Juicebox Podcast: Type 1 Diabetes – Episode #1768 "Break the Cycle"
Host: Scott Benner
Guest: Dr. Ernie Fernandez, Endocrinologist & Camp Sweeney Director
Release Date: February 11, 2026
Episode Overview
This episode tackles the often-overlooked but crucial intersection between mental health, sleep, stress, and technology use for people living with type 1 diabetes (T1D), particularly children and adolescents. Dr. Ernie Fernandez draws on decades of experience both in clinical practice and as director of Camp Sweeney—a transformative camp for youth with T1D—to discuss actionable ways for families and individuals to “break the cycle” of anxiety and exhaustion that can arise from the daily realities of diabetes management. The discussion also explores the impact of technology and social media, the critical need for community and resilience, and core strategies for supporting children (and parents) living with diabetes.
Key Discussion Points & Insights
1. The Unique Burden of T1D: Sleep, Stress, and Anxiety
- Many children—especially those with T1D—are facing increased anxiety and sleep disruption, exacerbated by changes in modern society and media consumption.
- Physiology at Play: During adolescence, the brain’s demand for neurotransmitters spikes, especially as higher-level functions develop. The production of these neurotransmitters is tightly linked to quality deep sleep, which is being eroded by stress, busyness, and especially late-night screen use.
[03:07-07:00] - Diabetes brings an “invisible second full-time job,” compounding the stress level for kids and their families. The constant vigilance required with T1D management—uncertainty about blood sugars, pump function, and the ever-present possibility of both highs and lows—keeps the brain in a state of heightened alert, making restful sleep even harder to achieve.
“You as a parent know this... it's sort of a hidden world that no one realizes. These kids and these parents have a full time job that no one knows is happening.” – Dr. Fernandez [07:06]
2. Social Media & Device Use: The Hidden Enemy
- Screen time—especially before bed—directly stimulates the prefrontal cortex, making it physiologically harder to relax and fall into restorative sleep cycles.
“Every person reaches for a device to try to unwind... when obviously it does just the opposite because the algorithms are so driven to... keep you there... It uses up so much neurotransmitter to decipher the video that it just takes you off.” – Dr. Fernandez [18:31]
- Diabetes devices contribute extra layers: kids necessarily use phones for pump/CGM management, making it easy to slip into social scrolling and further disrupt sleep preparation.
- Social media isn’t just draining chemically—it also chips away at self-worth by presenting unrealistic values and comparison traps.
“It insidiously tells you that if you're like this person, you're valuable in society... people lose their own value.” – Dr. Fernandez [32:56]
3. The Cycle of Anxiety and the Risks of Generalized Anxiety Disorder
- Not all anxiety is bad—some anxiety motivates action and adaptation. But the line is easily crossed into chronic or generalized anxiety, where the tank runs dry and kids “never surface,” needing professional help.
[at 09:50, again at 12:00] - Modern research post-COVID points to lack of restorative sleep as a chief contributor to the anxiety epidemic.
- For some kids (and adults), breaking out of the “hole” of chronic anxiety may require professional counseling or even short-term medication to restore neurotransmitter levels and hope.
“The cycle has to be broken so that the person has the chance to get back on top and get that resilience, get that push to want to succeed.” – Dr. Fernandez [23:19]
4. Strategies to Break the Cycle
A. Improve Sleep Hygiene
- Establish predictable bedtime routines
- Remove or restrict non-essential device use at least an hour before bedtime
- Use functions or physical setups to only keep needed diabetes alerts active at night
- Magnesium supplementation (2-400 mg), with physician approval, may help some adolescents to “unwind”
B. Build Resilience and Create Successes
- Encourage activities outside diabetes management in which the child can experience success—sports, arts, academics, etc.
- “Taste of glory” is self-perpetuating; experiencing success provides motivation to set aside distractions and push through discouragement.
- Involve kids in supportive environments where everyone “gets it” (such as Camp Sweeney)
“If you can get more neurotransmitter in your brain, you can make a little bit more serotonin... That changes everything.” – Dr. Fernandez [19:38]
C. Harness the Power of Community
- Peer support is critical for emotional resilience.
- Camp Sweeney’s four pillars and community events (PFC Life Nights) help break isolation and foster hope.
“You create this community... all has that second job, that all has those tough times, and they all celebrate each other's successes.” – Dr. Fernandez [21:22]
D. When and How to Seek Additional Support
- Recognize when struggles go beyond the “norm”—persistent inability to recover or regain hope may signal the need for counseling or medications.
- Since the pandemic, Dr. Fernandez notes greater need for SSRIs or similar interventions for breaking entrenched anxiety cycles.
5. The Universality of Burnout—And the Central Role of Purpose
- People of every personality type (active or not, passionate or not) can fall into burnout and anxiety cycles; key is harnessing a sense of meaning and constructive engagement.
- Doing fulfilling or meaningful things—whether many or few—supports good mental health; doing nothing does not.
“You just learn how to do hard better. Because people with type 1... are pretty much stronger than most anyone else. They have the super strength to take something and do a great job with it.” – Dr. Fernandez [27:24]
6. Technology: Tool or Trap?
- There’s a difference between using screens as tools (for learning, work, or diabetes management) and getting sucked in via endless-interaction apps (social media, games).
- “Doomscrolling” and infinite feeds are engineered to be addictive, paralleling the psychology of slot machines.
- Even the creator of “infinite scroll” has apologized for its impact.
Notable Quotes & Moments
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On the unrecognized complexity of T1D:
“These kids and these parents have a full time job that no one knows is happening.”
– Dr. Fernandez [07:06] -
On resilience:
“Resilience is the perseverance of getting through something that's tough and being able to start over again. It sounds easy to say. It's difficult to do.”
– Dr. Fernandez [13:16] -
On what actually hurts about screens:
“When you're just using the screen as a tool, you're not sucked into it... that's not harmful. What makes you get sucked into screens are things that you're having to constantly interact with, like a video game or... social media things where suddenly time just stops for you.”
– Dr. Fernandez [30:39] -
On loss of hope and discouragement:
“They just get discouraged for one reason. They forget what it felt like, you know, in that time of success... And that's what leads to... sometimes a loss of hope.”
– Dr. Fernandez [27:58] -
On the necessity of community:
“Everybody talks about the resilience they have because everybody comes together as part of that community... that's what keeps these kids, you know, going and keeps them from the, getting into that cycle.”
– Dr. Fernandez [21:22]
Timestamps for Key Segments
| Segment | Timestamp | |--------------------------------------------------------------|--------------| | Introduction to topic and guest | 00:00–02:12 | | The physiology of sleep, anxiety, T1D and adolescence | 03:07–10:19 | | Anxiety prevalence in T1D, factors contributing | 10:19–14:57 | | How/where to “break the cycle” of anxiety and stress | 14:57–18:17 | | Strategies—sleep hygiene, magnesium, devices, building success| 18:17–22:46 | | The power of community, Camp Sweeney’s model | 22:46–24:22 | | Are some people less affected or more resilient? | 24:22–31:32 | | Technology, social media as slot machine/doomscroll | 31:32–32:56 | | Social media and self-worth; values of Camp Sweeney | 32:56–34:12 | | Camp Sweeney scholarship giveaway logistics & philosophy | 34:12–38:01 | | Aggregated outcomes: Camp Sweeney’s impact | 35:03–38:01 | | Surrounding yourself with supportive people | 38:01–40:53 |
Memorable Moments
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Camp Sweeney Stories: Dr. Fernandez shares the story of a former camper who, after years away, reached out in adulthood asking if things ever “get easier.” Dr. Fernandez’s reply:
“It doesn't get easier. You just learn how to do hard better.” [27:24]
-
On community impact: “Everybody talks about the resilience they have because everybody comes together as part of that community...” [21:22]
-
Discussion on infinite scrolling as “slot machine psychology” and its deliberate design to suck you in: [31:32–32:56]
Actionable Takeaways
- Establish device-free wind-down routines before bed.
- Use devices to support diabetes management, but minimize exposure to interactive/social media apps at night.
- Parents: help your children achieve “daily wins” outside of diabetes duties.
- Create or join T1D communities—camps, support nights, online groups—to reinforce hope and shared strength.
- Be vigilant for signs of clinical anxiety; don’t hesitate to seek professional help, including short-term medical interventions if needed.
- Celebrate resilience for both kids and parents—learn to “do hard better.”
Further Resources
- Camp Sweeney: Offers transformative community experiences for children with T1D. Scholarship and program info at campsweeney.org
- Juicebox Podcast Giveaways: Opportunities to participate in future camp scholarships juiceboxpodcast.com/giveaways
- Touched by Type 1: Supporting the community in bold, practical ways touchedbytype1.org
This heartfelt and practical episode highlights that while diabetes management is never “done,” breaking cycles of stress and anxiety is possible—with the right routines, a sense of purpose, and the support of a community that truly understands.