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)

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.

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]

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]

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]

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]

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]

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]

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]

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]

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]

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]

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.” |

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.

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.

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.