B (3:07)

I see it from a lot of perspectives. I see it a lot in practice, not just with patients with type 1, but just many of our younger and older, older teens and our young adults. Social media has kind of fed into that quite a bit. But with our patients with Type one, it has really been something that has been magnified. And it makes sense because when you think about how this starts to develop in these kids, the normal brain physiology of most children as they enter adolescence and late adolescence and young adulthood is that they're higher functions of their brain start to develop rapidly. You know, kids when they're 10 or 11 think like kids in a very linear way. You know, kids that are 21, 22 years of age think more like an adult in a very abstract way. And that brings the abilities for them to deal with many, many things. But as that part of the brain develops quickly, the two hemispheres, the need for that part of the brain to be well fueled with neurotransmitters also increases. And just in a normal situation with any child and young adult, that always lags. You know, the brain's ability to make the neurotransmitter always lags, the development of what's being needed. And many things have kind of shifted in our world a little bit that don't make that as fruitful as it used to be in years past. Part of that has to do with the fact that you only make those neurotransmitters during your deep stages of sleep, you know, during sort of the higher quality sleep. And we don't live sort of in a society that kind of promotes that as much as it used to. You know, kids of different ages need different amounts of sleep. Younger kids need more sleep. They need, you know, nine to ten hours a night, while young adults need less sleep. But it's not just the quantity, it's the quality of sleep and how they enter sleep and how they go through REM into deep stages of sleep. And the problem is that many of our youth and even our adults have difficulty adopting patterns to get that kind of Sleep. You know, so many things are on people's plates, you know, whether it's sports or school or, or things that involve them in social ways with their, their colleagues. But probably the biggest one that seems to be in the forefront is the amount of time that, that we all spend on our screens and the addictions that sometimes these algorithms, you know, pull all of us into our screen time. And that tends to excite our brain and makes it difficult for them to settle down and to get into deep sleep. Now that's in anybody, whether they have type one or not. And so people tend to go through times, especially during these years, where they need the most rest, not getting the kind of rest. And what that leads to, of course, are decompensation. These wonderful young adults and adolescents will often just kind of run out of juice throughout the day. You know, their higher functions kind of decompensate and they become much more primal and their anxieties kind of, kind of take over and they become sort of like they were when they were two or three. You know, they get unfocused, they get very, you know, upset easy, and they have difficulty, you know, dealing with many of the challenges that are posed to them. But what happens in kids with Type one is that they have a whole different level of issues that decrease that normal physiologic sleep that they should be getting. You know, when you have type 1 diabetes, as you know, Scott, you as a parent of a child know this, it's sort of a hidden world that no one realizes. You know, these kids and these parents have a full time job that no one knows is happening. You know, it's like, you know, when somebody hurts their foot and their foot is killing them, and all they can do is think about their foot and everything in their life revolves around that. Well, you know, when you get type 1 diabetes, that's kind of like having something like that. You know, even as you learn and you adopt all these wonderful technologies and pretty prudent protocols that we teach our patients, it's still a full time management position. And the problem with it is that no matter how you know, how well you use your technologies, how well you follow your protocols, there's always some uncertainty with the outcomes each day because there's so many variables, as you well know, that affect diabetes and that causes people. When you have uncertain outcomes, all that does is it increases that excitability of your brain, the stress of your brain, which then makes it harder for these kids, and quite frankly their parents as well, to have that deeper sleep because they're always concerned, okay, am I going to go a little high? Am I going to go low? Did I do the right thing here and there? And then that causes them to deplete themselves a little bit more and allows them to decompensate into some of these larger forms of anxiety that, as I said, all kids, but especially kids with type 1, are much more susceptible to. And that's really what I spend a lot of my day talking to patients with. Yes, I talk to them about the newest pump and the newest things that we can be doing, but most of the time I'm talking to them about how to take care of themselves and be able to be successful basically with their two full time jobs that they now have, which is living their normal lives that they were living. And of course, dealing with the Type one that very few people relate to outside of their own little world. And so that's really what makes kids with type 1 so much more susceptible to this kind of stress and anxiety. And there's many ways to work with that. And one of the things that I'll give as a disclaimer at the very beginning is that it's very important whether you're a parent or you're a healthcare provider, that you're looking closely at the big picture. Because what you sometimes miss in a child who's going through the normal stresses of type 1 or a family that's working with the child is that some kids will get themselves really in a hole. They drain themselves so much of, of their neurotransmitters that they don't just go from having anxiety, which all kids with Type one have in one way or another, but they go into what's called generalized anxiety disorder, where they never surface. No matter what they do, they never get the rest, and they get themselves into a bit of a cycle that's hard for them to break. And those kids, besides the normal things that we use to decrease and to inspire kids to deal with the anxieties, sometimes need additional help to come see somebody, you know, like a professional like myself, a physician that works with kids with this, that, you know, they may need somebody to help them with, with some specific skills with counseling. And, and sometimes these kids also, you know, need medication because they've gotten themselves into, into such a hole that it's hard to get out of. You know, our goal today is just to talk about some of the things that help kids from, you know, putting themselves into that hole.

A (10:19)

Are there ways to impact it? Because, Ernie, I, you know, I've Interviewed thousands of people. And I had to stop myself at one point along the way from believing that the whole world was just anxiety ridden. But I started to see that. I think it's possible that people living with autoimmune issues maybe have a higher prevalence of anxiety for a number of different, you know, reasons. Cortisol, I don't know, gut health, like all kinds of different ideas. Right?

B (10:43)

There's so many components to it.

A (10:45)

Yeah.

B (10:46)

But at the end of the day, you know, you go from anxiety that everyone has, which is not good or bad. I mean, anxiety pushes people to do things. And so anxiety is almost, you know, something that in many ways, you know, pushes us to do well with our things, to where you cross over to where you actually have, you know, an anxiety disorder where you can't see yourself coming out of that. In other words, you've drained your neurotransmitters to a point. And they get drained for a variety of reasons. Sometimes it's poor gut health that they're not absorbing the omegas they need for that development. But most of the time, if you look back and you look at all the current data that's come out post Covid, you know, it comes from the lack of the normal sleep cycles that many kids put themselves out of. And it's because people can't settle themselves down. They become so, rightfully so obsessed on doing all the little things in their life, not only the normal things in their lives, but also the things that are T1D that when it's time to go to bed, their brain's going a million miles per hour and it's very hard to slow it down to allow us to go into natural sleep. And then you add, you layer on that, you know, being on a device before you go to bed. And many times, you know, kids, type one have devices right on them because they're using them obviously to monitor their things. And they pick it up and they're starting, they look at their device and then suddenly they're looking at apps and suddenly they're looking at social media. And so their prefrontal cortex gets more wound up and when they fall asleep, they enter sleep sort of in the wrong order. They start REM sleep and sort of going into the stage sleep and then the next day they' back with a low gas tank again and it leads to the uncontrolled anxiety.

A (12:24)

Right.

B (12:24)

And so, you know, part of that is, you know, teaching skills, you know, basic mental health skills, having nighttime routines, you know, that get people, you know, away from their Devices, an hour before bed, you know, locking down their devices to just have their pump functions or their CGM functions. You know, I even recommend some of those devices, you know, like the Pixel device that you can have, where you don't have to have your device so close to you. You have that to go off if you need it to go off. You go through teaching, you know, kids how. How to do things at night that don't require screens, reading things that slow the brain down. But, you know, at the end of the day, it's all about how you deal. We have the decompensations. You know, how do you deal when you think you have everything put together and the next day something happens and, you know, your pump has been bad and your blood sugar is 400 and you're having to deal that stress. And part of that is creating environments that parents, you know, and parents do this. You know, parents, you know, are very devoted to their kids. My patients, and I'm sure the ones you work with, and you work with thousands yourself, you know, are always wanting the best for their children. And, you know, it's all about trying to get kids to deal with the decompensations and to basically get resilience, because it's going to happen. You know, they're going to decompensate for a number of reasons, not just from their diabetes, but other things that go through that. And, you know, resilience is the perseverance of getting through something that's tough and being able to start over again. And you start over again. And it sounds easy to say. It's difficult to do. And so what you have to do is you have to create, you know, situations where the successes are so sweet for these kids that they have that desire to push themselves up, you know, many times. You know, we all fall many times every day in our lives, not just with diabetes, but that falls can either lead to the biggest enemy, which is discouragement, which keeps you from wanting to get back up, to falling, and say, I know what it felt like when I was doing great and I want that feeling again. And I long for that feeling. And that's what gives so many of these kids that strength to make that happen. Because the alternative is, of course, is that discouragement and the loss of hope. And then kids just, all the kings horses, all the king's men, can't get that. That kid back up again. And so that's what is a key to that.

A (14:57)

Yeah. Where do you think is the easiest spot to break the cycle? Because if it starts with I don't know, poor sleep. And then you wake up the next day and you have diabetes and that's hard and like, and I'm reading about stuff here while you're talking. Cytokine storm. When an autoimmune flare occurs, the body releases inflammatory proteins called CYT chickens. These don't just stay in the joints or your thyroid, for example. They can cross the blood brain barrier. Once they're there, they disrupt neurotransmitters, specifically lowering serotonin. Like when that's also happening to you and everything else. Then at the end of the day, once you've lived through that horrible day and you, and you're laying down in bed, I don't know if you've ever tried tick tock or any. It's awesome. Like so, like when you, so when you have right into it, when that's the way you're trying to calm down, relax, you know, turn your brain off, whatever it is. Like where in that cycle. Because you're gonna have to pick a spot to jump in and say this is the thing we're gonna do to see if it loosens up the nut for the next thing so that we can try to get this all working better. Where do you see people having more success? Or is it variable person to person? This episode of the Juice Box podcast is sponsored by Eversense365 and just as the name says, it lasts for a full year. Imagine for a second a CGM with just one sensor placement and one warm up period every year. Imagine a sensor that has exceptional accuracy over that year and is actually the most accurate CGM in the low range that you can get. What if I told you that this sensor had no risk of falling off or being knocked off? That may seem too good to be true, but I'm not even done telling you about it yet. The Eversense 365 has essentially no compression lows. It features incredibly gentle adhesive for its transmitter. You can take the transmitter off when you don't want to wear your CGM and put it right back on without having to waste the sensor or go through another warm up period. The App works with iOS and Android, even Apple Watch. 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. Let's talk about the Tandem Moby insulin pump from today's sponsor, Tandem Diabetes Care. Their newest algorithm, Control IQ technology and the new Tandem Mobi pump offer you unique opportunities to have better control. It's the only system with autobolus that helps with missed meals and preventing hyperglycemia, the only system with a dedicated sleep setting, and the only system with off or on body wear options. Tandemoby gives you more discretion, freedom, and options for how to manage your diabetes. This is their best algorithm ever, and they'd like you to check it out@tandomdiabetes.com juicebox when you get to my link, you're going to see integrations with Dexcom sensors and a ton of other information that's going to help you find. Learn about Tandem's tiny pump that's big on control. Tandem diabetes.com juicebox the Tandem Moby system is available for people ages 2 and up who want an automated delivery system to help them sleep better, wake up in range, and address high blood sugars. With auto bolus, you have to do.

B (18:17)

It in lots of spots. You can't just say, I'm going to fix it in one spot and it's going to do it all. Okay, so you start with the sleep first. You know, you do the conducive thing. You know, people say, what about supplements? What supplements help with this? Well, you know, a, a lot of good work has been done on magnesium and using a small amount of magnesium before bed. It's very safe to use the glucanide of that. You know, for most young adults, adolescents, 2-400mg is a great way to help them, you know, have that unwinding. Every person reaches for a device to try to unwind because they think if they do this enough, you know, scroll enough, that that's going to make them get numb and want to fall asleep, when obviously it does just the opposite because the algorithms are so driven to go keeping you there from 15 minutes to 30 to 45 minutes. And at the same time, it uses up so much neurotransmitter to decipher the video that it just takes you off. So, you know, putting those away from you as much as you can without losing connection to your devices is a critical element. But really it's a bigger picture item. You know, from a parent's point of view. It's about making sure kids have things that they, that they can succeed in each day, whether it has to do with diabetes or not, whether it's, you know, something, you know, athletic, something that's, you know, in the theater, something that's wherever it is, creating an environment that they can taste success is Critical. You know, we talked last fall a lot about Camp Sweeney and the four pillars and how that all works. And part of that, of course, is creating environments where there's something for every child to touch, whether it's something they've never done in their life, something they're trying to do. Because once you get that feeling of sort of glory in you, you want to strive for that every time. And people. That's what makes people want to break the cycle, because you have to have the desire to want to break the cycle. Nobody wants to put their phone away. Nobody wants to do that. But if you know that putting the phone away makes you feel that great feeling, that euphoria, the next day, you can start breaking that cycle. And you have, because it's all interconnected. If you can get more neurotransmitter in your brain, you can make a little bit more serotonin without having to take an sri. That changes everything. That changes your ability to compensate with so many things. You produce less stress hormone, and so you make less cortisol. So you have less in. You know, you have less of those things that cause us to get back in that hole. And so creating those environment of successes is great. I work with many, many families, and I think, okay, what's the one thing your child, you know, strive, can. Can strive in? And you try to put them in those things, you know, whether it is soccer, tennis, or basketball. That's what, you know, as. I don't want to go into this right now, but, you know, that's what Camp Sweeney has been driven to do for the last 76 years, is to find things for every child that allows them to just shine, right? And then you create this community, you expand the scope, and you put them in a community that all has that second job, that all has those tough times, and they all celebrate each other's successes. That's what allows them to retain the hope. I am like you. You talk to thousands of people. I've been doing this 42 years, and so I don't talk to thousands of people. But, boy, especially during the holidays, I talk to people of all ages with diabetes, in their 30s, their 40s, their 50s. I don't want to age myself here, but everybody talks about, you know, they struggle with certain things. And God forbid, you know, when we lose a precious one, we all come together and we struggle. But everybody talks about the resilience they have because everybody comes together as part of that community. You know, whether it be the Sweeney community, that's tens of thousands of big, but other Communities with type 1 where people are so connected that they care about each other. Just recently, and I won't say this name, I heard from a, a beautiful young man who was in Sweeney for eight years last year, was 28. And he's a wonderful guy. He's got kids, he's grown, he's done volunteer work around the world and I'm so proud of him. But he's had some difficulties with, with other health issues that have just hit him hard. But the community growls around him and that's what Cube gives him, though. That's what gives them the inspiration.

A (22:46)

Yeah.

B (22:46)

And that's really what you try to do. You try to create every little bit of it that matters. Not just the successes, but the community around it. You know, the Camp Sweeney PFC life, which, you know, the perseverance, faith, courage, life nights that we do, you know, two, three times a week throughout the country. That's all part of that, is trying to connect those communities because that's, that's what keeps these kids, you know, going and keeps them from the, getting into that cycle. But I will say I do treat so many patients that have true gad, generalized anxiety disorder. And you have to know when other things are needed. You have to know when counseling of a particular type is helpful. And you need to be aware of when an SSRI is needed. You know, people say, oh, I don't want to get on any kind of medication. That would just be terrible. But sometimes you have to break the cycle somehow. Even if it's a short term thing that you do for 90 days or you do for 120 days, 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. And that's really an important thing. And I don't want people to think, oh, I should never look for those things. There are times when you need to do that. Actually, since the pandemic, I've had to treat more patients with medication than I've had in my entire career. And I think a lot of it is because people are using this as a tool to try to break the cycle as opposed to doing the things that make more sense and healthy for people.

A (24:22)

Do you think there are people in better positions to deal with this than others? But yet do you see it? I guess across all of those levels? I was just having this conversation with someone this morning about work level, and today you and I are. It's the day after Christmas. Ernie they're not a lot of people working today. Right. And so, like, you and I are working. I don't think anything of it.

B (24:42)

We.

A (24:43)

I was up this morning. I had, at some point this morning, I had three devices in front of me. On one of them, I was learning audio about something that I like to do for myself recreationally. I had a computer in front of me where I was coding something to put on the website to help people bolus better. And on the third device, I was trying to learn about a mattress that my daughter and I are going out to get this afternoon for her. And I was talking to a friend of mine at the same time who was helping me moderate the Facebook group. And we were talking about somebody they knew who said, oh, they. They needed a break. And she laughed and she's like, I haven't had a break in so long, but I don't even know what I would do with it. And so for someone like her or someone like me or maybe you too, I don't really want a break. I like doing things. I like going. I was just sharing with her today. This is almost apropos of nothing and yet fits right in here. I created something that works really well. It's a physical thing in my house. And all I've been thinking about for the past three months and any free time I've had is doing it better and throwing out the old one and trying again. So I don't feel that way. But there are other people whose brains are just not wired like that. And they also have autoimmune issues and stress and they live through Covid and they're 10 and somebody's making fun of them and like, all that other stuff is going to. My question is, is could someone wired like me fall into this? I believe yes. And could someone not wired like me fall into this? I also believe yes. Is the pathway out the same for both of us? Do we both have the same chance of breaking the cycle and starting over, do you think?

B (26:16)

Absolutely. But don't get me wrong, doing nothing doesn't help anyone. It just increases people. People's anxiety.

A (26:24)

Yeah.

B (26:24)

You know, doing the things you're good at. Like, I have multiple jobs. I'm here in my office right now seeing pediatric patients start back in about 20 minutes. You know, I work at Children's and I'm taking care of kids with diabetes once a week. And then of course, I run Camp Sweeney, which is a year round thing that I spend every night where I probably spend 60, 70 hours a week. In addition to these two jobs doing camp Sweeney.

A (26:45)

Yeah.

B (26:45)

And you're thinking, how are you preaching, you know, normal, good mental health? Well, that's good mental health. Because I'm doing things that. Fulfill things that. That I'm passionate about. I'm passionate about, you know, trying to make sure the kids with type 1, for example, have tremendous opportunities to be able to get out of these ruts, not just when they're kids, but, like, as adults, you know, when they. They fall many, many times. Right. You know, I, like, a young man just called me about three months ago. He's 32 years old, okay? And he has. I haven't seen him in 14, 15 years. And he just said, Dr. Ernie, I just called he just. Because I just have one question. Does it ever get any easier? And I said, what do you mean by that? And he goes, well, you know, my diabetes. And I said, well, you know, it doesn't get easier. You just learn how to do hard, better. Because people with type 1, as you well know, are pretty much stronger than most anyone else. You know, they have the super strength to take something and just, you know, and do a great job with it.

A (27:51)

Yeah.

B (27:51)

But the problem is they all can run into the pitfalls of the little pit that we were just talking about, where suddenly that word that I can't stand, D, comes in discouragement. They just get discouraged for one reason. They forget what it felt like, you know, in that time of success, in that time of this. And that's what leads to, you know, sadly, with many of our older patients, sometimes a loss of hope. And all the stuff I've been talking about here this afternoon. How do you avoid those pitfalls? We're all gonna hit them. We're all gonna get discouraged sometime in our lives. I mean, that just happens because just the fact of how our lives go. But how do you steer away from them? How do you overcome that? How do you get that resilience? Well, part of it is the adversity. I mean, just the adversity itself makes you stronger. But what keeps you on top of it is that longing of what. What it feels like to be on the other side. And that's what I remind every person, you know, what they have. You know, I know this. It is Christmas time. And you always think about, you know, these. These movies like, you know, It's a Wonderful Life. And, you know, the. The poor man who got, you know, was so discouraged by all the things in his life, but he. He forgot those things on the other side. And that's how it is with Type one, everybody does have a different path. It all comes down to having the strength to get back up. And, you know, last year I had a long podcast where you're talking about the four pillars of how Camp Sweeney works. And every one of those pillars is designed. And I, believe me, I've spent my entire life obsessing on how highly adjust those and adjust those and adjust those year after year to try to get people to have that not when they're 15, but like when they're 35. And when they're 45, they can fall back on something that's that bedrock for them to push back up on, because that's what it's really about. With Type 1, yes, the technologies are going to change you probably. Your podcasts are wonderful. You're talking about this and that and all this wonderful stuff. But at the end of the day, it's just the same thing. Type one is Type one, and the challenges are going to be there, whether you have the most sophisticated system or the simplest of systems. And the real challenge is avoiding the discouragement and pushing oneself through these things I mentioned that help you produce more serotonin, trying to get the deeper sleep, you know, trying to avoid the pitfalls of getting sucked into those algorithms. You know, you say use screens all day. I use screens all day, too. I walk around with this laptop right over here from room to room constantly. But, you know, they did a neat little study back in the COVID days when people were co learning on screen. When you're just using the screen as a tool, you're not sucked into it. You're not so focused that you're looking at all the pixels that it's draining the heck out of your brain. What makes you get sucked into screens are things that you're having to constantly interact with, like a video game or, or these algorithmic things that are on all of these, these social media things where suddenly time just stops for you. You go from 10 minutes to an hour, and you've been staring at one little screen as opposed to using your. Your screens because you're writing on a chart or you're working on coding this or you're working on looking for this. That's a totally different level of engagement with your brain and the screen. And that's not harmful. And that's why kids that have the screens on their, on their. The buy on themselves, would they use them for their CGM or they use them, you know, obviously for their pumps or whatnot that doesn't drain them because they Just use it as a quick little tool. Their brain doesn't have to engage and try to decipher what's happening on the screen. So there is different levels there.

A (31:32)

And you basically have been given a slot machine which is, you know, been designed decades ago to put you down and in a seat, make you not want to move and somehow dull you enough that as you're losing money to it, you think, no, this is still a good idea, right? There's going to be, there's something's going to happen. I don't know if anybody's ever noticed this. Online gambling is very prevalent at this point. Right. But if you've ever sat in front of a machine or done something on like that, you can put a dollar into something, lose 80 cents. And the noises and the sounds make you feel like you're, you won something, it'll say you won 20 cents. It'd be like, I put a dollar in there, I lost 80 cents. But it doesn't feel like that. TikTok does the same thing, right? Like all the apps are designed that way. There's a great documentary, I don't know the name of it. Go find it. It's by one of the people who, who designed, what do they call it, like forever scrolling. Like, do you remember used to scroll to the bottom of something and eventually it would say, you're out. Yeah, you're out of content now. Now it just, it just uses what, what you paused on the longest. So the thing that you're more likely to look at again, it just regenerates and gives you more. You know, people call it doom scrolling colloquially, but there's an actual name for it. And it's so devastating, Ernie, that the man who designed it has publicly apologized for it. Yeah.

B (32:56)

And I know we're out of time, but I will tell you that it is not just what it's doing to your brain and draining your neurotransmitters. It's also like we talked about last year, you know, when we talked about the four pillars. It's teaching people what to value you. It insidiously tells you that if you're like this person, you're valuable in society. If you're like this person and you're taking this substance abuse substance, or you're following this thing, or you're good at hurting yourself in this way or tearing other people down, that's valuable. And so people lose their own value. I mean, they devalue them. So that's why the third pillar of Sweeney is all about, you know, what we possess or what we truly possess, you know, the true virtues we have, because you get to believe what's on that scroll. I mean, you believe what's on that scroll like it's truth. And as a result, kids devalue themselves tremendously. And that leads once again to them to not having a want to get back up. And it leads to that discouragement again, which is the biggest enemy I think kids with type one have. In my opinion, it's not just the pump site going bad. It's something much greater. And so that's really what I spend my year doing, is trying to empower these kids. Right.

A (34:12)

Well, I appreciate you coming on Talk about. You're actually also here because we are going to pick winners. So Ernie and I are giving away six spots at Camp Sweeney in 2026. And I have the first. I think 50 people have put in their entries. By the way, you can enter@juiceboxpodcast.com giveaways. Now, I want to tell everybody that everybody who doesn't win today, we're going to pull two today. Everybody who doesn't win their name stays in for the next drawing, where we're going to pull two more, and then we're going to pull two again. So that we've given a total of six spots away at camp before the 2026 season starts. We'll be doing that through the winter here in 2026. But, Ernie, they do have to pay something, right? So not only do they have to get themselves there, so travel's not included, but there's a 500. Can you explain that part?

B (35:03)

That's the deposit. And, you know, it costs $6,100 for us to have somebody go to Camp Sweeney. We ask families to pay 4,900 of it, and we fundraise the rest. And then we do have scholarships for kids that are financially need as well. About half of our kids come on something. But for the people on this giveaway, we have them pay the $500 deposit. And the reason you do that, Scott, is simply because it's occupying a spot. And sometimes when people get something for free, they'll occupy a spot that someone else could have had, and then it doesn't mean anything to them. And so we asked for the deposit because of the fact that it's secure. You know, we're not turning someone else away from it. And so we feel it's a small amount of the entire value that they get from going to Sweeney this year. It's magnificent. Summer 2026, and I'm more excited this summer than probably. I keep saying this every year. This is my 42nd year. Every year is a totally different thing at Sweeney because you have no idea how purpose driven we are. Our group of program directors meet every Monday night for a couple of hours from September through May to constantly titrate how these pillars work and how we make that better for each child. And every Tuesday, our medical directors meet constantly working on the algorithms and the data. It's unbelievable, the data that they did this year. We had a big conference in December where they took hundreds of thousands of blood sugars from the summer and they looked at every modality, whether it was an Omnipod 5 or it was a MOBI or whatever it was for every age and gender, and looked at every aspect of all 18 days that the kids are at camp. If they were a 12 year old boy on the sixth day in the morning, how did a MOBI do compared to an Omnipod 5? How did it do compared to a Medtronic device? And they constantly are changing our internal protocol so that we can maximize the time on control, because our first pillar is getting the kids to feel normal while they're at camp. And I am very proud to say that if you take the entire aggregate of all the kids that went to Camp Sweeney in the summer of 2025, no matter if they were on shots, MDIs, whether they were on any kind of modality, and you look at all of their blood sugars for the summer, and you look at what their time and range is as an aggregate. Remember, this is people from all over the world, all over the country, that have hemoglobin A1Cs that are either in their fives or unfortunately, pretty high. Our time and range was close to 69%, which is unbelievable. I mean, now for one person, you think, well, that's pretty low time and range. But when you take an aggregate git and you put people through a program like this with all these different modalities and you can accomplish that, let me tell you, it takes an entire year of work to make sure that you're ready for that for the next summer to try to enhance the best you can with those kids. And so we have a lot of wonderful things in 20, 20, 26, and I'm excited to have two, two people coming on board here today.

A (38:01)

All right, we're going to pick their name, but let me agree with you for a second. I think surrounding yourself with people who all have a common goal of, you know, living a healthier life is the Secret to this, you have to have good tools. You need to know what you're doing, but you do need to be supported all the time. I'll share with you. This morning I got a little frustrated. I saw someone post something in my Facebook group. My Facebook group has 78, 000 members as of today. And someone said, hey, did you know, look at this. This is crazy. If you cool pasta off and eat it reheated, it doesn't impact your blood sugar as much. And I thought. And I. I almost drove my head through the countertop because I've said that about a thousand times in that podcast. And all I could think was, if you were listening to the podcast, you would already know this. And I. But I don't feel like, don't get me wrong, like, Ernie, I'm like, I don't feel snarky about it. It's just. It's hard as a person who puts it out there all the time. Just goes to watch somebody realize that they've been struggling unnecessarily and they'd made their way all the way to the place. Didn't take the last step to the podcast. So I made a post about it. Just saying, hey, listen, imagine what else might be in that podcast that you don't know. Get together. And people started coming in talking about. And this one guy named Matt, I'm gonna use his first name because he comes on and said something that just indicated to me that he was a listener. It wasn't even anything deep. And I responded back and I said, matt said something in his reply that indicates to me that he listens to the podcast. I don't know who Matt is, but I'm gonn that he's got an A1C between 55 and 6 5, right? And he came back on and said, oh, My God, my A1C is 5 5. I was diagnosed at 13. I found the podcast, it's 55 now. And that to me, I was like, look, guys, there. There's your review. Surround yourself with people trying to do good for themselves. Good will come for you, you know. Anyway, we have two winners. The first two winners, you're gonna have to pay the $500 deposit. Get yourself to Texas and get yourself home. And this is an interesting split. Ernie, we have somebody who has been to your camp for three years and loves it. So. Hampton Madison Madsen. Excuse me. Congratulations. Your child Cooper is going contact me. Cooper has attended Camp Sweeney for three years. The family flies all the way. Boy, talk about a review. The family flies From Colorado Springs to Texas for it. That's how much they love it. Talks about the immense relief of the 18 day break that, that they experience. That's the other thing, Ernie. You're, you're inviting those kids out for nearly three weeks. It's not a, not a short thing. The second winner, Michael Gambrell. Congratulations. Your daughter Newt has won. Michael wants new to experience a deep sense of belonging, community that Sweeney offers. So thank you so much everybody else. Keep going to that link. Juicebox podcast.com giveaways it's super simple to enter and we'll pick two more. I won't drag Ernie out for the next one, but we'll pick two more maybe in a month or so and do it again a month after that. And six of you will, will have a great story to tell sometime later this summer.

B (40:53)

And I will mention too, Scott, that people that live far away, if they don't want, especially if their kids already come to camp once or twice, you know, we offer a service called Point to Point. They pay an additional fee and they can just we have if they take a direct flight from Boston or from wherever they're coming from Florida, wherever they're coming from. We, our medical staff meets them at DFW airport, picks them up, brings them up on a charter bus and gets them enrolled so the family doesn't actually have to make the trip both ways. They just want to do one way or both ways. Sometimes they'll bring them down to meet all the staff, but then we send them back on Point to Point so they don't have to come all the way down to Texas.

A (41:31)

Look at that. Ernie will FedEx your kid. Ernie will FedEx your kid to camp. Look at that. Get them in a nice box. It'll be comfortable, they'll be fine. You do amazing work, Ernie. I appreciate you sharing this with me. I don't know if there is an answer that's strong enough to break how awesome Instagram reels is or whatever, but I can tell you this, and I hope you find this to be helpful. As a person who makes content, I'm seeing it all shift again. So for a number of years, the algorithms have been beating on my head. Make your stuff shorter, make it simpler, make it fancier, and I've avoided that. I've ignored it and I haven't done it. And right now I'm actually seeing some of those algorithms. I think they've depleted how much they think they can wring out of people 20 seconds at a time and longer form content is starting to come back. So hopefully, maybe more thoughtful ways of sharing things will be coming through people's screens in the future.

B (42:24)

That is wonderful. Great work, Scott. Thank you.

A (42:27)

You're welcome. You're awesome. Happy New Year. Merry Christmas. Is lovely to see you. Thank you.

B (42:32)

Yeah.

A (42:41)

Okay, head over now to juiceboxpodcast.com giveaways and enter your child in the drawing to win one of those remaining four slots at Camp Sweeney. You're not going to want to miss it. Check it out@campsweeny.org too if you don't know what Camp Sweeney is, but you gotta join the giveaway to have a chance to win. The podcast you just enjoyed was sponsored by Tandem Diabetes Care. Learn more about Tandem's newest automated insulin delivery system, Tandem mobi with control IQ/technology@tandemdiabetes.com Juicebox There are links in the show notes and links@juiceboxpodcast.com Are you tired of getting a rash from your CGM adhesive? Give the Eversense 365 a try. Eversensecgm.com Juicebox beautiful silicone that they use. It changes every day, keeps it fresh. Not only that, you only have to change the sensor once a year. So I mean, that's better. Touched by Type 1 Sponsored this episode of the Juice Box Podcast. Check them out@touchedbytype1.org on Instagram and Facebook. Give them a follow. Go check out what they're doing. They are helping people with type 1 diabetes in ways you just can't imagine. Thank you so much for listening. I'll be back very soon with another episode of the Juice Box Podcast. If you're not already subscribed or following the podcast in your favorite audio app like Spotify or Apple Podcasts, please do that now. Seriously, just to hit, follow or subscribe will really help the show. If you go a little further in Apple Podcasts and set it up so that it downloads all new episodes, I'll be your best friend. And if you leave a five star review, ooh, I'll probably send you a Christmas card. Would you like a Christmas card? If you're looking for community around type 1 diabetes, check out the Juice Box Podcast. Private Facebook Group juice box podcast type 1 diabetes but everybody is welcome. Type 1 type 2 gestational loved ones it doesn't matter to me. If you're impacted by diabetes and you're looking for support, comfort or community, check out juicebox podcast type 1 diabetes on Facebook. I created the Diabetes Variables series because I know that in type 1 diabetes management, the little things aren't that little, and they really add up. In this series, we'll break down everyday factors like stress, sleep, exercise, and those other variables that impact your day more than you might think. Jenny Smith and I are going to get straight to the point with practical advice that you can trust. So check out the Diabetes Variable series in your podcast player or@juiceboxpodcast.com if you have a podcast and you need a fantastic editor, you want Rob from Wrong Way Recording Listen, truth be told, I'm like 20% smarter. When Rob edits me. He takes out all the likes, gaps of time. And when I go and stuff like that, and it just, I don't know, man. Like, I listen back and I'm like, why do I sound smarter? And then I remember because I did one smart thing. I hired rob@worldwayrecording.com.