#1922 Teen Factor

Summary

Juicebox Podcast: Type 1 Diabetes

Episode #1922: Teen Factor

Host: Scott Benner
Guest: Kari, clinical pharmacist and mother of a teen with T1D
Release Date: August 6, 2026

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Episode Overview

This episode dives deep into the challenges, strategies, and realities of managing type 1 diabetes through the teenage years. Kari, a clinical pharmacist and mother of four (including a 14-year-old daughter with T1D), shares her family's experience from diagnosis through adolescence. The discussion covers burnout, shifting parental roles, healthcare navigation, advocating in schools and hospitals, and why community and realistic expectations matter. Scott and Kari blend candid humor, empathy, and practical insights for parents, caregivers, and anyone living with or supporting those with T1D teens.

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Key Discussion Points & Insights

1. Kari's Background, Family, and T1D Diagnosis Experience

[02:53 - 04:13]

• Kari introduces herself: mother of four (ages 15, 14, 12, 10), clinical pharmacist in a hospital setting.
• Her 14-year-old daughter was diagnosed at age 8 with type 1 diabetes.
• There's family history: her mother likely had T1D, though it was undifferentiated at the time.

[07:53 - 11:29]

• Family has other autoimmune conditions (hypothyroid, Crohn's) and cancer history.
• Discusses cultural/community connections and why LDS (Mormon) families are often tight-knit in online communities such as the Juicebox audience.

2. Realities of Chronic Illness in Families

[12:35 - 15:13]

• Growing up, Kari’s mother’s diabetes wasn’t a constant open discussion; she wasn't heavily involved in care as a child and only reflects back on the experience with her adult medical understanding.

3. The Diagnosis Story: From Subtle Signs to Hospitalization

[19:08 - 24:30]

• First noticed classic symptoms in her daughter: excessive thirst, unexplained weight loss, mood changes.
• “The realization came to me that she had lost five pounds...” (Kari, 20:13)
• Got access to a glucometer through a friend and neighbor—blood sugar was unreadably high.
• Emotional response: “We took some time to just cry. We cried. Yeah.” (Kari, 21:25)
• Daughter was hospitalized but not in DKA; handled the experience with remarkable resilience once the initial shock and emotions settled.

4. Navigating Early Management & Parental Confidence

[25:48 - 26:44]

• Kari’s pharmacy background provided initial confidence; understanding insulin, blood sugar testing, and the importance of working with the system.
• “I think in the beginning, maybe the first couple of years, I was like, we got this. I can learn this.” (Kari, 26:01)
• Challenges became more complex as her daughter aged—especially with puberty and independence.

5. The Teenage Transition: Burnout, Independence & Parental Adjustment

[27:06 - 32:10]

• As her daughter hit her teens, hormonal changes, increased insulin needs, and desire for independence led to new management obstacles and some parental burnout.
• “Some of it's just like, this isn't reacting the same way it used to... she's kind of becoming a little more independent.” (Kari, 27:35)
• Ongoing balance: parental involvement vs. fostering the teen’s autonomy.
• Honest admission: “At some level, yes... we're not paying as close attention to it anymore.” (Kari, 30:29)
• Struggles to find the right line between gentle guidance and ‘nagging.’

6. Parental Worry for Long-Term Outcomes

[32:10 - 34:47]

• The hardest part: knowing as a medical professional the risks of suboptimal blood sugars, but needing to let go as kids become independent.
• “There's been so many times I thought if I could just have this disease, like, I’d have it under control...” (Kari, 32:32)
• The host and guest reflect on limited parental control as kids mature.

7. Navigating School Management & The Role of The School Nurse

[36:24 - 42:22]

• Kari relays input from school nurses: nurses have divided attention (many students to care for), cannot provide 1-on-1 diabetes care all day.
• Using Dexcom Follow/iPad for school monitoring—helpful for critical moments but not monitored constantly.
• Importance of good parent-nurse communication; not all families are as involved.
• If families struggle to supply snacks/supplies, school nurses can help find resources—parents must communicate needs.

Notable Quote:
“Nurses... they're not a one on one for sure, like medical... Sometimes there’s people who – their child doesn’t have snacks at the school, can’t get them to the parents to bring supplies... So she’s chasing them all the time.” (Kari, 41:10)

8. Medication Safety in Schools & System Limitations

[42:36 - 47:05]

• Kari advocates for double-checks when school staff administer insulin, akin to hospital protocols—Scott notes real-world, resource-oriented limitations.
• The topic highlights the gap between ideal and practical implementation, emphasizing the need for parent advocacy and realism.

Notable Exchange:
Kari: “If [school nurses] have to double check in hospitals, why shouldn't a school nurse have a double check?”
Scott: “I would also like to point out it’s one story in... with a million kids... I know how they should be, but that’s not always how the world works.” (44:07–44:47)

9. Hospital Diabetes Management: Self-Advocacy is Critical

[49:18 - 56:35]

• If a child with T1D is hospitalized, parents must inform every provider about pump/CGM use; staff may not be aware or trained.
• “I assume everybody’s an idiot... I don't expect anyone to do a great job. And I don't think it's their fault.” (Scott, 50:42)
• Blood sugar typically takes a backseat to other hospital priorities unless diabetes is the reason for admission.
• Be vigilant, ask directly, and advocate for in-range BGs for better recovery.

10. Cognitive Load & Compassion

[58:35 - 60:51]

• There’s a scientific limit (roughly 3–5 active worries) to how much “mental bandwidth” anyone (nurses, families, kids) can manage at once.
• Provides empathy for teens with T1D: “She’s having to think about that which my other kids don’t, you know? That’s on her mind constantly... and she’s only 14.” (Kari, 60:04)

11. On Providers & The Importance of Community

[61:42 - 64:19]

• Doctors and educators can be part of one’s support network; if yours isn’t supportive beyond prescriptions, seek someone better or supplement with community/online resources.
• The challenge of reaching families who are not digitally connected or resource-seeking—many struggle in silence.

Notable Quote:
“Most of them… are not connected to all of this stuff. There's so many people that… have had diabetes for a long time and it’s not being managed.” (Kari, 65:53)

[67:43 - 70:00]

• The limits of outreach and why even the best resources won’t reach everyone—relying on tech (automated pumps, etc.) may be the best broad solution.

12. “Teen Factor”: Humor & Acceptance

[71:12 - 72:22]

• Kari proposes “Teen Factor” as a new diabetes variable—acknowledging how teenage independence and mood affect management.
• “We should coin a new term called teen factor. Like there’s correction factor—why can’t we coin teen factor... it might be what’s affecting everything today.” (Kari, 71:12)

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Notable Quotes & Memorable Moments

• On letting go:
  “Either they're going to figure it out and do a better job for themselves... or they're not. And how crazy is it to think… there’ll be a day when [your opinion] won’t even matter.” (Scott, 33:34)
• On advocacy:
  “If you know how to take care of your diabetes, you need to make sure the doctors know and they are taking care of your diabetes.” (Kari, 55:49)
• On transition and imperfection:
  “We're probably not going to be perfect with our blood sugar management. We're darn trying, but we're not there.” (Kari, 72:10)
• On community:
  “Social media can be so helpful too, because so many people can give you tips… we’re connected in a way that we have never been connected before.” (Kari, 63:53)
• On limits of the system:
  “It’s not a fixable problem that there’s an answer to and you just don't know… like, there's no answer, really.” (Scott, 70:01)
• On technology and choice:
  “If the thing you're using has a thing about it that's valuable for you, then that's what's best for you.” (Scott, 76:28)

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Key Timestamps

• 02:53: Guest intro – family, background, daughter's diagnosis
• 19:08: Signs and story of diagnosis, emotional impact
• 27:06: Struggles with teenager's independence, burnout
• 36:24: School nurse perspective; Dexcom follow; parental involvement
• 42:36: School medication management, advocacy for safety
• 49:18: Managing T1D in a hospital, importance of self-advocacy
• 58:35: Mental bandwidth limits; empathy for what T1D kids carry
• 63:53: Role of diabetes community and support
• 71:12: "Teen factor" as the new correction factor
• 76:28: Choosing the right device/system for the individual

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Takeaways & Strategies

• Burnout is Normal: Parental burnout and frustration with shifting diabetes patterns in teens, especially during puberty, is common.
• Empower Independence: Gradually allowing T1D teens more control—even though it is hard—is critical for their growth.
• Realistic Expectations: Neither perfection nor full control is realistic; focus on modeling good behaviors and giving grace to yourself and your child.
• Advocate Relentlessly: Whether at school or in the hospital, parents/caregivers must continuously advocate for their child's needs; never assume others “just know.”
• Leverage Technology & Community: Tech tools (like CGMs, pumps, follow apps) and online communities (especially the Juicebox Facebook group) are invaluable for support and practical tips.
• Accept Human Limits: Healthcare and school staff are limited by human bandwidth; partnership, communication, and empathy go further than blame.
• Stay Flexible With Tools: The “best” pump or system is the one that aligns with lifestyle needs—A1C isn’t the only metric that matters.

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Final Thoughts

The episode is both a candid, practical playbook and a source of empathy for T1D families—especially as kids hit the turbulent teen years. Through stories, humor, and honesty, Scott and Kari show that success is about adaptation, community, and allowing yourself (and your child) grace.

“Maybe getting through a life with diabetes without making yourself crazy is more about allocating time and resources, both mental and physical.”
(Scott, 74:00)

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Want actionable support?

• Join Juicebox Podcast: Type 1 Diabetes Facebook group (currently 86,000+ active members).
• Explore resources, peer advice, and more at JuiceboxPodcast.com.

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Transcript

[A]

Hello, friends, and welcome back to the Juice Box Podcast. If you don't love today's episode, you can have your money back. I've been asking you all week, have you done it yet? T1D exchange.org juicebox you're over 18. You're a US citizen. You head over, you fill out the survey. You've helped to move type 1 diabetes research forward. It's not difficult. You'd be doing me a favor. T1D exchange.org juicebox do me a favor. Do everybody a favor, even you. You should not in any way, shape or form take anything you hear on the Juice Box Podcast as medical advice. I'm talking about medical advice, regular advice, any kind of advice. This is a podcast. 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. I cannot stress that enough. Today we've got a great podcast and it's sponsored by great advertisers, US MED, the Eversense365 and Twist. You know about Twist? It's an insulin pump I'll tell you all about in a second. I'm having an on body vibe alert. This episode of the Juice Box podcast is sponsored by the Eversense365. The only one year wear CGM. That is one insertion and one CGM a year. One CGM one year, not every 10 or 14 days ever since. CGM.com Juicebox this episode of the podcast is sponsored by the Twist Aid system, powered by Tidepool that features the Twist Loop algorithm, which you can target to a glucose level as low as 87. Want to learn more? Go to visit.twist.comjuicebox that's visit.twist.com juicebox and Twist has two eyes. You understand? Twiist.comvisit.twist.com juicebox hey, US Med is a longtime sponsor of the podcast. It's where we get our diabetes supplies from. You could as well usmed.com juicebox or you can call 888-721-1514 us med. That's where my daughter gets her supplies. Use the link or the number. Get your free benefits. Check today and get started with usmed. So I say testing and then I ask you to say testing. Say testing.

[B]

Testing, Testing.

[A]

Awesome. I used to say, and I asked you to say testing and then I get quiet and then I realize people are waiting for me to literally say say testing. It messed me up. You are being recorded. Take a breath. Talk to Jesus. Do whatever you want to do. Then Introduce yourself. We're going to start talking.

[B]

Hello, my name is Kari. I'm the mother of four children, wife of 18 years. I have a daughter, my second daughter with type 1 diabetes. I'm also a clinical pharmacist. Work in the hospital setting. Yeah.

[A]

Cool.

[B]

Me.

[A]

Nice to meet you.

[B]

Nice to meet you too.

[A]

Thank you. For kids, what's the age range?

[B]

So My oldest is 15, and then we have a 14 year old. That's the one with the type 1 diabetes. Those are daughters. And then we have a son who's 12 and another daughter who's 10, almost 11. Wow.

[A]

They're all very, very close together in age.

[B]

Very close in age, yes.

[A]

Are you stealing drugs out of that pharmacy to buy pay for college later? No. I know you're not, but I just saw an episode of. Of the Mentalist yesterday where a hospital employee was stealing drugs for themselves. Now, I think that's probably why it's in my mind.

[B]

Also makes a good episode.

[A]

Underrated television show. If you don't. If you don't know. Anyway, let's find out more about you. So how long have you been married? You said 18 years.

[B]

I was trying to figure out how many years before we started. I think it's been 18 years. We got married in 2008, so this August will be 18 years.

[A]

Okay, awesome.

[B]

Yeah.

[A]

Okay. So is there other autoimmune stuff in your family or is your daughter like an outlier?

[B]

So, okay, so where to start? So my mom had diabetes. She was diagnosed around the age of 45. She's passed away. And, you know, at the time, we didn't really discuss type 1, type 2. She lost a ton of weight in the beginning, and that's how she was diagnosed. And she immediately got put on insulin. So to me felt like a very type one kind of situation now looking back, but at the time, we never really talked about it. And, um. So did she ever call it type 1? No, but I think that's probably what it was.

[A]

How old are you at that time? When she's 45.

[B]

So I would have been. I was. Let's see. Let me do the math here.

[A]

All right, please.

[B]

If she was 45, she was born at 45. So that would have been 99. 90. So I would have been 20? No, no, no. 14.

[A]

So you're a kid. You're a kid. When she started, how old? What? How old was she when she passed away?

[B]

She was 63.

[A]

Was this from the diabetes?

[B]

So she had breast cancer about 10 years before she passed. Went into remission after surgery and radiation. Toward the end of her life, she started having a lot of what felt like kind of heart failure kind of symptoms, but I don't know that she was ever technically diagnosed with heart failure, but, you know, she was having trouble walking long distances without getting short of breath, and then she started just kind of downhill. She had some problems with her voice for a while, and she was in the process of getting a diagnosis for possible return of the cancer. Like, they were doing a PET scan, and during the PET scan, she coded and ended up in the hospital and never made it.

[A]

Oh, my gosh.

[B]

So that was. So we never really knew if the cancer came back, but we were suspicious because I think she had had some coughing up blood, and that was.

[A]

I'm so sorry.

[B]

Concerning.

[A]

So, yeah, no, I'm so sorry. That's terrible.

[B]

She lived a good life, though. She raised six children, and she. Yeah, she had a good life. She. She had lost my dad when I was 16, so she lived many years as a widow and. Yeah.

[A]

Die from having sex? Did he die from having sex? So much. What happened to.

[B]

From lung cancer? So we have a lot of cancer.

[A]

Do you live next to one of those big electric poles or what's going on?

[B]

I don't know. I'm not sure why we got. Why we got that.

[A]

But is the cancer in the family? Do you. Do you look back in other, like, family lines for cancer?

[B]

Not those particular types of cancer. You know, I think we have some GI cancer in my. One of my grandparents had some stomach cancer toward the very end of their life. You know, they were in their 80s, so.

[A]

Yeah.

[B]

But no, I mean, none of, like, you know, I have sisters and brothers, and none of us have had any problems with any of these types of cancer. I have another brother that has a. See, they're CML or cll. I can't remember. But he does have a cancer. But it's, you know, like a chronic type cancer that you. You can live with for a long time.

[A]

Do you get checked for breast cancer more frequently than other people? You do?

[B]

Absolutely. Yeah. Yeah. I started mammograms earlier than the typical just because of my mom's cancer history. And. Yep.

[A]

So for sure, that's a lot. Okay, but how about autoimmune stuff? Anybody have thyroid celiac?

[B]

So my grandmother had. Took a thyroid medication, you know, Levothyroxine, I believe. So she had hypothyroid. She's the only one I know of. I do have a niece that has Crohn's and I do have a brother that has diabetes, but his is also, I think, type two. I think that's technically what his diagnosis is.

[A]

Just to go backwards to your mom for a second, though. You don't know if your mom had type one or type two.

[B]

I don't really know what the doctor called it. But she immediately took insulin. Like, she never took oral medication. She was not. She may have been, like, slightly overweight before she started rapidly losing the weight. So, like, when she was diagnosed, she had lost a lot, a lot of weight. She's very, very thin. You know, like that typical type one presentation.

[A]

Yeah, yeah. You guys are Catholic, right? No, no.

[B]

Members of the Church of Jesus Christ of Latter Day Saints.

[A]

Oh, I was going to say. Why are you not talking about how you feel? I just assumed Catholicism when I saw all the kids. Oh. Oh, this is such a nice moment for me. Do you know, in the beginning of the podcast, I was huge in the church. Did you. Oh, yeah, yeah, yeah, yeah. I had. I had a couple of years where I thought maybe only Mormons were listening to the podcast. There were so many of them. I was like. I'm like, am I the number one diabetes Mormon podcast in the world? And how did that happen?

[B]

We tend to be online a lot, I think, you know, like, social media. We tend to be on these kinds of things. I don't know why. We connect a lot through the. Through these kind of things. But the way I had it, for what it's worth.

[A]

Yeah, the way I had it explained to me finally, because I would ask every time, because eventually they come on and. And they. I mean, people come on and they have a ton of kids. You're like, are you. Are you in the church? And they're like, yeah, how'd you know? I'm like, I think you all are. They were listening and. And I would start asking, why do you think the podcast is so popular there? And they. A lot of people, they. Again, I just don't know anybody who I was talking to. A lot of people would say we're very community oriented. So if somebody's having success with something, it's very reasonable that they would be telling other people.

[B]

Tell other people. Yes, absolutely.

[A]

And I was like.

[B]

And very connected. Very connected. So.

[A]

Yeah, but we don't talk about our diabetes

[B]

with our. With my family, you mean?

[A]

Yeah, yeah.

[B]

No. So, like, as a kid, like, I remember my mom, you know, obviously giving insulin. It just wasn't. I mean, I remember her getting low sometimes, and we. We knew that she needed milk. She always Treated her lows with milk. I remember one particular severe low where she was, like, almost not able to take care of it herself. We never really had to do it for her, like, except for that one particular time. I think I did have to help her, but, you know, I. We just didn't. I don't know, like.

[A]

It's okay. I'm not. I'm not trying to make you feel bad.

[B]

That's okay. No, I'm in the medical field now, and I would have a ton of questions for her if I could ask her those questions.

[A]

Yeah, of course, at the time, you

[B]

know, you're 14, you're just not thinking about that necessarily.

[A]

Yeah, See, you didn't know me when I was 14. I would have asked all those questions. And I. And I get. I think I get confused a lot of times. I don't know if everyone does this. I have a very bad habit of just assuming that my level of the way I think about something is how everybody thinks about it. And then I get confused when that doesn't happen, which is silly because I'm an adult and I know everybody doesn't think the same way, but I would just. I'm sitting here trying to imagine a thing about me or about my wife that my kids don't know, and I don't think I could come up with one.

[B]

Right.

[A]

Yeah. So that throws me off a little bit.

[B]

But. But nevertheless, I guess. I guess the thing about it was, at the time, none of us had any medical background. Now I have a brother who's a doctor, and I'm a pharmacist.

[A]

And so, like, diabetes, as you know, comes with a lot of things to remember. So it's nice when someone takes something off of your plate. US Med has done that for us. When it's time for Ardent supplies to be refreshed, we get an email. The email just rolls up in my inbox. It's like, hey, this is, you know, time for your supply order. I don't exactly know what it says. I open the email, there's a big button, I click on it, I reorder, and I'm done. Finally, somebody taking away a responsibility instead of adding one. And boy, oh, boy, has usmed done that for us. An email arrives, we click a link, and the next thing you know, your products are at the front door. That simple. Usmed.com juicebox or call 888-721-1514. I never have to wonder if Arden has enough supplies. I click on one link, I open up a box, I Put the stuff in a drawer and we're done. US Med carries everything from insulin pumps and diabetes testing supplies to the latest CGMs like Libre 3 and the Dexcom G7. They accept Medicare nationwide over 800 private insurers. And all you have to do to get started is call that number 888-721-1514 or use my link usmed.com juicebox using that number or that link helps to support the production of the Juice Box Podcast. This episode of the Juice Box Podcast is sponsored by the Eversense365. Get 300 and get 365 days of comfortable wear without having to change the sensor. When you think of a continuous glucose monitor, you think of a CGM that lasts 10 or 14 days. But with the Eversense 365, it lives up to its name, lasting 365 days. That's one year without having to change your CGM. With the Eversense 365 you can count on comfort and consistency 365 days a year because the Eversense silicone based adhesive is designed for your skin to be gentle and to allow you to take the transmitter on and off to enjoy your shower, a trip to the pool or any activity where you don't want your CGM on your body. If you're looking for comfort, accuracy and a one year wear, you are looking for Eversense 365. Go to eversensecgm.com juicebox to learn more.

[B]

You know, when we kind of got more into the medical field we obviously it became more of a conversation, that kind of thing. But you know, when you're a teenager, your parent has this thing, they don't make it the center of their life. You know, we knew she injected insulin. She wasn't like hiding it or anything like that. And you know, I saw her insulin vials but we just to what just wasn't like a regular talk of conversation like this is what you need to do if, if you, if I need help.

[A]

I hear you. Do you think that her care was adequate or do you, do you have any way to know?

[B]

So I think so. She ended up being on, I think it was actos at one point to help with insulin resistance and then that was taken off the market I think while she was taking it. So she had to stop that. I don't know if you remember that particular medication.

[A]

I don't know.

[B]

She, she, she saw and I'm trying to remember if it was an endocrinologist I feel like it was an endocrinologist that she saw, and she went to the doctor regularly. I. I remember her actually talking a little bit about how the doctor would scold her. You know, like, the doctor got upset because this or that. So I don't know what her A1Cs were. I don't think I knew she took her insulin regularly. Like, she didn't skip doses and that sort of thing, but, you know, she may have had an A1C, not quite optimal.

[A]

Okay, okay. Well, okay.

[B]

I probably would assume, since she did have kind of some complications toward the end of her life, the main complication she always talked about was the neuropathy in her feet.

[A]

Okay. Yeah. Is it. I don't want to talk about other people's, but I've met a number of people recently. I think, to backtrack a half a second, I think that GLP is being so, like, prevalent in people's minds now. Make a lot of people look at me in my private life now and go, what do you know about all this? Because they've been, you know, hiding their health issues for a while, and they know I make the podcast, but nobody ever asks about it in person.

[B]

Right.

[A]

And then. But a lot of people are asking about GLPs now. So I've had a couple of conversations with people, and I'm very surprised by the number of adults who look at me and go, I have neuropathy in my feet. I'm like, do you have type 2 diabetes? They go, no. And I'm like, you have pre diabetes? And they go, no. And I'm like, you sure? Yeah, yeah, yeah, yeah. Because it seems like you do, and, you know, like, the way you're talking and the things you tell me about. I just had a long conversation with. With, like, some. I don't want to call them friends. They're acquaintances. And as we were talking, I'm like, no, you were a perfect candidate for all of this. They're like, oh, my doctor won't give it to me, but the doctor will put them on a statin. The doctor will put them on 19 other different kinds of medications, but the one drug that I think would probably, like, most quickly and effectively help them with all their problems. They're like, no, you don't want that. You're going to. You'll have stomach trouble.

[B]

And.

[A]

And that's all they say. Like, I'm like, well, what kind of stomach trouble are you expecting? And they actually say, I don't know. The doctor didn't say, and I'm like, you didn't look into it. I was like. Because I, you know, I'll tell you, like, I had my fair of runs to the bathroom in the beginning of glp, and I was. And they're like, oh. And you just kept doing it. I was like, well, I was also losing weight. And so, yeah, like, I stuck with it for a while. You can'. A quitter. But it's funny. Good.

[B]

Sorry. I was going to say in. In my career. So my first job as a pharmacist was working for a university hospital system. And just kind of through the way that this clinic worked, I started out doing slightly different pharmacy work, but I ended up in diabetes education. Like, this was like, pre, you know, my daughter. Like, I wasn't married yet. I didn't have my daughter. Of course, my mom had diabetes. So I learned a lot about the diabetes then. And I. Yeah, I talked to a ton of patients. Like, I met with patients one on one, and ton of patients that. It really drilled into me the. The idea that, like, even before you get diagnosed with type two, for example, because most of the people were type two, you're having complications. Like, things are happening in your body that are damaging your body before you even have that diagnosis of type 2. Because even, you know, pre diabetes, so metabolic syndrome and all that, I'm just.

[A]

I'm more. That's very true. I'm more fascinated with the idea that people can be having actual physical problems. And then when you tell them I think this would help, they go, oh, yeah, but I don't want my belly to hurt. I'm like, well, your feet are trying to fall off. Don't you, Like, I mean, like, don't you think that's going to hurt?

[B]

And people were always very, very. It was hard to get people to be on board with taking insulin to, like, you know, when it was clear that, like, the oral medications were not covering the diabetes, like covering the blood sugars, and it was time to go to insulin. It was like, that was a hard sell for a lot of people.

[A]

And then the first question always, well, how long will I have to do this for? It's always that, well, like, if I use the glp, when can I stop using it? I'm like, well, I probably never. And. And then they go, oh. And I'm like, what? You can't feel your feet? Like, like, I'm like, what? Okay, so I guess we're going to just try not to make sense a little longer anyway. I'm so sorry.

[B]

That's okay.

[A]

Yeah, yeah. So what do you notice first about your daughter?

[B]

I guess, okay, so in hindsight, a ton of things. But at the time. So she. It was June, and it was getting hot where we were living, obviously everywhere it's summertime. She started drinking a ton of water. That was the main thing that made me think, what's going on? Since I'm a pharmacist and I have that background. I thought one night after she had gone to bed. Can't remember if she. She was the type of kid around that time and prior, you know, when she was younger, she would have these mega tantrums, you know, just like, meltdown, like. Yeah, I just thought, you know, I have four kids, and at the time, we had all four kids, and they all had different personalities, you know, And

[A]

I thought you were gonna say. I thought you were gonna say, well, we made four, and only one's broken. That's not bad.

[B]

Just always kind of thought she was a more sensitive child. Things set her off that, you know, like, maybe other people didn't get set off by, you know, and not that she was having tantrums all the time. I understand, looking back, there were kind of those major tantrums. It was like, whoa. Like, where did this come from? So that night, she had gone to bed, all the kids were in bed. And I was just. I had the thought, you know what? I think she needs her blood sugar checked. And I. The realization came to me that she had lost five pounds. I think we had had her stand on the scale, and not necessarily because of the diet, like, thinking the diabetes, but, you know, the kids just like to go and stand on the scale and see how much they weigh. And when she had stood on the scale, I realized it was 5 pounds less than maybe her most previous doctor appointment or something. And so that, along with the drinking, I thought, oh, boy. So I immediately caught on Facebook and I so to, like, a neighborhood group page, and I said, is there any in the neighborhood that has a glucometer? Because I did not have a glucometer. You know, even through my job, you know, I just didn't have need for one of those. I wasn't working in diabetes education at this time, but so I didn't have one. I found someone, a friend, like a daughter of a friend who had a daughter with type one and they had a glucometer. So she set it up to come over the next day and test her. And so we had her come over. And my daughter did not, I think my daughter. So she Was almost eight at the time. I think she knew something was wrong at this point. Like, when I said, she's going to come over and test your blood sugar, she knew, like, wait, what? And she didn't. She threw a tantrum. Like, she did not want to get her blood sugar tested, not want to get a finger poke.

[A]

Right.

[B]

So that took some, you know.

[A]

Do you tell her why did you say we're having a neighbor's friend?

[B]

No, we did not say why. I just said, we really have to do this. Like, I just knew we had to do it. So we. We convinced her to calm down and let this. This woman was a very nice woman. And she brought over her daughter with type one, actually. So, like. And they are a similar age. So I don't know, somehow that probably helped just having another kid there. And I. I don't know. So we eventually got her to agree to let us test her blood sugar. And the reading was high on the glucometer, so I. I immediately knew my husband was home at the time. And we, she and I, when I realized something was wrong, I was emotional and she was emotional, and we took some time to just cry. We cried. Yeah. And I said, we really have to go to the hospital. And she didn't want to go. Like, we. We had to convince her it's. It's time to go. We have to go. We have to do something. This. I. I know I didn't say you have diabetes, but I said this has to be taken care of.

[A]

Yeah.

[B]

So my husband was able to convince her to go to the clinic, to go to the pediatrician. She was a family friend of ours, but also our pediatrician. And so they ended. They started at the pediatrician and then just got, like, direct admitted from there, so.

[A]

Oh, gosh. How. How did she handle it in the short term? Was it. Did that upset continue, or did she. Which I. I'm definitely not going to use the word regulated, but as her blood sugar came back down, was she easier to talk about these things?

[B]

Yeah, I mean, in the beginning, it's fussy for all of us, but in the beginning, when she was in the hospital, like, she did fine with the shots. Once we got home, we only stayed in that. She was not in dka, so we caught it. Before that, she was only in the hospital for maybe like, two, three days. I feel like they did IV fluids, but other than that, like, you know, it was. It was a fairly easy hospitalization, and they just kept us that long so that they could get all of our prescriptions filled and ready to go by the time we got home. So that was good to be there, you know, and just kind of get the education that we needed. Even though I kind of knew, but I didn't for sure know what this all meant, right? So she, she did well. And then when we got home, you know, I feel like overall she did fairly well, accepting that she had to take shots and poke her finger. And it was not a fight every time. You know, it was definitely like something new that we had to get used to. And there was crying. But overall, like, not. I wouldn't say it was extremely difficult were the outbursts could be blocking out the memory side of it.

[A]

You're like, it's possible I. It's possible. I just can't remember any of this. Did the outburst get lesser? Here's what makes Twist different. It measures the volume of insulin delivered with every dose using sound wave technology. That gives it the ability to recognize a blockage quickly, allowing you to step in and deal with it before things potentially get out of range. It is also the only automated insulin delivery system that can be controlled from an Apple watch. So you can discreetly check in, enter carbs, or deliver insulin right from your wrist. You can also set your glucose target anywhere from 87 to 180 milligrams per deciliter and adjust it for different times of day. So if mornings, workouts, school, work, or bedtime all need a little different approach, Twist can flex with that. And here's a real life example. You enter carbs, then something changes and you do not actually eat what you planned. With Twist, you can go back and correct or remove the carb entry and the system adjusts based on the new information. Because diabetes doesn't always follow the plan. And your tech probably should not expect you to either. If you'd like to learn more, go to visit.twist.com Juicebox that's visit.twist.com JuiceBox don't forget, Twist has two eyes.

[B]

I would say yes. Yeah, I would say yeah for sure.

[A]

Okay. Well, it's interesting where you, I mean, you felt ready because you probably were like, I am a pharmacist. I will be fine at this. I've done this before in the past. Did that actually help you or did it only go so far?

[B]

No, I think it absolutely did help me. I think in the beginning, maybe the first couple of years, I was like, we got this. Like, I know this. Like, I can learn this. I, I think for sure that helped me. My husband's really supportive, so you know, in the beginning especially, like, he was helping with everything also, and so he was learning. But, you know, I think because I had had experience with, you know, what insulin is and how it works and how you test your blood sugar and even, like, insurance, you know, like, you don't really know the insurance troubles, but you kind of do as a pharmacist. So I knew how to kind of navigate medical system to get what I needed and what I wanted.

[A]

Right.

[B]

Yes. I do think it really helped in the beginning. And I had a good attitude. It gave me a good attitude maybe more than anything, like, I can do this.

[A]

Oh, just. Just a little self confidence, maybe where you didn't deserve it. Almost nothing wrong with that. And did that hold up or did it. Did it. Was there a ceiling and you thought, okay, what I now know is not enough. I need to find more.

[B]

Well, so that's kind of. Of where we kind of are right now. I mean, not that we are right now, but, gosh, we're in. She's 14 now.

[A]

Yeah.

[B]

And hormones hit and. And different types of physical activity that she wasn't doing before. And so, you know, in the beginning, I think I had. I had it down, and we. We were getting really good A1Cs. I think we were down to 6.2 at one point.

[A]

And now you're like, now they're not 6.2.

[B]

We're all burned out a little bit. You know, honestly, I think some of it's burnout, but I think some of it's just like, this isn't reacting the same way it used to. Like, you're not. You're not reacting the same way that I would have expected. We changed to a different pump also, which, you know, that took some learning, but. And then also in the process of it all, she's kind of becoming a little more independent. So, like, we're navigating, like, different things that we weren't navigating there in the beginning.

[A]

Well, do you think the burnout leads to, like, what do you. What am I asking here? Like, do you think the new challenges lead to the burnout, or do you think it's just time that got you there?

[B]

I think it's time maybe new challenges also. I. I anticipated hormones being tricky to. To deal with, but puberty and all that, I. I think it's time and just the change in management, honestly, you know, I. I think for her, as she's gotten older, she's needed more insulin, and that's difficult for her because she remembers just needing this certain amount and it always worked and now it's higher than that. And so she has maybe a little difficulty accepting that for some reason. Even though I don't really, we don't really talk about like more being worse, you know.

[A]

But is this, is this a feeling you're having as well? Do you think it's throughout the family do, even siblings. Is everybody just like guys, enough of this already.

[B]

I don't think so. I think so. The first few years I was very, very involved. Like I was doing everything with her. I mean, maybe more than few years. I think it's probably been in the last year to year and a half to two years where she's taken a more active role. So she started changing her own pump. When she went off to camp, there was a camp through school that she was going to and she had to be there for a week and she had to be independent, changing her po. So that's when we had her. I thought, you can do this. And she knew she could do it. And so we got to that point and she started changing her pod on her own. And she does that now. So like that was kind of a milestone step. You know, she's, she's a really active kid. She's like loves academics, she loves running. She just wants to do all the things. And so I think maybe the burnout comes because it's always in the background, you know, like we're all like, I'm also mom of four, I've got a part time job. I feel like I'm managing and I volunteer here and there. So it's kind of like it becomes in the background, like, oh, it's there, but it's not ruling our life. But you know, it is managed probably as well as it was because we're doing so many other things.

[A]

Yeah. So go through that for a second. It's not ruling our life the way it once was. Is that because you're not paying as close attention to it anymore?

[B]

At some level, yes. Yeah. But I guess like I try to balance. Like I want, I want to be involved, but like, you know how it is with a teenage teenager. They want to have some independence. Right. And I don't, I, I don't know that I do a great job, but I don't want to overstep step. I want to make sure that she feels like she's in control somewhat. And so I've had to come to this point where I think, okay, well, we're not perfect. Like our A1C is not, not as good as it used to be, sure. But, like, at the expense of me always nagging her and telling her that she needs to do this or that. Like, she knows what she needs to do, And I try to gently, like, help her, but it's just not the same as how it used to be when she was 7 going on 8. You know,

[A]

she was little and nice. I'm an adult. I hear that a lot.

[B]

Yeah, she's the kind of kid that's kind of 13 going on 30. You know, she. She feels like she could be on her own now and. And make it, and she probably could, honestly, to tell you the honest truth. Like, she's just. Does well at whatever she tries, but.

[A]

But it's a. It's a big part of this whole thing, and I. You're outlining it so well. But for people who haven't gotten to this part yet, you know, it's coming, and it's not a thing you fight against. It's not a thing you even want to not happen. Right. Like, you want your kids to get older and to mature and want to do things on their own. The problem, I think, for me always is, is that during the learning period, you feel like health is waning.

[B]

Yeah. And then that's tricky. And that's been hard as a pharmacist, like, knowing, like, just knowing the complications that come from even slightly elevated blood sugars. Like, that's been the hardest. Like, it's hard for me to swallow. And. And there's been so many times, And I don't say this to her, but there's been so many times I thought if I could just have this disease, like, I'd have it under control, you know, if I was in complete control of my body and it wasn't hers, you know, like, I. I could get this. I really do think. But, you know, don't you have that

[A]

feeling about life in general? You look at everybody, you go, just leave me alone. I could handle this.

[B]

I really could do it. Maybe I couldn't, but, yeah, yeah, yeah, it is.

[A]

So I. I mean, I take kind of putting this whole thing together, like, this conversation so far, even thinking back to me having conversations with acquaintances about type 2 diabetes. Right. Like, people. There's two things that happen here is your kids diagnosed when they're young, you figure out a great way to take care of it, and then at some point, they become their own person, and that gets in the way. And then you think, well, all right, so we. There's two paths here. Either they're going to Figure it out and do a better job for themselves than they are currently doing or they're not. And how crazy is it to think when you're the mother of a 14 year old there'll be a day when that won't even matter. Like your opinion of that won't matter at some point.

[B]

Point.

[A]

And, and like. Yeah, I, I say to my wife all the time, like, think back to when you were 25. Did you care what your mom was saying? Were we over here making a bunch of decisions based on your parents thoughts? I said we weren't. You know, like, and, and, and she's not going to either, by the way. So I, the way I think of it is model, model, model, model as best as you can for as long as you can. And then. Because then they're going to go and they might turn into my neighbor who goes, my feet hurt. Are you gonna do something about it? No. And maybe they'll turn into Jenny who's just like, I, I ate quinoa today and my blood sugar was 106 the whole day. Like I don't know like who she's gonna be. You know what I mean? Or who your daughter's gonna be. My daughter. Etc. But that's a hard thing to do when you're, when you're a parent.

[B]

Yeah.

[A]

Is to come to that point.

[B]

It's taken a little bit of time and I think I, I'm, I'm getting there. I'm, I'm not fully there. I still worry about it. Of course you worry about her. You worry about. Yeah. What, what is your life going to look like in 20 years or 10 years even? Like are you going to have complications? You hear people that say they don't have any and they've had it for so long and then you hear people that say they do have some. And so I, you just don't know. I'm just trying to do the best I can. I guess we all are.

[A]

I have found that. Not that I didn't before, but I found that it's helped me be more understanding about other people's problems. Like, you know, as an example, like a parent or a loved one of an addict, for example. Like did you ever try to put yourself in the shoes of a person who loves somebody who's addicted to heroin, for example, like the, the, the hopeless and, and helpless feeling that must exist as their loved one. And I'm not, I'm not equating type 1 diabetes with heroin use, but I am equating it with have a Thing that somebody's doing that may not be optimal, that you have no impact over. That could be hurting. Yeah, that could be hurting them, you know, and then. And what are you supposed to do then? Exactly. Right. So.

[B]

Right.

[A]

It's a. I'll tell you right now. Let me say this car. It's Kari, right? With a hard. Yeah. Yeah. The best part about life and the worst part about life is both people. People. I love people right up until this happens, and then I don't like them as much anymore. I wish they just listen. And I'm sure there's people that have been in my life that wished I would have listened. But the thing I wasn't listening about. Well, but the thing I wasn't listening about wasn't likely leading to a 9A 1C.

[B]

Yeah.

[A]

You know.

[B]

Yeah.

[A]

Stuff. It's tough when you can see the. When you can see the speeding up of the problem in real time. It's hard. It's hard to deal with, like, I. I don't. You know, anyway, whatever. You said you made a list. I. I want to make sure we. What's on your list?

[B]

So maybe first, like. So I asked our school nurses, you know, what would you. What would you want people to know, really? I told them I'm going on this podcast. Okay. And, like, we've had two. Well, we've had three school nurses so far, and I reached out to two of them that we worked with a little more closely, and I said, what. What would you want people to know? I've got this big audience, and the one that was our elementary school nurse was fantastic. They've both been fantastic. She gave me a lot of things that she said. You know, you got to remember that, like, your school nurse is not just taking care of your only, like. Like your child. Like, they're taking, like, we come from an elementary school that has maybe 500, 600 kids. And so she kind of, you know, pointed out, you know, there might be some kids that get tube feeds, there might be some kids with seizures, you know, like, different things that they're kind of, you know, keeping a tab on for children at the school.

[A]

Right.

[B]

And, you know, not. She was not minimizing, you know, the care of my type 1 diabetic child. She did a great job. But, you know, I asked her specifically, you know, how do you feel about monitoring, you know, blood sugars through the Dexcom follow? Because we had her. We gave her one of our, you know, iPads we weren't using anymore. And. And she was able to follow her blood sugars. I kind of asked her because, you know, now my daughter's out of that school. But I said, you know, what, what are your thoughts on that? You think it's a good thing? You think it's more harmful than good? Like what do you think? And she said, well I think it was very helpful like when she would test, you know, do like state testing that we could kind of see where her blood sugar was trending. We could give her a little, you know, glucose, you know, beforehand if she was dropping kind of low or trending low so that she wouldn't drop low during the test. So she did feel like it was useful. But know, of course she pointed out that, you know, I wasn't looking at that all day and I didn't think she was, I didn't expect her to look at that all day. I, I think I probably look at it more than she did. But you know, it was there as kind of a backup for her to, to see what was going on. And it, we, we worked well with her. Like we, she was very accommodating and we went into it not thinking that she was going to do everything for my child at school. And again my kid was, she was seven going on eight when she got diagnosed. But when we had this particular school nurse, she was gaining a little more independence where she went down to the school nurse to dose but it, or like to get treatment for lows but she was able to do a lot of it herself. So like the school nurse was there to assist more than anything. She wasn't giving doses. Obviously the school nurse wasn't.

[A]

So she found the iPad helpful in certain situations but wants to remind us all that, that you're not the only person I'm helping today.

[B]

Right. I mean, you know, she pointed out like she's in charge of like staff members that have like a medical issue or like kids that get hurt on the playground. You know, like they've got a lot of things that they do as a school nurse and that like they're not a one on one for sure, like medical. So and, and like I understand that like we, I don't think we ever expected her to be a one on one to our daughter.

[A]

But again, like why do you think when you asked her to share things, why do you think that's a thing she shared? Do you think you think it's how she felt?

[B]

I think sometimes there's pushback from parents like hey, you know, like you need to be catching this or that with my child. I, I Don't know that that's really realistic. Unless it's a very small school and the nurse is dedicated to. Yeah, I don't know. I guess. I guess I was some unrealistic expectations.

[A]

Yeah. Yeah.

[B]

I was sometimes from parents.

[A]

Yeah. Yeah. Yeah. I think what I was wondering was, like, wait, because if you asked me, like, what do you want people to know?

[B]

And.

[A]

And I. And my first thought was, you know, we can't be everywhere all at once. I would think that's how she felt. Like, I don't know if it. Even if people didn't put that on her, maybe she's just a good person who. Who felt bad that she couldn't help everybody possibly, you know.

[B]

Yeah, I. She kind of, you know, school nurses and, you know, as a pharmacist, you see all different kind of patients. And she said that we were kind of a unicorn family because I was quite involved. Like, you know, I. I checked in with her once in a while. I made sure there were snacks at the school. I made sure we had supplies. You know, I. I had good communication with her. So, like, I. She became one of, like, almost like one of the teachers at the school. We had that much, you know, contact with the school nurse. She said, like, it's not always like that. You know, sometimes there's people who. Who, like, their child doesn't have any snacks at the school, or like, they can't get them to the parents to bring supplies or just chasing them all the time. Yeah. So she's. You see all different kind of situations, and then, you know, there's kids that may not be getting that extra kind of thing that the extra things that they really need that the nurse can't really do on her own. So.

[A]

No. Anything else? What else was on our list?

[B]

What else did she say? The main thing was, like, she did say, you know, families should know that if you can't bring supplies or you can't bring snacks, like, say, financially, like, this is too much or, you know, for whatever reason, like, say you don't have extra supplies that you can give to the school. She said there's resources out there. I didn't specifically ask her what resources, but she said there's resources. So, like, we can remedy that situation. Just have to let us know. And I think from a nursing perspective, you know, she felt like, you know, in those situations, she can't really do her job if she doesn't have what she needs to take care of her child. So she. She said, you know, families need to let the nurse Know if that. If that's an issue so that we can remedy the situation rather than just either not communicating or, you know, not bringing the supplies.

[A]

Yeah. I wonder how hard people would find that to do, to admit to a stranger that you can't afford, you know, a couple bricks of juice boxes or something like that.

[B]

Yeah. Or even if it's just like you can't get extra from the insurance, like everything you have is at home for, you know.

[A]

Yeah.

[B]

You know, because you just. When you run out, you run out and you can't get extra or whatever. So.

[A]

Yeah. Where am I. How am I supposed to give you an extra cgm? I don't have an extra cgm.

[B]

Right, right, right.

[A]

Yeah, I got that.

[B]

So.

[A]

Awesome. Go, keep going. I'm not. You got a list here. I want to hear about your list.

[B]

Let me look at what else I had on there. So, okay. So kind of going along with school nursing, I had listened to your episode, which I think most, a lot of people have listened to that episode where that nurse gave too much insulin to that child at school. Yeah, yeah. And as a pharmacist, you know, working in a hospital, so, like, nurses are always required to have a double check on certain medications in the hospital. And I believe insulin is one of those medications. Like, if they're running an insulin drip, they have to get a double check on if they change the rate or, you know, is this the right rate to be running it at?

[A]

Right.

[B]

So I don't think this exists, but I feel like it should. Like, I feel like nurses in schools should definitely have a double check on things. You know, if they're going to be dosing a child's insulin, there should be a double check whether it's the parent or another trained individual in the school to double check based on, you know, their training and know, like, someone that knows this child and knows what they need and understands, you know, So I feel like there should be double checks always. And so if that doesn't exist in your school, like, you should. You should make that happen.

[A]

Whether it's double checking, I gotta point out that you just, in two different situations, pointed out that people don't have enough time to do the job they're already supposed to do. But here's some examples of where I think they should have to do more. It's not. I mean, I. I hear what you're saying, but, like, real world, that's not going to happen.

[B]

Yeah, well, I mean, like, so insulin, with it being a medication that, you know, it could have A serious adverse effect if dosed incorrectly. You know, that needs a double check. So why shouldn't a school nurse have a double check with that at school? If they have to do it in a hospital setting, I feel like that should happen at a school also.

[A]

Yeah.

[B]

So keep it.

[A]

Keep in mind, though, that in that, that scenario, that person didn't think they were doing. They didn't think they were changing anything. They just made it. They made a measurement mistake.

[B]

Right.

[A]

You know, but yeah, I hear. Listen, that to me falls under the category of, you know how things should be. Yeah, I know how they should. I know how they should be. But that's.

[B]

I guess the main thing I want to say is, like, parents should advocate for that at their school. Like, if you're. Your nurse is going to be dosing your child, make sure they have a double check. Especially if they were drawing up insulin. Now that's where it gets, like, more. A lot more high risk is if they're drawing up the insulin, because it's not as high risk if you've got the child wearing a pump and you put in the number. Right. But, like, if you're having to draw out insulin and get it to the right, you know, level on the syringe and make sure they're reading the syringe correctly, you know, that's. Well, that's higher risk than like. Like giving a dose on a pump, for example.

[A]

I hear you. I don't functionally know how to make that happen. Like, what am I going to do? Am I going to FaceTime you and show you the needle?

[B]

Right. No. I mean, but I think you could take a picture and send it to somebody, the parent, or you could have a double check by another staff member. I don't know. I just feel like it should happen.

[A]

You are definitely not an attorney, I'll tell you that much, because we brought an attorney to this conversation. They'd shoot this down six ways from Sunday. They'd be like, we're not doing that. That give your own kid insulin. Screw off. Listen, I'm not, you know, I'm not arguing with you. I think that's a very, like, lovely idea. And, and it would be awesome if it could happen, but it ain't gonna happen. So I can't get my township to pick up my recycling. You think that's gonna happen?

[B]

And I think it's more a situation where parents just have to advocate, you know, like, there's not going to be a rule that this happens. But if you advocate for that to happen, then and make sure that that's a hard, like, you know, this has to happen if you're gonna give my child insulin. Like, I think that's, I think that's appropriate.

[A]

Yeah. But I would also like to point out that it's one story in, you know, with a million kids getting five doses a day in, you know, all over the country, in the world. It was, it was, well, one time story of a thing.

[B]

It kind of makes you wonder too, though, like, how many kids are actually getting dosed with insulin syringes at schools anymore. I, I don't know. I don't have statistics on that.

[A]

I would think it's a lot more people are MDI than are on pumps.

[B]

Yeah, yeah, yeah. Pretty, pretty significant on a pen, but like a syringe.

[A]

Sure. Yeah. Or, or a pen, you know, which now you're twisting and turning and trust me, no, everybody's confused by everything. So, you know, like, you can try to make these pens as easy as you want. There's always going to be a person who's going to be confused by it.

[B]

I, I, there's a chance for error.

[A]

I'm stunned every day by how people are thwarted by their phone. You know, it's a, a thing they, a thing they carry with them constantly. What's the example from this weekend? Somebody tried to jump onto the Facebook page and say, hey, I don't know if any of you are using that, that bolus estimator on Scott's website, but you can like create a shortcut on, on your, on your phone, you know, to, so you don't have to go to the website every time. You can just click on it. Like, it almost acts like an app because it's a button. And then watching people go, I want to do that. I can't figure that out. I can't. Like, I'm watching that. I mean, you're saving a shortcut on your, on your phone. It ain't hard, okay? And I'm watching these people try to do it and I'm like, oh my gosh, guys, you have things in your pocket constantly. You really have never looked at it. Like, it's, but, but I'm with you. Okay? Like, so you know what, you know, when I hear somebody say every time a kid comes into a, a doctor's office and they have flu, like, symptoms, you should check their blood sugar. And I go, that would be nice. That's not going to happen. You know, and, and then somebody's like, well, I'm going to start a nationwide campaign to make this happen. I'll be like, well, you will be the 50th person to do that since I've been paying attention to diabetes in the last 20 years. And I once watched who was it? Was it beyond type 1? Beyond type 1. Tried hard and they had money and an infrastructure behind them. And do you notice that that didn't become a role?

[B]

Yeah, yeah, yeah. You can't. That's. That's gonna be a really difficult thing to change.

[A]

Good luck. Listen, I take a lot of comfort in this and this alone car. I don't know how the world's spinning. I don't understand why it's not on fire, why it hasn't exploded, why we're not all dead, but for some reason it is and we're not. So just go with it. You know what I mean?

[B]

Sounds good.

[A]

It's working. Mostly. Mostly. Not mostly. It's working enough. Okay.

[B]

Yeah.

[A]

Oh, anyway. What else you got there? I like your list. Keep going.

[B]

So since I work in a hospital, I wanted to talk a little bit about like dining management in the hospital. And again, like, you have to be an advocate for your child or for yourself if you have type one in and you're having a hospital stay. Like, you know, this probably already. But you know, I asked my coworker, like, I asked, I asked my coworker what would. She works in critical care. And she's. I said, you know, what would you want people to know? And she said, like, I walk into nurses rooms and I'll say, hey, is this patient using an insulin pump? And the nurse will be like, I don't know. And the nurse doesn't even know if, if this diabetic patient has an insulin pump. And so again, she said, and I believe, like, you have to advocate for yourself in the medical system and you have to communicate. So if you're going to use your insulin pump, you tell the nurse, you tell the doctor, you tell everyone who's in your, like, taking care of you that you use an insulin pump and make sure that everyone knows that. And then of course, like, I'm not saying like that nurse doesn't have responsibility to find that information out, but, you know, the reality is sometimes they just don't, you know, like they might ask or that might not get put onto your medication list on the chart, but it should be there. So, yeah, so that that kind of thing can happen.

[A]

Can I share my perspective there? Here's what I would tell you. I assume everybody's an idiot. Moreover, I would assume that nobody cares about me, the way I care about me or, or that cares about my kid. And by cares is the, is the wrong word, but it makes the right point. Right? Like, I just don't ex, I don't expect anyone to do a great job. And I don't think it's their fault. And I'm not here to blame them.

[B]

Them.

[A]

I just think that, you know, people are, people are limited by their intelligence, by their interest, by their amount of sleep, by their own health, by the relationships they have in their life. You don't know what they're going through. They still have to go to a job every day. You look at them and you think, that's a nurse. Well, it might be, yeah, okay, there's a nurse, but that nurse might be fighting with her husband. Her mom might have breast cancer. She might be three months behind on her car payment, and she's dragging her ass to that hospital and probably thinks, what am I doing this for? And you want that person to remember that you have an insulin pump or that, you know, it's just my assumption is, is that I'm responsible for me and mine always. And that, and that if someone else steps up and does a great job, that's a lovely bonus. But I don't think of that as an expectation. Yeah. And so no matter in what situation I'm in, from the lady ringing up my groceries yesterday. Okay. To the guy who changes a tire on my car, to the person that shows up at my house to, to fix a crack in my wall that I, he says he's a, a professional about, but turns out he's not. And, and everyone in between. My assumption is, is that nobody is doing their best. Their best wouldn't be great even if they were doing it. And I'm the only one between me and oblivion. So I don't know if that sounds terrible, but that's the baseline I run my life on.

[B]

Yeah, well, no, like, yeah, I, I, it's probably true to many, on many levels. And that's why patient advocacy, like advocating for yourself or advocating for your loved one is really important. You know, like, you can't expect that the doctor, the nurse, whoever, is going to be a super, superwoman superpower Superman, you know?

[A]

Yeah, no, I, yeah, 100 I, I almost don't. I understand. Advocate for yourself. You have to media. I mean, if you asked me, I'd say the same exact thing. I'm telling you that in the back of your mind, the way you should think of it is everything and everybody is trying to kill you and it's doesn't care about you. And if, and if you, if you want to succeed, flourish, etc, then you need to pay attention. And then, and, and if that, and if you're counting on somebody and things aren't going right, your next thought should be, I wonder if they even know what the hell they're talking about. I should check. Or is this a thing I don't have to check on? Because good enough is good enough. Like to me that's. And I don't even think of that as cynical. I don't even think of that as sad. I just think that that's, I think that's reasonable. And when you do bump into somebody who's above and who's doing a great job, I think of that as above and beyond. And I think I'm very lucky to have met that person. Like, I'm not mad at the bad one, I'm pleased that I met the good one. Does that make sense?

[B]

That's good optimistic way of looking at it.

[A]

It's an optimistic way of looking at the sheer horror of the effort people put into their lives.

[B]

I think like often in the hospital, hospital too. Like as a clinical pharmacist, you know, blood sugar management doctors have you in the hospital for more urgent matters, matters most of the time than your blood sugar. Unless you're in dka, you know, unless you came in for dka, your blood sugar management is not the number one priority of why you're in the hospital. And so it does kind of fall to the background sometimes. And because I have the background, I do, I, when I work in critical care and patients in the ICU or whatever, I'm always looking at blood sugar. Like I just, that's part of what I always think about. Yeah, but not everyone is always thinking about blood sugar. And so again, like if you have a loved one in the hospital and you don't know what their blood sugars have been like, you can ask and you can find out. And if they're not to your acceptable level, then you can advocate again, like, hey, like can. It is something that kind of. Unfortunately it falls to the background and especially with type one, but even type two, like providers are not in the hospital setting. They're trained to like treat your more emergent problems. And blood Sugars in the 200s are not making you. Well, I don't want to say they're not making you sick, but they're not making you hospitalized.

[A]

It's just, yeah, they're, they're focused on the thing Trying to kill you most aggressively.

[B]

Right. To get you, get you better so you can get out of the hospital.

[A]

But here's the opposite side of that. You're not going to get out of the hospital as fast with a 200 blood sugar.

[B]

Exactly. Yeah. So it's very important thing to have your blood sugars well controlled when you're hospitalized because you're going to heal faster, you know, everything's going to be better. But unfortunately it does fall a little bit on the back burner from what I've seen. And so I try to really make sure that it does not in my care. You know, when I'm caring for someone, I make sure, you know, do we have this patient on a long acting insulin and mealtime insulin if they're insulin dependent, you know. And you'll see sometimes where even type ones like they don't get on the right regimen, you know, like sure. So you just have to, again, if you know how to take care of your diabetes, you need to make sure the doctors know and they are taking care of your diabetes.

[A]

Because people can't keep that many thoughts straight in their head. Said I, I don't know if there's a, like a, a scientifically understood number of those things, but I mean if you stop, if you stop and think about what you just said and you step back and you examine it, it's ridiculous to think that a hospital and a doctor and a, and a, you know, a battery of nurses can't sing, can't, I don't know, fix your broken arm and keep your blood sugar in range. Doesn't seem like that big of a lift, you know what I mean? But, but, but it is. So get past that part because that shit's not happening. Okay? Like no, that, that's not going. I just explained to you how the world works. Just keep that in mind and then, and then keep. That's not happening. Okay? So you can cry about it if you want or say there should be a rule or they should do better, blah, blah, blah, blah, blah, blah, blah. Ain't happening. It's on, it's on you. And the problem is, is you're also probably not able to keep that many things in your head at the same time. What am I saying is, is you want the machines to come and take care of us, okay? They, the only thing, the only thing that's going to be able to keep all those balls up in the air is a, is, is a non human mind. Like it just doesn't. People just don't have that much access to bandwidth to handle those things. You're also not their only patient. So you know, you've got a nurse who's helping a floor full of people and they all have problems like you, how there's not enough time or compute power in that person's brain to handle all that. So.

[B]

Right. And I don't want to like minimize, you know, healthcare providers responsibility because I do feel like it's the responsibility of the healthcare provider to take care of the whole patient while they're in the hospital. But the reality is, is that some things become more urgent than others and they, the blood sugars often get put on the back burner and so. And some people maybe are okay with that. Like if my blood sugars are in the 200 when I'm in the hospital, whatever. But I wouldn't be okay with that. Like I would want them in control.

[A]

So I agree with you. I 100 agree with you. I really. Now you're making me think. I want to do a whole series of trying to find out how many active things that a person can keep in their head. I actually just asked our overlords and it said a useful answer is about 3 to 5 hours active chunks. But usually only one thing is in sharp center of consciousness at a time.

[B]

Wow.

[A]

So active thought in a spotlight. So your active thought is in a spotlight around three to five things you can keep in working memory. Ideas, concerns you can keep accessible without writing them down. And these are just basic concepts around life. Like I have to call the doctor, I have to finish editing something, I got to pay a bill. Like something like that. Right. So imagine that, imagine that that's the, the capability of the nurse and the nurse is helping 20 people. And then say well that makes me.

[B]

Sorry, that makes me think a lot about. So this morning I was looking at my kids like screen usage time, you know, when you look at their controls, like parental controls. And my type 1 diabetic daughter had, I think it was like three to four times of the number of times she had picked up her phone compared to my other children with devices. And the things she was on was her Dexcom app, her Omnipod app, you know, like.

[A]

Yeah.

[B]

And so like, you know, she's, she's having to think about that which my other kids don't, you know, that's on her mind constantly.

[A]

Sure.

[B]

So like it opened up my eyes to just how often she's having to think about this. You know, I think about it all the time and I don't like Think twice. But, but you know, she's only 14.

[A]

Well, that's by the way, way to pivot to a more positive part of this conversation. Good job by the way. But, but seriously, what a great point. You know, like, like your kid, you somebody. So, so if you're the parent of a kid with type one, you're, you're worried about low blood sugars, high blood sugars and long term health, you're probably thinking about it all the time. That's eaten up most of your focus and, and now you need other things to get in there. Like you know, sleeping or doing a sit up or eating better for yourself or cleaning the kitchen or the, any number of a billion other things you have to do.

[B]

Learning at school.

[A]

Yeah, exactly. Like, and then try to like, I mean, for yourself. I, you know, I, I would say keep that in mind. Offer yourself grace on the things that you're not getting to know. But don't forget that for the people in your life either, you know, your type one, if it's a child, you know, a spouse that has type one, you gotta really realize that this isn't easy. You know what I mean? Like we have like, like, like T shirt slogan ways of talking about like life's hard, like that kind of stuff. But this is what you're really talking about is you're asking somebody to do more than they have the physical capacity to do and then you're mad at them when they don't do a thing you wanted them to do or that you think should be important or whatever. Now I'm just directly talking to my wife in case people are wondering.

[B]

It kind of leads me. So like another thing I had on my list was, you know, because I'm in the healthcare field, I'm definitely like pro healthcare professional in, you know, managing type 1 diabetes. And I know like some people, people don't have good experiences with their provider or their doctor unfortunately. But I like to see our doctor as more than just, you know, the person that prescribes the insulin. You know, our doctors helped us with a list of therapists in the area who are familiar with treating type one patients or counseling type one patients. They've you know, obviously had, have a nurse educator there or a diabetes educator. We've talked to the Omnipod rep through our doctor's office, which was helpful. What else? Oh, like the MA that checked in, my daughter last time has diabetes herself and she was a runner and my daughter's a runner. So we started talking about, well, how do you manage at this, you know, this certain situation with running, you know, how do you prevent your blood sugar from going low? And she was helpful, you know, she gave us some real world experience of someone living with diabetes. So I, I like to see our doctor as someone that can help, help you with all of those little tricky things that, like, that you deal with with diabetes more than just like getting your insulin prescribed, getting your A1C checked, you know, ordering the labs or whatever.

[A]

So a part of your community, really?

[B]

What's that?

[A]

The doctor's a part of your community?

[B]

Yes. Yeah. And hopefully like everyone has that, you know, like, I guess if you don't have a provider that you feel like can provide those kind of extra helps to you, then maybe it's time to find a different doctor. But it's out there, you know, like the diabetes educators, they're out, out there. The people living with diabetes, they're working in the healthcare field are out there.

[A]

Oh, the good ones are workers, the

[B]

counselors, they're out there. She just have to find those that are going to help you with.

[A]

So good luck finding one of those people. I'm sure with all the free brain space that we just talked about that you have, you'll be out there looking for a new doctor and finding the right one in no time. Or, or being, being super serious, you're on your own, surround yourself with people that can be like, I think that's why community is so, so important. Yeah.

[B]

Even if it happens, social media can be so helpful too, because so many people can give you tips on, hey, you know, try out this, or I, I tried this, or this person was helpful, you know, like cuts through the noise. Connected in a way that we have never been connected before. So you don't have to live in a community with like a great endocrinologist that's connected to all the things. You really can be served well by the Internet and social media and support, support groups and that sort of thing.

[A]

So I try to think of it as a faster path to an actionable thing. Like. Right. Like instead of me, imagine, imagine you, you sat up today and you listen, you go, this is, I, this is right. I need, I need that kind of support in my life, but my doctor doesn't offer that. Well, now I have to find the time to find a doctor and then I'm gonna have to make an appointment, go meet them and what if they're not the right one? I might have to do this over and over and over again and then eventually I'll find the right right. Dr. Then I'll build a relationship with them and then, you know, in just two or three short years, I'll be able to ask my question and then, oh, oh, oh, they didn't know the answer. That's okay. Like, or they did, like, and instead you go to a, you go to listen, I'm just going to tell you my Facebook group's awesome. Like, you go to my Facebook group and say out loud to 85,000 people, I have a question and you're going to have an answer 24, 7 at some point that will at least be actionable for you or a reasonable place to begin the rest of your journey. Instead of, yeah, it just, it, listen, it is pretty obvious what the Internet does, but instead of it being one person, and this is a coin flip as to whether or not it's even going to be the right direction for me to go, you just open yourself up to tens of thousands of people and then get back 10, 20 responses and go, okay, in here must be the answer. You know, I think that's just, it's invaluable. And if you don't know that and you're listening to this, please try to, you know, open yourself up to that idea. Yeah, yeah. I think it's really, really helpful.

[B]

So in my practice, I also realize there are so many people, Scott, living with type 1 diabetes that are not connected to all of this stuff. Most of them that they really aren't. Yeah, there's so many people that, that are living out there with A1C's and the 11 and you know, they've had diabetes for a long time and yeah. Just not, it's not being managed. And that's like, how do we reach, how do we reach those people? I don't know. I guess that's like good luck.

[A]

I haven't figured it out yet.

[B]

Like, I, yeah, I've learned how to reach people.

[A]

Yeah, I've learned how to reach people who have a, an I, iPhone and free time and, and are motivated to learn more and otherwise. If you're trying to figure out how to go grab another person, it happens randomly and you know, every time you help somebody, it feels great, but it's not an in mass idea. Like you can't in mass grab those people and say, hey, I've got the answer for you. It's right here. Like, you know, it just, it. Those people are busy with their own pro problems too. And, and very likely they don't have the kinds of jobs or lives that lend themselves to having free Time, extra energy, once they have free time, even maybe the knowledge or desire to ask the right questions to get them moving in the right direction. Like, it's, It's a. Not. It's not. I don't think it's fixable. Like, I think you can put the information out there and do your best to get it in front of people and then hope that they see it. But, I mean, honestly, if you really look at the people like, I'm helping people of a certain age, of a certain economic stature that, you know, thought to go out and help themselves already, I don't know how to find those other people. It's incredibly necessary. I just don't know how to do it.

[B]

Yeah, well, I guess that kind of gives me motivation as a healthcare professional because we do, you know, interact with, you know, all of the. All of the different types of people. And so I always try to just make a connection with people. You know, like, even if it's just like a, you know, a connection that has nothing to do with the diabetes, but, like, hey, I hear you. I see you. I. I am trying to show empathy toward you and your situation. You know, maybe that will help those people. I don't know, know.

[A]

Well, all you can do is your best and.

[B]

Yeah.

[A]

And then you just, you know, that's what you do. I mean, I don't. I. I speak in public a lot and I think, well, there's an example of me finding people who wouldn't find me otherwise. But to see the, the grand effort that has to go on through an organization to pull 1200 people into a room on a single day is. It's a massive lift. It takes them all year to accomplish that.

[B]

That.

[A]

And it's amazing for the 1200 people that show up, and that just leaves the other 2 million. So, you know, like, it really. It really is just. I. I don't know. Like, I really don't know because you're. You. You say, I want to count on the doctor, but here's where the doctor's limited. What, What I hear every time any of these things are brought up is I hear there's a limitation at some point, and it comes from being here, human. And so, you know, is the answer eventually that, you know, like, you. You're diagnosed and someone says to you, look, here it is. Like, it's. It's on your phone. Go push a button. It'll tell you. And. And still they're not going to push the button.

[B]

Yeah.

[A]

You know, some people, like, some people will. And that'll help more, but you're never going to get to everybody. And that's the thing, like, when you do what I do, like, I, I, that used to, that used to be burdensome to me. Like, I would have, like, real, real problem with that, like, feeling because I, I've developed a thing that I know helps people. And then the pressure to reach more people hits you very quickly, you know, and then once you can't, once you realize that there's a limitation to that, it feels like you're letting them down. And if you can't get past that, then you can't even do the good job you're doing for the people who are fine finding it.

[B]

Right.

[A]

So it's been, I've gone through this. That's why I probably sound cavalier about it. But now I'm trying to be funny. But like, I, people are like, yeah, keep trying. It ain't working. But, but like, I, I really, it's, it's not a fixable, it's not a fixable problem that there's an answer to and you just don't know, you know, and nobody's doing it. Like, there's, there's no answer, really.

[B]

Right. So I just have to accept that you're not going to be able to help everybody, but just do your best with it.

[A]

Yeah, exactly. Or interact with, with or, or skip over all that and say we should be focused more on automated insulin pumping that doesn't need your interaction.

[B]

Yeah.

[A]

You know, and then the, for the, and for the people who do want to put more time, who have more time or effort to be able to put into it, then give them other controls and dials to work with. But for the, but for the masses of people who you either can't reach or once you reach, don't understand or whatever, the problem ends up being in the middle.

[B]

Middle.

[A]

Imagine if you slap this thing on them and it gives them an A1C in the sevens.

[B]

Yeah.

[A]

Amazing. For sure, right? Yeah. That kind of thing. Anyway, keep going on your, on your list of things that I think I got to almost, you're like, I'm not saying anything. Other, more hopeful stuff.

[B]

Scott, there's one thing that just kind of like a funny thing that kind of came to my mind that I put on the list. I think it was one particular day just dealing with kind of like the tea type, one diabetic child in my, in my family. I thought, you know what? We should coin a new term called teen factor. Like there's correction factor. Why can't we Coin the term teen factor. Like what's, what's my teen factor?

[A]

I was gonna say what's that? What's that? Setting in control of the amount of like, sass or side eye. Is it. Can it turn side eye up and down? Is that what it's for?

[B]

Yes, exactly. Because, you know, I might know my correction factor or your correction factor, and I might know your basal rate, but, you know, like, your teen factor might be what's affecting everything today, and it's not anything else.

[A]

Mom, I know what I'm doing. Then why aren't you doing it?

[B]

So that's just a little bit of humor that I had to remember. Like, we're in a phase that, you know, we can't, we're probably not going to be perfect with our blood sugar management. We're. We're darn trying, but we're not there.

[A]

I, and, and really the patience part is what I can be. I can pivot quickly back to being serious if you need me to. I, that's where like the patience and time comes in. I think you just again, keep modeling the right thing. Try not to get upset. Understand, they're going through a lot too. They only have, you know, a certain amount of, of conscious space. They can hold thinking thoughts and they also want to go bowling or have a girlfriend or a boyfriend or are, are struggling in class or they have a lot of other stuff going on too. Right. And every day, every second can't be about this blood sugar thing.

[B]

Right.

[A]

And yet I know what happens when it's not right and, and why you're trying so hard. So listen, my best advice, get a cgm, get on an automated system. And at least when those moments come, when life gets in the way, such that you're not actually going to put the effort in that's necessary. Let the, let the system jump in and do that part.

[B]

Yeah.

[A]

You know, until you can be your better self or have more time or, or whatever it is we're waiting or, or grow up or, you know, until your teen factor goes down.

[B]

I hear that adulthood is very different. So. Yeah, I don't, I don't know. We'll see.

[A]

I don't know.

[B]

I also know adults, we're just dealing with this.

[A]

Yeah. No, I, again, it's all just going to be human. It's all just different variations of, of people's ability, inability, desire, non. Desire to do, think, say, feel something. And.

[B]

Yeah.

[A]

And while. All the while, while this concrete thing of your blood sugar is not varying along with you, it doesn't it doesn't. You know, people like to say it doesn't give you a break. Doesn't care if it's Christmas morning. It doesn't care if you're fighting with your spouse. It doesn't care if you're sick or it's going to keep doing the thing it's going to do. And, you know, so maybe getting through a life with diabetes without making yourself crazy is more about allocating time and resources, both mental and physical. I don't know. You know, by mistake, I might have said some pretty thoughtful things in this episode.

[B]

Well, I think we're in a phase right now where, yeah, we're kind of like, just okay to keep what we're doing. We've hesitated to move to a different pumping system because we just don't know if we have the bandwidth to learn something new right at this moment. But we're hoping for. I don't know, we're sticking with what we have right now because I feel like we haven't quite optimized it. I don't know. I guess maybe. I don't know if that's.

[A]

What are you using right now? Using now?

[B]

Omnipod and Dexcom 7. Omnipod 5 and Dexcom 7. We've thought about doing looping with Omnipod Dash. That is a little overwhelming to me. I think we could do it if we just dedicated the time to the learning curve, you know, learning. Learning it. We're hoping my daughter had been on the tandem t slim x2, which is when we had the better A1Cs. I don't know if it was necessarily because of that pump. We had more lows with that pump, but.

[A]

Well, I can tell you this, Omnipod 5.

[B]

I want to go back.

[A]

Yeah. Omnipod 5 is in, like, late stages of an upgrade to the algorithm that's coming, so.

[B]

Right. I think that's what we're kind of

[A]

waiting for this summer. Right. There'll be a lower target, some other adjustments to the algorithm. I think they're already working on Omnipod 6. You know, any of these companies should actively, aggressively be trying to make their algorithms work better.

[B]

Right?

[A]

Yeah.

[B]

You know, and that's kind of what we're. We're kind of sticking with it because of that, I think. You know, otherwise, I think we would have maybe gone back to tandem. But my daughter being a runner, I think it's a lot easier for her to not have tubing. Just being. Since she became an athlete, she. The tubing is the thing that kind of Keeps her from going back. But, you know, we haven't never tried the Moby. But, But I don't know that we would.

[A]

I'm gonna say something that I'm sure every company who buys an ad from me will not be happy. I'm saying, but, like, if the thing you're using has an A thing about it that's valuable for you, then that's what's best for you. Right. You know what I mean?

[B]

That's kind of been for my daughter. I've let her choose because that is valuable. The fact that it's just on you and it's. There's no disconnecting involved and.

[A]

Yeah, a million percent. Like, I, I mean, listen, I think Tandem makes a great point pump. I think Medtronic does. I think that Twist pump is very interesting and doing a very good job. I love Omnipod. I like them all. I think there's the DIYs, we've used loop, we've used Trio. I know people doing great on Android aps. Like, there. What's working for you is what's best.

[B]

Yeah.

[A]

And that's, and that's a bigger thing than just, what is my A1C. Like, it's got to be. It's a, it's a, I think it's a holistic thing. What, what, what works best for us. Right. Like, I've talked to people who are like, I don't care about tubing. It means nothing to me. I honestly think that if I put a tube pump on Arden, she might throw it across the room in five minutes. I think it would, I, I think she would hate it. And, but she's used to an Omnipod. Right? Like, like, so, like, and, and I think if I would have put her on a tube pump when she was four years old, I don't think she'd think twice about it. So, like, just whatever's working for you, and keep in mind that working means more than one thing is the right thing for you. And if it's not working for you, then switch. But no matter what you switch to, always use one of my links. That's really what's important, Kari. That's, that's the important part. If you're going to switch to Medtronic, to Tandem, to twist the Omnipod, you should be using my link to do it.

[B]

Okay. Your advertising's working. I think I learned more about Omnipod through listening to the podcast than anywhere else.

[A]

Yeah, yeah. I, I, I'm, I'm joking. I'm not Joking. But I'll tell you this. If you are looking for a person who's going to be willing and able to have an hour and 15 minute long conversation like the one you and I had today, then Scotty got to sell ads, okay? Because like, that's, that's how this works. There's no one else out there.

[B]

No, I mean, it's education too. Like, it's not just advertising. It's education. I didn't really know much about Omnipod until we started listening to podcasts regularly.

[A]

So. Yeah, you hear that insulet, huh?

[B]

All right.

[A]

By the way, when I say that, I'm actually talking to a certain person who I know is listening and I'm laughing because she's so lovely and I'm just. And now I, now I, I'm thinking about her making it like that. She's so embarrassed right now for no reason. But like. No, yeah. I mean, listen, and being big, super serious and, and talking like people like, this is what. I'm going to shut it off. But I'm talking about myself for half a second. I'm doing a thing no one else is doing. Like, like it's, and it's, it's supported by ads. Like, it just, it is. So, you know, we. I'm glad you like it. I see people all the time talk about how great it is. You don't subscribe to this. Follow me on social media, click on those ads once in a while and, and, and listen to some. A podcast. Guess this, this doesn't exist anymore. Like, that's what keeps this all alive, this social media. These, these different platforms are so, so different than they were when I started doing this. When I started doing this, it was enough to just do a good thing and put a good thing out into the world and it spread. And now whether it's Facebook or Apple podcasts or any of the other podcast companies or YouTube or whatever it is, is, is they, they don't care about you. They don't care about me, they don't care about our diabetes chatting. They care about users in their ecosystem. And, and what I am to them is a person who drags somebody into their ecosystem once I get you there, they don't care if you're helped or not. They care if you're served ads. And I know this sounds crazy because I just said you have to click on the ads. I mean my ads, not their ads. And like, and so it's a really. This is how it works now. And if you're going to exist and succeed inside of this. You have to find a way to bring people good conversations, quality information, and do it within the rules of the game. And where I fall short is that I refuse to do it through clickbait. And no one else seems adverse to that. So I am not going to go out there and hit you constantly with like, oh, there's something new. Better. It's coming better. Is coming better. We're gonna cure it. This is. I'm not gonna click bait you into this. I'm gonna have a conversation with Kari. We're gonna. This is what we talked about. I'm gonna say in the, in the description, it's gonna say, Kari has a 14 year old daughter, has type 1 diabetes. And we talked about this, this and this. I can't explain to you all what's good in there. And you might look at that and think that's boring. But trust me, this conversation be valuable if you have type 1 diabetes. What I won't do is every day post some new thing about like, oh, my God, there's a new CGM coming. No, there's not. There's not a new CGM coming. It's not. It's a company who started a thing. It's four guys in a room, they raised a half a million dollars. They're never going to bring it to market. Like, stop acting like that's actually gonna happen. Okay? Like, you know, stop. What do they call it? It's clickbait. It's all just clickbait. I love what that doctor's doing in Chicago, but if you're out there pushing the cures here, the cures here is over. No, it's not. Like, like, and, and that. I think that's disingenuous and I think it's a sign of what social media has pushed people to try to do.

[B]

And there are, I think, you know, listening to your podcast, you know, it provides a little bit of support. It's like you're kind of eavesdropping on someone's type 1 diabetes conversation.

[A]

Yeah, for sure.

[B]

But, you know, like, you're, you feel supported and, but then also, like, I, I loved hearing like that doctor that you had on that's doing the. Oh, the name is escaping me. The trial where they're doing the islet cell Eladon trial.

[A]

Like,

[B]

he was fantastic and very, like, I think it was good for people to hear, like, hey, like, this isn't going to be tomorrow. You know, like, yeah, this is, this takes a lot of time and a lot of money and it takes a lot of effort, and it's not tomorrow. Well, I love listening to your conversations with all the different types of people you have on. Thank you. I just feel like you're. Yeah, it's a good. It's educational, it's supportive. It's. It helps us stay positive about all this. Right. At least for me.

[A]

No, I appreciate that very much. And I'm. I'm sensitive because I already had a conversation earlier today with somebody else in the space where they said, jesus, this space is overrun with influencers all of a sudden. And. And. And I said, really? You think there's that many people with influence? And he goes, they don't actually have influence. He goes, and they want to be influencers. She's like, they're everywhere right now. And I. I was like, yeah. And I answered very simply. I said, I was here before them. I'll be here when they're gone. Like, we're just going to keep doing this very sensible way of talking about things with some reality and. And. And it's not going to be flashy, and it's not clickbaity, but it's consistent and it's valuable, and I'm going to keep doing that. Like, I am not going to turn into a person who's just like, they cured it. Like, no, they didn't. Like, there's 12 people who aren't taking insulin right now. There's 2 million of you that have type 1 diabetes. It's not cured. Okay? And. And by the way, I had the doctor on and he said the same damn thing. So, you know. Yeah. Stop. Stop. Stop trying to bait me into clicking on your stupid Instagram reel. You're so sad. All you just. I'm sorry. That's as close as I've come to being shitty to people, but just stop already, okay? Go get a job. Job. For Christ's sake. You're not a creator. I am. And I would never call myself one. It's because it's douchey. Okay, there, Jesus, have some self respect. Get a job. I'm sorry. I know this is what I do for a living already, but I'm already doing it. Like. Like, how many somebody. How many. How many openings do you think there are for this? Like, Jesus, seriously, what happened to people, Kari? Why won't they just get a job? Why do they. You're just being polite now. But you know what I'm talking about, right?

[B]

I guess.

[A]

You guess? You're so nice. Stop it. Stop being so. Although, let me give you a lot of Credit before we hang up. I thought you did a really good job of making your points about the healthcare system, letting me push back on the other side of it and not getting offended or. I was really impressed by that because I've tried.

[B]

Oh, no, I'm not easily offended. So. Yeah, well.

[A]

Well, yeah. You have four kids. I don't know. You got to be tough. You know what I mean? And what are you, one of six kids?

[B]

What I've wanted?

[A]

No, are you one of six kids? You are, right? You said your mom had six.

[B]

Yeah. Yes. Yep. I'm the youngest of six.

[A]

Oh, hell. You're feral. Probably.

[B]

I'm a pretty strong willed, independent kind of person.

[A]

I was gonna say they were probably done being parents by the time they got to you. They were like, that one will be okay. Don't worry about it. Well, I really do good parents. Oh, no, I'm sure. I. I really do appreciate your time and if you hold on for one second, I'll tell you a couple things after we go, but.

[B]

Okay, thank you.

[A]

Thank you so much. Hold on one second for me. To learn more and see if you might be able to get to get Twist from the pharmacy and try it for free. Head to visit.twist.com Juicebox that's visit.twist.com JuiceBox or give them a call at 1-877-4-TWIST that's 1-877-489-4478 and tell them Scott sent you. Twist requires a prescription and is indicated for people with type 1 diabetes, 6 and older. Arden has been getting her diabetes supplies from U.S. med for years. You can as well usmed.com juicebox or call 888-721-1514. Many thanks to U.S. med for sponsoring this episode and for being and for being longtime sponsors of the Juice Box podcast. There are links in the show notes and [e-mail] to US Medicine, Twist, and today's other awesome sponsor, the Eversense CGM. They make, of course, the Eversense 365. And that thing lasts an entire year. One insertion every year. Come on. You probably feel like I'm messing with you, But I'm not. Eversensecgm.com Juicebox Check it out. T1D exchange.org Juicebox why aren't you typing? T1D xchange.com. juiceboxTokenSurvey be done. Want to take another survey? Juiceboxpodcast.com Survey hey, take surveys. What are you. You busy or something? I can see in your house. I know you're not doing anything I can't really see in your house. Sometimes people think that's true. It's not true, but please take the surveys one way or the other. Thank.

[B]

You. Foreign.

[A]

Let's face it, diabetes is tough, but it's easier when you have a community around you. So if you're looking for a great community around type 1 diabetes, check out the Juice Box Podcast. Private Facebook group Juice box podcast, type 1 diabetes but everyone's 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 the Juice Box Podcast. Private Facebook group Juice box podcast type 1 diabetes on Facebook. I promise you it is the most un Facebook like experience that you'll ever, ever find. What a great group of people. I don't like saying this usually because it dates the ad, but right now there are 86,000 active members, 86,000 people in there who might have your experience, know what to say or just be a great shoulder to lean on. Don't be too proud to find a community. It really does help and it's completely free. Juice box podcast, type 1 diabetes on Facebook I just want to say thank you so much for listening. I'll be back very soon with another episode of the Juice Box Podcast. If you're not subscribed, please subscribe in a podcast app. It really helps Apple Podcasts, Spotify or, or whatever your favorite audio app is like and subscribe. You know what the kids say on the YouTube like and subscribe. It really does help. And if you're already subscribed, please tell a friend or your endo or somebody you think might enjoy the podcast as well. Word of mouth is the only way that it grows. Once again, I've been. Scott, you've been fantastic. And we'll be right back with another episode of the Juice Box Podcast.