Juicebox Podcast: Type 1 Diabetes

Episode #1780: Best Of Juicebox – Type 3c Diabetes

Aired: February 22, 2026
Guests:

• Host: Scott Benner
• Guest: Lara (Type 3c Diabetes, pancreatic cancer survivor, British Columbia, Canada)

Main Theme / Purpose

This episode explores a rare diabetes journey: Type 3c diabetes as experienced by Lara, a 46-year-old Canadian who developed the condition after losing her pancreas (plus spleen, gallbladder, and part of her stomach) during cancer surgery. Lara and Scott dig deep into Lara’s diagnosis, her experience navigating both cancer and diabetes—especially the emotional toll, the inadequacies of the Canadian healthcare system, and practical and emotional strategies for managing a life-changing diagnosis. The episode offers hope, candor, and boldness for those dealing with complex diabetes, especially pancreatic and secondary diabetes.

Key Discussion Points & Insights

1. Lara’s Diagnosis and Early Symptoms

• Initial Presentation:
  • March 2021, severe back pain, radiating through shoulders, oily stool, abdominal pain, nausea, general malaise.
  • Initially attributed to a keto diet; symptoms were intermittent ("In hindsight, really, the warning signs were there from long ago." – Lara, 05:05)
• Diagnosis:
  • Hospitalized for pancreatitis; abnormal bile duct found later (July 2021); initial scans clear.
  • Follow-up CT in February 2022 found a 1.44cm pancreatic mass, described as "very small" and caught early. No symptoms at time of detection.

2. The Cancer Journey & Emotional Responses

• Cancer Confirmation:
  • PET scan & biopsy: invasive pancreatic ductal adenocarcinoma, very aggressive (13:12).
  • Past family trauma: Lara’s uncle died of pancreatic cancer, adding emotional weight.
• Honest Reflections:
  • Both host and guest share vulnerability, with Scott connecting via his mother’s cancer ("At some point I'm going to cry today. Just so you know." – Scott, 15:01).
  • Lara describes the shock of hearing about her cancer: "When I first got the first report that I had pancreatic cancer...the Google tells you no one comes out of it." (26:02)

3. Surgery & New Reality: Sudden Type 3c Diabetes

• Surgery Surprises:

  • Six weeks before surgery tumor grew rapidly (from 1.4cm to 4.5cm; "It grew by like 40 times its size in six weeks." – Scott, 19:24).
  • Surgery outcome: Total removal of pancreas (plus spleen, gallbladder, part of stomach).
  • Post-Op Shock: Nurses panicked over uncontrollable blood sugar (25+ mmol/L [~450 mg/dL]); Lara knew nothing about DKA or diabetes at that point (23:16).
  • "I awoke to nurses in sheer panic because they were unable to control my blood sugar." (20:44)

• Hospital Management (or Lack Thereof):

  • For nine days, little education provided; insulin given with meals, but no context.
  • First severe hypoglycemic event happened alone at night, with Lara not understanding what was happening (34:27).
  • Basic discharge orders: Fixed insulin doses with minimal instruction; no carb counting or education about lows (42:13).
  • Digestive enzymes prescribed for life due to missing pancreas, but dosage was guesswork: "Too little or too much have the same effect—serious diarrhea." (47:03)

4. Gaps in Diabetes Care and Self-Education

• Systemic Failures:
  • Little support or information about diabetes upon discharge or during recovery:
    • "No one told me anything about diabetes." (33:25)
    • "I didn't know that I could give myself more insulin if I had a snack. I didn't know any of that until I found your podcast." (42:18)
  • Lara fired her initial endocrinologist for being out of touch: "I like the facts. I don't need the fluffy stuff." (28:08)
• Self-Advocacy:
  • Discovered The Juicebox Podcast via searching for people "like me" (i.e., with no pancreas); Episode #279 with Jen was the entry point, after which Lara became a regular listener.
  • Became "Bold With Insulin" through self-education and community, not clinical guidance.

5. Canadian Healthcare System: Shortcomings and Workarounds

• Systemic Delays:

  • "In Canada, it's a province coin flip whether you get good health care or not." (07:42)
  • Delays in crucial scans (three months overdue), stat PET scans skipped due to waitlists; Lara paid privately to expedite her care, likely saving her life (56:04).
  • Bureaucracy: Delays in reading scans, need to physically deliver imaging discs to cancer center (59:27).
  • Insufficient access to emerging diabetes tech; had to fight for pumps and CGM.

• Host’s Comparison:

  • Scott highlights tradeoffs of Canadian vs. U.S. health care—cost vs. speed and access.
  • Both emphasize that self-advocacy is essential regardless of system: "If you take what someone tells you, you are very frequently not going to end up well." (67:43)

6. Cancer Recurrence and Ongoing Treatment

• Unexpected Recurrence:
  • Six-month "clean margins" post-chemo, but tumor marker spiked from <27 (normal) to over 1,800 (55:56).
  • Private PET scan showed new liver/kidney/lymph node metastases—while CT scan still pending.
  • Continued chemotherapy (Gemcitabine/Abraxane), plus naturopathic adjuncts (high-dose IV vitamin C, targeted hyperthermia treatments).
  • Positive response: Metastatic tumors shrinking/disappeared ("I am in the third of that third that are responding exceptionally well." – 63:06).

7. The Real Impact: Family, Legacy & Emotional Growth

• Motherhood and Mortality:
  • Lara is preparing for her daughter's graduation and for possible absence at future life milestones.
  • Preparing memory notes and experiences to leave behind—an honest dialogue about life, death, and legacy.
  • "We're trying to learn to be patient and graceful...giving each other grace and space and time." (75:18)
• Value of Hope & Attitude:
  • Lara cultivates a positive mindset deliberately, with the help of her support system and mental discipline.
  • "Some days I fake it and some days I don't" about optimism (80:32).
  • Focus on “helping others”—her motivation to share the story (51:14).

8. Advocacy and Advice

• Universal Takeaway:
  • Systemic gaps in care demand self-advocacy, persistence, and family/community support.
  • Knowledge is power: Lara cites the crucial role of podcasts and lived experience stories in filling educational, emotional, and practical voids left by healthcare systems.

Notable Quotes & Memorable Moments

| Timestamp | Speaker | Quote / Moment | |-----------|---------|----------------| | 05:05 | Lara | "In hindsight, really, the warning signs were there from long ago." | | 15:01 | Scott | "At some point I'm going to cry today. Just so you know." | | 19:24 | Scott | "It grew by like 40 times its size in six weeks." | | 23:16 | Lara | "I awoke to nurses in sheer panic because they were unable to control my blood sugar." | | 34:27 | Lara | "I didn't feel well...I pressed the call button and...I had a low blood sugar. I didn't know this was going to happen to me. They didn't tell me." | | 42:18 | Lara | "I didn't know that I could give myself more insulin if I had a snack. I didn't know any of that until I found your podcast." | | 47:03 | Lara | "Too little or too much [enzymes] have the same effect—serious diarrhea." | | 56:04 | Lara | "I ended up having to pay for a private PET scan because I couldn't get one done in a timely manner here." | | 63:06 | Lara | "I am in the third of that third that are responding exceptionally well." | | 75:18 | Lara | "We're trying to learn to be patient and graceful...giving each other grace and space and time." | | 80:32 | Lara | "Some days I fake it and some days I don't [stay positive]." |

Important Timestamps

• 02:03 – Lara introduces herself; medical history begins.
• 03:09-11:21 – Details and symptoms leading to diagnosis.
• 11:21-20:01 – Cancer diagnosis, PET scan outcomes, family cancer history.
• 20:01-26:13 – Surgery outcomes; instant Type 3c diabetes and emotional impact.
• 33:10-42:13 – Poor inpatient diabetes education and dangerous gaps in care.
• 42:13-47:14 – Discharge and life at home with new diagnoses.
• 51:14-52:12 – Lara’s motivation to help others by sharing her experience.
• 52:12-56:44 – Cancer recurrence, dealing with the Canadian health system’s delays.
• 61:29-63:06 – Positive chemo response; holistic adjuncts.
• 73:30-80:10 – Legacy, family conversations, preparing for daughter’s future.
• 80:32-81:49 – Mindset, positivity, emotional strategies.

Tone and Style

• Open, candid, humorous in adversity: Both Lara and Scott use honest, sometimes dark humor to cope.
• Supportive and educational: Focus on lived experience, not medical advice.
• Raw, heartfelt reflections: Vulnerability around loss, illness, preparing for the future.

Conclusion / Takeaways

• Be bold and proactive: In health, no one will advocate for you more powerfully than yourself.
• Stay informed & seek community: Education and support networks (like podcasts, Facebook groups) can make a life-saving difference.
• Cherish the present, plan with hope: Lara’s story is a testament to resilience—balancing hope, humor, candor, and purposeful living, even in uncertainty.

For more, listen to [Episode 279: Jen Had a Pancreatectomy] (referenced by Lara) and connect via the Juicebox Podcast Facebook Community.