#1707 Triple Greased Food

Summary

Juicebox Podcast: Type 1 Diabetes

Episode #1707: Triple Greased Food

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

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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.”

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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]).

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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])

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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]

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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.

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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.

Transcript

[Katherine]

Hello friends. Welcome to the Juice Box Podcast. From my family to yours, I want to wish you a happy holiday.

[Catherine]

My name is Catherine. I am currently in Bermuda. I've lived here now for 19 years. I have two sons, my son Max, who is 16 who has type 1 diabetes and his younger brother who is 14 who does not.

[Katherine]

If this is your first time listening to the Juice Box Podcast and you'd like to hear more, download Apple Podcasts or Spotify, really any audio app at all, look for the Juice Box Podcast and follow or subscribe. We put out new content every day that you'll enjoy. Want to learn more about your diabetes management? Go to juiceboxpodcast.com up in the menu and look for Bold Beginnings, the Diabetes Pro Tip series and much more. This podcast is full of collections and series of information that will help you to live better with insulin. While you're listening, please remember that 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 or or becoming bold with insulin.

[Co-host 1]

I'm having an on body vibe Alert.

[Katherine]

This episode of the Juice Box Podcast is sponsored by Eversense365. The only one year wear CGM. That's one insertion and one CGM a year. One CGM one year, not every 10 or 14 days. Eversensecgm.com Juicebox Today's episode is also sponsored by Touched by Type 1. Go check them out right now on Facebook, Instagram and of [e-mail] check out that programs tab when you get to the website to see all the great things that they're doing for people living.

[Co-host 2]

With type 1 diabetes.

[Katherine]

Touched by type1.org the podcast is also sponsored today by the Tandem MOBI system, which is powered by Tandem's newest algorithm, Control IQ Technology. Tandem MOBI 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 My name is Katherine.

[Catherine]

I am currently in Bermuda. I've lived here now for 19 years. I have two sons, my son Max, who is 16, who has type 1 diabetes and his younger brother who is 14, who does not.

[Co-host 2]

Okay, Max is 16. He has type 1. How old are you?

[Catherine]

I am 49.

[Katherine]

49. And you live in Bermuda?

[Catherine]

I do.

[Co-host 1]

And for the last 29 minutes you and I have been trying to get.

[Co-host 2]

Set up to do this and whether.

[Co-host 1]

We used your laptop or your phone or even calling from a Home phone.

[Co-host 2]

Through, like, Zoom's number.

[Co-host 1]

You were getting an echo while you were talking. So. So that everybody knows, I then went to my provider, my podcast provider.

[Co-host 2]

This is probably a backroom thing you guys don't really know or care about, but I employ a company to host the podcast, and then they distribute it to whatever app you're listening on right now. Even if you're listening on my website through the little player, it's all through.

[Co-host 1]

This great company called Libsyn, and they offer something called Connect, where people who don't have Zoom or something like that.

[Co-host 2]

Can record and make a podcast.

[Co-host 1]

So I don't know how this is going to sound.

[Co-host 2]

I don't know anything.

[Co-host 1]

I apologize ahead of time.

[Co-host 2]

If you don't like it, if you love it, check out Zoom or check out Libsyn.

[Co-host 1]

But, Katherine, let's start, because it's freaking me out a little because I can't.

[Co-host 2]

Hear myself in my ears, which I usually can do, but I'm just going to live with that.

[Co-host 1]

Like, I know that sounds strange, but.

[Co-host 2]

I can hear myself while I'm talking.

[Catherine]

Okay.

[Co-host 2]

But I need my headphones on to talk to you.

[Catherine]

Yeah.

[Co-host 2]

Feels like I'm underwater right now.

[Catherine (continuation or another participant, possibly same as B)]

Sorry.

[Katherine]

I'll be.

[Co-host 2]

Sorry.

[Katherine]

It's strange.

[Co-host 2]

I'll be okay.

[Co-host 1]

So how old was Max when he was diagnosed?

[Catherine]

He was diagnosed when he was 15 years old.

[Katherine]

This is recently.

[Catherine]

It is. It's been a whirlwind of a year with it. He was actually away on a band trip with his school over to University of North Carolina Greensboro, and it's one of those types of trips where, you know, the chaperone, or if you're local, your parent drops you off and you're on your own. Basically, you've got resident advisors. It's very much like Introduction to University or college life where, you know, you're responsible for choosing your own meals at the cafeteria. You're responsible for getting to practice. And so this is the second time he's done this camp. And he did what every teenage boy does, is he lived on pizza and soda for a week.

[Co-host 2]

I thought you were gonna say you found a girl, but okay.

[Catherine]

No, no, no. We wish. We wish he could talk to girls, but he's still. He's quite the introvert. He lived on pizza and soda for a week. And then on the final night of the camp, there's always a concert. And the chaperone that took the children from Bermuda noticed that Max got up from the concert in the middle of it and left and thought that was very Very odd. And then all the next day coming home, he noticed that he kept going to the bathroom consistently, even during the flight. And we have a high, high rate of type 2 diabetes in Bermuda. So he was fairly aware of some of the signs and signals. And he pulled me aside at the airport and said, please just keep an eye, something's going on. And we got home and we figured, well, maybe he's just tired. We're not sure what's going on. You know, you expect your 15 year old to be able to communicate to you if there's an issue? Yeah, of course he doesn't. And it turns out that it's like 11 o' clock at night on that same day when he flew back and we were getting my house ready for my parents from Canada to come stay with us for my nephew's wedding that week. And all of a sudden he's rushing into the bathroom urgently. And at this point we've realized this is absolutely just not normal.

[Co-host 1]

Can I ask a question? Did you just do a zipper before.

[Co-host 2]

Rushing into the bathroom as a sound effect? Because that was awesome, if that's what you did.

[Catherine]

No, no, no, no, no. I actually just undid my hoodie so that. That's quite weird.

[Co-host 1]

I was like, if you all are.

[Co-host 2]

Going to start doing, if you all are going to start doing sound effects, for me, I mean, that's really another level.

[Catherine]

I'm definitely not that good.

[Co-host 2]

You're like, he rushed into the bathroom, zip. And I was like, get out of here.

[Co-host 1]

Am I going to hear water next?

[Catherine]

No, no.

[Co-host 2]

All right, go ahead.

[Catherine]

So he rushes into the bathroom. And at that point I've realized that this is not normal. And I am a registered nurse myself. So I said, okay, we are going to the hospital because at this point, you know, something is definitely going on. You either have a uti, which is very rare in males, or you most likely have diabetes. Something's up, something's up. Like the nurse, case manager, risk manager and me, like, my brain is like already going through the diagnosis tree even before we've left the house. So thankfully, you know, Bermuda is very small. We're only 21 miles by one and a half miles long. So in. Our hospital is centrally located in the middle of the island. So it's really. We only have one hospital, it's not that far from us, so it's about a five minute drive. So we get into the hospital and it's like 11:30 at night and he. There's thankfully on a Saturday night, no one in the emergency room. At all. It's completely empty. And so he gets triaged and the nurse does a blood sugar and it reads off as high. So automatically we go into the back room, they draw some proper lab work to send to the lab and they come back and say that his blood sugars are 679, but he was not in ketoacidosis.

[Co-host 1]

Okay, well, good.

[Catherine]

Which was very, very good. And his hemoglobin A1C upon entry was 10.3.

[Co-host 1]

It had been going on for a little bit.

[Catherine (continuation or another participant, possibly same as B)]

It was.

[Catherine]

And you know, when I look back at it as a nurse, I should have picked up on some of the signs because his grades had started to slip in the last term of the school year. So he had been sick in the Christmas prior to it with the virus, not Covid. And then his grades started to slip. But I figured he's a 15 year old boy who happens to have ADHD and obviously there are just courses he doesn't really want to focus on. So I was more thinking, oh, this is just 15 year old boy. Wasn't thinking much more about it in terms of that. But then when I looked back in hindsight, about the month before he went away to camp, my husband and I had noticed that repetitively around midnight, one of our children would be getting up and going to the bathroom, which was a new thing. And that was just an unusual item that led us up to there. So I wasn't completely shocked when I looked at all this. All the signs in hindsight that I just hadn't put together.

[Co-host 1]

Your accent is so crazy. Is it Canadian via Bermuda? Is that what it is?

[Catherine]

Yeah. So I'm actually originally from Canada, born and raised. And then I lived in Boston for a few years as a nurse.

[Katherine]

There it is.

[Catherine]

And then I came to Bermuda. So it's definitely a little merge of different areas.

[Co-host 1]

Yeah, it's very unique. It's very unique. What got you guys to Bermuda? I mean, besides, were you just like.

[Co-host 2]

Why don't we go live in the sun? That's a better idea or no, no, no.

[Catherine]

My husband was Bermudian, so. And he owned a company with his brother, so. So it was just easier for me to relocate as a nurse here than it was for him to come to the US where I was working at the time, because there was no way he was going to get a visa to work in the US in his field. So we just thought it was easier for me to relocate here. And oddly enough, my. One of my sisters had married a Bermudian and was Living here already as well with her husband and family.

[Co-host 2]

Hold on, hold on.

[Co-host 1]

Are your parents farming you guys out overseas or something? What's going on?

[Katherine]

Exactly?

[Catherine]

No, no, no. We still have one left in Canada, but Yeah. It's just very, very odd that we both randomly met Bermudians.

[Co-host 1]

Yeah.

[Catherine]

And married them.

[Co-host 1]

So that's really crazy.

[Catherine]

Yeah.

[Co-host 1]

How long have you been there?

[Catherine]

I've been here 19 years.

[Co-host 2]

You live what we all assume is our dream, but is it a dream living on an island in a warm place or not really.

[Catherine]

We do get a little cool during winter, so it gets like a dampness. Cool with it. If you're coming from overseas, you still think the weather is beautiful, but if you live here locally the first year you think, oh, this winter is nothing. Every other year you're like, oh, this is cold, I need to find my hat. Like, you know, it's chilly out, we need a sweater.

[Co-host 1]

So there's no feeling of like you're.

[Co-host 2]

Missing something or the weather's too similar.

[Co-host 1]

To the rest of the day or anything like that.

[Catherine]

Not really. Bermudians are known to travel, so it's not unusual, like if you're missing like the snow at Christmas, that a lot of people will just travel if they're missing that. So we do have somewhat of seasons where it gets wet and cooler during the winter, but we never have snow. And honestly it's like, you know, everyone's like, life's a beach, but we just get along our lives like anyone else does in a small community, you know.

[Co-host 2]

Got it.

[Catherine]

You raise your children, you go to work, and it just happens that a lot of our activities outside of that surround, you know, either boating or beach or, you know, our natural area here, you know, we spend a lot of time on the water here.

[Co-host 2]

So if you go on a school trip, you get to go to North Carolina.

[Catherine]

Exactly.

[Co-host 2]

Interesting.

[Co-host 1]

Well, that's really cool.

[Katherine]

Yeah, I appreciate you sharing that with me.

[Co-host 1]

He gets diagnosed here and sounds like.

[Co-host 2]

You had a little bit of guilt. But like, is that, did that stick with you or are you okay with.

[Catherine]

That little bit of guilt? It did stick with me for a little while, but I did get over it when I realized that, you know. You know, unfortunately as nurses, a lot of times we are trained for hospital based items, which means you're being trained for the classic symptoms that are going to come through the door. So, you know, in working with our diabetic educator who I adore, you know, I definitely got over that guilt because there were so many signs that could have been attributed to other things.

[Co-host 1]

I'm glad. I'll tell you why I say s because I thought it was amazing. Teacher sees him go off to the.

[Co-host 2]

Bathroom, mentions something to you, you get him home, take him right to the hospital. It sounded seamless to me.

[Catherine]

It sounded like it was really seamless. But when I looked in retrospect, we were like, okay, the time, because we know this is an autoimmune disorder. So we started to look back and that's when I started to pick up some of these things that were explainable by other items as well.

[Co-host 1]

Other autoimmune in the family. No, you don't have celiac, you don't have thyroid, nothing like that.

[Catherine (continuation or another participant, possibly same as B)]

Nothing.

[Catherine]

So, all right. His grandfather had type 2 diabetes. His father was a BRCA2 carrier. But there's no link between that and diabetes at all. So we have no idea.

[Co-host 1]

His father was. His father passed.

[Catherine]

Yeah, his father passed this summer.

[Co-host 1]

Oh my gosh. Katherine, were you married still?

[Catherine]

Yes.

[Co-host 1]

Oh my God. Are you okay? What happened?

[Katherine]

This episode is sponsored by Tandem Diabetes Care. And today I'm going to tell you about Tandem's newest pump and algorithm. The Tandem MOBI system with Control IQ technology features Autobolus which can cover missed meal boluses and help prevent hyperglycemia. It has a dedicated sleep activity setting and is controlled from your personal iPhone. Tandem will help you to check your benefits today through my link tandemdiabetes.com juicebox this is going to help you to get started with Tandem's smallest pump yet that's powered by its best algorithm ever. Control IQ technology helps to keep blood sugars in range by predicting glucose levels 30 minutes ahead and it adjusts insulin accordingly. You can wear the tandemoby in a number of ways. Wear it on body with a patch like adhesive sleeve that is sold separately. Clip it discreetly to your clothing or slip it into your pocket head now to my link tandomdiabetes.com juicebox to check out your benefits and get started today. Today's episode is sponsored by a long term CGM that's going to help you to stay on top of your glucose readings. The Eversense 365. I'm talking of course about the world's first and only CGM that lasts for one year. One year, one CGM. Are you tired of those other CGMs? The ones that give you all those problems that you didn't expect? Knocking them off, false alerts, not lasting as long as they're supposed to? If you're tired of Those constant frustrations. Use my link eversensecgm.com juicebox to learn more about the Eversense 365. Some of you may be able to experience the Eversense 365 for as low as $199 for a full year. At my link you'll find those details and can learn about eligibility ever since. CGM.com juicebox Check it out.

[Catherine]

Good days, bad days, he was fine. Like he did everything he was doing. He was a Cub Scout leader and was getting ready to physically getting ready to take kids away to a camp in two years. That's extremely intensive physically. So he had been going to the gym, he had been losing weight, cutting back on his charcuterie, cutting back on his beers with the, with the Cub leaders after the children leave. He was doing everything right. And then he had just had had hernia surgery in May when all of his blood work was normal, everything was showing as normal. And then all of a sudden in early June, he looks at me, comes out of the bathroom after he was shaving and says, I think my neck is swollen. And I'm like, yeah, that is really swollen. We have an issue. So that actually prompted multiple doctor's appointments and CT scans and biopsies. And in Bermuda, because we are so small, we actually send our pathology for cancer related items out to some of the best hospitals in the Boston area for their pathology team to manage it. So that way we're getting the best experts. So by the end of June, we knew that he had an aggressive form of cancer, but we didn't know what type. Like the pathology was not being nice at all or acting normally. They were still having a lot of difficulty figuring it out. So he actually goes to Cub camp for the week like he always does to spend time with these cubs. And he actually I was already planned to be in the Boston area with my son and a few other children from Bermuda to take them to a well renowned diabetic camp just outside of the Boston area. And I was actually volunteering there as a nurse because I figured while I'm in the area, they need someone in the country. I'm a nurse, I might as well volunteer, right?

[Co-host 1]

Yeah, yeah.

[Catherine]

Which was great experience to see all these different pumps that we don't even have access to in Bermuda, by the way. Amazing. So I was supposed to be there for two weeks and one weekend I get the notice that he's coming up to Boston right away for some appointments and I was supposed to just go back and forth because he was going to be okay. But after seeing him, we were. He was admitted right away, and the pathology finally came back after three weeks that he had a very aggressive and rare form of neuroendocrine colon cancer.

[Co-host 1]

Oh, my God.

[Catherine]

So, yeah, so we.

[Katherine]

Sorry.

[Catherine]

Thank you. So we. We spent the summer in Boston, and he unfortunately passed away just 99 days ago. Yeah.

[Co-host 2]

Oh, my God.

[Co-host 1]

I just. As you were saying the story, and.

[Co-host 2]

You were like, june.

[Co-host 1]

I'm like, that's this year?

[Catherine]

Yeah, it's very recent, so. And my children kind of bounced back and forth between Boston and Bermuda for the summer because we wanted to try and give them some sort of normalcy, but we didn't want them to feel like they weren't with their father. But the same point is being in a hospital is very stressful. So they kind of bounced back and forth, and they got very familiar with certain tourist attractions in Boston. Like, you know, we got a full membership at the science Museum and they went, like, every day. So, like, for a few hours. Yeah.

[Co-host 1]

Wow. My gosh. Oh, and did you make this booking before this happened?

[Catherine (continuation or another participant, possibly same as B)]

I did.

[Co-host 1]

I was just gonna say, like, I. Oh, I found It's. It's only because you said was.

[Co-host 2]

That's what. I'm sorry, I shouldn't have asked.

[Catherine]

That's okay. No, that's fine. That's.

[Co-host 2]

I should have kept my head down.

[Co-host 1]

I was like, oh, no, no, no, that's fine.

[Catherine (continuation or another participant, possibly same as B)]

So. But it actually.

[Catherine]

It actually kind of, like, impacts Max's story because I will say this honestly, the food in the US Is horrible. It's horrible for diabetes, especially if you are not cooking things from scratch yourself at home.

[Co-host 2]

So you were having trouble managing his Type 1 while you were in. In Boston.

[Catherine (continuation or another participant, possibly same as B)]

Oh, my God.

[Catherine]

Horrible, horrible trouble.

[Co-host 1]

Oh, no kidding.

[Catherine]

Like, you know. So I would go from all day being at the hospital because as a nurse, I was my husband's translator for everything that was going on for. And managing all of that. And then I would get back to the apartment and I'd realize that my son has decided at 9 o' clock at night is a great time to have a cannoli from a famous pastry shop in the North End where you can't find online any carb details about how many carbs are in that cannoli.

[Co-host 2]

Just assume a lot, I imagine.

[Catherine]

Oh, it was a bad night. I looked at him afterwards and I'm like, what are we going to do next time? He's like, I'm never going to have a cannoli again. I'm like, no, you can have it, but can you have it at noon?

[Co-host 1]

Well, now if he has a baked good at home, that doesn't happen.

[Catherine]

You're saying it doesn't happen because we know the foods. Like it's been trial and error that we know that from this place. It's, you know, it's about this carb size. Like our portion sizes in Bermuda are smaller. Even though a lot of our food comes from the US we get a lot of our. We get a good portion as well from the uk. We only have one US fast food restaurant here in Bermuda.

[Co-host 2]

Which one is it?

[Catherine (continuation or another participant, possibly same as B)]

Kfc.

[Co-host 2]

Okay.

[Catherine]

Because we have an anti franchise law. We used to have McDonald's, but when the US forces left a few decades ago, that left with them. We do have like fast food areas, but it seems like that fast food is made, it's not made with the same type of food that your. Or in the same way that is being processed in the U.S. i see.

[Co-host 2]

So there's a KFC there, but it's really just a place that makes chicken and.

[Catherine]

Well, no, I mean that is actually a proper kfc. But if I go down the road to a different fast food place for a burger and fries, those fries are definitely not like McDonald's fries.

[Co-host 2]

Gotcha, gotcha.

[Catherine]

They are. They're not like double or triple greased and everything else. You're going to see that release a lot sooner of the carbs. And you would with fast food in the U.S. okay.

[Co-host 2]

It holds on longer here.

[Catherine]

It really does.

[Co-host 2]

I'm gonna try to use the words triple greased at some point in my life. I don't know where, but I don't know.

[Catherine]

And it just seems, it's like because of the layer of grease along the fast food that obviously it takes a while for the stomach to break that down. So next thing you know, you're spiking a lot higher. It's almost the same concept as pizza. You know, you've got to just learn how it, how it works. You know, when you're in a situation where you're in and out of hospitals, you're not really cooking great food, so you're letting your child eat whatever they want for the summer. So there was some very interesting times with his blood sugars this summer. Yeah.

[Co-host 1]

I have to ask you, how did your children handle, you know, your husband's passing, like, and how do you contextualize.

[Co-host 2]

That for them while you're busy trying to work it out for yourself, when you actually have to go back to Bermuda and be by yourself? Too.

[Catherine]

So thankfully. So my children already had a therapist.

[Co-host 1]

Okay.

[Catherine]

And oddly enough, when my son was first being told that he had diabetes, one of the first messages was to his therapist to say, okay, we need a session right now. So his therapist was very well aware as to what was going on with my husband and what. They did virtual sessions throughout the summer with both my children and then when my husband passed and they continue to see him now. It's very interesting because when you look at studies about grief and how teenagers react, you know, like, there's like almost like two paths that they tend to go on where one is either very like quiet and they don't really say a lot about it, almost like it never happened. And then the other one is very angry and vocal and both my children took a different path.

[Co-host 2]

Awesome for you.

[Catherine]

Yes.

[Co-host 2]

Yeah.

[Catherine (continuation or another participant, possibly same as B)]

So.

[Catherine]

But they are getting through with the support of like, I mean, they've got an amazing family support here through my husband's family and through. Because my husband was a Cub Scout leader and I'm a scout leader through our scouting family. So they've got tremendous support in the community and I guess that's one of the benefits of being from such a small place.

[Co-host 1]

Yeah. What path did you take?

[Catherine]

I've taken the path of keeping myself as busy as possible and just realizing that I just have to get things done because I have two boys.

[Co-host 2]

Yeah.

[Catherine (continuation or another participant, possibly same as B)]

Yeah.

[Co-host 2]

My gosh.

[Catherine (continuation or another participant, possibly same as B)]

Yeah.

[Co-host 2]

On your note here, to me it.

[Co-host 1]

Says, I want to discuss how to deal with the stress of GCSE exams for type ones. What do you want to talk about there?

[Catherine]

So GCSE exams are British exams for exiting high school. They are two year courses. That comes down to most of the courses will have two exams. If it's a language, it might be four. If it's a practical thing like shop or what we call design and tech, you might have a practical part of it. But generally you're studying for two years and you have two exams and that's your mark. It doesn't matter what you did through the two years.

[Catherine (continuation or another participant, possibly same as B)]

Those test days are your days and.

[Catherine]

If you have a bad day or a bad night with your blood sugars, we all know that you are not mentally clear for your exams. And that's it. It's like that is the mark that you are going to get and there's no do overs. The best you can do is try and get a letter from your doctor to say that can you please give some leniency because of this situation. But you have to provide that on the exact same day that the exam is taking place.

[Co-host 1]

How do those exam scores impact life?

[Catherine]

They impact where you go next in your educational career. So some schools, some universities and colleges will use those to help determine entrance into it. So most of the children in his class go on to what's called an international backlog baccalaureate, the IB program, which is basically pre. Like junior college. But the schools overseas will definitely look at their GCSE levels in terms of entrance for universities.

[Co-host 2]

It could have, like, a really big impact on the rest of your life.

[Catherine (continuation or another participant, possibly same as B)]

Exactly.

[Catherine]

I mean, thankfully, if you go further on with either, you know, your IB level, you can kind of try and make it up if you had a bad situation to show that you. You do have growth and you have the potential for it. But it can be very. It can be very stressful because there's. Because unlike the SATs, there's no rewrites.

[Katherine]

Yeah.

[Co-host 1]

And. And so this is.

[Co-host 2]

This looms over everybody when you think about this.

[Catherine]

Oh, two years worth of stress where children are pulling their hair out because.

[Catherine (continuation or another participant, possibly same as B)]

They know the importance of.

[Catherine]

Of doing well in these courses. And it literally comes down to two exams. And are you having a good day on that exam or a bad day?

[Co-host 1]

What did you end up doing?

[Catherine]

There was a couple of days where he has some really, really bad nights, and we had to get a letter from the doctor that day to say, please give leniency because it's his diabetes that's causing mental fog, and give him a little bit of leniency. But there was actually one day where his pump, because he's on an omnipod, broke and he didn't have any spares with him.

[Co-host 1]

And that was during testing.

[Catherine]

It was during testing. It was so much fun because technically he's not allowed to have any technology on his desk. He had put his phone on silence because he wanted to be respectful of everyone else. Testing. And he uses a PDM rather than the app because it just tends to work better. Bermuda.

[Co-host 2]

I see. And so.

[Co-host 1]

So he had a failure and he.

[Co-host 2]

Didn'T know it even happened.

[Catherine]

He didn't even know it happened, so. Because he. Because when the invigilators.

[Catherine (continuation or another participant, possibly same as B)]

There's always a chance that an outside.

[Catherine]

Invigilator from the UK is going to show up. And if they see a phone, something that looks like a phone on a desk, that's a big problem. And of course, the PDM looks like an iPhone, you know, from a distance. So that's all sitting in the back with an invigilator who has no idea what's going on. But thankfully, I'm getting notifications that his sugars are climbing and climbing and climbing. And I'm like, what is going on?

[Co-host 2]

I bet you freaked out. I would have been like, are you kidding me?

[Catherine]

Oh, it was a. It was a horrible day. So I'm contacting the main receptionist, and I'm saying, okay, he's got a spare bag with him. I don't know what's going on right now, but his sugars are rising too much. Get a message to him that he needs to, you know, give himself an additional bolus, and then I'll call back and see whether it worked. Well, that didn't work. So then I'm like, can you grab his spare pen and tell him to give himself a dose right near the site? Because we've got to figure out what's going on. Is it the site or is it the pump? So we're working through our troubleshooting with things, and that did bring it down a little bit. So we realized, okay, this is a pump issue, and he did not have any spare pumps at school.

[Co-host 2]

Okay, so does he always have spare pumps now?

[Catherine (continuation or another participant, possibly same as B)]

He probably doesn't, to be honest.

[Catherine]

Yeah, he just kind of wings it a lot of time, unfortunately, as a teenager. Does he's got spare pens at. At school if he needs to. But oddly enough, he. I don't think he actually has a spare pump there or a vial.

[Catherine (continuation or another participant, possibly same as B)]

Does he keep more at school now? No. Should he? Absolutely, yes. But my husband, at the time, thankfully, because I was in crazy work mode that day, so my husband grabs some pumps, runs it down, and we're switching the pump. He's, you know, he's allowed to leave the room for, like, two minutes to switch the pump.

[Co-host 2]

Okay.

[Catherine (continuation or another participant, possibly same as B)]

And get back under control. But his sugars, at that point, they were over 300.

[Co-host 2]

Oh, gosh.

[Catherine (continuation or another participant, possibly same as B)]

Yeah, it was. It was definitely a very, very stressful situation. So. And it was in one of the courses that he actually really, really enjoys. It was in his chemistry. So it was definitely an extremely stressful situation. When you're entering those exams and you know that this is it, you don't get great. You don't get a rewrite, you don't get an opportunity to get classwork or any of the tests you did through it the last two years to count.

[Catherine]

Like, this is it just what it is.

[Catherine (continuation or another participant, possibly same as B)]

It is what it is. So it's an extremely stressful situation. And after that, I actually had a. We learned a lot because we didn't realize what we would have to do if there was an Illness or a situation like that. In the middle of the test, we didn't know what our rights were or anything through the testing board. So I sat down with the headmaster of the school after that happened. I said, okay, now we. Because there was definitely some communication breakdowns during it as well, because I'm handing over pretty complex medical directions right. To a receptionist.

[Co-host 2]

Okay.

[Catherine (continuation or another participant, possibly same as B)]

So there was a few things that we were a little lost in. Translation. Translation. We figured it out. We figured out a plan for moving forward that, you know, we would just like, keep things in writing as well. Max had to learn that he cannot keep his things on silent during these exams.

[Co-host 2]

Okay. Yeah.

[Co-host 1]

Can I ask, how was his actual performance?

[Co-host 2]

Did it get.

[Co-host 1]

Did it get impacted or did it.

[Co-host 2]

End up not being an issue for.

[Katherine]

His grading, et cetera?

[Catherine (continuation or another participant, possibly same as B)]

He did pretty well on that exam is one of his stronger subjects. He could have done better had he not been in a high blood sugar mental fog situation. But he did well enough to get into the higher level chemistry class that he's doing through his international baccalaureate. So he did well enough to get in.

[Katherine]

They weren't like, oh, you're going to.

[Co-host 2]

Be raking the beach.

[Catherine (continuation or another participant, possibly same as B)]

Yeah, exactly. Because he wants to be an engineer, so he needs to have high marks in his sciences and he has successes. Yeah, exactly. Because when he had a brain fog and a different one, it was in his language class, which he was horrible at anyway, so it's like not as stressful because you know he's not going to do well.

[Co-host 1]

Did he, does he describe what that fog is like by any chance? Have you talked about it?

[Catherine (continuation or another participant, possibly same as B)]

Yeah, he says he just, like he can't focus. It almost feels like he's swimming. Like, you know, that he's like underwater swimming. Like nothing is making sense or being comprehended to him. It's almost like that dream world or swimming, hearing things underwater sort of deal really.

[Co-host 1]

What happens then?

[Katherine]

Does he push through it or does.

[Co-host 1]

He, does he step back and say, oh, I'm.

[Co-host 2]

My blood sugar's high, I'm in trouble. Like, I wonder how.

[Co-host 1]

Like, like how does that, how does that mind handle that situation?

[Co-host 2]

You know what I mean?

[Catherine (continuation or another participant, possibly same as B)]

It depends on how high he was. So if he is over a bit, you know, if he's around over, above 300, 350, he finds it difficult to mentally remember that, oh, this is my blood sugar, I need to do something about it. But if he catches it when he's still in about that 250 low 300 range, he'll be like, this is my blood Sugar. I need to make sure I dose appropriately for this.

[Co-host 2]

Okay. All right.

[Co-host 1]

So, yeah.

[Catherine (continuation or another participant, possibly same as B)]

So if it gets too high, he is. He's not going to think about it. He needs intervention to help him to.

[Co-host 1]

Realize that course of a regular day. What's his blood sugar like?

[Catherine (continuation or another participant, possibly same as B)]

Much better than what it was. So when he first got diagnosed, because I'm a nurse and we have an awesome diabetic educator and awesome endocrinologist on his team, he was actually out of the hospital within two days. And his first hemoglobin A1C went from 10.3 down to 8.3. And then this past June, before he knew that his dad was Sick, his hemoglobin A1C was down to 5.8.

[Co-host 1]

How did his dad's illness impact his. His blood sugars?

[Catherine (continuation or another participant, possibly same as B)]

It ended up going up to 6.3, which I still thought was an amazing number given how bad the summer was with his blood sugars.

[Co-host 2]

Was it just our triple greased food or was it other things that you think impacted?

[Catherine (continuation or another participant, possibly same as B)]

I definitely think, you know, you've got a teenager with hormones and growth going on and then you impact. Add in all this stress of what was going on with his dad with his blood sugars, it's definitely made it a lot harder to control. And I was trying to explain the management of his diabetes to his aunts and uncles and grandmother to say, this is how you have to do it. And they're like, is there a list, like a prescription list? If it's this, you do this, I'm like, it's an art form. I hate to break it to you. It's kind of like trial and error and it's. It's more of an art form than a science.

[Co-host 1]

So when your husband's in Boston, how long has Max had diabetes for?

[Catherine (continuation or another participant, possibly same as B)]

Just one year.

[Co-host 2]

Oh, my gosh. Okay. So, yeah, yeah, yeah. So you were just starting to figure it out a little bit, and then now you're having to pass it off to other people. Have no context for it.

[Catherine (continuation or another participant, possibly same as B)]

They have none. Because I had been managing everything with Max and we had done really well with getting his blood sugars under control. You know, it's like six months into his diagnosis, his honeymoon phase seemed to be ending. And we knew that he was going into practice exams and he was going on a ski trip for school. So we went ahead and we got him on a pump at that time.

[Co-host 1]

And devices available in Bermuda are different than in America.

[Catherine (continuation or another participant, possibly same as B)]

Yeah. So we have access to the Omnipod.

[Co-host 2]

Okay.

[Co-host 1]

And to Medtronic 670G. Or do you not know which one?

[Catherine (continuation or another participant, possibly same as B)]

Any of the Medtronic range. We have any of them, but those are the only ones we have access to.

[Co-host 1]

CGM.

[Catherine (continuation or another participant, possibly same as B)]

CGMs, we have access to the Freestyle Libre, but most of them come from the Caribbean or from Canada. So it's a little interesting when you're trying to set it up on your phone. We have access to the G6 without any issues. But the G7, which I know fewer and fewer people are using for the G7, they actually have to take your phone to the US because of the fact that it is location based when you're setting it up.

[Co-host 1]

Okay.

[Co-host 2]

They have to take your phone to the US to set up the. Oh, geez.

[Catherine (continuation or another participant, possibly same as B)]

Yeah. Because we tried the G7 first, thinking the reviews were like, this is amazing. It's going to be great. So his aunt was going to the U.S. so I said, take his phone, please. Take it with you for the week. We'll download the app there. So that way when he comes home, everything works well.

[Co-host 1]

Geez. I have to tell you.

[Catherine]

Yeah.

[Co-host 2]

Arden's been using the G7 since it came out. And I mean, it's been good for us.

[Co-host 1]

We've had like, you know, you're lucky.

[Co-host 2]

So I don't know how to think about that, Catherine.

[Co-host 1]

Like, because I recognize that there are.

[Co-host 2]

People who are having trouble with the device. Actually just saw somebody talking about Libre yesterday too. There's been something with that.

[Co-host 1]

I, I don't know. Like, I, I wouldn't minimize anybody having trouble with it.

[Co-host 2]

Like if it was five people, like, you know what I mean? But I do wonder, like, how many they sell versus how many they have trouble with. And I don't, I don't know. You know what I mean?

[Catherine (continuation or another participant, possibly same as B)]

That statistic would be really interesting to know, but he was just having so many issues with it.

[Co-host 2]

Yeah.

[Catherine (continuation or another participant, possibly same as B)]

And I'd have to call Dexcom all the time and say, my son is in school in Bermuda, but I'd like you to send us our replacements. And I'd be like, to this address in the US and they're like, and who is that that we're sending this to? So it gets really interesting.

[Katherine]

Yeah.

[Co-host 2]

When you're international.

[Catherine (continuation or another participant, possibly same as B)]

Exactly. So we just found for us the G6 was a lot more stable.

[Co-host 2]

So less phone calls for you.

[Catherine (continuation or another participant, possibly same as B)]

He's never had a failure on the G6.

[Katherine]

Yeah.

[Co-host 2]

So if you have fewer phone calls, you don't have to be messing with people. That's the, that's the real value for you.

[Catherine (continuation or another participant, possibly same as B)]

Exactly. It's like, you know, I did ask him once the Omnipod app was supporting the G7s again because that was one of the main reasons we switched to the G6. I said, do you want to try the G7 again? And he's like, no, absolutely not. He's happy with the G6. He understands there's a two hour warmup, but he's okay with that because it means that he knows it's going to work for the 10 days.

[Co-host 1]

Can't wait to see where this all goes.

[Co-host 2]

Seriously, Because I have no idea. I want to be clear, but I.

[Co-host 1]

Wonder how much of it is the form factor because it seems like now.

[Co-host 2]

Libre and Dexcom are having similar issues.

[Co-host 1]

So I wonder if it's something to.

[Co-host 2]

Do with manufacturing or form factor or materials. I, I guess we'll find out eventually.

[Catherine (continuation or another participant, possibly same as B)]

We'll find it. I mean, what we find interesting, like in Bermuda, we find most of our, most people who have type 2 diabetics are the ones using the Libre.

[Co-host 1]

Okay.

[Catherine (continuation or another participant, possibly same as B)]

But if you have a type 1, if you're a type 1, most times you are using a Dexcom product in the Bahamas.

[Co-host 2]

That's your finding?

[Catherine (continuation or another participant, possibly same as B)]

No, in Bermuda.

[Co-host 2]

In Bermuda.

[Co-host 1]

Excuse me, what did I say? Bahamas.

[Co-host 2]

That's okay because I've been to the Bahamas and it starts with a big.

[Catherine (continuation or another participant, possibly same as B)]

And it's lovely. I've been there as well. Yeah, so, but, yeah, so most of, the, most of people around here who have type 1 diabetes use the Dexcoms. And we're such a small community that we, all of those who have type 1 diabetes or who have children with type 1 diabetes, we all kind of know each other and we, we do have events where, you know, they bring in special educators, you know, for us as well, but it's a very small community.

[Catherine]

So here.

[Co-host 1]

Well, listen, if anybody wants to fly.

[Co-host 2]

Me to a warm island to do an event, please just let me know. I'm happy to do this.

[Catherine (continuation or another participant, possibly same as B)]

Awesome.

[Co-host 2]

Any warm island, honestly, I just want to be. I just want to be clear.

[Co-host 1]

Yeah, well, that's really something. I, you know, it's funny, I can't, like, I, I can't stop thinking about.

[Co-host 2]

Your bigger, like, family issue. Right.

[Co-host 1]

Because, because I just, in my mind.

[Co-host 2]

I'm like, God, you're, you're in Bermuda.

[Co-host 1]

Yes.

[Co-host 2]

You have your husband's extended family. Right. But your family's, your family's not there.

[Catherine (continuation or another participant, possibly same as B)]

Well, I have, I have a sister here.

[Co-host 1]

Oh. Yeah, I guess that's true.

[Co-host 2]

Right. Okay.

[Catherine]

Yeah.

[Co-host 2]

But how often do you get the back to Canada?

[Catherine (continuation or another participant, possibly same as B)]

Not very often, generally. Maybe about once. Or so a year, depending on the year.

[Co-host 1]

Yeah.

[Catherine (continuation or another participant, possibly same as B)]

Just because, you know, when you've got limited vacation time, you want to go different places. And my kids tend to love the wonderful theme parks down in Orlando and, you know, and they like traveling to other places as well, so.

[Catherine]

Yeah.

[Co-host 1]

Yeah, you gotta move. Are your parents alive?

[Catherine (continuation or another participant, possibly same as B)]

They are.

[Katherine]

They are.

[Co-host 2]

Okay. My gosh.

[Co-host 1]

I guess, like, video calling and stuff.

[Co-host 2]

Makes things a little easier, right?

[Catherine (continuation or another participant, possibly same as B)]

It definitely does. During everything that was going on with Max during the summer with my husband, I mean, he had gone from being 90, 95% of time in range down to about 30, 40% of time in range where his basal tabolis was completely out of whack. You know, where he was, like, his basal was accounting for, you know, as low as 10% of his total insulin dosing. All of his numbers were completely, like, problematic. Where he would normally have been using Anywhere as around 25 units a day through his Omnipod. All of a sudden, there was some days where. Most days when we were in Boston, he was using 50 units a day and then still only being in range about 40 or 50% of the time.

[Co-host 1]

No kidding.

[Co-host 2]

Okay.

[Catherine (continuation or another participant, possibly same as B)]

Once we came back to Bermuda and we got settled, we sat down with our educator again. And we made some pretty drastic changes in his pump settings.

[Katherine]

Okay.

[Co-host 1]

Yeah. Well, how long had he been on Omnipod? 5 at that point.

[Catherine (continuation or another participant, possibly same as B)]

So he's been on it since January.

[Co-host 2]

And has he gained weight since then?

[Catherine (continuation or another participant, possibly same as B)]

Not really.

[Co-host 2]

Not even like, five, ten pounds?

[Catherine (continuation or another participant, possibly same as B)]

Maybe about five or ten pounds. But, I mean, he's. He's a pretty skinny kid.

[Co-host 2]

Okay. Okay.

[Catherine (continuation or another participant, possibly same as B)]

Tall and lanky kid. Teenager.

[Co-host 2]

So I just think that sometimes you just gotta reset the Omnipod 5, you know what I mean? If you've had changes in activity or your weight or something like that, I just feel like it needs to change.

[Co-host 1]

Is that a cat, by the way?

[Catherine (continuation or another participant, possibly same as B)]

It is. I'm so.

[Co-host 2]

Don't be. Don't be sorry.

[Co-host 1]

Like, I heard you. I could.

[Co-host 2]

I could audibly hear you struggling with. Because you're thinking, I could hear it.

[Co-host 1]

But I couldn't tell if it was. I couldn't tell if it was a kid in the distance calling you or.

[Co-host 2]

If it was a cat.

[Catherine (continuation or another participant, possibly same as B)]

No, no, it's my cat. I'm sorry.

[Katherine]

Don't be sorry.

[Catherine (continuation or another participant, possibly same as B)]

So. So we made some pretty drastic changes about a month ago. And since then, you know, we lowered his goal rate because initially with the Omnipod, we didn't know how they were going to react. So they put him at a goal rate of 180. And then it got decreased to 150. So now he's at a goal rate of 110. They changed his ratio. They also changed the lasting time for the insulin because they. It wasn't lasting as long for him as it normally would. So we made some pretty big changes with his educator just about a month ago. And all of a sudden I'm sleeping through the night now, maybe five nights a week now.

[Co-host 1]

That's awesome.

[Catherine (continuation or another participant, possibly same as B)]

So we learned a lot and by looking at the data and to try and figure out exactly what we needed to do in order to get his numbers back under control with it. But also what I've noticed, especially since his father's passing, is he's actually taken a more active role in his diabetes management.

[Co-host 2]

Oh, do you think he sees that you're struggling a little and he wants to take more on or what do you think it is?

[Catherine (continuation or another participant, possibly same as B)]

I think it forced him to grow up a lot. He's recognized the fact that for the last year, like, if he was having issues during the night, I would be. He's asleep. I'd be the one saying, okay, let's do some more insulin. Let's do a finger prick. Oh, let me go bolus you on your pump. That was all me. So I think he.

[Catherine]

He's realized that.

[Catherine (continuation or another participant, possibly same as B)]

So he's getting much better. You know, I don't. 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. Okay, Completely ignore it. Because I need to see whether or not he's going to manage it.

[Co-host 1]

Okay.

[Catherine (continuation or another participant, possibly same as B)]

Because he doesn't. I don't want to nag him, you know, so. And most times he is seeing it and recognizing it with it, so. Which is a good thing.

[Co-host 2]

So what's the low that you wouldn't ignore?

[Catherine (continuation or another participant, possibly same as B)]

What number I wouldn't ignore? In the 40s or lower.

[Co-host 2]

Okay, so you're really going to let him see what he can get accomplished then?

[Catherine (continuation or another participant, possibly same as B)]

Well, yeah, because I also know that based off of the time of day, he is odd in the fact that even before the pumpkin, he would go very, very high between midnight and 3am okay, so. Which is not the normal phase, probably growth. Exactly. So they're relating it to growth. And I would know that if he went to bed with a blood sugar of 150, I know by midnight he's going to be 300. It's going to happen. So a lot of times if he looks at me before bed and says, you know, I'm. I'm 60 and I'm like, well, how many units do you have on board? And if he doesn't have very many, I'm like, ignore it, because I know what you're going to climb to because of the fact that you're a teenage boy who's growing, I know what you're going to climb to. So if you start at 60, there's a very high chance that you're not going to end up over 200.

[Co-host 2]

Okay.

[Catherine (continuation or another participant, possibly same as B)]

And so. But it's helping him to make and learn those decisions.

[Co-host 1]

I see. Yeah. No, it makes a lot of sense.

[Catherine (continuation or another participant, possibly same as B)]

Yeah.

[Catherine]

Yeah.

[Catherine (continuation or another participant, possibly same as B)]

If he's low and he's driving. Yeah, that's not. There's.

[Co-host 2]

Then you say something.

[Catherine (continuation or another participant, possibly same as B)]

Oh, so in Bermuda, you do not get a car license until you're 18, but at 16, you can get your bike license for a 50cc bike.

[Co-host 2]

Okay.

[Catherine (continuation or another participant, possibly same as B)]

So all these kids, they have government projects, like education courses they have to do for it. So he has a bike. And I looked at his blood sugars one day, and I'm like, oh, he's 50 and he hasn't responded. And he's on his robotics program. Message him. He ignores me. Try calling him. He ignores me. And he ignores me because he was literally getting on his bike to come home at that point.

[Co-host 1]

Did you talk to him about it?

[Katherine]

I'm wondering, was he thinking, like, oh.

[Co-host 2]

I'll take care of it when I get home. Was that his mindset?

[Catherine (continuation or another participant, possibly same as B)]

Yeah, yeah. He didn't think it was such a big deal. And I said, well, here's the big deal. If you were in an accident, how would they know that you're diabetic? And this was related to blood sugars because his emergency bracelet was left at home.

[Co-host 2]

So you think he saw all that as thoughtful when you laid it out for him, or was he like, mom, leave me alone.

[Catherine (continuation or another participant, possibly same as B)]

Oh, no, it was very, like, he took it on board. And I said to him, listen, if it ever happens again, those bike keys belong to me.

[Co-host 1]

So it's an electric bike or gas.

[Catherine (continuation or another participant, possibly same as B)]

No, is. He actually has a gear bike.

[Co-host 1]

Oh, it's pedal.

[Catherine (continuation or another participant, possibly same as B)]

No, no, it's a proper, like, motorcycle. Change the gear with your feet and like, clutch.

[Co-host 1]

Oh, I see.

[Catherine (continuation or another participant, possibly same as B)]

Bike. So. So most. Most kids get a gas scooter, like turn and go. Kind of what you see in, like, little mopeds in the. In the movies, you know, sort of deal. He wanted a gear bike that's got a clutch and a catalytic and like, whatever that is, like, all that stuff. So he wanted to go old school. So it requires you to Actually think and do a lot more on that bike.

[Co-host 1]

Yeah. And they go, they go pretty quickly too, right?

[Catherine (continuation or another participant, possibly same as B)]

They can. So the new gas ones that they sell here are all what they call a four stroke, not a two stroke. So they don't actually have a huge amount of power to get up hills. They're only a 50cc bike. You know, our speed limit here is 20 miles an hour.

[Katherine]

Okay.

[Catherine (continuation or another participant, possibly same as B)]

Like, most people will go 35 miles an hour. Like, it is not super fast speeds here. So. But he can manage, like his bike is a two stroke, so it's got enough power to, to get him up hills at a reasonable speed. Like he could go faster than what I let him go fast go at.

[Catherine]

So.

[Co-host 1]

And it's safe to go all over the island.

[Co-host 2]

The kids do. The kids do like, What'd you say, 11 miles long?

[Catherine (continuation or another participant, possibly same as B)]

We're 21 miles long by.

[Co-host 1]

Yeah, I'm sorry.

[Co-host 2]

I had it in my head that it was 10 miles to the center because I thought about hospital.

[Co-host 1]

Okay.

[Katherine]

Yeah, yeah.

[Co-host 1]

So 21 miles long, mile and a half wide.

[Co-host 2]

They can go wherever they want.

[Co-host 1]

That's nice.

[Catherine (continuation or another participant, possibly same as B)]

Yeah, yeah. So it's.

[Catherine]

So.

[Catherine (continuation or another participant, possibly same as B)]

So they're on their bike. So there was. So when he gets low and I know that he's going to be on his bike, that's a whole different situation. And a conversation with him, you know, and I think that conversation, he did listen to it, you know, he. But I, you know, we'll see how things go. Because he's a teenage boy, so.

[Co-host 2]

Yeah, well, I hear you.

[Catherine (continuation or another participant, possibly same as B)]

Sometimes his emergency bag doesn't have any emergency snacks in it, even though.

[Co-host 1]

Do you look into that once in a while? Like, do you like, pull the bag aside and check?

[Catherine (continuation or another participant, possibly same as B)]

I do. Every so often I pull it aside and I pull out all the garbage that's in there. All the old test strips and the protein bar wrappers and the gummy wrappers. And then I'm like, okay, dude, you obviously need to restock.

[Co-host 2]

Yeah.

[Catherine (continuation or another participant, possibly same as B)]

So he's okay with restocking generally, but sometimes he absolutely forgets what's the situation.

[Co-host 1]

On the island like here?

[Co-host 2]

Like, you know, in New Jersey, I, I would say to you that Arden might never. If she's in a car, she's probably never more than a few minutes away from being able to like get something for herself. But, like, is that necessarily the case there?

[Catherine (continuation or another participant, possibly same as B)]

Oh, yeah. So we're so small, it's like, you know, literally you might be two minutes away from either a pharmacy, corner store, gas station, someplace like that where you can grab something if you had to.

[Co-host 2]

Do you think he feels like he's covered so it's okay if he doesn't have stuff with him?

[Catherine (continuation or another participant, possibly same as B)]

Exactly. So when he's got his wallet with him. But mind you, at school, we start every year by sending in, like, a bulk pack of protein bars and gummies just in case, you know, something happens and he runs out.

[Co-host 1]

How often do you think he needs.

[Co-host 2]

To adjust the low blood sugar with. With snacks in the course of a day?

[Catherine (continuation or another participant, possibly same as B)]

Not that often. Right now, when we were first getting the hang of it and learning how his body reacted, definitely there'd be like three or four times a day. But now he might need a low recovery. Maybe two times a week, maybe.

[Co-host 1]

I think he's doing well.

[Catherine (continuation or another participant, possibly same as B)]

Yeah, he is doing really well with it. So.

[Co-host 1]

Good for you. That's nice. That must feel. That must feel good that he's.

[Co-host 2]

That he's got a grasp of it and he's. And he's getting better and better as time goes on.

[Catherine (continuation or another participant, possibly same as B)]

He is. And it really depends on what he's doing. Like, he's getting ready right now to go camping for the weekend for a practice journey for his Duke of Edinburgh Gold Award, which is a massive camping trip he's got to do in the summer, where he'll be hiking in the Appalachians.

[Co-host 1]

Is this for. Is this for Scouts?

[Catherine (continuation or another participant, possibly same as B)]

No, this is for another organization that's British based, called the Duke of Edinburgh.

[Co-host 1]

Yeah, when you said that, I did.

[Co-host 2]

Not know what that was. Okay.

[Catherine]

No.

[Catherine (continuation or another participant, possibly same as B)]

So it's an award that encompasses dedication to learning as well as to an adventurous journey, as they call it. So they have to do charitable work, they have to do physical recreation. They have to learn a skill, be it like robotics or music or whatever they choose for a hobby. But they have to show that they're working on it every week for so many weeks. And then they have to do an adventurous journey where literally everything that they need is carried on their back between them and their teammates.

[Co-host 1]

That's awesome.

[Catherine (continuation or another participant, possibly same as B)]

And they will hike for, depending on the level, you know, however many days you actually have to hike for. So he's in the last level, which means that when he goes away this summer for his official journey with it, he has five days of hiking in the Appalachians. So we're actually in communication with the host group that's. That's managing this in the Philadelphia area to say, okay, now how do we manage insulin during this time?

[Co-host 2]

Right. And extra supplies and low, low blood sugars and probably no cell service and a lot of other things.

[Catherine (continuation or another participant, possibly same as B)]

Right, exactly, exactly. Like, how are we going to. To manage this? So. So recently I've bought, I think, almost every device on Amazon.

[Katherine]

Sorry.

[Catherine (continuation or another participant, possibly same as B)]

About how to keep insulin cold.

[Co-host 1]

Oh, is it going to be in the summer months? It's going to be hot.

[Catherine (continuation or another participant, possibly same as B)]

It is. It's going to be hot.

[Co-host 1]

Yeah.

[Co-host 2]

What'd you land on? What are you going to use?

[Catherine (continuation or another participant, possibly same as B)]

Haven't decided yet. We're still testing them. So we started with the. I'll say the name, the Vivi Cap.

[Co-host 2]

Okay.

[Catherine]

Yeah.

[Catherine (continuation or another participant, possibly same as B)]

Threw that one out.

[Co-host 2]

You didn't like that?

[Catherine (continuation or another participant, possibly same as B)]

No, that one didn't do it for us. And now we've got another container that has an ice pack that goes in it, but then you can plug it in to a battery bank and it's got a separate fan that will also keep it cool.

[Co-host 1]

Have you looked at the Frio bags?

[Catherine (continuation or another participant, possibly same as B)]

We've tried those. We're not in love with those. We found we couldn't get them cool enough.

[Co-host 1]

Yeah, I don't know if it's a.

[Co-host 2]

If it's a situation where you're trying to actually keep it like refrigerator level or if you're just trying to keep the heat and the humid. The heat off of it. You know what I mean?

[Catherine (continuation or another participant, possibly same as B)]

Yeah, yeah. We tried those in the past. We weren't in love with those. So this weekend he has a different one that's got some for camp that has some gel ice packs that will go in it. It actually has a digital temperature gauge on the outside of it to tell him what it is, so. And I said, and I don't expect him to need to change his pod at all this weekend because he'll change it on Friday before he goes. He's back on Sunday, he should be fine. But I'm more curious to see how does this work and is it gonna.

[Catherine]

Work well for him?

[Co-host 1]

I would also listen.

[Co-host 2]

I don't know, people might be mad.

[Katherine]

At me for saying this.

[Co-host 2]

I have no idea. We'll find out in a second. But actually we won't find out for months.

[Co-host 1]

But nevertheless, I mean, it's only a.

[Co-host 2]

Week long trip, right?

[Catherine (continuation or another participant, possibly same as B)]

Yeah.

[Co-host 1]

And I think as long as you.

[Co-host 2]

Can keep that insulin from like, you know, going into the 80s and 90s, who care? Like, even if when you get it home, you just. Yeah, I'm sure it'll be fine.

[Catherine (continuation or another participant, possibly same as B)]

Oh, I have. I have thrown out so much insulin over the past few months because of. Oh, it didn't stay cold enough in flight. It had gone through too many temperature shifts.

[Co-host 2]

I got to tell you.

[Catherine (continuation or another participant, possibly same as B)]

We would notice. We would notice it's like, the insulin is bad. It's not working. Check it. New vials. Yeah.

[Co-host 2]

Catherine, I'll tell you, like, if insulin works, it works that I'm good with it.

[Catherine (continuation or another participant, possibly same as B)]

Yeah, yeah.

[Co-host 2]

If it gets exposed to something and then suddenly doesn't work, then. Then okay, I'm happy to get rid of it. But if it gets warm, I don't like. Arden took a vial with her. She doesn't travel with insulin a ton, right? But she took a vial with her for something last week, and I think it sat in. Now, it's cooler here now, right? So it's probably not going over like 50 degrees during the day.

[Co-host 1]

But it sat in her car.

[Co-host 2]

It was in a bag. It was, you know, a number of different places, and it came home. But, like, I never thought rid of it. We just kept using it and it was fine.

[Catherine (continuation or another participant, possibly same as B)]

Oh, no, no, no. We realized when we would put some insulin in and we're like, okay, you're not reacting, just not working at all.

[Catherine]

Okay, it's not working at all.

[Catherine (continuation or another participant, possibly same as B)]

It's the insulin. Check it out. It's traveled a little too much for us.

[Co-host 1]

So will he travel? Will he travel with backup injectable?

[Co-host 2]

Like, would he even know what to do?

[Catherine (continuation or another participant, possibly same as B)]

He always does. So whenever he travels, he has a letter from his diabetic educator and his pediatrician, just in case there's any issues at security. Leaving Bermuda. There's only two ways off the island. You can sail off the island or you can fly off the island. That's it. So. So a lot of times he'll, you know, we only fly off the island. So he has those letters, and he will have everything he needs for at least two or three more worth time of to what he's traveling for.

[Co-host 1]

Okay.

[Catherine (continuation or another participant, possibly same as B)]

But he can, just in case.

[Co-host 1]

So he can manage without a pump if he has to, he can.

[Catherine (continuation or another participant, possibly same as B)]

So he normally travels with obviously, enough spare pumps, spare insulin. He'll also travel with Tresiba, just in case. He'll carry extra sensors. He will carry extra strips. His carry on bag is insane. We actually switched from juice boxes to the little packages of gummy bears because you get just as many carbs. They don't explode in your emergency bag or in your backpack or, you know. Well, you know what kids are like. They throw down their bag and it's like, yeah, they don't care. Next thing you know, you've got juice everywhere.

[Co-host 2]

I have definitely thrown a box, a juice box away before and thought, like, this is moments away from bursting open, so.

[Catherine (continuation or another participant, possibly same as B)]

Exactly. So it's like. So it's like, so he switched to the gummy to the gummy bears because it's the same number of carbs and he likes them. So I'm like, awesome. So he will travel with so much stuff that if he's going away for say like a 10 day trip, which is what this trip will be for his Duke of Edinburgh Gold Award, he will bring enough supplies with him for 30 days.

[Co-host 2]

Wow. Okay, well, he should be ready.

[Catherine (continuation or another participant, possibly same as B)]

Well, and it's also because when we go to a different country, we can't exactly just go into a regular pharmacy and say, this is what I need. Because they have no idea. Like they need an order from a physician.

[Co-host 2]

Right. So, yeah. So if you really do get in trouble, there's nowhere for you to really go once you're off the island. Really?

[Catherine]

No.

[Catherine (continuation or another participant, possibly same as B)]

Well, I mean, I mean, if you're.

[Catherine]

In the US or you know, do your scripts work?

[Co-host 2]

Like, can you use a script in the US that you use in the bomb?

[Catherine (continuation or another participant, possibly same as B)]

No, no, no, no, we can't. But it's like, at least his insurance has got Teladoc, so he could call in there. We could go to an urgent care if we needed to. When we were in Athens last year, that one was a little bit more, you know, it's like, where would we go? What language barrier would we have? And could we even get the same supplies? Because most of our medications here come from either Canada, the US or the uk.

[Co-host 1]

Yeah. Listen, I have to tell you, I.

[Co-host 2]

Think it's pretty great how travel and adventure is word you used earlier. Like, is not being squelched it all by this diabetes thing. It's pretty cool.

[Catherine (continuation or another participant, possibly same as B)]

No, and actually, oddly enough, the night that he was diagnosed with diabetes, that was 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. You just need to bring your supplies with you.

[Co-host 1]

Did you actually have any private moments.

[Co-host 2]

Where you thought, oh, God, maybe he can't?

[Catherine (continuation or another participant, possibly same as B)]

No, no. I knew that he could. You know, I've seen kids do it before. I'm a scout leader. You just plan. Now, one of the award leaders for the award last year was like, do you want me to call you if there's an issue? And I'm like, no, only if there's a big issue. But otherwise he has everything you need. You do not need to call me to tell me what his blood sugars are periodically because during the journeys, all tracking devices have to be off. Like, parents cannot know. They have to be completely cut off electronically from the rest of the world.

[Co-host 1]

Interesting.

[Katherine]

Yeah.

[Co-host 2]

Do you think there's a world where if he was in a situation that he could not get it under control for some reason, do you think he would push through to his own detriment, or do you think that he would reach out for help if he needed it?

[Catherine (continuation or another participant, possibly same as B)]

I think he would get to a point where he would reach out for help.

[Co-host 1]

Okay, that's awesome.

[Catherine (continuation or another participant, possibly same as B)]

Like, he. He would. He would reach out. Now, obviously, he. He's. He's 16, so he hasn't entered the world of alcohol and how that affects blood sugars or anything like that yet.

[Co-host 2]

So you're expecting that to happen?

[Catherine (continuation or another participant, possibly same as B)]

I've actually. And, okay, so let's be upfront. The legal drinking age In Bermuda is 18. I have actually looked at him around the table and said, do you want to have. Do you want to try a beer? He's like, do you want to try a drink? He's like, no, absolutely not. And so he's absolutely adamant. So we'll see what happens when he turns 18, whether he still has that same.

[Co-host 2]

Yeah, he's still thinking the same way.

[Catherine (continuation or another participant, possibly same as B)]

Exactly. So. And you know, because that's the one thing that when they go off to school, and even if they're not of legal drinking age where they are, it's part of university culture in a lot of areas.

[Co-host 1]

And will he go to the mainland for school, do you think?

[Catherine (continuation or another participant, possibly same as B)]

Yeah, he's looking at schools in Canada. He did actually spend some time looking at schools in the Boston area this summer. He was not in love with. With any of them, unfortunately.

[Co-host 1]

How smart is this kid?

[Co-host 2]

Is he looking at, like, McGill and stuff like that?

[Co-host 1]

What's he doing?

[Catherine (continuation or another participant, possibly same as B)]

He's pretty smart when it comes to the sciences. Languages? No, but his sciences, like, that's how his brain works.

[Co-host 1]

Well, Katherine, I have to tell you.

[Co-host 2]

This has been a bit of an adventure on its own, you and I, but I really appreciate you taking the time to do it. I'm glad we got it recorded and we handled it.

[Catherine (continuation or another participant, possibly same as B)]

And, yeah, I am so glad as well. I was like, this has been a great experience to talk to you, and I just hope that some of the things that we went through can help other people as they face their own challenges as well.

[Co-host 2]

It is my finding that every conversation is valuable to somebody, so I'm sure that will be the case.

[Co-host 1]

Katherine, thank you so much.

[Co-host 2]

You really were delightful. I appreciate it.

[Catherine (continuation or another participant, possibly same as B)]

No, I appreciate you so much.

[Katherine]

The conversation you just heard was sponsored by Touched by Type 1. Check them out, please, at touchedbytype1.org on Instagram and Facebook.

[Co-host 2]

You're going to love them. I love them. Them.

[Katherine]

They are helping so many [e-mail].

[Co-host 1]

The.

[Katherine]

Podcast episode that you just enjoyed was sponsored by Eversense CGM. They make the Eversense 365. That thing lasts a whole year. One insertion every year.

[Co-host 1]

Come on.

[Co-host 2]

You probably feel like I'm messing with you, but I'm not.

[Katherine]

Eversensecgm.com juice juicebox head now to tandom diabetes.com juicebox and check out 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. Okay, well, here we are at the end of the episode. You're still with me.

[Co-host 2]

Thank you.

[Katherine]

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 group. As of this recording, it has 74,000 members. 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. Hey, I'm dropping in to tell you about a small change being made to.

[Co-host 2]

The Juice Cruise 2026 schedule.

[Katherine]

This adjustment was made by Celebrity Cruise Lines, not by me. Anyway, we're still going out on the Celebrity beyond cruise ship, which is awesome. Check out the walkthrough video@juicebox podcast.com JuiceCruise the ship is awesome. Still a seven night cruise. It still leaves out of Miami on June 21st. Actually, most of this is the same. We leave Miami June 21, head to CocoCay in the Bahamas, but then we're going to San Juan, Puerto rico instead of St. Thomas after that. Basteria. I think I'm saying that wrong. St. Kitts and Nevis. This place is gorgeous.

[Co-host 2]

Google it. I mean, you're probably gonna have to go to my link to get the correct spelling because my pronunciation is so bad.

[Katherine]

But once you get the St. Kitty.

[Co-host 2]

Kits and you Google it, you're going.

[Katherine]

To look and see a photo that says to you, oh, I want to go there. Come meet other people living with type 1 diabetes, from caregivers to children to adults. Last year we had a hundred people on our cruise and it was fabulous. You can see pictures again at my link juiceboxpodcast.com juicecruise you can see those pictures from last year there. The link also gives you an opportunity to register for the cruise or to contact Suzanne from Cruise Planners. She takes care of all the logistics. I'm just excited that I might see you there. It's a beautiful event for families for singles. A wonderful opportunity to meet people, swap stories, make friendships and learn. Check out my Algorithm Pumping Series to help you make sense of automated insulin delivery systems like Omnipod, Five Loop, Medtronic 780G Twist, Tandem Control IQ, and much more. Each episode will dive into the setup, features and real world usage tips that can transform your daily type 1 diabetes management. We cut through the jargon, share personal experiences, and show you how these algorithms can simplify and streamline your care. If you're curious about automated insulin pumping, go find the Algorithm Pumping series in the Juicebox podcast. Easiest way juiceboxpodcast.com and go up into the menu. Click on Series case and it'll be right there. The Juice Box Podcast is edited by Wrong Way Recording wrongwayrecording. Com. If you'd like your podcast to sound as good as mine, check out [e-mail].