointment. I was like, oh, and I wonder when the last time I did this was, you know, so I know how I know what how I know what happens. And I know how you feel. And I know that it can feel like between the guilt and the shame and the uncertainty about how to deal with things, and not really understanding nutrition, as well, as we all think we do. All that stuff together can feel like it's too much, but it's not. And I'll end with this. And then you can say whatever you want. At the end, I have now interviewed three people with type two diabetes, who have significantly changed their life through listening to this podcast. And they're really good. I left I've listened to them. Yeah. And we're going to put them back into like, circulation with these episodes too. Awesome. But But it's so doable. And these people like, I wait, I want to be clear. They're not like superheroes. Like, they're not a person you'd look at and go, Oh, well, yeah, of course, they can do it. Look at them. These are these are people just like you and me. You know, and, and they did it. They figured out what was going on. They made some adjustments, some of them added medication. And they came out the other side better off. And I think that's possible for everybody. So anyway,

Jennifer Smith, CDE 57:52
I agree. No, that's excellent.

Scott Benner 57:54
Thank you. I thought you were gonna say something thoughtful at the end, but just goodbye.

Jennifer Smith, CDE 58:01
I just Well, actually, what I was gonna say is that I think this was a really good place to start. Because I think it's a big piece specific to type two, despite the comments that you had from the type ones and how they felt and kind of that background. You know, that background piece of, I don't know, feeling bad about like, Why did I do something wrong that I have this? I think it's really important to address some of the reason that type two hasn't been well navigated in terms of helping people know how to do better for themselves, there

Scott Benner 58:44
is some disconnect between between the machine and the people. And the people don't believe in the machine, the machine doesn't believe in the people. And that's how it looks. To me, it looks like nobody thinks anybody can be helpful. And I think maybe, maybe they can't be helpful, but I do think there's help that's available, that would be beneficial and create a big change in your life. I'm just tired of watching. I'm tired of watching people say like, oh, I we really do care about this population. And I'm like, well, we should make some content for them. My we don't have a budget for that. Okay, thanks. Great. So you know, so it's just it's everybody, it nobody wants to they want, they want them to be there. If you're listening type twos, they want you to be there right because they want to market to you and they want to tell you what you need and everything. They don't know how to get you all together. And turns out I don't want to get you all together. I want you to go live your life and be happy. I'm not looking to make a pile of people with type two diabetes who we can sell something to write, write, write. I'm not that's not my thing. Like so I want to make content that helps them and I want them is I have the same feeling about type juices I have about type ones. I love People listen to the podcast. And I think that's amazing. But I want them to get to a point where they don't need it anymore. And they can go on and just live their life. This should be a pitstop in your life, not the story of your life.

Jennifer Smith, CDE 1:00:11
Right? You know, and it should be a place to that you get enough information in digestible. Yeah. In a digestible way that you can take action from just listening for 20 minutes about something that was very specific, like you know, your Med, here it is, I'm gonna listen to this one, because this is what I'm on. And you're like, well, darn, it's supposed to be doing this. And it totally isn't. Maybe I could just go back to my doctor and talk about this, right? You know, it's those pieces that are really important, because they're empowering, right? They're, they're a way to say, Gosh, I get this now. And I want this to work. But it's not. So I have to try something different.

Scott Benner 1:00:53
My hope is that when this is over, people will understand how food impacts them, how medications can impact them, how exercise will help them, and then they can go do these things on their own. Like it's just it to me, it's it's not as difficult as people have made it out to be. But I do, I do believe that the reason that somebody hasn't successfully put together a large type to community is because of, of the stuff that we talked about here. And that's why I just wanted to dispense with it and just get it out of the way right away. Like, let this go. Let's get to the part where we we do something positive. So Right. That's great. All right. Excellent. Awesome. Thank you very much, Scott. Yep.

Jennifer Smith, CDE 1:01:30
Thank you. Okay, bye, bye.

Scott Benner 1:01:36
I hope you're enjoying this. So far. The next three episodes are going to be about your medical team, your fueling plan, and technology that might help you with type two, or pre diabetes. Keep coming back. This series is going to be terrific. Thank you so much to Jenny, and of course to you for listening. And to all the people who shared this with you. I also want to thank the contour next gen blood glucose meter and remind you that if you're testing your blood sugar, you want to get a good, accurate number. And you can do that with the contour next gen contour next.com forward slash juicebox. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast.

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