#1752 Diabetes Spectrum - Part 1

Summary

---

Juicebox Podcast: Type 1 Diabetes

Episode #1752: Diabetes Spectrum – Part 1
Host: Scott Benner
Guest: Trisha (51-year-old mom, former healthcare administrator, current master’s student in counseling)
Date: January 28, 2026

---

Episode Overview

In this first part of a two-part conversation, Scott Benner welcomes Trisha, who shares her complex, decades-long journey to a correct diabetes diagnosis. Trisha’s story is an illuminating case study on how autoimmune diseases, family history, and healthcare systems intertwine—at times to the patient’s detriment. Together, they explore the challenges of “the diabetes spectrum,” the pitfalls of standard medical practices, and how lack of critical thinking or communication between providers can delay care. The episode aims to empower listeners to question, advocate, and understand that diabetes and its related disorders can be much more nuanced than simple “type 1 or type 2” labels.

---

Key Discussion Points & Insights

1. Background and Professional Experience

[02:33–07:47]

• Trisha details her background working in New York City’s hospital administration.

  • Supported operations, budgets, employee health (notably during COVID-19).
  • Observed the tension between “patient-centric” care and the business realities of health systems.
  • Insight: Focusing on patient and employee wellness is “contagious,” transforming work culture for the better.
  • Quote: “When your leader cares about the patient, it's generally also going to be someone who cares about you. So it really changed the whole environment. It's contagious.” – Trisha [07:06]

• Increasing regulatory demands (e.g., Joint Commission surveys) can bog down actual patient care.

• Insurance’s controlling influence over what care patients receive.

2. Trisha’s Medical Odyssey: Missed Diagnoses and Family History

[09:19–21:49]

• At six, Trisha was diagnosed with Hashimoto’s and started on Synthroid, but was taken off in adolescence when numbers improved.
• Chronic, worsening symptoms (constipation, weight issues, irregular menstruation), were repeatedly dismissed or attributed to benign causes.
• Family culture (her mother’s lack of diabetes education and communication) led to medical red herrings and lack of follow-up.
• Quote: “We can't look at the care through the lens of now. And what happened to me was a perfect storm… It shows the impact of type one on a family if it isn’t education.” – Trisha [14:56]
• Multiple instances where doctors defaulted to “treating the symptoms” (acne, menstrual irregularities) without investigating root causes.

3. Gaps in Care: Silos and Assumptions

[21:51–34:58]

• Trisha’s symptoms worsened in adulthood, including severe constipation, abdominal pain, and gynecological problems.
• Despite a family history rife with autoimmune disease (mother with type 1 diabetes, paternal relatives with Graves’ and hypothyroidism), doctors rarely did comprehensive screening (e.g., no regular A1c testing).
  • Quote: “My primary never gives me A1C in my 20s, despite family history. My new doctors don't give me A1C because I'm under 45, even though I have family history.” – Trisha [23:30]
• Paper charts and scattered records compounded the confusion and broke continuity of care.
• Misattribution to lifestyle or family norms (“that’s just how we are”) further delayed diagnosis.

4. Autoimmunity: Family Ties and the “Purebred Problem”

[27:08–31:55]

• The family’s Irish/Austrian heritage and lack of genetic diversity seemed to contribute to a high incidence of autoimmune issues.
  • Quote: “You’re having purebred problems.” – Scott [29:23]
• Discussion on the clustering of autoimmune diseases and the environmental, generational, and possibly genetic factors involved.

5. The Trouble with “Normal” Labs and Slow-Progressing Diabetes

[32:07–43:46]

• Trisha’s slow-onset type 1 (LADA) flew under the radar because of “normal” lab values—normal A1C, normal glucose, despite symptoms.
• Multiple doctors ignored autoimmune markers unless they perfectly fit established clinical parameters.
  • Quote: “People do not know. You can have diabetes and have a normal fasting blood sugar. You can get type 1 diabetes and have a normal A1C.” – Trisha [34:02]
• She highlights the danger of relying solely on labs without critical thinking, as well as the need for root-cause investigation rather than symptomatic patchwork.

6. Breaking Through: Finally, a Doctor Listened

[58:21–59:02]

• Eventually, during menopause, an A1C of 5.7 and worsening symptoms led her new endocrinologist to recognize, “Diabetes is a spectrum. I’ve seen it.”
  • Quote: “Diabetes is a spectrum. Can be a spectrum. I've seen it.” – Trisha’s new endocrinologist [59:01]
• The validation—after years of confusion—was vital for Trisha’s health and perspective.

7. Larger Systemic and Human Issues

Throughout

• Critical thinking is sorely lacking among many healthcare providers, who may be overloaded, data-focused, or lacking comfort with diagnostic complexity.
  • Quote: “There was no critical thinking.” – Trisha [42:10]
• Scott and Trisha critique a medical system that isn't built for the gray areas of autoimmunity, or the “spectrum” nature of diabetes.
• Patients often become their own best advocates, piecing information together through lived experience and community knowledge.
  • Quote (Scott): “What makes people good doctors doesn't necessarily make them good at communicating, and it doesn’t necessarily make them good at … the investigatory part of it.” [57:15]
• The value of sharing these stories: real-world experiences fill the knowledge gaps left by medicine.

---

Notable Quotes & Moments (with Timestamps)

• “Focusing on patient and employee wellness is contagious… it really changed the whole environment.” – Trisha [07:06]
• “When your leader cares about the patient, it's generally also going to be someone who cares about you.” – Trisha [07:06]
• “You’re having purebred problems.” – Scott [29:23]
• “People do not know. You can have diabetes and have a normal fasting blood sugar. You can get type 1 diabetes and have a normal A1C.” – Trisha [34:02]
• “There was no critical thinking.” – Trisha [42:10]
• “Diabetes is a spectrum. Can be a spectrum. I've seen it.” – Trisha’s new endocrinologist [59:01]
• “What makes people good doctors doesn't necessarily make them good at communicating, and it doesn’t necessarily make them good at … the investigatory part of it.” – Scott [57:15]

---

Memorable Moments & Listener Takeaways

• Scott draws parallels between Trisha’s family’s medical history and the overlap of autoimmune symptoms across many families and communities.
• Both discuss the staggering number of people whose hypothyroidism or pre-diabetes go untreated due to rigid provider mindsets.
• Discussion of how breaking the “type 1 or type 2” dichotomy is vital: there is a spectrum, and failing to acknowledge that costs real time, money, and wellness.
• Stories from listeners and family members—highlighted by Scott—underscore the importance of broadening medical curiosity and skepticism.

---

Timestamps for Key Segments

| Segment | Timestamp | |--------------------------------------------------|----------------| | Trisha’s healthcare administration background | 02:33–07:47 | | Family history, medical culture | 09:19–14:56 | | Gynecological and digestive issues, missed cues | 21:51–34:58 | | The "purebred problem" and autoimmunity | 27:08–31:55 | | Living with "normal" labs, slow-progressing LADA | 32:07–43:46 | | Providers and critical thinking | 42:10 & 57:15 | | Spectrum of diabetes acknowledged | 58:21–59:02 | | Importance of speaking out & community learning | 64:43–65:33 |

---

Conclusion: Message to the Community

The episode ends with a call to arms—spread the word, advocate, and don’t accept “this is just how we are” or “your labs are in range” when symptoms persist. The spectrum of diabetes and autoimmune conditions is broader, subtler, and affects far more people than standard medical paradigms recognize.

Trisha: “You don't just get type one and then there's type two. CGMs are showing us that people are high… Some people are high glucose responders… We did not really see what diabetes was in the past.” [64:45]

Scott: “If you took my GLP from me today, I'd go find a Gila monster and I'd French kiss.” [65:33]

Stay tuned for part two, where Trisha continues her story and discusses approaches that finally helped her reclaim her wellness.

---

Transcript

[A]

Here we are, back together again, friends, for another episode of the Juice Box Podcast.

[B]

Testing, testing, testing.

[A]

That was Trisha and she is today's guest and this is part one of a two part episode. The next one's coming right away tomorrow. Go check it out when you're done with this one. 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. If you'd like to hear about diabetes management in easy to take in bits, check out the Small Sips. That's the series on the Juice Box Podcast that listeners are talking about like it's a cheat code. These are perfect little bursts of clarity. One person said. I finally understood things I've heard a hundred times. Short, simple and somehow exactly what I needed. People say Small Sips feels like someone pulling up a chair, sliding a cup across the table and giving you one clean idea at a time. Nothing overwhelming, no fire hose of information, just steady, helpful nudges that actually stick. People listen in their car, on walks or while they're actually bolusing anytime that they need a quick shot of perspective. And the reviews, they all say the same thing. Small Sips makes diabetes make sense. Search for the Juice Box Podcast Small Sips wherever you get audio. The show you're about to listen to is sponsored by the Eversense365. The Eversense365 has exceptional accuracy over one year and is the most accurate CGM in the low range that you can get. Eversensecgm.com Juicebox USMED is sponsoring this episode of the Juice Box Podcast and we've been getting our diabetes supplies from USMED for years. You can as well. Usmed.com juicebox or call 888-721-1514 use the link or the number get your free benefits Check and get started today with usmed. Today's episode is sponsored by the Tandem MOBI system with Control IQ technology. If you are looking for the only system with auto bolus, multiple wear options and full control from your personal iPhone, you are looking for Tandem's newest pump and algorithm. Use my link to support the podcast. Tandem diabetes.com juicebox Check it out.

[B]

Tricia and I'm a 51 year old mom, former healthcare administrator, currently in getting a Master's in professional counseling.

[A]

You're a former health care administrator? What does that mean? What did you do?

[B]

I worked for a very large health care system in New York City. My last I did many I wore many different hats working for chief executive, like the chief executive nurse, as a project manager, you know, sort of chief of staff positions. And then the last position I had, ironically in 2020, was working for workforce or what a lot of places call employee health. And so we really were supporting the organization and getting N95 masks, procedures for calling out of work, getting the vaccine, declining the vaccine. Uh, so that was a large part of my former life for a while.

[A]

Would you consider what you did more of the business money side or the medical side?

[B]

I did everything. So I like, you know, you just, I'm 51, you have a long career. So for a while I worked in supporting operations for one one of the academic medical centers. So in that regard, managing budget, you know, helping make sure people get across the different departments, like lab, emergency department can fund a new MRI machine, things like that.

[A]

Can you give me a couple of like, I don't know, like high level takeaways, what it's like for a system to be patient centric, health related and basically a retail business at the same time? Like what, what are some of the oddities that come when you mix those two things together?

[B]

Well, I think what I saw was big changes in the environment because I started working there in 2007. Before that I had been in corporate working for insurance companies, very different. And when I first started working there, they were only touting that they were patient centric. And as time went on, I really saw the organization realize that if we don't treat our employees well, that's going to trickle down to the patient.

[A]

Okay.

[B]

But then at the same time, you know, I went through like many organizations, there were times when we had to cut staffing. You know, we were very impacted with being over the budget. And so it was also, you know, there were times that you would realize this is a business and we're letting go. You know, Jane Doe in department X, even though she really great with patient care and she's been here for 20 years. So you see those, you know, ebbs and flows and you see also just a lot of bureaucracy and you know that the, you know, when you're working with individuals in a C suite, just really how competitive and you know, stressful their jobs can be.

[A]

And is a hospital more A, a doctor's office that has to collect a payment or B, a business that's selling health care?

[B]

I go with more the latter. But I do have to say that going through many different leaders, I did have one leader who really always emphasized the patient. I mean, really genuinely, earnestly, you know, just you know, it just really permeated through the organization.

[A]

And that's what was that people's preference. Do you think. Do you think that when it went more like that the staff was happier?

[B]

Yes, because I think, like I said, I saw. I started in the beginning where it was all about patients first and, and it was like, who cares about you, the employee? And when your leader cares about the patient, it's generally also going to be someone who cares about you. So it really changed the whole environment. It's contagious.

[A]

Have you ever lived through an iteration where really it's about the widget like that the healthcare is just a widget and we're just here to like, put them in people's hands as fast as we can so we can send them a bill for it.

[B]

Now I think, I think what I saw more is, especially when I worked for corporate nursing is just how bogged down you can get in meeting regulatory requirements. So you know that you're taking all of the, you know, data points about like pressure ulcers and, you know, smoking cessation and how you chart in the mri and it just gets so bogged down with, you know, the Joint Commission can show up, the Department of Health can show up at any time. And I was in the command center for which we called, which is basically you're helping the organization as the surveyors are going, you know, yeah, tooth and comb through the organization. So I think that can get in the way of patient care is that you're trying to be sold to the letter of those regulations.

[A]

And then how much of the health care people receive is dictated by their. By insurance.

[B]

You know what? I did not work in revenue cycle, but, you know, it was just an absolutely huge focus of the organization.

[A]

What would happen? I mean, is there a world that you can imagine where it could just go back to like the way it was, or is it just too. Is it all too intertwined at this point?

[B]

And I think right now it's very, very intertwined. And even if I tell my own story, I think one of the reasons I'm sure that contributed is just the insurance model of why I was not diagnosed with type one fully progressing for over 16 years.

[A]

Okay. Oh, you had, you had Lada. And what were you being told? It was type two.

[B]

No, no.

[A]

What happened? Go ahead, tell me.

[B]

Go ahead.

[A]

Start at the beginning.

[B]

Story is unbelievable.

[A]

Find out.

[B]

I got Hashimoto's. At age 6, I saw an endocrinologist. My numbers, you know, so I was born in 1974. So you know, when I'm in grammar school, you know, they're thinking, okay, we just treat you with some Synthroid and off you go. What happened is my numbers started to look better. The doctor, the endocrinologist I saw said, okay, she doesn't have to take Synthroid anymore. I think I was about 11, my parents were moving from a borough of New York to another suburb in the tri state area. And so he said, you can just, you can take her, you know, to the primary, her primary care doctor. And then my body never functioned properly.

[A]

You've probably heard me talk about US Med and how simple it is to reorder with usmed using their email system. But did you know that if you don't see the email and you're set up for this, you have to set it up? They don't just randomly call you. But I'm set up to be called if I don't respond to the email because I don't trust myself a hundred percent. So one time I didn't respond to the email and the phone rings at the house. It's like, ring. You know how it works? And I picked it up, I was like, hello. And it was just the recording, it was like, US Med doesn't actually sound like that, but you know what I'm saying? It said, hey, you're. I don't remember exactly what it says, but it's basically like, hey, your order's ready. You want us to send it? Push this button if you want us to send it. Or if you'd like to wait. I think it lets you put it off like a couple of weeks or push this button for that. That's pretty much it. I push the button to send it and. And a few days later, box right at my door. That's it. Usmed.com juicebox or call 888-721-1514. Get your free benefits checked now and get started with US Med, Dexcom Omnipod Tandem Freestyle. They've got all your favorites, even that new eyelet pump. Check them out [e-mail] juicebox or by calling 888-672-11514. There are links in the show, notes of your podcast player and [e-mail] to us Med and all of the sponsors. 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 auto bolus, 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 tandemdiabetes.com juicebox to check out your benefits and get started today.

[B]

Functioned properly. I had difficulty from puberty gaining weight. I would have bouts of constipation. My menstrual cycles were extremely irregular and then disappearing sometimes for eight months. I don't, you know, I was seeing a primary care doctor. My own mother was a type 1 diabetic without much education. She herself at that point, when I was a teenager was going through a lot of high highs, a lot of low lows, a lot of emergency situations. I actually as a teenager many times had to call 91 1. I saw her turn purple, I saw her convulse and start to bite her tongue off. So here I have this craziness in my own home and I march off and my issues keep growing with my menstrual cycle, et cetera. So then long story short, around 2011 I start to go to my doctors because I say, hey, I'm starting to get really bad digestive issues.

[A]

Wait, wait, wait, 2011 sounds like 24 years after they took you off Synthroid.

[B]

Yeah. Okay, so, so I got, I go off Synthroid and then you have all these problems.

[A]

Wait, yeah, hold on Trisha. You go off Synthroid, you have all these problems that are easily attributable to not being medicated for your thyroid. And no one goes, hey, we should probably put her back on that Synthroid.

[B]

Well, this is what I think. My mom, my parent, my mom got diabetes type 1 when she was 12 and think about it was 1960. She had very uneducated parents. Her mother was like a first generation immigrant and my mother had that mentality. So my mother took me to the primary care, didn't ask questions about me, didn't ask questions about myself, except she just said she's thin. And I remember the primary was like, is your, some of your family thin? And she said, yes. And so that was the end of it. Yeah. What I realize now is, like, we can't look at the care through the lens of now. And what happened to me was a perfect storm of an. And it shows the impact of type one on a family if it isn't education.

[A]

How so?

[B]

My. Because my mother would only say this. You don't have to worry about this. You'll never get it. You don't have to worry about this. The doctor told us the primary care could handle you. I don't think the primary care literally meant, if she starts to have all these issues, you shouldn't bring her back to an endocrinologist.

[A]

I think, Trisha, it occurs to me that it is so simple that, like, I don't know, if we threw you in the pool and you started to sink and we said, oh, no, look, she's sinking. And someone said, here, give her a piece of Styrofoam to hold onto. And you held onto the Styrofoam and you didn't sink anymore. And then a few years later, they were like, oh, look, she's been bobbing around in the pool for a couple of years. She's doing good. I don't think she needs the Styrofoam anymore. And we took it from her. And then you sank again. Is the next thought not give her the Styrofoam back?

[B]

Well, this is kind of what I'm thinking, right? I move. I'm seeing new primary care doctors. I don't get it. I'm showing. And I still. This was then, but I still. The elements of it in the health care system.

[A]

Tell me, tell me, because it's so. It's fascinating to me because there had to have been a chart that said you were on Synthroid and then you weren't. Somebody had to have read that at some point.

[B]

Well, that chart would have been New York, and it wouldn't have been in the new place I moved.

[A]

It wouldn't have went with you unless your mom went.

[B]

Because it was paid. It was paper charts.

[C]

So my mom.

[B]

I think the only thing my mom ever did. My mom never read about Hashimoto's. I remember we had a. You know, we're in the information age, so we can get all of us, but you have to think we had a medical book in our house. Okay. My mom would look at it if we had bronchitis. She didn't look up Hashimoto's. She did. Right. Because one of the things I even found in the 80s books was it. It can cause irregular menstrual cycles and, you know, constipation. So I'm looking and I'm thinking to myself, oh, my God. I knew I was different than my friend. I was. And then the problems are getting worse in my 20s, and I'm calling my mother and I'm saying, okay, like. And she would say things like, I love this. That's. I guess that's just the way we are. I love that. That's like a great. A great. A great. A great old school.

[A]

What's your mind? Mom's background. Is she Italian?

[B]

Irish? Her mother was first generation Irish.

[A]

Okay. That's how we are, right?

[B]

So, like, I'm hemorrhaging. I'm severely constipated. Like that. That's the way we are.

[A]

So, mom, the whole. The hole where stuff's supposed to come out of, nothing's coming out of it, and the other one's doing the opposite, and I'm in a lot of trouble here, and I'm bleeding a lot. And she goes, that's just how we are. You were thin when you were little.

[B]

No, that was the whole thing. And the whole. The whole thing, Scott, is that, like, I would have. What I realized now is I was having some type of flares.

[A]

Okay.

[B]

Then maybe the symptoms could get better for six months. And they. The solution in the 90s for women, and we're really getting strong women now, is like, okay, don't just throw me on the birth control pill. Why did my cycle disappear when I'm 17 years old for 8 months? My menstrual cycle just. That's not normal. And then it happened. When I was in high school, they called me home from. I had to go home from college to the doc, to the OB GYN. And they knew my cycle had disappeared for eight months when I was 17. So they go, oh, we'll just give you medication to make you ovulate, and then we'll throw you on the birth control pill. So it was like, no investigation of, like, my body screaming like, hey, I don't function right.

[A]

Yeah.

[B]

And there's no prevention. No. No root cause analysis. And then I fast forward to my 30s and I start to get first sign, which I didn't realize now is I suddenly. I always had beautiful skin. I started to get cystic acne when I was about 31 or 32.

[A]

What are you.

[B]

Then the doctor. Oh, go ahead.

[A]

What do you attribute that to?

[B]

And I had a little bit of cystic pimples in my 20s, a little bit. So sometimes I wonder. So now I know what it is. I. I'm pretty sure it was, like, a first sign of insulin resistance. And then they put me on a drug called. I went to the dermatologist to put me on a drug called spironolactane.

[A]

Spironolactone? Yeah, yeah, yeah, yeah.

[B]

Spiralactone.

[A]

That was a big one back then.

[B]

It makes you pay. By the time I was 33, I'm starting to pee more. I think it's the drug. I think it's the drug from that because I had a reaction right away to taking it to peeing more. So I start to get nocturia. Then I'm in grad school. I'm working for a chief executive. I'm going to NYU at night. I have a very demanding job at first. My job's in New Jersey.

[A]

Trisha, can I stop you for a second?

[B]

Yeah.

[A]

Is your alarm going off somewhere?

[B]

Oh, yeah. Hold on. You can hear that?

[A]

Yeah.

[B]

I'm gonna get it.

[A]

Thanks, guys. I put a new rock in with one of my geckos. He's climbing all over it. It's feeling like a good purchase. So what was that alarm for, by the way?

[B]

Oh, that's not for anything important.

[A]

You don't want to tell me?

[B]

For us? No, for us. I usually. I take medication, but I. I already took it. Okay. So anyway, peeing a lot.

[A]

30S. I got you. Go ahead.

[B]

So, yeah, so I go on spiralactant. I start to pee a lot while I'm on it. It's controlling my acne, but I noticed I already have. I always have heavy menstrual cycles, but now they're off the hook. It's like I went from five or. Or, you know, my whole life of being, like. On a scale of, like, one to five, like, being too heavy, maybe like five, six. So, like, now I'm like an eight. I feel like I have the flu every time I get my period. So I'm going to the OB gyn. I start to get more and more constipated. I get married. I go for fertility treatments. They tell me, like, I have poly. Oh, no. They told me I had a lot of. I don't think at that point I got diagnosed with pcos. That came later, but. So I'm trying to get pregnant. I'm surveilled all the time. They're always taking blood. Okay. Nothing showing up in terms of my glucose being out of whack, but no one's giving me an A1C. My primary never gives me a1C in my 20s, despite family history. My new doctors don't give me an A1C because I'm under 45, even though I have family history. I go to the primary care back in New Jersey because I'm getting more and more abdominal pain and more constipation. And I say to him, I'm urinating too much at night. I'm like, what could it be? I've got all these problems. Gynecological. You're. You know. He goes, I don't know what to tell you. He's like, I just go to a woman's doctor about that. Okay. He treats my mother, who is a type 1 diabetic, who. We can get to this later. I only lives till 76. We lost her last year because she had a kidney pancreas transplant. She also was legally blind. Okay. So he's treating her not well. But never gives me an A1, an A1C never. And I'd been seeing him since my 20s.

[A]

When you think of a CGM and all the good that it brings in, your life is the first thing you think about. I love that I have to change it all the time. I love the warmup period every time I have to change it. I love that when I bump into a door frame, sometimes it gets ripped off. I love that the adhesive kind of gets mushy sometimes when I sweat and falls off. No, these are not the things that you love about a cgm. Today's episode of the Juicebox podcast is sponsored by the Eversense365, the only CGM that you only have to put on once a year, and the only CGM that won't give you any of those problems. The Eversense 365 is the only one year CGM designed to minimize device frustration. It has exceptional accuracy for one year with almost no false alarms from compression lows while you're sleeping. You can manage your diabetes instead of your CGM with the Eversense365. Learn more and get started today at eversensecgm.com JuiceBox One year, one CGM. Hey, let me stop you for a second. I feel like your voice has gotten farther away. Is there a way that we can change? Like, is the. Is your hair covering the headphones? Anything like that?

[B]

Okay, there.

[A]

Okay, thanks. Yeah, keep your hair off the headphones. So, yeah, so this guy's treat. I'm gonna make air quotes around treating your mom. He's treating her right into seven horrible complications, including blindness and. Oh, yeah, yeah.

[B]

And a lot of that had started, you know, way before her, way before even him. But he didn't. I don't know how much he helped and when.

[A]

And when you asked him for help, he said, you got to go find one of those lady doctors.

[B]

Yeah. And then he said, why are you still coming here? You should go in New York. And this guy was treating my dad, my brother and my. And my mom. So, you know, I think back in the day, sometimes you really did have that old school family doctor who's like, let me. I can keep an eye on this whole family.

[A]

When you saw your mom, like struggling, you didn't think, like, is this really the doctor I want to go to? Like, how does that occur to you? Because I'm.

[B]

No, you have to think it's a different time. And we each have her own family culture. So my mom's never made. Not an educated person on type 1 diabetes. Not educated by her parents. She said she read a book about type one when she was younger in the library, got stuck because it told her in the 1960s that she would be dead by her 40s. So she. You learn my mom's famous expression, which you call it, the apple doesn't fall far from the tree. So I always look at my story as the perfect interaction between a family that is not talking about the type 1 diabetes, is not vigilant. You know about it, and then you have the interface with a non prevented, preventative, siloed health care system.

[A]

Okay. How much better do you think? So access to information obviously has changed a lot over your. Your lifetime, but do you think it's using your. Your professional background and your personal experience? Do you think it's where it needs to be or do you just think it's better?

[B]

I think from working in the hospital. I love the story. They put all the alarms to say the. When the page, you know, on different pieces of equipment that are in the room with the patient. So then the nurses or clinicians hear them so much that they start ignoring them. My husband and I almost fell over when we looked at my chart, my online medical record, when I. Because I then started to seek care in New York and it. Type 1 mother, paternal grandmother had graves, mother had hypothyroidism, paternal aunt has. What is it? Hyperthyroid. And father has some type of autoimmune. My dad has some type of autoimmune arthritis.

[A]

Ra. Like he had ra.

[B]

Maybe he's dead. He gets so many different diagnoses, it's not even funny. He's been told he has five different types of.

[A]

Is your dad Irish, too, by the way?

[B]

So my father had better health when he was younger. He's more of a mutt. But he does have some Irish.

[A]

Yeah.

[B]

On his father's side.

[A]

Because it sounds like what's wrong with your family is pasty white European.

[B]

Well, my brother and I joke. What I see with my mom's family is it was too much of the same ethnicity over and over and over. And when I look at my dad's family, like, he and his brothers had pretty good health. And his mother. And paternal. And his. His mother and his father were more of a mix together. And my dad. But my dad's mother with the graves, she was, like, all Austrian, and there came from Pennsylvania, some area in Pennsylvania, and there wasn't a lot of heterogeneity.

[A]

Yeah. I have to tell you, I'm like, I think I've talked around this a million different ways. Not on purpose, but you're the first person that kind of put their finger on it before. Like, you're having purebred problems. You're having, like. Like, you know. You know, when you. Like when you say, like, you buy a puppy and they event. And eventually, like, you know, people say, oh, like, you know, I bought a mutt. It things always healthy. But I got a. I got a purebred. And it's got all these different problems because you're keeping the line too tight. And the problems breed, too. That's interesting.

[B]

Oh, yeah. No, I see so many autoimmune. My mom, like, even in her. Like, they'll be my second cousins, her first cousins.

[A]

Okay.

[B]

On and so forth. And I'm like, yeah, it's like a lot of. But not a. Not. I'm an avid reader. I. I remember listening to a podcast in the Royal Family that they all started to get, like, super messed up and have. What is it? One of them had hemophilia. It's like, yeah, not. Not enough diversity.

[A]

They can look a little inbred sometimes, too. How about that?

[B]

Yeah, yeah, yeah.

[C]

Like a little.

[B]

Not enough diversity. And some of it's. I mean, like, a lot of. It's like stories of the Royal family going back way, way, way.

[A]

Yeah.

[B]

Yeah. So.

[A]

Well, I saw Game of Thrones, too. I know what's up. Yeah. But I know that's fictional in case people are like, oh, God, I think he thinks that's real. I know it's fictional, but I think the idea is there. Right. Like, you just. Yeah. Well, anyway, because my Point is that you hear a lot of these celiac, thyroid, diabetes stories out of, like, England, Scotland, like that kind of area around there.

[B]

Yeah. And you have to think, like, my brother did not end up getting it and his. The Y chromosome for my dad was protective and I got hit on both X's with endocrine issues because my dad's mother had graves. And I think that what I read is, like, there you need an expert to weigh in on this. I always look at it the same way. Something with the HLA type 1 and Graves. They're almost like attached houses. Like if you had two houses in a neighborhood that were attached to. And then I think a lot of things, like my mom, I was told my mom had very high sugars when she was pregnant with me. They didn't think I was going to make it. You know, I was a C section, and when I was born, my mom was very sick. All these things, antibiotics when I was little. So, you know, it's tons of factors from the environment that program the program the stuff to turn off.

[A]

Yeah. They make the decision. So you live in a community. The doctors all do the same things. People have the same. And so you're saying, like, even, like, as an example, like, I had a lot of antibiotics when I was little and who knows what that did to my immune system long term.

[B]

Yeah, yeah. Wipes your microbiome. Like, you know, there's a lot of theories now, and I'm not the expert, but, like, I can see that everything that could go wrong, like, went wrong. And even like when I probably. I believe that I was experiencing symptoms, early symptoms, a lot of. And my doctor actually says, he's like, listen, they can call it whatever they want. You're one of the slowest progressing type ones I've ever seen. Right now, I say that with a grain of salt because we don't have data on me. We don't have the A1C from, you know, around the time that it first happened.

[A]

You live through it. You know your situation. Also, you've said twice now, I'm not the expert. First of all, this is a podcast, so you don't need to be an expert. You're just sharing your experience. Also, you've told a lot of stories about how experts didn't seem to know what they were doing. So I, I see the value in you just laying out what happened to you so that someone else can maybe pick through it and go. That stuff's happening to me too.

[B]

Well, I'm here to advocate for the, like I just got a newsletter from a large academic medical center, and it said there's only type 1 and type 2. People are not speaking about the fact.

[A]

That your voice disappeared again. Trisha, did you. Did you cover the mic?

[B]

No. Hold on.

[A]

Sorry.

[B]

Can you hear me?

[A]

Yeah. You just got farther away. I don't know what happened.

[C]

Okay.

[B]

All right.

[A]

I don't know.

[B]

I'm adjusting them away from my hair. Is that better?

[A]

Maybe make sure it's closer to your mouth.

[B]

Okay. Is that good?

[A]

I mean, good to relative term. We got Rob. He's going to jizz you up and make you sound better, but when you start disappearing into the fog, then I say something usually.

[B]

No, that's good. Okay. Am I still disappearing?

[A]

No. Good.

[B]

What happened for me or why I'm doing this is because people do not know. You can have diabetes and have a normal fasting blood sugar. You can have. You can get. Start to get type 1 diabetes and have a normal A1C.

[A]

It.

[B]

There is not just like a perfect. You know, diabetes can be a spectrum and it is not getting enough pr. You need to get the message out because I went to a doctor in 2016. I was desperate. I could no longer eat. I had lost so much weight. I was shaking. I was so weak. My periods were crazy. My. My iron stores. I think my hemoglobin was 7.8. My iron, my ferritin was like 2. Okay. Which is just. Basically, I had no iron in the bank.

[A]

Yeah.

[B]

And when you don't have any iron, you feel like you have mono.

[A]

I've had low ferritin in my life, and it's horrifying.

[B]

No, it's horrible.

[A]

Yeah.

[B]

So I couldn't use my brain. I said I had brain fog. So I go to an endocrinologist based on a referral. My primary in the city is really not doing anything for me. I'm going from gastrointestinal doctor to gastrointestinal doctor. They do colonoscopies. They don't do a motility test. I didn't realize I needed a motility specialist because, long story short, I don't know anything about gi, you know, the specialty. And I'm thinking my primary care does. And I was pushing her. And after seeing five of them, I said to her, I constantly asked you if my TSH is okay because of my family history. I said, let's send me for a full endocrine workup. And I was confused because when I had been going for fertility. Fertility treatment in 2011 and 2012, I was seeing a Reproductive endocrinologist who's running a ton of things on me. So I said, something's. This is. I'm desperate. So I go to the endocrinologist. She says, maybe I'm going to find something. My blood work comes up. I had just started maybe four months before a low carb diet because I had been diagnosed with sibo. That was my one success out of going to five gastrointestinal doctors.

[A]

They found out your gut, your gut biome was messed up.

[B]

Yeah. They're like, you have really, you have the sort of sibo like. And I had a decent number, not super high. So then I. So I'm diagnosed with sibo. I'm on the sibo diet. The doctor takes out a long sheet. The gastrointestinal, like, eat this, don't eat this. It's like she gives me a handout. So I'm like, oh, maybe I'm going to. With antibiotics. Get, get rid of this thing. Yeah, Endocrinologist, right?

[C]

Yeah.

[A]

Sauerkraut's going to save me.

[B]

Well, that's what you think, especially if your physician is handing you, I hear you, like, five page recipe, like, eat this, don't eat these. I mean, it was like crazy. So then the endocrinologist tests my blood. She calls me at work and she goes, you've got a GAD antibody reading. She goes, you might have type one. And she says to me on the phone, but your A1C and glucose were in the normal range. Maybe it's your low carb diet. I, you know, have a nervous breakdown at my office at 5 o'. Clock. I'm like, holy crap, I have type 1 diabetes. So my co worker, who's a nurse, takes my blood sugar and oddly, like I'm in the like 80s or something. Like the high 80s. I then go to the next appointment because she says, let's do lab, let's go. Let's just do. Let's do labs and an adrenal sufficiency test. So I do that and everything comes back the same. You want to know What? I was 97, I was in the 90s on my glucose and my A1C was 5.4. Now, I had been a runner and I, probably because I worked in New York City, I had an iPhone and then I got the watch. I walked between 10,000 and 12,000 steps frequently.

[A]

Yeah. Now if you're in the city, you're walking constantly.

[B]

Right, right, right. So all this doctor does is redo the blood. The labs and doctors have told me the actual Process and processing time generally will make your glucose appear like your, your regular, you know, fast. And glucose, it could like 10 lower than it is. I've had like four or five doctors tell me that you can look it up on the Internet. So like if you get a reading on your lab, that was 95 or 90, you know, mine was like 97. You really could be like 110, 120, know. So she goes, oh, I thought he was going to find something here, but I, I didn't find anything. And I said, well, do I, should I, you know, come back? And she says, no, no, no. She's like, I don't know, she's like, you have to go investigate what's going on with you. You know, back with a GI doctor or someone else. So based on the second lab result, she says, you know, I call my parents and now I look back, I'm like, how dopey that my own family didn't say, hey, we've got a glucose sticker.

[A]

Why?

[B]

You know, I'm living apart from them. I'm living apart from them.

[A]

Yeah.

[B]

And, and I think part of it is too. And we'll put this to the side for a minute. Psychosocially, type 1 has such a impact on the family, especially when the family, you know, my mother suffered so many complications. So sometimes I think there was weird psychological component to all of this. But what do you mean on her way meaning?

[A]

Yeah, like that everybody's just like a little dazed from this life.

[B]

I, that my mother didn't want to see it.

[A]

She didn't want you to have, she had. That she didn't even understand.

[B]

Right. And that she got so many complications from. So it was like, let's not, I don't think it was on a conscious level. I think the same for me because my, my first of all, when you hear bad news, you need. I learned a long hard lesson. I always bring my husband with me now to appointments because you have like an out of body experience and you might have experience that with your own daughter. Like when you're first told, you kind of like need someone to keep your feet on the ground because you're levitating. And I didn't really have that person to be logical. And then I think my family was acting the same, was a little bit like, like that as, as well. And of course there's, what do they call it, White coat syndrome. So you'd like.

[A]

Yeah, you think the doctor knows everything so you don't say anything. I take notes during like, I just Pull out my note app and I jot things down as people are talking.

[B]

Like I go with the notepad pad.

[A]

Yeah.

[B]

To scare them sometimes now to intimidate them. My husband always comes with it. But if I go alone.

[A]

Yeah. Trish, let me say something. You've been talking for a half hour, right? And what I hear is, is that you've intersected a number of doctors who have done tests on you, looked at numbers on paper, and if the numbers on paper didn't tell them what to do next, they didn't know what to do next.

[B]

There was no critical thinking. Yeah, My new endocrinologist said she needed to react to that dead animati. Use critical thinking.

[A]

Trisha, I hate your mic. Trisha. Trisha, I hate your microphone. I hate it. What can we do? You just like. You just. It sounded like you were underwater there for a second.

[B]

Oh, really?

[A]

Yeah. And then.

[B]

How is it now?

[A]

And it comes back. It comes and goes. I don't know what to say.

[B]

Oh, I wish I'd known. I would have bought something good.

[A]

It's more reliable than your doctors, but it's not great.

[B]

Isn't that true?

[A]

Yeah.

[B]

Isn't that true? But I think that my friend who's a physician says some doctors are just, like, book smart, and they're very trained to just look at labs and then they just like.

[A]

Will you do something? Will you do something for me? Will you go get your. Will you get your AirPods for me?

[B]

Yeah. Yeah.

[A]

Okay. All right. I'm just gonna sit here. I'm gonna talk to the people while you go. Hi, everybody. So, as you may or may not know, I have these little geckos, and they live in, like, a hot environment. Very. A dry, hot environment in a tank. And I had this big, like, rock for them to, like bass gone under the. Under the light where they stay warm. And I thought, I think they need more rocks. So I. I got some more rocks and I put them in there now. And they are just having a little party on these rocks today. And it's making me think. I hate this because I love this one plant that's in there. Maybe I should pull that plan out and just put more rocks and maybe they just love the rocks more, you know? I mean, you don't know because you're not here, but. But the plant looks nice. I can. I could probably take that one out, leave that one in and put a bunch more rocks over there and then replace that slate with the other. It looks so much more natural. The other rock. I Got too. They look so happy. I bet you they don't think about their endocrine issues. Actually, one of them died. Nothing. Just, you know, laid an egg one day and then looked at me and was like. And then. And she was gone. But the others are doing good. They live in a little trio. Two ladies and a boy. It's very progressive. Very 70s, very 30s company, if you know what I mean. And. Oh, I hadn't thought about that. Should I name the male Jack Tripper? And then what would the other one be? Oh, my God, it's Janet and Chrissy. Right. I'm going to name my geckos Jack, Janet and Chrissy. But then if they bring in another one, what do I do? If I brought in another male, I could call it Larry or Mr. Roper. Does anyone remember this TV show besides me? And she's been gone for a while. You think she's okay? Trisha? Anything could happen. She could have fallen down the stairs.

[B]

Yeah.

[A]

Nope. No, she's back now.

[B]

I'm here. Hold on. I'm just trying to add the thing.

[A]

Take your time. Everything's fine. Don't panic. I think you have a lot of important things to say and I want to make sure people hear them.

[B]

Yeah, no. Okay.

[A]

Your experience is very valuable. I have a lot. I have a lot of questions.

[B]

So it's been frustrating because you feel like you're.

[A]

I would imagine also you're in your 50s and. Tick tock. You know what I mean?

[C]

Oh, yeah.

[B]

And then I'll tell you what happened to my body.

[A]

Well, okay, hold on. We'll get to it. Don't you worry. But for. Do you have those headphones on now? The AirPods.

[B]

Okay. Why? I'm trying to add my device. I have like the new AirPods.

[A]

Would you like to. Would you like to jump out of this completely? Come back in through your phone wearing the AirPods?

[B]

Yeah, that's good.

[A]

Do that. Drop out. I'll let you back in.

[B]

Okay, bye.

[A]

Technology, my friends. She didn't drop out. I'm gonna kick her. Give her the boot. Let's see, what do I do here? Remove Trisha. I'm removing you. Come back in through your phone on the same link. She's gone. Knocked her right out. Bam. Just like that. Boom. Shotgun. Listen, I don't know if this part's gonna stay in or not. Cause I don't do the editing anymore. But this lady's story is super important. You guys really gotta listen through what she's saying. There's a big picture situation here that you are all on some level living through and you don't realize it. And maybe it works out for some of you, but for some it's not going to. Truth is, 30 years ago, if she would have had like a low level GLP medication, it would have put off her onset even longer, would have kept her insulin resistance down. She probably wouldn't have had a ton of these problems, would have helped her with those pcos that she hasn't really gotten to yet. And here she comes back. Let us all pray for loud noises when we hear her voice. Trisha.

[C]

Okay, I'm here.

[A]

Oh my God, that's so good. Leave it like that. Dear God.

[B]

I think new AirPods.

[C]

I don't know how the air canceling fancy lady work.

[B]

Hopefully it's better.

[A]

No, it's beautiful. When we set it up, if you would have told me you were a fancy lady, I would have said, just wear these originals. So I was just telling the people listening while you were gone, I told them about my, my sand geckos, but I also told them about. I also told them about.

[C]

I thought I heard something.

[A]

Yeah, yeah, yeah, they're lovely. But I also told them how important your story is because I think that you were just experiencing a mass amount of something that Everybody with type 1 or other autoimmune issues is experiencing on some level, which is that there is a. Not a complete understanding of what is happening to you. But we treat it like we have a complete understanding of it. And then you start having secondary issues. And maybe they're not all going to be as bad as yours. Right, because you have a bunch of stuff that's layered on top of each other. It becomes debilitating. But everybody's got something like this going on. I just had a conversation with one of Arden's friends this weekend who has type one and she's having problems. She can't figure out what it is. And she asks a doctor and they don't know, or every woman who has a problem with their period, they just throw a birth control pill at you. And that either helps or it doesn't. Or people say to you like, let's run a thousand tests, let's stick this pipe up your ass. Let's do all this other stuff. Oh, nothing here. Sorry, sorry, I'm still sick. And they go, no, I don't know. And you know the number on the page. You know how many people have a TSH of 3 and 4 and 5? And a doctor's telling them, that's fine, that's in range. And meanwhile you have 17,000 hypothyroid symptoms and nobody will give you a Synthroid.

[C]

Oh yeah, and I forgot to advise that when I was going for fertility treatments. They're like, oh, you have endometriosis. So inflammatory, right? Like total.

[B]

It's showing.

[C]

My whole immune system is not.

[A]

You guys, we all have. Like, I'm going to throw myself in there too because my kid has type one and my other kid has Hashimoto's. And like there is an A level of inflammation existing in us, like people living with autoimmune that is just higher than the average, than the general population and it makes stuff not work. And it.

[C]

My brother has low level issues, so. And we just, I made him put on a CGM and he just caught that. When he eats white, he cannot look at a white carb. He goes well over 200 even though he hasn't had the antibody attack flowers. And he had severe cystic acne when he was a teen, which now I'm reading can be part of a metabolic, you know, profile. And my brother sons has severe food allergies and his A1C or some of his sugars came out a little funny. He's on thyroid for Hashimoto's.

[A]

It's like, yeah, it's a problem and nobody understands it, is my point. And you don't, you don't understand it till you've lived with it for so long that you just, you've seen it come at you from so many different angles that you're like, oh, that makes sense now. Like it doesn't make total sense, but I understand where it came from and I, it's just, it's not, it's not a broken bone. You're not going to go to a doctor and they're not going to go, my God, your, your fibula is broken. We will put a cast on that and it will be better later. Like it's, it, it just doesn't work that way. And people don't have the expertise, they don't have the experience. They lean on lab values that they don't understand that apparently don't even have to be right because it's not a perfected system either. From what you were saying earlier about glucose and so, you know, and now it's. Is it fair to them? It's not. But what happens at the end of that, of the rainbow, you don't get a pot of gold. You get like you slid off the rainbow. And we don't have any answers to Just keep walking and good luck, and maybe you'll. You're going to die. But, like, yeah, that's it, Scott.

[C]

These are the things I was told. I had a male physician who stood over me who was a GI doctor.

[B]

And he said, well, you don't have.

[C]

Cancer after a colonoscopy. And then I went to his office after. I said, I'm still having severe digestive issues. And he goes, I don't know what to tell you. Do you think it could all be in your head? Do you think it could just be.

[A]

They told psychological. My wife, right. My wife's thyroid exploded after she had Arden. And that's not a technical term. And. But. But it's what happened. And. And they. They everything. You should exercise more. She says, nothing's changed about my exercise. Well, you're. You should eat differently. Nothing's changed about how I eat.

[B]

That reminds me of my diet, the doctor with the diet.

[A]

And then. And then when that stuff didn't work, they said, maybe you're depressed. And she's like, I'm not. I'm not depressed. Like, I just. And everything. So then at some point, you get so desperate. She's like, she tried depression medication for a while for her thyroid problem.

[C]

I totally believe it.

[A]

She came to me one day, she goes, I'm taking this medication for. I'm not depressed. This is ridiculous. And I was like, great. And seven years. Seven years it went on until, by.

[C]

The way, I believe, yeah, 100% 16 years. 16 years, Trisha.

[A]

In that time, my wife, she gained an unfair amount of weight that was from not having thyroid medication. You know, it plagued her for most of her adult life until, by the way, somebody came up with a GLP and took a. Fixed it for, you know, in two years, like, big center, right back again. But my point about. I guess probably where my passion comes from, about people sharing their experiences is the only reason we even knew my wife had a thyroid issue is because I shared her problems with Arden's nurse practitioner when Arden was little. And the woman just said this offhanded thing to me, and her name was Sakina Boyd. And thank you very much, Sakina. And she just said, oh, yeah, autoimmune stuff, like runs in families. And it doesn't have to be like, diabetes. Diabetes. It doesn't have to be Hashimoto's. Hashimoto's. She's like, sometimes you just see, like, a potpourri. Like, I don't think she was.

[C]

That's my mom's side of the Family.

[A]

Yeah, right. And. And then I stopped and I thought, oh, my goodness. And I started going through Kelly's side of the family. Her. Her grandmother had what they used to call the sprue. I don't know if you know about that, but it was celiac. Because it was celiac.

[B]

Got it, got it, got it, got it.

[A]

They'd be like, grandma has the sprue. The sprue. This is what happens when morons talk about technical things. By the way, no offense, but she's. She's dead, and she wasn't that smart. And so, like. And so, like, they're talking about the sprue over here. Nobody. Everybody's. And all the time, like, nobody can. Like, everybody gets nervous and runs to the bathroom all the time. Like, that's the thing that happens. You know, I've got a niece who's sick all the time. Right. One. And I've got. You know, I've got. There's a. There's a person who has a lot of, like, issues that he probably would call bipolar, but maybe not. It's never been able to be knocked down. And then I started making this podcast and asking people all these questions. All y' all mother have these problems in your family. Okay? Like, I get so, like. I'm like, okay, so Sakina shares her colloquial thought, and it makes. And it saves my wife, right? Because then one day I go into a doctor's office, and I'm like, she clearly has hypothyroidism. And he goes, no, her TSH is only whatever it was. And I was like, I don't.

[B]

There you go.

[A]

So. But here's the difference, right? I'm an asshole. So, like. So I looked at him and I said, in not a polite way, will the medicine hurt her if she doesn't have hypothyroidism? And he goes, no. And I want. Well, then fucking give it to her. Are you out of your mind? It's not gonna hurt her to try it for a month, but if it's the right thing, then this all goes away. And you're saying no. Sorry, the number on the paper doesn't indicate this. You're out of your mind. You were willing to give her depression medication. You were willing to tell her that she doesn't exercise. You were willing to tell her she doesn't eat.

[B]

Right.

[A]

You were willing to say a whole bunch of things that. That weren't true that you were guessing about. But this one thing that has the most common sense wrapped around it, this you're not willing to do because the test says what? It's green. That's all he said. It's in the green. He said, by the way, when someone starts telling you your test is in the green, I think what you should hear is that person doesn't know what the. They're talking about. And, like, if they did, they'd have a technical explanation for you. Not, it's green. Green's good. Green means go. Like, are you out of your mind? So, you know, so then I. Kelly gets the thing, and she's okay, and then I come on the podcast and talk about it more. You want to know? Like, I don't know if I get more notes from people who are grateful about having their thyroid problem fixed or about their diabetes being better. Like, it's. It's rampant. And. And. And I'm not even mad at anybody. I just think it's the.

[C]

No, no, no. We have a. I feel like we have a broken system. And, like, for me, I ended up at a gastrointestinal doctor telling her my symptoms were getting far and far worse. And despite being put on something called LIN S. Okay, I was getting worse. And she also told me. And I was like, I'm out of here. To distract myself and accept that I was complicated and that I just needed to be on meds. And I had told this doctor, this gastrointestinal doctor who was. She's probably in her early 60s. I said I probably should go back for an endocrinology and consult, considering my family history. She told me I didn't know what I was talking about. And then again, I just needed to accept that I had, you know, these digestive issues and sort of move on.

[A]

Yeah, that person's a dipshit. So, like, she shouldn't.

[C]

This doctor should not be practicing.

[A]

But. But you. You just said the system's broken. I just think that's a thing people say. Forget that you said the real problem earlier. It's not that the system's broken. What. What was lacking when people had to help you? Critical thinking. What. There's not a. There's not a systematic issue. There's a people issue. Like, not everybody's cut out to think through a problem like this, And. And often. And God bless you all who are doctors. Like, what makes people good doctors doesn't necessarily make them good at communicating, and it doesn't necessarily make them good at, like, the. The investigatory part of it. Right?

[C]

So realize this doctor would get anxious. She couldn't solve a problem. Didn't know how to solve a problem. So it was take a drug and get out of my office.

[A]

Yeah, she's probably. Listen, she's probably on the spectrum. Like, anybody that can sit in college for eight years and learn all that stuff and then remember it, something's up. You know what I mean? Like, I don't. I don't know shit about anything. I can't remember anything. I've helped more people with type 1 diabetes than most endocrinologists are going to.

[B]

Yeah.

[C]

I ended up going to, finally to a doctor who was different. And I was telling her, brain fog, et cetera, et cetera. We caught on my labs when I went through menopause that my A1C went to 5.7. And I said, first her office did goof up because they're like, oh, maybe you have type two. I go, hello, My mom has type one. Look at my freaking chart. I finally then got the doctor on the phone and she said, well, diabetes is a spectrum. Can be a spectrum. I've seen it.

[A]

Yeah.

[C]

And I said, what. What do you mean? I thought you were either diabetic or you or you weren't.

[B]

You were like.

[C]

Like just how we talk about story with Arden. Like, like, you know, you go dramatically to the emergency room.

[A]

Right, Right. Oh, my gosh. But you. What you gotta do is listen to that episode with Dr. Hamdi where he discusses that, like, in the very near future, you're gonna see people with dual diagnosis is type 1, and insulin resistance is basically a type 1, type 2D. There's going to be a lot more versions of diabetes that are going to.

[C]

Get like, yeah, Like I said, why does my. Why can my brother not look at a white carb? Like, he doesn't have the antibody attack, but yeah, he could be a high glucose responder.

[A]

Not yet.

[C]

Could be like, yeah, right.

[A]

Also.

[C]

Yeah, but nobody's would look at him if I forced him.

[A]

Oh, God.

[C]

Just said, your brother should go get thoroughly checked. And my brother finally did.

[A]

Yeah, but thoroughly checked for what? And then what are they going to do after that? Like, there's. Listen, I. I'm. I'm telling you all, like, right now, I probably sound like. I don't know. I guess I don't care how I sound, actually. But, like, there's that something in that glp. Well, no, but something in that GLP medication is affecting a lot of things for people, and no one understands what it is yet. Right. But I. I'm. I'll say over. I'll say over and over again, there are A lot of ladies pregnant now on a GLP that weren't pregnant before. And basically what happens is that when you say that out loud, common medical wisdom is well, yeah, they lost weight and they're healthier now. So they got pregnant. Some of them are getting pregnant weeks after beginning to use it. They haven't lost weight yet, they start shooting it and then boom, they're pregnant. And I'm talking about people who've been trying to get pregnant for decades to the point where they don't think about, yeah, they don't think about contraception anymore. They just bang all over the place because they think it can't possibly happen. They go, oh, I heard, I maybe I can be a little thinner on this glp. They put it in and woo, pregnant. And there's so many of them that they found each other online and created like a giant Facebook group about them which then made the medical community right, what's going on? Think, oh, what's going on now? They're going to start looking into it now. They'll take 20 years to figure out what's happening. And like, and, but in the meantime, people talking will know the difference, right? And, and so, so like I'm, I'm sitting before you right now. I'm 70 pounds lighter than I was two and a half years ago. I don't eat or act or do anything differently today than I did two and a half years ago. If I feel bad because Arden has a needle phobia, so she has a little trouble taking shots. But if you give Arden a small dose of glp, not a full dose of it, a small like micro dose of it, her insulin needs go down by like 30%. There's been a man on here who had type 1 diabetes, all the antibodies using all the insulin, et cetera. For a couple of years they stick him on Manjaro for weight and the next thing he knows, he's not using insulin for a while now he's got, oh my God. Yeah, he's got lotta. So it's, it'll come back eventually. But there's also a 15 year old girl that came on that for two years between 15 and 17 was down to like one unit of basil a day from like, from like 50 units a day of total insulin down to one unit a day. Had to take her pump off. But she has and has the antibodies. She has type 1 diabetes, right? And she was using all the insulin, like she, and, and gaining weight and all the stuff. So they put her on and her mom recognizes it because her mom used the GLP for gaining weight and some PCOS type symptoms. So solid in the daughter put her on the meds and then all of a sudden they, you know, they said, hey, you might have to turn your base, you know, your insulin down a little bit. It wouldn't stop going. Her need wouldn't stop going down. Like, so her situation's not another person's situation. Like, your point about the spectrum was well taken by me.

[C]

I only. Okay, so first of all, doctors, like, especially in an urban area, I walk to all my appointments, right? Doctors don't have any critical thinking about the labs in an urban area because in New York City, man, you walk. Okay, so other things you talked about, like in terms of. I realized during what you call it, 2020 with all the EMRs, I had one. I had, you know, you get multiple labs after you go to a doctor and they start to come in your email. There was one of them I missed with my glucose. My glucose was 120 out of range. Dr. Never called me about it. It was an OBGYN. OBGYN, okay. Never called me. And then number two, for me, having diabetes, being so physically active, not having a car, and even now I still exercise a mat. My doctor says I only take two units of background insulin.

[A]

Yeah, you're super active.

[C]

Yeah. And so she's like, you don't look like my normal, average type 1.

[A]

So keep thinking about it.

[B]

Diabetic.

[A]

That's the, like, that's the part I don't get. Like. Like what? Oh, you don't look at the average one. So. And then like, it just. I don't know what to say exactly. Like, I. I'm not blaming doctors. They're just people, right? And we have these experiences and you live with it all the time, so you have more time to think about it. But not everybody thinks about it. Some people just do. The thing that that lady told you to do was just accept that you're a sickly person and be done with it. And.

[C]

Oh, yeah, right. Oh, yeah.

[A]

And there's just. I don't know the answer. I really don't. Like, I don't. But there's something going on that nobody's really quantified yet.

[C]

This is my answer.

[A]

Go ahead.

[C]

And that's what you and I are doing right now. We have to spread the word, talk about it. You don't just get type one and then there's type two. CGMs are showing us that people are high. Some people are high glucose responders that you know you can be a diabetic with that. An A1C can hide that you're in the early stages. I know my endocrinologist now says, like, by the time it's coming out in your A1C, it's been brewing often for a very long time. So I think with what you're saying with the GPL1s, like we're in an explosion, explosion of data and like we did not really see what diabetes was in the past.

[A]

No, I, I, I'll tell you right now that if, if you, if you my, my A1C has never been a problem ever. Right. It but, and if you took my GLP from me today, I'd go find a Gila monster and I'd French kiss. This episode was too good to cut anything out of, but too long to make just one episode. So this is part one. Make sure you go find part two right now. It's going to be the next episode in your feed. The 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. Come on. You probably feel like I'm messing with you, but I'm not. Eversensecgm.com Juicebox US Med Sponsored this episode of the Juice Box podcast. Check them out at usmed.com juicebox or by calling 888-721-1514. Get your free benefits check and get started today with US Medicine. Arden has been getting her diabetes supplies from US Med for three years. You can as well usmed.com juicebox or call 888-721-15140. My thanks to US Med for sponsoring this episode and for being longtime sponsors of the Juice Box podcast. There are links in the show notes and [e-mail] to us Med and all of the sponsors. If you're new to type 1 diabetes, begin with the Bold Beginnings series from the podcast. Don't take my word for it. Listen to what reviewers have said. Bold Beginnings is the best first step. I learned more in those episodes than anywhere else. This is when everything finally clicked. People say it takes the stress out of the early days and replaces it with clarity. They tell me this should come with the diagnosis packet that I got at the hospital. And after they listen, I they recommend it to everyone who's struggling. It's straightforward, practical, and easy to listen to. Bold Beginnings gives you the basics in a way that actually makes sense. Okay, well, here we are at the end of the episode. You're still with me. Thank you. 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. 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.