Juicebox Podcast: Type 1 Diabetes

Episode #1707: Triple Greased Food

Date: December 12, 2025
Host: Scott Benner
Guest: Catherine (listener and T1D mom, Bermuda)

Main Theme & Purpose

This episode features Catherine, a nurse and mother of a teenager recently diagnosed with type 1 diabetes, sharing her family's journey through diagnosis, major life changes, and practical diabetes management. The conversation candidly explores the medical, emotional, and logistical hurdles faced in a small island community, especially during a turbulent year of personal loss, travel, and high-stakes exams — all while learning to be “bold with insulin.”

Key Discussion Points & Insights

1. Diagnosis Story and Early Experience

• Max's Diagnosis:
  • Diagnosed at age 15 while at a self-managed school band trip in the US.
  • Classic symptoms (excessive urination, tiredness, changes in school performance) were initially missed due to overlap with ADHD and "teenage boy stuff."
  • Blood sugar at diagnosis: 679 mg/dL, A1C: 10.3% ([08:14])
• Parental Guilt:
  • Catherine (nurse) processed guilt over missing signs but emphasized how many symptoms could be attributed to other causes:

    “As nurses, we are trained for hospital-based items…You're being trained for the classic symptoms that are going to come through the door.” ([12:50])

2. Family Context & Coping with Loss

• Background: Catherine, Canadian-born, has lived in Bermuda 19 years, raising two teenage boys, one with T1D.
• Recent Bereavement:
  • Catherine’s husband (Max’s father) died unexpectedly of an aggressive cancer just 99 days before the episode was recorded, during the same year as Max’s diagnosis ([19:10]).
• Coping Strategy:
  • Used therapy for both children, community/scouting support, and personal resilience. Children responded to grief in different ways: one quiet, one angry ([24:54]).

3. Managing Type 1 Abroad and Food Challenges

• US Hospital Experience:
  • Catherine stayed in Boston for her husband's treatment, coping with US food’s higher grease/sugar content versus UK/Bermuda norms.
  • “Triple greased” US fast food made BG control unpredictable, with portion sizes and fried foods leading to extended high blood sugars:

    “It's almost the same concept as pizza. You’ve got to just learn how it works…” ([23:14])

• Food Labeling & Access Issues:
  • Lack of available carb counts on US foods (e.g. cannoli) made dosing a challenge.
  • Bermuda has only one US franchise (KFC); other fast foods are less processed, leading to fewer unpredictable BG spikes ([22:12]-[23:05]).

4. Exam Stress & Diabetes (GCSEs)

• What are GCSEs?
  • UK-based “exit” exams, forming the basis for further education – no retakes ([25:43]).
• Impact of Blood Sugars on Testing:
  • Highs caused mental fog during exams, requiring real-time advocacy with medical documentation for leniency ([28:09]).
  • Example: Pump failure unnoticed due to off-phone policy, resulting in severe hyperglycemia during chemistry exam ([29:13]-[31:38]).
• Blood Sugar / Cognitive Impact:

  “He says he just, like, he can’t focus. It almost feels like he’s swimming…underwater, nothing is making sense.” ([34:17])

5. Technology, Logistics, and Remote Living

• Available Devices in Bermuda:
  • Omnipod and Medtronic pumps, Dexcom G6 (G7 only through workaround), Libre (though less commonly type 1s) ([37:45]-[41:16]).
  • Logistical hassles: international shipping, location-based app restrictions, frequent failures with newer tech (G7).
• Community:
  • Type 1 diabetes community in Bermuda is small, close-knit, supportive.

6. Teenage Independence & Safety

• Gradual Transition to Independence:
  • Catherine is teaching Max to manage his own data and alerts, only intervening for severe lows (<40 mg/dL) ([46:35]-[47:02]).
• Driving/Biking and Hypos:
  • Bermuda licensing: bikes at 16, cars at 18.
  • Real-life scenario: Max ignored low BG for convenience when cycling home; led to discussion on medical alert ID and the seriousness of lows when operating a vehicle ([48:25]-[49:41]).

7. Travel, Adventure, and Diabetes

• Max’s Questions Post-Diagnosis:

  “The night that he was diagnosed with diabetes, that was his first question to me — could he still do Duke of Edinburgh?”

• Approach: Meticulous, over-packing of supplies for travel (30 days’ worth for 10-day trips), backup pens, and alternate snacks (gummies over juice boxes for portability).
• Keeping Insulin Cold:
  • Extensive testing of cooling products (Vivicap, Frio, gel packs, insulated tech) for long, cell-service-free trips ([55:36]).
• Travel Obstacles:
  • International prescription limitations, language barriers, reliance on Teladoc or urgent care ([60:57]-[61:04]).

8. Mental Health & Resilience

• Therapy:
  • Promptly engaged for both sons, especially at diagnosis and after the father's passing ([24:03]).
• Max’s Growth:
  • Became more proactive managing diabetes post-bereavement, with Catherine encouraging independence and logical decision-making ([46:06]-[48:09]).

Notable Quotes & Memorable Moments

• On Diagnosis and Guilt:

  “When I looked back in hindsight…about the month before he went away to camp, my husband and I had noticed…one of our children would be getting up and going to the bathroom, which was a new thing…” – Catherine ([08:44])

• Describing BG "Fog":

  “It almost feels like he’s swimming…Nothing is making sense or being comprehended…like that dream world or swimming, hearing things underwater…” – Catherine ([34:17])

• Teenager’s Troubles with Tech Rules:

  “He had put his phone on silence because…he uses a PDM rather than the app...the PDM looks like an iPhone…that’s all sitting in the back with an invigilator who has no idea…” – Catherine ([29:11])

• On Food Differences:

  “There’s a layer of grease…obviously it takes a while for the stomach to break that down. You’re spiking a lot higher…almost the same concept as pizza…” – Catherine ([23:14])

• On Teaching Independence:

  “We’ve almost come to an agreement now that if I get a low or a high alert, if I get one, I ignore it…because I need to see whether he’s going to manage it.” – Catherine ([46:35])

• On Packing for Travel:

  “He will bring enough supplies for 30 days for a 10-day trip…” – Catherine ([60:36])

• On Continuing Life and Adventure:

  “Oddly enough, the night that he was diagnosed…his first question to me was whether he could still do Duke of Edinburgh. And I’m like, well, why wouldn’t you? Of course you can.” – Catherine ([61:49])

Timestamps of Important Segments

• Diagnosis Story: [04:22]–[09:54]
• Grief & Loss (Father's illness and passing): [14:08]–[20:04]
• Challenges with US Food during Crisis: [20:22]–[23:44]
• Exam Stress & Diabetes (GCSEs, pump failure): [25:43]–[34:11]
• Describing High BG "Brain Fog": [34:17]
• Device/Technology Hurdles in Bermuda: [37:45]–[41:16]
• Building Teenager Self-Management: [46:06]–[48:14]
• Low BG + Biking Incident: [48:25]–[50:21]
• Travel Prep (Supplies, cooling, emergencies): [53:34]–[60:36]
• Duke of Edinburgh Expedition Planning: [53:34]–[61:49]

Tone & Style

Catherine is open, resourceful, and pragmatic — blending humor, vulnerability, and hard-won insight. The episode is empathetic and supportive, with the host regularly affirming and encouraging the sharing of “real life” stories.

Summary Takeaway

Catherine’s story illustrates the immense challenges families face when managing a new diagnosis of type 1 diabetes through personal tragedy, major exams, travel, and daily life. She candidly shares strategies—everything from handling unexpected food environments, to navigating exam accommodations, to fostering teenage independence in diabetes management. Underlying it all: community, humor, meticulous preparation, and a determination never to let diabetes or loss restrict opportunity for adventure and growth.