#1446 Curious George

Summary

Juicebox Podcast: Type 1 Diabetes

Episode #1446: Curious George
Host: Scott Benner
Guest: Alicia (20 years old, living with Type 1 Diabetes for 12 years)
Date: February 27, 2025

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Episode Overview

This episode centers on Alicia, a 20-year-old navigating 12 years of type 1 diabetes largely independently, while contending with cultural misconceptions, family misunderstandings, and evolving self-responsibility. Scott and Alicia cover her diagnosis as a child, the challenges of growing up with minimal parental involvement, cultural pressures (notably around herbal remedies), burnout, emotional burden, care access, and her recent determination to assert control over her health. The conversation is marked by candid discussion of heavy issues (including depression and grief), practical strategies, and the importance of education, community, and persistently advocating for oneself in the health system.

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Key Discussion Points and Insights

1. Diagnosis and Cultural Influences (02:10–07:00)

• Family Response at Diagnosis:
  • Alicia was diagnosed at age 8; her family’s approach was heavily influenced by Hispanic cultural traditions of using herbal remedies.
  • Parents and relatives promoted cinnamon, moringa, and other herbal “cures” based on anecdotal and type 2 diabetes stories.
  • Language barriers and lack of accurate hospital translation compounded the confusion. Alicia became her own translator at 8.

“They would tell me, you know, take… it’s called moringa… that [it] cures diabetes… but their friends didn’t specify that they were type two.”
— Alicia, 02:33

2. Childhood Self-Management and Family Dynamics (04:09–07:00)

• Alicia was expected to self-manage her diabetes from a young age with minimal oversight—parents would prompt her to "go take your insulin" but seldom checked dosing.
• This led to episodes of overdosing insulin and subsequent unexplained lows.
• Eating out (often in Mexican restaurants) presented challenges, especially as her family underestimated carbohydrate contents and effects.

“My family’s from Mexico... Mexican food doesn’t have a lot of carbs. Realizing, like, now, I should’ve spoken up… I never got the chance to explain… maybe this is not a good choice for me.”
— Alicia, 04:38

3. Struggles with Herbal Remedies vs. Medical Necessity (06:32–11:36)

• The family’s belief in cinnamon and moringa persisted for years despite clear indications they didn’t replace insulin.
• Alicia gradually stopped the herbal regimen herself, recognizing its ineffectiveness but still shouldering the need for insulin alone.

“I just kind of stopped [herbal remedies] slowly on my own because… I still have to depend on insulin no matter what. These are not going to work.”
— Alicia, 07:06

4. Cultural and Generational Barriers (11:36–13:14)

• Persistent cultural ideas around “natural” remedies for diabetes are recognized as both confusing and dangerous when applied to type 1.
• The host and Alicia discuss stories from the wider Hispanic community reflecting a lack of knowledge—and even outright fear—of insulin.

“If you can find me one person… took cinnamon and moringa pills and it just went away magically, I would love to talk to them.”
— Scott, 11:36

5. Teenage Burnout, Crisis, and Turning Point (13:35–18:37)

• Puberty and teenage social pressures led Alicia to burnout, neglecting diabetes management (“wanted to be… normal”).
• She experienced a diabetic coma (DKA), which was misread by paramedics as ibuprofen overdose; hospital staff had to correct them, highlighting a lack of general awareness.
• This crisis spurred her mother’s increased involvement, but also highlighted boundary tensions between support and overbearing behavior.

“She [mom] became more involved… but there is a boundary.”
— Alicia, 17:32

6. Impact of Grief and Mental Health on Diabetes Control (19:45–22:32)

• Major family losses—her grandmother (mentor) and godfather (missing)—led to grief-related depression and further neglect of self-care.
• Alicia candidly discusses how her coping mechanism was “giving away the diabetes,” knowingly letting her management lapse (“I wanted to give up. Not like hurt myself… maybe if I just stop the insulin, that’ll fix it for me”).

“You had more to think about than you had space for.”
— Scott, 21:48

7. Self-Education and Support Systems: The Shift (22:42–32:29)

• Meeting her boyfriend marked a turning point; his genuine interest in her condition, willingness to ask questions, and advocacy in health appointments gave Alicia renewed motivation.
• She highlights how peer support (even just one person) changed her sense of agency.

“He’s a Curious George, definitely. He’s asked the doctors… ‘what can I do to prevent her from going high?’… He’s looking out for you.”
— Scott, 31:43

8. Healthcare Access, Insulin Resistance, and Systemic Barriers (33:04–47:19)

• Ongoing high A1C (spiking over 12), despite heavy doses of insulin (54 units of basal Lantus for ~170 lbs), leads to suspicion (confirmed by a new endocrinologist) of insulin resistance.
• Struggled with insurance as she transitioned to the Omnipod and later Beta Bionics iLet pump; issues with supply coverage, pump communication, and insurance denials prompted persistent advocacy.
• Insulin, CGM sensors, and potential GLP-1 agonists (Trulicity, Wegovy, Ozempic) were variedly denied or restricted by insurance—requiring knowledge of codes, persistence, and sometimes, relentless fighting.

“My A1C dropped from a 12 to a 9. That’s on the… the eyelet took you from a 12 to a 9.”
— Alicia, 36:41

9. Weight Gain, Nutrition, and Medication (38:15–55:35)

• Weight management became a major concern as Alicia recognized the link between high insulin doses, resistance, and weight gain.
• She and her boyfriend tried various diets, including low-carb, calorie tracking, and gym routines—with very little weight loss until GLP-1 medication was considered.
• Systemic health issues (thyroid, hypertension, family heart disease) complicate her management and drive a sense of urgency.

“The scale did not move to like, maybe three pounds, and that was about it… That’s when my new endo was like, yeah, you have insulin resistance. You need medication.”
— Alicia, 53:40

10. Navigating the Medical System: Advocacy and Assertiveness (59:13–66:46)

• Scott coaches Alicia to become her own advocate: request specific labs, assert her needs, phrase requests in ways more likely to convince doctors and insurance (emphasizing BMI, comorbid risks, etc.)
• He underscores the need for one “motivated doctor with three brain cells” to help her successfully access the tools and medications she needs, including re-check of her thyroid, trial of GLP-1s, retaining her CGM/sensor, and ongoing pump.

“Every day is dire. I need your help. I need you to help me save my life. That’s what I would say to her.”
— Scott, 65:03

11. Concluding Reflections and Community Support (64:42–67:22)

• Scott encourages Alicia to use available support systems (the Facebook group, social media), offers to help draft insurance letters, and stresses the power of persistence and community—noting that Alicia’s journey from an unrecognized, unsupported child to a young woman fiercely advocating for her health is itself heroic.

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Notable Quotes and Memorable Moments

• On cultural and familial misunderstanding:

  “I got in trouble for, like, technically being a diabetic without you guys knowing I was diabetic.”
  — Alicia, 25:55

• On grief and giving up:

  “I just wanted to kind of give up… maybe if I just stop the insulin, that'll fix it for me.”
  — Alicia, 21:08

• On finding support and motivation:

  “He was supporting me… He knows every sound of everything. He’s paying attention. He’s doing what you asked your dad to do.”
  — Scott and Alicia, 30:12–30:41

• On health system frustration:

  “Medicaid should definitely cover a CGM. I mean, there’s no way you shouldn’t be able to get your CGM… You just need one motivated physician with a pen and three brain cells.”
  — Scott, 45:56 & 47:03

• On self-advocacy:

  “Every day is dire. I need your help. I need you to help me save my life. That’s what I would say to her.”
  — Scott, 65:03

• On her progress:

  “Going from a 12 to a 9 is pretty awesome. Like short term it—that is fantastic for you.”
  — Scott, 50:50

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Timestamps for Key Segments

• Introduction of Alicia and Cultural Context: 02:00–07:00
• Childhood Self-Management Challenges: 04:09–07:00
• Herbal Remedies vs. Insulin: 06:32–11:36
• Teenage Burnout, DKA, and Mom’s Involvement: 13:35–18:37
• Impact of Grief & Depression: 19:45–22:32
• Support System Shift (Boyfriend): 22:42–32:29
• Transition to Insulin Pump and Insulin Resistance: 33:04–37:48
• Weight Management Struggles and Medication: 38:15–55:52
• Insurance Barriers and Healthcare Advocacy: 59:13–66:46
• Closing and Offers of Community Support: 66:46–67:22

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Takeaways

• Cultural context and family support: Navigating misunderstood, culturally-rooted ideas about diabetes can delay proper care—but doesn’t preclude change with education, support, and assertion.
• Transition from childhood to self-reliance: Early forced independence may breed resilience, but also risks dangerous mistakes and burnout.
• Emotional and mental health are intertwined with diabetes management. Grief, trauma, and social pressures can profoundly disrupt diabetes control.
• Patient advocacy is critical: Alicia’s story highlights the importance of learning, asking for help, and—when necessary—demanding appropriate care from medical and insurance systems.
• Community matters: The role of supportive partners, friends, and patient communities (like Juicebox’s Facebook group) is transformative.

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This summary captures Alicia’s journey of negotiating cultural expectations, grief, adulthood, and the health system with increasing self-agency—providing both a compelling personal narrative and highly practical insight for others living with type 1 diabetes.

Transcript

[A]

Welcome back, friends, to another episode of the Juice Box Podcast.

[B]

I'm alicia. I am 20. Been diabetic for about 12 years. It'll be 12 years in January.

[A]

Nothing you hear on the Juice Box Podcast should be considered advice, medical or otherwise. Always consult a physician before making any changes to your health care plan. When you place your first order for AG1 with my link, you'll get five free travel packs and a free year supply of vitamin D drink ag1.com juicebox don't forget. To save 40% off of your entire [e-mail] all you have to do is use the offer code juicebox at checkout. That's Juicebox at Checkout to save 40%@cozy earth.com I'd love it if you would go to T1D exchange.org juicebox and take the survey. When you complete that survey, your answers are used to move type 1 diabetes research of all kinds. So if you'd like to help with type 1 research but don't have time to go to a doctor or an investigation and you want to do something right there from your sofa, this is the way. T1D exchange.org juicebox it should not take you more than about 10 minutes. This episode of the Juice Box podcast is sponsored by the Contour Next Gen blood glucose meter. Learn more and get started today@contour next.com juicebox. The episode you're listening to is sponsored by us med usmed.com juicebox or call 888-72115. You can get your diabetes testing supplies the same way we do from U.S. med.

[B]

I'm Alicia. Been diabetic for about 12 years. It'll be 12 years in January.

[A]

How old are you?

[B]

I am 20.

[A]

Okay. All right.

[B]

I've kind of dealt with diabetes practically on my own because my family's more on the Hispanic side. They kind of are just trying to heal my diabetes with, like, cinnamon tricks and medicine tricks, like herbal stuff. And I would take it.

[A]

So, like cultural stuff.

[B]

Yeah. So like, they, they would tell me, you know, like, take, it's an herbal seed and it's called moringa. And they said that that cures diabetes and that it cured their friends diabetes. And most of their friends didn't specify that they were type two.

[A]

Right.

[B]

So, like, my dad was like, no, take this and take that. And I took it because as a kid, like, you know, they were mostly like, just trying to help me. So I, I understood where they were coming from until I hit the age of starting high school, actually, I Just kind of gave up on it. I really didn't take care of myself much. I was really frustrated. I want to be. I wanted to be the teenager with hormones. I wanted to be, you know, like, the, like, normal, like, without having to deal with diabetes. I wanted to eat a bag of chips with my friends because I would see them, you know, do it. Yeah, I was okay with it. And my mom didn't know half the time that I was doing it until I got. I had a cold. Usually started with, like, allergies and colds and headaches and stuff. And freshman year, right before freshman year.

[A]

Alicia, are you being attacked by a pack of hounds? What's going on?

[B]

It's my dog. He barks at everything in the background.

[A]

Oh, good. That'll be great for a podcast. That's good. Let me ask you a quick question before you keep going about this. I'm going back to, you know, you're diagnosed at 8, so you're pretty young. Obviously, you're alive still. So they gave you insulin, right? Yeah, but it was on you, though. They weren't really paying any attention to.

[B]

Was more of. They helped me with it until kind of like, they taught me to do it on my own. My mom would, like, send me to the bathroom, hey, go take your insulin. So I kind of, like, depend on myself to. Okay, they're sending me to do my insulin, but they're not really overseeing it, you know. Overseeing? Yeah, overseeing the units. So there was a time where I would take, like, a few more units and stuff, and then my sugar would drop, and my mom didn't know why.

[A]

Okay.

[B]

And then I would tell her, like, hey, I did take a few more units than expected because I, you know, we were with the family who was out of town or whatever, so we would eat. We'd eat, like, out often. My parents really didn't consider the eating out affected my blood sugar more because my. My family's from Mexico. So when eating out, we go to Mexican restaurants, and Mexican food doesn't have a lot of carbs. It has a lot of carbs. Realizing, like, now I'm like, I should have spoken up about it, because I never, like, got the chance to explain, like, hey, maybe this is not a good choice for me. Yeah, I shouldn't be eating, like, a. A big plate of this or a big plate of that.

[A]

Were you actually told that the food didn't have many carbs in it?

[B]

Not really. When I was diagnosed in the hospital, they didn't really give a really well explanation because my dad Is not really fluent in English.

[A]

Okay.

[B]

So to have a translator there, we really never had one. It was me trying to translate it.

[A]

And as an eight year old, for your parents.

[B]

Yeah. I barely even experienced.

[A]

As you're being diagnosed with diabetes, how long did they give you the cinnamon before they decided it wasn't going to work?

[B]

They had me on. My parents had me on cinnamon pills, did cinnamon tea for about a few years, actually. I was. My godmother was trying to influence my mom to give me cinnamon pills and all these, you know, vitamins and moringa pills and stuff.

[A]

And moringa pills. What is that?

[B]

It's like a seed, but they would make it into powder and put it in pills for people who didn't like chewing the seed.

[A]

Okay.

[B]

You had to chew it and it was a very bitter, bitter seed. My dad was like, oh, you know, take this and take that. And it was never really a cure. So it's just like, no, like, I still have it.

[A]

My question is, is if your parents give you a moringa pill, for example, which by the way, is made from the leaves of the moringa tree plant, Rich with nutrients, antioxidants and anti inflammatory compounds. It's often touted for its potential health benefits, including blood sugar regulation, anti inflammatory properties, high in antioxidants, lowers your cholesterol, rich in nutrients, and I think it's going to make you taller and prettier too. It seems like it does a lot of things. They're giving this to you. You still need insulin. Like, is there a moment where somebody comes to you and goes, hey, listen, the moringa pills are clearly not working, so we'll stop doing that now or like, you know what I mean?

[B]

So with me, I just kind of like I stopped them slowly on my own because I was like, these are just not, like, I still have to depend on insulin no matter what. These are not going to work. They would sometimes regulate my sugar at the same time. I was taking it before a meal, so I was taking my insulin as well. So sometimes it would bring it a little bit lower.

[A]

Yeah. I was gonna ask you, do you not buy much? Instead of spiking to 300, Scott, I would spike to 275. It was a miracle.

[B]

Yeah, like, like it was. It was not by Right.

[A]

By the way, I don't doubt that there are, you know, supplements that people take that they see value from in a lot of different ways. But that's not type 1 diabetes, you know, like, that's a different animal. You don't have type 1 diabetes and just take a big dose of zinc and it goes away. But my confusion here is like there's never once a moment where someone says to you, hey, I want to say out loud that the thing we told you to do is completely unnecessary. Clearly not working. You don't have to do that. You just were left to regulate it on your own. The Contour Next Gen Blood Glucose meter is sponsoring this episode of the Juice Box podcast, and it's entirely possible that it is less expensive in cash than you're paying right now for your meter through your insurance company. That's right. If you go to my link contour next.com juicebox, you're going to find links to Walmart, Amazon, Walgreens, CVS, Rite Aid, Kroger and Meijer. You could be paying more right now through your insurance for your test strips and meter than you would pay through MyLink for the contour Next Gen and Contour Next Test strips in cash. What am I saying? MyLink may be cheaper out of your pocket than you're paying right now, even with your insurance. And I don't know what meter you have right now. I can't say that. But what I can say for sure is that the Contour Next Gen meter is is accurate, it is reliable, and it is the meter that we've been using for years. Contour next.com/juicebox and if you already have a contour meter and you're buying test strips, doing so through the Juicebox podcast link will help to support the show. Diabetes comes with a lot of things to remember, so it's nice when someone takes something off of your plate. US Med has done that for us. When it's time for Ardyn's supplies to be refreshed, we get an email rolls up and in your inbox says, hi Arden, this is your friendly reorder email from usmed. You open up the email, it's a big button that says click here to reorder and you're done. Finally, somebody taking away a responsibility instead of adding one. Usmed has done that for us. An email arrives, we click on a link, and the next thing you know, your products are at the front door. That simple. Usmed.com juicebox or call 888-721-1514. I never have to wonder if Arden has enough supplies. I click on one link, I open up a box, I put this stuff in the drawer, and we're done. UsMed carries everything from insulin pumps and diabetes testing supplies to the latest CGMs like the Libre 3 and the Dexcom G7. They accept Medicare nationwide, over 800 private insurers. And all you have to do to get started is call 888-721-1514 or go to my link usmed.com juicebox using that number or my link helps to support the production of the Juice Box podcast.

[B]

Yeah, so my dad would kind of just like, keep on telling me, hey, you know, take this and take that. And my dad's stubborn. I'm stubborn. He would tell me, and I'm just like, it's not. It's not going to work. It's not going to go through. Sometimes there was times where he was like, hey, you know, like, maybe you should try this instead. And I'm like, I've explained so many times I have to depend on insulin for the rest of my life. I've talked to my doctors, I've told them, you know, the things you. You have me take. And even my mom was like, yeah, the doctor said, know that's just not going to work. And my dad's like, well, how does this person. I'm like, because that person probably has pre diabetes or type 2 diabetes to where they're able to reverse it, you know, like, for me, it's. It's not reversible.

[A]

Yeah. Also, if you can find me one person that told me that they had pre diabetes or type 2 diabetes, took cinnamon and moringa pills, and it just went away magically, I would love to talk to them.

[B]

Right. So, like, it was just. It was very confusing.

[A]

Yeah. Yeah. And you're. You're your little kid, too. Like, that's the thing that, like, throws me off. It's cultural to some point. Right. Because this is going to sound like I made this up, but years ago. I'm not making this up. By the way. Years ago, in a, like, a Walmart parking lot, I don't know how I met a person in a parking lot who, like, looked at me and, like, said, excuse me. And I said, excuse me. And then she was like, are you the guy from the. Like, she heard my voice and knew I was from a podcast, which was freaking weird. But, like, we started talking and then she started telling me how she's like, my son has diabetes, type 1 diabetes, and I have a real struggle. My mom doesn't want him to have insulin, and she started telling me this story about, like, you know, I keep fighting for him to have insulin, but my mom doesn't want him to have it. And my ex's parents don't Want him to have it. My ex doesn't want him to have it. And I'm like, I don't understand what you're telling me. And she said, oh, I think it's an Hispanic thing. And I was like, okay. Like, I didn't know. I mean, she was sharing her story with me in a parking lot, but that's what she said. She said everyone in my family, they were all Hispanic. She said, everyone in my family just believes that we can, like, just get rid of it some other way.

[B]

With herbs. With herbs or some type of seed. Yeah.

[A]

I can never. I'll never forget this girl because she was the only thing standing in between that kid dying and not dying. Like, because everyone around him didn't want him to have the. The insulin. Anyway. Okay, so this is your life. It's not. It's not going great. Are you managing with injections, pens, and insulin pump? How do you.

[B]

So I was managing with pens, and Because I wasn't, I just kind of, like, gave up. The hormones. Puberty, everything hit. I did fall into diabetic coma once, and the paramedics thought it was a overdose because I did take ibuprofen or a headache.

[A]

You thought you OD'd on ibuprofen?

[B]

Yeah.

[A]

I gotta get you away from the adults you're around.

[B]

They took. They took it as an overdose. They didn't give me Narcan because I was practically already in dka, so they were, you know, giving me cpr. My mom was freaking out. And once they arrived to the hospital, the nurses and the doctors gave the paramedics how. They gave them how. Like, no, tomorrow.

[A]

Yeah.

[B]

And we're yelling at them because they were like, no, this is not an overdose. This is diabetic coma. She is in diabetic coma. How do you guys, like, not see? Like, her body is in. In shock. Her body's trying to. Trying to wake up and not waking up. What are you guys not seeing?

[A]

They come into your home, your parents. The first thing they say isn't, she has type 1 diabetes.

[B]

Yeah. So that's what my mom said. My mom told them she is diabetic. She took some medicine for a headache. I just got back from the store because I went to go get her some tea. She wasn't feeling good.

[A]

But you had a headache because your blood sugar was 700 or whatever.

[B]

Yeah, yeah.

[A]

How do you get there? How did. Did you stop taking care of yourself?

[B]

I was. No. So I. When I was sick, I was trying to give insulin, and from my. With my Body, I've noticed is when I am sick, I cannot control my blood sugars. Trying to give insulin, and it wasn't going down, and I was sleeping more than half the time without alarms. Okay, so just kind of waking up, checking my blood sugar, seeing it was high, give insulin, go back to bed.

[A]

What kind of illness? Like. Like a flu or a head cold or. What did you have?

[B]

It was a cold that I had, and it was, from what my mom told me is it was like a cold that I guess went around the house because everybody was sick that week. So it was a strong cold. My body wasn't able to fight, I guess, because Covid, same thing happened to me. I didn't fall into DK because I called the ambulance myself, and I told them I'm type 1 diabetic. I can't control my blood sugars. Covid is really taking over my body at the moment. I need to go to the er. My family has Covid as well. So the whole house was in Covid. So ambulance came, and they saw my blood sugars were just going up. I wasn't even eating. I was trying to just control it, and I couldn't. So when I first fell into dk, it was a very traumatizing moment. That's when I kind of was like, okay, I need to get a hold of this. I need to take care of myself. My mom noticed that. She was like, okay, I need to start watching her. My dad's a very busy, busy person, so half the time he's not home. And we've had those arguments, like, maybe you should have stepped in. Because I tell him, like, I see so many families on the type 1 juice box group be so involved. I was like, you have to understand that herbs and. And seeds are not going to cure it.

[A]

Right?

[B]

What's going to help is you being involved. You checking on my blood sugars the way my mom was, because after that, she would wake up in the middle of the night because she heard my thing go off a few times, and she's like, hey, what's your blood sugar? Is it low? Is it high? Correct. If it needs to. She'd even open my phone because she's like, I know you're not going to check your phone. She's like, I know you're not going to wake up, so I'll check it for you. There was times where she even try to, okay, so we're gonna go here and eat. Take your insulin before we leave the house, because by the time we get there, you know You're. You'll be able to eat comfortably.

[A]

She was reminding you to do these things throughout your life.

[B]

Yeah. So throughout. I was. I was on pens because high school, she was constantly checking on me. She was constantly texting me and stuff. So she. She became more involved until I was like, okay. Because she would try to, like, over push it sometimes. I'm like, mom, there is a point. You know, there's a boundary of, like, okay, I got this. Like, I understand you're trying to make sure because I'm your daughter, and I know we had a very traumatizing situation and stuff, but there is a boundary.

[A]

Yeah. So let me make sure I understand the timeline correctly. You get sick, you go into dka. That freaks your mom out. She gets more involved.

[B]

Yeah.

[A]

Okay. Are you taking care of yourself at that point? Because earlier you said you kind of burned out during high school and stopped taking care of it. When was that?

[B]

So that was right before freshman year was DK High school. I was, like, trying to give insulin, but then enjoy all the snacks with my friends, and I'm, like, having to give insulin again. So, like, my sugars were kind of like a roller coaster. And my A1C was still high. It was at, I believe, a10.

[A]

Okay.

[B]

At the time.

[A]

Can I ask, did you go to doctor's appointments regularly? Did your parents go with you?

[B]

Yeah, so my mom would take me and go with me. She was kind of like my voice at the doctor's appointment.

[A]

Okay.

[B]

And it was very difficult to communicate with the, like, the doctor myself.

[A]

How come?

[B]

We would tell her, like, what I'd eat, We'd let her know what's going on with my life, stuff like that. So it was very not helpful. Yeah, it was because my mom would try to, like, communicate with her more than I would and stuff. And my doctor did kind of like, was like, oh, okay. You know, because my mom was involved, but, you know, she wasn't with me all the time. So, yeah, for me, like, sneaking little snacks here and there, not bolusing for.

[A]

Them, stuff like that.

[B]

Let me enjoy it.

[A]

What was your understanding of a 10, a 1C, and what was your mom's understanding of it?

[B]

My mom was like, okay, we need to work on it more. She was like, okay, give insulin this time. In this time. And this time. I've always had a difficulty with my A1C until about two years ago.

[A]

Okay.

[B]

My A1C skyrocketed really high because I had two losses in my family. So very important people.

[A]

Give me a second. Somebody. Somebody People passed away. And then. Tell me how that affects your A1C.

[B]

That affected me really, really difficult because it was two of the most important people who. Who were in my life. My grandmother who taught me how to cook and how to make meals and stuff like that. I didn't want to do anything. I kind of. And I was in my technically second senior year because I had to take another year to graduate. I fell behind. I kind of just slapped.

[A]

You think that you were depressed? Do you think that your blood sugars were just so all over the place and high that you were cloudy? Do you think there was a mix of that happening?

[B]

I think it was a mix for me. I didn't want to do nothing. And then two weeks after that, we found out that my godfather went missing. And in Mexico, it's. It's. It's a lot different. So in Mexico, when. When, you know, somebody went missing, you know, like, something happened to them. For me, it was. I was just, like, done. I was kind of like, did you.

[A]

Ever know you were sad? Did you ever think about hurting yourself during that time?

[B]

There was times where I just wanted to kind of give up. Not, like, hurt myself, but, like, because I knew I was diabetic, I was just like, okay, maybe if I just stop the insulin, that'll fix it for me. Yeah.

[A]

It wasn't like you just needed a break and you needed to give something away, so you gave away thinking about the diabetes to lessen your burden. It was more than that.

[B]

It was. Yeah, it was. It was more. It was. I just kind of wanted to give up on life.

[A]

Okay.

[B]

Not just like, life, just like, not worry about anything. My health. It was more Worry about my family. My family was hurting. I was hurting.

[A]

Right. So you had more to think about than you had space for.

[B]

Yeah.

[A]

Okay. And you kind of gave the diabetes away. Then you're like, okay, I'm not going to pay attention to this. This will be one less thing for me to do.

[B]

Yeah. And because my body was really kind. What my endo told me was my body was kind of already immune to a high a 1C. That my body was just kind of used to it. Kind of used to being high?

[A]

That's the wrong word. I hope he didn't say immune.

[B]

Well, not immune, but, like, just being used to it.

[A]

Yeah. Your body tries to adjust to the bad things happening to it so that you can feel better, but you know what it ends up doing is you feel normal when your body is in trouble. And so.

[B]

Exactly.

[A]

Yeah. Right. Okay. Just as long as the doctor didn't say, your body's immune to high blood sugars now, because I would just, like, I'm going to come take you away and, like, adopt you if that happened to you. Okay?

[B]

Right.

[A]

But two years ago, things changed for you. You started doing better. Like, what happened that shifted you?

[B]

So I did meet my boyfriend, and I was still kind of in the dark stage, and I was telling him, you know, I am diabetic. I haven't been taking care of myself. Not gonna lie to you. I was like, I'm gonna be completely honest, because I've seen diabetics pass away from not taking care of themselves. My auntie passed away from type 1 diabetes because she wasn't taking care of herself. She had a really high A1C her whole life. She passed away at the age of 40.

[A]

Oh, my gosh. This your mom's mom or your dad's mom?

[B]

It was my mom's cousin.

[A]

Why didn't they give her cinnamon, do you think?

[B]

My mom's side of the family is not really Hispanic. They're Philippine. My dad's side is the more Hispanic side. To where?

[A]

Okay.

[B]

They would tell us, like, take cinnamon.

[A]

I gotcha.

[B]

It came to the realization, though, my auntie did tell my dad, like, my son's diabetic. You know, I tried to tell him to take cinnamon, and it doesn't. It doesn't help. And my dad's like, oh, but, you know, it could help. And my auntie's older than him. Like, that's his older sister. And she was just like, no, just give up on it. Let her focus on insulin, and you focus on just supporting her because you're not helping.

[A]

Alicia, are you crying when you're talking about your life, or are you just.

[B]

It's just realizing that I didn't take care of myself. Kind of like a hit in the face, like I should have.

[A]

Oh, well, you know, though, like, listen, you're young, so you don't. Let me try to help you a little bit here. I don't know if you know the term. I'll give you a couple. You can tell me which one. You know, dumpster, fire show. Have you heard these things?

[B]

Yeah.

[A]

Yeah. Okay. I like to say you started out. You didn't start out in a hole. They went to the bottom of the hole, dug another hole, threw you down in the sub basement of the hole, then threw the dirt over top of you, then threw a lot of cinnamon on top of you, and then said, let's see if you can climb out of the hole. And then you got out from under all the dirt. You're like, oh, my God, I'm still in a hole. And they were like, yeah, let's see if you can get out of that. Now, listen, deference to your parents, that got, you know, if they didn't know, they didn't know. And cultural stuff can really, I mean, can really, really manipulate people. No one was helping you. And eight years old is too young to figure out how to take care of yourself with type 1 diabetes by yourself.

[B]

So, yeah, it was, you know, go ahead and take your insulin. And I'm like, okay. So, like, like, yeah, they did teach me how to poke myself with syringes and stuff and whatnot. But then I was like, okay, I'm still young. I'm still trying to adjust to it.

[A]

Sure. There's a lot more to it than that.

[B]

Yeah, definitely. Living in a Hispanic home, there's a lot of sayings, like, if you wet the bed as a kid, you know, like, something's just not okay or whatever. Well, I'd get in trouble for it. Realizing that they didn't know I was diabetic yet. I threw up in my grandpa's truck. We were in California. They didn't know I was diabetic yet. There was so many symptoms that they missed. We kind of, like, realized it now. Like, you guys missed that, you know, high blood sugar, you pee constantly. And because I was a little kid in a bed, wetting the bed was, like, something that happened and you guys didn't really realize it. I got in trouble for it.

[A]

Right.

[B]

Like, a really difficult situation because I kind of, like, make fun of my parents. Now I'm like, you know, I got in trouble for, like, technically being a diabetic without you guys knowing I was diabetic.

[A]

Are you mad at them?

[B]

No, it was just more of, like, paying attention would have really helped because I feel like I was type 1 diabetic before I got diagnosed and realizing, like, now I was just like, wow, I was type 1 diabetic for a while without them realizing it. I was wetting the bed, like, constantly. So it was, like, kind of confused about. Because I was like, why? Like, I'm trying to get up and wake up, and I can't. And then when I threw up, I was just like, why do I constantly feel sick? I was going to the bathroom often, and my mom was questioning it, but kind of just like. Like, she'd question it, but then just forget about it, if that makes sense.

[A]

Yeah, there's no follow Through.

[B]

Yeah, yeah.

[A]

Like you'd leave the appointment, she'd say, we have to do better. But then nothing actually happened after that. Right.

[B]

There was times like it'd be like a week or two or three weeks, like, okay, constantly take your insulin, take your insulin, take your insulin. And then just after a while, you know, just stops. She wouldn't put push as much and.

[A]

Stuff, but also just take your insulin. That's not actually valuable. It's just somebody bugging you to take.

[B]

Your insulin, take your medicine. Yeah, it's like telling somebody to take their medicine.

[A]

Like, did you know why you had to like, let's go back a little bit. Did you understand what the insulin was doing? Did you understand how it worked? Or was it just as simple as like, please count those, young kid.

[B]

I just knew that it was just going to help me, okay. I just knew that it was gonna help me live because the way that the doctors kind of explained it, like as an 8 year old, you think, huh, like, what, what do I have now?

[A]

Like, yeah, you understand it as a.

[B]

Child you're shocked, you're like, what is my body doing to me? You know, because you don't know your body at a young age. So for me it was like, what.

[A]

What'S your level of understanding right now of it? Like, and where did you get that understanding from? You meet the guy, it sounds like you felt guilty almost. You're like, look, you're going to, if you're going to like me, I should let you know I might die. That's what you did, right?

[B]

As a diabetic. Because I didn't really comprehend everything until I did more research until, because my auntie would even be like, oh, you know there's medicines on the black market. No, no, there's not. She, she tried so hard and I love her to this day because, you know, she, she does worry about my diabetes, but not in the same way as like, because she's like anti government type. So it was just more of like, I'm like, you don't understand. Like, I have to live with it. So when I explained to my boyfriend, I was like, it's something I have, it's something I have to take before I eat to help my pancreas live, do its work. Because my pancreas is not producing, so I have to take an insulin for it. He actually kind of like looked into it and he's like, okay. He goes, now I understand the difference. He goes, because I thought maybe it was because of eating. And I was like, no, that's type two. I'm like, type two is more of you kind of just screwed yourself over.

[A]

I mean, type 2 is insulin resistance of some kind. Right? So, yeah, listen, there are plenty of people who, you know, have type 2 diabetes that you'd look at, and they don't look like they eat an extra calorie all day long and they have type 2 diabetes.

[B]

Right.

[A]

It runs a spectrum of people who have it. It was just helpful enough because that's how he thought of it. Right? Like, what he thought was, if someone says they have diabetes, that means they ate too much food and now they need insulin.

[B]

Right. So that's what he kind of understood and was like, no. For me, I was diagnosed with it at a young age, and it can happen to anybody. I was like, and I have to make sure my portioning is proper and stuff like that. Because that's when I was kind of, like, looking into it more. He was. He was supporting me. He was asking me, hey, what's a normal blood sugar? What's a high blood sugar? What's a low blood sugar? So I know to this day, like, he even. He knows, like, the sounds. He knows every sound of everything.

[A]

He's paying attention. He's doing what you asked your dad to do.

[B]

Yeah. So he. He's like, okay, I know your blood sugar's high. He's. What is it at? Let me help you. He's like, go ahead and take your insulin. We'll go for a walk or make sure to drink plenty of water.

[A]

He's looking out for you.

[B]

He constantly was doing it, and I just. I felt like, okay, if he's going to help me, I need to help myself too.

[A]

Alicia, is it fair to say that you just felt alone and once you didn't feel alone anymore, it felt more doable?

[B]

Yeah. Okay, definitely.

[A]

Let me ask you a different question. You listen to the podcast, right?

[B]

Yes.

[A]

Okay. You know, Jenny, you listen to any of the pro tip stuff or any of that?

[B]

Yes.

[A]

Okay. In your mind, just make a scale in your head and put Jenny somewhere on the scale of understanding diabetes right now. If Jenny. Let's put Jenny at 100. Okay. And let's say the scale goes from zero to a hundred. Where are you on that scale? Where's your boyfriend on that scale?

[B]

So that's a.

[A]

That's a will make your dad 0. Your boyfriend 100. Where do you fit?

[B]

I put myself maybe at a 75.

[A]

Okay. By the way, people should know, Alicia, and you should know, too, that for reasons that I can't quite understand. I'm holding my hands apart, making a scale, even though no one can see me. Why am I doing that? All right, I'm gonna stop. I'm gonna stop doing that now. Okay. All right, so you're just. Why was I doing that? All right, you're at a 75. Where. Where do you put your boyfriend?

[B]

Like, right next to me, probably, like a 74.

[A]

So you and he kind of have a similar understanding of it at this point.

[B]

Yeah. So, okay, he's gone to doctor's appointments with me. He sat there, he's asked questions. He's a Curious George. He's a Curious George, definitely. Because he's asked the doctors, like, what can I do to prevent her from going high? Because stress has affected my blood sugars a lot. So he's like, what can I prevent her from? Like, trying to stress out or trying to freak out Because I don't want her to go to a high blood sugar because I'm a mean diabetic.

[A]

Because you're mean. When your blood sugar gets high, I am so mean. He's not Curious George. He's Scared George. Actually, I just want to say, Alicia, had you said Curious Jorge, we would have had a title for the episode. But no, it's okay.

[B]

That even works, too, because. Because he's. He's like. And when she's low, she is shaky and she feels lightheaded and stuff, and she feels like she's like a person I don't recognize.

[A]

You've been with this guy two years now, right?

[B]

Yeah.

[A]

Okay. In this last two years, you've gotten the eyelet, though. When did that happen?

[B]

So the eyelet happened about, I want to say, 10 months.

[A]

Okay, let me make sure I understand. A couple of years ago, you start dating someone, you think, I'm going to do better for myself. You go out, you try to learn more then, right? And you're at that point, your A1C is in the tens or greater.

[B]

So it spiked, and then it went down to about a 12.

[A]

Okay. It went over a 12, came back to a 12. You try to figure things out six months later. So 18 months ago, before the eyelet. Where's your A1C?

[B]

So before the eyelet, it was that 12.

[A]

Okay.

[B]

Because it was. We were trying to work with it with the. Just the insulin pen. And there was times where I was. Just. Because I was working in a very difficult area where they didn't understand my diabetes either. My job was very questionable. Like why I'd go to the bathroom to go get my insulin often because I worked in a kitchen for two and a half years. It was very. Why do you need to go constantly to the bathroom to go give your insulin? Well, because, you know, my body depends on it. My blood sugar is running high, so I have to make sure that it is controlled. They weren't so supportive of, like. Because I did the Omnipod for a little bit, they weren't supportive of it. They're like, why do you have that on? And why are you so. Like, you got a lot, like, customers about it? Because customers did ask. They were like, oh, what's that on your arm? How is that working for you? They were curious about everything. So I'd explain to them, like, in the simplest way, and they were just like, why do you have to explain to everybody what it is? And. And very difficult with me? So I was just like, you guys don't understand. My health is more important than this job.

[A]

Can I ask a question here? I know you're young still and everything, and it's. You got a crappy start with all this, and you're. You're getting it together, but how does a person forget you for a second? I can't wrap my head around having a 12A 1C. Like, were your settings wrong? Were you using not nearly enough basal insulin? Was your carb ratio way off? Like, how. How is that possible with mine?

[B]

They had my carb ratio one unit per five carbs.

[A]

Okay.

[B]

And I would give the insulin. So I'd give it about 15 minutes earlier than when I would have to eat. Sometimes it was, like, right before I would eat because we didn't have a lunch break half the time at work.

[A]

Okay.

[B]

I didn't know, like, the next time I was gonna pretty much eat, it would still spike after I gave my insulin.

[A]

How much basil were you taking then.

[B]

For, like, the lantus? It was 54 units. She had me at.

[A]

You were using 54? Alicia, if I ask your weight, are you comfortable with answering?

[B]

Yes. So I was at a weight of 1, 170.

[A]

Okay.

[B]

When I was doing the 54 units, and I gained quite a bit of weight trying to take care of myself, trying to get my A1C down. I tried to cut out, like, the carbs more and try to just, you know, like, limit my carbs because my sugar was still going high recently. About six months ago, I found out that I could be insulin resistant as well.

[A]

Well, yeah. Hey, Alicia, thank God I didn't have to bring this up because. Yeah, rough math on basal insulin at your Weight puts you somewhere between, like 31 and 39 units a day. And you're using way more than that and having an A1C in the 12s. And I mean. And you're A1 for five carb ratios. I mean, it's pretty heavy, you know what I mean? So, like, it's not like they were way off on that. So somebody finding. I mean, listen, does this story end with you getting a GLP medication? Because it feels like this is where this is going or. No.

[B]

Right now I'm on the pump. I've been on the pump for a little bit. My A1C dropped from A12 to A9.

[A]

That's on the. The eyelet took you from A12 to A9.

[B]

So what happened at first was the. They put me on the eyelet, which. It works great. It works wonders. I'm a full time college student. I'm a full time worker. So both of those were just like. Because I got a new endo and she completely changed everything for me. She's like, no, she's like, you're insulin resistant. She's like, for your insulin, you. You take insulin and you're still high.

[A]

Yeah, she was.

[B]

And they had you at a 54 unit. The one that's. That used to be my endo is now above her. And she's like, how do you let Alicia, you know, get to a high A1C like this? Because I have her at A9 right now. They. They kind of like did comparison. Like, I dropped her for a 1C because I put her on a pump and she's like, oh, I tried putting her on her pump, and I was like, you pushed me to do an omnipod, which obviously didn't work because I'd have to switch out the pump within a day and a half.

[A]

I was going to say you were using up too much insulin.

[B]

Yeah.

[A]

Did you say your mom's side is Peruvian?

[B]

No, they are Philippine.

[A]

Filipino. Okay. I mean, between that and Mexican, you can't be more than five three. Am I right?

[B]

Yeah, I am five foot. Exactly.

[A]

Yeah. It was good. Okay. All right. So, yeah, you didn't have, like, the height gene on your side is what I was getting at. So you're using that amount of insulin, you're having that outcome. Something about getting on the eyelet, changing your. Your settings is making a dent in it for you, but it is not. But you're also gaining weight, using more insulin, right?

[B]

So, yeah.

[A]

Is it fair to say that you. Are you taking in more calories a day? Than you need.

[B]

Like, as a young kid, I didn't focus on that and I just focused it on the car. Focused on the carbs and the sugars. Now me and my boyfriend are. We. We kind of like, realize this, like a year in, we're like, wow, like, the calories kind of do make it. Because he would eat out a lot.

[A]

Yeah.

[B]

Now he. Okay, maybe we should stay. And he was. I don't want your blood sugar going high. So we kind of noticed, like, it is a big difference because my boyfriend has gained weight as well.

[A]

Yeah.

[B]

He goes, it's because, you know, I'd eat out. And now that I'm, like, eating in with you and we're cooking healthier meals and sometimes we do, like, munch out on the weekends. We noticed the calorie difference and we noticed the weight because we both got told, like, you guys have gained so much weight. And it's like, well, he gained weight because of relationship. I gained weight because the insulin.

[A]

I'm making that boy happy, and that's why he's getting fat. Okay.

[B]

Yeah. It's a huge difference. So with the calories, we kind of just were like, we notice and we're like that, like, damn. Like this. This is a lot.

[A]

Are you excited to have figured out a thing that cult that. That maybe culturally, but definitely familially. You didn't know about. Right. Like, so.

[B]

Oh, yeah, definitely. It was like, I wish I could tell my parents. Like, hey, you. You guys know that y' all never really cured me, but, like, listen, I'm.

[A]

Not cured and you didn't teach me how to eat for dam. What did you guys do exactly? Also, I'm working full time while I'm in college. I don't feel like anybody's really covering my ass here. But no, seriously, Nick, now you have. You have a different idea of the world. Like, you have a different idea of, like, how to fuel yourself and, like, how many calories you. Listen, I'm going to tell you, like, I just looked online to get a window. If you're an active person at your height and weight, you need maybe 1800, 2000 calories a day. And if you don't do much exercise, you're more like 1400 or 1500 and. Oh, well, yeah, I mean, just track your calories for one day to get an idea of what's in what you're eating.

[B]

Right.

[A]

It could be startling. It could be a lot different than you think if you put yourself on some sort of a. I don't know, whatever. Like, you know, if you put yourself on some sort of a regimented system that got you around the caloric intake that you, that you needed, I don't know what you actually need. You'll find out. But when you dial it back to a number where you start going backwards with your weight, you'll know that you're in a bit of a caloric deficit. And then you know you're going to start losing weight for being in that deficit.

[B]

Yeah, yeah.

[A]

And then you will, like, listen, you will 100% use less insulin as you lose weight.

[B]

So I switched insurances currently and now they're not wanting to cover. So my, my endo put me on trulicity right now.

[A]

Okay.

[B]

To see how it affects my weight, it affects my blood sugars. Just like this week I found out that they don't want to cover it.

[A]

Oh, I started getting so excited. I was like, oh, this is good. We'll see how this goes. Like, yeah, so I want you on Ozempic or like, well, they'd give you Wegovy. If your insurance covers GLP medication, you will qualify for your weight.

[B]

Right.

[A]

You could go back to your doctor and say, hey, I'd like to take Zepbound or WeGovy based on my body mass index and can you please, like, don't even mention my diabetes. Just that that's what I want to see. And if your insurance covers it, you're.

[B]

Going to get it, right? So. Because I was looking into it and stuff and I noticed trulicity depends on your body weight. And it depends on. Because it said max weight you lose is 10 pounds. I was like, that's not much.

[A]

You're like, great, yeah, yeah, it's gonna.

[B]

Help me a little bit, but it's not gonna help me, right? Completely. Like, I need it to because right now, currently I'm over £200. Like the pump. She was like, oh, you know, just put in that you have to take a meal and it'll cover your insulin. And so when I was doing that, it, it would last me a day. And I was like, 160 something units is not gonna. That's just gonna make it worse for me. She was like, oh. You know, she said. Explained it as like a small reset on my eyelid. And I was like, it's not a small reset because it's gonna get used to giving me that 160 units a day.

[A]

She wants you to push more insulin so that the pump starts to try to use more insulin because she thinks that'll keep your blood sugar Down. I'm going to tell you, I. I wouldn't think about it that way. I would think about it.

[B]

Yeah.

[A]

Like food. I mean, I would wonder. Have you ever had your thyroid checked, too?

[B]

Yeah. So she checked my thyroid right away when she first became my endo. And my thyroids are abnormal just by a bit. And they put me on medication for.

[A]

They gave you, like, Synthroid?

[B]

Yeah.

[A]

Okay.

[B]

And then they were normalized. She said that everything was fine with my thyroid.

[A]

You stayed on it though, right? No, hold on. If the medication fixed, it doesn't give in. The medication away put it back again.

[B]

She put it as like 90 day supply and just until my next appointment, pretty much, because my. My appointments are every three months.

[A]

Okay.

[B]

And this was my. With my old endo.

[A]

This isn't the new doctor.

[B]

Yeah.

[A]

Okay.

[B]

The new endo checked my thyroid again and it looked normal.

[A]

Did you tell her that's because you just got done taking the medication for 90 days?

[B]

I told her. I was like, well, I was on a medication before it, but she had me stop it because I guess it was not needed anymore. She's like, well, your thyroid came back normal, which I don't understand, because thyroid runs in my family quite bad.

[A]

All right, Alicia, listen, here's what you need to do. Just scream and run in a different direction until you've gone as far as you can and start over again in another place. I don't know what to say.

[B]

I been back and forth with. Because this is the General Hospital in New Mexico. So it was very, very difficult because now that I'm on the Blue Cross, they don't want to cover my sensor.

[A]

They don't want to cover your cgm.

[B]

Yeah. So thank God I have, you know, test strips and a meter, but I'm.

[A]

Like, where's this insurance coming from? Who are you getting it through?

[B]

Blue Cross and Blue Shield?

[A]

Yeah, but why, like, through your job or through someone else's job or.

[B]

No, my mom has me under her Medicaid.

[A]

Okay, well, Medicaid should definitely cover a cgm.

[B]

So I was like, wait, what the.

[A]

I'm almost cursed. Hold on a second. Yeah, hold on a second. You gotta teach me. You gotta teach me some Spanish curse words so I can get away with them. Hold on a second here.

[B]

Because I was. I was with my boyfriend yesterday, and I was like, they're not covering. So I opened the mails like, they're not covering the Chula City anymore because I'm supposedly not type 2 diabetic. They stopped covering the Dexcom G6. And I was like, this is my thing to monitor my blood sugars constantly for a reason.

[A]

Because we're not giving that away. Because, by the way, your pump needs it.

[B]

Exactly. So I was just like, what? So I tried calling yesterday, and they're like, oh, I tried calling the pharmacist yesterday, and she's like, your insurance is not wanting to cover it, so we're trying to talk to your doctor to see why it's not being covered and stuff. And I was like, this is something that I need. This is not like my pump relies on my dexcom. Without my pump, I can't wear my pump, and then you guys can't fill my insulin. What's going to happen then?

[A]

Yeah, you can't say my pump is covered if the pump needs the CGM. If the pump's covered, then the CGM's covered. Like, boy. I'll tell you what. Thinking's not people strong suit. Okay, so here's what I've learned using the Internet a little bit. So Medicaid should cover CGMs. That shouldn't be an issue. Medicaid part B covers therapeutic CGMs like Dexcom G6 Freestyle Libre under specific conditions. Beneficiaries with type 1 or type 2 diabetes who have need for insulin dose daily and regular blood sugar testing requirements are often eligible. There's no way you shouldn't be able to get your CGM. And then Medicare Medicaid coverage for GLP medications for weight management, such as Ozempic and WeGovy, vary by state. I tried to figure out if New Mexico was covered. It says Medicaid offers limited coverage for GLP medications specifically for weight management. That's perfect. That's what you need. So. However, this coverage often has conditions, including prior authorization and verification of other weight loss efforts. Okay, well, we can get a doctor to say that there have been other weight loss efforts. Like, it should take one motivated physician with a pen and three brain cells, make sure that you have CGMs and a GLP medication.

[B]

Right?

[A]

Yeah.

[B]

So with that, I was. I was very like, you guys are joking, right? Because this is ridiculous. I've had my sensors covered. I've never had an issue. And we just switched to Blue Cross and Blue Shield because they said that they cover more.

[A]

I believe.

[B]

Noah, this is like F you to your face right now, because I've had this covered my whole life, so I shouldn't have an issue with it.

[A]

I just want to be clear. You can't afford this stuff in cash, right?

[B]

No.

[A]

Okay.

[B]

It Is I work at work at a Walmart. It is not.

[A]

And that's where I met that lady.

[B]

And it's in. And I'm in college, so paying for textbooks is already a struggle.

[A]

Yeah.

[B]

And paying for other stuff and to be driving to a far campus right now is. Is a struggle.

[A]

What are you studying?

[B]

I'm studying pharmacy tech.

[A]

Oh, okay.

[B]

So, like, realizing, like, everything, I'm like, okay, I'm not gonna, like, yell at the pharmacist because it's not their fault, but it's also, like, had this cup life. This should not be an issue.

[A]

Yeah. You need the doctor to come to your rescue here and to set this up for you properly.

[B]

Right. So I was just like. I was explaining, like, insulin by itself is so expensive. I've seen people struggle buying insulin here in New Mexico. The Dexcom alone is $300. Where am I going to pull $300 from?

[A]

Would your parents be helpful or no?

[B]

My mom told me, you know, for right now, if anything, depend on the test strips and the meter. She goes, but we should be fighting this. We shouldn't be having to pay for.

[A]

Something that it should be covered. It should be covered. Yeah.

[B]

We were so just irritated this morning because we're, like, ridiculous. And then to be on the phone and wait and wait for somebody to answer. I was already irritated. I was like, you guys are just messing with my mind. And then for my endo's office, it's more of, we have to leave a message and then they'll get back to us. I'm like, this is an emergency here.

[A]

Yeah, like, yeah, right.

[B]

I'm just asking a question. This is more of a. My health, at this point matters because what if they don't even want to cover my insulin?

[A]

Yeah. Because now you're worried that everything's going to go away. Alicia, listen, between you and I, your doctor's office should see your weight as an emergency. It should see your insulin uses as an emergency. It should see that the CGM not being covered as an emergency. They should not be putting you on trulicity. They should be trying. There are clear medications in the world that work great for this. Or I've lost £52 in the last year and a half.

[B]

Right.

[A]

I know people who have lost 85 pounds. I know people who have lost 70 pounds. I know people have lost 100 pounds. Like, there's a world where if you could get on this. This medication, it would. Listen, it's going to slow down your hunger, like, probably significantly, which is going to curb Your, it's going to curb your appetite. It's going to. You're going to take in fewer calories, you take in fewer calories, you're going to lose weight, you take in fewer calories, you're going to take in fewer carbs, you're going to need less insulin. As you lose weight, you'll need less and less insulin. You keep it, you know, the eyelet, you know, hopefully can kind of keep up with that, you know, that adjustment as you lose weight. And there's just no reason why literally six months from now you couldn't be, my God, you probably could be 40 pounds lighter six months from now and on your way to doing something using a lot less insulin, your A1C would probably be down into the. You know, we would imagine that the sevens at that point and you could be in a completely different situation.

[B]

I been dreaming of like, yeah. Since I feel like I really want to get to a seven. I seen so many diabetics happy. More of like a, an excitement for me. It's just like, okay, I'm at a nine, I still gotta go down.

[A]

Yeah. Well, I want to say this, going from a 12 to a 9 is pretty awesome. Like short term it. That is fantastic for you.

[B]

I cried. I cried like a little girl because I was like, finally, like I begged for this. Pretty much, I've, I fought for it. So like for me, like, even my boyfriend was like, oh my gosh, like, holy crap. Like you, you did it yourself.

[A]

Did you ever try like a low carb lifestyle?

[B]

Yes. I went on pretty much the kind of like veggie light protein type diet. So it was consist of like broccoli, carrots, small amount of carrots. Because I realized I was like, oh my gosh, like these even have carbs. Like, this is ridiculous. Celery, Brussels sprouts, stuff like that.

[A]

What about protein? Like animal meat proteins like chicken. Yeah. Beef, fish.

[B]

We're not too much on the like red meat side because my mom did get diagnosed with heart failure last year.

[A]

Okay.

[B]

And it was due to like smoking cigarettes. And she did have a high blood pressure and it runs through the family. So she had that for quite some time.

[A]

Well, that's even another reason to help you because I mean, we could easily pull together a couple of articles about GLP medications, lowering heart attacks, strokes.

[B]

So that's what I explained to my endo because my mom went on the off brand of Ozempic.

[A]

Okay. Like she listened to your aunt, but on the black market, what are we talking about?

[B]

No, so she. She talked to a doctor because she was diagnosed with heart failure, and she had high blood pressure, and it was very difficult for her to lose the weight. So when she spoke to the doctor about getting the weight loss medication, they gave it to her. But she does have to pay out of pocket. She has to pay, if I'm not mistaken, about 175 for the medication. And she's lost a ton of weight.

[A]

Good. Oh, good for her.

[B]

A ton of weight. She's moving around more. She's, you know, she's healthier. Her appetite has gone down almost completely. So I was like, okay, you know, that's something. I want to speak to my doctor because I tried the gym. I was working out about five times a week. I was on the treadmill. I was trying to, you know, try to just lose the weight somehow some way, because I always struggled with it, but because I was taking care of myself, and the insulin just kept on going. The scale did not move to like, maybe three pounds, and that was about it. And I was so irritated because when I first got out of my doctor's appointment with the weight of about two something, I was like, okay, let me go to the gym. I didn't weigh myself until another three months, and it only moved a few pounds down.

[A]

Yeah.

[B]

So it's like something is wrong. And that's when my new end. I was like, yeah, you have insulin resistance. You need medication. She's like, I'm not for sure gonna give that to you yet, because I want to see how your sugars are. And I'm your new endo. I do have all your, like, old paperwork, but we need to see what's going on.

[A]

Yeah, tell her I said, and I'm nobody, but tell her I said that. Let's go. Okay.

[B]

Right. So I was kind of like, okay, you know, wait. My mom's like, no, you need to go on a weight loss injection. Like, something that can help you forget the whole insulin resistance thing, because that's what your body's really like.

[A]

You're fighting too many battles at the moment. I don't think you're going to over. You're not going to be able to overcome all the things. Like, even if you work out like crazy, eat ultra low calorie, you know, low carb, like on a line, you know, with a. With a sight on trying to lose weight and trying to get down, you know, your insulin needs. You know, insulin resistance comes with fat. Like, it just. That's part of it. Like, so you're just. You're kind of behind the eight ball now. You need something to kind of boost it. Yeah. Give you a little help.

[B]

Yeah. So I was just like, this is not working. This is just. So when I went in for my last appointment, I told him, I need a weight loss. I need something, because this is not helping. This is not helping at all. I was like, I've tried tried losing weight. I've tried going on just like, a no carb for, like, constantly. Like. Like, I would do, like, no carbs. Pretty much. I do, like, max, maybe 15 carbs out of the day, right. My body, it felt great, but it felt still horrible because my sugars were still moving like a roller coaster. And I was like, I haven't even eaten that many carbs today. Like, so it was just a lot. And I was just like, I need something. And so she put me on the trulicity. And then just out of nowhere, I was like, where's my trulicity? It's not come in yet.

[A]

And then they tell you that's no good. Listen, the trulicity is a nice idea, but it's not gon gonna. It's not gonna make a dent in your situation big enough.

[B]

Yeah. When I realized, like, I looked it up and I was like, what's the side effects? Just to, like, kind of prepare myself. The max weight is like 10 pounds. Like, they. They really put me on this. Right.

[A]

Even if it would help you out, you need something to help you with a number of different things, like with the insulin resistance, hormonal stuff, you know, as you gain fat, excess fat, like that, visceral fat around, like, people get around their stomachs. Like, it interferes with insulin signaling pathways. I'm not real good at all this. Like, but, like, it increases, like, an inflammatory response. It increases insulin resistance in a number of different ways. And it's not something that's just gonna, like, magically go away. You're not. Like I mentioned it earlier, right? Like, no one taught you how to eat growing up. They didn't teach you how to take care of your diabetes, right? And now this is what's happened, right? And now you're paying attention to it, and you're, you know, as an adult, you educated yourself and you're trying to learn more. There's nothing wrong with giving you a boost here. Also, I don't understand the thyroid medication thing. Like, if your TSH was elevated enough that the bad doctor thought to give you the thyroid medication, well, my God, you know what I mean? Because that doctor didn't understand Much. My guess is your TSH was really high. If they saw that and was like, here, take medication. So then, great, the medication works. You need to stay on it to keep it down again. I'm going to guess if you go back for blood work right now your TSH is high again. And that's probably another reason why you're having trouble losing weight, right? Yeah. Also, that makes using insulin more difficult, too, by the way.

[B]

Yeah. Because I explained to them, like, the high blood pressure. Thyroids. Type 1 diabetes does run in the family.

[A]

Yeah.

[B]

I explained to them, maybe I was like, could it be my thyroids? Because my mom's on thyroid medication.

[A]

Right.

[B]

I was like. And she's been on thyroid medication for a year now because they noticed her thyroids were high.

[A]

Yeah. Alicia, can I say if I was you, if you were my kid, I'd go with you to the doctor, and I'd be like, I know she's 20, but I'm here. And then that would be that. And then I would say, I want her labs redrawn. I need you to get her a GLP medication, not trulicity. I don't want a pill. I want an injectable. I would like Manjar. I would like the Zepbound. If you can't give me the Zepp bound, I'll take the Ozempic. I want to go on a schedule like I'm supposed to. I want to take it for a month. I want to make sure I'm okay. I want to move up for a month. I want to move. I want to keep going. I'm trying to lose weight here. Don't tell the doctor. It's, you know, don't tell the. Don't tell Medicaid. This is for my diabetes. This is for weight loss. I mean, my rough math says your BMI is, like, close to 40, so you qualify under any BMI that I know. As long as the insurance company covers the medication, you should qualify for it. Right? I don't want to hear that. It's like, oh, it's not good for type ones, because that's not true. Like, you know what I mean?

[B]

Like, so I said so many times, I'm like, no, you guys just don't.

[A]

I want my Synthroid back. Okay? Like, if you need to test me again, that's fine, but if my TSH is above 2, I want my Synthroid back. And if you want to know why I'm saying all this to you, my mom has heart failure. That's going to be me. I don't want that. You know what I mean? Like, so these things will stop that from happening. These are the things I need. Please make this happen right now. And I need your help. You might need to write a letter to the insurance company. They might say to you, has she tried exercise? Well, I have. You might need to write that down. I went to a gym. I did all that. It didn't help. I tried trulicity. It didn't help. Like now, like, let's go. I'm telling you, one motivated doctor should be able to set you right.

[B]

Right?

[A]

Yeah.

[B]

My Last appointment was August 26, and with the whole like not covering my my stuff, I called this morning and I specifically said I just need to speak to my endo. That's it. There's a concern my medications aren't wanting to be covered because the islet communication wise with the Beta Bionic company is very, very stressful, very difficult.

[A]

Tell me why. Because I'm interviewing them soon. I'll tell them. Tell me what you want me to tell them.

[B]

Because my doctor tried to communicate with them to ask because she could see my blood sugars and stuff and like the doses and all that on the Omnipod, but she could not see it through the Islet Beta Bionic. She had so much trouble trying to reach out to someone in Colorado who was an educator on the islet Betabiotics. She tried reaching out to the one here in New Mexico. Nobody reached out to her until, I want to say, a month after my appointment. And then that's when she called me. She's like, hey, okay, so now we can communicate about this. But nobody reached out to her. She sent several emails, tried to call, and nothing. She was having a very difficult time seeing like everything that was happening on my islet until they called me and they were like, I heard that you guys needed some help. I was like, my endo, she cannot see anything through my eyelid. It's only shared to one of you guys as the educators of Islet Beta Bionic. But it needs to be shared with my endo because my endo can't see it. I was like, my endo can only see my dexcom blood sugars, but not my eyelet. So why is that, like, not happening? And she's like, let me see what's going on.

[A]

I'm not sure about that, but I mean, I can ask somebody to see if I can get an answer.

[B]

After a while she reached out and my endo was like, after so long though, and for you to have to be On a pump. Because at first my pump was lasting me a day and a half again like the omnipod. So I was like, it's only lasting me a day and a half. Like this is just not like I, I love it because it's changed my A1C, but it's making me gain the weight. It's only lasting me a day and a half. Not even two, two and a half days.

[A]

I'm gonna, I'm gonna say something here. Like, I don't know, like you have a lot of different implications. Right. But the one thing that we can kind of control on our own here is the, is the caloric intake. So insulin, letter of the law. Insulin doesn't make you gain weight, calories do. So if you're able to eat a lot and keep your blood sugar down because the pump is pumping so much insulin, that's not the insulin making you gain weight. It's, it's the, it's the caloric intake. Right. So do you have, I know you haven't looked at the calories in your food, but is there like, can you tell me like a genuinely like kind of average day of eating looks like.

[B]

For you, an average day would be like a really small like breakfast usually, which is about eggs. Sometimes they heated up sausages because I'm usually running inside and out the house. So usually it's just a small breakfast lunch. I usually eat like at work. So usually it was like pre made sandwiches right. From Walmart. Like they have like the lunch box I guess now.

[A]

Okay.

[B]

So it comes with like a small sandwich, carrots, a cheese stick.

[A]

I'm looking at it here like an, like an all American half sub kind of thing like that. Okay, all right.

[B]

Like a simple, you know, like lunchbox usually. Or sometimes I'll eat like a fruit bowl because I'm like craving sweets and that's like my go to if I don't want to eat a payday bar or something.

[A]

Yeah, I mean that sandwich is only360 calories.

[B]

Like the protein which is like the, the meat, cheese and crackers. Yeah, it just depends on all three of those. Or sometimes I'll get like the, the chicken from the, from the heated up area and I'll take off like the breading because I don't know, crispy chicken tenders always have made my sugar go just a bit spike.

[A]

Yeah. So the bread and the breading and then it's greasy because it's deep fried. So it pushes up your blood sugar, then it holds it up because the fat Holds it up. Yeah.

[B]

So I'll do those.

[A]

Yeah, keep going.

[B]

And then dinner wise, is usually a chicken with veggies and then like a side, like rice or mashed potatoes or.

[A]

Yeah, so that should be like carb. Yeah. And so, Lisa, that shouldn't be the issue then. The food's not the issue. You don't think.

[B]

No, Like, I feel like. Because when I do eat, there is times where I do snack on, like, a bag of chips or a baked good.

[A]

Yeah.

[B]

Because in the household, there's. There's quite a bit of sweets. Not gonna lie. There's no.

[A]

I understand. No, I listen, I understand. I really do. I mean, listen, I. I know what I said, what I think already. I think if you could get those couple of items, they would make a big difference to you. I think you'd come back on the show a year from now and be like, oh, my God, Scott, I weigh 125 pounds now. You know what I mean? Like, mine, I'm not using nearly as much insulin and my A1C is lower, and I feel amazing, and my thyroid's better. And I think that's very doable for you. You just got to get somebody that's willing to help you.

[B]

Right? Yeah, that's what I. I've told. Because my endo is like, you know, it's technically still. Because I'm 20. They still have it as like, your, like the children's.

[A]

No, no, no, no. What are we doing?

[B]

So they're focused on, like, just the diabetes, and I'm like, I'm 20 years old. You guys gotta understand, there's so much more with my body now that I understand that, that I know I need.

[A]

Yeah.

[B]

So she's like, okay, we'll move you to, you know, like the adult type one.

[A]

This is bull. This isn't gonna help you. What I said earlier is what you gotta do. You have to call the doctor and say, listen to me, I am in crisis. My mom has heart failure. How old's your mom?

[B]

My mom is 42.

[A]

Okay? My mom, who is 22 years older than me, is in heart failure, and I am following right along in her footsteps. I have Medicaid. I want you to get me this. And, like, stop asking them. Tell them what you want. Be nice, but tell them what you want. Tell them you need help getting through the system. This needs to happen immediately. You're gaining weight at an uncontrollable rate, and you don't know where this is going to go. Every day is dire. I need your help. I need you to help me save my life. That's what I would say to her. And then. And I would say, please, like, let's stay on the phone right now and work this out. I need a GLP medication. I would prefer Zepbound because I think it'll help me lose more weight. But if you can only get me Wegovy, then that's fine. But let's start with Zepbound. And then I want my labs redrawn. I want you to check my TSH again. And if it's above 2, I want my Synthroid back because I have hypothyroid symptoms. I can't lose weight. Like. But, like, we probably have other ones too. Right?

[B]

Right.

[A]

Yeah. Right. And I have a familial issue with that. My mom is also on that. And you need to make sure I get me. I'm keeping my CGM here because this pump brought my A1C down three points. And if you help me lose this weight, my A1C is going to come down three more points. But I need to stay on the CGM and I need to keep this pump and then just make sure that happened. Like, do not stop until that happens. I'm telling you, those three things are going to save your life.

[B]

Definitely.

[A]

Yeah. Go get them. Okay.

[B]

Thank you.

[A]

You're welcome. I'm sorry you're dealing with this when you're 20. My daughter's 20. If I told her I have to do all this, she'd be like, I'm. I don't. How am I going to be at this time? But, like, you're a little. You're a little more. I think you've been on your own a little longer, so if you need anything, write to me on the Facebook group. If you want me to outline this again or say it again if you want to try to help get people to help you get language. There's a girl in the Facebook group that could write a great letter to your insurance company to help you with your GLP and your CGMs. If you need help. Like, you let me know through that Facebook group if you need help. Okay?

[B]

Alrighty. Thank you so much.

[A]

You're very welcome. Hold on one second for me. Don't hang up. Okay. Foreign. The conversation you just enjoyed was brought to you by usmed usmed.com juicebox or call 888-721-1514. Get started today and get your supplies from U.S. med. Having an easy to use and accurate, accurate blood glucose meter is just one click away. Contour next.com juicebox that's right. Today's episode is sponsored by the Contour Next Gen Blood Glucose meter. If you're looking for community around type 1 diabetes, check out the Juice Box Podcast Private Facebook group Juice box podcast type 1 diabetes but everybody is welcome. Type 1, type 2 gestational loved ones. It doesn't matter to me. If you're impacted by diabetes and you're looking for support, comfort or community, check out Juice box podcast type 1 diabetes on Facebook. Okay, well, here we are at the end of the episode. You're still with me. Thank you. I really do appreciate that. What else could you do for me? Why don't you tell a friend about the show or leave a five star review? Maybe you could make sure you're following or subscribed in your podcast app. Go to YouTube and follow me. Or Instagram TikTok. Oh gosh, here's one. Make sure you're following the podcast in the private Facebook group as well as the public Facebook page. You don't want to miss, please. Do you not know about the private group? You have to join the private group. As of this recording, it has 51,000 members in it. They're active, talking about diabetes. Whatever you need to know. There's a conversation happening in there right now and I'm there all the time. Tag me. I'll say hi. The episode you just heard was professionally edited by Wrong Way Recording wrongwayrecording. Com.