Juicebox Podcast: Type 1 Diabetes

Episode #1712: Porcine Cell Recipient
Date: December 18, 2025
Host: Scott Benner
Guest: Kelly

Overview

This episode features Kelly, a woman living with type 1 diabetes (T1D) for 38 years, who recently became a recipient of a porcine (pig) islet cell transplant as part of a clinical trial. Together with host Scott Benner, Kelly discusses her journey with T1D, the highs and lows of disease management across decades, the decision to participate in a groundbreaking study, and her hopes for the future—both personally and for the diabetes community. The conversation is honest, practical, and layered with humor as they dig into the day-to-day realities and psychological burdens of T1D.

Key Discussion Points & Insights

Early Life and Diabetes Diagnosis (03:05–04:28)

• Kelly's Backstory: Diagnosed at age 7, just before third grade, living in South Florida. Experienced classic symptoms: frequent urination, excessive thirst, weight loss, and even hair loss.
• Early Diabetes Care: Parents took a leading role in her initial care; tech and resources were very limited ("I don't know how we made it through the 80s and the 90s, to be honest." - Kelly, 03:56).
• Major Change: The biggest improvement in diabetes care for Kelly is the accessibility to real-time blood glucose data through continuous glucose monitoring (CGM), which contrasts sharply with the unpredictability and guesswork of earlier decades.

Young Adulthood: Lax Management and Turning Points (05:34–08:23)

• College Years: Admits to periods of “laziness” with diabetes management, including not checking blood sugar before bed and a notable episode involving waking up in the basement after a severe hypoglycemic event.
• Critical Wake-up Call: A severe low at age 25, with her father attempting to take her to the hospital, marks a turning point. Kelly decides to be more serious about her health ("I got serious and never had any issues like that again." - Kelly, 07:43).
• Maturity and Management: The neurodevelopmental aspect of the mid-twenties is touched upon; Kelly affirms she’s thankful for parent involvement and is proud of having had two healthy pregnancies with T1D.

The Ongoing Burden and Search for Clinical Trials (08:24–12:13)

• Living with T1D: Despite adapting to life with diabetes, Kelly describes it as an inescapable burden: "You can never, like, take a step away from diabetes."
• Move to Illinois & New Opportunities: Moving introduced her to a wealth of clinical research happening in the region (Chicago and Madison, WI). She learned about islet transplants in both the cadaveric and animal (porcine) form.
• Insurance and Barriers: Cadaveric islet transplantation wasn’t available due to insurance coverage. Kelly reflects humorously, "Of course you won't cover a cure. Like, why would we do that?" (11:03).

Porcine Islet Transplant: The Procedure (12:13–18:12)

• Clinical Trial Entry: Kelly qualified for the University of Illinois at Chicago’s porcine islet trial; she became only the second US participant to receive this type of transplant.
• Details of the Procedure: Islets from pigs are encapsulated (not in pouches, but infused into the omentum—a fatty, well-vascularized area in the abdomen) to avoid anti-rejection medications.
  • "They put them in your omentum, which I had to Google. I didn't even know this was a body part that we had." (Kelly, 12:47)
• Surgical Experience: The minimally invasive laparoscopic procedure required only a short hospital stay, little pain, and an uncomplicated recovery (17:15–17:41).

Expected Results and Life as a Trial Participant (16:05–18:30)

• Waiting for Impact: No change in insulin requirements within the first month, but participants are told to expect possible changes after about six weeks (“They told me that I shouldn't really see any changes for about six weeks.” - Kelly, 16:11).
• Responsibilities Post-Transplant: Ongoing frequent follow-ups, blood draws, and C-peptide tests. Life-long monitoring as part of the study; involvement in further phases is likely.
• Interaction with Pioneers: Kelly shares her positive encounter with Dr. Jose Oberholzer, one of the leading transplant surgeons and the founder of the Chicago Diabetes Project (“His entire life is dedicated towards developing cures.” - Kelly, 34:38).

Motivations and Psychological Impacts (21:25–29:55)

• Why Take the Leap?: Kelly honestly describes diabetes burnout and the exhaustion that comes from endless decision-making: “It’s just one of those things where it's enough already. It's a full time job.” (Kelly, 24:27)
• Openness to Innovation: Expresses willingness to try other novel therapies if needed; evaluates the risks and benefits rationally.
• Family Considerations: Kelly’s family history is free of other autoimmune conditions; she is proactive in monitoring her own children through TrialNet testing for T1D risk (29:15–29:55).

Technology Through the Decades (30:03–34:18)

• Current Therapy: Uses Omnipod 5 (AID: Automated Insulin Delivery) with Dexcom CGM.
• Critical Take: Finds her A1C was better with older, less automated pumps. Dislikes some algorithm behaviors on new tech (“There are times where I think it does not correctly estimate or predict that you're going low... That sends you back up to the 160s or 180s sometimes.” - Kelly, 31:57).
• Still Proactive: Admits to overriding her device at times to improve results: “I am guilty of overriding some of the decisions that the five is making.” (Kelly, 32:59)

The Emotional Realities: Guilt, Burnout, and Hope (39:15–54:50)

• The Infinite Decisions: Discusses the daily grind of meal planning, exercise, and insulin dosing: "It's all those many decisions... just so exhausting all day long." (Kelly, 39:15)
• Cravings for Normalcy: Dreams of a day when she can "order the meal you want" or "go take an exercise class" without advance planning or stress.
• On Guilt: Guilt can come from multiple sources—avoiding family treats, going high after a meal, or simply not following routines. ("No, that's all, that's all true, right?" - Kelly, 49:30)
• Coping & Sharing: She expresses hope that sharing her story will encourage more T1D individuals to explore clinical trials and new approaches.

On Clinical Trials, Risks, and the Future (54:50–59:29)

• Addressing Skepticism: Has encountered skepticism about participating in an experimental study. Her response: “That's the whole point. It's a clinical trial. If no one does it, we're never going to find out.” (Kelly, 55:03)
• Comparing Therapies: Weighs the pros and cons of islet transplantation from cadavers (requires immunosuppression but potentially more established) vs. porcine islets (experimental but avoids life-long anti-rejection drugs).
• Support System: Her husband’s support was crucial; she insisted on understanding the real risks before deciding.
• Hope for a Cure: Kelly is optimistic about the trajectory of cell-based therapies and research: "I do believe that's where we're headed… It's not really new." (Kelly, 59:11)

Notable Quotes & Memorable Moments

• On the Difference Modern Tech Makes:
  “It's the not knowing. We can just look down at our CGM and see… I just sometimes think it's amazing that we lived through all of that.” – Kelly (05:24)
• On Burnout:
  "It's a full time job… all those many decisions are just so exhausting all day long.” – Kelly (39:15)
• On Willingness to Try New Therapies:
  “If there are options out there… I'm certainly open to it.” – Kelly (28:00)
• On Clinical Trials:
  “That's the whole point. It's a clinical trial. If no one does it, we're never going to find out.” – Kelly (55:03)
• On the Psychological Toll:
  “You feel guilty for not partaking with your family. You could feel guilty after your blood sugar goes up later… Then if you try to ignore it, then you feel guilty for ignoring it.” – Kelly (49:12)
• On the Search for a Cure:
  “I do believe that there will be a cure for us in the near future… cell-based therapies, there's so much happening right now in this space.” – Kelly (20:24)

Important Segment Timestamps

• Kelly’s Diagnosis Story: 03:05–04:28
• Turning Point at Age 25: 06:48–07:43
• Search for Clinical Trials & Decision Process: 08:24–12:13
• Details of Porcine Islet Transplant Procedure: 12:13–14:31
• First Month Post-Transplant, Expectations: 16:05–16:20
• Surgical Recovery & Team: 17:15–18:12
• Meeting with Dr. Oberholzer (Chicago Diabetes Project): 19:33–20:24, 34:38–35:29
• Motivation for Joining Clinical Trial: 21:25–24:48
• Technology & Devices Old vs. New: 30:03–34:18
• Daily T1D Burden, Decision Fatigue: 39:15–40:01
• Guilt & Social Challenges: 48:07–49:33
• Skepticism & Trial Participation: 54:50–55:03
• Hope for Cell-Based Therapies: 59:11

Additional Insights

• Eligibility and Unique Risks: Each study has unique criteria (blood type, BMI, hypoglycemia unawareness). Kelly’s long-standing T1D and blunted hypo sensations made her a strong candidate (20:32).
• Animal Ethics: Kelly acknowledges the emotional conflict regarding the use of baby pigs’ islets for her transplant; she weighed this carefully.
• Long-Term Impact: Even if the intervention is not a full “cure,” partial benefit—such as reduced insulin needs or greater glucose stability—would be valuable.
• Advice for Others: Encourages T1Ds to research local clinical trials, especially in cities with major research centers, and not to self-exclude from opportunities.
• Role of Family: Support and communication, especially with her husband, played a decisive part in her willingness to pursue the procedure.

Tone and Language

The conversation alternates between meticulous, reflective, and frank, with Scott bringing humor and empathy while Kelly speaks candidly about her experiences, frustrations, and hopes. The episode is a blend of medical exploration, lived experience, and emotional honesty—creating a supportive and inspiring narrative for listeners, especially those touched by diabetes.

For more information, visit: juiceboxpodcast.com
Key name to research further: Dr. Jose Oberholzer, Chicago Diabetes Project

End of Summary