#1647 Grand Allegro

Summary

Juicebox Podcast: Type 1 Diabetes

Episode #1647: Grand Allegro (Oct 8, 2025)
Host: Scott Benner
Guest: Leslie (mom of three boys; middle son, Ephraim, diagnosed with Type 1 Diabetes)
Notable Appearance: Leslie’s husband, Stacy (brief discussion on type 2 diabetes and heart health)

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Episode Overview

This episode dives into Leslie's family's journey after her middle son, Ephraim, was diagnosed with type 1 diabetes as a teen. The conversation touches on the family’s unique medical history, Ephraim's ADHD and earlier signs, hospital and diagnosis experience, the psychological impact on both mother and son, insulin technology choices, and the supportive role of the Juicebox Podcast and community. The show wraps with a candid side discussion about type 2 diabetes, GLP-1 agonists, and heart health with Leslie’s husband.

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Key Discussion Points & Insights

1. Family & Medical Background

• Leslie is the mother of three boys (ages 14, 16, 17) – Ephraim, the middle child, has type 1 diabetes, diagnosed at age 14.
• Strong family history of autoimmune disease (lupus, fibromyalgia, rheumatoid arthritis, Sjogren’s syndrome), but Leslie herself has no diagnoses. Her husband has type 2 diabetes.

"My mom has a plethora of autoimmune. She's got lupus, fibromyalgia, rheumatoid arthritis, Sjogren's syndrome... but no other type one that I'm aware of." — Leslie [03:57]

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2. Early Signs and Diagnosis Journey

A. False Alarm at Toddler Age

• At age 2-3, Ephraim showed early diabetes-like symptoms (polydipsia, frequent urination, fatigue), but finger stick and glucose tolerance test were normal.
• Leslie’s “mama gut” kept her vigilant for years.

"You caught it so early that, like—"
"So I don't think it ever worked, right." — Scott & Leslie [08:33-08:37]

B. The Real Diagnosis (11 Years Later)

• At 14, after major changes in energy and activities (left competitive dance, tried wrestling), Leslie noticed increased drinking and eating, especially over the holidays.
• A home test (using husband's type 2 diabetes meter) twice showed blood glucose >600 mg/dL.
• Prompt hospital visit led to diagnosis and immediate care for DKA.

"I'm sitting there and I kind of rewind everything and I play back the past month in my head. We're sitting at this diner. I said, oh, my gosh, Ephraim, I think you have diabetes. We're gonna check your blood sugar when we get home..." — Leslie [12:33]

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3. Hospital Experience & Immediate Aftercare

• Small-town hospital, rapid triage due to high blood glucose; local doctor connected to the family.
• Ephraim was transferred via helicopter to a bigger children’s hospital due to DKA (first time in a helicopter, which he thought was “cool”).
• Parents impressed with education/transition—Ephraim quickly became independent with injections.

"He was really chill... by the time we got home, he was giving all of his own injections." — Leslie [19:33]

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4. Managing Type 1 as a Teen (with ADHD)

• Ephraim diagnosed with ADHD at age 8/9, as was Leslie and an older brother.
• ADHD impacts executive function. Leslie notes that better blood sugar management has improved ADHD symptoms for Ephraim.
• Their approach: logical, pragmatic, not fear-based.

"I'm very thankful that he's not afraid... of using his insulin. In fact, sometimes I have to be like, 'dude, if you're going to crush the high, you have to catch the low.'" — Leslie [28:00]

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5. Technology Choices: Insulin Pumps & CGMs

A. Pump Selection

• Leslie let Ephraim choose his device; he preferred the Tandem T:slim over Omnipod for algorithm and customizability, favoring features like profile segments and smaller site size.
• The tubing on Tandem wasn’t an issue for them.

"She [the educator] said one of the things she liked...is that you can set up your segment, you know, to increase your basal at that time. And she really liked that." — Leslie [30:53]

B. Practical Strategies with Tech

• Created a separate “Disconnect” profile on Tandem for Dexcom signal loss, with gentler settings as a workaround.
• Experienced issues with G7 sensors losing connection, but developed a system handling supply backups and replacements.

"Oh, because your settings...are more aggressive...but when you lose a connection, you don't want it to continue to be that aggressive." — Scott [36:10]

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6. Community Support and Learning Curve

• Leslie highly values both the podcast (especially long-term “success stories”) and the Facebook group.
• She appreciates hearing how people handled the condition decades ago and how children like Ephraim can thrive in the long term.

"My favorite episodes of the podcast are the ones for the people with the folks who've been diagnosed for a really long time...it gives me hope, like, for the future that everything really is going to be okay." — Leslie [46:05]

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7. Navigating Adolescence, Independence & Parenting

• Leslie is shifting from hands-on management to scaffolding Ephraim’s independence, training him to make his own adjustments and decisions.
• Struggles with balancing oversight and fostering autonomy, particularly with the impending transition to college.

"I feel this pressure to get him ready before college...I feel like we don't have as much time." — Leslie [59:15]

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8. Insulin Management Insights (for Pumpers on Control-IQ)

• Puberty has increased Ephraim’s insulin needs by 50% in three months (“insulin is water”); settings must keep pace with rapid growth.
• Cites Juicebox “Control-IQ Ninja” and “Lazy Ninja” episodes as particularly influential.

"In real life, if I were to give him, like, a unit via injection, it would probably bring him down 40 points. At this point in puberty, insulin is water." — Leslie [53:14]

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9. Type 2 Diabetes, Heart Health & GLP-1 Agonists (Stacy’s Segment)

• Stacy (Leslie’s husband) discussed open-heart surgery, recent type 2 diagnosis, and his struggles with medications.
• He trialed Mounjaro/Manjaro (tirzepatide) for weight loss and blood sugar; lost some weight but experienced intolerable nausea and vomiting at higher doses.
• Next steps: discuss with doctor the possibility of maintaining a lower dose or trying an alternative (Ozempic).

“When I hit the 7.5, the side effects of nausea, vomiting, it just wasn’t worth it to me.” — Stacy [67:16]
“If it would have ruptured, the aneurysm would have ruptured, I would have never made it from my house to the hospital, and we're probably half a mile...” — Stacy [74:02]

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10. Memorable Quotes & Moments

• On Parenting Openness:
  “With our boys, we are totally open about everything. Like, we don't hide stuff from them...to the point where they're like, 'mom, do we have to talk about it again?'” — Leslie [06:17]

• On Early Diagnosis Instincts:
  “You've been sitting around, sneaky, waiting to be right about this for 11 years.” — Scott [14:39]

• On Algorithm Adjustments:
  “I'm always the one saying, don't let the tube deter you... I see more people talking about knocking an omnipotent off than I see them saying they ripped their site out.” — Leslie [32:44]

• On Balancing Supplies:
  “There is a moment where there’s diminishing returns on having extras...you get more of these than you can look at.” — Scott [37:48]

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Timestamps for Notable Segments

| Time | Topic / Quote | |-----------|-----------------------------------------------------------------------------------| | 02:12 | Leslie introduces her family and Ephraim’s diagnosis story | | 07:20 | Describing early, "missed" signs of diabetes in toddler Ephraim | | 12:33 | Realization and confirmation of diabetes using home meter | | 13:17 | ER/hospitalization process (over 600 mg/dL, DKA, helicopter transfer) | | 19:33 | Ephraim’s quick adjustment to self-management of diabetes | | 27:05 | Addressing fear of insulin—family’s logical approach | | 28:19 | Pump selection process and factors influencing decision | | 35:10 | Device settings—creating “Disconnect” profile workaround | | 46:05 | Value of podcast and Facebook group—"hope for the future" | | 53:14 | Puberty, algorithm, and “insulin is water” | | 67:02 | Stacy recounts his open heart surgery and Mounjaro experience | | 74:02 | “If it would have ruptured, I would have never made it to the hospital.” |

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Tone & Style

• Conversational, candid, and occasionally humorous (e.g., jokes about numbers, “Santa Claus”).
• Honest about fears, challenges, and victories.
• Supportive and community-focused, encouraging agency for individuals and families managing diabetes.

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Conclusion & Takeaways

• Vigilance and “parent gut” play a crucial role in diagnosis, even if signs are present years before clear confirmation.
• Modern technology (CGM, pumps) and flexibility in device choice can empower teens to take control, but adapting settings is a continuous process, especially through adolescence.
• Community is invaluable—not just for technical advice, but for emotional support and hope (both in person and virtually).
• Leslie’s open, logic-driven approach (not fear-based) helped her son become competent and confident in self-management.
• Additional real-world perspectives: ADHD comorbidity, the transition to independence, and managing comorbid type 2 diabetes and cardiac risks in adults.

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For listeners newly diagnosed or supporting a diabetic adolescent:
This episode is packed with relatable stories and hard-won strategies for thriving with T1D, managing devices, balancing independence and oversight, and filtering advice from a vast diabetes community. The family’s resilient spirit and Leslie’s problem-solving mindset offer hope and practical guidance at every stage of the T1D journey.

Transcript

[A]

Hello, friends, and welcome back to another episode of the Juice Box Podcast.

[B]

My name is Leslie and I am the mother of three boys. My middle one has type 1 diabetes and he was diagnosed about a year and a half ago.

[A]

Go. When I created the Defining Diabetes series, I pictured a dictionary in my mind to help you understand key terms that shape type 1 diabetes management. Along with Jenny Smith, who of course is an experienced diabetes educator, we break down concepts like Basil, time and range, insulin on board, and much more. This series must have 70 short episodes in it. We have to take the jargon out of the jargon so that you can focus on what really matters, living confidently and staying healthy. You can't do these things if you don't know what they mean. Go get your diabetes defined juiceboxpodcast.com go up in the menu and click on series. 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 healthcare plan. Usmed is sponsoring this episode of the Juice Box Podcast and we've been getting our diabetes supplies from USMED for years. You can as well usmed.com juicebox or call 888-721-1514, use the link or the number, get your free benefits check and get started today with usmed. This episode is sponsored by the Tandem MOBI system, which is powered by Tandem's newest algorithm, ControlIQ technology. Tandemoby has a predictive algorithm that helps prevent highs and lows and is now available for ages 2 and up. Learn more and get started today at tandomdiabetes.com Juicebox the episode you're about to enjoy was brought to you by Dexcom, the Dexcom G7, the same CGM that my daughter wears. You can learn more and get started today at my link dexcom.com juicebox My.

[B]

Name is Leslie and I am the mother of three boys. My middle one has type 1 diabetes and he was diagnosed about a year and a half ago. A little more over a year and a half ago.

[A]

Three boys. What are their ages?

[B]

They are 15. I mean, I'm sorry, 14. Almost 16 and 17.

[A]

That was interesting. You did them completely out of order. You were like 14, 15, 17. That's interesting. No, no, no, Leslie, don't wait. From bottom to top.

[B]

Oh, well, that's how numbers work.

[A]

Yeah, but that's not how people usually do it, though. That's what's interesting. Usually when you ask people to list their kids, they start at the oldest and go backwards. Oh, isn't that interesting?

[B]

I Don't know. I always. In age wise, I always list them in numerical order, but their names are actually alphabetical.

[A]

Like, in age order. Their alphabetical. Like, it's like.

[B]

Like backwards. So my oldest is Elijah, middle Ephraim, youngest, Levi. So it works. And they're okay. I'm their mom. I can say their name.

[A]

I'm just saying that it's. I feel like we're gonna learn something today while you're talking, because, I don't know, I just. Your brain works differently also.

[B]

I think my brain totally works differently.

[A]

No, it definitely does. So I think this will be fun. I was interviewing somebody the other day, and they're like, can, you know, can I make some observations about you? And I was like, yeah, sure. She goes, you say interesting a lot. And I was like, oh, that's interesting. Do I? And now I just realized that you said that. And it's the first thing I pop. I need a better synonym. Maybe we'll come up with that later. The child was diagnosed. The child was diagnosed over a year and a half ago. Type one?

[B]

Yes.

[A]

Any other autoimmune in the family or other health issues?

[B]

So my mom has a plethora of autoimmune. She's got lupus, fibromyalgia, rheumatoid arthritis, Sjogren's syndrome, probably other things I don't remember. I think both of my sisters probably also have fibromyalgia. And there's other rheumatoid arthritis in the family. There's probably other autoimmune, but no other type one that I'm aware of.

[A]

And do you have anything specifically?

[B]

No, no.

[A]

Like, was it your entire life that your mom was struggling with different things?

[B]

She. I was probably a freshman in high school, so 14, 15, when she admitted that she had these things. But I think she was struggling with them for a long time before she told me.

[A]

Oh, okay. Are you the oldest?

[B]

I am the baby. So I was always protected from all the things I see.

[A]

So admitted to you or admitted to everybody that she had stuff going on.

[B]

I'm not sure if she told other people first. I mean, I remember as a little kid, you know, her back hurt, but I don't remember. And I. And she was a headache mom. She got headaches, but I don't remember her being, like, sick. And then I remember pretty distinctly when she told me that she had lupus. We were on our way to church on a Wednesday night, and she told me she had it and gave me a brochure.

[A]

So your mom Told you on the way to church that she had lupus and gave you a brochure about it so you could study up about it.

[B]

Yes. I love my mom so much. Mom, I love you. If you ever listen to this. She doesn't like to talk about the things, so it'll kind of be in passing, and then we can circle back later.

[A]

What genre of. Of religion? Catholic.

[B]

We're just Christians.

[A]

Just not Catholic.

[B]

No.

[A]

Oh, that was so interesting. If you have any questions, please consult this pamphlet.

[B]

Yeah, I think, you know, it helps so she doesn't have to explain it. I don't know.

[A]

I mean, you know, it's funny, right?

[B]

It is. Oh, it is funny. It is absolutely funny.

[A]

But how old are you?

[B]

So I am. But you're not supposed to ask a lady their age.

[A]

Oh, fine. How old's your mom?

[B]

I'm 45.

[A]

Okay, so your mom's in her 70s.

[B]

Yeah.

[A]

Okay, well, it's just a different generation. I just think that that was probably her being very open. That's what it is.

[B]

Yeah. With our boys, we are totally open about everything. Like, we don't hide stuff from them. We have had open conversations about sex and, you know, just everything to the point where they're like, mom, do we have to talk about it again? It's terrible. I'm like, I just want it to not be a thing.

[A]

Well, you're doing the opposite of what your mom did, right?

[B]

Yep.

[A]

Yeah. I would have loved to have been there the day your mom was like, do you have any questions about your front butt, Leslie, or whatever ridiculous term.

[B]

She did not.

[A]

Didn't even go that far.

[B]

No, but I had older sisters, and they helped me with all that stuff, so.

[A]

Yeah, but who helped them? Encyclopedia Britannica?

[B]

I have no idea. Then go to the library. I don't know.

[A]

It's hilarious.

[B]

But no, I mean, my mom is great. She's just of the generation that just doesn't talk about the things I think.

[A]

No, I understand. Okay, so that's going on in your background. What do you notice about your son that gets you to the doctor first? So.

[B]

Oh, gosh. There's kind of. Okay, so the interesting thing about Ephraim, that is my little type one. So the interesting thing about him is that when he was, I think, two or three, he was still a cute little pudgy thing, and I was noticing symptoms of what I thought were diabetes symptoms. He was peeing all the time. He would literally get out of his bed in the middle of the night and go, you know, like, hang on the bathroom sink and try to drink from the faucet because he was so thirsty, he fell asleep in random places. Frankie. And so I took him to our fabulous pediatrician and she said, oh, that does not, you know, sound like normal behavior. Of course, they tested him for UTI and everything, and they did a finger poke, and it was fine. Actually, I don't even know what the number was. I don't remember what the number was or even asking, but they told me it was fine. And. But she's fabulous. And she said, but I trust you and I trust your mama gut, and if you would like, we can give you the option of doing the three hour glucose tolerance test. And I said, yes, I want to do that, because I want to just make sure he's fine.

[A]

Right, right.

[B]

So we did that, and he was fine.

[A]

Oh, you might have. You caught it so early that, like.

[B]

So I don't think it ever worked. Right.

[A]

Well, do you think maybe, like, he was honeymooning so hard that you just happened to pick a day where you went to the doctor where everything was doing what it was supposed to do?

[B]

I don't know. But this kid also, he was one of those who was super sensitive to food. And when he was hangry, he was super duper, like, hangrier than hangry. And so just, you know, looking back, there were a lot of. I guess maybe some. Some signs. And then so fast forward, and I just thought, he is diagnosed with adhd, as am I. And another brother and his dad probably would be. So fast forward to. He's 14. And Efraim had been. It was. It was a very strange lead up to his diagnosis, but he had been. He just was a freshman in high school. He had quit his hobby that he'd had for five years. Just overnight. Just like went from I want to do this professionally to I never want to do it again. Then I said, okay, that's fine, but you need to pick a sport or a club or something. Like, you can't just, you know, you need to do something.

[A]

Yeah.

[B]

So he chose wrestling. And high school wrestling is crazy. They're insane. And so he joined this wrestling team. And of course, the workouts are crazy. Preseason. And so he was doing all of that, and he was absolutely miserable. He hated it. He was so tired. He came home and I was exhausted. Of course, they're always watching their weight. And right when the season started, he just came to me one night at bedtime. He's like, mom, I really hate it. I'm miserable. I really just don't want to do this. I'm so tired, it's awful. And I said, that's fine. Yeah, just pick something else if you're that miserable. The season hadn't really started, so that's fine.

[A]

Yeah, we picked the wrong thing, that's all.

[B]

Yeah. And so at the same time, this is important. His brother, his older brother had joined the wrestling team at high school and then his younger brother had also joined the wrestling in the middle school. So everybody's weighing themselves all the time. And so this is around October, end of October, around Halloween time that Ephraim quits wrestling. So he's been doing all this crazy physical activity and he quits wrestling. And then, you know, it's the holidays and Christmas and all this stuff and Ephraim is just drinking everything he could drink. Everybody's weighing themselves and you know, the other two are trying to, to cut weight for their weight class or, you know, whatever they're trying to do. So everybody' weighing themselves and everybody, everybody's talking about, oh, I dropped a pound or I dropped an ounce, whatever. And Ephraim is drinking and I didn't really notice how much he was drinking and eating until he was home from school for Christmas. And we had these like glass bottles in the fridge with filtered water that would just fill up from the reverse osmosis. And he would drink them and I'm. And they were mine. And I said, that's fine, just refill it. But he never refilled it. His 14 year old boy. And you know, we're just, we're doing Christmas, everybody's being lazy, everybody's eating junk food, whatever, whatever his brother goes up to, they went up to Long Island I think for a wrestling tournament that they left on Christmas Day and then they came, come home on the 29th and we go out to dinner as a family to celebrate. He did great. And so the younger ones at a friend's house and so the four of us go, we go out to dinner and we're sitting at our favorite diner and Ephraim said, Ephraim, he got like two, two sodas before the meal even came and he wanted to have a third. And I was like, no, dude, you need to like slow down and you know, just wait, have a glass of water or something. And then I, and said, well, maybe you've been drinking so much you've messed up your electrolytes and you know, cause I think that's a thing. I don't know, you start having the.

[A]

Craziest ideas, you're like, you know what I think probably happened? Your electrolyte balance is off.

[B]

Well, I say that, and then as I'm sitting there, I kind of rewind everything and I play back the past month in my head. We're sitting at this diner. I said, oh, my gosh, Efrem, I think you have diabetes. We're gonna check your blood sugar when we get home because his dad is a type 2. And so we had a meter, okay. And so he eats. We eat, and it's. You know, he eats giant burger and fries, and we go home, get him some full sugar Gatorade, of course. And then we check his blood sugar, and it read over 600. Please seek medical attention. That's what his meter says.

[A]

Oh.

[B]

And I was like, that's gotta be wrong. Did you wash your hands?

[A]

The last thing anyone says to another person before they're diagnosed with type 1 diabetes. Did you wash your hands?

[B]

Yeah, yeah, yeah, yeah. Well, I mean, you know, Gatorade powder, you know, I don't know.

[A]

You're just hoping.

[B]

So wash hands, wait 15 minutes, do it again. It says the same thing. And I was like, oh. You know. And in the meantime, I have gone to Dr. Google and he literally has every symptom. We did it a second time. Says the same thing. I said, efraim, go brush your teeth. Go put on your sweatpants because we're going to the hospital and you're not coming home today. Sure enough, mom was right. It was kind of funny, because in the meantime, my husband's meter is connected to, like, a Teladoc thing.

[A]

Yeah.

[B]

The phone's running and they're calling. They're like, mister, are. Are you okay? You need to go to the emergency room. It's my son. We're on the way.

[A]

It's like the smoke alarm where you have a company like. Like following it. They're like, you have to get out of the house.

[B]

Yeah.

[A]

How long was this after the glucose tolerance test at the doctor's office?

[B]

11 years.

[A]

Wait, really?

[B]

Yeah.

[A]

Holy. Wait, no, no, no. Wait a minute. How old's the kid?

[B]

He was a toddler when he had the glucose tolerance test.

[A]

No kidding. I didn't understand that aspect of it.

[B]

He was a cute little baby.

[A]

Oh, my gosh.

[B]

11 years later. I just don't think it. I think it. I don't think it ever worked right.

[A]

You've been sitting around, sneaky, waiting to be right about this for 11 years.

[B]

Yeah, absolutely.

[A]

Look at you.

[B]

And it's funny when. When he. So he had his. Well, check a Couple weeks after he, this is like his regular checkup after he was diagnosed. And we go in and our pediatrician's and I told her, I said, I told you I was right.

[A]

She's like, I don't even remember what you're talking about. Like, well, listen, a decade ago, amazing. Oh, okay.

[B]

She was fabulous. She's the best.

[A]

Did she offer anything back on that when you were like, look, remember 11 years ago when I told you I think this kid had diabetes and now today actually has it?

[B]

She said you were right. She said it is, it is strange and you know, things like this happen.

[A]

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[B]

I don't know. Like, I just.

[A]

Or do you think it went off and on?

[B]

Like, I think maybe off and on.

[A]

Okay. Because, like, using as an example, like, his behavior or like, being hangry was that constant through just, like, periodic.

[B]

There were definitely times when it was better than others. When he was more physically active, it was better. And I think that helped control blood sugar. But I don't know. I mean, you know, we don't know.

[A]

I'm not making a pronouncement about it. I just think it's. God, I almost said interesting. I'm just going to say it anyway. Like, I think it's interesting to talk about.

[B]

It's interesting.

[A]

Yeah, yeah, yeah. To hear about it. Okay, so is this, like, the. The chillest kid in the world? You're like, hey, go put some sweatpants on. You have diabetes. We got a head. And like, he's just like, all right, whatever.

[B]

He really felt like crap. Oh, I am so thankful that I did not put him to bed that night.

[A]

Oh, you wonder? Yeah, for sure.

[B]

Yeah. I am so thankful that I did not put him to bed. And I'm so thankful my family listens to me.

[A]

You're lucky you had a meter at the house, honestly.

[B]

Yeah, if we didn't have one, I probably would have told my husband to go to his mom's house because she has one. So. Yeah, I would. I would have pushed that.

[A]

How did he handle, by the way? I think I know one. Ephraim. In my. It's Efren Zimbalist Jr. There's no other one.

[B]

Right. There's an actor, and it's funny, he said there's a Canadian actor and his name is Ephraim Ellis.

[A]

He's Canadian now. I don't know if that counts.

[B]

His last name is Ellis, and then my son's middle name is Ellis, but he's totally not named after him.

[A]

Sure, whatever.

[B]

He's not. He's named after my dad.

[A]

Yes, he's your dad named Ephraim?

[B]

No, Ellis. His middle name is Ellis.

[A]

Yeah, Gotcha Gotcha. So, okay, so how does. How does Ephraim handle being diagnosed? What's the first couple weeks like?

[B]

He was really chill. It's funny because, you know, when we were checking his blood sugar at home, it took my husband and I to, like, hold him down and prick his finger. He did not want to have anything to do with that. He was a kid who was really bad about needles and such. And it was a Friday night, and we came home on New Year's Day, which was a Monday, and by the time we got home, he was giving all of his own injections and doing all of his everything. So he just. I guess he just figured he had to do it, and that was that.

[A]

That's it. You don't know anything about diabetes going into it. So they give you good tools. Do you have to ask for them? If you had to ask, where'd you learn about it? Like, how'd all that work?

[B]

So here's what happened. Our hospital experience was really fabulous. We are in a small coastal town, less than 10,000 people here, and so there's no children's hospital or anything. But when we got to the emergency department at our hospital, I knew one of the physicians, the one who actually triaged him. He knew her daughter from his previous hobby.

[A]

You keep saying previous hobby. What was he, a gun runner?

[B]

Efraim, I love you so much. He was a competitive dancer.

[A]

Oh, I see what. You're trying to save him. I gotcha.

[B]

Yeah, he was very good.

[A]

Wait, like, ballroom or like ballet? Ballet. Oh, no kidding. Oh, good for him. But he burned out on that. He's like, that's enough of that.

[B]

It is really hard for boys in dance because there's. They don't have, like, the camaraderie that the girls have. And so it's kind of a fight the whole time to even have a dressing room.

[A]

Sometimes you feel like you're like an afterthought at the events.

[B]

Oh, yeah, totally. And then when you do win an award, oftentimes they say, oh, well, you just got it because you're a boy. So it was a tough thing. And then you get people in your other life who, you know, want to say this and that about a male dancer. And I think he just a lot from different angles.

[A]

But he enjoyed the dancing.

[B]

Yeah. Yeah, he did. Yeah. He's very naturally gifted.

[A]

Okay. Yeah. I mean.

[B]

But anyway, you just.

[A]

You were so avoiding it on purpose. I was like, now I got to find out what he's. What she's talking about. That's Fine.

[B]

I don't think any of his friends listen to this podcast, so it'll be fine.

[A]

Listen. I make a podcast. It's not exactly the most masculine thing you've ever heard of in your life.

[B]

Oh, cool.

[A]

Yeah. And I got it. I got to tell people all the time, like, what do you do? And I'm like, I make a podcast. If you're telling somebody over 40, they're like, oh, I didn't know you, like, lived in your parents basement still. Like, so it's, you know, it's not a ton of fun, but. So I understand what you're saying, but. Okay, I'm sorry. Met the person, bumped into the person.

[B]

Our hospital experience was fabulous.

[A]

Yeah.

[B]

We knew the physician who was. Who was triaging. I told her what was going on. And everybody's eyes just, you know, get really big. Because I said, well, our meter said it was over 600. And so they got their meter and it also said the same thing. We also didn't have to wait. There were people in the waiting room. But because I told them what I told them, we didn't wait. So apparently our hospital does a decent job triaging.

[A]

Okay.

[B]

They pricked his finger. Everybody's eyes get big. They took us directly back to her room. We don't have a. I guess there's a pediatrics unit at our hospital. I don't know what they do. Maybe like appendixes, I don't know. But nothing big. He could not be treated there. They did get it started, so they contacted the closest children's hospital and contacted the endocrinologist on call, and she gave them the orders. So they did start the insulin and everything at our hospital. So they got him, you know, hooked up to everything, you know, did all the blood work, got him hooked up to everything. Insulin, potassium, whatever, fluids. And I'm sitting there and I'm just. And my husband and I are pretty chill. I'm not a chill person, but I was chill about this. I don't know. I guess, because I knew. And he would come in and, you know, he told me that, you know, he most likely had type 1 diabetes. Of course, they couldn't tell us until antibody tests came back, like, for sure, for sure. But. And he was in dka and he kind of explained to me what that was and what was going to happen. And I was just like, okay, like, can we take him to the next hospital?

[A]

Yeah.

[B]

And they said, no, absolutely not. I said, okay. I said, how is he going to get there? And they said, well, the helicopter is going to come and get him. And I said, okay.

[A]

They thought he was in that much trouble.

[B]

Yeah. And it's the only. I mean, I don't think there was an ambulance to available, and it was just faster to get the helicopter.

[A]

Did that seem like a. Like an escalation of the situation or do you think that it was just the smartest thing to do in that spot?

[B]

It was just the smartest thing to do. I mean, we just. It's a small hospital and so they use the helicopters.

[A]

Was your understanding of what was going on? Like, let me ask this a different way. Like, I'm trying to figure out if, like, you're like, okay, my kid has diabetes. I've kind of thought that for 10 years. It's been in the back of my mind a little bit. So, like, I'm not super surprised. You know, we're going to go to the hospital, we're going to do the thing. Whoa. A helicopter. Like, you know what I mean? Like, is, was there an escalation or in your mind or. Not really.

[B]

Yeah. So I did get, you know, I mean, I had like the mommy tears a little bit, but I wasn't. I was not freaking out.

[A]

Okay.

[B]

I sent my husband home because we were gonna have to drive. And the hospital's about almost two hours away, you know. Cause they told me that I couldn't ride with him. And I really. I didn't like that part. I wanted to be with him.

[A]

Sure.

[B]

So I said, well, you go home and get some sleep because you're gonna have to drive and I'll just stay here with him and. Because they assured me that the transport people would tell them when they left the other hospital to come and get him. Well, they didn't.

[A]

Oh. So they were just there.

[B]

So I get a. Like a nurse comes in eventually, you know, and of course they're checking vitals and, you know, poor guy, you know, he's trying to get some sleep. And they come in, they're like, the helicopter is about 10 minutes away now.

[A]

We've got our quick turn now. Suddenly you're like, here we go. Right?

[B]

You know, I called my husband and I said, come on, let's go.

[A]

Stop sleeping. That part's over now.

[B]

Yeah, you're done sleeping. He came and then we drove there. And of Ephraim had gotten there like a full hour before we did. Yeah, the helicopter crew was like, they were super cool. They were the coolest, like, big uncle dudes. I don't know. Like, if you could think of a cool big uncle that is what these guys were like.

[A]

You didn't feel like he was alone because you were worried about him being alone for that hour, but you didn't, like, you felt like they stepped up in that spot.

[B]

Oh, absolutely. Because. So there were three of them, you know, like a pilot, a co pilot, and a nurse or medic or whatever. And they were all these big, burly you know, mustached dudes. So they were. They were super cool. Ephraim thought they were cool. He's wanted to be, like, a paramedic his entire life. So he did think that part was cool. Yeah, that's. So he was in PICU for about 24 hours, and then he got bumped down to a room, and then we did all the education and everything, so.

[A]

So you feel like he translated or transferred from, like, oh, my gosh, you have to pin me down if you want to check my blood sugar. To taking care of himself pretty effortlessly.

[B]

Yeah, really. When we got home from the hospital, we were doing the long acting injection. He wanted us to do that one, but he could have if he needed to, and then he was doing everything else.

[A]

So in your note, you talk about wanting, like, talking about not being afraid. So he wasn't afraid. Like, was it you that was afraid?

[B]

I don't. Gosh, I wrote that note so long ago, I don't remember what I meant.

[A]

Yeah, you wrote of insulin. You said, I want to talk about the diagnosis of a teen adhd. Understanding tandem and not being afraid.

[B]

Not being afraid. Oh, maybe it's not being afraid of insulin. So in our education, of course, they taught us about lows and what to do, but they did not. I don't know if other educators just drill it into your head that you're gonna go low and, like, keel over. They did not do that for us. I mean, at all. They taught us how to treat a low. You know, of course they talked to us about glucagon and maximi.

[A]

But did it seem like it couldn't possibly happen? Like, that was my takeaway. Like, you know, all that training about, like, this is what glucagon's for and blah, blah, bl. But then they would follow it up by going, don't worry, that's not going to happen.

[B]

No, they didn't really do that either. It's just. I don't know, maybe I have kind of a logical brain. So I'm like, well, we have the tools. Oh, so if something happens, we'll do the thing.

[A]

It'll just work out the way they said. Yeah, yeah, good luck. With that.

[B]

Yeah, I know, right? I'm very thankful that he's not afraid.

[A]

Of using his insulin.

[B]

Using his insulin. In fact, sometimes I have to be like, dude, if you're going to crush the high, you have to catch the low.

[A]

Can't do the first part, not the second part.

[B]

Pay attention.

[A]

Gotcha. Well, what gear does he use today? Is it been what he's always done? Did they send him home with needles or pens or.

[B]

So when we came home, we had Semgle because our insurance didn't cover Lantus and Novalog pens. So he was diagnosed on December 29 and on April 29 he got his T slim. He chose it. I thought for sure he would want to do Omnipod, but he did not. And I didn't try to push him one way or the other.

[A]

Sure. How did Efraim choose Tandem over another pump? Did he tell you what he was considering when he, when he came to his decisions? Let's talk about the Tandem Moby insulin pump from today's sponsor, Tandem Diabetes Care. Their newest algorithm, ControlIQ technology, and the new Tandem MOBI pump offer you unique opportunities to have better control. It's the only system with autobolus that helps with missed meals and preventing hyperglycemia, the only system with a dedicated sleep setting, and the only system with off or on body wear options. Tandem Mobi gives you more discretion, freedom and options for how to manage your diabetes. This is their best algorithm ever and they'd like you to check it out at. Tandomdiabetes.com juicebox when you get to my link, you're going to see integrations with Dexcom sensors and a ton of other information that's going to help you learn about Tandem's tiny pump that's big on control. Tandemdiabetes.com juicebox the Tandem mobi system is available for people ages 2 and up who want an automated delivery system to help them sleep better, wake up in range and address high blood sugars with auto bolus.

[B]

So we did do at one of his endocrinology appointments, the trainer came in and she presented a few different ones to him and she was a Tandem person and the Moby had just come out, so she didn't have one and she hadn't had one yet, but she was going to try it. He, at that point he had already was kind of leaning towards the Tandem, I think because of the algorithm and because you can create your different segments during the day.

[A]

Okay, how does he know about that?

[B]

I don't know. Maybe I sent him something.

[A]

Oh, did you hand him a pamphlet one day?

[B]

I don't. Maybe you're like, you're gonna have to.

[A]

Pick an insulin pump soon. Here's a pamphlet. You could educate yourself when we're not together. I don't want to talk about it.

[B]

He isn't. No, I want to talk about it. He does not. He is a very independent young man.

[A]

Well, he must be if he went out and learned all the stuff about, like, how the algorithm works and everything.

[B]

So she presented it to him, and, you know, we were asking her questions, and she said one of the things she liked is because. Is that you can free bolus foot on the floor or dawn phenomenon, whatever, whichever one. Because you can set up your segment, you know, to increase your basil at that time. And she really liked that. And that you can have several different profiles for different things.

[A]

Yeah. So the educator liked that the Tandem offers you, I think, of the Tandem algorithm kind of offering like a. It's like a. I don't know, like a little bit of one, a little bit of the other. Like, you have the aid aspect to it, but it does allow you to say, like, right here, I want you to have, I don't know, more basil than you do in this segment. That kind of thing. And that part was attractive to her and probably then translated to him once she explained it to him.

[B]

Yes. And then the other thing for him was that he didn't want something as big as the omnipod stuck to him.

[A]

That's interesting. I think of that omnipod as so small.

[B]

Yeah. But he. I don't know.

[A]

Listen, no matter what you buy while you're listening, I want you to know this. Tandemdiabetes.com juicebox omnipod.com juicebox medtronicdiabetes.com juice just use the links. The links in the show notes. Just click on those. I don't care what pump you get. I don't care why you think one of them's better than the other or for you, just as long as you go through my link when you do. Doesn't matter to me, Leslie. I had to keep this train rolling. You know what I mean?

[B]

Yeah.

[A]

Okay.

[B]

Keep it rolling.

[A]

Yeah, yeah, yeah. But in all honesty, I really do think whatever's best for you is perfect. Like, it doesn't matter if someone prefers tubes or tubelessness over something else. In the end, it's what's going to work best for you. You got to be the one that's comfortable with it. So good for him for going out and figuring out what he thought that was, he did.

[B]

And the, the tube has been a non issue in the group. I am always the one who is. When people are looking at pumps. I'm always the one saying, don't let the tube deter. Deter you.

[A]

Yeah.

[B]

You know, I see more people talking about knocking an omnipotent off than I see them saying they ripped their sight out. So I mean, it's probably fairly even.

[A]

Yeah. I think it's in general, like you're going to find some people who love something to a fault. You're going to have you find people who had one problem and they can't stop complaining about it. You know, like there's always somebody who's like, dexcom never makes it 10 days. How are they gonna ever make it 14 days? I'm walking around here like trying to talk ardent. Like, I'm like, the thing's gonna expire in five seconds. We could take it off, please. Oh no, we have a 12 hour grace period. She like rides it right to the end and it works great. Like, why does that work that way for some person and not the other? I don't know. Also, I want to apologize. I forgot to say twist.com juicebox that's twistwithtwoeyes.com juicebox. I forgot they were a newer sponsor. And by the way, I love that idea, that twist pump, because it's got that loop algorithm in it and that's an attractive idea. So all different kinds of options.

[B]

So the twist is really interesting. Like that's very appealing to me. Ephraim has said that he is kind of interested in the Omnipod now. Of course, you know, we've got that four year thing with Tandem, but I think maybe we could still try Omnipod because it's pharmacy.

[A]

But I also think they have a free trial that you could figure out more about it. My link, I just want to say hello. But in the end, again, I think it's like the joking aside about like the fact that I think I have four pump companies that buy ads on the podcast. Like there is something out there that'll be good for you and you need to go look at what those things are and what they bring and what your needs are and try it. And like try something, you don't love it. If you can try something else, try something else. Like in the end you're going to be wearing this thing every day for a really long time. I'd like you to have whatever the best fit is for you. That's just Makes sense to me. So anyway, yeah, I mean, and that goes for the CGM stuff too. If it's Libre, if it's Dexcom, I think now there's Medtronic is going to have a new CGM that works with just their system that Abbott's making. You know, there's a lot of options out there. Go figure out what they are. Anyway, so he is using a pump and you're saying he's taking care of himself. Are you not that involved in day to day decisions? And how did he pick it up so quickly?

[B]

I am kind of the master settings decision maker at this point, but I am actively working toward kind of guiding him when a decision needs to. Like when something needs to change, you know, it'll be something like, okay, we've gone high after this meal, you know, for the last three days. What do you think we need to do and kind of guide him to think about it, making the decision. You know, we have different profiles set, so we had a slew of Dexcom of the G7 that were just, they were losing their connection.

[A]

Okay.

[B]

All the time. One thing with Tandem is that your settings need to be more aggressive than what you need and it works better. So what we've done is we've created a profile on his pump that I've called Disconnect. And so anytime the CGM is being crazy, we move over to the Disconnect profile and that's just a milder profile. And.

[A]

Oh, because your settings. So you have your settings set up more aggressively because you find the algorithm works better when your settings are more aggressive, but when you lose connection, you don't want it to continue to be that aggressive. So when you lose a connection, you go to Disconnect and that's a gentler profile as far as insulin use goes. Yes, I got it. That's an interesting workaround.

[B]

I thought of that all by myself.

[A]

Good for you.

[B]

Thank you.

[A]

How long did these disconnects last for?

[B]

I mean, sometimes they would last for a few hours and during the day it's not that big of a deal because you can just keep your eyes open. You know what I mean? You're more aware. But at night especially, I would say just, you know, go to disconnect. But, but, well, just walking him through the steps of, okay, this isn't working. Right? We're still not, you know, maybe it'll come back.

[A]

Are you saying that, that you're losing Dexcom signal completely or just the connection to the Tandem algorithm?

[B]

He was losing it completely. We had just A string of dexcoms that were not working, and now we've had a string that are. So I don't know if we had a bad shipment or what, but there seemed to be better. Now, the upside to having a string of bad G7s that only last day 7 or 8 is that when you get your replacement, you now have.

[A]

You end up with extras.

[B]

Yeah. So we haven't done anything to cheat the system or anything like that, but we have. We have a few extras now. They typically die on day nine and they're supposed to last to 10. So we call it in and they replace it every time.

[A]

Yeah. So you basically. You get nine days for free on the next one.

[B]

Yep.

[A]

Yeah. Oh, listen, everyone should call in their devices when they don't work and get them replaced.

[B]

Call them in.

[A]

Yeah, for sure. There is a moment where there's diminishing returns on having extras, though. There's a spot where you're like, oh, this is like baseball cards. I have more of these than I can look at. Then I find myself, like, when that happens, eventually of like, I'll get the email from us men. They'll be like, it's time to refill. And I'm like, we're going to skip this one, you know, or at least put it off for a few weeks and try to use up some of the backlog that we have to get back to even again. I've. I've done that a number of times. I did it with insulin once when Arden was used to GLP for so long, their insulin use went down so long that when it was time to refill in some, I was like, we don't need it. Like, you know, like, we still have too much. So I put it off a little bit, try to keep a balance between having a little bit on the, you know, backlog backstock, but not so much that I'm like, we're never going to use this and it's just going to go out of date. I'm trying to split the middle, if that makes sense.

[B]

Yeah, totally. We're not there with the dexcoms yet, but infusion sets, we have so many those.

[A]

And if somebody said to me the other day, like, oh, I just paid a bunch of money for Lancets, and I was like, oh, I could have given you some. We have extra lances here for sure.

[B]

Yeah, he's 15. We don't change that.

[A]

We use ours. And I still have, like, just over time, you just, like I said, you get. They give you too many one time and then you've got them. And I was like, I don't want to waste them, so hold on to them. Adhd. How old was he when he was diagnosed with that?

[B]

So he was eight, nine.

[A]

Okay. Anybody else in the house have it?

[B]

Me. His older brother was just diagnosed about six months ago.

[A]

What do they do for that?

[B]

So Efraim has. He had been taking a stimulant for a while, and then now he's done a non stimulant.

[A]

Okay.

[B]

I can't think. You know, they just. They need more help with, you know, executive functioning, doing, getting moving, doing the thing a lot of times and paying attention. I think also getting blood sugar under control has really helped some of those symptoms as well. It was just kind of exacerbating an existing problem.

[A]

How do you get an ADHD diagnosis?

[B]

We went to a psychiatrist, psychologist. What do you say what her title was?

[A]

What's the entree to that conversation?

[B]

I think my kid has adhd.

[A]

You know, what made you think that?

[B]

He just had this, you know, trouble paying attention, outbursts, you know, a bunch of different things. And he was younger when my older one asked to be, like, I was 100% sure my older one had it. He's highly intelligent. He just really has trouble focusing, and it's. And he would say, mom, I. I just can't focus in school. But this kid is wildly smart. Finally, he. My oldest one asked me if he could have a diagnosis. So I just made an appointment, and I. And they kind of just do a full psychological evaluation. And it has, like, an IQ test and other stuff. So it doesn't just test for adhd. It tests for other things, too.

[A]

Give me an example of an outburst, please. What does that mean? Like, start singing. Start yelling incoherently. Like, what's an outburst?

[B]

So not like a temperature. Like, super angry. And there's no, you know, we had tried all the tools where you. You see them going to get angry, and then you try to, you know, take a deep breath and calm down first. But there's no. There's no period of time where you could do that.

[A]

Count backwards from 10. You okay?

[B]

Pretty much.

[A]

Awesome. That didn't work.

[B]

Look at your glitter bottle. Glitter bottle across the room.

[A]

But how about I throw the glitter bottle at you? How would that be okay? Right. Right.

[B]

And it's not. I mean, it's not just that. It's just not. It's being very quick, but almost too quick. Ephraim is paying attention. We homeschooled for a long time. Not anymore. We did this thing where they were memorizing throughout the whole year. They memorized this timeline. Okay. And it was basically a timeline of kind of important events in the world from the beginning all the way to. Okay, whatever the last historical event is. So, like, now the last one would probably be Covid. I don't know. And so you memorize five a week for the whole school year. And I just didn't think Ephraim was paying attention. And I was quizzing my older one on it one day, and then Ephraim just says the whole thing. So he was always paying attention when you don't think he is. But then it's. It's, like, hard to control when you're paying attention. It's hard to explain.

[A]

Okay, I'm interested because I. I don't know. And it's fun to hear people talk about it from their perspective, but you also have it. So are you doing anything to mitigate your situation?

[B]

No. I wish I had tried medication when I was first diagnosed, and it did work well. But then there was an issue. I think there was an issue for a while where. Where you couldn't get it prescription filled. So I would take it for a month, and then it would take me two or three weeks to get my prescription. So I was going on and off of it, which is far worse than just being off of it.

[A]

Where do you live that you can't get ADHD medication?

[B]

There was a whole thing in the whole country.

[A]

Oh, oh, during COVID when. When everybody. Yeah, because people use it. Like, I was gonna say off label, but I don't mean it like that. I mean, they're using it as a stimulant.

[B]

Yeah, it was. It was post Covid because it. I think it was around the time, right before Ephraim's diagnosis, we had about eight months of medical craziness in our household. And it was around that time that I couldn't get it. And I was like, I can't keep taking care of all these people and going on and off my meds. My brain is not working.

[A]

So I just were using VY or Adderall or Vyvanse. Okay.

[B]

And then I would. If I had a long. An extra long day. I did have some, like, little Adderall boosters that I could take in the evening because, you know, it doesn't last all day long. And so if I had a show. A show day or something like that, and I knew I was going to need my brain for later that evening, I could take a little booster okay.

[A]

It gets misused by the public sometimes, and then I guess that's what causes the shortage.

[B]

I don't know what caused the shortage, but it was a whole deal. And I remember I would have to call around. We were using CVS at the time, and I would have to call CVS and figure out which CVS had it and then go to that one and get it, and it was just a pain in the.

[A]

Well, listen, when you make meth legal, some people are going to really want it, is what I'm saying.

[B]

Yeah.

[A]

Yeah. Because I mean, really, in the end, that's the.

[B]

But when you have adhd, it doesn't feel like you don't get any benefit from it besides just regular brain.

[A]

Yeah, no, I know. I'm assuming that people, like, buy it and sell it and, you know, misuse it and everything else. Yeah.

[B]

I don't know.

[A]

Probably leads to the whole thing.

[B]

It's a small town. There's not a lot to do here.

[A]

Is meth a problem where you live?

[B]

Opioids.

[A]

Oh, really?

[B]

Yeah.

[A]

Oh, I'm sorry. Sucks.

[B]

It's funny because we're a little, like, we're a tourist destination, so.

[A]

But the people who live there are using the perks. What are we talking about?

[B]

Yeah, so, yeah, I mean, it's just a. I guess it's a small town thing. I don't know. People claim that the kids are bored, so they have to do drugs. I mean, I don't know. My kids are, like, doing school stuff, so they're not bored.

[A]

I'd love to get bored enough to wonder about, like, something like that. Yeah, I don't want the problem, but I'd love the boredom. Once, just one time. Yeah, I want to feel bored.

[B]

I always say. Well, just like, yeah, put your kids in theater or band or, you know, a sport.

[A]

Give him something to do. What else should we talk about? What? Because we have good time left here. I like this. I like that you're a group member in the Facebook group. I, you know, obviously I recognize your name.

[B]

Yeah.

[A]

And I'm wondering if I could ask you, if you don't have more to add. I'd like to ask you some questions, but I want to make sure we've gotten to everything that you want to talk about first.

[B]

Yeah, go for it.

[A]

Okay, cool. So you've been in this diabetes game for, you know, a little over a year and a half now. You're an active member in the group. You listen to the podcast. That's all fair, right?

[B]

Yes.

[A]

Yeah. Can you tell Me. What helped you in the podcast? What helped you in the group? I'm interested from a person who's utilizing both pieces of the community.

[B]

So my favorite episodes of the podcast are the ones for the people with the folks who've been diagnosed for a really long time.

[A]

Okay.

[B]

Because it gives me hope, like, for the future that everything really is going to be okay. And especially the ones who, you know, say things like, oh, yeah, when I was a teenager, you know, things weren't perfect and I'm fine now.

[A]

Yeah.

[B]

Because, you know, you worry about your kid. And Ephraim is very responsible and he does a really good job of taking care of himself. But, you know, sometimes he forgets to change his sight and then it doesn't, you know, work as well or, you know, we don't get that fast food bolus. Right. And then, you know, there's fast food tomorrow, too. And so it kind of keeps things in perspective for me. And then the group is just great because you just get a lot of feedback on different things and you ask.

[A]

Questions or do you learn? Are you more of a lurker or more of an asker?

[B]

I do both. I don't ask as much as I used to. I think my last post was something about. He'd been to ROTC camp, and I have never seen numbers like I had seen.

[A]

Were they very, like, it was so bad. They were like, higher blood sugars. Lower blood sugars. What are we talking about?

[B]

So it was just a continuous roller coaster the whole time. And it was very humid. I mean, we're in the south, so it was very hot, very humid. They didn't have electricity, so they were sleeping. Hot and sweaty and doing. It was orienteering. So that is like running around in the forest looking for things, I think. I'm not exactly sure what they do.

[A]

Oh, fun.

[B]

He had, like, lost sights, which had never happened before, and he would just go up into the three hundreds and then plummet down to the fifties and then just go up into the three hundred. And I was just, I want to go get him.

[A]

So what did you use the group for that time? For answers for his insulin in the heat or for.

[B]

I think I was just asking, like, can he do this? And, you know, you get a myriad of answers. You get people being nice, people not being nice, people being like, you're worrying too much.

[A]

Yeah, yeah, yeah. But all that feedback somehow gets you to where you need to be.

[B]

I think it does. And at least it gives you, you know, something to do when you can't sleep. At 3am when you're looking at the number.

[A]

And that was happening to you?

[B]

Yeah. Oh, yeah, yeah.

[A]

Oh, I'm glad it was helpful because I don't. I'm on the outside. It's. It's an interesting thing, right? Like, it's my community, it's my group, it's my podcast. I made it, it's here because I put it here. And yet I don't really get to understand it from the inside out because, you know, it's all virtual. So I'm interested always in what makes people interested in the podcast over the Facebook group or the Facebook group over the podcast. And every once in a while you meet somebody who uses both of them kind of equally. And it's always different personalities or different needs. I think that people use the, all of the content, not forever. Like, there are some people who are just podcast listeners. They listen forever. Those people, you guys are like the backbone of all this. I really appreciate it. But the ones who come in and out are like, oh, I'm gonna soak up five series and get, get to a situation where I know how to bolus for this. And then I'm probably not gonna listen to that podcast again because I'm not, you know, interested in hearing a story from a 62 year old woman who's, you know, had diabetes for 40 years. But then there's somebody like you who finds that very interesting.

[B]

Oh, I find it so fascinating. I, I don't know why, but just the way that they used to handle diabetes, I just find it very fascinating.

[A]

Well, I do too. Well, listen, I'm a podcast person. I enjoy everybody's story. I like hearing people talk and tell me, you know, things that they've witnessed and experienced throughout life. I think that's just, to me, that's very interesting. I'm like more interested, like in the people who are listening. Like, what are they getting out of it? Like, who told them about it when they got here? What did they hear that made them stay? Why did it become valuable for them? You know, if they continued to listen, why did they continue to listen? If they stop listening, why did they stop? How come podcast listeners don't go check out the Facebook group all the time? How come the Facebook readers don't go check out the podcast all the time? I think there are answers to how to help people in the answers to those questions, but I can't get those answers without asking people directly. Because if you go online and you try to start that conversation, it just turns into somebody who's Like, I don't listen to audio. Like, awesome, great. Like, that's not helpful, but thank you. You know, what is it about a person who could go to a Facebook group and say, I am lost. I'm in trouble. My health is terrible. And someone come along and say, you should try listening to these five episodes. I think they would answer your questions. And they go, I don't listen to podcasts. Like, that's the. Like, that human part of it that I'm super interested in. Or you get somebody who's listening to the podcast been really helped with something. And, you know, I say, like, hey, you should go check out the private Facebook group. They got Facebook. I don't use Facebook. There might be something there for you. Go check it out. If you don't like it, then leave it. It's fine. Anyway, I don't know. I'm just. I'm always interested in how that stuff gets found and consumed and. And why it's valuable for people.

[B]

Yeah. I was trying to think of how I heard about Juice Box, and I think it was. I found, like, just a generic parents for children with type one group, and I think maybe somebody there recommended it. But I found out about Juice Box. I think he was still in the hospital, or maybe a nurse told me. I don't know. It all kind of went by. It runs together really, really quickly. I did tell our endocrinologist that I was gonna be on your podcast. She thinks that's cool. She's really great. I think we lucked out.

[A]

No, it sounds like you did. You have the kind of endocrinologist that might tell somebody about, hey, you should go listen to a podcast.

[B]

Yeah. And she is, you know, I mean, they have to say what they have to say. Like, they have to do what they have to do. And I understand that, but she has been really interested in the bolusing for the fat and protein.

[A]

Yeah.

[B]

Because we started doing that early on when he was still mdi, if he was having something really protein or fat heavy. So we started talking about that with her early on, and she always asks us questions like, what do we do and how do we do it? She's pretty cool. I have even consulted her for Pumped pump settings when I couldn't figure things out. And she's just great. I mean, she's. She's really great. You know, we talked about the different profiles and all of that stuff, so I really feel like we got lucky.

[A]

Yeah, no, it sounds like you did. Did you listen to, like, Bold Beginnings or the Pro Tip series, or is it just listening to stories that helps you?

[B]

So in the beginning, I did listen to Bold beginnings and pro tips. And then when he was deciding on a pump, I listened to the tandem episodes that were out. What was it the guy?

[A]

Control IQ Ninja.

[B]

Yes, Control IQ Ninja. And then there was a lady. There was a mom.

[A]

Oh, yeah, yeah, yeah.

[B]

You had a really good episode.

[A]

Is it called Lazy Ninja or something like that? Is that it?

[B]

Oh, maybe. But she's the one who talked about the correction factor being like the throttle for the algorithm. And that has stuck with me. So it makes such a huge difference. So in real life, if I were to give him, like, a unit via injection, it would probably bring him down 40 points. At this point in puberty, insulin is water. On the algorithm. It is either set to 20 or 25 in most segments. That's what works. And that's it. I mean, that's just. That's what works.

[A]

I found something that worked and it works.

[B]

Once I figured that out, I could change it, actually.

[A]

So there's an episode called Control IQ Ninja 662. But then there's one called Lazy Control IQ Ninja, which is 800. I think that's what she called herself while she was. While she was talking about it. Maybe that's the one you're talking about.

[B]

Probably, yeah.

[A]

I don't know how you guys find your way through this podcast. I'm looking at a list right now of algorithm pumping episodes, and some of their titles are just ridiculous. There's one called Rise of the Machines. There's Fastidious. There's one about the 780G, but it's called Suck it out of My Thumb. Why would it be called that? And I named it. I don't know why the hell it's called. That's ridiculous. Sorry, everybody.

[B]

So what I do when I need an episode is I go on the Facebook group and I say, hey, Nico.

[A]

Well, yeah, poor Nico. Like that. Her de facto job in the world. She knows so much about the podcast, it's incredible.

[B]

Don't be good at something.

[A]

Don't be good at something. People will ask you to do it. I would also tell you that juicebox podcast.com has a search function. You can type keywords into it. You probably will get some stuff back there, too. In the end, I start running out of titles for things. And also, I guess in fairness, when I make the episode, I don't think of it as an episode about the 7 ADG. For example, like, I had a long conversation with Somebody I was like, oh, I'm going to call this one Suck it out of My Thumb. And then someone else comes along later, which is usually like, Nico or Isabel, those people. And they're like, hey, this episode's really about the 780G. You should put it on the list with the algorithm pumps. And I'm like, okay. Because I don't plan ahead like that. So I don't know if that makes sense or not. But, yeah, there's. There's a ton of stuff for Omnipod 5. We have a lot of loop content. I'm working on getting some Trio content. I have. I think I have someone lined up who wants to come on and talk about it. It's going to do, like, a short series, but that person's becoming difficult to connect with, so I'm working on that. And I'm getting ready to put together a Control IQ series as well, because I, you know, I want people to be able to get as much information as they can and make good decisions and go pick the pump they want and be successful with it.

[B]

Yeah, that's the goal. Yeah. I really think Control IQ is great when you understand it. The problem, like any problem that I have had with settings or keeping his number is because he is. You know, first of all, we're pretty new to this still.

[A]

Yeah.

[B]

He has grown 40 pounds and, like, 4 inches since he was diagnosed.

[A]

Wow.

[B]

So his needs are just changing drastically. His needs went up, actually 50%. He just had an endo appointment last week, and his insulin usage was up 50% three months prior. So it's. It just changes so rapidly. Keeping the settings accurate is. Can become difficult.

[A]

Yeah, no, I understand. Because he's putting on weight and size and that he needs more aggressive settings then because of that. Also, there's probably hormones going on, growth hormone, like, all kinds of stuff in there that needs to be counteracted with insulin as well. Like you said, it feels like insulin's water right now.

[B]

Oh, yeah, yeah.

[A]

No, and it's hard to keep up with. So there's an episode called Waxing, Waning and Hulk Hogan's Dragon. How can that be the title of a podcast episode? What does that even mean?

[B]

I don't know.

[A]

I should go listen to that to figure out what that is. Episode 300. 302. God, how long ago was that? No, I mean, you're going to be at this for a while during his growth time, and, you know, and then hopefully it'll balance out. You know, their hormonal impacts are going to Continue, you know, forever. Whereas usually with guys usually kind of, like, levels out at some point after they're done growing.

[B]

Yeah, that is. That is what I've heard. So, you know, we'll see. And we're just gonna keep at it. And he works really hard. He's really responsible. I don't have to remind him to bolus for meals. He boluses for his meals. You know, he may not always choose the foods that are the easiest bolus for, but he tries and he makes an effort to. So I.

[A]

Really good for him and good for you. Well, listen, I'm proud of him. I think that's awesome that he's. That he's putting that effort in, and it's nice that you guys have him set up thinking about it that way. It's a really great start to a life with diabetes, it sounds like. So I think that the way you start is important, and when you start with good information and good tools, you oftentimes are able to avoid a lot of the problems that everybody's trying to avoid. And it sounds like that's a thing that's in your head too, so hopefully that brings you some comfort.

[B]

Yeah. Yeah, it does. And on the days when I'm trying to bother him less and on the days when I'm bothering him too much. Why are you. Leave me alone, Mom. I'm like, I'm sorry. I just love you. I just love you, and I want you to live a long, healthy life.

[A]

Yeah. And then you're gonna have to leave him alone.

[B]

All the teenager eye rolls at the same time, too.

[A]

How old is he?

[B]

He'll be 16 next week.

[A]

Yeah, he could use help. Don't worry. There's a balance there. But you just have to, you know, you have to find ways to talk about it where you don't. It doesn't feel like you're up his butt all the time. Like that's what he's looking for. He's looking to feel a little autonomous, and that's gonna keep happening, by the way, as he gets older and older, he's gonna be looking to break away from you.

[B]

Yeah. And I think one of the hard things, too, is having him diagnosed when he's already in high school is. I feel this pressure to get him ready before college. Yeah. Or just. I feel like we don't have as much time.

[A]

Yeah, but you will. Like, I mean, I get the feeling, and. But I mean, as long as you keep good communication, once he goes off to college, you should still be able to, you know, be a valuable part of his life. He's just gotta. I don't know. I mean, I don't know how to accomplish this, but you obviously have to get into a position where he's going to be open to conversating with you about it while he's away at school and not just like, it's not going to be the ROTC thing over again, where it's just a, you know, a show and there's nothing you can do about it.

[B]

Yeah, I mean, I think if he were to do a trip like that again, we would. I don't know what we would do. We would maybe consider doing, like, the untethered method for the week or something. So at least he would have some long acting in his system in case the heat and everything made things go haywire.

[A]

He did that trip with Moby on.

[B]

He doesn't wear the Moby. He wears the T slim.

[A]

But he did that trip with that one on.

[B]

Yeah.

[A]

Okay. And he still had trouble. Was he not bolusing, like, pre bolusing? Was he. Was it. Was he falling from activity and then over treating. Did you ever figure out what was going on?

[B]

I think it was a lot of it was the heat because they never got cool. Like, they just never had.

[A]

Yeah.

[B]

Because there was no AC anywhere. And so then the heat made it go kind of haywire. And then also, like, sites weren't sticking, and we'd never had a problem with that before, but it was so humid, it just. They weren't sticking. And it was just a combination of everything. Food, of course, you know, they never feed teenagers, like, decent food.

[A]

Yeah, I know.

[B]

You know, he does his best, but, you know, he's 15 and wants to do what everybody else is doing.

[A]

I got you. I understand. Okay. Well, Leslie, I appreciate you doing this with me. I really do. Thank you for taking the time. And thank your husband for setting up such a nice microphone. I appreciate that.

[B]

I will thank him.

[A]

Yeah.

[B]

Yeah. I will say I did ask in the group if anybody had ever had an experience like ours where, like, they thought something was wrong when they were a baby and then were diagnosed later and absolutely nobody had had that experience.

[A]

You're like, great.

[B]

I was like, out of all of you people.

[A]

Well, I mean, I do think there are people who have low blood sugars. And then, you know, I've heard enough people say, like, oh, when I was young, I had low blood sugars. Like, I had to take stuff. Like, I got dizzy and stuff like that. And then 10, 15 years later, I got type 1 diabetes. That stuff I've heard. But Yeah, I don't. I don't know. I really don't know. Like, if you just caught a thing one time or.

[B]

Yeah, it's just weird. It's just.

[A]

Is it just a really slow presentation? I mean, are there ways you can check to see. Is he insulin resistant? Like, do you think he has insulin resistance or.

[B]

No, I don't think so.

[A]

Okay.

[B]

The endocrinologist, she really said like that the amount he uses, even though it feels like a lot to me, she said it's not.

[A]

How much does he use a day? About.

[B]

He is averaging around 70 now.

[A]

Okay.

[B]

So she says it's not really, you know, for. And because he's in, like full blown, you know, hormone growing, puberty. She said that it's fine. So.

[A]

Yeah. Interesting. I mean, your husband has type two, right? Is he insulin resistant? I mean, obviously, yeah.

[B]

So he doesn't. He only takes metformin.

[A]

Okay.

[B]

So he was diagnosed type 2 in February. Then my mom, who lives with us, had a knee replacement in April. Six weeks to the day after that, my husband goes into the hospital for what we thought was a heart attack. Ends up with open heart surgery. And then eight months after, seven months after that, Efram was diagnosed.

[A]

Wait, so your husband had open heart surgery for a while?

[B]

He did. Very dramatic.

[A]

No. How did that happen? What was that?

[B]

We're coming. We had dropped Ephraim off at dance, and I come home when I need to dye a costume for him to match the ladies. And so I have my husband send him outside to get a bucket for the dye. And he goes, gets the bucket, rinses it out, comes in the house, and I'm walking around doing things, and I look over at him and he's droopy. And I said, are you okay? And so then he. In the meantime, he'd gotten my mom's blood pressure cuff. We just have things, so it works out. Took his blood pressure and it was something crazy, like 180 over. I don't remember what it was, but it was. It was crazy. And I said, excuse me, I think we need to go to the emergency room. And he was like, just bring me a baby aspirin.

[A]

Jesus. How old is he?

[B]

He is 10 years older than me at this time. He was like 52. So I said, I will bring you the baby aspirin and you can take.

[A]

It on the way to the hospital.

[B]

Yeah, basically I said, but you're going to take your blood pressure again right now. If that wasn't if that was accurate, then we're going to.

[A]

Because I'm not raising these three kids by myself.

[B]

Yeah, we have life insurance, but.

[A]

But, yeah, I don't.

[B]

Yeah, I don't want to.

[A]

It's not gonna paint the house, so let's go.

[B]

It's not. No.

[A]

Oh, no kidding. And what. What was the problem?

[B]

So they, you know, they kept him instead of sending him home because he didn't have a heart attack. But they said if we keep him, he can get the test, like, tomorrow instead of coming back in three weeks. So they kept him, did the stress test, did the heart cath to look. And so they were thinking they'll do the heart catheterization and put in a stent, and he'll be fine. Well, that was over in, like, 20 minutes. So I knew that they couldn't fix whatever was broken with that procedure because it would have taken longer. And turns out he had a 90% blockage in his aorta, which is the widowmaker. And right above that, he had an aneurysm, so they couldn't use a stent, so.

[A]

So he had to have open heart surgery to have that stuff fixed.

[B]

Yeah. So he also got transferred to a better hospital.

[A]

Hey, is that the heart problems running his family?

[B]

Yes. Yes.

[A]

Does type two.

[B]

Yes.

[A]

Do you think that he's had type two implications for much longer than he's been on metformin?

[B]

I think he had type 2 implications for a couple of years before.

[A]

What's his A1C right now?

[B]

I think it was 6.3.

[A]

Does he have any weight to lose?

[B]

Yes. Yeah.

[A]

What's my next question?

[B]

So he tried triazepatine or Manjaro. Is my Manjaro Tri. Zeppetatine?

[A]

Sure. Yep.

[B]

He tried the Manjaro. He. He could not handle the side effects.

[A]

What does that mean? He couldn't handle the side effects?

[B]

You know, he said it made him feel like crap, and he just couldn't. So he may try something else.

[A]

How long did he try it for?

[B]

I don't know.

[A]

How long you guys been. You guys have been married for so long, you're like, I don't know. I don't really care, to be honest with you.

[B]

We have been married for 18 and a half years.

[A]

That's not long enough for you not to know how long he tried Manjaro.

[B]

It was a few months. Well, so at the same time, I was trying to get one just for weight loss for myself, but of course, insurance doesn't cover that.

[A]

Yeah, but you tell me. It made him feel nauseous.

[B]

It made him. I'm not sure what all the side effects.

[A]

What was going on. Can I talk to him for a second? Leslie, I'm done with you now. Bring your husband and I want to hear about this real quick. Does he want to be on a podcast for five minutes?

[B]

Oh, I think he's on the phone.

[A]

Unbelievable.

[B]

He is really popular guy.

[A]

These people, their lives and things to do. All right, well, listen, if he wants.

[B]

To come on, he might be coming.

[A]

Is he coming?

[B]

Scott has questions for you.

[A]

All right, Leslie, I'm done with you now.

[B]

Okay.

[A]

What's your husband's name?

[B]

His name is Stacy.

[A]

All right, cool.

[B]

Fun fact. He looks like Santa Claus.

[A]

How is that a fun fact for him? What do you mean? Like, he's got a white beard.

[C]

Oh, I look like Santa. I portray Santa.

[A]

Oh, Stacy, how are you? I'm Scott. Good. Hey, I just have a couple of questions. You tried Manjaro, correct?

[C]

For about two months.

[A]

What level? Like, what dose? Dose is the word I was looking for.

[C]

She started me off on the 2.5 and I got up to 7.5.

[A]

Okay.

[C]

And time I hit the 7.5, the side effects of nausea, vomiting, it just wasn't worth it to me.

[A]

So were you getting benefits at the 5? Like, was your A1C lower, your blood sugars better? Were you losing weight?

[C]

Blood sugars were probably better, yes. I did lose probably 5, 8 pounds in that time frame.

[A]

Okay.

[C]

Just that short amount of time. So I have a follow up appointment. I'm gonna talk to her about staying at the 5 for a while and seeing how that goes.

[A]

Tell me about the nausea and the vomiting. Like, did you change how you were eating? Were you eating a lot of fatty or greasy foods on the 7.5?

[C]

No, I wasn't hardly eating anything. And that was concerning to Leslie because I was like, eh, no food sounds good.

[A]

Yeah, no, I. I hear what you're saying. Like there's days. Yeah, Yeah, I think I had two eggs so far today. And I was like, that's good.

[C]

Yeah, you gotta like force eat or drink a protein shake.

[A]

Right? Right. But so you started at the 7.5. You had nausea and then nausea was making you vomit. You don't think you were backed up? Were you still going to the bathroom?

[C]

No. Oh, yeah, I was still going to the bathroom. No, it was the nausea and then the vomiting. I was like, I don't even like being around people who are vomiting, let alone me vomiting. So I was like, it's not worth it.

[A]

Yeah, so did you think to try to go back to the five?

[C]

That's why I said I'm going to talk to her about going back to the five.

[A]

Yeah, I'd be interested in that for you because I mean, especially she explaining about your heart issue and, and type 2 and etc and I mean a 6, 4, a 1C on. On metformin is nice, but like, I mean, obviously you'd love to see it lower, right? Yeah.

[C]

And that's what she was saying. She liked to see it lower, but she was more concerned about me losing the weight because the Metformin, you know, it's like taking candy. It really wasn't helping, wasn't doing with anything.

[A]

Yeah, no. How much weight do you think you could lose?

[C]

I want. Right now I'm probably at 235. I want to get down to at least 200.

[A]

How tall are you? Nine feet tall. How tall are you exactly?

[C]

Yeah, I wish. Probably five, seven and a half.

[A]

Let me tell you something. I'll share a good day. I'll share this with you and, and hopefully it'll be valuable for you. I'm 5, 9 and the day I started a GLP over two years ago, I weighed 236 pounds and I got it. I told my wife, I was like, look, I need to. Obviously I need to lose 20 pounds. And my wife's like, 20 pounds. You think that's how much you have to lose? And I'm like, no 20s, right. I lost 20 and looked in the mirror and I was like, oh, well, obviously I need to lose £30. And then I got down to 200 and I was like, oh, maybe I should be more like 190 pounds. And this morning I was 166 pounds. Is that what I was this morning? Yeah, 166. And I'm telling you, I've got five more pounds to go.

[C]

Holy moly.

[A]

Yeah. And so I think what happens is over time you just get a. A confused view of your body because you think of yourself as stocky or strong or something. Like, I don't know exactly how you think of it, but like, I'm speaking for myself and that's the end of it. Like, I prob my body probably if I go ahead and add back on some muscle that, you know, that I think I need to have. I think maybe there's a world where I weigh 165 or 170, and that would be if I was in a perfect balance of fat and muscle on my frame. But if I just stay a thin person. And I never add weight back. I still have a handful of fat around my stomach that I have to get rid of, and I weigh 166 right now. So I'm going to tell you that I think I'm around my correct weight. I just don't think my body composition's right at the moment. The balance between muscle and everything else. But if you think you need to be £200, you. I think you're probably wrong.

[C]

Yeah, probably. But that was just my, you know, my short term goal for right now.

[A]

Oh, no, no, no. I'm not saying it's not a good goal to, like, shoot for. I'm saying, like, when you step back and see the big picture. I was shocked by the number when it was over. And even seeing myself in the mirror, I was like, I never thought this is the size that I was supposed to be at, but now when I look at myself, I'm like, this is clearly. This is the size my body's supposed to be.

[C]

Yeah.

[A]

Yeah. I hope you figure something out. At the very least, I hope the five helps you. Have you considered just trying Ozempic instead of Manjaro?

[B]

No.

[C]

And that was another thing I'm going to talk to her about. Just maybe switching up and seeing a different one would help.

[A]

Yeah. Because the Manjaro has a GIP in it. Also for weight loss. Maybe you're not jiving well with that. Like, who knows? Yeah. Yeah. Also, how long were you nauseous for before you stopped using it?

[C]

Oh, probably good. Three weeks.

[A]

Yeah. Yeah. I'm not sure if there's an amount of time where you might have gotten a little more accustomed to it. Was the nausea worse at the beginning of the week than at the end?

[C]

No, it was actually towards the end of the week, probably as it was wearing off.

[A]

Oh.

[C]

Because I was set. I had it set up.

[A]

Where?

[C]

Routinely on Monday mornings before I went to work, I was giving myself my shots.

[A]

And then by, what, four or five days later, you started to feel nauseous? Yep. Huh. So is there an argument to be made that you needed more, not less, or a different coverage of it? Maybe.

[C]

Maybe. Like I said, I got an appointment with her in the next couple of weeks. I gotta look at the calendar again.

[A]

Yeah. I. I'd encourage you not to give up. That's the only thing. And I would tell you, if you get constipated, you could add, like, magnesium oxide to your regimen of, you know, vitamins, and that'll keep things moving. If you get constipated, I don't know if you will or not, obviously. Right. But I wish you a ton of luck, because obviously we don't want to see you, and we don't. We don't want to see you having another surgery, that's for sure. That must have been scary as hell, huh?

[C]

Oh, yeah. Yeah.

[A]

What's the recovery like from that?

[C]

I wouldn't want to ever do it again, but I was out of the hospital in three days. They said I was like, psycho trooper to get out. And they're like, you can rest at home. You don't need to rest here. Because the goal was before you left the hospital, you had to climb a flight of stairs up and down. And they had me out walking the next day. I had the chest tubes still in, and I was up walking.

[A]

Wow. Yeah. You were determined to get out of there.

[C]

Yeah, yeah, yeah. I mean, the worst thing was ever. Coughing or sneezing was the worst.

[A]

Yeah. How long until you felt like, back to yourself?

[C]

It's probably a year.

[A]

No kidding. And now. Yeah, you're there now, but, like, do you feel like with that blockage gone, is there a noticeable difference in. I don't know how your body works?

[C]

Yeah, yeah, definitely. It was a definite. It was different because I wasn't fatigued all the time.

[A]

Yeah.

[C]

And they're like, yeah, your body was starving for oxygen and.

[A]

Well, it's scary, man.

[C]

Yeah.

[A]

Did they tell you how long you were from just shutting off?

[C]

No, they said if. If it would have ruptured, the aneurysm would have ruptured. I would have never made it from the. From my house to the hospital, and we're probably half a mile. Mile to the hospital.

[A]

Oh, that's scary. Holy crap. All right. You're gonna make me go to the cardiologist. Well, I'm glad you're doing better now, and I. And I hope you're able to figure out the other part of it. I appreciate you setting up the microphone for Leslie and everything today. I just wanted to ask you that question about the glp. So I appreciate you jumping on. Thank you.

[C]

Yeah. And I listened to the one that you put on there about the GLPs.

[A]

Oh, you are listening to them?

[C]

Oh, yeah.

[A]

Yeah. I have a ton of them. There's been a lot of people are using them now, a lot more than usual or a lot more than even a couple of years ago, especially type ones. My brother, who I'm adopted, so it's not like a blood thing, but, like, my brother's has type 2 diabetes, and he is really like flourishing on a GLP as far as his A1C and his weight goes and just his life in general. So I, I hope you can find something that'll that balances you feeling well with actually getting all the benefits that come with it. Because a couple years from now on one I think you'd, you'd lose that weight and you'd be surprised. It takes a while, you know, but, but it does happen like pretty consistently. It's a valuable thing for sure. Anyway, I appreciate you taking your time. Thank you so much. And please tell Leslie I said thank you as well.

[C]

Sure will.

[A]

Thank you. Have a great day. Bye Bye bye. Head now to tandom diabetes.com juicebox and check out today today's sponsor, Tandem Diabetes Care. I think you're going to find exactly what you're looking for at that link, including a way to sign up and get started with the Tandem MOBI system. Dexcom sponsored this episode of the Juice Box Podcast. Learn more about the Dexcom G7 at my link dexcom.com juicebox A huge thanks to USMED for sponsoring this episode episode of the Juice box podcast. Don't forget usmed.com juicebox this is where we get our diabetes supplies from. You can as well use the Link or call 888-721-1514. Use the link or call the number, get your free benefits check so that you can start getting your diabetes supplies the way we do from US Med. 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. If you're looking to meet other people living with type 1 diabetes, head over to juiceboxpodcast.com juicecruise because next June. That's right, 2026 June 21st. The second Juice Cruise is happening on the Celebrity beyond cruise ship. It's a seven night trip going to the Caribbean. We're going to be visiting Miami, CocoCay, St. Thomas and Saint Kitts. Yeah, the Virgin Islands. You're going to love the Virgin Islands. Sail with Scott in the Juice Box Community on a week long voyage built for people and families living with type 1 diabetes. Enjoy tropical L luxury, practical education and judgment. Free atmosphere. Perfect day at Coco Bay Saint Kitts Saint Thomas. Five interactive workshops with me and surprise guests on Type one hacks and tech, mental health, mindfulness, nutrition, exercise, personal growth and professional development. Support groups and wellness discussions tailored for life with Type one and celebrities. World class amenities, dining and entertainment. This is open from every age. You know newborn to 99. I don't care how old you are, come out. Check us out. You can view staterooms and [e-mail] JuiceCruise the Last Juice Cruise just happened a couple weeks ago. A hundred of you came. It was awesome. We're looking to make it even bigger this year. I hope you can check it out. The episode you just heard was professionally edited by wrongwayrecording wrongwayrecording.com.