Juicebox Podcast: Type 1 Diabetes
Episode #1742: Penny Drop - Part 1
Date: January 20, 2026
Host: Scott Benner
Guest: Liesl (Diabetes Specialist Nurse, DAPHNE educator)
Episode Overview
In this first part of a two-part conversation, Scott Benner sits down with Liesl, a diabetes specialist nurse and DAPHNE (Dose Adjustment For Normal Eating) educator. They take a deep dive into diabetes education, the evolution of diabetes care, and the transformative impact of structured programs like DAPHNE. Liesl shares her journey, the philosophy behind DAPHNE, and the profound shifts she’s witnessed in people living with diabetes—including healthcare professionals. Together, they discuss stigma, patient empowerment, the importance of community, and how both education and technology are shaping the future of diabetes management.
Key Discussion Points & Insights
Liesl’s Background and the DAPHNE Program
- Liesl introduces herself as a diabetes specialist nurse and explains DAPHNE as a not-for-profit NHS-partnered entity delivering free education to people with type 1 and type 2 diabetes, as well as healthcare professionals (02:33, 03:35).
- The DAPHNE program is based on structured education for insulin dose adjustment and is rooted in the German model developed by Michael Berger (10:01).
- DAPHNE reverses the historic approach of rigid dietary recommendations and instead teaches flexible insulin dosing so people can match insulin to real life, not the other way around (11:01).
Liesl’s “Penny Drop” Moment as a Nurse
- Liesl recounts being a specialist nurse for 6 years but feeling “disenfranchised” until attending DAPHNE educator training. The realization of her own knowledge gaps was profound (04:35).
- “I just thought, 'well, if people can eat whatever they like... this could be a disaster.' But then I went on the DAPHNE course and properly understood that triangle between carbohydrates, insulin, and blood glucose, which I’m ashamed to say I hadn’t fully appreciated for the six years that I’d been a diabetes specialist nurse.” (06:03)
Traditional Diabetes Care: Misconceptions and Limitations
- Liesl details how, prior to DAPHNE, even diabetes professionals failed to connect food, insulin, and blood glucose in practical terms. Education focused on “healthy eating” not carb counting, and care often meant minor insulin tweaks without understanding patient realities (07:03).
- She reflects on the norm of giving advice rather than listening:
- “I felt I was a vehicle of information and my job was to give information and tell people what they should be doing... But doing the DAPHNE course taught me to listen and understand what it’s like, as well as I can with a condition that you can’t have a day off from.” (08:07)
The Power & Structure of the DAPHNE Course
- DAPHNE’s five-day course uses progressive learning, starting from identifying carbohydrates to advanced real-life meal calculations and insulin adjustments (12:56-15:27).
- Real-world, tangible improvements are seen in patient confidence and skills:
- "Most course participants will come in with a [confidence] score of 1 to 5 before the course. When the course is finished, they'll mostly be scoring between 7 and 10.” (17:16)
- The most impactful realization on Day 1:
- “They couldn't have done anything to avoid it [type 1 diabetes]... That relinquishing of guilt for a lot of people is really powerful and that happens within the first couple of hours.” (21:36)
Peer Support and Community Building
- DAPHNE’s group format provides support unlike what patients get elsewhere—breaking isolation, building lifelong friendships (22:47-28:43).
- “It's often the first time they've had a proper conversation with somebody else who lives with type 1 diabetes... they realize they’re all as good as each other or all as bad as each other, and they share the same problems, anxieties, fears.” (22:47)
Stigma, Language, and the Danger of “Non-Compliance”
- Liesl and Scott challenge the medical concept of “non-compliance,” emphasizing individual challenges and the complexities of life with diabetes (30:24, 31:46).
- “If you understood that, you’d never label somebody as non compliant.” (30:24)
- “The number of doctor trainees... who manage to [carb count] 100% for five days is really small. Not a criticism, just a reflection of life.” (31:43)
- Burnout from both diabetes and technology is addressed—even those perfectly “suited” personality-wise aren’t immune (34:53).
The Visibility of Diabetes in the Modern Era
- With CGMs and pumps more visible, diabetes is inherently less “invisible” in public. Liesl expresses ambivalence—should we acknowledge each other in public as a kind of solidarity? (35:34-36:25)
- Scott: “We need a Jeep wave...”
- Liesl: “That’s what we need. Yeah, we need a type one wave.” (36:15-36:25)
The Need for Constant Innovation in Education and Technology
- Both host and guest agree: successful programs (like DAPHNE or popular pump companies) must innovate to stay relevant, meet evolving needs, and avoid stagnation (38:55-42:26).
- Liesl highlights DAPHNE’s expansion: pump courses, hybrid closed loop training, education for type 2s on insulin—adapting to tech and the full spectrum of diabetes.
- “We’re trying to evolve to suit diabetes in the 21st century... that education is absolutely crucial.” (39:16-40:31)
Lessons from Diabetes History: Progress and Perspective
- Liesl shares a moving story tracing insulin’s history—her great-aunt providing near-starvation diets, the arrival of insulin, primitive glucose testing, and today’s rapid innovations (42:26-45:10).
- “So to think in the last 25 years we’ve gone to pumps and CGMs, rapid acting analog insulins, ultra long-acting basals. We’ve seen so much develop... if DAPHNE as an organization doesn’t keep up, then we're not providing what people need.” (42:26)
Looking Forward: Technology, AI, and Ongoing Change
- They reflect on how future generations will look back on today’s tech as primitive—and that AI may revolutionize care yet again (45:10-46:06).
- “There will be a time... people will look back on 2025 and say, oh my gosh... look what we have now...” (45:10)
Notable Quotes & Memorable Moments
- Liesl, on the “penny drop” for both patients and professionals:
“It was the best bit about being a diabetes specialist nurse, watching people’s confidence grow and seeing their understanding just expand beyond what they’d expected… Watching the penny drop, it’s like it’s a professional drug.” (15:27) - On stigma and guilt-lifting:
“That relinquishing of guilt for a lot of people is really powerful, and that happens within the first couple of hours [of the DAPHNE course].” (21:36) - Scott on diabetes as invisible burden:
“If you could imagine a thin wet towel laid over top of you, how uncomfortable that would be… But if everybody has the towel, it disappears. It's gone.” (28:43-30:11) - Liesl on the limits of "compliance":
“Not a criticism, it's just a reflection of life.” (31:43) - On innovation and the need to keep evolving:
“You know this thing you’re doing works, but you still have to get it out there... If things didn't need to be new all the time, then we'd all just be still watching MASH…”* (40:31-42:26) - Liesl reflecting on a century of diabetes care:
“She would have been looking after people and nursing them to their death when insulin suddenly appeared... To think in 25 years we've gone to pumps and CGMs... we must keep up.” (42:26-45:10)
Timestamps for Key Segments
- 02:33 – Liesl introduces herself and DAPHNE
- 06:03 – Liesl’s misconceptions before DAPHNE, and her penny-drop moment
- 07:03 – Description of limited pre-DAPHNE care for people with diabetes
- 12:56 – How the DAPHNE course builds confidence and patient autonomy
- 17:16 – Quantifying the confidence boost from DAPHNE
- 21:36 – The liberating “not your fault” realization for course participants
- 22:47-28:43 – The transformative power of community and peer support
- 30:23-31:46 – Challenging the concept and stigma of “non-compliance”
- 34:53 – Discussing diabetes burnout, tech burnout, and visibility
- 38:55-40:31 – DAPHNE’s diversification to stay relevant
- 42:26-45:10 – Century-long reflection on diabetes advances
- 45:10-46:06 – Looking ahead to future innovations
Tone and Language
- Conversational, warm, occasionally humorous (Scott’s analogies and self-deprecating moments)
- Empathetic and compassionate, especially from Liesl as she discusses teaching, listening, and community-building
- Candid and reflective—both speakers comfortable challenging assumptions and sharing personal insights
Summary for New Listeners
This episode is a must-listen for anyone living with diabetes, healthcare professionals, or those supporting someone with diabetes. Liesl’s honesty about her own professional growth mirrors the journey many patients take—from confusion and rigid rules, toward empowerment and flexibility. Scott and Liesl’s discussion highlights not only the life-changing impact of structured education and peer support but also why diabetes care must always be evolving. If you’re looking for reassurance, practical understanding, and hope, this episode delivers all that with humility and heart.
Next Steps
This is Part 1. Be sure to listen to Part 2 to continue this fascinating discussion!