Juicebox Podcast: Type 1 Diabetes

Episode #1691 – Autumn Needs an Answer: Part 2
Date: November 26, 2025
Host: Scott Benner
Guest: Autumn

Episode Overview

In this heartfelt and candid episode, Scott Benner continues his conversation with Autumn, a 44-year-old woman with an evolving diabetes diagnosis journey. Having been diagnosed with type 1 diabetes at age 13, Autumn recently discovered she actually has MODY 4—a rare genetic form of diabetes. The discussion focuses on the impacts of misdiagnosis, the emotional and physical transformations from using new medications (notably GLP-1 agonists), and the importance of self-advocacy in navigating the healthcare landscape. The episode is rich with personal insights, humor, and reflections on both the struggles and triumphs of living boldly with diabetes.

Key Discussion Points & Insights

1. Identity Crisis and Medical Journey (02:31–06:10)

• Autumn shares the "total identity crisis" she experienced during her reevaluation, struggling to reconcile decades of living as a type 1 diabetic with the new reality of another diagnosis.
  • "If I'm not type 1, what am I? What do you mean?" (02:32 – Autumn)
• She withheld the unfolding events from most of her family, confiding only in her husband and a close friend due to societal criticisms, especially around the use of GLP-1 medications.
• The fear of changing treatment—like removing her insulin pump after decades—was substantial, but ultimately, she chose to try, emphasizing the mindset: “no regrets.”
  • "If you don't try, how will you know?... I don't ever want to live my life thinking I should have, could have, would have. Like, no regrets." (02:55 – Autumn)

2. Struggles with the Healthcare System and Advocacy (04:49–06:57)

• Autumn recounts dismissive doctors who ignored her symptoms of insulin resistance, urging others to advocate for themselves if their healthcare doesn't feel personalized.
  • "No. Healthcare has to be personalized to the individual's needs. And I don't give a rat's ass what your book says or how many years you went to school. I know how I feel right now, and I've never felt this good in my entire life." (05:10 – Autumn)
• Resentment and anger followed the realization that she could have lived differently for years if properly diagnosed, affecting her family, health, and life choices (like having more children).

3. Impact of Medications and Life Transformation (05:29–12:00)

• Autumn details her dramatic weight loss—from 238 lbs to 160—much of which occurred after stopping insulin pump therapy and starting GLP-1 medication.
  • "Seriously, the last 40 pounds, as soon as I took that insulin pump off, it just came off like water." (05:44 – Autumn)
• Both Autumn and Scott share how GLP-1 medications improved their quality of life far beyond weight; they gained energy, better digestion, and a renewed ability to enjoy everyday activities.
  • "Without that, whatever the hell is in that stuff... it has fundamentally changed how my body works." (10:01 – Scott)
• Autumn describes losing “food noise”—constant preoccupation with food—which GLP-1 therapy resolved.
  • "The food noise, completely gone after starting that medication was a complete game changer in my life." (14:41 – Autumn)

4. Societal Judgment and Moving the Goalposts (15:07–18:09)

• Scott and Autumn commiserate about public backlash against new medical solutions, especially the idea that using medication (like GLP-1s) is “cheating.”
  • "It took some dork in a lab 30 years to figure this out and he figured it out, and your hot take on it was, ‘oh, you're going to cheat like that?’" (15:39 – Scott)
• They push back on goalpost-moving, judgmental attitudes, and advocate for kindness and understanding.
  • "If you think yelling at poor Autumn here for cheating is a good use of your time, go for it. But she's off living a better life while you're busy telling her what she's doing wrong." (17:19 – Scott)
  • "And you know what that person do? They can right off." (17:29 – Autumn)

5. Body Image, Visibility, and Social Treatment (21:44–24:12)

• Autumn discusses how weight impacted her visibility in family photos, her willingness to participate in life, and even how strangers interact with her.
  • "There are so few photos of me with my family[...] Of course, the ones that we do have, I had to make sure that they were okay. I don't look like a complete cow in that picture. We can share that one kind of thing." (21:44 – Autumn)
  • "People are nicer to you when you’re not overweight... I’ve had more people offer to help me... That would have never happened, you know, 80 pounds ago." (23:36 – Autumn)
• The need for acceptance, both self and societal, and the healing power of sharing stories are emphasized.

6. Growth, Learning, and Letting People Be (24:43–28:34)

• Scott reflects on the value in changing one’s mind as you learn, and the futility of trying to correct others harshly.
  • "You have to trust the process of being alive and learning and growing and not want to hold people accountable for things that they thought or did in the past that they understand are different now." (24:52 – Scott)
• A plea for kindness and perspective sharing, not judgment—a major recurring theme.
  • "Telling people they're wrong is not a good way to get them to know they're wrong. That's not how you do it." (26:42 – Scott)

7. Healthcare, Modern Technology, and AI in Medicine (31:38–46:35)

• Autumn looks to the future, participating in further genetic testing and clinical management for her MODY 4 diagnosis, with hopes of “paying it forward” through research.
  • "If that means you throw me in a lab and do all the tests and sign me up, because, again, I have nothing to lose and helping somebody else is really my goal at the end of the day..." (31:54 – Autumn)
• Scott speculates on the promise of AI to streamline diagnosis and personalize care, especially for rare cases like Autumn’s.
  • "Wouldn't it be awesome if you just sat down with your phone and told it all of your little problems and then at the end had it say to you, ‘this is crazy, but sound like you're MODY 4.’" (45:04 – Scott)
• Frustration with hospital care is highlighted through a story about Autumn’s father's poor diabetes management during a hospital stay.
  • "They're giving this man insulin, crashing him, bringing him all the way up to 500, crashing him again... Just stop." (34:29 – Autumn)
• Both agree that clinicians are limited by training, system constraints, and risk aversion.

8. Lost Time and the Value of Shared Knowledge (40:36–44:31)

• A poignant segment details the grief of realizing how much life was lost to misdiagnosis, a sentiment Scott shares from earlier conversations with listeners.
  • "All she could say was, why did no one tell me this? I’ve been living this way for decades." (40:36 – Scott)
• Autumn credits the podcast with giving her tools to manage her diabetes and push for the “answer.”
  • "I learned more from listening to your podcast about bumping and nudging, things I could do, about being bold with insulin… why isn't this information more readily available?" (41:38 – Autumn)

9. Humor and Episode Title Banter (33:58–48:12)

• The hosts riff on mispronouncing “sulfonylurea” (an oral diabetes medication), joking about titling the episode “Sulfur Uranus” or “Unicorn Anus” to much laughter and levity.
  • "Can we call this episode Sulfur Uranus?" (33:58 – Scott)
  • "Go for it." (34:04 – Autumn)

10. Epilogue: The Blessing of Good Doctors and Looking Forward (47:06–End)

• Autumn notes her gratitude for finally connecting with skilled clinicians and being rare enough to contribute to future case studies.
  • "You're the 21st case that we have in our registry. And I'm like, holy shit. 21st." (47:33 – Autumn)
• Final, warm encouragement from Scott to focus on future gains, not past losses, and the importance of sharing personal health journeys.

Memorable Quotes by Timestamp

• Identity & Self-Advocacy:
  "No. Healthcare has to be personalized to the individual's needs. And I don't give a rat's ass what your book says or how many years you went to school. I know how I feel right now, and I've never felt this good in my entire life."
  — Autumn (05:10)

• Transformation & Medication:
  "The food noise, completely gone after starting that medication was a complete game changer in my life."
  — Autumn (14:41)

• Societal Judgment:
  "It took some dork in a lab 30 years to figure this out and he figured it out, and your hot take on it was, ‘oh, you're going to cheat like that?’"
  — Scott (15:39)

• On Judging and Growth:
  "You have to trust the process of being alive and learning and growing and not want to hold people accountable for things that they thought or did in the past that they understand are different now."
  — Scott (24:52)

• On Loss and Moving Forward:
  "All she could say was, why did no one tell me this? I’ve been living this way for decades."
  — Scott (40:36)
  "Don’t think about what was lost. You know, think about what you’ve got left and how much better."
  — Scott (43:17)

• Humor:
  "Can we call this episode Sulfur Uranus?"
  — Scott (33:58)

Notable Moments and Tone

• Humor & Humanity: The episode is laced with raw humor (naming the episode after medication mispronunciations), helping offset the gravity of chronic illness.
• Vulnerability: Autumn is deeply open about her regrets, anger, and relief at finding answers.
• Empowerment: Both voices emphasize the importance of persistence, advocacy, and self-education in the diabetes journey.
• Honesty: The conversation includes candid admissions about mental health, fears, relationships, and medical frustrations.

Key Timestamps

• Identity crisis and secrecy: 02:31–02:54
• Struggles with misdiagnosis: 05:10–06:08
• Weight loss after medication change: 05:33–05:44
• Societal criticism of GLP-1 use: 14:26–15:07
• Social treatment after weight loss: 23:19–23:51
• Healthcare system critique & advocacy: 34:26–38:39
• AI and technology in diagnosis: 31:38–46:35
• Lost years and gratitude for progress: 40:36–43:17
• “Sulfur Uranus” banter: 33:58–34:19

Conclusion

This episode is a resonant exploration of chronic illness, the shifting nature of diagnosis, the power of advocacy, and the liberating effects of effective modern medications. By sharing her vulnerable and unique MODY 4 story with Scott, Autumn gives hope and camaraderie to listeners grappling with their own health journeys—and reminds everyone to approach each other (and themselves) with kindness, persistence, and a willingness to learn.

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