Scott Benner 8/3/24 Scott Benner 8/3/24

#1270 Weekly News 7/29/24

For the week of July 29, 20024

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

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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
OmniPod. Hello friends and welcome to Episode 1270 of the juice well. Did you hear them? 1270 of the juicebox Podcast.

Today I'm going to go over the news stories around diabetes that jumped out at me for the week of July, 29 2004 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. Don't forget, if you use my link drink AG, one.com/juicebox, you'll get a free year supply of vitamin D and five free travel packs with your first order. And if you go to cozyearth.com and use the offer code juicebox to check out, you're going to save 40% off of your entire order. The juicebox podcast is full of so many series that you want and need after dark, ask Scott and Jenny algorithm pumping bold beginnings, defining diabetes, defining thyroid, the diabetes Pro Tip series for type one, the diabetes variables series, mental wellness, type two diabetes pro tip, how we eat? Oh, my goodness, there so much at juicebox podcast.com head up into that menu and pick around. And if you're in the private Facebook group, just go to the feature tab for lists upon lists of all the series. Always free. Always helpful. What's up? Everyone? This is the news that caught my eye for the week of July, 29 2024 let's get started. So there's a recent trial investigating the use of ozempic to manage kidney disease in individuals with type one diabetes. The study aims to determine if ozempic can reduce insulin needs and improve blood glucose control in people with in people newly diagnosed with type one diabetes. I can only talk from my perspective here with my daughter, but I don't think we need to study for this one. The answer is yes. Study Details participants and dosage. The trial involved 10 adults aged 21 to 39 who started taking semaglutide With three months of within three months of their diagnosis, they began with a weekly dose of point 125, milligrams, which was gradually increased to a maximum of point five per week. The mealtime insulin doses were reduced based on continuous glucose monitoring data, key findings, it says, After three months, participants no longer required mealtime insulin. And after six months, seven out of 10 participants no longer needed basal insulin. Additionally, there was a significant improvement in glycemic control, with a 1c levels dropping from an average of 11.7 at diagnosis to 5.9 at the six month mark, and 5.7 in one year, most participants achieved a time and range of 89% some participants experienced mild hypoglycemia. Sounds like they gave them too much insulin while the semiclutide dose was being increased, but no severe side effects like diabetic ketoacidosis were reported once the dose stabilized. I'm just going to jump in here and say all the people who came to me and said, You can't share stories of people who are using less insulin on glps, because type ones will get confused and think they don't need insulin. First of all, I don't think type ones are easily confused like that. I still know you need insulin if you have type one diabetes, but to all you people who mercilessly, mercilessly, mercifully, mercifullessly Ram your hot poker up my ass for spreading news that is absolutely legitimate. Let me just go say to you now yourself. In addition to these findings, a separate trial starting in March 2020, will investigate the use of karadia for preventing kidney disease progression, adults with type one. This study, known as the fine one trial, will enroll 2220 participants, and compare the effects of finaroni. I mean, how do they F, I N, E, R, E, N, O N, E, against the placebo. Over six months, if successful, finaron could become the first new medication for managing kidney disease in type ones in 30 years. That's very cool. I got this information from a number of different places, but one of them I really enjoy is diatribe. The rest was kind of cold over the internet and I asked, of course, our chatgpt overlords, the carodemia trial for preventing kidney disease is actually accepting participants. It must be 18 years old, diagnosed with type one diabetes, have an A 1c of less than 10% diagnosed with chronic kidney disease, meeting specific criteria for estimated Glomar, really. I mean, why do they these words? Fill? Rate, EGFR and urinary albumin. I know this one, albumin, creatine ratio, UA, CR, I don't talk so good. Sometimes must be on a stable dose of an ACE inhibitor or an angiotension receptor broker for CKD exclusions. Individuals with type two or those taking SGL t2 inhibitors or GLP one receptor agonist, they're not eligible for more information or express interest in the participant. You can contact the study directly, 888-842-2937, and to add some clarity to what I was poo pooing a minute ago. I've had two conversations so far with type ones who have used the GLP and their insulin needs have significantly decreased. Episode 1136 is called 15 year old type one using GLP. You should check it out. Episode 1230 is called off insulin with Manjaro. That's an adult with type one. Listen, does he have Lada? Probably, but he's not using insulin right now. Go listen to his story. Jenny and I talk about glps as part of the diabetes pro tip for type two series. That's episode 885, actually, that whole series is terrific if you have type two diabetes, or know somebody who does or even has pre diabetes. It's great for them to know what's about to happen to them, so that they can tackle it well. But in the end, today's story is about kidney disease and looking at glps and how it might help. It's a big deal. I hope you check it out. Looks like I've received an email from OmniPod today, most of you have probably received it as well. I'm just going to read it to you. Hey, Arden, you insert your name there. We're excited to share the latest information on the OmniPod five integration with Dexcom g7 launch and limited market release of OmniPod five app for iPhone with Dexcom g6 sounds like things are moving. OmniPod five, Dexcom g7 you will receive a free over the air update to complete on your controller starting July 30. That's today. OmniPod five app version 3.0, point one will add the option to pair your system with Dexcom g7 you can choose to install the update immediately, or delay it until a time that is convenient to you. It's important to know that the software update requires 15% battery level and should only take a few minutes, depending on the strength of your WiFi connection. During the update, you will not be able to navigate with the OmniPod five app, including the ability to bolus Bazel insulin will continue to be delivered in the background. There's a link here for where you can find out more, but I am not going to be giving you that link so you can do some Googling. Let's see here there's more. The new pod. Oh, the new pods compatible with Dexcom, g6 slash g7 may be at your current pharmacy as early as August, with full availability expected in the fall continue using your Dexcom g6 supplies until you see this is going to be written right on the box, the words compatible with Dexcom g7 right in the top right corner of the face of the box. It'll say that you don't need a new pod prescription. Oh, this is nice, but a new Dexcom g7 CGM prescription will be required if you decide to change your CGM, which I think makes sense. If you have g6 and you want to go to g7 you're going to need a script to go to the g7 that's got nothing to do with OmniPod now iPhone control with Dexcom g6 the limited market release of OmniPod five app for iPhone with Dexcom g6 is underway. The first version of the app will integrate with the Dexcom g6 only if you prefer. And so ends the part of the show where Scott reads you his email. This last thing here. I mean, it's not news, but I keep seeing people talking about it in the Facebook group, so I thought I'd go over it with you real quickly. You can get a free lifetime national park pass if you have diabetes. I don't know if you knew this or not. Eligibility US citizens or permanent residents with diabetes qualify as it is considered a disability by the ADA. The pass, called an Access Pass, grants free entry to over 2000 federal recreation sites. Apply in person for free, online for $10 or by mail for $10 you have to provide evidence, a physician statement or document from federal or state agencies are needed. I don't love reading URLs, but www.nps.gov/sub, s.gov/subjects/accessibility/interagency-access-pass.htm

There you go. Have fun with that. One tickets for the 2025 juice crews are limited. I'm not just saying that they actually are. Limited. We have a certain window to sell them in, and then that's it. Juicebox podcast.com, scroll down to the juice cruise banner. Click on it. Find a cabin that works for you and register right now. You are absolutely limited by time on this one, I'm so sorry to say that. It sounds pushy, but it's the absolute truth. Juice cruise 2025 I hope to see you there. We're gonna get a tan, talk about diabetes and meet a ton of great people who are living with diabetes. It's kind of gonna be like floating diabetes camp, but you won't have to sleep in a log cabin. You'll get a tan. And it's not just for adults or kids. It's for everybody. 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.

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. You.

#1269 Multiplicative

Christi has four kids all with different auto immune issues. Her youngest son has type 1 diabetes.

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Scott Benner 0:00
Hello friends and welcome to episode 1269 of the Juicebox Podcast

so Christie has four kids, they all have different autoimmune issues. Looks like her youngest son has type one. Her husband and herself have other autoimmune. We talk we talk about a lot of stuff in this episode, you're gonna love this. 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. When you place your first order for ag one with my link, you'll get five free travel packs and a free year's supply of vitamin D. Drink ag one.com/juice box. Hey, you like we're uncomfortable stuff sleeping uncomfortable sheets drying off with beautiful towels. If you're that kind of person. Cozy earth.com use the offer code juice box at checkout save 40% off of your entire order. If you've taken a quiz to find out what Gossip Girl you are or what Hogwarts house you belong in, and you haven't gone to T one D exchange.org/juice. Box include the survey. You're personally hurting my feelings. You have questions? Scott and Jenny have answers. There are now 19 ask Scott and Jenny episodes. That's where Jenny Smith and I answer questions from the audience. If you'd like to see a list of them, go to juicebox podcast.com up into the menu and click on Ask Scott and Jenny. Today's episode is sponsored by Medtronic diabetes, a company that's bringing together people who are redefining what it means to live with diabetes. Later in this episode, I'll be speaking with Mark he was diagnosed with type one diabetes at 28. He's 47. Now he's going to tell you a little bit about his story. And then at the very end of the episode, you can hear my entire mini interview with Mark. To hear more stories from the Medtronic champion community or to share your own story. Visit Medtronic diabetes.com/juice box and check out the Medtronic champion hashtag on social media. This episode of The Juicebox Podcast is sponsored by us med us med.com/juice box or call 888-721-1514 Get your supplies the same way we do from us med this show is sponsored today by the glucagon that my daughter carries. G voc hypo penne Find out more at G voc glucagon.com. Forward slash juicebox

Christi 2:37
Hi, my name is Christie and my son Silas is 11 years old. He is a type one diabetic. diagnosed two years ago tomorrow. Two years ago tomorrow

Scott Benner 2:49
February of 2024. How old is he?

Christi 2:53
He's 11. He was nine. Yeah,

Scott Benner 2:57
he was diagnosed.

Christi 2:57
I started off math. So

Scott Benner 2:59
two years if I can't do the math on two years I'm in trouble. Silas that's an interesting name. Is that a family name? No. Where'd you get it?

Christi 3:07
It's not the Bible.

Scott Benner 3:08
Oh, nice. Yeah. Which one? The older the new one? I don't really new

Christi 3:12
one. The new one? Mm hmm. Yeah, he was Paul's buddy. Missionary.

Scott Benner 3:19
Hold on. Sorry. I used a lot of words just there. Like I actually just thought, can I call this episode Paul's buddy? Maybe?

Christi 3:26
Possibly. Yeah.

Scott Benner 3:27
But you mentioned it's so early on. It's you know, I don't like doing so by the way. Not for nothing. Christie. You then said Paul's buddy and missionary all the same time. And then I was like, I don't want to say anything inappropriate. So I kind of I stopped thinking about okay, okay. Sorry. Do you have any other kids?

Christi 3:47
Yes. He's our youngest. We have four. Wow. Okay.

Scott Benner 3:52
Your youngest is 11. How old are you?

Unknown Speaker 3:56
I'm 44.

Scott Benner 3:58
Are you done with the kiddie making?

Christi 4:00
Oh, my gosh. Yes.

Scott Benner 4:01
I will say

Speaker 1 4:04
she's 18. Wow. In high school,

Scott Benner 4:07
any other autoimmune with the kids?

Christi 4:10
Well, now that I've learned a lot about autoimmune stuff, the answer is everybody has something. Our 16 year old. He he's the first one who had anything he's had asthma like just not bad, but like, you know, when he would get sick since he was little. And then right around when Silas was diagnosed with type one. Our daughter who's 18 She's our only girl. She started getting hives. Horribly, horrible, horrible hives, was diagnosed with chronic hives a few months later, she's on Zoeller injections. I can't figure out what you know what it is, but we're guessing it's auto immune. I mean, that makes most sense. And then back in our 13 year old, he has to auto antibodies and is last August they said he was into Stage two, that I've just been doing fasting blood sugars, and they've all been really like in the 70s and 80s. So he'll redo that in May, because they want him to do a clinical trial. Right. So they'll redo that in May and I, I'm kind of doubting that he's eligible.

Scott Benner 5:16
They thought he was but for like, tz old or something like that?

Christi 5:19
No, it's a new one. Oh, gosh, I shouldn't under organizing this. It is through trial net. And it is. It's a it's some drug that they give to kidney transplant patients. Okay. I can't remember

Scott Benner 5:34
what it's called. I'll see if I can figure that out while I bring up something else. Okay, have you on a second? Let's do this first trial that I was going to try to type and talk about something different. I'm like, I don't think my intelligence goes that far. I tried try on that and kidney to see if I could get something ATG onset. Yep. Yeah. That's it. Okay. trauma.org If you want to learn more, but I want to go to your daughter for a second. Sure. So my son, Arden was diagnosed when she was two, and colts about, you know, I don't know how old he is five years older than her. I don't know how old he is. I just had to do I just had to remember how old my kids were. So Arden's diagnosed when she's too cold, five years older. And we don't know anything about autoimmune issues as we're raising a young family. Although if I look back now, my wife's grandmother has celiac. Some people with like, irritable bowel and her life, there's a person with bipolar distance away, you know, some depression, like, you know, like stuff that as you hear people talking more and more, you hear kind of clustered together around people with autoimmune issues. Anyway, my son, Doring, COVID, was going to school at home. That was fun. By the way, any of you who have ever sent money to a college and then watched your kids zoom, you're like, I got my money back, please. He's getting through that season. And he says, As soon as I'm done these last tests, I'm going to start working out again. And you know, we started talking about stuff he was going to do for baseball. And he finished up all this testing. It was definitely a stressful time, he disappeared into the basement to start working out. And a couple of days later comes running up the stairs covered in hives. And we couldn't figure out what was going on. So you do all the things that you think you know, at first, it feels like a thing. It's just not going to happen again. And then you see it happen again, he's working out again, he breaks out again, you go to a dermatologist, because that seems to be the way to go. They treat for all the things they know how to do. You probably went all through this, they probably gave her a cocktail of like over the counter, and histamine and stuff like that, right? It didn't do anything. And then we started talking about Xolair and injections and oh my god, he's got a chronic hive issue, etc. And then one night I was up late online trying to figure out what was wrong with them. And I hit on this NIH article that mentioned that a very uncommon thing that you see with people with hypothyroidism is hives. And so we contacted our endocrinologist who put him on tiersen, which is like Synthroid but a different brand, because Arden already used tiersen and his hives went away, and he's been fine ever since. A nice

Christi 8:28
thing about our allergist is that she is with our endocrinologist, so they knew all of styluses history. So they tested her, her thyroid, I asked him test her for celiac. Yeah, and everything came back normal and thankfully, because I've been listening to you, I knew what normal was right. So yeah, I wish I don't know. I mean, do I wish she had thyroid now? But her Oh, that's normal. Her

Scott Benner 8:51
TSH is under two even.

Unknown Speaker 8:53
Yeah, I'm

Scott Benner 8:54
so sorry. I wish it was an easy answer. How long has she been taking the injectable about

Christi 8:59
a year and a half? Does it work? So with she also takes an Anna histamine and Zantac with the cocktail of all three of those. It works that their their desire was that she would be able to wean herself off of the oral meds and just do the injections. And that has not happened.

Scott Benner 9:25
So she needs the injection and the oral over the counter. But oral medication too.

Christi 9:30
Yeah, it was I mean, if you saw it was horrific. I could not believe the Porvorim thing. The Hives were so so so bad. Yeah, so that's been a little bit more, you know, type one at least is pretty cut and dry. You know, they go in and it is you know, then you start treating it but the hives have been a bit of a challenge.

Scott Benner 9:49
If you take insulin or sulfonylureas you are at risk for your blood sugar going too low. You need a safety net when it matters most. Be right Edie with G voc hypo Penn my daughter carries G voc hypo pen everywhere she goes because it's a ready to use rescue pen for treating very low blood sugar and people with diabetes ages two and above that I trust. Low blood sugar emergencies can happen unexpectedly and they demand quick action. Luckily G vo Capo pen can be administered in two simple steps even by yourself and certain situations. Show those around you where you storage evoke hypo pen and how to use it. They need to know how to use G vo Capo pen before an emergency situation happens. Learn more about why G vo Capo pen is in Ardens diabetes toolkit at G voc glucagon.com/juicebox. G voc shouldn't be used if you have a tumor in the gland on the top of your kidneys called a pheochromocytoma. Or if you have a tumor in your pancreas called an insulinoma. Visit je voc glucagon.com/risk For safety information. You've probably heard me talk about us Med and how simple it is to reorder with us med using their email system. But did you know that if you don't see the email and you're set up for this, you have to set up they don't just randomly call you but I'm set up to be called if I don't respond to the email because I don't trust myself. 100% So one time I didn't respond to the email, and the phone rings the house that's like ring. You know how it works. And I picked it up I was like Hello. And it was just the recording was like us med doesn't actually sound like that. But you know what I'm saying? It said hey, you're I don't remember exactly what it says. But it's basically like hey, your orders ready? You want us to send it. Push this button if you want us to send it or if you'd like to wait I think it lets you put it off like a couple of weeks or push this button for that. That's pretty much it. I push the button to send it and a few days later box right at my door. That's it us med.com/juice box or call 888-721-1514 Get your free benefits check now and get started with us med Dex comm Omni pod tandem freestyle, they've got all your favorites, even that new eyelet pomp check them out now at us med.com/juicebox Or by calling 888-721-1514 There are links in the show notes of your podcast player and links at juicebox podcast.com. To us Med and to all the sponsors. Yeah, no, I as we were considering them as the possibility that something my son was going to live with. I found it much more overwhelming than diabetes to think about. And it's maybe weird to think but like because it seems so if your blood sugar gets high or low, you know why? You know what I mean? But like the hives, they appear to come out of nowhere and for no reason that you can discern. So, so scary.

Christi 12:49
Well, they tell her they're like they could go away at anytime. Like Great. Well, that'd be nice. If that happened, that's

Scott Benner 12:55
the other thing or you find some poor kid online on YouTube is like I've been living in this bed for three years because of my you know my breakouts and stuff like that. My son couldn't his trigger was getting warm. So yeah, for people who haven't heard me say it before he he spent like months in his bedroom with the windows open in the middle of winter trying to keep his body temperature down. He couldn't like exercise or get moving or like even get excited or laugh. They all these things would make them break. That was really crazy. Yeah,

Christi 13:24
that's the weird part is that when she was little, she would get high. It's like a heatwave, just like a heat rash. And then anytime she got a virus, she would get hives at the end of it, which is also pretty normal. So when it first came up, we were like, Oh, you must have just like had a virus, you know, or something like that. But they just didn't go away this time. So I think she's always been prone to them. They also did the allergy testing on her back. And everything, including the saline. She was allergic to the saline. She was alert. Yeah, they just said that she's got some hyper reactive skin. So every single I mean, you know, so I said, Well, should we change detergent? And they said, well, it doesn't really matter.

Scott Benner 14:06
Okay, well, my son has our like some allergies to like, you know, pets, hay fever, stuff like that he can be real susceptible to. And I had terrible allergies as a child that just kind of went away at one point in my life. Yeah, that's what my husband is. Yeah, I can't I could never explain it. But I was a person. I couldn't go outside during the summer sometimes. And then one day in my like late teens, it just stopped. was really crazy. That's great. Yeah. Anyway, that's not why you're here. I don't know why you're here. But that's not why we take a look here. I can look TrialNet advocating managing super active kids Oh, with Omnipod five being a foster parent, in the mindset of type one diagnosis. 23 and me, maybe I don't want to talk about that assess. Okay, so whatever you want well at that cocktail, these children and some of them are foster kids.

Christi 15:01
Not anymore. So

Scott Benner 15:04
are you, you did a rent to buy house? What are we talking about?

Christi 15:08
So we, before styluses diagnosis, we've been involved for a long time with foster care or like foster care adoption organization, and helped with just supporting families who had foster children like bringing meals and helping with one another. we ever did child care, but mostly helping with food because feeding a lot of kids is very hard. Then a sibling set of four came up that needed help. My husband and I both felt like they were supposed to come to us. So we started that it wasn't it was all through, it wasn't through like the state or anything was just through relationships. And this, basically, their aunt had taken them in because their situation was really bad. Neglect, mostly neglect. And then it had just become a lot for her for some different reasons. And we stepped in. But in the midst of all of it, Silas gets diagnosed with type one, which was mild. So we still he was, we started the process in December. And he got diagnosed in February. And then we ended up taking them in May. And we had them for eight months. And then they went back to there. And she was at a better spot to care for them. But now they're back with their mom, which is not great. But the court was never involved. So her rights were never removed. She just abandoned them basically, that because it wasn't I mean, the courts were involved in like we had guardianship of them, but she was never, you know, like detox was never involved, I should say. So or whatever you call it. And you know, every state is different. Anyway, so we're in the Atlanta suburbs, that the children are now back with her in Portland, Oregon, which is hard. So they're really far away now. But But yeah, it was the hardest. I mean, 22 is just really hard. Really hard.

Scott Benner 17:09
You're in the middle of trying to do something really kind and then the diabetes comes at you. And it's it's a lot. Jeez, you know? I mean, it would have been a lot. It would have been a lot to take on for children if you didn't have children.

Christi 17:23
Seriously, yeah. Oh, oh, my gosh, it. It was, yeah, I really had a hard time deciding what to do. After styluses diagnosis that we thought, well, we'll just give it a shot. We didn't know very much. I mean, we really didn't know anything. Your podcast was an absolute godsend. Because I literally knew nothing, then I knew we had all this potentially happening. And so I knew the priority was his health, like that has been the priority from the very beginning. I'm like, I'm, you know, I'll do everything. I want to do everything. I can have my kids out with me, you know, and, and I want him to be able to do all the things. He's an incredible human, and he loves to go out live 100% Every single thing he does, so I didn't want any of that to stop. So it's like, how are we going to do all this? And then what ended up happening is he did great. I mean, his his agency has been under six since its original diagnosis. I mean, he's been just, he has not slowed down a bit. But then we added these four children who he actually loved. I mean, he, they were right around his age, he had a blast with them. But I because I also have some like autoimmune stuff. And so I've been basically in remission for the last 13 years. And I could feel that I know what I have to do to keep myself healthy. And I could just feel things like my pinky swelling up randomly and myself, you know, just I could feel things happening to me because I couldn't take care

Scott Benner 18:53
of myself. Yeah. Do you have lupus or so I

Christi 18:57
have it's a nonspecific connective tissue disorder that they think probably is the beginning of lupus that just never got like I have mild kidney disease. And then I did have like joint issues dry mouth dry, which I still have, but those are just annoying, you know, because I do. And I was on Plaquenil for like, two years, I guess. And then we wanted to have another child it was after it was during my second pregnancy that it all happened. And then we wanted to have another child. So we didn't know did all the consoles and everything and all the doctors were like I think you're fine do it. So I went off the clock well and that pregnancy. I mean, something happened and everything just kind of turned around and after that, like I haven't been taken steroid haven't been on Plaquenil I haven't done anything other than just diet exercise, get enough sleep, you know, try to alleviate stress and that of course is very challenging when you have eight children, one of them being diabetic and four of them being we

Scott Benner 19:56
get the hive start by the way, was the hives after this was the hives before or after the lead time of thinking about taking on for more kids or my daughter. Yeah.

Christi 20:05
They really started when Silas got diagnosed. So it was right in the middle of

Scott Benner 20:10
everything. So her stress went up. And then she had this. Oh, for sure.

Christi 20:14
Yeah, her stress. It was definitely stress related. That is like the trigger. For sure, huh?

Scott Benner 20:19
All right. What made you want to be on the podcast? Well,

Christi 20:24
primarily, just to say thank you. Yeah, you're

Scott Benner 20:28
receiving reason to turn the podcast the receiving line, that'd be nice. Right now, we're going to hear from a member of the Medtronic champion community. This episode of The Juicebox Podcast is sponsored by Medtronic diabetes. And this is Mark. I

David 20:45
use injections for about six months. And then my endocrinologist and a navy recommended a

Scott Benner 20:50
pump. How long had you been in the Navy? Eight years up to that point? I've interviewed a number of people who have been diagnosed during service and most of the time they're discharged. What happened to you?

David 21:00
I was medically discharged. Yeah, six months after my diagnosis. Was

Scott Benner 21:04
it your goal to stay in the Navy for your whole life? Your career? It was?

David 21:08
Yeah, yeah. In fact, I think a few months before my diagnosis, my wife and I had that discussion about, you know, staying in for the long term. And, you know, we've made the decision, despite all the hardships and time away from home, that was what we loved the most, was the Navy, like a lifetime goal of yours? lifetime goal. I mean, as my earliest childhood memories, were flying, being a fighter pilot,

Scott Benner 21:30
how did your diagnosis impact your lifelong dream?

David 21:33
It was devastating. Everything I had done in life, everything I'd worked up to up to that point was just taken away in an instant, I was not prepared for that at all. What does your support system look like? friends, your family caregivers, you know, for me to Medtronic, champions, community, you know, all those resources that are out there to help guide away but then help keep abreast on you know, the new things that are coming down the pike, and to give you hope for eventually, that we can find a cure. And

Scott Benner 21:59
you can hear more stories from Medtronic champions, and share your own story at Medtronic diabetes.com/juicebox.

Christi 22:10
And because what I found is that because of everything, because I had the outlet of being able to listen to the podcast, like in all the pockets is nice, because you don't have to really change anything. And I mean, I didn't have to take a bunch of time to like, this sounds bad. I like to read, but didn't have to take a bunch of time to like, sit down and read a book, or follow the doctor's office constantly. I just listened as I drove and learned. And in this season that was so busy and so overwhelming, that like I was continuing to expand my understanding of how to manage Silas his care. And there is this like, I mean, everybody experiences this, but I had such mom guilt when he was diagnosed. And listening to the podcast, and having so many people tell the same story helped me just free myself from that, because I was like, Oh, this is kind of what happens. When they're kids diagnosed, it's all it's all the same story. And I think you giving people the space to share that really helped us let go of those feelings. Oh, I'm so

Scott Benner 23:17
happy. That's excellent. It's interesting, because everybody's story is so similar at its core, you know, and then you let them kind of blow it up and tell the rest of it and you go, that's a detail. And that makes it entertaining enough to carry a podcast. You know what I mean? Because if we just had somebody come on once a week and was like, I had to pee a lot. And then this happened. And they like, you know, you'd be like, Oh, my I've heard this already. You know, like so. Trying to keep it fresh by letting people tell bigger stories and and get more down into the details and stuff like that, I think is has been valuable, but I'm glad it helped you. I really am. Where did you find it?

Christi 23:54
So Abby, she was on a roll and episode she was on episode 573. Wow, that adoption? Oh, yeah. Yeah, she so my husband used to direct a family care like a summer family camp. And she and her family were campers. So and then, when Silas was diagnosed, she reached out to us over Facebook and because I posted something I think right after he was diagnosed and she responded and said, You have to listen to this podcast start with the newly diagnosed are starting over. So she just sent me right in the right direction. So I think I mean, I right from day one.

Scott Benner 24:31
She's a curly redhead. Yes. Look at my memory. Hey. Let's take a minute. That's pretty impressive. All right. I've interviewed that was back in November of 2021. And I don't know why did we do it over video maybe that's why I remember what she looks like. Ah, that's interesting. Like I don't listen, Christie don't let anybody take this the wrong way. Okay. But I make this podcast like Fast and Furious like so. You If you said to me, Hey, Scott, what were last week's episodes about? I honestly off top my head don't bow. But they were also recorded like six months prior to that. And so like you don't I mean, like, I'm like so far ahead of the podcast that I don't really remember it sometimes. So I'm sometimes the worst person to ask about it, though. Like, you know what episodes about this? And like, I have no idea. I was just very pleased with myself that I remember that. So anyway, I'm glad she shared it. hello to her if she's listening. So basically, this is through the adoption thing that you found this. I

Christi 25:28
mean, she just does happen did happen to adopt but no, they can't. My husband directed was just for any family. Oh, anybody? Okay. This family's? It's like a resore It's It's nice. It's not like what you think

Scott Benner 25:43
it's a camp like camping, or is it? glamping? So yeah,

Christi 25:47
it's a little different. But it's, it's a great.

Scott Benner 25:53
What's it called Pine Cove? panco.

Christi 25:54
Chimney point is the camp we ran right there in Texas and in like, the Georgia, South Carolina border.

Scott Benner 26:01
Nice. Are you from Atlanta originally?

Christi 26:04
I'm from Oklahoma.

Scott Benner 26:06
I was gonna say you don't sound like you're from there. So I was trying to figure out what was going on. Did he drag you there? Or did you just move there? Have you on for a while.

Christi 26:12
He's from Illinois, actually. So we met working at a different camp in Missouri. Like halfway between both of our homes. Matt was there for a little bit. And then we ended up in Atlanta for a job and just never left.

Scott Benner 26:27
Very nice. My son just left Atlanta, saying and I'm not directly quoting, but I hate it here. I have to go.

Christi 26:38
Yeah, I mean, we live in the suburbs. It's It's definitely different out here. But I, I we lived in Texas before we lived here. And that's kind of my that's what feels the most like home to me.

Scott Benner 26:48
Really? That's interesting. Whereabouts in Texas. Like what part? Fort Worth? Okay. That's interesting. I don't know. I liked it where he was it seems safe and everything, but he's like, I don't think he's a city person. You know what I mean? So yeah,

Christi 27:03
I totally, and it's a monster in the tropics are atrocious, and you know, yes. Yeah. Good trouble. No, good. It's public transportation. So it's, I

Scott Benner 27:14
know when people complain about traffic in places, they're like, Oh, the traffic's bad everywhere. But Atlanta has its own different animal. Yes. Especial really something. Yeah. Anyway. Okay. So you come on to say thank you. And I do that, by the way, say your Well, and, and to share our story a little bit. So what about this year with managing an active child with Omnipod? Five. So how long has Silas had Omnipod? Five?

Christi 27:35
Since July of 2022? Oh, well, you

Scott Benner 27:39
got to pretty close to the beginning. Oh, yeah, I

Christi 27:42
was just all over that. Okay, like we're, we're getting all the stuff as soon as we can. And he's been on it

Scott Benner 27:48
before just tell me before that. Just MDI or pens or what was he done?

Christi 27:53
So he started on parents, you know, right from the hospital. And then he is a he does not use as much insulin I think is like they expected or what kids his age do because of his activity level. And I don't know why from the hospital, they gave us the one unit pins, which that's silly. Just didn't give me he needed a half unit. So we struggled with that for a little bit. Finally got the end pin, which was better. I knew I wanted to put them on on the pod just for listening to the podcast. And understanding that he we could do a lot with his Basal rates because of his activity level has basil is it just changes constantly. Also, he had a really bad reaction to that basic or is that a great fan? I think he started

Scott Benner 28:36
the Basal insulin. He had a problem with

Christi 28:38
Yeah, okay. Yes, he would get this big red welt around the injection site. Yeah. So really quickly. I mean, within two months, he was on the dash. And we did that. So in April, he started on the dash. And then I just kept bugging them until they would they let him get on the five. But I want to alter on the pod. I hear people say like their doctor had problems with their doctors giving them a prescription and you know, don't my recommendation would be go through Omni pod and let them advocate for you let them bug the doctor. Let them deal with insurance because they want people on the device. So they will they'll they were such a partner with me as far as getting him as fast as possible on on the devices and doing all the training. So I didn't have to wait for the doctor's office to

Scott Benner 29:22
Yeah, yeah, sometimes everybody's dragging their feet, but the people who are selling it, they're very motivated.

Christi 29:28
Right, exactly. Go through them.

Scott Benner 29:32
You want attention, go to the people who are getting paid. They'll hustle, right? Yeah. That goes for everything, by the way. Not just Yeah. All right. Yeah, for sure. Find someone who has a stake in it that will help you. So you wanted to use Omnipod five? Is it an interesting tool with the all the different kinds of like, I don't know, allergies that might be kind of streaming through your family. The Basal guard was was tough for him. Yeah, but it hasn't any trouble with any he's though, I

Christi 30:00
mean, his skin's not great. He's always had dry skin, but he's never really had like, you know, eczema, psoriasis or anything. So the winters are hard when I take off a pod, it's usually pretty inflamed. But he doesn't, he can tolerate it. The problem becomes like he's really lean, and he only likes to wear him on his, like, upper back and on his thighs. So getting him to it's the challenge is finding new, you know, clean spot. So we off on the aquifer, we're just putting lots of aquifer on. You

Scott Benner 30:34
and your husband are quite a little played a little auto immune mix here. You guys. Yeah, we

Christi 30:39
Yeah. A special, special. Yeah. But all that's his uncle had type one. His brother has graves. And then I might have, yeah, I've got lots of stuff on my side. But we didn't really know, you know, you get married and you're like, I don't even think half the stuff had been diagnosed. And it was uncle had died from diabetes, but I just assumed as type two because I felt like that's so much more common.

Scott Benner 30:58
For sure people don't pay attention to stuff like this even like 20 years ago, like nobody's like it was just like, you're itchy. That guy's got dry skin. He can't go outside. And when the weather like you know, whatever. I mean, look at me like I'm, I have terrible allergies as a child. My wife has hypothyroidism. My kid has type one diabetes. It's not always like just the cut and dry like diagnoseable thing that has a name like I just I sneeze a lot around grass. I have, you know, my bodies. I have I carry inflammation in ways that I don't even think I completely understand. So, you know, I think that all blends together. So

Christi 31:35
funny story when my husband and I got married. His mom, hands me this typed out from like, 1983 probably typed out on this yellowed old, you know, paper, a list of everything that he's allergic to.

Scott Benner 31:52
Is this after you said I do?

Christi 31:55
Yeah. It was so strange.

Scott Benner 31:57
Did she say, hey, what do I do? She say, hey, here you go, sucker. Like you just bought some swamp land from her. And that was the deed.

Unknown Speaker 32:12
Good luck for nature. Yeah.

Scott Benner 32:13
Good luck. Watch out for the Gators say yeah. Did you ever talk to her about that?

Unknown Speaker 32:22
No,

Scott Benner 32:22
I'd love to hear me. She's probably like, I was so thrilled to offload this kids care to somebody else.

Christi 32:27
She and I are complete and polar opposites. So

Scott Benner 32:31
your sounds like she was worried about him. And she just wanted to make sure that like he was safe. But at the same time, maybe she was like, yeah, here's what you're in for.

Christi 32:38
He's like, I don't have any of that anymore. None of it. Okay,

Scott Benner 32:45
is there anything embarrassing on the list?

Christi 32:47
No, it's all it's every tree and it's everything outside. You could basically just write outdoors. Yeah. And then be done with it.

Scott Benner 32:54
Have you ever seen the movie with John Travolta where the boy lives in the bubble? This is probably your best bet. Yeah. hermetically seal your house run an air conditioner constantly. Don't let him outside. Good luck. He didn't tell you you're gonna get a kid with hives, asthma, type one diabetes. Did you just gonna say to her mom hand something to your husband? Like, she's got some what we're going to call on specific connective tissue disorder. The key would be like, hey, that didn't come up during dating. Oh my gosh. Well, none

Christi 33:30
of that was there yet. Nobody you know, later. Yes. I have always had stomach issues. So we shouldn't when something goes wrong.

Scott Benner 33:37
Oh, the digestion part. That's the first sign Don't you think? Yeah. Oh,

Christi 33:42
for sure. Oh, for sure. It was like my constant struggle my entire childhood Christy. I

Scott Benner 33:47
always imagine people who are finding the podcast in the beginning and they just pick up an episode and they're they're right here and they're just in their house gone. Least a digestion bipod somebody mentioned bipolar disorder without making notes furiously calling their mom. Hey, Jim have bipolar. Does doesn't yet know it. Like. It's better to know than not to know Christie. What's up? That's all. I think. That's what I decided. Yeah, yeah, knowing is better. You can be ready. And at least Gird your loins a little, you know, so I haven't used that as a episode title ever. But I'm dying for it to fit in somewhere. I love that phrase. Also, you know, I don't want to out myself as liking girls movies too much. What's the one with Devil Wears Prada? Do you know that movie?

Christi 34:38
I do. I forget movies immediately after I watch

Scott Benner 34:41
them. I've seen Devil Wears Prada like a dozen times.

Christi 34:46
You blamed that on your daughter and the fashion

Scott Benner 34:48
stuff some of that's hard. I'm not gonna lie. I don't think I've ever sat down and been like finally two hours to myself. What will I do? Devil Wears Prada. That doesn't happen. But there's a great line in it where Stanley Tucci who of course is a national treasure? Says Gird your loins. Um, one day, it's going to be an episode title. Not today, sadly, but one day, because I'm gonna run out of other stuff at some point, too. Yeah. I'm at the point now where I name an episode and I go, I should check to make sure that hasn't been used before. And I've never once. I don't know how that happens, like, there's like 1100 episodes. That is really impressive. I've never once been like, oh, call it like purple bananas and then like gone. Oh, I did that three years ago. Like it hasn't happened yet. I'm pretty impressed. So anyway, people who are new to the show must be like he mentioned Omni pod 515 minutes ago. Then this lady has given her a list of stuff for the husband and now we're talking about Gird your loins. I heard Stanley Tucci in there somewhere, is going on. Well,

Christi 35:46
I completely forgot what we were talking about. Don't worry. I

Scott Benner 35:49
got the whole thing I had. We're doing it. So activity I know from before we started recording your son plays soccer. And what else does he do? He

Christi 35:58
plays basketball. He is He does theater as of right now he's kind of I don't know if that will keep going but he's also just you know, there's kids who just go like there's just something in them that is it's like he's wound he just have to go all the time. So like at recess he's not one of those kids at recess who's like swinging on the swing or you know, playing I don't know something quietly he's running full bore all recess. They play football or soccer every day and he I mean the car ride home is usually about what happened during that game and if he got a you know, a got passed to or who he you know, interesting intercepted or what yeah, he's just I feel bad time that there's competition. He is

Scott Benner 36:41
just go go go. I feel bad for you, Christy because I've watched my son explained sporting events to my wife and just she tries so hard not to glaze over. And you know, she's, she's like, that was what inning and then you're saying who hit the ball? And you did what you caught it. And she's just trying to like, you know, try not to lie and I have, I have three of those. Oh, three boys that have like that gogo energy. Well,

Christi 37:09
three boys who play sports and two of them have that gogo energy one of them would prefer to just, you know,

Scott Benner 37:15
stop these four sports, because everyone else is doing it. Don't worry who grew up to hate you. Daughter active? No, no. Did you say what you just said that Chrissy was very telling, you know,

Christi 37:34
trying to get her to good. I'm just trying. Yeah, I would like for her to just get into some type of rhythm where she felt. I think that exercise is if you don't build it into just your normal life, then you won't do it when you're older. I would love for her to be a little bit more she's she'll go run occasionally. She did. I mean, she she danced and then she ran track and but now

Scott Benner 38:00
yeah, the girls sports that are more like softball and like stuff that's more like kill something with something. You know what I mean? That's that's a purse. That's it's specific personality. I don't think I've ever met one girl who played softball for Arden played softball forever, who was very meek. Like they all even if they were quietly so even if they were quietly so they still were like, I don't know, like little murderers inside like cats. You know what I mean? How you think if your cat was bigger, it would probably take out your eyes and eat them as an order of like, like that kind of like that energy behind them. Yeah, you know what I mean? Maybe she just doesn't have she doesn't have that going on. Right? She doesn't

Christi 38:37
she's I mean, she's a very strong personality. She's really tenacious, but she's more like she's editor in chief of this school yearbook. Okay, so she loves to be in charge. She loves to she's very creative. But she doesn't like

Scott Benner 38:51
Christie. You said she loves to be in charge. Oh, yeah. I heard you told me she was a girl earlier. You didn't have to repeat yourself.

Christi 38:59
And the oldest and has three brothers three little brother.

Scott Benner 39:02
I got what's going on. Also, I can't wait for the one interview that calls me a misogynist now for joking like that. But whatever. People have no free it's too much free time. So you're looking for something for her. That's more like more exercising and less activity, right? Because she's not like into like that. Yeah. So

Christi 39:20
she goes to college and they have the, you know, they have the gym rec center or whatever. Yeah, I think she'll do that. I've just been encouraging her. She like me

Scott Benner 39:27
to tell you the story of six months ago when art and FaceTime me all read her face. And I was like, What are you doing? She goes, she goes, Kaylee and I went to the gym. And I was like, Yeah, I was like, How was she just really nice to get a lot of good equipment. And she's like huffing and puffing and walking back to her room and everything. And I said, What do you guys gonna go on the schedule? Because I think that's the last time we're gonna do it.

It was a lot. And I was like, gotcha, because I'm so out of shape. You know, she was like, she said to me, I don't think I could go play softball right now. And I was like, Yeah, you don't look like it. Yeah, so Anyway, you keep hoping. Yeah, go to college. Take up a sport. How about you guys? Do you? Are you active people, you and your husband? Yes. Okay, so you're hoping to lead by example, maybe?

Christi 40:14
Yeah, I do, like a sort of CrossFit type thing. It's not as hardcore as CrossFit that nobody does that with me, that they've seen me go every day. And I think that, just having that or they know that, that's my habit. And then my husband played every sport under the sun, and he coaches, our boys and basketball. And he goes, he played more like, I mean, you know, things are starting to get out. But

Scott Benner 40:38
I love your hopeful nature, like they see me go do it. There's, there's a case study, by the way, where you walk out of the house, and the rest of them get together in a kitchen and go, she's out of her mind. Are you burning?

Christi 40:51
Do you think? Oh, well, I

Scott Benner 40:52
know, please, are you? Are you burning off some of that? Like, I mean, there's a lot going on around you, like a lot of health stuff, a lot of things to keep track of, you're trying to stay kind of Zen about it for your own health reasons? Is that what the exercise is for you, you just get offloading that, that anxiety there.

Christi 41:10
I think for sure, I'm not a very introspective person. So I don't feel a lot of anxiety like, or I know I shouldn't, I don't think like in my brain, a lot of anxiety, it ends up coming out in physical symptoms. So I do think that the exercise, so I was active through like college, say, and then I started having a lot of health issues. So I really stopped until I was in like my late 30s. And I saw a picture of myself and I was like, Oh, my arms, oh my gosh. And then at some of my friends had bought this gym, just like perfect timing. So I've been at my husband, I both started going there. And at the same time, my parents were going through anyway, they were kind of a hot mess. So I needed a place to get out some anger in a healthy way. And that's when I started going. And I just haven't stopped. So yeah, all this has happened since you know, I've been there since for the last six years, I think. Yeah. And, and a lot of life has happened since then. But it's a great and I have like that's a lot of my community is there. And I love it. I love my I love. Yeah,

Scott Benner 42:17
that's excellent. So I'm hearing that in the attempt to not push your parents off a cliff, you start working out. Is that what I heard?

Christi 42:24
Yeah, that's basically right.

Scott Benner 42:26
They still together? Yeah. Ah, gotcha. Yeah. Had the same tone as is your daughter active? No. By the way, yeah, possibly one of the most honest things anybody's ever said unprompted on here is I'm not a very introspective person. Well, I'll be honest, thank you kids, like murder a puppy and just get past that no problem are like, What do you mean? Like, how much interest? What are we talking about? Exactly?

Christi 42:54
I think it's usually good. Yeah, I'm

Scott Benner 42:57
not saying it's good or bad. I'm just interested in what you mean by it.

Christi 43:00
I don't spend a lot of time trying to figure out how I'm feeling. I think that on purpose. No, it's just how I am. But if someone asks me, I can figure it out. It just isn't something like I can just, you know, immediately tell you. And I, I think that a lot of people, and I don't think this is a cambium may get stereotyped as a male female thing, because it's probably more women than men. But I think that a lot of times, women specifically, but it can also be men to not just have a lot of thoughts. Like there's just a lot happening in their brain. And then we'll kind of say, well, men don't do that. But I'm probably more like that side where I don't, I don't necessarily have like a ton of things running through my brain all the time. It's

Scott Benner 43:51
interesting. I was out the other day with Kelly. And we were talking about this because there were some people with some very far away looks on their face. You know what I mean? And like, maybe they weren't thinking about anything. And I remarked to Kelly, I was like, Look how relaxed that guy looks. I said, I said, I'm thinking about seven different things right now, while we're walking through this store as crazy to believe that that's not how everybody brain works. I mean, I know it's not but still, for me, like I was literally walking around thinking about something I had to do for the podcast. Arden needs an apartment for college, we're looking for some certain foods, there's things I can't say in the grocery store, because they get me in trouble with my wife. And I have to stop myself. Because I mean, it's only been 30 years, but I have not yet shown an ability to just not say it. And you know, like so like I'm doing all these different things and having all these different thoughts. And I like having a conversation while we're walking around and everything. And then I just looked over at somebody that looked like they were like, just a half a second away from drooling on themselves. And I thought God that looks nice. You don't I mean, like there's no way that that guy right now is worried about what's going to be on the podcast three weeks from now. I understand I think I know what you're saying like so you're not unaware of how you feel. You don't spend a lot of time mulling it over. If I asked you about it, you could tell me. So you're more of a person that you consider yourself sort of like a head down, get things done person?

Christi 45:21
No, no. Okay. No, I really don't know. I'm not very No, My poor husband. He's loved that. That

Scott Benner 45:29
was more. Do you have a job? You work? Yes. Well, we

Christi 45:31
have a couple of businesses. Oh, so I'm more of like a future thinker, big idea. person.

Scott Benner 45:40
I'm an ideas man, Scott. So what does that mean? Where we're going on vacation next year? Like that kind of thing? Or?

Christi 45:48
I mean, yes, planning it, I would rather someone else plan it for me. Because I don't really care about the details. That's one thing that's been a challenge with diabetes is that it's so in the weeds, it feels like that's been probably the most draining part. I love problem solving. Like, I think that they give me a problem. I like to help think of I like finding a solution that to me is like, enjoyable,

Scott Benner 46:12
but not the day to day stuff. The day to day

Christi 46:15
stuff can be Yeah, it's very, it can be very draining. At the same time, I'm just so committed to the big picture, I think I'm just looking for, you know, I'm looking forward and saying, if we figure this out, well, now then, when he's 20, and on his, you know, in college, he's just learned to expect to have, you know, low variation, and to have a good a one C and he feels good at a lower blood sugar. And, you know, like, all these things. So I'm just always kind of balancing this, I'm here now, doing the like, nitty gritty of making sure that his blood sugar is, is stable, and that he's has every opportunity here, but I'm also thinking, I just want that to be his expectation. So when he's taking care of himself, that's what

Scott Benner 47:07
he's doing. No, I think it's a great idea to to set up expectations so that they become norms. That's really terrific. I just, I'm just literally laughing to myself, because again, you've been an incredibly on a show, like, Look, I'll have the ideas, but I don't want to facilitate them. Like I don't Yeah, it's interesting. Have you always been like that?

Christi 47:24
Yes. Interesting. Yeah, like my rent was always a mess growing up, and I don't, yeah, we've always our entire marriage, we've had to have separate closets because my husband's very tidy and very organized and very, like, he's the doer. And I'm the one who has like, like, we always buy fixer upper houses is one of these things we do. The house we're in now we're in the middle of working on and I'll have you know, I'm usually the one who's like, this is what I want it to look like. And he wants more, more details and more information. And then he's the one who actually does the work. Ah,

Scott Benner 47:57
that's interesting. Yeah, no, I understand. Again, I think pretty honest. Cuz you're just like, I don't really do that much. So I do know you do? Yeah, but not the stuff that nobody wants to do. Yeah, I've really tried to stay away from that. Yeah. Because Christy that's the truth of it is is that I don't think anybody wants to do those things. I just something I think some people see it and do it. And I think some people see it and go, Oh, God, I hope somebody else does that.

Christi 48:23
Well, some people get more satisfaction out of it being done. That's the thing

Scott Benner 48:27
you tell yourself to make yourself feel better, I think because maybe anyway, tries that on me all the time. She goes, Do you enjoy cutting the lawn? Like Oh, no.

Speaker 2 48:38
What are you talking about? She goes, You don't like being alone? I was like, No, I like being alone. She goes here for an hour every week. You have to be alone. I'm a kid. That part's great. Because the light coming on. I'm like, No, I could be alone somewhere else. I don't like cutting the lawn. Like I for years. I think she thought I liked that. But then I really looked as like she doesn't think I like that she just wants to tell herself. He's out there having a good time. So she didn't have to feel bad about it. And just for clarity, I am not having a good time.

Scott Benner 49:07
It's hot and sticky and dirty. And like, Yeah, I mean, I come back inside. I'm like, Oh, don't touch me. I have to get immediately into the shower. I'm covered in dust and dirt. And she's like, did you have fun? Are you talking about?

Christi 49:23
Well, that's what I tell my kids all the time. They're like, Oh, I don't want to do this work or I don't want to you know, do anything fun today. And like, yeah, that's why I like you think I like doing the dishes three times a day or I don't really like thinking about what we have to have for dinner every night. You guys are hungry constantly. Yeah. I'm constantly having to think of somebody to feed you. stuff that we do. Because I love you and I want you to have

Scott Benner 49:47
Yeah, yeah, but I'm not making I'm not making dinner for fun. I used to tell my kids I'm like, Look, if it wasn't for you. I wouldn't even eat tonight. I have to be completely honest. I'm like, I just had my own self preservation. I would skip this meal just so had some time to do anything. I don't think time is such a. It's so valuable. And like I got up this morning and I was up pretty early. I had a meeting this morning with a new sponsor who by the time this comes out, you'll know ever since CGM says a new sponsor of the podcast, oh, very lovely. I'm having a meeting getting, figuring out their messaging and how to talk about their products and stuff like that. And you know, I had a little meal. And then I was standing there cooking, and I was gonna get on with you. And I was like, Oh, God, by the time I get off with her, it's gonna be 130 I got so much more work to do. It just, it's crazy. How at noon, I already feel like I'm running out of time. You know? Yeah, that's really something. I gotta get a wife like you who doesn't do anything, but give me more stuff to do. I'm just teasing. I know you do things. I'm just teasing. What I wanted to know is around that idea. How does that relate to diabetes, though? Like, like, is it? Are you the one who's like, Hey, you got to change your pump on time? Are you the one actually pulling it out of the drawer going? Hey, come here. Silas, we got to do this now. Yeah,

Christi 50:59
no, I do it. Sometimes I forget, though. And he'll be the one who's like, Hey, Mom, I need to change my pod. I mean, I put everything in my calendar. So I don't, you know, forget all the dates that we have to change all the things that the pod is the one that will give me his CGM is hard to it's hard to get it to last a full 10 days. So I'm usually right on top of that, because I can see it's like, you know, failing or there's scissors. No, he's still only with the G six because you know, Omnipod, five, G seven. So there's no grace period. So it's like, well, when it's over, it's over. He doesn't like to go.

Scott Benner 51:33
Actually, right now. It's in a limited market released g7 With Omnipod? Five. So yeah, so it's coming pretty quick, I

Christi 51:41
think. Okay, good. Because,

Scott Benner 51:43
I mean, if it's in an LMR, then they think it works. And they're trying it in a small population. That's gotta be close.

Christi 51:50
Yeah, I'll be great. Because but

Scott Benner 51:52
what are you saying with the GS six? Like, are you saying when the adhesive starts to fail, or when the when the readings aren't good anymore? Readings

Christi 52:01
just start to drop, like I can tell when it's getting a little wonky, you know, it'll like, his line will look a certain way. And then it'll just drop down like, you know, 15 by 15. And then it'll pop back up. Yeah. So I'm, like, drink a bunch of water and let people get this to last the rest of the day, or, you know, yeah,

Scott Benner 52:19
it actually because with all the talk of allergies, and your family like that doesn't surprise me because it makes, because the way I feel about that is that that sensor wire obviously looks like a foreign object to your body. And if your body's already on a heightened alert for things like that, doesn't it like attack with like white blood cells? And like, do you mean like, that makes sense that you'd have more trouble? Yes. Makes sense. Yeah. I think that's like, what we don't talk about a lot is that these, these devices are all very contingent on your body chemistry, and gear, because some people will say things like, I'd never have any trouble with it. And you know, Arden's on a g7. It she wears that into its grace period every week. Like, I mean, the amount of times I've heard her say, this has to come off this thing isn't working. It's like once in the last seven months, so it's she just doesn't have that trouble. That's great. Yeah, but it's random. Whether you know, other people will have trouble with stuff like that.

Christi 53:12
But yeah, I think has has a lot to do with hydration. realize he's a little boy. Yeah, he's a little boy and he forgetting. I'm, like, I'm when my kids grow up. They're gonna say, What's the most annoying thing your mom said to you? One of them is going to be? Do you have your water,

Scott Benner 53:29
drink more. But listen, I'm not a little, I'm not a little boy. And I'm holding the water that I gave myself four hours ago, it looks like I've taken three sips out of it. So I'm right there with him.

Christi 53:41
Let's just stay hydrated, please, it'll help so much with all the things, you have

Scott Benner 53:45
no idea how quickly it changes. So I'm very in tune to now with my much more paying attention to my body. I think now that I'm using a GLP medication, if that makes sense. And so, last week, this has got to do with hydration. But last week, I decided I'm going to make potato chips like from scratch for the Super Bowl. So I wake up on Saturday morning, and I take five pounds of russet potatoes and I mandolin them down into these little thin slices and then I leach out all the I don't know if people have heard of this pre soak them in cold water and rinse them till they run clean. You pat them dry and then actually like kind of squeeze them out dry so that they'll fry right and fry them and salt them put them in a bag, Baba. And so this is not a thing I do very often. And obviously there's a lot of salt involved that normally isn't involved with my life. I probably ate a handful of chips in the five hours and people are like Did it take five hours to make potato chips it did. I probably had a handful of chips and like the five hours took me to make the chips. And then because they were there I had a couple of dinner and I had them the next day during the Super Bowl. And not a lot of them. Now I woke up Monday morning, over two pounds heavier than I was on Saturday morning when I got up and just the salt. And so like as soon as I realized that I start like over Were hydrating myself and watch the weight just pour off of me again, like in those two pounds, even a tiny bit of dehydration, or you know, too much salt, or little things like that really can throw your body off. It's fascinating. If you're not paying attention to it, you would notice I don't look any different Monday than it looked on Saturday. You know, but I can tell what was going on because I'm tracking my weight more specifically. Anyway, it was kind of interesting. The nobodies hydrated the way they should be it honestly.

Christi 55:29
Okay, that made me think of something. Do I worry, this is another tangent. But when you have been listening to her, we go the episodes. And when you cried, and then we go the episode. And then later you apologize for crying. And I just wanted to say, I don't think you need to apologize. Because I think that your genuine emotions were really powerful. And it really helped me like I've never been one to struggle with my weight. And I've never understood it. And you I think it can be such a taboo topic that you sharing vulnerably and helping just explain your perspective and what what your it's been like to battle that it helped me understand so much better. And I think it one thing that I've learned from diabetes and from like listening to your podcast is I think that it has opened up the door to, for me and I think a lot of people to just be more compassionate, and see the world through other people's eyes better. And it that episode for me, it was very powerful. And I think I cried along with you.

Scott Benner 56:33
I'm sorry. You're welcome. I appreciate your sentiment very much. It's not an apology. Like, I don't know what it is. It's I think it's the part of me that knows I'm making a podcast, you know what I mean? Like, I feel like I know you're there to hear something. And me like fall apart might not be part of it. But I take your point about how valuable it is as well. I mean, I obviously could have cut it out if I wanted to. But you know, I see how it's valuable for people. It is a thing, no different than when you were you're pumping public or or test your blood sugar in public, you're helping to spread awareness about it. Like, there's no way for you to know, like what that feels like. Like, I still can't adequately put a word as to how I feel just sitting here right now for I'm like 45 pounds lighter than I was almost a year ago. I can't explain to you what a joy that is yet, or how much better I feel like physically or like mentally, you know, or what a relief it is to go out in the world and not wonder like, am I wearing the right color shirt so that I don't look fat. And then realizing now in hindsight, looking back at pictures, it didn't make a goddamn but a difference what color shirt I was in. You know what I mean? Like so I'm now I've got all this worry about like colors and cuts. And you know, that kind of stuff to try to hide the fact that I know I'm carrying extra weight. And I mean, while I look back at these pictures, like it didn't matter what I was wearing you none of it hid anything. It didn't, it didn't matter. You don't I mean, so that's a psychological shell you're putting on not to have to worry about that it's freeing. Really cool. Like it's aesthetically nice. But it's got so much more to do with just not feeling encumbered than it knows about what you look like. And I've also been in that situation I was talking to Jenny yesterday, we were privately talking about GLP a little bit. And I said to her Jenny, I've been chubby since I was five, that was 1976. There wasn't a lot of fast food, there wasn't a lot of like things that we all now today connect with people being overweight. Like, it's just how my body works, which is to say not well, you know what I mean? And then you add this GLP and and then suddenly, that's not a problem anymore. And you're like that mean, you're just lucky. I'm not over here like banging my head against the wall, but like, how come they couldn't have come out with this 40 years ago? You know, because there's a lot of monumental steps in my family's life that there are photos of that I'm not in because I was taking the pictures, but I was probably also taking the pictures to keep myself out of the pictures, you know. And then there's like these real big ones where you just suck it up and get in the photo artist sent me a photo of her high school graduation the other day, keeping in mind She's halfway through her sophomore year. And it's a picture of her and I at her high school graduation. I gotta tell you, I don't even recognize the person that I apparently walked around. I was like, it's I don't even think I could share it online. I want to say not because I would be scared to share it. But there are some people who don't like that I talked about you know, take insulin for what you eat and sometimes they'll be mean to me online. I don't I'm not looking to give them pictures of myself looking terrible. But I'm telling you these this photo of me yesterday and a photo from me two years ago, it would really stung you. So it's not like I was out there eating like crazy. Like I know I said I just made potato chips from scratch, but it's a thing that I've done like once a year You know what I mean? Not like a thing I do every day or something like that? Well, I mean,

Christi 1:00:03
yeah, if it takes five hours, that's a reasonable thing to do. You

Scott Benner 1:00:08
know, Saturday mornings when like, everyone's asleep, you get up early, and you're like, let me do something, it takes time. But I can kind of go slow with and, yeah, that kind of thing. Again, I don't know that I'm eating much differently now than I was before. I mean, I've cut like, seed oils out of my life. But I've had done that prior to GLP. And it didn't really help me. I mean, it didn't help me with my weight at all. It helped me in other ways. And I'm still happy not to do it. But honestly, not. Not a lot is different. So yeah. And I appreciate you saying, so I appreciate that. You're listening to my weight loss diary when you don't need to lose weight. That's very nice, though. Thank you for keeping up the dowel. Well, it's

Christi 1:00:45
just it's been kind of controversial, you know, and so I just, I wanted to hear your perspective on

Scott Benner 1:00:51
it. Because I think it's controversial amongst people who don't know what they're talking about. Right?

Christi 1:00:57
Yeah. And, yeah, there's been kind of a, I was in a conversation with some friends about it the other day, and it was just good for me to be able to share a different perspective. I'm glad and then have a friend who honestly said, you know, I would, I would consider it and, you know, she kind of shared her struggles. And I thought that was good, because I don't know if she would have felt like she had a voice if I hadn't to be

Scott Benner 1:01:18
able to speak up. Oh, that's really wonderful. I hope it helps her. Yeah, I mean, there's a difference between comedians and you know, guys and bro. You know, bro guys on their podcast, like being like, oh, you know, just work harder. Like you don't I mean, like, I get up every day. Let me tell you my day, I get up at 4am I cold plunge, then I do a sauna. Then I run 75 miles, do you understand that I have tantric sex. And then I'm like, Okay, you're making $9 million a year on your podcast, like so. Like, you got a lot of free time and I'm happy for you. And then what I do, then I have tuna. Right? I love tonight, a little bit of tuna. And then we go out, we bow hunt, then we kill something. It's great. You like you don't like I'm like, okay, and ozempic is cheating. Good for you. Like, like, I'm glad it worked out for you like your genetic freak. I'm happy. It all worked out for you. I ate well, and exercise. And that all kept me chubby. At best. You know what I mean? Like I was telling you the other day, I used to work out twice a day, for two hours a day in my early 20s just to maintain a chubby vintage, like, seriously, like, just to keep my weight at like 220 pounds. And that was it just didn't matter. I don't know what's wrong with my body just didn't work, you know? Yeah. And then to hear people say like, oh, like, you know, they're gonna ozempic Fie the world. Like, maybe that's not a terrible thing. Like maybe the people who like I'm not just saying, spread it on everybody who could just go for a walk and things would change for them. I want those people out walking, I want to be out walking to. But if people genuinely have a GLP deficiency or something like that, and that all the exercising in the world is not going to help them, then what are we doing making them feel badly for feeling for getting healthy? It's no effort whatsoever. It's like, click done, I'll see in seven days. You know, and I'm gonna hear from people who are like, Well, I tried it, and it my digestion was, everything doesn't work for everybody. Like, I'm not saying that, you know, like, you might take a somebody's immediate gonna say Google GLP. And what are they gonna say intestinal blockage, like, alright, well, you don't know any of the details of that. But okay, yeah, that could be a person who's, you know, pre diabetic, they might have gastroparesis and not know it, and then you slow down their digestion more with a medication that causes the blockage. I mean, that's terrible. They definitely shouldn't take the medicine. That's what happened, you know, so. But yeah, I know, the bigger thing you're talking about is just people's attitude of like, oh, that's fat people who don't want to shut their mouth. So they're going to take an injection, get skinny. And that shouldn't be how this works. And by the way, even if that's the situation, what do you care? Like, you know what I mean, but, but, you know, I understand where they're coming from, but it's very often not actually what's happening. Right? It's not what was happening for me. So, anyway, also, you know, I know a person right now, who's typed to and has a weight issue and took a GLP medication. And a year later, confided in me that I lost my way with the eating like I was doing better with eating because the medicine kept me from eating as much and they lost like 35 pounds, and they but here's the thing, the A one C went from in the sevens to in the fives, and then they said, I think I gotta go to a therapist. I asked why. And then this person said well, because I'm eating terribly again. And I don't know why I'm just eating bad foods like I there up to the part of the medication where it's not that hard to eat, you can eat through it is the way I usually put it like your full but you're not so full that you couldn't eat if you wanted to. So this person said I may maybe I need to see a therapist because I don't know why I'm eating like this. And I said, that's a good idea. You should do that. But guess what, in the meantime, you know what their agency still is? In the fives. The fives they didn't gain any weight. And that's awesome. That's awesome. Yeah. So yeah, sorry. Anyone has a lot of talking to me. I apologize. You have anything else we haven't spoken about? Okay,

Christi 1:05:22
I had a couple things I wanted to just go share with you. Okay. One thing was that you've talked about a few times too. These are my encouraged my little encouragement. So I want to share is when you you've sometimes said, You're sometimes discouraged that you're not helping enough people, because the people with access are the ones who are. Yeah, and I agree, I feel like good management of type one is, it takes a lot of knowledge that a lot of people don't have. And it takes, I think the technology that a lot of people don't have access to. But I think that the part you're doing is multiplicative, like you, you share with me. And then I'm sharing with friends, yes, sharing the podcast, but also just sharing what I've learned, then trying to do some outreach with JDRF, with new families. And then thinking for me, one thing that was eye opening was when we had our foster kids, they had a lot of like, cognitive, some deficits, especially around that. And so now, I don't know what it's going to look like. But I think one day like I want to figure out how to how to help people who don't have those like they, they don't have, like my, my nine year old could count his carbs and tell you how, like he knew his carb ratio. And he knew how to do that at nine, that's not normal. You know, it's not normal. For us. I know that a lot of people struggle with that even as adults. And so I think that what we're doing is, I think that you're creating a movement. And I think that that movement will continue to reach more and more people in in more and more diverse socio economic levels and all over because this vision of how do we help one another and share victories and not just share, you know, frustration, so I don't know what it'll look like in the future. But having those anyway, having those sweet foster kids seeing like, I don't know how they got type one, how would they manage? And how would their their mom definitely wouldn't be able to, you know what I mean? Like, how do we help people in the margins? Yeah,

Scott Benner 1:07:26
they'd be on a fast path to bed to some bad health problems,

Christi 1:07:29
right? And all because they just don't have the education or the access. Yeah. And what do we do about that? So?

Scott Benner 1:07:37
Well, I want you to know that when I, when you'll hear me sometimes say, like, I'm not doing enough, I'm not reaching enough people like that's a momentary frustration, because I'm in it constantly. Like, every day, Monday through Friday, I get up in the morning, I do the things around my house that everyone else does. And then I make this podcast. And I do that all day long, in one way or the other, like Monday through Friday, and oftentimes on the weekends, it is my job, but it's also a lot to do with my life. And when you have a moment, like you put out like remaster the Pro Tip series, and put it back out again, and you see it downloaded, you know, you see each episode download, like 20,000 times, and you're like, oh my god, it's amazing, right up until you realize that there's 1.8 million people with type one diabetes in America, and you go, Oh, 20,000, I didn't do anything. And then the bigger picture comes up and you recognize like, there are people that are sent to the podcast every day or to the group from doctor's offices, that means that somebody in a doctor's office listens to the show, and talks about diabetes and insulin in a way that's valuable for people that that will like you're talking about, like grow very slowly. And then I think that feels good. And I'm like, okay, good, because in generations to come, I've had a real impact on this. But I'm also 52 So, you know, I'll probably be dead. And then, you know, I'm gonna be like, I would like to see it once. You don't mean like, I'd like to see it like workout. I guess that's not really how things like this work. But anyway, you've also named the episode finally multiplicative.

Christi 1:09:14
Oh, wow. Okay.

Scott Benner 1:09:16
A funny word. That's definitely going to be the title of the episode.

Christi 1:09:21
Okay. I like that word. Actually.

Scott Benner 1:09:24
I love it. You like whipped it out. Like you said, it's amazing. I use this word all the time. And I was like, pride myself on having a fairly large vocabulary when you said it. I was like, she made that up. She made up a word, or she said a word wrong and she's just cruising over and I love the attitude. I love that I'm just gonna say multiplicative and keep going and then I looked it up and I was like, God damn, that's an actual word. So for sure that's the title of the episode but but okay, don't worry. I'm not over here like crucifying myself. It just every once in a while when you're really like in the nitty gritty of it? How have I built the most popular diabetes podcast in the world, and it's never once had a leap. It always just grows consistently, which is not something. Anybody who wants growth knows not to complain about consistent growth. I'm certainly not but like, could I not just wake up one day, and 20,000 new people have found the podcast, but it's never gonna happen like that. It's always gonna be 510 15 new people a day, it's just gonna go like that, you know? So, unless,

Christi 1:10:33
okay, this is my other thought. Okay, so you were a, I'm sure you've heard it a long time ago, but it just came out the episode with Gregory. He was the Fisher on the fisherman. Yeah, yeah. Okay. And you talked about the app, your app idea? Okay. Well, my thought was, if you can do an app like that, when it can be translated to different languages, I would think so that could break your language barrier.

Scott Benner 1:10:57
Yeah, I'm already doing that with AI stuff behind the scenes, I haven't really put it up yet. I've done key takeaways from the Pro Tip series through AI. So you'd be surprised. Or you might not be surprised how accurately AI can pull the key takeaways out of it. When you look at the list, it sounds like you went up to me and said, Hey, tell me the key takeaways from Episode 1000. And everything I would think to say is right there. It's fascinating. So then I said to him, Give me the key takeaways in English, Spanish and Hindi. I chose those right? And then boom, it spits them right out.

Christi 1:11:35
That's awesome.

Scott Benner 1:11:37
I don't speak Spanish. And I don't speak Hindi. But I have pretty big Spanish in Hindi, like listening populations, like who are who are multilingual. And so I'm like, boy, how do I make sure this is right? Do they mean like, is it as easy as putting a disclaimer on it and saying, Hey, this is AI generated, it might not be right? Or do you ask somebody to prove it, then you know, it's not a thing, I can afford to pay a proofreader so and you can't hold them to task, they would if they get it wrong, like that kind of idea, too. Those are the kind of like the leaps you have to make. What I think I'm landing on is just like, look, here's the disclaimer, these are key takeaways from Episode 1000, as derived by AI and translated by AI, I cannot be certain that any of this is accurate, or in any way, shape or form, you're reading it at your own risk. Like I think that's what I have to do if I want to put, but I do think it would help a lot of people because I get a lot of, especially just from the Indian population, they're like, You have no idea how big because I have a pretty big following in India. They're like, but not enough people speak English, enough to listen to the podcasts. So those are big idea, things that are more possible now with technology. And then you just have to like get to wrap your head around how you're going to introduce them to people. And then once they're out there in the world, Christie, the next trouble is the like, again, it's spreading it. Now you're down to one person telling another person and then waiting for that exponential, but very slow growth to happen. And that's, you know, I'm not going to outlive that. You know what I mean? But I do think it's completely possible that 15 years from now, somebody in India will learn how to use an insulin pump because of me, and I won't know anything about it. You know, so it's, it's kind of that anyway, what else you got?

Christi 1:13:24
Okay. Last thing, I think, one reason that people resonate with you so much, and I heard you ask a couple of ladies about why you had such a large like Christian population who listens to your podcast, okay, because you're not okay. Yeah. And part of the reason is your story is so redemptive. Because you took a really heartbreaking situation, and you turn it into hope, you turned it into hope for all of us who got this life altering diagnosis, and I heard your story and saw what you'd done with it and saw how well your daughter was doing. And sad. You can do this, too. So I think that it's just it's very inspirational. I think that every Christian resonates around this idea of redemption. And you're not. You're preaching a different gospel. It's not that it's not the you know, the gospel of Jesus Christ, but it's the gospel. It's a gospel of it's a good news. It's like good news to us, to anybody to say, you can turn this and you've made something really good out of that, which is so inspirational to say, to say, Oh, now what do I do like what Silas my, you know, 11 year old, I wish he could have come to talk to you, but he wants to be an entrepreneur. ologists and he's like, he always wanted to be a doctor. And now because he wants to help people. Like he's been helped. And I just think that it's it resonates so much with us, but I think that's one reason people are so drawn to you. And everything that you share because you said it haunted you. I think that Once I knew I was gonna be on the podcast, I like started picking him, like picking up little things. But what did you say recently about? You said something about how you thought and I did that same episode, but you might have ended up being the better person to make a podcast like this and someone who actually had type one, because I feel more positive,

Scott Benner 1:15:18
I find that I can be dispassionate about it, because not happening to me.

Christi 1:15:22
Exactly. Yeah. But that is actually redemptive to that one feels more. Yeah, cuz it feels more like, like, what you're, I think what you're saying, it just seems more hopeful, in some ways.

Scott Benner 1:15:35
You know, there's one person listening to this right now, who's about to text me and say, you're going to be on a candle one day? And I don't I won't tell you who that person is. But we have. We have not Catholic? No, we have, we have this little like, we have this little like back and forth. Like it's not a joke. But it's, this person will say to me, sometimes those people would put you on a candle if they could. And she's meaning the little Religious Candles that you get in the grocery store. And it gets that meaning. And I think that's very nice. She's like the way some people talk about you sometimes. And I was like, oh, that's, it's first of all, it's lovely. But you know, like, just joking between me and one other person. But I hear what you're saying. I'm like Jesus Christ, I hear you. Wait, that's not what you were saying. I might have misunderstood. No. I think I'm, I'm following you. This terrible thing happens to you, you kind of rise above it, then you walk out into the world and try to help other people not have to go through the same thing. Exactly. Yeah. Yeah. No, I listen, I it will sound weird for me to say, but I agree with you. I think that's a good reason why people would resonate with the podcast in general. But I have wondered like, at times, like, I am very much and Christie, I don't mean this in a pejorative way. But I am not a religious person. Like, not at all. Like if you asked me if I thought there was a God, I would definitely tell you no, I don't think after I die. I'm going anywhere. Like I don't hold any of those feelings or beliefs. But people who do often feel very close to me, and I get that's a great insight. I appreciate it very much.

Unknown Speaker 1:17:10
Well, you're welcome. Thank

Scott Benner 1:17:11
you. Also, I am also not a what's the word when you don't believe at all? Atheist? Yeah. Because trust me, I know myself if like, I get hit by a truck and I opened my eyes back up and there's like pearly gates are something and I'm like, sign it up, like a registration book or something like that. I will start backpedaling 100 miles. Oh, my God, I will be like, I'll start my own podcast in heaven about how wrong Scott was about heaven. God, yeah, I don't, I don't want anybody to take that. Personally. I was just going off my best of the best I could tell. I am a failed person. Like trust me, I'd be fallible right valve valve would be different. How would it be if I pooped my pants? Right? Like it's not that but no, I would I would backpedal 100 miles an hour.

Unknown Speaker 1:17:57
People would be like, holy, she's

Scott Benner 1:17:58
going back in time he's talking. I knew really, Paul, you might have heard me tell that joke about the missionary position in your body one day, but I was just walking around trying to make a fun podcast and people would listen to it, learn about their diabetes. That's all. You're very nice to say that. I appreciate it. I'm gonna get off now because the editor is going to charge me extra for how long this is. Okay. Okay. All right. Thank you for doing this. I really appreciate it.

Christi 1:18:26
Yeah, you bet. Thank you

Scott Benner 1:18:35
this episode of The Juicebox Podcast was sponsored by us med us med.com/juice box or call 888-721-1514 Get started today with us med links in the show notes links at juicebox podcast.com. A huge thank you to one of today's sponsors. Je voc glucagon. Find out more about Chivo Capo pen at G Vogue glucagon.com forward slash juicebox. you spell that GVOKEGLUC AG o n.com. Forward slash juice box. Mark is an incredible example of what so many experience living with diabetes, you show up for yourself and others every day, never letting diabetes to find you. And that is what the Medtronic champion community is all about. Each of us is strong, and together we're even stronger. To hear more stories from the Medtronic champion community where to share your own story. Visit Medtronic diabetes.com/juice box. Alright kids, we're done. We're at the end. Just do me one last favor if you can, if you could please, if you have the need or the desire for something that one of the sponsors is providing. Please use my links or my offer codes. They help the show so much and that means me you're helping me to make this podcast every day. I'm helping me to support the private Facebook group, do all the things that I'm doing. I'm not asking you to buy something you don't want or something you don't need. But if you're gonna get one of these items, use my links or my offer codes. They helped me a ton. Thank you so much for listening and for supporting. I really do genuinely appreciate it. I'll be back very soon with another episode. 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

#1268 Ask Scott And Jenny: Chapter Twenty-Five LIVE

#1268 ASK SCOTT & JENNY: CHAPTER TWENTY-FIVE (LIVE)

• Should we pre-bolus for dessert if we have insulin on board from a meal?

• I had my son before I got type 1 diabetes: Is he at a higher risk of developing type 1 or another autoimmune disease?

• How long should we wait to give insulin again after a meal?

• Tips for teenage diabetic daughter with an irregular menstrual cycle?

• Scott, which clinical trials would you want your daughter to sign up for if given the opportunity?

• What's the reason why my blood sugar goes up when I change my sites?

• What are strategies for bolusing for stress?

• Have you heard of idiopathic type 1 diabetes?

• My doctor told me that I need to reduce my insulin usage to aid losing weight but I'm unsure how to do that without letting my numbers run high?

• I'm interested in looping, I watched tutorials, listened to podcasts but I couldn't figure it out?

• If you were going to take a couple of units of glucagon to address a low, is there a general guideline for adults?

• Do you think GLP for reducing insulin needs is feasible for a slim underweight kid?

• Why is it so hard to bolus for anxiety?

• If your A1c remains 5.8 for the last year on Omnipod 5 manual, would you still consider trying the algorithm?

• Tips for adjusting Omnipod 5 and basal rates for kids with rapidly adjusting needs, illness, etc. and thoughts on what you've seen in practice with loop or tandem being better or worse?

• Can you tell us more about digestive enzymes and constipation?

+ Click for EPISODE TRANSCRIPT

Scott Benner 0:00
Hello friends and welcome to episode 1268 of the Juicebox Podcast.

Guys, Jenny is back and she and I recently did a Facebook Live, this is the audio from it. So what does that mean? We got on the interwebs. And we talked to people who listened to the podcast if you like this and you're not following the public Facebook group for the Juicebox Podcast or aren't a member in the private Facebook group, well, you might want to become one. So you hear about this the next time it happens. 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. I know that Facebook has a bad reputation, but please give the private Facebook group for the Juicebox Podcast. A healthy once over Juicebox Podcast type one diabetes. The group now has 47,000 members in it, it gets 150 new members a day. It is completely free. And at the very least you can watch other people talk about diabetes, and everybody is welcome type one type two gestational loved ones, everyone is welcome. Go up into the feature tab of the private Facebook group. And there you'll see lists upon lists of all of the management series that are available to you for free in the Juicebox Podcast. Did you know if just one person in your family has type one diabetes, you're up to 15 times more likely to get it to so screen it like you mean it. One blood test can spot type one diabetes early tap now talk to a doctor or visit screened for type one.com For more info. Today's episode of The Juicebox Podcast is sponsored by the contour next gen blood glucose meter. This is the meter that my daughter has on her person right now. It is incredibly accurate and waiting for you at contour next one.com/juicebox This episode of The Juicebox Podcast is sponsored by ever since the ever since CGM is more convenient requiring only one sensor every six months. It offers more flexibility with its easy on Easy Off smart transmitter and allows you to take a break when needed. Ever since cgm.com/juicebox. Good morning, everybody. This is it. Usually Jenny and I look at each other and then we start a recording, and then ask each other questions that you guys have sent in. So you're gonna need to send some questions, and we're gonna be in trouble pretty quickly.

Jennifer Smith, CDE 2:46
We can't just keep saying good morning.

Scott Benner 2:48
We could chat if you want. But I don't know how interesting. Yeah, I'm not sure how interesting that'll be for how long. So this is Jenny. So you know, this is on YouTube. It is on Facebook on a lie on the private group. It's in the public group, and it's on Twitch. So hopefully, I think I could put it on Instagram, but it's weird. So I didn't do it. I think you have to do just Instagram. Good morning, everybody. If you have questions, go ahead and put them up. Okay. And if you are interested in hiring Jenny, you can email her at that link up in the corner. We'll put that up out periodically. Also, lets everybody remind you that that's the disclaimer if you want to read it, but it says that nothing we say you can take as medical advice. So it also says a lot of other things. If you want to read it, feel free to read it. It's actually on juicebox podcast.com as well.

Jennifer Smith, CDE 3:42
Good morning to everybody who's saying good morning to me. Good morning.

Scott Benner 3:47
Hey, Susie, how are you? Alright, so what do we have here? Should we Pre-Bolus for dessert? If we already have insulin on board from a meal? To

Jennifer Smith, CDE 3:57
Great question. It's a question I get all the time you go ahead and go first. Oh, okay. So I think it does differ, right, it differs for the content of the meal that you already had. And it also differs from again, now we have directional from CGM information. So depending on where you're sitting, if you're already rising in the aftermath of that meal, then potentially it's a great idea to Bolus especially if it's a particularly simple carb type of dessert, you know, sitting down to cotton candy versus sitting down to, I don't know, something else that's higher fat creams, cheesecake for example, right. So I think it definitely depends. And then in terms of the the piece here of should we Pre-Bolus for dessert? Not necessarily again, depending on where your blood sugar is sitting. It may depend on whether you need a Pre-Bolus or whether you want Just a little bit of the meal kind of Bolus that's already there play out, and then Bolus right before you start to eat the actual dessert.

Scott Benner 5:08
Right? So can I give like that was a very detailed answer, I'm gonna give a little piece of it that I think of, which is, obviously there are different scenarios. Jenny's just outlined a number of them. But overall, what you eat, generally speaking, needs insulin. So if you've made a terrific Bolus for your dinner, and your blood sugar's at five and super stable, well, great job on the Bolus from the dinner, now you're not eat something else. Again, it's time to probably Pre-Bolus that as well with a little bit and then keep that train rolling nice and flat like that, unless of course you've overestimated dinner. And now you know, the dessert could be part of it or underestimated it. And maybe the dessert plus a correction is needed. Right.

Jennifer Smith, CDE 5:51
And that's, that's again, where I think the benefit of having a continuous monitor really comes into play. Because you have a little bit more, I think it's wiggle room to determine do I need Pre-Bolus? Can I Bolus because it's a really slow kind of dessert. And it'll be okay. Do I employ the use of one of the smarter features like an extended Bolus or something that like that along with, you know, the meal Bolus that's already there. I also had a really great conversation yesterday with somebody about the number on your CGM and the directional arrow. Okay, versus really just looking at the trend line. Right, because I feel like the number on the CGM and the arrow, they go hand in hand, they're almost like a marriage. Right?

Scott Benner 6:41
How do you mean? Meaning?

Jennifer Smith, CDE 6:43
If you go solely based on the trend arrow, and then number, you may make a different decision in this questions example, compared to what the trendline looks like. Okay, the trendline. You can think of it almost absent of a number. Yeah. Because the trendline even if that in a lot of people complain, Oh, my CGM is off the number is off from a finger stick when it's trending this way, or it's going that way or the arrow is off or whatever. But the trend line itself isn't lying. Right? There's a decline happening. There's stability happening, there's a rise already happening. And so in this case, from do I Pre-Bolus, or do I Bolus at the meal or do I Bolus after the desert is eaten or whatever? The trendline can really help you there versus just looking at a number. This

Scott Benner 7:34
episode of The Juicebox Podcast is sponsored by the only CGM you can take off to get into the shower. The ever since CGM ever since cgm.com/juice. Box. Well, I mean, sure, you could take the other ones off, but then you'd waste the sensor and have to start over again, but not with ever since ever since is a six month were implantable CGM. So if you want to take a shower without anything hanging on, you pop off the transmitter jump in the shower, when you get back out, put it back on, and you're right back to where you started. Come to think of it. You could do that whenever you wanted to. Maybe it was your prom night or your wedding day. Maybe you just don't want the thing on for a little while. But you don't want to go all through the hassle of taking it off and having to restart it and you know, starting back over with like wonky numbers and having you know all that that goes with it when you take off the CGM and put it back on Oh, but you don't have to do that with the Eversense CGM. Because ever since is the only long term CGM with six months of real time glucose readings. This gives you more confidence, more convenience and flexibility. The Eversense CGM is there for you when you want discretion, a break, or maybe just a little adult time. Ever since cgm.com/juice box, pop that transmitter off, pop it back on, you're right back where you started without any wasted devices, or time. Getting older means a world of change, but some things still stay the same, like being at risk for type one diabetes. Because type one can happen at any age. So screen it like you mean it. If just one person in your family has type one, you're up to 15 times more likely to get it too. And 50% of type one diagnosis is happen after the age of 18. So screen it like you mean it. type one diabetes starts long before you need insulin and one blood test could help you spot it early and lower the risk of serious complications like diabetic ketoacidosis, known as DKA. So don't get caught by surprise. Screen it like you mean it because getting answers now can help you get prepared. The more you know, the more you can do. So don't wait. Talk to a doctor about how to get screened. Tap now or visit screen for type one.com to learn more. Again, that's screen for Word type one.com and screen it like you mean it. There have been times with the g7 that I know people got upset, because they used to smooth the number out like with software a little bit. So it kind of made you happier when you looked at it. But now I'm noticing that the direction of the line seems more accurate with what's actually happening. Okay, have you so I don't know if you've seen that or not like, there'll be times where like, you'll see I don't know, like a down arrow. So like, sometimes the arrow is indicating down. And at the same time, the number makes it feel like I'm moving in the other direction. And so I do tend to do exactly what you just said, which is put them both together. Yeah. And say that the arrows telling me one thing, the lines telling me another thing? Right, you know, but the this direction seems to be spot on, right, like the direction seems to be spot on for me. Sure.

Jennifer Smith, CDE 10:59
And from that smoothing angle with G seven, I think what I've seen is really that, because they don't smooth as you mentioned, right, G six, the data was smooth. So it was almost a from my understanding, it was, look, the system's algorithm looked at the data points preceding the current. And there was some averaging, which provided that was going on to provide a smoothing into the next numbers you saw, where as g7 took the smoothing out. And so each data point isn't, it's supposed to be an accurate one and an actual data point. Yeah.

Scott Benner 11:38
Emily says here Good morning, I had my son before I got type one diabetes, is he still at higher risk of developing type one or another autoimmune

Unknown Speaker 11:47
disease? I had my son before I got type one. Oh,

Scott Benner 11:50
I see what she's saying. Yeah, Emily, I don't think it changes auto immune probably runs in your family. You know, like, I think what's going to happen was going to happen whether you got type one before or after the pregnancy. That contour next gen blood glucose meter is the meter that we use here. Arden has one with her at all times. I have one downstairs in the kitchen, just in case I want to check my blood sugar. And Arden has been at school, they're everywhere that she is contour next one.com/juicebox test strips. And the meters themselves may be less expensive for you in cash out of your pocket than you're paying currently through your insurance for another meter, you can find out about that and much more at my link contour next one.com/juice box contour makes a number of fantastic inaccurate meters. And their second chance test trips are absolutely my favorite part. What does that mean? If you go to get some blood and maybe you touch it and I don't know, stumble with your hand and like slip off and go back, it doesn't impact the quality or accuracy of the test so you can hit the blood not good enough, come back get the rest without impacting the accuracy of the test. That's right, you can touch the blood come back and get the rest and you're gonna get an absolutely accurate test. I think that's important because we all stumble and fumble at times, that's not a good reason to have to waste a test trip and with a contour next gen you won't have to contour next one.com forward slash juicebox you're gonna get a great reading without having to be perfect correct

Jennifer Smith, CDE 13:27
and really with the testing that we have now depending on how old your son is whether testing is an option yet or not for his age, that really is the best tracking that you can do for the potential now there are other anything we talked about this we talked about the thyroid episodes and that kind of stuff, there are antibody testing that can be doing done for a number of other autoimmune conditions thyroid in included there. So if you are concerned at all that is one of the best ways that you can just keep up with checking Yeah, and

Scott Benner 13:59
actually you'll hear in the last half of the year on the podcast ads for something called screened for type one.com which you could go to now even though I don't have the ads up yet it's literally screened for type a digit one.com And you can look into that they're about screening if you're worried Brenda says but you know what give me you have one more second on that like yeah, I don't know that because you have type one diabetes means there's going to be more autoimmune or not like it's very likely no and possibly yes but you know it at least gives you things to look out for you start seeing tired behavior you know, dry skin hair falling out you think thyroid right you know like crazy weight gain loss all the sudden lack of energy etc like ooh, they drink a lot maybe I should be looking for type one least you know to look now,

Jennifer Smith, CDE 14:46
right and even you know in in kids from a standpoint of celiac being another one that kind of is within that realm of autoimmune and kind of links in with type one kiddos who haven't been been tested, they may be underweight, they may not gain, they may complain of tummy, like my tummy bothers me. Or, you know, kids are not very descriptive in terms of their body stuff. They just tell you something hurts and it doesn't really mean very much unless they keep complaining about it. So those are things when there is autoimmune in the family that you know, oh, and or you have type one, because celiac often pairs with that. It could be something you look at.

Scott Benner 15:27
So Brenda said, how often? Should we wait to give insulin after my daughter? Right? I'm thinking she means how long? But are you saying Brenda? You have to? Are you saying that you gave insulin and now there's another meal or a higher blood sugar? And how long do you wait? Are you trying to ask about stalking? You might have to clear that up for us. I'm gonna go to the next one. While she figures that out. Okay. Oh, she said long. I got her. Okay, how long? Okay,

Jennifer Smith, CDE 15:54
so how long should you wait really, to give insulin after your child eats or anybody really, regardless of age, quite honestly, here. I mean, we have to remember the action time of our current day, rapid insulin, the more rapid like fiasco or loom JEV have a faster onset for most people and a half a faster finish. But in general, rapid insulin still has a timeline of action, as you have talked heavily about even discussed heavily. Right. So how often should you give it? Or when should you start to give extra? It really does, you know, look like evaluating? Did you count pretty precisely? Is it a pretty well known meal? Should the rise that you're seeing not really be happening? And if it is, the question would be, well, goodness, you could probably give a little extra insulin. But again, that now Bolus of extra still has its timeline to get moving. Right. So yeah, you know, I think in this it's like I give and I give in now. Okay, I've given how long do I wait to see if this is going to turn around? And that's the waiting is the hardest thing I think insulin use,

Scott Benner 17:07
I always think that the the part that you can never know, right is did I do it? Right? The first time. If I did, and it's going up, then I need insulin. And if I didn't, then the timings off and this insulin is going to catch back up all the sudden, I don't want to put more in there. I would say Brenda more than anything is as unsatisfying as an answer is this may be is that with? With experience comes knowledge. And eventually you'll just do it. You'll just be like, well, I know what to do. Right. So good luck. And

Jennifer Smith, CDE 17:34
that's why I brought in the idea of Is it a pretty typical meal? Yeah. Is this usually what you would see happen? And if it's not, my mind, personally always starts to say, Well, is it like close to the last day of my pump sight?

Scott Benner 17:50
Right like is this is the is the pump old is you know, that kind of see Brenda's newly diagnosed. Brenda, listen, I'm gonna tell you something else to listen to the bowl beginning series if you haven't. And if you have move on to the Pro Tip series, and I'll put code I'll actually right now I can give you in the top corner. There's the bold beginnings link if you haven't listened to it. Michelle 14 year old diabetic daughter irregular menstrual cycle using loop and g7, sudden insulin sensitivity and then resistance through the month. For example, we'll have a great day then dinner Bolus tanks, her and that's the start of two to seven days of needing to half dose food. Oh, yeah. I would also listen to the Pro Tip series there. And we have a lovely episode on on on hormonal stuff. But we do I mean, listen, Jenny, it feels inappropriate for me to go first. But my daughter has what I think of as three different implications throughout a month. She has an amount of insulin she needs about the five days before her period begins the amount during the beginning of the period and then at the tail end of it and afterwards, they all are different now loop will do a pretty good job with it. And I'm getting a little lazy now because I EPS is making adjustments for me as I go with the dynamic settings. But how do you talk to people about this in practice? Yeah, in

Jennifer Smith, CDE 19:15
practice, I guess I give the general idea of what a typical cycle should be. And I also clear up the fact that your cycle is not just the bleed period, it's not just the men's right? Women have females have a, let's call it a 30 day cycle of hormones. And so what you're describing here is the very normal thing that should be happening in a female body. Essentially, we call day one the first day of bleeding, right the first day of the cycle period. And that oftentimes will be your most sensitive from about day. One or two. Maybe it starts 24 hours into the period starting this in crease insensitivity, and that can often last for usually about 10 to 14 ish days, where a next cycle or a next cycle of hormones comes into the picture around ovulation. Ovulation happens when we're not on any type of birth control, you know, not menopause or anything like that. So we've got ovulation around ovulation, it could be another cycle of resistance, it could be heavier than as you describe Scott, the days before your daughter has her period, that's a time of some intense resistance as the body's hormone levels rise to either support the growing uterine lining If pregnancy is occurring, or a plumping up, and then the period starts, and it sort of discards all of that, and then the hormone levels fall down. So that's why you have this rise, fall in resistance versus sensitivity. So you're not you're not crazy in what you're seeing with your daughter, this is supposed to be happening. And it's really important that you also discuss that with her, this is normal, we're going to adjust this way. So you might have with loop and I don't know what version of loop you have, some of the versions allow you to have multiple profiles set to choose from, and then for loop to interact with. And some of the versions of loop do not where if you just have that one main profile, you may have to make adjustments to it by 1020 30% more insulin. So that loop then can work to its advantage for you by adjusting off of high the higher needs or the lower needs. No loop also has those overrides that you can use a percent adjustment up and a percent adjustment down. But what you're seeing is normal.

Scott Benner 21:41
That's all I did was the overrides with loop. Yeah, we just go percentage higher, and then you know, it was uncomfortable, because you have to save your donor like let me know as soon as your period starts, because we got to like knock this off. And then it can really tell away at the end. And then yeah, it's even strange to call it normal because I think the whole thing is normal. Obviously. It's just, it's just sucks. But like, then the normal like couple of weeks comes at the end. I'll say again, try the Pro Tip series. There's some great conversations in there about menstruation. Actually, I just put information up in the corner because a lot of people are asking about screening. So there's a link up in the corner here about how to get screened for type one for the rest of your family. So that's the answer to this question here. Kobe. Oh, Kobe wants to say something nice, Colby. Thank you very much. I appreciate Oh, yeah. Yeah.

Jennifer Smith, CDE 22:28
Thank you very much.

Scott Benner 22:29
We feel good about that. Don't worry. Let's say hi to you, Jennifer. And thanks. She's 10 months old. He'll do the antibody testing when he's old enough. Okay, that's Emily from a little while ago. Here's a question from the private group. Good morning. Which of the clinical trials would you want your daughter to sign up for? If given the opportunity? Oh, that's for me. That's just like Jenny doesn't have a daughter?

Jennifer Smith, CDE 22:50
No girls.

Scott Benner 22:52
Well, I'll tell you what. More recently I'd signed her up for that GLP study in Austin, Texas that Dr. Blevins talked about? On the podcast. That would be one. You know, if she was really, really early diagnosed, maybe I would look at two Ms. apoB. Right. I know I'm not pronouncing that correctly. That's one that I would I would think about tz old is that what it's called? Now it's easier. If you're really newly diagnosed, I'd look at tz old. But especially for a doctor. The impacts that I've seen a GLP medication have on Arden's insulin needs are significant. And if you're listening to the podcast, I think you can tell that I'm pretty high on the idea of it's going to help people. I would probably do that when Austin Texas, Dr. Blevins, there's a link in the private Facebook group somewhere for it. That's one I haven't looked at, but I think it'd be in Austin. Other than that, which ones are you excited by Johnny?

Jennifer Smith, CDE 23:44
You know, I mean, there are so many all over the place. Again, depending on where you are in diagnosis. That's really how you would search out studies that may be appropriate both age and where you lie in diagnosis or post diagnosis. Many of the studies that are being done are in the newly diagnosed, I find the studies easiest to find for those who've been diagnosed in the past like six months, okay. There are a lot of studies for siblings of children who have type one as well, especially if they are antibody positive, but yet to you know, reach that stage three, sort of of symptomatic type one really being there. I would usually look also at Jazlyn does a fair amount of studies that Barbara Davis Center out of Denver, Colorado does a lot of different types of studies, both in children as well as in adults. There's the diabetes Center, which is in Rochester, Minnesota, they have a lot of studies that come out of there, like the beta cells sort of testing. I know there's a study there are several studies that are I can't remember exactly where in Florida they do it, but they've got a number of the studies coming out from like transplants. Another

Scott Benner 24:56
way to keep up with that for everybody listening is if you go to my Link T one D exchange.org/jukebox. and complete the survey, you will get emails from them when they have stuff coming up. And that's a nice way to hear about things. The next question is, how high is it? What's the reason why my sugar goes up? Right? When I change my sites? Oh, that's an easy one, and still goes up within like 20 minutes, I will see it come down. But before then give myself and some tea Simon exon I think we

Jennifer Smith, CDE 25:24
talked about it in this in one of the episodes. Yeah.

Scott Benner 25:27
But Nellie, I think I recognize her thing, I think she's, she might be a little new to diabetes. So a couple of reasons that could be first of all, there's kind of a little trauma that happens when you know, when you put the the site in takes a little while for it to get going. Sometimes it has to soak in right, you have to get some insulin in there to get it going. You also could be nervous while it's happening and not realize it and be getting a bump in your blood sugar from adrenaline. What else Jenny?

Jennifer Smith, CDE 25:55
Well, the resistance that comes with creating the trauma under the skin, I think the best, the best way for people to see like the light bulb often goes on. If you were a G six user, and you had that two hour startup window, the real reason that that's there is because the sensor needed to get wet, or a lot of people call it marinating right, they even do it longer insertion time, but it really decreases then the inflammation at that trauma site, which allows both insulin to start getting absorbed the way that we would expect it to. The another reason though, often and this is regardless of the type of insulin pump that you use, or the type of infusion set, it really has to do with when you start up a new site, most people remove the old site, because that's what you're taught to do. And what often happens, especially if you're one to change it right after a meal. Often what happens is you pull that old site and it's wet. What that is, is leakage from the old site, the insulin that was under that area has not yet completely absorbed. And so not only are you starting a new site that's now a little bit inflamed and not quite absorbing the way you hope it will. But now you're losing insulin from the other site. And so you're creating a deficit

Scott Benner 27:11
all those possible implications. So I think about simple ways to fix it is you can kind of flood the new site with a Bolus, when you first put it on, you can give a Bolus for the rise, you know is going to happen from the old pump before you take it off. If that site still working well leave the old site on for a while after you've Bolus to make sure all the absorption happens. But I don't think people would realize about the just like you saying, like, you know, you're you're causing a small wound, the body floods the area with like white blood cells and inflammation, everything and it's just not a great host for the insulin right away. Right.

Jennifer Smith, CDE 27:45
Yeah. I mean, I usually go about it. I mean, again, years ago, myself, even before using the pump that I use my old tube pump, I found that pretty quickly after I started pumping that the old site had to be left in, I just disconnected from it, left it hanging out there. And then I to kind of start saturating that new site with insulin, I gave a little Bolus with the new site to really encourage that site to start doing something. Yeah,

Scott Benner 28:15
you guys are interested in hiring Jenny, you can click on that link in the top corner there and send her an email. Thank you. Of course. Thank you. What are you kidding? Strategies? Dakota says for bolusing for stress, is there even a way sometimes my blood sugar rockets when I get to work? Not always just sometimes? Well,

Jennifer Smith, CDE 28:32
that's what I would. This is not only for adults, but also for kiddos. There's a very big difference seen between heading to school, or I call it like foot in the door at school. So this might be foot in the door at work kind of thing. It may also be depending on the type of job, Dakota, it looks like, has it really is it a job where some days, you have a lot of meetings to get to you have to host something, you've got a project that's due that you've got to present versus other days, you just move into the office and you get rolling with the things that you need to do. But there's not really an adrenaline type of interaction. So you may want to look at what your work schedule looks like. Pay attention to what your blood sugar does. And you can make some associations in the moment. You can address it. Yeah, but if you want some historical to it to be able to say when and if you will need extra insulin. That's the best way to do it.

Scott Benner 29:27
I can just tell you that like used to drive art into high school. And I'd look at her graph on the way out the door and if it was going up, we'd get in the car and I'd say just Bolus and she'd like throw a unit in just to go to school. And then she had very aggressive Basal rates throughout the day at school that we had to kill. I could never stop them long enough. They were so aggressive during the day to keep her stable like there was not a big there was not an early enough time to stop them. So I knew that when she left from school, there was a snack that had to happen in like 20 minutes because as soon as She left school and all that adrenaline or nervousness or whatever left her blood sugar started to come down really quickly. Right? Yeah, it was really interesting, actually.

Jennifer Smith, CDE 30:06
Yeah, there are a lot of kiddos that I get a chance to work with who the afternoon after having things ramped up during the day are much more aggressive, like Bolus strategy, usually with the school day ending around three or 330. By about 130. We've started pouring things down because otherwise there was such a considerable drop that many kids could have an uncovered snack in the afternoon, because of just that joy of I'm done with school. Yeah, it's

Scott Benner 30:34
really crazy. I often used to eat for free in the afternoon for sure. Yes. Hey, Jonathan, how are you? Due to love Dr. Blevins saying diabeetus Yes, he is. He is a Texan for sure. There'll be a new episode with Dr. Bill Evans in two weeks, but next week, you're going to get Jim who is 58 got type one when he was 50. Antibodies whole thing he's got type one full blown. You know, using insulin, everything started Manjaro. No, Jenny, and is off insulin completely right now. has been for like a year and a half. Crazy story. We don't miss that one next week with Jim. He won't say diabeetus though. I'm sorry.

Jennifer Smith, CDE 31:08
I know. That was I actually I listened to that episode. And as soon as he said it, I was like, Oh my god.

Scott Benner 31:15
How knowledgeable is he though? He can tell he's off the top of his head just talking about those GRPs. Man.

Jennifer Smith, CDE 31:20
That was why I didn't stop listening after he said diabeetus. Yeah.

Scott Benner 31:27
It's like a cringe. I found him on YouTube. Doing a talking head on YouTube about GLP. And I was like, This guy knows what he's talking about. Yeah, that's awesome. Jonathan said question for Jenny. Have you heard of type one idiopathic type one? Type one B idiopathic type one. Do you know it?

Jennifer Smith, CDE 31:42
Yeah, I not. I mean, off the top. I do I know it by name. I do know it by name. There are so many of these different classifications of type one that isn't specifically what we call just type one. Right? It is a remember correctly. It's a Modi. It's one of the Bodie types of type one. But again, there are type one C, I think there's type one D, I think that it skips a bunch of letters. And there are a whole bunch.

Scott Benner 32:11
We did an episode once where we went through all them. It was mind numbing. It did

Jennifer Smith, CDE 32:16
I can't remember which episode it was. But I do remember doing it. And I think there were a couple that you brought up that I hadn't even

Scott Benner 32:23
well here. I went to our chat GPT Overlord, it said, idiopathic type one diabetes, also known as type one. diabetes is a form of type one diabetes, where the cause of insulin deficiency is not related to auto immune response. Unlike more common, here's some key points about it. insulin deficiency, non auto immune heterogeneous group, this group can include various other causes of insulin deficiency, including genetic factors and other pancreatic issues. It's far less common than type one a. That's what Chad GPT and Jenny knows about it. Jonathan? Hey, tell me why you ask that, Jonathan? Yeah,

Jennifer Smith, CDE 32:55
that would be interesting. I mean, again, I would expect it's something to do with knowing you have this, which means that you had a really good doctor to actually catch that there was a difference. Yeah. Right. And or the question being, well, are there new therapies? Are there there ways to navigate this? And I wonder also, if maybe Jonathan was misdiagnosed initially as a type two, given that there wasn't an autoimmune, notable component. And with further testing, maybe, you know, I

Scott Benner 33:27
get lots of questions here. Karen says my daughter tried recibo, she needed more Bolus s as expected, while she changed the longer transceiver profile. However, by day three, she was in the hospital of high ketones and told the change back to her old long lasting insulin and the only thing I can think of is there just wasn't enough, or you talk because that shouldn't that doesn't make any sense to see the use correctly shouldn't end up with like ketones, it

Jennifer Smith, CDE 33:53
should definitely not. And I'm wondering, again, lots of questions for things that come up like this is it that they adjusted the Basal dose back from what the original base Basal was, and thus, we just needed to go to the real amount of Basal insulin that you had been using? Or, I mean, again, in really rare cases, there are some people who just react very differently to one brand or type of insulin versus another. So again, it could certainly be that your

Scott Benner 34:24
initial concern though, is where my brain left to like Did they get really conservative on or when they switched and maybe maybe her daughter like I'm guessing her maybe her daughter started at one level you know, has increased over time and then maybe they were took it back to be safe and then didn't give her enough? I mean, I don't see why Tracy but would cause that and it is a really good Basal insulin. Yeah, is

Jennifer Smith, CDE 34:48
very good. In fact, the majority of the older school people with type one who use Lantis usually I highly recommend that they switch to the

Scott Benner 34:58
same amount as love them. err. Oh, that sounds like she used more

Jennifer Smith, CDE 35:04
Bolus to that is really interesting. See,

Scott Benner 35:07
though, like, Do you really think that you would expect to need more Bolus if you went one to one change from level miniature? Siba? No, that just I feel like it means she needed more basil with a Joseba.

Jennifer Smith, CDE 35:19
Yeah, yeah. And again, it depends. I mean, all questions, right, that you ask is this daughter going through a menstrual cycle at the time of the change is there but she's,

Scott Benner 35:34
I'm sorry, she's not day three, day three, just a time where I want to say nothing you hear on that 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 listen to us. Okay. Let's move on to Stephen by doctors saying I need to reduce my insulin usage to aid losing weight. But I'm not sure how to do that without letting my numbers run high. And by the way, Jenny, before you say anything, I think Stephen has tried to GLP and it hasn't dropped well with him if I'm not mistaken. Oh,

Jennifer Smith, CDE 36:03
okay. Yeah, that would have been my potential option would be a GLP. One. Again, not knowing any lifestyle things here, it could also be that in order to reduce insulin abroad, look at lifestyle inclusive of intake of food, are you meeting your need, it sounds like you know, you're wanting to lose weight. So oftentimes, if weight is higher than what the body should normally support, then you are going to be a little bit resistant, potentially. So adding in again, some activity and doesn't mean going to the gym or buying a member just take a walk every day. I mean, if you if you again, aren't doing any of these things, and then as I said, already taking a hard look at overall intake comparative to your output of movement and whatnot during the daytime, because they think, and I've said this so many times before that we become really carb centric with diabetes, especially type one diabetes. Yeah. In terms of insulin use, that we ended up covering, covering, but the other parts proteins and fats, they play a really big role in caloric intake. And if they're not being contained, either.

Scott Benner 37:20
Yeah, I find sometimes and I don't know that this is the even situation. But I find sometimes with people with type one, they get so focused on like, can I Bolus for this and they figured out how to do it. They stopped thinking about the food like calories, and it's just like a thing they conquered. They were like I eat a thing. And I didn't I didn't have a bolt like a blip. And I don't think that that's his situation. But I mean, I also might say if you can't handle the GLP, Metformin might help to some degree now. Yeah,

Jennifer Smith, CDE 37:47
it looks like he actually he said his doctors suggesting a medical procedure. He doesn't want to do that. Try GLP. One works out almost every single day of the week and eats less than 30 grams of carbs a day. So that's crazy. Again, Metformin, it could be an option. Absolutely. The Extended release is usually the best tolerated. starting dose is probably not going to show much. But once you get to the upper levels, usually around 2000 milligrams of Day of metformin is more the therapeutic amount.

Scott Benner 38:17
Also, Steven, I wonder if you couldn't find a doctor who would be willing to like dabble in micro dosing GLP is with you. Because right now they're stuck with that dosing strategy. Right? They put you on ozempic They move you move you move, you put you to two and leave you there like, I mean, right? could point to five just make a difference for him. You know what I mean?

Jennifer Smith, CDE 38:36
I don't know if he wondered GLP. One, there are many GLP ones. I don't know which one you've tried. The older generation provided a little bit in terms of weight loss, but really nothing compared to the new generation GLP ones?

Scott Benner 38:50
I don't know if he tried Manjaro know, or just I'm not sure but I do remember seeing online and talking about that it was not jiving well for him.

Jennifer Smith, CDE 38:57
Yeah, I mean, the other you know, in terms of again, the disclaimer of don't take any of this as medical advice but as could be very beneficial. I mean, there are some supplementals such as Berberine that are very beneficial in terms of insulin sensitivity that could help you especially more at mealtimes, which is when it's recommended to take allow cottage at least in Bolus doses of insulin depending on what your you know, sensitivity or body acceptance is to to using that and that could be an option. Also

Scott Benner 39:30
I've seen people use digestive enzymes, magnesium oxide stuff to help things move so that they don't feel backed up on the GLP this one here I'm interested in looping but I couldn't figure it out of watch tutorials and podcast but could not loop T one D PAL is a company that will set it up for you. Yep, Jenner you guys don't deal with all right.

Jennifer Smith, CDE 39:52
We do not we do not we absolutely 100% support all loopers in fact any of the do it yourself types of automated delivery systems we 100% support, we will not build it for you. If there are one of our educators, Catherine, she's very helpful in terms of there are during your build some questions and issues and whatnot that come up. Um, she's very helpful in terms of helping direct you to the right adjustment or to clear an error in the app. No, yeah, but we will not make the app, I do know that there is I can't remember the doctor's name out in California, you have to be part of his practice, obviously, but you will build it. And then does does it usually through something called testflight, which just download the app right onto your phone for you. So that is an option, I will tell you that to one pal. They do a wonderful job. But it is a monthly cost. So just be aware that this is don't want in one and done they build it and then you're on your merry way. It's a monthly upkeep. So when there are upgrades to loop, they do that for you behind the scenes, you don't have to really keep up with any of that I

Scott Benner 40:58
might say my moreover just go to the loop and learn Facebook group and ask if somebody will help you build it I'm sure somebody would and there's Mike is in our group, he would probably help you there's there's definitely people who would help you get it built. And then you know, there's nothing really to maintain after that after

Jennifer Smith, CDE 41:13
in the loop group. I've seen people who have done weekend we're gonna get together at the library together to do the build all together. So you may want to outreach to your community to

Scott Benner 41:25
Sarah saying if you guys if you were going to take a couple of units of glucagon to address a low is there a general guideline for adults, I think I've seen one unit for a year for kids.

Jennifer Smith, CDE 41:35
Actually, that's it's great. You already know the guideline for kiddos. If you can treat a low yourself with the old school glucagon kit, the red kit. The other kit that can be micro dosed is what you're really talking about here micro dosing of glucagon is G voc makes, not their usual one shot done. But they also make the hypo kit. The hypo kit comes with a pick a room temperature stable pre mixed vial of glucagon. And it comes with a syringe that's empty. In general, you would usually use that syringe to draw it up and dose in an emergent situation. If you're micro dosing that though, you would use an insulin syringe, and you would draw up out of that vial. And in order to do it, for adults, it's usually one unit per year of age under the age of 15. And then it's 15 units, or, you know, 30, if you read dosing it that 15 would be the usual sort of micro dose of glucagon to see if you and treat a low that you can address yourself before getting lower. And then you evaluate to make sure blood sugar comes up, stabilizes up and then technically you shouldn't have to read DOS,

Scott Benner 42:51
I believe I've signed a contract that says I can't talk about that. So I'm moving on to the next one. Okay.

Jennifer Smith, CDE 42:58
Well, I talked about it. I

Scott Benner 43:00
have nothing to do with you know, he loves the group we love, you know, a thank you very much. Any news about g7 and Omnipod? Five, there's an LMR. And I saw something on their Facebook recently where they were looking for more people. But that's all I know about. And that's just, I don't know, nobody tells me anything. Just in case you're wondering. I told me

Jennifer Smith, CDE 43:20
last night I have you know more about that than I sometimes

Scott Benner 43:23
I know stuff for a couple of days before they happen, but not, not for weeks or months. And also, I think if they knew they would tell us for certain so I'm not sure why it's taken the time it is to be perfectly honest. Susie says do you think GLP is used reduce insulin needs are feasible for a slim underweight kid. So I think if the person has a real need, like a real like insulin resistance, like you have, like, you know, your carb ratios one to two or something like that, there probably is a place where in the future, they'll find smaller doses to help people but there's no doubt in my mind, you will not be as hungry, it will be more difficult to eat. And if you're underweight or low weight, it could end up being an issue for sure. Right? Yeah, because it

Jennifer Smith, CDE 44:06
really does impact appetite. That's one of the biggest things that I hear from people one to a positive when they're noticing the definite difference in appetite, sometimes to the detriment right, where a person really just has to remind themselves to eat and that's not the goal of this medication at all.

Scott Benner 44:26
It listen, I'm on the GLP I have to remind myself eat somedays like there's no doubt I could go forever without eating and never notice it. But moreover, like, you know, as we were getting hard on it, there were times where we just had to take what we could get. And at one point, she lost, I think more weight than we meant, like she lost a healthy amount of weight. But then she probably lost I would say another seven or eight pounds more than she should have. We thought we adjusted her dose and she's putting that weight back on now. Yeah,

Jennifer Smith, CDE 44:55
I think this is a really interesting question too, because it's the The effect of thinking that with a child that doesn't have a weight issue, it sounds like in fact is more slim to being a little bit slimmer than desired. And the want to reduce insulin

Scott Benner 45:14
Yeah, I wouldn't take a GLP just to use less insulin, need to have like a real insulin resistance issue PCOS symptoms, weight gain, that's just doesn't make sense based on your situation, and

Jennifer Smith, CDE 45:26
are really heavy users of insulin that suggest we have to change the pump site every single day because the reservoir is empty. Absolutely, then, but that often doesn't, most often, in fact, doesn't go along with a kid or an adult who is already fighting to gain or maintain weight. Yeah,

Scott Benner 45:44
yeah, I agree. I don't I don't think that GLP is just going to be a thing that every type one gets one day, I think it's going to be very specific uses. Let's see. Next question. Michelle said so hard to Bolus for anxiety? Are Ms. 10. As she gets there calms down? And then she drops? Yeah, that's trust me. There's conversations all over the podcast about when Arden would sometimes shoot up for sports events, and not always, and we'd end up bolusing for it. And then if she didn't get anxious, we gave her juice to cover it. But yeah, it isn't easy, that's for sure.

Jennifer Smith, CDE 46:18
No, it's certainly not. And sometimes, again, depending on what your targets are, what your goals are, and also paying attention to how your child or your teen or yourself how you feel, honestly, with that, sometimes those sporting events are also really long, right? So you may get that spike on the way there. And if you don't Bolus for it, as soon as the movement gets going. A good majority of kiddos it comes down on its own

Scott Benner 46:44
to drop on its own. Yeah. So hey, this isn't really a question. But I just wanted to say good morning to Yolanda. And you know, I hope she has a good day. And we all trust us. All of us hate this. So no one no one's excited about it. Super excited to have diabetes.

Jennifer Smith, CDE 47:00
No. 30, after 36 years, I could I could easily if somebody knocked on my door and said this is it. Yeah, here's what you get. I'd be like, great.

Scott Benner 47:09
Yeah, Jonathan said it took a long time for him to figure out he was type two, he has an episode, if you want to hear it, it's a type two story. Okay, I asked Jenny to see how common that type why this is an old reply to another question. Okay. Let's see, the

Jennifer Smith, CDE 47:23
type one beat. Yeah, it is not as a response. It is not a common but I also think in terms of proper diagnosis, you really have to have the right clinician to be able to say, this is not the typical, you have these sort of, you know, visible things going on, you don't look like a classic type one, you don't look like a classic type two, it takes further testing. And I think that's also why, as I mentioned earlier with that Modi is, I've heard a lot more about it in the past five years. But Modi is also one of those things that it's really poorly tested for general, in general.

Scott Benner 48:05
So what about this hear that Cassandra is saying that receiver needs three days to get going for full coverage? Yes, so

Jennifer Smith, CDE 48:13
this is so for fully effective, meaning there's almost a ramp up to it, getting going at the full effect. You know, this, I would say is about a 5050 in those that I've seen using trustee, but specifically have a couple of little kids who definitely if we are going to adjust their trustee bar, we have to give it about two to three D days to actually see that it's truly making the difference that we would expect before adjusting again, and other people can go like I went from Lantis to tercio. Myself, and I was curious. So I went off my pump for a number of days just to test receba comparative to what I knew about my Lantis years ago, and I had no issues with it whatsoever.

Scott Benner 49:01
About the same so I'm putting this up because if Isabel or Nico or somebody who's looking can give Jennifer a list of the GLP episodes, that would be great. Somebody else says BC diabetes can build loop for you.

Jennifer Smith, CDE 49:14
Correct? That's Canada, though. Yeah. Just FYI.

Scott Benner 49:18
He's got across the border to get it done. Then, if anyone sees remain five, eight for the last year on Omnipod, five manual, would you still consider looping or? I mean, there's trade offs. Maybe. But, you know, it sounds like you're doing a great job manually. If you're not if you're sleeping, and you're, you know, not having a bunch of lows then. I don't know. It seems like you're doing a great job.

Jennifer Smith, CDE 49:39
And it sounds like the question here is really if I've got this and lows are not a big piece in the picture, and I'm navigating this with good stability, then I think it's really could I do better. Could I get better?

Scott Benner 49:55
She says she's not sleeping. I turned it on. Absolutely. All right, because Susie if you're all dead, but you've got a great day once. And I'm sure you can find a way to get Omnipod five and get your a one C there, you're just going to need to Bolus not an incredibly aggressive algorithm. But you know, and

Jennifer Smith, CDE 50:15
considering that Omnipod five has been being used in manual thus far, it does have some historic insulin data already.

Scott Benner 50:24
Yeah, your starting setting should be rock solid, that's for sure. And then you're just because I know she has a young son, but he's still going to keep growing. So when you see those, like, if he makes a leap and weight or needs or something, you might have to go back and do a reset to keep up with it once in

Jennifer Smith, CDE 50:40
a while and or the insulin to carbon sensitivity get adjusted. Or if you've got a higher target set, lower the target, or you know, lots of

Scott Benner 50:48
little things. Yeah, Sarah's saying thank you, I don't want to breach my contract, which evoke that's for sure. We're going to start looping after Omnipod. Five, we will need to get our settings dialed in. I'm a bit worried since we were never able to fine tune it in Omnipod. Five. Yeah. Well, were you in on the pod five manual and you were trying to fine tune it? Are you waiting for the algorithm to figure it out? Because those are probably two different things. Crystal, I have to tell you that I have recently taken the three episodes, Jenny and I did the math behind Basal insulin sensitivity and sunder carb ratio. And I've actually turned the math into code and put it on my website. But I haven't had the nerve to put it public yet. It's disclaimer it out the ass so that I'm not really worried about but like you can literally plug in numbers about yourself and get a starting place. But that math is available in those episodes for you to figure out for yourself. You know what I mean? You know what I mean? Jenny, like, I can just put them up online. And people can just say like, literally like, this is how much I weigh. I'm an adult, I'm meter active, etc. It just spits out the information. Yeah, I had Isabel do it. And it like it pegged her settings. Wow. So I wanted to do a smaller test group before I made it public. That's

Jennifer Smith, CDE 52:03
a great idea. I'm quite sure that many people would donate their information.

Scott Benner 52:07
Yes, did to find out. But for the moment, there's the three episodes the math behind and you can definitely figure it out. Oh, Crystal. Okay, send me an email and I'll get medical advice. Oh, no, I I'm an idiot. You should definitely not listen to me. Have we heard anything about the twin health program? What does that help? I don't know what that I don't

Jennifer Smith, CDE 52:27
know what that is either. I'd have to look that up myself.

Scott Benner 52:31
Let's look at this.

Jennifer Smith, CDE 52:32
Whether it is a confined by a state or is it a national?

Scott Benner 52:41
Also, I'm going to be at the touch by type one event in Orlando. There's a link to it right there. It's Free to get tickets. I don't know if somebody else is going to be there or not. I haven't talked to her.

Speaker 1 52:50
Me. Yeah, we'll be there. Oh, oh. I already have topics.

Scott Benner 52:55
Oh, well. You can come see Jenny and I in Orlando. When is that? Do you know? Oh,

Jennifer Smith, CDE 53:01
it's September. Something touched by? Yeah, that link

Scott Benner 53:05
will take you to touch by type one.org. You can go to the programs tab hit annual conference. I'll get the date for you. September 14. Oh, September 14. Okay. Yeah. Are we gonna go out to dinner afterwards? Sure. I you can you're gonna have your family with

Jennifer Smith, CDE 53:20
dinner with my family.

Scott Benner 53:22
Oh, oh, good. I have something to do in the evening. All right. Anyway, touched by type one.org. If you guys want to see it's completely free. It's actually Jenny, I'm not gonna ask you to out anybody. But it's a well put together event No. 100%

Jennifer Smith, CDE 53:35
No. Touch by type one is lovely. I think this is the third thing. Is it third year that I've that I'll be there. But it is a wonderful event. Can

Scott Benner 53:47
you look at the screen?

We're working on that. We'll say let's see so far. We're not sure. working it out. We'd love to see a beta two. All right. So awesome. Can you test it to Cassandra? Sure. Like everybody just email me and I'll let you say it. Yay. Are we out of questions? They can

Jennifer Smith, CDE 54:10
pull it off to me too. I'll test it. You. Brilliant. That's super awesome. Okay, well, yeah, the twin health I, you know, twin health is interesting. They have a the one that's connected to diabetes is it looks like an advanced like, like digital, like whole body evaluation. So but know that I mean, I've heard of other things that evaluate you know, taking like poop samples, and that kind of stuff, right to evaluate, evaluate, what kind of metabolism do you have and what should you eat and what shouldn't you eat? And some even go as far as suggesting the impact on glycemic, you know, excursions and shifts and changes? I don't know if this this looks a little bit more comprehensive. But yeah, there are lots of Different things like this out there.

Scott Benner 55:01
Okay? I don't know, I can tell you that I'm working on my gut health designer poop. And I watched

Jennifer Smith, CDE 55:08
that's actually one of my favorite words is poop. Isn't that appeared? I don't know why.

Scott Benner 55:12
That's a little strange thing. It's

Unknown Speaker 55:14
kind of fun.

Scott Benner 55:15
Did you watch the Netflix documentary about gut health?

Jennifer Smith, CDE 55:18
I don't think so. Is it newer? Okay.

Scott Benner 55:21
It's newer. Yeah. Let me see if I can find it real quick. I found it really interesting. But one of the things they talked about was people. It's called watch. It's called Hack your health, the secrets of your gut. I enjoyed it. Okay. And so, but there's a woman in there, this was the craziest thing you have a second. There is a woman in there who decided she couldn't afford to have like a company give her like a fecal implant basically. So she went to her brother. Let's not get into the details of this and because I don't know exactly how she did it, but she got her brother's poop and put it in capsules, like she took it. Now, her gut health improved, but you gotta go watch this to hear the story. In case I'm getting the wrong

Jennifer Smith, CDE 56:05
science plant is what you're talking? Yes. Okay. She she

Scott Benner 56:08
got hormonal acne that she'd never had before. But her brother struggles with it. So she stopped taking his poop. Her acne went away. And she thought okay, but I want the good gut health. She went to her boyfriend got his puppies, but started to pick up his depression. Oh, is that not crazy? Wow. Like, I don't know if that's right or not. But I was like mesmerized while I was listening. I was like, Is this true? But anyway, I thought it was really crazy. That

Jennifer Smith, CDE 56:36
is very interesting. I will have to I will have to look that up on Netflix.

Scott Benner 56:41
Yeah, Crystal. I'm making an episode about this. And it's not done until I'm done. But I've been working with a gut health guy named Josh deck and we record as we do stuff for ourselves. So it'll come out eventually come out. Like my poop honeypot five adjustment and Basal rates for kids with rapidly adjusting needs illness, etc. The lag with on the pot five is rough. Do you have any thoughts on what you've seen in practice with the looper tandem being better or worse? Etc?

Jennifer Smith, CDE 57:08
Yes, it's a great question. My personal as well as professional in practice, what I have seen is that loop is, for lack of a better word, it's easier, because there are adjustments that can be made more or less aggressive, depending on what you're seeing in terms of sensitivities. The next of the ones mentioned here, tandem does a lovely job as well, tandem is the only company for their T slim or their mobi, that actually allows multiple profiles to be set and enabled for their control IQ to work off of. So for kiddos who have a high growth period, and then it goes back to you know, more stability or lower needs, you can have almost like a high, moderate or low need sort of profile. And you could enable those then for again, the algorithm to work with. And that can be a huge advantage. You're You're right. And I think it's unfortunate because I think Omnipod five is a really lovely product. And it does do a really great job, but it is by far the leg if it accommodated, respond

Scott Benner 58:23
to Quick, Quick Change, it really doesn't. It's just not going to listen to artists using IEPs, which is like dynamically changing almost all of our settings and it still doesn't move that quickly. Like it's and it's moving fast. You don't I mean, like it's not unless you're gonna go in there and have settings set up which Omnipod five doesn't, doesn't have like, you know, different profiles, then, you know, that's the quickest way to change is with different profiles.

Jennifer Smith, CDE 58:49
And IPS is definitely you know, above and beyond in terms of its decisions that it makes in its adaptive nature with with the unannounced meal and the small micro Bolus and depending on what it sees in the rise and the rate of change and all it knows it makes a decision on which of those kind of navigates between it's a fantastic

Scott Benner 59:11
Arden kappa six three at college she was a college by herself for six months, she kept a six three a one C and I don't think she was Pre-Bolus thing that much and I don't know what she was eating half the time she was pulling all nighters not eating, eating going all over the place like it really held up. I thought

Jennifer Smith, CDE 59:30
I have to say hi to him. He says hi to both of us.

Scott Benner 59:35
He's in a great episode of the podcast. It's got to be years old by now but it's nice to say yes. And

Jennifer Smith, CDE 59:40
he just agreed. You're just a great guy. Nice that you said hi.

Scott Benner 59:44
Could you Donny get in like love back? Chinese give them flowers as they say if we were famous. That's what we would say we say Jenny gave Donnie his flowers but we're not famous and we just say hello.

Jennifer Smith, CDE 59:54
I know.

Scott Benner 59:55
It's very nice to say started vitamins recommended with the Hashimotos Episode. I've seen improvements in several ways. Oh, that's great crystal are fantastic. It is great. I'm doing a protocol right now of methylated, vitamin B, and A C, Milk Thistle and something else. And I've noticed I'm losing bloating in my, in my upper stomach. So I'm working on that right now. We'll talk about in the podcast one day.

Unknown Speaker 1:00:20
That's great. So

Scott Benner 1:00:21
let's see profiles tomorrow. Yeah, I mean profile. That's what you just what you need sometimes is more or less. I think we only have Jenny for a couple more minutes. For let's celebrate with Jennifer diagnosing at nine at 11 years old. 35 years going only on a sensor for the last five years. Ray once he is six. She's self taught old school diabetes. Good for you. That's fantastic. Really very cool.

Jennifer Smith, CDE 1:00:49
I'd be curious what kind of glucometer she was started with? Because

Scott Benner 1:00:52
that's right around five years ago.

Jennifer Smith, CDE 1:00:54
Yeah, that's right around the time that

Scott Benner 1:00:55
probably had that guillotine like poker that you had to?

Jennifer Smith, CDE 1:00:59
Yes, it was like the being down. Like, I'd hold the platform slightly above my fingers that it didn't quite kill my finger reached.

Scott Benner 1:01:09
Yeah, Amy, you can feel free to send that email to Omnipod. And tell them what you think. Can you tell us more about the enzymes, I tend to get constipated digestive enzymes. I like pure encapsulations. They make one. But you can find them probably at most health food stores. If you have type one, which I know many people here do. You might see a slowing and your digestion they could help to supplement it your meals. And do you have anybody say

Jennifer Smith, CDE 1:01:37
No, I was just gonna say for that one. Also hydration. It's really, really important does hydration and oftentimes even hydration. You think about that being just water. And you can over hydrate with just water. And that can create enough issues too. So hydration with some baseline electrolytes can be very beneficial.

Scott Benner 1:01:57
Yeah. Also, as your I'll tell you what, four or 800 milligrams of magnesium oxide a day and you will take it.

Jennifer Smith, CDE 1:02:03
Go Yeah, and use it at bedtime. Work on your gut all night. Yeah,

Scott Benner 1:02:07
God, do you want to poop do that? Start with 400. But after like two or three days, if you're not going go to 808 will happen. Do you have any clients Jenny with gastroparesis? That's using a GLP?

Jennifer Smith, CDE 1:02:18
I do not personally know. I mean, I could check with the other clinicians in our office and see if they do but I have not in all the years that GLP ones have been out. I've not had anybody use it.

Scott Benner 1:02:31
I'm interested to see how it goes. Because Are there going to be a whole generation of type ones that this is not available for because they actually have clinical gastroparesis. They have nerve damage that slows their digestion, or are we going to start learning more about people just having gut health issues with type one? Right? And you know, they don't have actual nerve damage. They just digest their food slowly. Right? Exactly. Interesting. Jenny, you have to go. I imagine. I have three minutes, three minutes. Okay. You guys have three minutes to ask any question. There's a link up here now to the diabetes Pro Tip series. But you can get all this at juicebox podcast.com. Of course, nothing we said here today was advice, medical or otherwise. And you can email Jenny at work if you'd like to work with her with that link that's right up there. This is the first time we've done this. But we held we got up to 70 people at one point we held 50 people real consistently. So I thought this was a great success. Fabulous. Yeah, super exciting to talk to people like this, especially on a Friday and launch into the weekend. Knows Jenny if this is going to be a thing we do every day as well. Yep. Okay, everybody will take care. I'm going to hang out for a couple minutes. But Jenny's gonna go back to work. Are you literally going to jump into a call and help somebody? I'm jumping into a call. Yes. What kind of plant is in your window?

Jennifer Smith, CDE 1:03:49
It is a Christmas cactus.

Scott Benner 1:03:52
Oh, does it flower often? Well,

Jennifer Smith, CDE 1:03:54
that's the interesting thing. So it flowered around Christmas time, which was lovely because it doesn't always and then in April, it got all these blooms again. And it is in the blooms on a Christmas cactus last for quite a while. And it just started losing. You can see some of the dead ones on it. But it just started losing those blooms like recently. So yeah, Christmas cactus. It's a lovely plant. I

Scott Benner 1:04:19
have a giant one. I can never make flowers come out of it. When the flowers come out. I don't know what I did to make it happen. So you have to sometimes

Jennifer Smith, CDE 1:04:25
you have to kind of shock it. It's almost like bulbs that you take out of the ground. And then you put them in a dark place. And then when it starts getting warm and the ground on freezes, you plant them and that sort of kind of sparks them. So Christmas cactus. I did not do this. So it just was random. But my basement is also which is where my office is it's also colder than the rest of the house. So I think when I brought it down here I moved office spaces. I think the cold kind of shocked it.

Scott Benner 1:04:56
Okay, so anyway, there you go. Wow, the thank yous Jenny, hear from everybody.

Jennifer Smith, CDE 1:05:01
This is really wonderful. I like the live option to do this.

Scott Benner 1:05:05
Michelle stayed up in Australia to talk to us. It's 1am there. Oh, that lovely. And I think Isabel makes a good point. There are maybe 30 episodes of Ask Scott and Jenny where you can hear us pontificating ad nauseam about your questions. So, alright, Jenny, thanks so much. I'll talk to you. Yeah.

Jennifer Smith, CDE 1:05:24
Thank you. Bye, bye.

Scott Benner 1:05:24
All right, guys. That was it. Should we do this again? I literally threw this on Jenny. Like yesterday afternoon. I was like, would you do something tomorrow at 10 o'clock with me? And she was like, Yeah, sure. We maybe we'll do this again. I mean, there's a lot of people here it was great to see everyone want to thank you all, for your support, remind you seriously, you subscribe to the podcast. If you don't, it helps the show immensely. And Apple podcasts or Spotify or wherever you get your audio etc. Please, if you're in the private Facebook group, follow the public page. Because this thing you see here with the chat, it really only works through the public page, this software, it's not the software's fault. Facebook blocked the software from getting into the private groups. So if you want to be part of that, this is a great place to do that. If you love the podcasts, leave a five star review wherever you listen, five stars and a great review that will help somebody else be interested in the show. Please, if you're an apple podcast, don't forget to turn on your automatic downloads and your settings so you don't miss an episode. And so that I get downloads, because downloads is what the advertisers care about. And if you want Jenny and I popping up like this, the middle of our day, Scotty gotta make money somewhere. So keep pumping out those episodes, please. Very, very helpful Spotify as well. If you care. People are saying goodbye. I'd like to say goodbye. And we thought it was awesome. That was great. Appreciate that. I think we'll do it again. Hopefully I saw a number of you clicked on Jenny's link. So Jenny will not that she did this for business. But you know a couple of you check her out. I'm sure she'll definitely come back. Great weekend. Oh, thank you. Oh, my God, please. I'm not camera ready. We will definitely try to do it again. Calvin has gotten a chance for an annual subscribers to have all the episodes uncensored, Calvin, I am working on it slowly. It is very expensive. Every time I uncensor an episode, it costs a significant amount of money through the bank. So I'm trying at least going forward. We're we're trying to do it. But it's another problem. Like even producing two different two different files increases my costs by like twice as much. So I'm trying to build up enough money where I can use that money to pay for that. Okay, all right, you guys are still chatting with each other. Thank you everybody for coming. I'll see you later. I'm going to try to make this when I end the stream. I'm going to try to save it and make it available but it should be floating around in Facebook for you for quite some time. Take care have a great weekend.

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