#944 Bold Beginnings: Treating Low Blood Glucose

Bold Beginnings: Treating Low Blood Glucose Originally aired Oct 27, 2022. Bold Beginnings will answer the questions that most people have after a type 1 diabetes diagnosis.

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Scott Benner 0:00
Hello friends, and welcome to episode 944 of the Juicebox Podcast.

Hello, everyone, and welcome back to another episode of the Best of the Juicebox Podcast. Today's episode is from the bold beginning series. This episode features myself and Jenny Smith. It originally aired in Episode 780. That was back on October 27 2022. And it's called Bold beginnings treating low blood glucose. While you're listening, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan, or becoming bold with insulin. If you want to check out Jenny, you can hire her at integrated diabetes.com. And if you want to check out the entire bold beginning series, it's available at juicebox podcast.com. Go to the menu at the top click on bold beginnings, you'll see all the episodes there. It's available in your podcast player, any audio happy listening. And if you're looking for another list, but you don't want to go to the website, you can go to the feature tab in the private Facebook group Juicebox Podcast type one diabetes

this episode is ad free. But please remember to use the links if you have the need. They're in the audio app you're listening in right now in the show notes. Those links are also at juicebox podcast.com. Or you can type them into any browser. I appreciate you thinking about the podcast, when you're making purchases, when you support the podcast by using the links, if you're keeping the podcast free and plentiful. I'm gonna hit record gently to tell you this little preamble bit that I normally would have said ahead of time, but what we're done, you and this is the last one the not yay, I should say, oh, no, we're done. We're done with the bold beginnings, then we will move on to the long list of things that I have to do with you for next year. So but I'm gonna throw a little curveball in here. So you and I were going to talk about insurance. And then we were finished. But I'm going to bring somebody else in to talk about insurance. Cool. So because otherwise, it would just be you and I, you know, talking about our experiences with insurance, which might not answer some of the people's questions.

Jennifer Smith, CDE 2:37
No, I think that's great. Because I think there are quite a number of people that definitely no more about the navigation. And I think in terms of this topic, it's more how to really nudge yourself into insurance and get what you need, and get to be able to talk to the right person about it. Yeah. So I think that's great. Yeah.

Scott Benner 3:01
So you and I would have done, we would have had fun. And I would have told stories about yelling the F word into phones to get art and things and stuff. But I can do that with someone else who can also hit the technical sides of it for us a little awesome. So instead, you and I are going to add our very last episode to the bold beginnings series together about how to treat low blood sugars. Oh, right. Because you get diabetes. And nobody says to you, hey, you might get low. And the low might be slow. And it might be fast. And it might be harsh, and you might be dizzy. They just say if your blood sugar gets low at 15 carbs, wait 15 minutes.

Jennifer Smith, CDE 3:43
And then it might respond really fast. Or it might not resolve for a couple of hours. And you're thinking Where did the food go?

Scott Benner 3:52
So so so I want to kind of talk through a number of scenarios. And I know, I know, I'm dropping this on you out of nowhere. And of course I don't Is that is that anything new? No. But I don't have any notes whatsoever. Like we've been doing bold beginnings off of people's questions. So, you know, we might have gotten lazy because we're like, we don't have to drive this conversation. I'll just wait and see what this person said.

Jennifer Smith, CDE 4:14
Well, I'm sure there are probably lots of questions that have come in about low blood sugars.

Scott Benner 4:18
There may have been but they were not. They were not called together for me for this situation. So we're just going to fly by the seat of our pants, which I think will be fine. Not like before. All right. So let's think about this. Your newly diagnosed and I guess the first thing we can consider is that you might be honeymooning, still true. All right. So if that's happening, if you're getting help from your pancreas that you don't expect, you might see protracted I saw somebody online the other day whose kids blood sugar was like low all day. And she's like this has to be a honeymoon because, like we're not doing anything different than we've done in the past. So I guess if you're MDI, and you start experiencing low blood sugars that seem like they're being, I guess, impacted by your pancreas still, you can't cut off your your Basal insulin because you've probably shot it already that day. Correct. But you could start limiting, I don't know, would you limit

Jennifer Smith, CDE 5:23
limit your Bolus insulin, right? Right, or you could look at for that day, making your insulin to carb ratio, more conservative. You know, if you're floating around at a ratio of an in honeymoon, I mean, kids, and even some teens might be a one to 30 ratio, right? You could suggest one to 45 or one to 50. Or right, if you know that you're floating, pretty stable when there's not food introduced, but the stable is low, and you're having to give it a little bit of carb to keep it from like, dipping, then it would be the Bolus is that would be the easiest to adjust in that day. And in looking forward into the next day thinking, this might be what it is, you could downplay your basil that day, whether it's morning or evening time dose, you could take it down a little bit, and see if then the next day floats just slightly higher, and leaves you without having to add so much extra carb

Scott Benner 6:31
to treat. And on the day that you get surprised by it and your basil is already in. You can kind of feed the basil a little bit for the day. Yeah, right and spread out and spread out carbs to cover the timeline. But so this is where you need to understand the difference between like a faster acting car, but a more sustainable impact, right. And so if you're being drugged down constantly over hours and hours and hours, a couple of skittles might stop it for a minute. But the minute you bounce back up again, and this extra Basil is there that you don't need, you're gonna get drugged back down again. So you need foods that are slower to digest. Right? You start you start reverse engineering your problems from diabetes and using your problems as solutions, right? Like, right, if you ate pizza, that might take that might sit in your system for hours and hours and hours impact you. So what a great opportunity to have pizza, a little bit of pizza. Or what are

Jennifer Smith, CDE 7:30
pleading some proteins with some carbs. Right, you might want to treat if you're dipping or lower already. And if you do, then knowing what you just said you want some sustaining power after that to not drop yet again, you could do something that incorporates some fat and protein in it to hold things level because again, the other consideration that if if it is a honeymoon based, like drop in blood sugar, it could be that anytime your blood sugar does nudge up from what you treated with simple sugar. It could be that your betas are also like oh, look at that. There's a rise in blood sugar. Let's give some help. And it doesn't really know that you've got basil injected, that's also there.

Scott Benner 8:15
That's see you know, isn't that interesting that you brought that up? It didn't occur to me that I've always just thought of it is like you're getting help from your pancreas, but your pancreas seeds the carbs and attacks them while the insulin you've learned the manmade insulin you've put in is also drawing your blood sugar there. Wow. So you have dumb insulin and smart insulin working at the same time.

Jennifer Smith, CDE 8:37
Correct. And common time for that. And honeymoon is overnight for a lot of people actually, where they may have corrections that work pretty well in the daytime despite them being really tiny, you know, miniscule amounts of correction. But I've got person after person that says I can't correct unless my blood sugar's 300 At night, because if I correct with just a minor half unit of insulin, I'm sitting at like a 60 blood sugar.

Scott Benner 9:06
And this is the reason we're newly diagnosed people.

Jennifer Smith, CDE 9:09
Correct. It's specifically more honeymooning. I mean, you can even see it on nights where blood sugar is going up. You don't correct the high blood sugar because you have the hindsight to know what's coming. Blood sugar could hit 202 20 and it downplays you wake up in a beautiful number. That's that's not injected Basal that did that. Your body helped you?

Scott Benner 9:33
Yeah. Okay. So that's one kind of low you could experience now another one might be activity, right? I'm trying to think of I'm trying to put myself in a newly diagnosed person's situation right, like they go back to their life like I have diabetes. diabetes isn't gonna stop me and then they go play tennis, and then their blood sugar falls really quickly. There we need fast working sugar are correct something that's going to hit you very quickly and stop this freefall. So if you're in a freefall, for whatever reason, you can't eat. That's not the time to have a slice of pizza.

Jennifer Smith, CDE 10:12
That's not the time to have peanut butter cups, the slice of pizza, the nacho meal breaks, not

Scott Benner 10:17
because that's because you're gonna keep crashing before it has an opportunity to start digesting and to stop you. You're looking for simple sugars. I mean, in emergency situations, I know, I know, people don't seem to talk about glucose tablets anymore. Like they've become persona non grata, right. Because they taste achy,

Jennifer Smith, CDE 10:37
they're not the greatest. I mean, they are they are okay. I think the greatest thing about them for me personally, is that I am never going to over treat with glucose tablets. Right? I mean, they do their job. They're doing the job that I want them to do. But they're not like a bag of I don't know, licorice, like licorice. I like black licorice. So you might be like, easy to keep eating with a low blood sugar. Well, that

Scott Benner 11:04
is one interesting thing. There's a plus for for glucose tablets, you will you won't eat them for fun, that's for sure. No. Gel. I mean, I don't even know Do people carry that still, they should, right?

Jennifer Smith, CDE 11:16
We should and or it's easy, especially if somebody needs to help you. Because you can just get it into kind of the gum line and sort of massage it in it. It does work really quickly. So if you don't love the taste of glucose tablets, that glucose gels might work really great. There's a nice liquid glucose, that I just heard about two that I really liked.

Scott Benner 11:39
Okay, so, but in but in general, juice boxes, people are gonna use Skittles gummy bears stuff like that. Right? Correct.

Jennifer Smith, CDE 11:47
Exactly. But the another good thing as you bring up glucose tablets, glucose, or dextrose is the simplest form of sugar, right? So your body doesn't have to go through this breakdown of the structure of of sugar, if you will. And so it gets absorbed really fast. So if you're looking for candy, specifically, you really want to look for candy that has glucose or dextrose as one of the first two or three ingredients. Because it's going to have the fastest impact on a low or really quick drop that you want to stop.

Scott Benner 12:21
Yeah, the timing. So super important. Because I know a story about a person, I won't say their name, but they're an adult. And diabetes for a long time, felt themselves getting low knew it, ate a bunch of carbs passed out, and then just turned back on when the carbs hit them. They were just like, hey, I'm back. And so so there's an it's an example of having the timing wrong. Like you're falling at a certain degree of speed or rate of speed. And you need that sugar to come in and to slow like a parachute almost to parachute that that number fall down and to stop it. You know what a nice level sponsor don't go too low. So things need to work the way you need. I mean, that really is the message of this episode, right? Like if you're one if you're 120, and you're wearing a CGM, and you see this gradual fall, and you look back over at 90 minutes going down, geez, like I Bolus for this meal, it clearly looks like it's too much insulin, I'm going to get low a half an hour from now. Well there, you could just add some more carbs to your meal or have a couple more bites. Correct. And you might stop that. But if that same 120 was falling quickly, you're in a different scenario, you need to use different carbs.

Jennifer Smith, CDE 13:38
You need to use quicker exactly the simple carbs on a quick drop. If you've got a gentle sort of glide down something that's a little more complex, like crack, you know, something like peanut butter crackers, I hear a lot kind of get used because there's a little bit more to the cracker with the peanut butter added to it. Right. So something like that could use it down. But if you're really really dropping then sugar,

Scott Benner 14:06
yeah. And you have to in the beginning, it'll be hard not to overeat a low but that is a skill you need to learn. Because otherwise the bounce comes and then you're like I don't know what to do. I was cheeky of that fear from you've just been low. You don't want to Bolus like you get caught in that. That bouncing rhythm. You don't want to be in that so maybe you'll learn at some point to look at your situation and say half a juice box here. Or you know, take a couple of sips just have two Skittles you know I say to people all the time just because you open the bag doesn't mean you have to eat all of them. Right? Yeah, just eat what you need.

Jennifer Smith, CDE 14:43
All right, which is also why those little tiny bags I mean this is a popular time of the year for a lot of people to end up stocking up on simple car because we have Halloween coming up. Whether you celebrate it or not. It's a great time of the year to find really little packets of somewhere between eight and maybe 15 grams of carb, simple sugar, Candy really prepackaged. So the whole bag of Skittles versus the tiny little packet helps you to contain things a little more. And if

Scott Benner 15:17
you're not lucky enough to have a CGM in the moment and you're just leaning on your, your finger sticks. How frequently do you tell people to after they think after they've identified a low or felt it and treated it? How often do you stick your finger and look, I find myself, you know what I mean? I use a lot more test strips in that moment than you do sometimes for the whole week

Jennifer Smith, CDE 15:41
you do. But you can expect that even simple sugars going to take a little bit of time for digestion, right? So you're really not going to see much shift. If you do a finger stick, confirm your low, treat the low and five minutes later, you're doing another finger stick, you're probably not going to see not much of a difference, right? So that's where old school was that 1515 rule. 15 grams, 15 minutes while you might not need or take 15 grams to treat this low that you have. Waiting about 15 minutes to retest will give you enough information to say, well, I treated it. It doesn't look like it's come up, but it hasn't also fallen. So that should give you enough to say it's not dropping. Clearly, digestion is happening. Well, let's give it another 15 minutes and test again.

Scott Benner 16:33
Yeah, you know, I have two thoughts. So one of them I'm going to make a note about and then the other one I'm going to say if you are wearing a CGM. Sometimes it will not register as quickly. So you can see like a like, Oh my God, my blood sugar's 50. You know what I mean? And you take a bunch of carbs and, and then there's this way to look at the arrow with the Dexcom. At least I don't know how it works with libre, you'll, you're stopping a low blood sugar, let's just say it's 60. And it's the arrows diagonal down, and you take some carbs in and the next reading is 55. And the arrows still down. And then all of a sudden, the arrow will like sometimes disappear. Like almost like the algorithms like I don't know what's happening right now. But the number stays the same. Or sometimes the number or the number will get lower, but the arrow changes. And do you know what I mean by that? Yeah. And so your whereas

Jennifer Smith, CDE 17:32
if you were testing in a look, then it said 55 with an angled arrow down, you've treated it. And now you can see it has a horizontal arrow, but the number is reading like 51 or 50. And you're thinking well, what that really indicates is the system has found a stability, even though the number has slightly nudged down yet, it's not dropping, what you've done is actually making some impact overall. So it's not really time to treat with yet another like whole box of juice.

Scott Benner 18:06
It's so weird. It's a weird moment because the CGM is a little behind. And what you did with the carbs is maybe more in the now, but you can't see it. And so there's like, there's like multiple things happening at once that the technology has, has difficulty showing you. But you can see that something's happening. And so that's when that's when I say to myself, Okay, now this thing looks stable. And we've gotten to, you know, readings in a row that say 50. But I want to know what's really going on, because either the CGM seems confused and I didn't do well. And we're lower than we think. Or we're higher than we think. And I don't want to treat more. That's the perfect time to do a finger stick to me. Absolutely. You have to. Right,

Jennifer Smith, CDE 18:51
absolutely. Especially for those those numbers where you're treating I say at a number less than 60. Honestly, if you're varying at all and decision about whether I should do a finger stick or not. If you're less than 60 and you've treated it and the numbers on the CGM just don't necessarily add up. Or you're mentally not quite like with it enough with a low blood sugar like that. Just do a confirmatory finger stick, because at least that's going to show you real time right now. Where is your number? Yeah,

Scott Benner 19:29
yeah. And I know we're trying not to over treat. But if you get caught and you don't know, like, this is the time you're going to hear me say I'd rather I'd rather just Hi. Yeah. Because Because what you're saving yourself from or saving another person from we don't talk about very much like in diabetes in general, even on the podcast very much like it just doesn't get talked about very much. You're talking about becoming incapacitated. You're talking about having a seizure. You're talking about death, like you're talking about out. There's a lot that happens between 40 and then I don't know how low anybody's ever been right, you know, but while they were still alive, I saw Arden's blood sugar. I saw Arden's blood sugar 22 wants on a finger stick when she was really little. And she was okay still. And I was just like, keep eating, eat, Yeah, II keep going. And then all of a sudden, it was 30. And I was like, Oh, I might have tested, I might have tested her blood sugar 10 times in seven minutes. I was like, but But I mean, it's the truth, right? Like you, you have to learn to do this. Because you use manmade insulin and your blood sugar is going to get low. I just don't care who you are, it's going to happen. So you need to know how to handle it, or how to handle it for somebody else. And you need to know how to handle it without causing a problem in the future. Whether that problem is a high blood sugar, or calling an ambulance, like right, you're it's not. I guess we don't talk. It sounds scary. It's probably why people don't talk about it, huh? Yeah, yeah. So

Jennifer Smith, CDE 21:03
it's absolutely it's it's more around how to treat. There's not even an emphasis on like the overtreatment. It's just treat it. But why, right? Why is it so important to recognize a low sooner than later or deal with it sooner than later? Or stop it from happening? sooner than later? Because there is that scary factor of? I don't know. I don't know why some people can have a blood sugar. I might the lowest I was ever was 26. I don't I was fine. My mom actually thought the number had to be bad. I mean, it was really old. I mean, this was like 1988. So clearly, the meters were not what they are today. But she's like, that's gotta be wrong. You feel good, right? We were camping. Did it again, it was like it was pretty much the same. Just like you need to eat. Here's the juice. Where's it? Where's the regular soda? You know, why could I be there? And fine, when somebody else could be passed out, have a seizure, need an ambulance need assistance? When their blood sugar is 61 and low?

Scott Benner 22:10
Right? Right. Yeah, everybody's going to be different. And so. So let me let me say a couple things here. I use a football analogy, because it's football season, right? You can't like the reason they offensive linemen are these giant blobs of people is because they're trying to stop this insane force that's coming at them. Right? Correct. You can sometimes put carbs in. And you've made such a mistake earlier in the day with insulin or, you know, there's just so much power on the side of the insulin. It's like the carbs aren't there, like you might as well not have anybody blocking because it runs right through them. Right? That's a panicky situation. The first time that happens to you, where you take in a juice box, and realize that it's, it's like you didn't drink it. If you're enjoying the Juicebox Podcast, and you would like it to remain free. Please support the sponsors. Today's sponsors are Dexcom G six dexcom.com, forward slash juicebox. And Omni pod, both the Omni pod five and the Omni pod dash are available at Omni pod.com. Forward slash juicebox. It's a hard moment, you know what I mean? Because this is what you know is going to work. And now suddenly, it's not working for some reason. And you're like, Oh, God, what do I do? You can't find yourself in those scenarios. Wondering what's in the cabinets? Or what's in my bag? Or what do we have in the car, like you have to be prepared? Correct all the time. Just all the time. You know, anywhere you are. There are fast acting carbs. I don't give a crap if you don't use them for six months. I don't care if they get stale, throw them out and replace them. If the juice, you know, when the juice box gets some spongy from being in the car in the heat, throw it away. Put another one in there. Like just don't. Don't ever find yourself in a situation where you're like, it'll be okay.

Jennifer Smith, CDE 24:06
Right? Yeah, right. I mean, It's fall now and I were just like rotating through. We don't really have summer jackets, but like into fall into the winter jackets. We're kind of rotating them into the mix, right? So I bring up my winter stuff. And absolutely in at least like one if not two of my, like fall into winter jackets. They're old, nasty, bad glucose tablets. Like they've gotten the like crystallized sugar like dots, though and like if I had to, I would still use this. So like that juice box that's like nasty and squishy. If that's all you got, you use the squishy juice that

Scott Benner 24:45
you could spread them around your life like your grandma's spreads around her reading glasses. Do you know what I mean? There's just a pair in this room and over here. You need to be listening. You can't be it's a weird scenario. You can't be scared. You can't live your life scared If you don't want to live your life with a 200 Blood shirt, because you don't want this to happen, because also, that's not any safety from not being low, right, as a matter of fact, that might put you in a situation where you're alone more frequently, but, but I like to say about diabetes, that you don't learn these things, you don't prepare for these things so that you can stop a problem. The problem is always going to sneak through somewhere, it's never going to be where you think it's, you know, because if it was where you think, then you'd get ahead of it, right. So you have to be ready for when it happens. And then the last bit of this is, if all else fails. I mean, please be carrying glucagon, you know, with you, like not, it's in the cabinet in the kitchen, but we don't take it, you know, anywhere. I left it in the car when I went pumpkin picking like it needs to be with you. Right. Yeah, exactly. So well, this is a fun conversation.

Jennifer Smith, CDE 25:51
Harder, I think it's a harder conversation than you think about before. Because there's a lot of, there's a lot more on the back end of not taking care of a low well enough. That is actually scary. Yeah. And it doesn't get talked about. We always try to like smooth it out, like not to worry about it so much, and whatnot. But in order to not really worry about it. Preparation is needed. You have to have things in your purse or your car or your backpack or, you know, at your friend's your friend's house that you go to all the time, or whatever it is. I guess it's like being a girl scout or a Boy Scout be prepared

Scott Benner 26:33
how to be prepared. Yeah. You know, when Artem was younger, she spent her whole day in one classroom, right? Or she went to art or something like that. So she had a bag and she took it with her when she hit middle school and high school and she started having English in one room and math in another room. When that started happening. We put supplies in each room. Like we didn't say to ourselves like she should be humping this stuff all over the place constantly. Let's put a little here there was a couple of juice boxes in every room. You know, it's interesting. It's when you learn about your management to how come we're always restocking the English class. And never the math class. What's the time? Yeah, it's the time of day we're doing something that's making a low around this time of day, it's actually an interesting way to learn a little bit about your management is where am I grabbing my supplies from? You know, do you think that? Do you think that every low is different? Because there's there are questions here from people that are like, you know, after I stopped a low with a fast acting, should I put a protein in every time afterwards? But not necessarily, right?

Jennifer Smith, CDE 27:38
Yeah, no, I mean, the idea. Again, it's kind of an older concept. It's sort of like the 1515 rule, it's 15 grams, 15 minutes, and then you essentially may need to follow that up with a snack. But again, there's lack of enough information about why the idea really was simple carb will typically help keep your blood sugar up for about 90 minutes, give or take. Now, again, a variable in the picture is why was the low there. If it's excess insulin, you may actually need to treat with more than what you thought you would need. But the other idea is that the simple carb to keep your blood sugar up is it's meant to sustain you for that time period, before you might eat again. So if you treat a low blood sugar at, let's call it three o'clock in the afternoon, but you don't typically eat dinner until seven or eight o'clock at night. Lows can bring on another low they can. And so if you treat the low, but there's something in the picture that's keeping you lower, could be honeymoon, it could be excess insulin, it could be more movement in the day, whatever. You may actually for longer than two hours before your next meal. It may be beneficial to have a handful of nuts a spoonful of peanut butter a piece of string cheese a boiled egg, whatever it might be. The the idea there is that that's a little bit more sustaining and or a snack that might have a little bit more complex carb to it long with some protein to sustain things. So you're right every low is not the same

Scott Benner 29:20
right art in tried art in psychology right now. She tried to use a falling blood sugar as a Pre-Bolus for her lunch, but it just didn't like she didn't time it well enough. So like at 60. So listen, for anybody who's listening. Here's how I did it. Arden's in another state. She's 13 hours away. I'm able to look at her phone and see where it is. Right so I use Find My Phone to see. Okay, she's in the cafeteria, so at least I know she's right. So now where she should be near food. I text her Hey, what are we doing about this? Because she's got this like seven One day that became 65 pretty quick. And then I looked at the arrow and then I looked at the line and I thought this isn't stopping. Like this is not a low that's going to stop right like this is this is going to be negative 15 If we don't do something about it, right. What are you doing? I'm trying to like Miss like, you don't I mean, I don't want to be upper asked Jenny. And at the same time, I don't need her dropping dead. It's College. Like, I'm trying to find the middle. I'm like, Hey, what's up? And nothing. Now I know she's with the food. So I'm like, you see this? Nothing. Art and I really need to know you're okay. I'm eating now. I'm like, okay, like the food's going in your mouth. Yes. But Jenny 6060 560-560-5550 5540. I'm like, Are you eating now? Yes, I'm eating. I told you. I was What are

Jennifer Smith, CDE 30:49
you eating lettuce leaves. So

Scott Benner 30:53
what's happening? Like, you're eating like handfuls of sugar, right, like, and so, but so I texted her to test her. So then I sent a text to test her cognitive, like, where she was cognitively. Right. And I'm just like, how do you feel? And she's like, I feel fine. And I'm like, Okay, have you been eating for a while? She said, Yes. So I said, Okay, I got it. There's food in there. It's working. The CGM hasn't caught up yet. But I had to stand there. for like three go rounds. That CGM watching that 42 Just sit there knowing she's not really 42. She's in the mid 60s already. I know. I know this. But I only know this from

Jennifer Smith, CDE 31:35
you. Because you've lived with her. You've dealt with it long enough. You knew the questions to ask. You knew how to get her to respond and whether or not she was going to answer you the right way. And that it takes learning Oh, it's

Scott Benner 31:48
yours. Because otherwise I would have been like drinking juice. I don't care if you don't drink the juice. I'm bringing you home. I'm not paying for college. Like I don't you know, like, you know, because the number because we've done everything's over come home and live in this room for the rest of your life. Because the because the number was so scary, right? But I was able to pick together enough information. I swear to God, that CGM. One more time went from 42 to 66. And I was like, Okay, I was right. But I'll tell you, you're like, God, what if I'm wrong, you know what I mean? Like, I don't want to be wrong, but I might be. The next thing I think we should bring up about lows. Because we're in a we're in an algorithm world now. Right? Control like you on the pod five, that thing that Medtronic makes i What is it? Which one is that? Let me learn the number. Medtronic, don't they have an algorithm right now?

Jennifer Smith, CDE 32:39
Say, do they've I mean, they've had an algorithm for a long time I use as a their CGM, right. And I don't know that their does their algorithm have a name like Omnipod, five, six, so their new their new one and the ISC, that number is what you're looking for seven, seven DG. And I know some plays I don't know if it's here. I don't think it's here yet. Seven. ATG I know is available in some places in Europe already. But 777 80

Scott Benner 33:11
I just I feel like they buy they buy ads for in pen. So I figure I, I owe it to them to learn the name. I just can't keep saying the thing that Medtronic has they're gonna be like, How about how about if you're not the podcast that we sell the embed on anymore? Like? Alright, so the 770 GE, right. So yeah, so whether it's one of those algorithms, we all live in a new space now, where the algorithm sees a low coming, and it takes away and takes away and takes away your basil and takes it away. But it isn't, it isn't always going to get it right. And so you might end up treating a low after a prolonged amount of time of not having any insulin. And then your blood sugar shoots back up very quickly, because there's nothing to stop it. And what is the algorithm do when it sees the higher number gives you more it gives you more insulin, sometimes sometimes can happen. That's what I'm saying. It can happen that's a better way to and when that happens. Here's what I know for certain Yeah, gonna be low again later. Because because, you know, they, you know, when you're taking, you know, sugar and for a low if you take in the right amount, you've been getting on a regular you know, on a regular pump or on an MDI you've still been getting your Basal the whole time. So you're, you're correcting that low more in real time. When you do it right algorithm. The algorithm thought it was going to stop you. It does not expect these carbs. And now you jump up and it Bolus is the number or it's pushing basil at the number that the other night. I guess I should have listed lupus one of those Arden had Jenny I think it was around her period and she was tired. She's rundown and she's getting her period at the same time. We had this whole day where she was a little too low. And it persisted into overnight. And so around eight or nine o'clock we fixed the low and I said Listen, take these carbs, go into the settings and shut off micro bolusing without carbs. I was like, where this thing's gonna hit your, your correction, right? And it's gonna push it back again. And she did that we went through the night really nicely. It was a nice learning experience for her because then she brought it up the next day. She's like, should I put the micro balls back on again? And I was like, Yeah, everything looks good now. So, but anyway, you have to be aware of that. So, I mean, I don't know what you do. Me. I mean, there

Jennifer Smith, CDE 35:29
are other you know, for other systems, you can certainly also navigate something like that. If you've treated a low, you know that you've overtreated it, but the system is going to give back eventually, and you know that it's going to be too heavy, similar to your scenario there. The other systems do have, I guess, adjustable targets or different targets that would be higher. So then it would adjust less if you adjust the target up and say, Hey, I'm aiming for this now. So as my blood sugar is going up, it's okay. You don't have to give me as much because I want to be higher

Scott Benner 36:07
anyway. So like an example with Omnipod? Five, you might tell it to shoot for the higher range. And that's correct. And yes, with I'll tell you what, in that exact scenario with art, and I said, I asked her what did you take for the low? And she's like, Oh, I had gummy bears. They hit her really hard. So I was like, Oh, crap, she's gonna jump straight up. But they don't hit her and hold her. They hit her. And then they disappeared on her. So I was like, oh, no, no, don't let that thing Bolus. Yeah. Anyway, this probably all sounds much more confusing than it will be you have diabetes for a few months. It's all gonna make sense. Don't

Jennifer Smith, CDE 36:41
maybe know very well, yeah. There's still some things I throw my hands up. And I'm like, Well, clearly, like Venus is not in the right place in the orbit of something because I, I just I don't know right. Now,

Scott Benner 36:57
you're maybe just said Good. Luck is what I heard.

Jennifer Smith, CDE 37:01
That was so not the case. That's not the beginning of this is what you want to hear. Yes. Forget the maybe nine I shouldn't say maybe should be like the point 1% of the time. You know, it doesn't take much to learn, especially with CGM is in the mix. These days, it doesn't take much to learn how much is needed. And as you were sort of, you know, talking into the effect of algorithms, you'll see, well, gosh, I was used to using this much, I probably need to use a quarter to a third of what I used to use to treat when I didn't have a system that was helping me

Scott Benner 37:37
You know, I saw a woman yesterday say, I don't know the exact numbers, but the gist of it was on control IQ, I needed 14 or 15, carbs stop below and on Omnipod five, I'll need four or five carbs to stop below. Interesting that interesting, I found that incredibly interesting actually. So especially

Jennifer Smith, CDE 37:53
system to system, given the fact that they're both doing a give and take of insulin, but they are they are very different algorithms. Yeah. So that it does make sense.

Scott Benner 38:03
Alright, so check me on this. You need to know how to stop a low they're going to happen. You're not going to stop a low from never happening. You need to understand the different impacts that these different carbs are going to have on your low blood sugars. After a while teaching yourself to stop a low without creating a high is a great tool to have.

Jennifer Smith, CDE 38:22
Yes, if you it will happen. Yeah, yeah. Oh no,

Scott Benner 38:25
you're gonna rebound high until you until you learn how to do it in a real panic situation. Screw everything else save your life. Correct. And that's it right? Have glucagon with you have snacks with you. Don't go anywhere without ways to treat Lowe's, the people who love you and are around you should understand how to help you if you're unconscious or unable to help yourself.

Jennifer Smith, CDE 38:49
And I think another thing as you mentioned, caregivers or loved ones or you know, whoever. I think within that for Lowe's is recognizing the like what you mentioned about cognitive when you're doing kind of a check with Arden the people that are around you enough should be able to tell whether you're responding or or talking or whatnot, the way that you normally would. And in the case that your CGM is off, or you aren't using a CGM or technology, somebody who knows you well should be able to kind of chime in and say, Hey, are you okay? You know, and don't be angry at them for that. It's just a it's a checkpoint to be able to keep you safe. So

Scott Benner 39:38
yeah, also for I guess caregivers, low blood sugars could leave you with people who are difficult to yes help, right? They could become combative or and that's a real concern, especially as they become adults and I There's one story that sticks out in my head all the time of this woman whose husband got low and she just wasn't big enough to overwhelm him. Do what he needed, you know? And she had to call 911 because of that. But yeah, I mean, the people around you just need to know. And people should be following you. If you have CGM, like I don't know if liberi has follow like Dexcom does, but it doesn't. Okay. Arden is in a suite with girls. And the girl in the next room follows her on Dexcom Oh, wow, that's awesome. She only has a 55 alarm and nothing else. But we explained to her I'm like, if this thing's beeping, please go find Arden. And make sure she's okay. That's all. Yep. And it just, I don't know, especially for adults living by themselves or kids off at college, like somebody, you know, has your back because it also not everybody hears the alarms to like I had a low last night. It was only like 65. But I was sleeping. And in my sleep. I thought did I hear something? Like that was all I thought, right? And then I'm like, I woke up and I looked, and I was like, huh, yeah, I'm gonna watch that for a second because the being honest with you, it was a real slow drift. The loop had been taken basil away. I'm like, I think this is gonna bounce. Like, I think it's okay. I don't want to wake her if it's not going to be okay. And it waited and waited and waited. And then I was like, Oh, it is gonna be okay. It went back up again. But I talked to her this morning. And I was like, you know, you're a little last night. She has no idea. But since she had that seizure more recently, if you listen to her last episode, she'll tell you about it. If she has a she experiences any kind of a quick fall while she's sleeping now. I don't know. I don't know how that rewired her brain. But she's boom. I'm up. I drank juice. I'm good. Hey, Dad, I did this. Do you think this is enough? Like she never used to wake up. And now I don't know if she's feeling the fall while she's sleeping right now. Which has only happened twice since she's been away. But anyway. Alright, Jenny, did we do it? We did it. I think so. Yeah. Yeah. For us then.

Jennifer Smith, CDE 42:00
Okay for us. Awesome. Thank you. Oh,

Scott Benner 42:02
I guess we should say something like thank you for listening to the beginning series. And I hope you found it like, helpful.

Jennifer Smith, CDE 42:08
Absolutely. Especially in the beginning when everything is so new. So

Scott Benner 42:11
let us know if you want us to add to this series. If you go back and listen to it and find something that should have been in there that wasn't please send me a note. And Jenny and I will we'll add it if we think it needs to be added? Absolutely. What are we doing? What are we busy or something?

Jennifer Smith, CDE 42:29
Got nothing else to know. Right? But just hanging around?

Scott Benner 42:38
Well, as I mentioned at the beginning, we've already found more stuff for bold beginning. So this was not the last episode. Let me thank Omni pod and Dexcom. While I have your attention on the pod.com forward slash juice box, see if you're eligible for a free 30 day trial of the Omni pod dash. Or if you're interested in the Omni pod five. For full safety risk information and free trial terms and conditions, you can also visit omnipod.com forward slash juice box. And of course, thank you to Dexcom for being a longtime sponsor to the podcast dexcom.com forward slash juice box see blood sugar in real time, the speed direction and the number right there on your iPhone, Android, or on your Dexcom receiver. There's so much more I want to tell you, but I'm on about day seven of this illness that I have. And to be perfectly honest, editing the show together almost killed me. So I'm gonna go take nappy, and I'll see you next week with another episode of The Juicebox Podcast. Hey, everybody, it's me. I hope you enjoyed the episode. I want to remind you about the private Facebook group Juicebox Podcast type one diabetes. I don't know if past Scott said that in that episode. But future Scott, or I guess President Scott wants you to know about it. Juicebox Podcast, type one diabetes on Facebook. It's a private group that now has 40,000 members. And there are conversations going on night and day. Doesn't matter what country you live in. That group is always jumping, you have a question, somebody in there is going to answer it for you. You need a link, somebody in there will find it for you. There are group experts that will help you find episodes of the podcast that can help you. And I'm in that group every day. So please just stop by and say hello. That's pretty much all I have for you today. I hope you enjoyed this episode. I'll be back very soon, with much much more. Thank you for subscribing, following sharing, telling a friend telling a doctor whatever you do to get the word out about the podcast. I really appreciate it. Keep it up. You are helping the podcast to grow

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Summary

• Intro to the show. 0:00

• Welcome to episode 915 of the juicebox podcast.

• Nothing on the podcast should be considered medical.

• Understanding insulin action and time of action. 2:49

• Fear of insulin is the biggest sticking point.

• Insulin action and time of action.

• Tug of war analogy, insulin and carbs.

• How blood sugar works in the body.

• Take insulin and start to eat. 8:37

• Rapid is a misnomer for insulin.

• Rapid insulin is 100% in most settings.

• Continuous glucose monitor, dexcom, continuous glucose monitor.

• The story of a 17 year old boy.

• Timing and amount of insulin. 12:12

• Timing and amount is the first step to insulin use.

• The importance of visualization.

• Dexcom g6 continuous glucose monitor.

• Share and follow features for android and iphone.

• How to make good decisions. 15:38

• Omnipod headquarters in massachusetts.

• Request a free experience kit.

• Dancing for diabetes and dancingthenumberfourdiabetes.com.

• Making the first move is the key.

• Diabetes is a science experiment. 19:22

• Diabetes is a daily science experiment.

• The pre-bolus piece is 80% of control.

• I don’t count carbs. 21:28

• Don't get mad, don't count carbs.

• No accurate insulin to carb ratio set up.

• The importance of the arrows in dexcom.

• The least important aspect of dexcom is the direction.

• What is pre-bolus and pre-basal. 24:54

• Temper basal is a fraction of the basal rate.

• Pre-bolus time is 20 minutes.

• The importance of pre-bolus and extended bolus.

• Pre-bolus vs extended boluses.

• Trading bolus for basal. 28:08

• The concept of super bolus.

• Never suspend basal insulin.

• Pre-bolus and multiple daily injections.

• Sponsor, better help. 10% off first month.

#943 Campfire Stories

Nancy's daughter has type 1 diabetes.

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.

+ Click for EPISODE TRANSCRIPT

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

Scott Benner 0:00
Hello friends, and welcome to episode 943 of the Juicebox Podcast.

On today's episode of The Juicebox Podcast, I'll be speaking with Nancy. Nancy is the mother of three, one of her children has type one diabetes, the others have other issues that we'll talk about briefly. While you're listening, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan, or becoming bold with insulin. Don't forget to check out the private Facebook group Juicebox Podcast type one diabetes, there's over 40,000 members and the conversation is happening right now that you may be very interested in. You can get five free travel packs in a year supply of vitamin D. When you go to my link athletic greens.com forward slash juice box. That's right start with ag one today and get those five free travel packs and a year supply of vitamin D at my link athletic greens.com forward slash juice box and you can save 35% off your entire order at cozy earth.com. Just use the offer code juice box at checkout. bath towels, bedding clothing cozy Earth has it all. The podcast is sponsored today by better help better help is the world's largest therapy service and is 100% online. With better help, you can tap into a network of over 25,000 licensed and experienced therapists who can help you with a wide range of issues. betterhelp.com forward slash juicebox to get started, you just answer a few questions about your needs and preferences in therapy. That way BetterHelp can match you with the right therapist from their network. And when you use my link, you'll save 10% On your first month of therapy. You can message your therapist at any time and schedule live sessions when it's convenient for you. Talk to them however you feel comfortable text chat phone or video call. If your therapist isn't the right fit for any reason at all. You can switch to a new therapist at no additional charge. And the best part for me is that with better help you get the same professionalism and quality you expect from in office therapy. But with a therapist who is custom picked for you, and you're gonna get more scheduling flexibility, and a more affordable price. betterhelp.com forward slash juicebox that's better help h e l p.com. Forward slash juicebox. Save 10% On your first month of therapy.

Nancy 2:47
I feel like I'm meeting a celebrity. Oh, well, you

Scott Benner 2:50
obviously are. You're not meeting a person who just went downstairs and had to mop up dog urine because because this dog is 15 years old. doesn't know when to give up. That's not what's happening here at all. Yeah. Now. You're not talking to a guy who was just in his kid's room shaking or going. You said to get you up. You said Yeah, yeah, I'm famous.

Nancy 3:16
I'll say this year I get to talk to you last year. I got to meet Dr. Stephen ponder. Did you really? Yes, yes.

Scott Benner 3:22
Were you in Texas or was it somewhere else?

Nancy 3:24
No, he actually came and spoke to a group in my area. I live in Georgia. Okay. My Endocrinologist, Dr. Hutchins is in Macon, Georgia, which is about middle of the state. And she did some just sort of a family day with some vendors. And he came in he was our speaker and had some activities for the kids and things like that. And he was there. So

Scott Benner 3:48
Oh, that's lovely. Jessica, right. Yes. Love. Dr.

Nancy 3:51
Hutchins. She's

Scott Benner 3:52
wonderful. Okay, well, I apparently my children live on either side of

Nancy 4:00
that. Yes. Yes. I kind of suspected I know that you I didn't feel like in any of the podcast or your post. You're real specific. But I kind of guessed that. Your daughter was kind of in my vicinity.

Scott Benner 4:11
Yeah, yeah. I'm supposed to say that. She's in Connecticut. Okay, so or Chicago or something? That's

Nancy 4:18
it's pretty hot in Connecticut this time of year. That's where she is. Chicago.

Scott Benner 4:24
But my son is in Atlanta, but he's, he's trying to get out pretty quickly. So,

Nancy 4:30
yeah, well, my town is uh, we're almost the southernmost town in Georgia. So I'm about an hour north of Tallahassee, Florida. Oh, wow. So I'm all the way at the bottom of the state. So which is geographically challenging with a type one diabetic because they're rare and big town so especially in rural Georgia, harder to find somebody. So the nearest town Hassey Jacksonville Savannah, Macon Atlanta. So

Scott Benner 5:04
are they great once you get there? Dr. Hutchins is

Nancy 5:07
yeah she is but previous one that we used not so much and unfortunately I spent way too much time with her.

Scott Benner 5:15
Oh, yeah, that can definitely happen. Well speaking time I have perfected the Georgia to New Jersey 14 hour drive.

Nancy 5:21
Oh my gosh. That sounds gross.

Scott Benner 5:24
It's horrible. It has moments where it's worse. To name those moments. South Carolina.

Nancy 5:34
Savannah is a really neat place. That was part of my my husband's honeymoon. We did Jekyll Island State at the Jekyll Island Club then went to Savannah and Charleston.

Scott Benner 5:44
Oh, that's lovely. You know, so Arden was there for a year. And we were picking her up. We're by the way we're recording Nancy. Is that okay? Okay. We were picking her up at the end of her first year. And, like helping her like we actually went and visited our son and then we went to get her and helped her brain, like put stuff in storage and like it was our first time everything. We went to help her out. And Arden has a car at school. So Kelly says to me, I know this is hokey, but let's take like a trolley tour of Savannah. Yes, I was like, okay, so Arden's making fun of us. She goes those tour people just stare at us, you know, and I'm like, I'm like, why won't stare at you already know who you are. And we're on the trolley tour. And Arden's got one more class. One more class to go. And my phone rings. And I'm on the tour, but it's art and so I pick it up. And she is pretty hysterically crying. And she's going Dad, dad, a man, a man, dad a man hit Oh, no, like and I'm like, wait a man hit you on like, wait, what's happening? And she's really upset. Arden's not like real flammable. So I was like, yeah, what's going on here? And now I'm worried that someone's like, like, physically attacked her. Yeah, I'm like, I'm like, calm down. I'm like, what, what's happening? And she's like, I was stopped at a red light. And a guy on a motorized bicycle hit me. I'm like, Okay. And I'm like, are you alright? Yeah. And I'm like, is he alright? She was, I think so he stood up and yelled at me for a while and then ran away. And I'm like, Wait, what happened? Like, so I'm like, calm down. I'm like, if you're, you know, like, you're, you're off the road. She's like, I pulled over and I'm like, okay, and I hear talking to somebody, but I don't get a lot of context for that call. Anyway. So she says, you know, there was this guy on this old busted up like, bike that was, yeah, rised. And he was driving really slow. So like a block or so back. She went around him, she stopped. She stopped at a light and was stopped at the light for a bit and looked in her mirror and thought, but he's coming at me quickly. And then she kept looking and thinking, Oh my God, he's gonna hit me. And she's like, I tried to just like, should I like, pull out into the intersection like swerves. Yes. And a red light or cars next to me. I couldn't really do anything. And he kind of veers the last second and catches the back left corner of her car. But what had her so upset was that he flew through the air pass. Oh, that's her driver's window. And I think that was it like the human body flinging made her really upset. Yeah. So she gets out. She's like, are you okay? And he starts yelling at her. And she's like, wait, what? Why are you yelling at me? Like, what happened just now? And he goes, You can't do that. And she goes, what? And he goes, Stop at like a yellow light. And she goes, you're supposed to Yeah, and he goes, Well, you have to know the brakes on my bike. Don't work that quickly. Well, how are

Nancy 8:52
you supposed to know that?

Scott Benner 8:53
I don't know. That's what she wondered. So then they start yelling at each other, like a little bit. And then he just gets flustered and she's like, are you okay? Like, let's make sure you're okay first. And he gets flustered picks the bike up, throws it down a hill on the side of the road off an embankment and runs away into the city. So she pulls over to talk to me. And later she says to me, I pull over and she does that. Like if you want to know what it's like to be a pretty girl and I'm like, okay, she was like, pull over. And I'm very upset. I'm I have a person in my car with me who I don't know that well. Well, I'm just taking taking her to class. She's like, can I call you because I know you're here. And as I'm getting you on the phone, she goes an honest to god crackhead comes up to me and goes, Hey, you from New Jersey. And she's like, not now buddy. So he's, he's like he's hitting on her in a park. Yeah. A

Nancy 10:01
lot of panhandlers in Savannah. And we call them the woohoo girls, all the girls there.

Scott Benner 10:09
Because you yell woohoo app. Or they're yelling. Yeah. So anyway, she's like, and then I just calmed her down. And then I pulled my parenting hat on. And I was like, listen, you're okay. The car is okay. I'm like, you have a class to go to. It's your last class. You're presenting your project. You to pull yourself together and go to that class. Yeah. And I was like, and when you come out, I promise I'll be standing in the parking lot. Yeah. And so I just, you know, couple hours later made sure I was there when she came out. She told us the whole story. He was laughing. But anyway, you visit Savannah?

Nancy 10:47
Yeah, we used to go almost every year, like whether it was for our anniversary or Valentine's Day or special trip or whatever. We haven't been in a while. The drive from my town to Savannah. While it's not 14 hours, it's long, boring. Nothing to look at all the way there. So it's kind of a boring drive. I'm

Scott Benner 11:07
just gonna tell you that. 18 months ago, I had only ever been to Atlanta or to Georgia. Once in my entire life, maybe twice. And now I feel like I live there. So yeah, yeah. Anyway, it's a it's a nice area, I guess. Yeah. My son does not like Atlanta.

Nancy 11:24
I could understand that. My son interned at Atlanta Athletic Club. I guess it's been three summers ago. And the Johns Creek area lived up there. And his fiancee because he they offered him a job after graduation. And his fiancee was like, I don't want to live in Atlanta. No, thank you.

Scott Benner 11:43
I'm not usually a person to talk like this. Because I live in the northeast and I love driving fast and recklessly at times. But Atlanta driving in Atlanta is

Nancy 11:53
Yeah, yeah. It's a sport. contact sport. Sometimes

Scott Benner 11:57
I've seen to hit and runs, and I've only been to Atlanta three times. Yeah. Anyway, okay. So Nancy, we already know you're Nancy. Yes. You are the parent of a type one or you have type one yourself.

Nancy 12:10
I'm a parent of a type one. Elena.

Scott Benner 12:14
Yeah. Tell me about Elena, please.

Nancy 12:15
So Elena is birthday, ironically, is today Happy Birthday, Atlanta, she turned 17. Congratulations. We just celebrated her 10 year diversity. She was six when she was diagnosed. So I guess, diagnosis story, how we figured it out? Well, are just about her.

Scott Benner 12:38
Like how you're going into like how you're thinking of the big round picture. Let's let's start with, are there any other autoimmune issues in your family?

Nancy 12:46
Yes. So my oldest son who will be 23, in a few months, two years ago, was diagnosed with Crohn's disease. My grandfather, my paternal grandfather, had celiac disease. Both my dad and his dad, paternal grandfather. I know my dad has type two, I've always been told my grandfather had type two. He was insulin dependent, before he passed. And I've often wondered with him having celiac. Was it a misdiagnosis? Or just,

Scott Benner 13:28
you know, was it a late in life diagnosis? Celiac was yes, but his diabetes required insulin was longer. The requirement

Nancy 13:37
of insulin didn't happen until later. So it could have just been I guess the progression of type two was my dad nor my grandfather are overweight, big people as a stereotype we talk about a lot as parents, but I just remember as a child, seeing him with the syringes and some insulin. Not knowing Yeah, blast to the future that that would, you know, be us. But so type two, he had celiac. There's been a few times that I've wondered if my middle child my other son had some gluten issues, but we've not done like true tests, but sort of tried to eliminate diet and stuff. But yes, my oldest has Crohn's.

Scott Benner 14:31
That's a pretty rich history of of issues, I would say.

Nancy 14:35
Yeah. And yeah, I always laugh and tease that my husband and I just created these great medical anomalies. Our oldest has Crohn's, our middle son who's 20 has epilepsy. My daughter who's the youngest seven team has diabetes, and she has seizure disorder as well.

Scott Benner 14:54
Oh, no kidding. How's your dog? My dog? See, okay, Yeah. I didn't know if maybe you guys were like the epicenter of something.

Nancy 15:04
Yeah, no. Whenever David and Elena started having seizures, my mom was like, There's something at your house. You can't go back to your house. There's something going on there. Because Ironically, when their seizures started, it was days apart. So we we both Yeah, I can see how we thought it was environmental. But Elena has not had a seizure in over two years, which is never, in my opinion, diabetic related. She had on a Dexcom I could always see her blood sugar. No testing has ever told us anything about her seizures. We've done MRIs, CTS, the was an EEG, that's the brain. I always get that. But worn monitors, we've done DNA testing, David's they can diagnose and see right where it's happening on the brain, hers not so much. So it's been over two years. And one of her last appointments they are discussing weaning her off her seizure meds, maybe it was the column psychosomatic, not that she's faking them, but there's no, there's physical or physiological. I know what the right word would be reason that they can see why she's having her seizures. So David went through a lot his junior and senior year of high school, and has a lot of mental health struggles with the seizures. And so we're holding off until she finishes her senior year to titrate her off the seizure meds because I don't want her to miss out on senior year if stuff starts happening, and

Scott Benner 16:40
are there side effects of the medication? Yes,

Nancy 16:43
Elena, thankfully has never experienced any side effects that I know of. Dave David, yes, we've had to change a few times he had what they call cap rage from Keppra gives you rage issues. Some of his medicines have caused weight gain, and just the disease itself. And the side effects from some of the seizure meds is a terrible tornado of mental health. grossness, so.

Scott Benner 17:16
That's a lot. How old are you?

Nancy 17:19
I am 48.

Scott Benner 17:21
Okay. Your daughter's diagnosed at Did you say six at six? And how does that come about?

Nancy 17:29
So we just, uh, I can't remember how long we'd had our camper. We were tent campers as a young married couple and then started having our kids went on a few tent camping adventures. And then we eventually got us a little camper. So met my parents at a campground for the weekend to camp the weekend. Elena had had her field day on Friday. And then when school's out, we drove over and went to the campground and noticed that she was going to the bathroom a lot. She was thirsty a lot. But I was like, oh, maybe it's just because we're in the camper. And maybe it's just because I'm having to walk all the way to the bathhouse and I'm just, I'm more aware of it because we're not at home and shit. You know, I'm more involved in your bathroom visits. And then by the second day, like she'd ride her bike, she go down to my mom's camper, which is not very far away. We're a state park. Thirsty, haven't used the bathroom again, back in ours thirsty, haven't used the bathroom again. And my mom and I sat around the campfire. When my brother was younger, one of his friends was diagnosed with type one very similar symptoms to Elena. And my mom said, You know what the sounds like and I was like, Yeah, I was like, but no. Well with my dad and type two, I was like, Well, does he have his meter with him? We can pray? Well, he didn't. My uncle was there. He didn't have nobody had a meter or couldn't prick her finger. So we're just there Friday, Saturday, Sunday, came back home Sunday. And at that time, we lived in Middle Georgia. And I was a ParaPRO and a kindergarten class. My kindergarten teacher my class used to be a nurse and went back and got her master's in education. So I called her and I was telling her the symptoms and she was like, let's just hope it's a UTI. I was like, Yeah, but a UTI. You don't go to the bathroom. You just feel like you need to go to the bathroom. She's gone to the bathroom. Yeah. So we got to school Monday morning. And I asked the school nurse I said can you just dip her urine and see if she has a UTI. And so she dipped her urine and the glucose part on the strip, turned colors. So she pricked her finger, and she was 365. And she's like, You need to call your pediatrician. I was like, okay, so I went out to the car almonds are the school and I was calling the pediatrician I was on hold, telling him the symptoms on hold whites. And she started getting nauseous. And our stomach started bothering her everything. And that's when the doctor told me like, you just need to hang up and go to the ER. Well, even though I'm rural, where I live now, I was very, I mean, I was an hour away from pretty much any hospital 45 minutes to an hour. But all of my co workers, I mean, the principal, the school immediately was like, what do we have to do, she's gone and gather and somebody to drive me to the ER, they're getting my purse, they're getting the latest things. And the next thing I know, the teacher that I worked with, is driving us to the ER my car, and I'm in the backseat with Elena, and she's just reassuring me the whole way there. This is going to be fine. You're you're super intelligent. If any parent can handle this disease, it's you. God knew what He was doing. Whenever he gave a line to you, as a parent to manage this disease, you're going to be fine. So that was the pep talk. I got all the way there may I'm just like, What are you talking about? I have no idea what I'm going into. So we went to the hospital, where her pediatrician is, and it's a smaller hospital. And then I have a I would call it like a sister or like a cousin hospital. They're not affiliated but a bigger hospital nearby that he also has. He can see patients. Yeah. So we went to the first small one because it was the closest and I went to the window and I said I'm here with my daughter. She's starting to feel nauseous. I think she has diabetes. I need to have somebody look at her. She's like, I can't admit you to the ER, just because you think she has diabetes. I'm gonna need you to tell me something else.

Scott Benner 21:51
Okay, I want saw big foot while I was like, outgoing. She's like,

Nancy 21:57
that's just not something I can. Oh, okay. She's nauseous. She's throwing up, she doesn't feel that's what got us in the ER not scared that we have type one diabetes, which is very dangerous. Now I know that 10 years later, it was she's throwing up.

Scott Benner 22:12
That's what what's the tree to human ratio where you are? The what? The tree to human ratio. There's lots of trees, okay, I'm just trying to figure out what I'm talking about here. So you had to drive an hour to get to someplace where nobody knew what they were talking about?

Nancy 22:28
Well, what's the pediatrician that called him from his office and he came over. And my husband's still taught us about this. I don't know if it was a student, or a medical student or a nurse or whatever. I mean, our heads are spinning, we have no idea. We didn't know anybody with type one diabetes, I don't know what I was getting into. She just came up to us. And she said, I just feel really sorry for you. And walked out of the room. And I was like,

Scott Benner 22:55
what? Wait, this is a student nurse. I was either a nurse

Nancy 22:59
or a student doctor, someone on the medical staff. It was not just a random person in the hallway, it was actually a hospital medical staff. And that's nobody has yet even said, this is the diagnosis. This is what's going on. And

Scott Benner 23:15
can I say something? You've motivated me? Hold on a second. Okay. Like we've ever done this before. I want everybody listening to picture 30 people that they know. And then tell yourself, like, go through them. And tell me how many of them are really, really bright people. And let's keep that in mind. While we're discussing how all the things you go to get your tires changed. You need new tires, and the person you're talking to you're thinking like, Oh, God, I'm like, I'm afraid to let them touch my car. Or, but But you know, there's a there's one person at the tire place like you've been there before you like, you know, there's one there that knows what they're doing. But where where is he and you're looking around and you don't see him? You're talking to this one instead? You're like, oh, no, no, no, no, they're definitely gonna mess my car up. Or when you're in a clothing store, and the person helping you seems to be staring at a wall or or you're in a hospital and someone says something to you like that. Like, yeah, I I think we all need to stop being so surprised by this. Yeah, that's all. And I'm not saying I'm brilliant. I'm not saying that. I'm not saying that. There are people out there. I just think there are there are levels of understanding people, people, you know, have different levels of of understanding. Have you ever noticed when you talk to somebody that you can't go sometimes more than like three thoughts deep before use them? Right.

Nancy 24:43
Yeah. And I tell a lot of people through the last 10 years with diabetes. Before that diagnosis, I help medical people and I apologize to anybody in the medical community that's listening. I used to hold them at a higher regard than I do. Now, I absolutely go into a medical situation, especially at an AR, or non endocrinology environment. I go into the environment with the assumption that everyone in there is ignorant of diabetes, and I'm the smartest person in the room with about diabetes. And you're not going to tell me what is right and wrong to do. I'm the boss of diabetes. Also my shut up and let me manage until

Scott Benner 25:28
someone proves otherwise, I'll give you exactly. Because so far

Nancy 25:31
99% of our experiences at a hospital or that type of environment that's not endocrine, they're ignorant. And I'm using that word not in a derogatory way in the uneducated. Oh,

Scott Benner 25:46
it's yeah, I want to say something. And I mean this like, sincerely. I know and love people who are not like, people who can think two or three steps into a problem. I'm not saying I'm not saying there's anything wrong with you, if that's how your mind works, or, like, I'm not saying you're better, if you can think six levels deep into a problem. I genuinely genuinely don't think that I think people are lovely, like, yes, you know, yeah, but there's a lot of jobs to fill. Yeah. And very often, they get filled by people who in an ideal situation wouldn't hold that job. And then you don't know who's who, because you're in the tire store. And your, your assumption is, well, everyone here must know about wheels and tires, right? But that's not always the case.

Nancy 26:36
Right? Yeah. Well, just like so whenever we got transferred to the larger hospital, and our pediatrician was still caring for us. One of the things another just so like, blew my mind. There pricking her finger, we were there for like six or seven days, staying in for obviously getting our blood sugar regulated, but they let us stay for education. kept us admitted to the hospital for that. And one nurse that was our nurse for the evening. When she'd come in to prick her finger to check her blood sugar. She'd put a bandaid on our finger, like stop putting a bandaid on her finger. Like she's gonna have band aids all over. Stop and she would keep putting the band aids on her finger like what do you do and I don't draw blood. You just pricked her finger. If she goes through life putting a bandaid on her fingertip Every time she's testing her blood sugar, we've been covered. I am not bashful. Again. I forgive any. Forgive my edit. Please apologize for my attitude. I have fired doctors and I have fired nurses. In the midst of medical care. I have told nurses to leave our room. I have told doctors that I do not trust their medical judgment and that I do not want to see them anymore. I have told nurses and doctors, I don't think you know how to care for this. I want someone higher than you. I want someone to call my endocrinologist call somebody else. Elena several years ago, broke her leg. And we had to have surgery for it. And in the ER that's all I kept panicking about like you're not even checking her blood sugar. And she didn't have a Dexcom at the time. So it had to be a fingerprint. I understand you're gonna take care of her broken leg. But what about what? The last time I checked it was when we're flying here in the car, and I checked her blood sugar to see where she was. When she was in recovery, her primary care doctor called while they were given him the update and everything and they came to the door in the waiting room. They're like the doctor wants to talk to you on the phone. Okay, and I picked up the phone and he's I understand you're a little nervous about the diabetes care. I said I'm very nervous. I mean, nobody's even paying attention to it. He said how about I write in the records that you make all diabetes decisions and they can't do anything without your okay, I said that would be perfect. And that's what we did for that hospital stay.

Scott Benner 29:07
I want to say to this is not me being like a geography snob I've been in I don't want to say where because they're lovely people, but I've been in some more in a really prestigious medical institution. Where I'm pretty sure that if I would have listened to those people, Arden would have been lucky to have an ad one say yeah, and they are shiny and smart and have degrees from places you would be impressed by. And still that was it. Like I'm not saying it's because it's in Georgia and I know I joked earlier about the tree to people but I just really just looking for a title for the episode. And and but but uh, but seriously, like in any place in anytime and listen, you can go through I mean, you look at all the trouble we seem to have sometimes with policing Yeah. And yet I know police officers that are just salt of the earth, people who do a really great job all day long. And I know we get focused on the people who don't do a good job, right? More often than not, and there's reason for that, obviously, it's important. But if you can get into, and those are the positions, you said it earlier, right, like you held people in the medical field in very high regard, but really, for no reason. Just Chairman just like me. Exactly. But you just assumed well, they went to more schooling than I did. Yeah, they do a hard thing I don't understand. And so they must be smarter than me.

Nancy 30:33
But if you're just a general practitioner, if you're just a general, er, staff nurse, yeah, I mean, you can do trauma, and stuff like that. But I mean, when's the last time you counted carbs? When's the last time you did you know, a corrective factor for insulin? When's the last time I doctors I know that they're not super medical, but eye doctor years and years ago, she was getting her eyes checked. And he said how she checked her blood sugar today.

Scott Benner 31:03
That happens constantly to people.

Nancy 31:05
I'm like, Huh? Like, of course she did. Right? Well, what was her blood sugar when she checked it? I posted this and I think you mentioned it in another podcast, or I don't know if it was Jenny or somebody. Y'all are talking about my comment. I was like, which blood sugar testing? Do you want the one just before walked in here? The one on the way here? The one at launch? The one after her snag the one this morning was? I mean, she's on index calm? Yeah, yeah, we check her blood sugar. If we didn't, we might make a terrible decision. And she would die.

Scott Benner 31:36
Let me now I'm going to stick up for the other side. This is my favorite part about talking. I love taking all sides of ideas. You said something earlier? That completely explains why an eye doctor who's? Who's really just trying to say are you I see you have diabetes? I don't really know anything about it. I hope you're paying attention to it because diabetic retina, right? Like that's what's in their head. Right? Right. And why why is that something? So first of all, we can expect the eye doctor to understand type one diabetes, that will correct. And you went camping with two people who had diabetes? Who didn't even bring a meter with them. Yes, that's true. That's true. So you're now making have already previously made the point of the physicians who are just like saying things like, Hey, you check your blood sugar once in a while, right. And so you get put in this type one world, where it's, I'm being honest, if people manage if a person's managing their type two diabetes properly, they'd have as much knowledge of diabetes as you do as a person with tight like managing a time person, right? Where would that fall short? Is there a lot more people like your your family who like went into the woods, and it's like diabetes, not while I'm camping? And you don't have that luxury? Because, you know, she has type one, not type two.

Nancy 32:59
I will say that for my dad since a lightens diagnosis. And as he's gotten older, I think but I don't know, I'm gonna guess. And I have no idea if my parents will listen to this podcast. But I want to guess that having the experience of what we pay attention to. He's always been, I mean, a fairly healthy eater. He pays attention a little bit more to Well, what was my agency? And what can I do better? You know, before my next checkup, and he does monitors blood sugar a little more frequently than the camping trip era. So I don't know if it kind of opened his eyes to and we'll talk sometimes like even though they're different, but you know. So I think it's made him more aware of if he is more in tuned with his then possibly he'd have better results. I

Scott Benner 33:57
think that's completely common, right? Somebody just shows you the things like I don't think people are nobodies. Most people there we go. I don't believe I don't believe that most people are willfully ignorant of things. Right. I think that your you know, father's doing what he thought he was supposed to be doing. And type two doesn't kill you quickly. So it's hard to know why it would be important. I'm up, I'm alive. I'm doing my stuff. Like, I have type two diabetes, but I'm okay. Yeah. Nope. It's it's because I just don't think that people in general understand. Yeah, they're their bodies in many different ways, like so to tell them like the your blood sugar's higher. It's not good for you. So we want to keep it lower. Is not, it's not the full picture. The full picture is if you have diabetes, I don't care what kind it is. And you're not managing it in a way that your body can do. deal with, you will eventually die of something related to those high blood sugars. Right? It might, you know, it might say heart attack, it might say seizure, it might say stroke, it might say all kinds of things on your death certificate. But in general, it's going to be because the level of sugar in your blood was too high for too long. Right? You know, and just the same as you see, I mean, my favorite example is people smoke their whole lives. And they'll always be like, doesn't it's not getting me like, I don't know what they're talking about, I'm fine. And then eventually, they die of respiratory heart failure, which is directly from their, their smoking. But there's also people who won't get up and exercise who eventually will die of not doing that, and, or eating like foods, such a great example. You and I can go out now to a fast food restaurant, and eat it. Yeah. And eventually, that fast food will come out the other side of us. And we'll be like, Wow, we have completed the cycle. Everything is fine. But it's not really fine. Because you have slightly degraded the your body by doing that. Not enough to die in the moment, right? It's not poisoned, you don't like you don't eat the whatever you just bought, and you're just body just because it shuts off. But if you think of yourself as being at 100, the day you're born, you know, on day 3000 When you have a chicken nugget that was made in oil, that's probably not chicken, your number moves down a slightly little bit. But yeah, there's gonna be a full point, but you are taking away from your body's ability to stay alive. Yeah, right. And, and life is already trying to do that. So not a lot of reasons to help it is what I'm saying. That's all Yeah. And you know, I'm a hypocrite like everybody else. Yeah, we all Yeah, but I'm not. I'm not saying like, I'm not saying it to put paint out a picture that if you all would just be I just said, y'all, I've only been talking to you for talking to me a little bit. And I'm already I'm about to find a banjo. But, but but I'm not saying that saying like, you need to be perfect or you're going to die. I'm saying you need to understand the impacts of the things you're doing. Right. That's pretty much it. That's all and I think the disease of diabetes forces you to think about those persons. Yeah, it's your understanding.

Nancy 37:30
Yeah, just so. But then for type one, my, not my initial goal. I mean, I had some mentors reach out to me whenever Elena was diagnosed, and as I don't want to talk to anybody, but eventually I did connected with some other moms and support groups, local support groups and online support groups and things like that. And when I met Dr. Hutchins, she's the one that introduced me to the Juicebox Podcast and listen to that. But my goal for wherever I am, wherever Elena's participating has always been to be a voice and an advocate. Our school system has some great nurses, we have a great nurse coordinator. I've never been disappointed with Elena's care at school. I've never been scared or nervous. When she was diagnosed, we were in the middle of relocating. So we were relocating from Middle Georgia to South Georgia, where we live now is where I grew up. It's my hometown, were moving back here after I'd been gone for 20 years. But where I lived, we had been there for a while I knew the school nurse personally, I knew all the teachers, and I'm fixing to be thrown into a new school system that I know, no one sure I might bump into somebody I went to high school with to have a talk to him and 15 or 20 years, I was going into a panic, I was like I should homeschooler I'm not going to send her to school. I don't know these people. I did not do that she went to school. But my goal has always been to be an advocate and to be a voice for diabetes. Wherever we go, whether it's school, or extracurricular, or family or friends or wherever, because the more everyone knows that's around her, the better people are going to care for her. If something happens, the more that people know, the more educated I educate two or three people, you educate two or three people then they educate three or four people and so on and so forth. Maybe some of those stigmas and the the misunderstandings or just all of our type one kids can have a better quality of life, socially. If more people understand what this disease

Scott Benner 39:48
is, yeah, you're putting up those little signs around the world that when you see them you think why is this necessary, but at one point, it was I saw a sign once on a an overlook with like a little bit of water below it, and it just said, don't jump will cause that. And I was like, wow, they had to put a sign here to stop people from jumping off of this. Like who they weren't trying to kill themselves. They were like you could jump off this and live, right? It happened enough times that somebody in power was like, I have to educate people that they can't jump from here. And so when that when that needs to be done, like this is, I mean, you're doing a good thing. You're just out there. I think of it as like being Johnny Appleseed like you just you a little information behind, and hopefully a tree grows. And you know, you don't stay to watch the tree grow. You just go on, right. Yeah. Hopefully this happens.

Nancy 40:43
And I've been excited to watch a lineup grow into it, because when she was young, she didn't want people to see her prick her finger. She didn't want people to see her given her shots and stuff like that. And fast forward to the last several years. She's become her own voice, her own advocate. Now, she's not one that gets super butthurt over diabetes jokes. There's a few that she's like, Come on, guys, come on. But she's not too bashful that if a teacher or an adult around her says something. She's like, Come on, guys. You know, that's not true. Yeah, I didn't eat a lot of like, you know, I didn't do she'll correct them politely. So she's, and there's been a few times that her and the school nurse maybe didn't see eye to eye because I know school nurses manage it a little bit differently than we would at home. They're more cautious. I get that. But as she was finding her voice, and you know, if a nurse is like, Oh, you're 85, you need to correct she's like, correct. Why would I treat at 85 like that. That's a great number. I'm gonna, she's learned to have her voice. I'm super proud of her. She loves showing off her devices. Couple of years ago, she started modeling for a local former workshop. And she's purposefully tried to have her Potter Dexcom exposed when she's modeling, so that she's an advocate for other teams. And she's even said some adults that don't want to show their devices. She has a little Instagram that she posts every once in a while. She's not like the super influence or anything but everyone smile Omni pod has. She just did what we taste as a media blitz for her die aversary With Omni pod, and she was interviewed by a local TV station and several newspapers and articles about her. So she's much more outspoken and willing to somebody comes up to her and says, What's that on your arm? She's like, Oh, well, let me tell you about it, and blah, blah.

Scott Benner 42:48
Can I tell you what Arne just shared with me while she was meeting, so all of her girlfriends are home, right? But they all went to different colleges. Obviously, they're back now for the summer. And she was in this scenario, like on a big video call with a bunch of friends from one of her. One of her friends colleges. And they all sort of know each other because they talk about each other. And you know, they don't really and Arden's like talking, she's on camera, bunch of this big group. And someone says, not with any sense of irony, they weren't joking. And they weren't being cruel. Like they just they they said the thing out loud that they thought, You know what I mean? Yes, all her pod on her arm and said, Hey, what's that on your arm? Is that for autism? Well, I've never heard that one. And Arden goes wide. Any and I didn't know that you could wear a pod for autism? I don't think you can is the point. I mean, I'm not a I'm not a what you would call like, an absolute person who knows everything about autism, but I'm gonna just go out on a limb and say, yeah, the kid was probably that pretty wrong. Right? Yeah. And, but Arden didn't like she goes, No, she's like, I have diabetes. And this is where I get my insulin from. Right. And then all the other kids kind of made fun of the kid like, What are you talking about? You know, but But honestly, honest statement. That back, Carolina's been asked if it was a nicotine patch. That even makes a little sense. Yeah.

Nancy 44:20
Was it a birth control? Patch? Interesting. Sometimes little kids, you know, and she says it's difficult with younger kids, because you know, how detailed do you get? How vague, are you? She teases sometimes that she's a robot, and that's part of the parts of her robot. And she has we're Apple people. So with the Omnipod five, we have to have the separate controller. And people ask why she has two phones and she's she has all these scenarios. She's like, Oh, I'm a spy. And that's my contact phone. That's how they contact me or Oh, that's my business line. That's how so she has fun with it sometimes. So I'm glad that she's here. From the beginning, from diagnosis, we've always respected the disease. But we have never ever made it a big scary monster to her.

Scott Benner 45:10
Yeah, Arden didn't make a big deal out of it, she explained. And then they moved on. And she didn't break the kids balls over. Right?

Nancy 45:17
Yeah. And that's sort of Halloween, he handles it. And she can have fun with it and not be totally offended and a guest that, you know, yeah. So I'm glad that she's old enough now and embraces that and understands. Just like, I know, there's a ton of memes out there that say this. But the day before Lennon was diagnosed, I didn't know either. So why should I assume that everybody else does? Yeah,

Scott Benner 45:43
it's a weird thing to put on somebody. There's, I say all the time. There's plenty of medical issues. I don't understand. I wouldn't, you know, and I wouldn't be mad at somebody for not understanding my life. Right? When it becomes like that feeling like you had with a broken leg like, well, your ignorance is going to cause me a real problem. That's when it the panic kind of sets in. Right. I need you to understand this right now.

Nancy 46:06
But I will, I will say that took care of her way we did fine, didn't manage well, they let me count carbs and calculate. You can ever think you found

Scott Benner 46:15
the guy who understood the wheels and the tires, and he got it all set up for you to pick through the shop a while till you found him I will just

Nancy 46:21
I just would want if a parent is listening, that if you're ever in a medical scenario, you know best how to care for your diabetic child, do not let the intimidation factor of someone with a degree tell you otherwise. You take care of your kid. But and if they're being if they object to that, ask for someone over them. Ask for a patient advocate ask, you know best how to care for your diabetic child, not them. Yeah,

Scott Benner 46:51
it's not rude to expect somebody No.

Nancy 46:53
You know, I mean, we would do it in other scenarios. Yeah. Well, 100% I mean, if you order your food, and it's wrong, what do we do? We we question and we say, This isn't what are ordered, or this seems a little undercooked or whatever. Why wouldn't we do the same thing for our children? Some people

Scott Benner 47:10
eat it? That's true. Yeah, that's so I heard you say something that surprised me a second ago. Cellphones made all the way to where you live. That's fantastic.

Nancy 47:20
We have running water and indoors. That's crazy.

Scott Benner 47:23
But speaking of technology is what I was going for. You is your daughter using Omni pod five?

Nancy 47:31
Yes. So we started Omni pod five. I'm gonna guess we've been on a little over

Scott Benner 47:36
a year. Okay. And how are you? I love it.

Nancy 47:40
I love it. Love it. We have to reset the controller with the replacement they sent us We haven't done that yet. We're doing that at the next pod change. But I want it. I heard something a podcast the other day. Our Basal to Bolus is right in that sweet spot of almost 5050 5050. So I don't want to start over from square one. Just I mean, nobody does. I don't want to put the old settings in there. It's been a year we stay in automated mode all the time. We don't use manual. Sure we're in limited sometimes during a warm up. But we're an automated all the time. And we have been from day one. So those bezel settings are way out of date. So Dr. Hutchins helped me calculate what we needed to put in for current Basal rates and everything. The first thing I saw right away was we weren't dealing with Lowe's as often. Excellent. It was very, very good. Right out of the box for Lowe's, and my time and range clarity report. Typically, there's nothing reporting. You know, it's like that less than 1% thing at the bottom and the low and very low. Typically, that's what our charts have been since we've been on Omnipod. Five. We're anywhere from I'm gonna guess ballpark 60 to 80% and range. Even at summer camp the other week, she was 75% on range at summer camp on on the pod. I've been happy with it. Did we have some highs at the beginning? Sure. While it learned her and from what I took from the community was correct every high. That's what we did when she was high and it wasn't doing very much I would have her put in the Dexcom and have it calculate and give a correction. I would tell you know, put in the CGM reading on the algorithm and we just did that over and over and over and it took us some days. I don't remember how long but

Scott Benner 49:48
we've been very pleased with it. Excellent. That's what

Nancy 49:50
we started with. It was ironic we had a checkup just before we started it, so I knew her I want see And so Dr. Hutchins and I were like oh this will be interesting because we're just We're starting it and then we have a checkup in three months. We'll see her Awan see when we started Omnipod. Five was a 5.9. We were on dash before that 5.9 went back for the three month checkup. 5.9. Wow. Fantastic. And then the last checkup it was 5.3. So I'm pleased, I'm not disappointed.

Scott Benner 50:21
Yeah, I don't see how you could be.

Nancy 50:23
I mean, we don't micromanage it. You know, there's her, her range is 80 to 180 on the decks calm to alert me. I learned that from the podcast, gives me time to react before and I could probably tighten that. But I just, I'm lazy, and I didn't. So if it's alerting me to at least pay attention to it, see what's going on. So we can catch that before it becomes a problem. If it's one at like, where are you going? Let's fix that before it gets really hot. And then we're chasing it all afternoon. I say we respect the disease, and we do but I'm pretty laid back about it, too. I mean, I don't I don't know. I don't feel like we micromanage it. Yeah, sometimes we ask her like, Did you Did you forget you have diabetes? Like just get from the dinner table? I just said like tonight? We don't have that. I mean, you know, we joke about it that. And I feel like with Omni pod font, I certainly do not think about it as much. And I don't feel like I get as many Dexcom alerts as I did. That's great.

Scott Benner 51:25
And our use house sleeping going better, worse. Same.

Nancy 51:29
Same for me. Unfortunately, I my body has gotten accustomed to the Dexcom alerts. And I've tried to change the sounds but my phone I don't know if it's because it's a dinosaur. I must sounds I can't get adjusted. I sleep through alerts.

Scott Benner 51:46
How does that make you feel when you wake up in the morning, you see that you slept through why?

Nancy 51:49
I'm angry and scared and frustrated myself. But I will say the other morning just a few days ago. And I think it was a compression load. But my husband handled it and so he didn't prick your finger. But I would be interested. I really think it was probably compression. Like I woke up and I see that it had been alerting that she was 40 I was like holy cow. Like I slipped through that well. But he gave her a juice it came. I said but I really think because she had been in range been in rain, she drops and then she comes right back. Probably, I think I don't know. But yeah, I feel like a terrible parent if I wake up and it's been alerting, alerting, alerting. However, she's 17 she's a senior, she is going to be going away to college in a year. She's learning to wake up herself. And there's been times that I've slept through. She's heard on she's gotten up. She's handled it go back to sleep. And excellent, fine.

Scott Benner 52:44
That's good. Well, I'll try not to beat yourself up. And yeah, yeah, I mean, when those new phones when the good speakers get to you, I'm sure you'll where they come through the Suez Canal. How does that work? I don't know. That part of the world.

Nancy 53:00
Savannah port, the international port in Savannah.

Scott Benner 53:03
Oh, you know, I get to watch those big boats come in through there. While we're visiting with Arden. It's amazing to see a container ship close up is ridiculous. Yes. How big it is. It's it's really something if you've never seen it. I mean, it's amazing one time it's not. I'm not gonna tell you it's like not like seeing a unicorn where you're like, oh my god every time this is amazing. But you know, just see it once you go out I think is huge. I don't how is that floating? That's crazy. And then how long does it take to get from wherever it came from? China to Georgia? Yeah, months, I'm assuming. Yeah, no, I don't know anything about that. Yeah, no idea. Okay, so we're doing by the way, first of all, I know what I'm gonna call the episode. What is that? It's nothing you said or that I said, but it's the vibe that the episodes gives me and a little bit about what we talked about the beginning. I'm going to call it campfire stories. Okay. Yeah, I feel like that's what we've been doing a little bit. Yeah. So I'm down with that. Is your daughter going away to college?

Nancy 54:13
What she's choosing to do right now, she'll be only about an hour from us and is actually in a town, my son and feature daughter in law will be living there. So she's not going to be terribly far from us, but enough to have separation, independence, I guess you could say. She doesn't want to go to a super big college. And right now she doesn't seem interested in going very far from home and not because she's scared of it. But she's still trying to decide what she wants to do to so that could change this year, her senior year that if she finally the light bulb goes off, and she says Aha, I mean, that could also change where she goes, but right now she'll probably be only about an hour away from us.

Scott Benner 55:00
Okay, but she'll be. She's not driving it. So she'll be living there. Right.

Nancy 55:04
Right. That's she would live when she teases my son. The duplex that they've gotten. They have an extra bedroom and she's like, this is my bedroom. I'm gonna live with y'all while I'm at college. I was like, I don't know if newlyweds would really enjoy that. But

Scott Benner 55:20
whatever. Yeah, I'm staying here where it's free. That's what I was. Yeah. So that's what

Nancy 55:25
they all joke about. But probably yes, dorm dorms. And I think everybody should get to experience living away and learning some independence. And yeah, I'm not there to wash your clothes and change your sheets. And it should a class and stuff like

Speaker 1 55:44
that been good for my kids. I can tell you. Yeah, I didn't do that. But I we were so honestly, I was so broke as a college. How do you pay for that? I just like I somebody once told me. Well, you get started like a local community college. And I was like, How can I afford to get to it? Right? Like you don't know what it's like to be broke. I can tell ya. I don't have $10.

Nancy 56:10
Last year, whenever my oldest, my oldest just graduated from college. So Elena takes college classes like dual enrollment. They have that through our high school. So she takes some college classes now during high school and gets college credits. My husband's getting his master's, my boys are in college. And I used to tease I'm the only person in my house. It's not taking college classes there for a while. Yeah, no care to go back.

Scott Benner 56:35
Please. Do you think there are people right now who are like, wait, I'm listening to a podcast about diabetes or somebody didn't go to college? You absolutely are. You're listening to a podcast run by somebody who barely got through high school. So

Nancy 56:46
hey, you know, life experiences sometimes or teachers? Books that we were just talking about the degrees don't matter. The degrees don't matter. It's your experience with taking care of something?

Scott Benner 57:01
Yeah. Okay. There's definitely some people are like, I'm not turning this back on. I'm gonna tell you right now. i When I graduated from high school, I sat there and I thought suckers definitely shouldn't have given me that diploma. That was ridiculous. I have I Nancy, do you listen to the podcast with any frequency?

Nancy 57:21
I do. I live at a small town. So my commutes are not very long whenever I drive to town. So sometimes when I listen to an episode, I have to then pause it and then listen to it again later. Oh,

Scott Benner 57:33
that there's that that's the proper way to handle that I listened to. So I don't get

Nancy 57:37
through them. Quick as quickly because I'm having to listen to him. But I will set up posted the other day. And I was listening to the snake oil episode. And when he talked about the coffee enema. Oh, I was rolling. I was driving down the road and laughing out loud because your commentary on that was hilarious. Yes, I listened to him. And I'm gonna

Scott Benner 58:01
break I'll tell you why. Like, because I'm not sure if I've ever told the story of the fact that I missed on purpose, to go to work 52 days of my senior year of high school. I didn't missed school. I was absent 52 days in my senior year of high school. Wow. So I used to go to the technical school alongside a regular high school, which was part of this high school scam. When I realized that you can't go to the way I got through high school I think of as a high school scam. Okay, but they used to have it set up where two weeks of the month, you went to a regular like books school. And then two weeks a month you went to a technical school, I didn't actually have any interest in learning a trade. I had an interest in only going to high school for a year and a half instead of three years like that was. So I just took up a trade in high school to get out of going to school. So you made a visit to the technical school like to try to decide what you want to do. I mean there I mean, literally, cosmetology right. Engine Repair, like there's a sheetmetal shop there was like this school did a lot of everything. And what I did is I walked around, I found the class with the prettiest girls, and then I decided that's what I was going to do, which I thought was a rock solid way to make that decision.

Nancy 59:21
So what was that? What was that? Well,

Scott Benner 59:24
I'm a hell of a baker now.

Nancy 59:27
That makes sense. With all your stories about your cooking and everything.

Scott Benner 59:30
I can make bread, you know, 100 pounds at a time. Like forget. Look at what skills that gave you even though I got a job in a bakery out of high school. I kept it for a week. I was like I'm not working overnight. This is ridiculous. And I quit. So but point is I'm old. So back back then. Computers. Were really just starting to be a thing. Yeah. And the internet really wasn't a thing. Right. So the computers at the height school didn't talk to the computers at the technical school. So I learned that you could, I found out that you could what the maximum days were that you could miss. And I missed that many days at each school. And they never reconciled and I graduated. Nice. Yeah, it was lovely. And but I would go to work like for all of you are thinking like, Oh, great. Well, Scott was smoking crack. Scott went to a sheetmetal shop and broke his ask for $5 an hour because he was poor. But but it was. I don't know. I just I didn't even go to high school, I think is what I'm trying to say. Yeah.

Nancy 1:00:37
But you learned to bake? Well,

Scott Benner 1:00:40
that is for you all,

Nancy 1:00:41
but I don't know. I mean, sometimes when you talk about I have a recollection in the podcast talk like hearing you talk about cooking, or maybe it's on the Facebook page or whatever, talking about meals and everything and all your meals always sound so. Great. See, well,

Scott Benner 1:00:57
I don't know when the war of 1812 was though. Well, I think it wasn't 1812. But I'm maybe I can't be 100%. Sure. And that's concerning. Gosh, you said something that made me want to say something else. And now I can't remember I had two thoughts in my head. Here's a little secret. My whiteboard is full. I had two thoughts. Normally, I would have jotted them both down then told you the first one. But I didn't. And so now I don't know what I wanted to say. It's okay. Don't worry. Okay. You've been delightful. I wondering if there's anything we haven't talked about that we should have?

Nancy 1:01:29
I don't think so. I think I enjoyed the conversation. And I feel like I got to share our story and brag about my daughter how awesome she is. And she's going to conquer the world and she's not afraid of going out there and taking it on herself. So excellent. I think I did okay, in that chapter.

Scott Benner 1:01:57
Okay, sounds like you did better than okay. Also, because we've been having such a good time. We've now all forgotten that each one of your children has an issue. And so two people in your family and that's a lot to deal with. It's usually I usually ask, are you okay, like, what do you do for yourself?

Nancy 1:02:12
Ah, not much. I have a favorite saying that. Just because I look like I carry it well, doesn't look just because I make it look easy. Doesn't mean that it always is. So check on your friends. There are days that are pretty tough. I mean, I've gotten phone calls when David was in college, that they that he had had a seizure and I had to whisk myself away there. You know, watching the Dexcom Elena's on a overnight trip with she's an FFA which is it used to be stand for Future Farmers of America. They don't they just call it FFA now, but she does horticulture and she learned welding and stuff this year. But she goes on field trips for competitions and everything overnight. My son, he's older sort of caring for himself with his Crohn's, but you know, headed to the ER, I'm having a flare. So, I do juggle quite a bit. And I probably do not care for myself quite as much as I care for others. And that's probably not a good thing. But yeah, my kids are the most important thing to me. And I have been blessed with a husband that allows me that I work very part time so that I can be very available for our children at any time that they need me.

Scott Benner 1:03:40
Well, I will share with you and and I'm sure you know this but I think there's probably a way that you could do some more for yourself and, and still instill hope your kids. Yeah, there is Yeah. Plus you painted a picture of some pretty independent children. So they're gonna get sick of you pretty soon anyway. Yeah,

Nancy 1:03:56
no, soon I'll have an empty nest. And then I can I did ask for a little small greenhouse for my birthday last year. And so my husband, a mother in law, and my sister in law got me this little small greenhouse. It's not really big a smaller than like an outdoor shed. But as I started that little hobby, growing some stuff I've always had, like little, like might do vegetables or something. But I started doing flowers because I thought Oh, how fun would it be to just go and cut up okay, in your yard and have fresh flowers. So I've told myself, I need to pick up some hobbies because when Elena leaves to go to college, there's not going to be anybody but the dog or my husband to take care of. And that's all I've done for 23 plus years with kids is so yeah, I need to find some hobbies to

Scott Benner 1:04:43
I know how you feel. Yeah, yeah, it's it's a stark moment. And when that happens, you'll it'll hit you right in the face. Like, oh, no, I'm only good at this. I don't need anything else.

Nancy 1:04:56
Yeah, somebody had asked me you know, if you take away wife, mother, you know your career. Who are you? And I was like, Oh, I don't know.

Scott Benner 1:05:09
I'm the lady who might want to grow flowers. Yeah, seems shaky. Who lives two hours from anything?

Nancy 1:05:17
Ya know?

Scott Benner 1:05:19
How leaving to get the seeds? Do

Nancy 1:05:22
you drop them with pigeon? The

Scott Benner 1:05:24
Oh, yeah, because the helicopters can carry. Yeah, yeah, what happened? Yeah. I have one last question. I'm gonna let you go. Sure. Why is there no diet drinks in the South? Why are there no diet drinks in the south? We have diet drinks. They're very hard to find once you get below North Carolina.

Nancy 1:05:46
Elena loves Diet Dr. Pepper that's her go to and if they don't have that, or there's some machines she's learned fast food that the mixture doesn't make it taste right. Not the freestyle but like they don't mix the soda and syrup. Right? She'll order a Diet Coke but we have

Scott Benner 1:06:03
all right drives feel like I can't find them. It feels like you people just want to drink sugar is what I'm saying. I'm in the wrong places then. Yeah. All right. Nancy, I really appreciate this. I also appreciate that your sound is so clear. I don't have to edit this episode. We did. Oh, wow. Verse. We didn't say anything ridiculous. That has to be cut out. Okay. And the sound is you just saved me two hours of my life by having all your wealth and bake some bread. I don't know how the hell you got them to deliver that thing to wherever you are. But I really appreciate it.

Nancy 1:06:40
My middle son's gaming headset and gaming microphone. I'm in his bedroom at his computer. Well

Scott Benner 1:06:45
thank him for me because I really do genuinely appreciate it. Hold on one second for me. Okay, okay.

A huge thanks to Nancy for this really terrific conversation. I really did enjoy it. And thanks to you guys, for listening. Don't forget to check out the private Facebook group Juicebox Podcast type one diabetes 40,000 members, conversations about everything happening right now type one type two doesn't matter. Kido full time karbi just salads. Doesn't matter. Everybody's invited Juicebox Podcast type one diabetes on Facebook. I want to thank you very much for listening. And remind you that when you click on the links for the advertisers, you are supporting the podcast and helping to keep it plentiful and free. tell somebody else about the show. If you're enjoying it, won't you? Hey guys, just jumping in to remind you that one of our sponsors better help is offering 10% off your first month of therapy when you use my link better help.com forward slash juice box that's better. H e l p.com. Forward slash juicebox BetterHelp is the world's largest therapy service. It is 100% online boasts over 25,000 licensed and experienced therapists and you can talk to them however you want text chat phone or on video. You can actually message your therapist at any time and schedule live sessions when it's convenient for you. Better help.com forward slash juice box save 10% On your first month.

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#942 Get DiabetesWise

Korey Hood, PHD has type 1 diabetes and is the founder of DiabetesWise.

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

Scott Benner 0:00
Hello friends, and welcome to episode 942 of the Juicebox Podcast.

Quarry hood has type one diabetes. He's also a professor and health psychologist at Stanford University. And today, the creator of diabetes wise is here to tell us more about it. While you're listening, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan, or becoming bold with insulin. If you'd like to save 10% On your first month of therapy, you can@betterhelp.com forward slash juicebox you can save 35% on your entire order at cozy earth.com with the offer code juice box at checkout and of course, ag one get yourself some delicious ag one at athletic greens.com forward slash juice box and when you use my link, you'll get five free travel packs and a year supply of vitamin D with your first order. After you're finished listening to Cory if you're interested, check out diabetes wise.org.

This episode of The Juicebox Podcast is sponsored by the contour next gen blood glucose meter. Learn more and get started today at contour next one.com forward slash juicebox. Actually just you can get more than started you can actually buy the contour and the strips right at that link and they may be cheaper in cash than you're used to paying for your current meter through insurance and the contour next gen is super accurate and offers Second Chance testing. today's podcast is also sponsored by Omni pod now Omni pod offers the Omni pod five if you're looking for an algorithm, or the Omni pod dash, if you want to go old school, either way, you're going to be to Bliss and carefree with the Omni pod Omni pod.com forward slash juicebox links in the show notes links at juicebox podcast.com To contour Omni pod and all the sponsors.

Korey Hood 2:27
Hi, I'm Corey hood. I'm professor at Stanford University psychologists. I'm also a person with diabetes. I'm glad to be here to chat with you a little bit about myself and diabetes wise and whatever wherever this

Scott Benner 2:41
leads are nice. Well, it's nice to meet you, Cory. You've type one.

Korey Hood 2:46
Yeah, I do have type one diabetes,

Scott Benner 2:48
how old were you when you were diagnosed?

Korey Hood 2:50
So I was diagnosed in 2000. So I was I was 26. So I'm going on, I'm on my 23rd year, I have kind of an interesting diagnosis story, which was that I had started working my my PhD. And when I when I came into the Ph. D program, I had to pick some program and I just happened is one of the only ones that was available is what was in diabetes. And so I was interested in psychology and health but not didn't really have much of an interest in diabetes, but started that work. And then within six months, I was diagnosed myself I had, you know, I had lost like 30 pounds and, you know, had all the classic symptoms. So, so yeah, it was an interesting experience, right, as you're starting that work, but

Speaker 1 3:43
it sounds like all the circumstances of your life are pushing you in that direction. Yeah, exactly. Exactly. What did you have your undergrad in? And what were you hoping to build on? But you know, I mean, when you when you set up that that PhD program, what's your goal?

Korey Hood 4:00
Yeah. You know, I was interested in I think I was just interested in psychology as an undergraduate. And that was what my degree was, and it was in Bachelor of Science in Psychology. And I was interested in, I don't think I had a specific area that I was really interested in, but I was just, I thought that it was really, it was fun to understand why people do the things that they do. And so to understand behavior and thoughts and then I think as I explored it a bit more, I thought more and more about health and how does the what is the psychology of health and so as I started work on my PhD, which is in clinical and health psychology, it was you know, it was really just what something at the intersection of health and, and disease or, you know, the psychology side of it. And then as I worked in the field, I think that my interests have also evolved into understanding how this technology play a role in this and how we think about health and the things that we can do and the benefits of it. Sometimes the drawbacks, and that's ultimately what has led us to work on diabetes wise and other programs where we're trying to understand the intersection of how someone thinks about health and themselves and technology and devices. And obviously, diabetes is a huge part of my life, personally and professionally.

Scott Benner 5:30
What do you find? I mean, you're, you're diagnosed as an adult, right? So what did you find to be the most difficult in the early going? And what is sticking with you? Later?

Korey Hood 5:43
Yeah, it's, I think that what was, even though I had worked in diabetes, I, you know, I think you feel a little bit like this is, you know, this is this is outside of me, this is not part of me. I get to go home in the evening and not, you know, check blood sugars, take insulin injections, do all those kind of things. So I think that getting used to how much work it is, was probably the hardest part, just thinking about it. And it'd be on your mind all the time. And then I think, as I've gone along in the 20 plus years, I think that there have been different times. But they've all they've always been driven a little bit by devices and technology, you know, in terms of, do I want to do this? isn't accurate enough? Am I getting burned out by using it? Everybody says this is the best thing ever isn't really the best thing ever. And so I think it took me a little while to I don't know, maybe find my comfort place with technology and devices and all that as we kind of moved along with the, with the diagnosis and then just having diabetes. Long term.

Scott Benner 6:56
I remember. Right off the bat, Arden was just diagnosed for a couple of days. And this is going back now. I mean, she was two and she was diagnosed, she's about to be 19. So it's 17 years ago. And I can as clear as day picture, the nurse coming in with this little meter that she said we were going to take home with us. And then she had a cart with this giant meter from the hospital. And she's like, look, I'm you know, I'm going to test her for her charts here. And she tested with the big meter from the hospital. And she goes, go ahead. Now you test here with this meter. And the numbers were so different than each other. And I don't mean within like 20% tolerances. I mean, like, it was shocking. And, and she's and I said, Well, I you know, I'd prefer like that meter. Why don't you let me have that one? Because that thing costs $10,000. You can't have that belongs to the hospital, you're going to use that when I said well, which ones right? And that was it. Like right there. It was like frozen. You know, I thought well, I don't understand like, how am I supposed to do this? If you know, yeah, it is an odd thing to say that. It doesn't matter. Like I don't know how that like it eventually it kind of just I don't I've never been able to put this into words. It just I mean, meter technology has obviously gotten better over the years. And Arden uses a much more accurate meter. But back then. I don't know. It just it was never an issue after I let go of it. But it was really difficult to let go of.

Korey Hood 8:21
Yeah, no. And I think one thing that that brings up, as I was thinking about, you know, we talked to a lot of people as we were in both research, and then that as we've created diabetes wise and other projects, but the one of the things that I think a lot of people that have been diagnosed longer than maybe 10 or 15 years, they talk a lot about this kind of feeling of just flying blind, like having no idea what their glucose might be, because they're getting either different readings or they're, they don't have access to one it's a it's when I've had that it's really kind of an unsettling experience when you're supposed to be doing something or someone tells you that you're supposed to do it a certain way, but you don't have the actual equipment to make those decisions.

Scott Benner 9:14
I just got done speaking with a 64 year old woman who's had diabetes for like 50 years. And it was interesting, she tried to pump and she had some issues with the set and so she got away from it. And even though her a one C was almost a full point lower on the pump than it was on MDI. She didn't live through a time when even the insulin and the way people thought about it and technology would allow you to make adjustments to your blood sugar after you ate or something like that. So she didn't see that as a as a concern. She She was well aware of that or a once he was lower that she was doing better. It was healthier. She said it was a little more work, but it wasn't enough to make her feel But I'll persevere with the pump or even check on another one. If maybe this insulin pumps not right for me, I'll try a different one. But she spoke about her Dexcom. Like it was just irreplaceable. Because it actually, it actually fixed a problem for her. That scared her horrible, horrible life. She wasn't scared of a six, seven, a one C, she thought that was terrific, even though the pump was giving her a six. But not being able to know she was low. That meant like the world tour. It was just interesting to me how she embraced one side of it, but didn't care so much about the other side, until I realized that this is just the perspective she grew up through, you know, anyway, it's interesting. So yeah, so diabetes wise, is what we're How does it start? Who is it? What is it trying to accomplish?

Korey Hood 10:52
Yeah. So we started, we started diabetes wise, about five years ago. And we, what we were realizing as we looked kind of the landscape of devices, and technologies was that there wasn't really a place you can go to that had, you know, everything, all the different devices, all the different technologies, what you had to do was you had to go to one device manufacturer website and compare it to the other device. You know, there wasn't really a place where you could do a lot of those comparisons, and get it some of the things you're talking about, which is what are some of the features that people are interested in? What are the what are the some people are interested in the actual specs of how accurate one is versus the other in terms of CGM. You know, which ones have to been which ones don't on the pump side. And so we realized we needed to create something that could could fill that void. And then we thought it was also important to do it in a way that, you know, wasn't branded or wasn't biased toward one or the other. And that's why we sought funding from the Helmsley Charitable Trust so that we could be you know, we certainly have a bias that devices and technologies work really well. But we don't have a, I don't have a bias toward which one I want you to use, I just want more people to gain access to it. And so and I think that that aligned with with their mission, and also, you know, obviously sitting at Stanford, you know, the the idea is to promote more awareness and education just through one of the missions of the university. And so, so we really tried to create something that could be as untethered to device manufacturers and technologies as we could but offer a, you know, a true, you know, unbiased view of what these different technologies have to offer.

Scott Benner 12:50
So did you do a an independent study of each device to give I mean, so basically, I don't want to dumb this down, because I'm on the website. That's obviously more than what I'm about to say. But it's an impartial review site for glucose monitors, pumps, meters, that kind of stuff.

Korey Hood 13:09
Yeah, absolutely. And, and I think that one of the things that, you know, I think that everybody's gotten used to this, or at least I have, I think many other people, you know, when you search for something on Amazon, and it says, What are other products, like the one that you're looking for? And so we wanted something that was able to, you know, for example, you could compare the Dexcom g7, to the Abbott libre three, you could compare it to Sensi on it, you could you can line those three up. And you could say, how are these? What are the what are the features? What are the priorities, what and then the part that we added, it gets to your question about the independent work on each one, we reviewed all of them, we don't give them a value, we actually decided to stay away from us giving them a review, you know, four out of five stars or whatever it might be, but we but what we wanted to do was really get to know each of those devices. And so we actually have a lot of people on our team that have diabetes themselves. We have, we've run focus groups, you know, studies to really get at what people say. And so one of the other parts of the website includes, you know, wisdom and stories and quotes from people about what their experiences have been. And not all of them are positive, you know, we're not, we don't try and sugarcoat it. So

Scott Benner 14:36
no, I mean, I always say what works for you is what's best. Yeah, I mean, that's just sort of simple. If you if you abhor tubing, then you're looking at an omni pod if you don't care about that then you know when I don't know the inset works better for you with handle them than right on if your insurance covers metrics, like you know, do what works is it's always been my my feeling But who who pays for this diabetes wise? Like you said you went to Helmsley. But is that the only funding it has?

Korey Hood 15:08
Yeah. So right now the so we've had funding from the Helmsley Charitable Trust was so since 2018, specifically on diabetes wise efforts. And then before that we had studied funding to do projects where, you know, we would interview, we have one project where we interviewed 1500 People with type one diabetes, about the reasons why they started and stopped CGM. What makes them go off? And it's to your point a little bit earlier about the 60s something, you know, that that you talked to, you know, we heard a lot from people that, you know, it's for worries and concerns about hyperglycemia or for other things. And then so, so we've had funding from them. So right now, all of the funding to support diabetes wise, and the the HCP side of it, diabetes wise Pro comes from the Helmsley Charitable Trust, we sit at Stanford. And so, you know, Stanford helps us have an ability to have different computing programs and things like that, but Helmsley is the one who supports it.

Scott Benner 16:18
So for a regular user, they can use the website for free, but there's a pro side is that is that? Is there a fee for doctors to use that?

Korey Hood 16:27
No, both both sites are free. So diabetes, ys.org is for people with diabetes, but anybody can look at it. It's all free. There's no part that there is nothing that's unlocked by having a subscription or anything like that, we don't have that. And then on the pro dot diabetes, Whiteside org site, the HV HCP side, it has some some similar features in terms of being able to compare different devices look at a device library, but the pro site has a prescription tool where a provider but a personal diabetes could also do this, where they put in, what their plan is, what device they're looking for, where they live, and then it'll spit out whether or not you need prior authorization to get your device, and then it'll spit out. You know, who provides this? Because I mean, you know, from from doing this, I think he said 17 years, you know, there's, you probably had five different DME companies or pharmacies in the last like five weeks. So it's this kind of experience. So, so also trying to give people information about prior off, do you need it? If you do, where are you going to get it? And so we tried to make that as easy and as simple as possible to kind of simplify the prescription process. Well,

Scott Benner 17:55
while you were explaining that I checked to see if a Dexcom G seven was available. I mean, I know it is in New Jersey with my insurance, and it came right back with an answer. So let's go That's great. Yeah. That's wonderful. So there's the goal isn't the goal of this website's not to make an income, you're just providing the service? Why okay, why? Now I like you know what I mean? Like what is? Yeah, I'm not saying everybody's doing something for money. I'm not saying that I'm saying that like, when you sit down and say this, obviously you you thought of this as a need so I guess from your professional training, what did you think this was going to alleviate for people like what what? What thing did you see happening that you thought that needs to be righted?

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Korey Hood 22:47
That's a great question. I think, as I've thought about it, I, I think that the critical first part is that I think there were there's not enough awareness about what's available from devices and technologies. And so, you know, if you think about someone who's diagnosed right now, they may, they may have to do a lot of searching a lot of information to get to increase their awareness of what's available to them. So I think that the first part was to increase awareness of devices and technologies that they work and that they're available. The second part was to broaden access, because we know that, you know, if you in your search right there, if you would have put in a different type of insurance, or maybe you put in Medicaid or Medicare, it may come back as not being covered. And so then, you know, many times people in those situations will just stop and they'll say, you know, I don't know what I'm supposed to do, I can't access this. So we wanted to, you know, help people become more aware, help them gain access. And that may be you know, we have different kinds of programs, or not programs, but guides for them to seek approval, how to get, you know, pre certification, do all of those kinds of things that are that are a lot of work. So, and then and then the last part is that, to get people on technology and get them on devices, we think that that'll improve both quality of life and their health outcomes. And that's, you know, that's further down the road, things that we don't track as closely, but, you know, we're, we're interested in that, and I think they, you know, your your question about the the money side is, is a great one. I think that, you know, the reality is you couldn't sustain this without, you know, philanthropy, you can't, and you couldn't sustain this without some income and you can't maintain a, I don't know, an unbiased or unbranded view, if you start taking money from device manufacturers, or companies and so we have to find a way Our long term program, our long term ideas, we've got to make this sustainable in a way that we can still remain neutral. But we were gonna have to generate some income to support it in some way.

Scott Benner 25:09
Well, Cory, you should have came to me earlier, because what I do is I just say, Look, you can buy ads in the podcast, but if somebody says something crappy about your thing, I'm not sticking up for you. I just think it's, it's people's experiences i. So you know, it's funny. I relate to exactly what you're saying, you can have a thing that is so valuable to people. But that doesn't mean anything. You still have to make them aware of it, show them how to use it, make them understand why it's helpful for them. Like it really is. It's a difficult thing. Like I have Episodes Series within this podcast, I am completely comfortable telling you, Cory, you listen to those series, you're able to see is going to be a six with very little trouble. And I don't mean in the six. Yeah, I mean, a six. If you apply a couple of the other ideas, you can live in the fives with a little bit of technology, free podcast, like that's it like I, because I take ads, because I got into the same spot you were at, I was like, I'm gonna have this thing. And it turns out, if you turn to people and say, Hey, I could save your life for $5 a month, they'll go no, thank you, and you don't like it. And you know, and that's just the thing you can't get past. I, I tried to make the podcast for a little while without ads. And then my wife was like, You better get a job. And I was like, Okay, so. So we took some ads. And what I find is that I just stay focused on in my mind, my job is helping people. That's all I see my job as, and I take advertising money for people. So I can do that. And I also find that the honesty, which is why I like this idea. I think the honesty fixes everything, because nothing's perfect. And in fairness, I don't see any device manufacturers running around saying our thing is perfect. And your thing is, and I think it's pretty obvious once it's in your hands, everything has limitations one way or the other, right? It's what's best for you. And I actually think from a marketing perspective, that's the best thing that the companies could say, is that you should try our thing. And hopefully it's right for you. That I mean, to me, that's that's how you sell this stuff like it's a TiVo. You put it in their house, and then they'll love it, or they'll hate it, and they'll keep it or they won't, and you move on to the next person. Is this terrific that you're doing this? Really, it's, I guess, then the next leap? Right? It's probably what you're here is how do you how do you make people aware of it? That's absolutely difficult. Yeah.

Korey Hood 27:39
And I think that, you know, I, I appreciate everything that you mentioned there. And I also think these are the things that I think we're, we're thinking about as we try and grow this and reach I think that one of the biggest efforts we've tried to make in the last probably six months is making more diabetes care professionals aware of the site, because we think there's a lot of value with the prescription tool, we think there's a lot of value with, you know, the comparison of the different features. And I mean, you think about I mean, we're not just thinking about the endocrinologist here, we're thinking about those in primary care, you know, the 60, something that only gets to see primary care, never sees the diabetes specialist, but, you know, how are they going to get become more aware of this. And so, I think that so some of those efforts include reaching out to specific clinics, making them more aware doing things like this. And, you know, it's, it's a great opportunity to be on here and talk about this, and, and, you know, just to continue to get the word out about it, but also, you were trying to exhibit at, we're planning at the American diabetes Association and a couple of weeks to have a booth and to talk about it. You know, they give nonprofits a little bit of a price discount, which is the only way that we can be there and exhibit but but but it's really the, you know, the idea you're right, making people more aware is really the the first part and I think that as we hopefully what we can do is we can we can increase access, because we think that there's a lot of people who, who can't access these or just aren't aware of them. So let's let's do that.

Scott Benner 29:25
And this is the pathway to, to that. I did a I mean, you're an actual researcher, but I did an informal poll, maybe a 50 question survey. I think I got 1100 listeners to the podcast to respond. Okay, which and I had a great I had a great person who has type one who was at Johns Hopkins, she was finishing up her MPH and she wanted to help the podcast and I said, you helped me like facilitate this poll, like make it as close to what you know, real researchers would do. We'd be impressed by. And what I learned is that overwhelmingly, the people that listen to this podcast are helped by this podcast, sometimes three or four to one over their doctor, and like six to one over other materials online or in print. And that is, was a real big lesson for me. You know, I just thought, like, wow, I thought I knew what the podcast did for people, I see the reviews, I have a bustling, like Facebook group, like, so I hear back from people constantly. But I thought, Alright, well, let's make it so that they're not, you know, their face isn't an avatar, maybe if they want to say something, you know, sideways to me like this will be a good place for them to do it. I couldn't, I couldn't get anybody to say anything different. It was it was just, it was fascinating. And so when I think about my job, I think my job and your job are very similar. I've been doing this for nine years. And when people asked me what I want the goal, what is the long term goal of this, I always think I want for one day, somebody goes to their doctor's office, and actually gets the right information immediately. And because you can't count on your doctor, right? Like they're not with you all the time, they can't, they can't be in your pocket, but they can put you in the right direction. And I am really, I'm really sure that by trying to sometimes save people's feelings or not overload them, you can send them down the wrong path, then they can have a bad outcome. And then they can come to believe that that outcome is there, is there a lot in life, and then they don't look up again. And then they just live like that. And they go, they go down? You know, I mean, you have no idea how many people come on here and talk about their 11 a one sees for 10 years of their life. And then I somewhat fixed it. I was in Costco one day, and a lady saw my pump and told me about your podcast. And now my one sees a six. And, and I think about technology the same way. So many people, especially kind of old school type ones, especially their expectations aren't the same. And so when they're presented with these ideas, so like now, this is good enough, I'm fine. But with pumps, like, I mean, I know you don't use like, but I mean, any of the algorithms on the pod five control IQ, this eyelet thing it's about to come out, right? I mean, I think I like shooting for like a seven a one C I'm not sure I'm about to interview him this week, right? But so don't hold me to that right now. But if I slap a pump on someone with an 11, a, one C, and they can keep a seven? Well, you just changed their life. You know, absolutely, you know, and so but then again, it becomes about awareness and access and and that feeling like I could do this. And and that's not something you get from your doctor, your doctor who by the way, could be in practice for 25 years, and be giving you a certain pump, because 20 years ago, 20 years ago, like a pretty girl with broader bagels on Fridays, and was like holding up a pump, you know, like you don't know why you're being told what to do. And I wanted to ask you about that. Because if you're willing to talk about it, when you speak to doctors, do they really no. Where are they just doing what they do, too? Does that make sense?

Korey Hood 33:24
Yeah, no, it does make sense. And I and I, I think that I appreciate the the context to why you know, why we think about this, I think I guess I would leave no answer from both the personal and then more of like the diabetes, wives diabetes, why sigh? I think that, personally, I think what I what I have found myself doing is gravitating toward doctors that that No, and that are in the know. And so I've been fortunate to be in places where there are some really great, you know, endocrinologist or diabetologists, who I can access. And so, and there have been several that, you know, you you push to the side, because there may be not as it's not even about being aggressive, but just being you know, I guess listening to me, and doing what I think might be helpful or are going to, but I think I'm in a really unique and privileged position to be able to do that because of the because of where I've worked and people that I've gotten to know. So I think that what I would love is for people to feel like that. You know that to have that personal connection to a provider where they can tell them things and the provider is going to have their back or they're going to do that and I think that they're out there, but those are also the ones that you'll have a waiting list of a year long because they know that they're really great. So I think that you so that's a little bit about Part of it. And then I think the other thing that it reminded me, when you were you were mentioning that was that on diabetes wise, we have a section called wisdom. And it's really these stories that people have. And some of them are quotes, some of them are videos, you can watch about their experiences. And a lot of times, it's about their experiences with devices. But the amount that people feel empowered, when they, when they take over some part of management, and maybe that's through device and being able to see the numbers make a decision about device, you know, when they feel empowered about it, it really changes I think, their, their approach to management, and that I think that you were talking about, you know, the example of the person that has that interaction in Costco and then goes from an 11 to seven, a one C, I mean, it's because they've been empowered, and, you know, in your podcasts, empower them. What we're hoping is what diabetes wise, we empower them in a way. And the last thing I'll say real quick about that, is that, you know, there's some, there's some really good, some really interesting research on the way that people view, patience, you know, view different kinds of providers, even though they don't always agree with them, or they still give them a lot of power. You give them a lot of I mean, they're, they're in there's so much reverence to the providers. And then, but the reality is that they listened to other people who are in the in the trenches are on the front line, in the same way they they listened to them in a different way. And I think it's often a more powerful way,

Scott Benner 36:46
those two things can conflict a lot, too. I've come to believe, yeah, doctors, teachers, police officers, we just believe, like, hands down, we're just like, okay, no matter what, like I was raised to say, yes, and the white coat doctrine, you went to more school than me, you must be smarter than I am, you know, like all that other stuff. And then you go out into the real world, and someone says, Have you tried Pre-Bolus thing, and they go, Oh, my doctor says not to do that. And then there are some people whose personalities allow them to just break free of that and try. But overwhelmingly, a lot of people are rule followers. And, and so they'll spend this, this breaks my heart, most specifically, they'll spend their time knowing that what they're doing is wrong, believing there's a better way, and not being able to act on it. And I think that psychological punishment is maybe one of the sadder things I've seen in diabetes, like to get up every day, to be scared to eat, to be scared to use your insulin to know there's something you should be doing. Not only do you know that there has to be something else here. But I was just talking to somebody and they're doing it. And then they can't take that step. I mean, I hope you're putting a lot of effort into getting this to doctors, like specifically, obviously, there are plenty of doctors that know what they're doing. We're not talking I mean, if they all did, then we wouldn't be talking about it. But I'm not even coming down on the ones who don't. I mean, honestly, like my daughter just crossed out of pediatric into adult endocrinology. And we were very lucky. You said the same thing. We were lucky that. I mean, we were able to find a head and shoulders above the rest physician, who, by the way, doesn't do type one anymore. But he's doing it for Arden, you know, and you know, my mom's still alive, man, because my neighbor's kid grew up to be a doctor who knew another doctor who set us up with an oncologist. When other people were saying, now your mom's too old will will let nature take its course. And that guy was like, Oh, you want me to help her? I'll help her. And that's a privilege right there just by knowing people. I think that most people are not going to come into that situation. So you really it is your job. You know, to circle back around, like, I don't ever think I finished my thought completely. I see my job as telling enough people in the moment how to help themselves. So that then they go to their doctors. And inevitably, the doctor is gonna say, How did you do this? And this, they will say, I listened to the Juicebox Podcast. And then I had doctors come on i There's an endo. They came on the show a couple of years ago. And she said the podcast fundamentally changed how she helped people. That and so like, I think that's it. Like I think when I like when I lay down and die, you know, I'd like I'd like to think that I changed how doctors talk to people about their diabetes. On some level, like somewhere and this is how these things happen. Very, very small steps.

Korey Hood 39:49
Yeah, no, I absolutely agree with you. And I think that I mean, both on the the idea of the impact but one of the one of the you're pointing things out actually ties into what we thought about what diabetes wise was that the only way that there's an authenticity to it? Or is if you hear from other people with diabetes? You know, it's not, you know, I think that we can listen to a lot of different providers. And there's, there's great providers, like you said, and there, I think the ones who aren't as aware, it's usually because they, they don't have the time to it, you know, and they're, you know, they've got, they're seeing 40 patients in a day, and then it's trying to figure out a time to, like, learn something new. It's really tricky. So I think in on diabetes wise, we, we wanted within the wisdom section to insert that, but we also added to your point about, you know, kind of the guides and giving some people some, some, it's, it is advice. I mean, we're not, we're not reserved about offering advice. But we, you know, we offer guides for how to talk to your provider about getting on a device, you know, here's some things that you can say, that are going to be helpful. Here are some phrases you might want to use, this is the time to do it, you may even want to send a message through the patient portal. Before you go, because I want to talk about getting on a pump. I want to talk about starting on CGM, that, and then excuse me, and then also on the provider side, and we really think about what are, you know, what are some better ways to listen to, you know, what your, what the person with diabetes is coming to you about what are some, and if you want to prescribe, here's some, here's ways to do it. And if you get that first, you know, denial, don't give up, we've got to keep pushing through on these ways,

Scott Benner 41:50
I find it's helpful to give people expectations. So there's another thing I think, that I'm doing here is I somehow by the way, before Ted Lassa was popular, I saw part of my job is just like, I'm like the coach, like as you're running out on the field, it's a slap on the ass and like you can do it get out there. You know, like, there's part of that. There's also part about I bucked the system years ago, and you've been around a long time, Cory, so you're gonna know what I'm talking about. But there was a, there was a an edict in the diabetes community, people who created content that you didn't celebrate, because it made people feel better. And I don't like I don't think you should be running around in the endzone, like spiking the ball and, you know, flipping people off in the stance. But, but, but I do think is there, there's, there's a mistake that if you think of people as being above you, they're not above you, they're ahead of you. Like, like, it's not a it's not a score, it's a path. And so why would we not illuminate the people up ahead who have already traversed all the problems? Know the answers are having the success that you're hoping for? Why don't we shine a light on them as hope, like, so to me, you give people expectation that they deserve better, and hope that they can achieve more. And then you show them, look, here's how, here's how I did it. That's all I'm doing here, I just share what worked for my daughter. And you can cherry pick from it or copied it exactly, or ignore me, I like I don't care, I'm just doing my best to put it out there. And I do think that was the other thing that this space missed for a while was that a lot of the content was coming from people who were struggling, which then makes it feel like that's the whole world. And then the people who like figured it out, they kind of go away and go back to their life. And I said to my wife one time, I'm like, I'm gonna stay behind and, and like, try to be a beacon. You know, and that takes a little bit of, I don't know what that takes. I was gonna say chutzpah, but I don't know if people know that work that but but what I did was I looked at my daughter and I said, I have a system. I don't call it something. I haven't marketed it to anything. I didn't name it all. But I know if you do these things, you're a one season the fives. It just is I know it. I'm gonna stay behind and tell stories about it, where I'm at a maybe I'm just going to translate right into this thing. I'm worried for you, you've got this wonderful website. But the one thing I've learned, being around us for so long, again, going back to the beginning, is having good information doesn't make you definitely successful and help you reach people. The reason the podcast works is because there's great information mixed in with stories about like people being diagnosed on a heroin vendor. And so like, you know, like, that's the actual story on the podcast, like, you know, where people coming on and being like, so emotional and honest about themselves. And like, really, it's the long form that allows it to happen. And then I mean, not for nothing. I just got here first. So my my camera's been set up longer. And so that's where that's where the numbers. I mean, I don't know what you think about all day, but most of the day, I think about helping more people, like how do you reach more people? And I mean, I'm happy to have you on here and help about this, because this is just a wonderful idea. And I know how hard it is to put it in front of people.

Korey Hood 45:15
Yeah, and I think I think that there, there are a couple things that I thought about as you were mentioning that, one is that, you know, simply giving people education and information. I mean, we've done that, and we know not forever, but we still do it, which is, you know, it doesn't change outcomes, often, you know, what, you know, what, and what we tried to do with diabetes wise, and I'm thinking about a specific story of a guy on, on there named Dan who, who talked a lot about his journey in diabetes, trying some different devices, and then going off them. And then, you know, how, how it made him feel different times, how it made him frustrated, angry. And then to come back, you know, have to give it a couple of years and then come back to it. But then ultimately, what it what it unlocked for him was the ability to do some of the things that he really loves doing. And his specific example was motorcycles. And like being able to do things as a group with other friends that he wasn't able to do before. He had CGM, because he was so worried about going low and things like that. And so I think that the part that helps a lot, and I think that you do this in the podcast, and then what we try and do our diabetes wise as well is to walk people through the process to of when they run up against those barriers, or those challenges. What what do you try and do and then give examples of people who have problems solved to figure it out? And those are the ones that, like you said, are kind of out in the front leading. And, and I can do that a little bit. But if you hear that, from, you know, if you if you listen to stories and you know, ton of other people who did it in the same way, were you were you on the pro side, if you talk to you listen to some of the providers who have struggled over time giving prescriptions, but have found a way to do it. You know, it's I think that's a much more powerful story than anything you're gonna get in a relatively short visit with your provider. Yep.

Scott Benner 47:24
And bullet points are, are, they're useless? Like you, I've said before, like, there can be the secret to life and this episode, if it's not entertaining, you're not gonna get to it. If the sound is bad, Cory, people will shut it off. Like there are so many like, like, little speed bumps that derail people, and I understand why, you know, but it's just it's so dry. And you mentioned it earlier, it's already your whole life. Right? Like, you're living with it constantly, like, well, I'm going to spend my entertainment hours listening about diabetes like, yeah, to your mind. You don't I mean, but that's why when I first started doing this, I had someone come up to me and say, You can't do what you're doing. They said, You're Not You can't tell people how you manage your daughter. It's dangerous. And I said, I disagree. And I think back on that person all the time. And I wonder what would have happened, if I would have just like, let them scare me off, you know, and I said, No, I said, I don't agree with you. I said, I, I reject, honestly, the idea that all of our everyone's diabetes is that different. Your your variables are different, and your personal life is different, etc. But insulin works, the way it works. Hydration works, the way it works. Those things are consistent. And it's sorted to me like, I'm so old now. But it's the matrix. Right? Like, like, I know, when you stop and look at it, in the beginning, it looks like a guy in a black coat. But it turns out, it's ones and zeros. And you know, you can manipulate it. Is it hard? Not after you understand it, you know, it's never gonna be easy, you get better at it, you know, like, it's, there's a path through that. And you have someone's got to give you, I'm gonna ruin my own metaphor, because I forget which pill showed you the matrix. But But someone's got to give you that pill and say, Look, there's more here than what you're seeing. You know, I hate when people say, that's just diabetes. Because to me, that means you just don't understand how insulin works. Like, like, you wouldn't, you wouldn't say that, like diabetes isn't a thing that happens to you. It's a thing that happens that you more frequently don't understand. And understanding it gets you a lot farther and understanding that technology is going to take people a lot farther. I mean, this is this is really wonderful. I appreciate you doing this.

Korey Hood 49:49
And one thing I would add, add to that. I completely agree with that. That idea and I think that what also happens I think with devices and technologies which makes Diabetes, why is unique is that, you know, given our, my experiences personal and diabetes, but also as a psychologist and then a lot of people on our team, how many diabetes? I think that we better understand the the psychological connection to devices and technologies because here's the big one. And, you know, at the core of it, is this relatively straightforward. You know, like you said in The Matrix ones and zeros, I mean, there's a relatively straightforward approach to it. But then you add in all of these emotions, do you add in all of this extra junk that you bring into it or that others bring to it, and it makes it really complicated. And so I think that trying to get through a bit of that with some of the tools that we have on on the sites, I think can help people get through a little bit of that chunk in that baggage. Because if you can make it a bit clearer if you can manage it in a lot better way

Scott Benner 51:02
1,000,000%. It's, it's, listen, Cory, you'll, you were older when you were diagnosed, but I sent my daughter off as a freshman this year, she went 700 miles by car from my house, oh, live by herself. And she kept her agency in the low 60s, mid 60s by herself eating crappy food, it's great first time away. And her agency went up like a half a point from when she left. And I was like, I didn't, I was like, You're doing terrific. You know, like, it just it's and what does she have? She's got a CGM, she has a pump, she's isn't an algorithm. Those things are great. I see plenty of people use those that don't have a one sees like that, like, if you like people know, the food at colleges is horrendous. And a lot of calories and fried food. And you know, bolusing for it is, is a Herculean effort. But But what she really has is, like the things, the ideas that we talked about over the years and went over and, and that when something comes up, she doesn't pause and go, I don't know what to do. She goes, Oh, this is this thing. I do this. You know what I mean? Like, she's got knowledge. And it's, and it's available to her without having to wonder. And I just think that that's incredibly important. And I think that you could the doctors need that. Like when I walk into an office and I say, Hey, do you have a suggestion for an insulin pump? I don't want to hear about the one that you know, you like because the company's up the street from here, which happens in the Midwest a lot, you know, and, like, I don't want to hear which CGM like the commercial you saw. Like I saw the commercials too, like what do you know about them? And if you don't know, learn, and learn by talking to people, not by reading a pamphlet or looking for bullet points. Go find people who are listened to them and you have your patients right there, listen to them, and then figure it out yourself? It's not Do you think the model is I don't know, if I'm going to take you in an uncomfortable way. I often think that the model of one patient going to one doctor for a prescribed amount of time around diabetes is completely wrong. I think that every day 300 People ought to come into an auditorium and all the endocrinologist and the practices stand up front. And they should just talk to everybody, enough people ask questions that everyone's questions will get answered. And I see I see that being I know, there's HIPPA and stuff like that, but you could sign well, but I think that I

Korey Hood 53:34
think that I think you bring up right there at the end, you'll one of the biggest barriers to that is, you know, all of the kinds of regulatory things that make it hard. And there is a conflict between helping people and all of the the kind of roadblocks that we put up from a regulatory standpoint. And I think that, and I think that's partially partially why you've seen people move to some of the things like diabetes wise, and I mean, your podcasts, other sources, where you can you can get more of a Frank, you know, view a more authentic view. And, and I think that there's a lot of value in that. I do think that, I mean, I would love to be able to do more group visits and have people together and, you know, it's it's something that they've been trying to do for two decades. And it's been really tricky to get enough people to want to do these group visits because of some of those kinds of things with privacy and confidentiality and all of that. But the other thing that I think, and this is where I actually thought that you were going with it was thinking about, you know, providing care more remotely and more broadly. And people not having to come into clinics, people not having to come in two places. I think we're moving in In the direction where you're gonna have maybe a little bit more of a, an option to do things remotely and to have a little bit more of a menu of who you might want to see. And if that's the case, then we we need to help people become more informed about making those decisions and choices. And I think that, you know, we try and do that a diabetes wise and, you know, I think that we want people to feel empowered, feel like they can make these choices and decisions on their own, but they need the information, they need the knowledge, they need other people's stories to support, you know, they're pushing us to do this, you're making

Scott Benner 55:37
me think I should get back to something I was doing. I did during COVID A lot. We did these, like zooms. And if I'm, if I'm being honest, I came out of I was trying to prove something at first, I saw a very big diabetes organization, do an online zoom and 14 people are in it. I thought, Oh, is it hard to get people in these things? So then I did want to have to get like 250 people in it. And I was like, Ah, all right, that made me feel better. But then, but then I got in there. And I was like, What is this supposed to be? What's it going to do? What we turned it into was, I will sit here as long as I can and answer as many questions as you can, while everybody listens. But what I have that no one else has is that I get to say at the beginning, but nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise. And then And then, and I'm not telling you what to do. I'm giving you my opinion of your question. And I don't know, when I don't know how long it's gonna have to be before people in a position of power look up and see that they're being served. They're being supplanted by a guy in an extra room in his house, you know what I mean? Like, I'm reaching more people, and, and that, that's where it has to change, really, like, you have to give up that idea of the model, which is like, I'm smarter, I went to school, I know, even though any doctor you talk to will tell you that they like studied diabetes for 18 seconds while they were in med school, right? And you know, like so. But then they get out there with that idea of like, this is this is how it works. It doesn't work like that anymore. My podcast last week was in the top 10 on the US medicine list, with with shows that are run by Fortune 500 companies that have staffs of hundreds of people. And if that doesn't tell you that these people need accessible information that they can walk away and use acceptably, and they don't want to come to your office, and they don't trust you. And we're you're not doing it the way that you should be. If that's not clear at this point, then like, I don't know how, how much clearer to make it. You know, it gets Do you know that we don't just help people here with diabetes, we've taught people how to advocate for themselves with their iron issues, their thyroid issues, their mental health, we branched out, you know, in a world where people told me Don't mix diabetes together, not we help people with type two diabetes, like, you know, like it just, it's not a, all those old models are supposition that doesn't work in the real world anymore. Like this, this is this is how people get information now, like get on border or get left behind, and don't right away. And I'm not and I'm not calling anybody out, although I am thinking of somebody, don't get it in your head to start a podcast, and then make it the same boring stuff that they hear in the office like that, like, yes, the delivery systems, not the problem. The message is the problem. So anyway, yeah, I don't know how

Korey Hood 58:37
I think. No, no, I really appreciate all those comments. And I would also say I think it also ties a little bit back into what you said early on was, you know, thinking about what the value proposition is for people. And in thinking specifically about diabetes wise, I think that, you know, they have to feel like there's some value in it, that they're hearing some advice, or some suggestions or, but but it's also relevant to their life and their daily, the daily grind of diabetes. And I think the, you know, you can speak to that, and the the experience that people have to have, whether we're talking about people with diabetes, or the health care professionals, they have to view it as something that's valuable. It's something that's going to move it along. And I think that, you know, even we make the site free, and we make them accessible to everything. But that's not that's not value value is the feeling like I learned something new. I'm going to apply it to my life. This is how the other person did it. These are technologies that can move me along in my journey with diabetes. And I think that that's what we're trying Well, that's what we're trying to do and hopefully we're we're achieving, and we can keep moving on and along with diabetes wise.

Scott Benner 59:56
Well, bravo. Thank you. I appreciate you doing it. I have other questions that don't have anything to do with this. But I don't want to muddle the the conversation up. So maybe I'll just ask you, if we haven't talked about anything that we should have before I let you go.

Korey Hood 1:00:13
No, I, you know, I really appreciate this time. And I also think, you know, a couple reflecting back on our conversation, I think that I want to just emphasize that diabetes wise is free, that we're, we have a bias toward getting people on devices, but we don't care which ones they are, it's kind of like you said, it's got to fit your life, it's got to be the best one for you. And I think that we have some, some features and some tools on it that help you figure out what that is, what is going to be the best fit for your life. And so then I shouldn't, you know, also note, you know, we've great relationship with the homes we trust, and we really support them from both the funding but also just the, they're, they're allowing us to do the things that we want to do with this and make it accessible to people. So

Scott Benner 1:01:04
David's been on the show. Yeah,

Korey Hood 1:01:07
I listened, I listened to it back and listen to is, and I realized you're you're approaching, you're probably approaching 1000 episodes soon, right? Like, sometime this year, or next year, you'll put

Scott Benner 1:01:17
out delightful and a couple of months, I O in a couple of months. Okay. So Cory, the same thing is, when when I was imagining all this, usually I used to keep this stuff private, but I guess nobody's gonna, like try to do it. So I guess I can just say what I'm doing. Most podcasts come out once a week, some come out once a month, there are people I know a person who tells me that their podcast is in its ninth season. But it has, you know, 80 episodes, I put, I put out 80 episodes in two months. Because for me, it's content. And it's keeping you here, right like because I don't know how to put this. But it's social media, if people don't understand social media is like trying to keep a rock hot with a match. As long as you hold the match on it, the rock is hot, the minute you take the match away, the rock is cool. And before you know it, someone else will come along and heat up a different rock. And that's it like so it has to be informative. It has to be accessible, you have to meet people where they are, it has to be entertaining, it has to be valuable. And it has to be plentiful. Like you I can't just put out an episode once a week and hope everyone remembers to come back. You don't mean like because in the last seven days, Netflix put out three different shows. You know, Joe Rogan had somebody on that everybody wanted to hear about and they're all yelling and screaming, there's too much going on. So I don't think of this as a podcast, as much of it as they think of it as a community. And it's a community of people who you don't meet. But I have to think of one of the one of the people who was on the show a couple of years ago. So young girl and like her mid to late 20s. And, you know, she told me she was coming on and telling me how much the podcast helped her. And we had a long conversation. I think like 45 minutes into it. I said, like, how did the podcast help you? I was like literally sitting back getting ready for my kudos about how I taught her how to Bolus or something like that. She goes, No, I knew all that before. And I said, Oh, I don't understand how the podcast helped you. Then she goes, I don't either. But when I listen, I want to do better. And that was it. When she said that I thought, well, then I can't just put up one episode this week, because what if that's not for her, I'm going to put up four. She'll want one of them. You know what I mean? Like one of them will meet her need this week. And that's how I think of it now. Like I just I want you to have a ton of options just like with these devices. And maybe you're not going to want three of them. But you'll want one that'll keep you here listening to other people's stories. And you know, 35 minutes into a story you might hear like, Oh, is that how you Bolus for pizza? I didn't know that. You know, what's a fat rise? Like how fascinating it is at Cory? How many people are using insulin to control their diabetes, and not one doctor has ever told you that fat slows down your digestion? And that's why you spike later. No one ever says that. You know what they say? You should see a nutritionist. Great. Yeah, yeah, that'll help me. Thanks a lot. So give me something I can work with here. Anyway, you get me all upset now. Cory I can I get

Korey Hood 1:04:18
right as we're wrapping up, I

Scott Benner 1:04:19
go on and on. I'm like, I just I just it. It just all seems like common sense. And and I have to say something. It's an aesthetic decision on your website. I don't know who made the decision. But using sort of just line drawings of devices in Azure graphics instead of images. It's it's nice because it really doesn't feel like a marketing tool. And it's clearly not but I mean, it could get shiny if you started using the images. It's a nice, it's a nice, small decision. Aesthetically. It's wonderful. Well,

Korey Hood 1:04:51
I appreciate you saying I don't know just call out the cell recruitment and the team that helped me which was a design company in San Francis so that we worked with closely on this, and Sarah has type one diabetes, and we found surrounding ourselves with a lot of people with diabetes has helped a lot of really smart people, you know, has helped us figure out some of these things. So that was her decision.

Scott Benner 1:05:16
That's wonderful. You tell Sarah if she ever wants to make some free graphics for a podcast, I know somebody will take her up on it. Great, thanks very much.

I want to thank Corey for coming on the show and remind you that you can check out diabetes wise at diabetes ys.org. And let's thank Omni pod and the contour next gen blood glucose meter for sponsoring this episode of the podcast, Omni pod.com Ford slash juice box get that free test drive or learn more about Omni pod five and Omni pod Dash. And of course contour next one.com forward slash juicebox. read up about our meter. Get one for yourself. Buy it right there online. The whole shebang. It's a great website. They're both great websites, they explain everything, using my links help support the show. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast. If you're looking for community around your diabetes, check out Juicebox Podcast type one diabetes on Facebook. And that group is for everybody. I know what the title says But uh, your type one, your type two. You're welcome. I don't care how you eat. I don't care anything about what you do. Your business is your business. Come on in. Check out the group. Watch some of the conversations jump in and get involved or just sit back and try to learn from others. Juicebox Podcast type one diabetes. There's something in there for everyone.

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