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MoneyBall Medicine
What Exponential Change Really Means in Healthcare, with Azeem Azhar

MoneyBall Medicine

Play Episode Listen Later Jan 18, 2022 57:25


As we say here on The Harry Glorikian Show, technology is changing everything about healthcare works—and the reason we keep talking about it month after month is that the changes are coming much faster than they ever did in the past. Each leap in innovation enables an even bigger leap just one step down the road. Another way of saying this is that technological change today feels exponential. And there's nobody who can explain exponential change better than today's guest, Azeem Azhar.Azeem produces a widely followed newsletter about technology called Exponential View. And last year he published a book called The Exponential Age: How Accelerating Technology is Transforming Business, Politics, and Society. He has spent his whole career as an entrepreneur, investor, and writer trying to help people understand what's driving the acceleration of technology — and how we can get better at adapting to it. Azeem argues that most of our social, business, and political institutions evolved for a period of much slower change—so we need to think about how to adapt these institutions to be more nimble. If we do that right, then maybe we can apply the enormous potential of all these new technologies, from computing to genomics, in ways that improve life for everyone.Please rate and review The Harry Glorikian Show on Apple Podcasts! Here's how to do that from an iPhone, iPad, or iPod touch:1. Open the Podcasts app on your iPhone, iPad, or Mac. 2. Navigate to The Harry Glorikian Show podcast. You can find it by searching for it or selecting it from your library. Just note that you'll have to go to the series page which shows all the episodes, not just the page for a single episode.3. Scroll down to find the subhead titled "Ratings & Reviews."4. Under one of the highlighted reviews, select "Write a Review."5. Next, select a star rating at the top — you have the option of choosing between one and five stars. 6. Using the text box at the top, write a title for your review. Then, in the lower text box, write your review. Your review can be up to 300 words long.7. Once you've finished, select "Send" or "Save" in the top-right corner. 8. If you've never left a podcast review before, enter a nickname. Your nickname will be displayed next to any reviews you leave from here on out. 9. After selecting a nickname, tap OK. Your review may not be immediately visible.That's it! Thanks so much.Full TranscriptHarry Glorikian: Hello. I'm Harry Glorikian. Welcome to The Harry Glorikian Show, the interview podcast that explores how technology is changing everything we know about healthcare.Artificial intelligence. Big data. Predictive analytics. In fields like these, breakthroughs are happening way faster than most people realize. If you want to be proactive about your own health and the health of your loved ones, you'll need to learn everything you can about how medicine is changing and how you can take advantage of all the new options.Explaining this approaching world is the mission of my new book, The Future You. And it's also our theme here on the show, where we bring you conversations with the innovators, caregivers, and patient advocates who are transforming the healthcare system and working to push it in positive directions.So, when you step back and think about it, why is it that people like me write books or make podcasts about technology and healthcare?Well, like I just said, it's because tech is changing everything about healthcare works—and the changes are coming much faster than they ever did in the past.In fact, the change feels like it's accelerating. Each leap in innovation enables an even bigger leap just one step down the road.Another way of saying this is that technological change today feels exponential.And there's nobody who can explain exponential change better than today's guest, Azeem Azhar.Azeem produces a widely followed newsletter about technology called Exponential View.And last year he published a book called The Exponential Age: How Accelerating Technology is Transforming Business, Politics, and Society.He has spent his whole career as an entrepreneur, investor, and writer trying to help people understand what's driving the acceleration of technology — and how we can get better at adapting to it.Azeem argues that most of our social, business, and political institutions evolved for a period of much slower change. So we need to think about how to adapt these institutions to be more nimble.If we do that right, then maybe we can apply the enormous potential of all these new technologies, from computing to genomics, in ways that improve life for everyone.Azeem and I focus on different corners of the innovation world. But our ideas about things like the power of data are very much in sync. So this was a really fun conversation. Here's Azeem Azhar.Harry Glorikian: Azeem, welcome to the show.Azeem Azhar: Harry, what a pleasure to be here.Harry Glorikian: I definitely want to give you a chance to sort of talk about your work and your background, so we really get a sense of who you are. But I'd first like to ask a couple of, you know, big picture questions to set the stage for everybody who's listening. You like this, your word and you use it, "exponential," in your branding and almost everything you're doing across your platform, which is what we're going to talk about. But just for people who don't, aren't maybe familiar with that word exponential. What does that word mean to you? Why do you think that that's the right word, word to explain how technology and markets are evolving today?Azeem Azhar: Such a great question. I love the way you started with the easy questions. I'm just kidding because it's it's hard. It's hard to summarize short, but in a brief brief statement. So, you know, exponential is this idea that comes out of math. It is the idea that something grows by a fixed proportion in any given time period. An interest-bearing savings account, 3 percent growth or in the old days, we'd get 3 percent per annum, three percent compounded. And compound interest is really powerful. It's what your mom and your dad told you. Start saving early so that when you're a bit older, you'll have a huge nest egg, and it never made sense to us. And the idea behind an exponential is that these are processes which, you know, grow by that certain fixed percentage every year. And so the amount they grow grows every time. It's not like going from the age of 12 to 13 to 14 to 15 were actually proportionately—you get less older every year because when you go from 15 to 16, you get older by one fifteenth of your previous age. And when you go from 50 to fifty one, it's by one 50th, which is a smaller proportion. Someone who is growing in age exponentially would be growing by, say, 10 percent every year. So you go from 10 to 11 and that's by one year. From 20, you go to 22, two years. From 30 to 33. So that's the idea of an exponential process. It's kind of compound interest. But why I use the phrase today to describe what's going on in the economy and in the technologies that drive the economy, is that many of the key technologies that we currently rely on and will rely on as they replace old industrial processes are improving at exponential rates on a price-performance basis.Azeem Azhar: That means that every year you get more of them for less, or every year what you got for the the same dollar you get much more. And I specifically use a threshold, and that threshold is to say essentially it's an exponential technology if it's improving by double digits, 10 percent or more every year on a compounding basis for decades. And many of the technologies that I look at increased by improve by 30, 40, 50, 60 percent or more every year, which is pretty remarkable. The reverse of that, of course, is deflation, right? These capabilities are getting much cheaper. And I think the reason that's important and the reason it describes the heartbeat of our economies is that we're at a point in development of, you know, sort of economic and technological development where these improvements can be felt. They're viscerally felt across a business cycle. Across a few years, in fact. And that isn't something that we have reliably and regularly seen in any previous point in history. The idea that this pace of change can be as fast as it as it is. And on the cover of my book The Exponential Age, which I'm holding up to you, Harry. The thing about the curve is is that it starts off really flat and a little bit boring, and you would trade that curve for a nice, straight, sharp line at 45 degrees. And then there's an inflection point when it goes suddenly goes kind of crazy and out of control. And my argument is that we are now past that inflection point and we are in that that sort of vertical moment and we're going to have to contend with it.Harry Glorikian: Yeah, I mean, we are mentally aligned. And I try to talk to people about this. I mean, when we were doing the genome project that Applied Biosystems, you know, when we had finished, I think it was 2 percent or 4 percent of the genome, everybody's like, Oh, you have like ninety something [to go], and they couldn't see the exponential curve. And then we were done like five years later. And so it's it's this inability of the human mind. You know, it's really not designed to do that, but we're not designed to see exponential shift. We're sort of looking around that corner from an evolutionary perspective to see what's happening. But, you know? Exponential growth is not a new concept, if you think about, you know, really, I think the person that brought it to the forefront was Gordon Moore, right? With, you know, how semiconductor chips were going to keep doubling every two years and cost was going to stay flat. And you know, how do you see it playing out? Today, what is so different right now, or say, in the past two, three, four, five years. What you can see going forward that. May not have been as obvious 10 or 15 years ago.Azeem Azhar: I mean, it is an idea that's been around with us for a long time. You know, arguably Thomas Malthus, the British scholar in the 18th century who worried about the exponential growth of the population destroying the land's carrying capacity and ability to produce crops. And of course, we have the sort of ancient Persian and Hindu stories about the vizier and the chessboard, who, you know, puts a grain of rice and doubles on each square and doubles at each time. So it's an idea that's been around for a while. The thing that I think has happened is that it's back to its back to that point, the kink, the inflection in the curve. The point at which in the story of the chess, the king gets so angry with his vizier that he chops off his head. The point with the semiconductors, where the chips get so powerful and so cheap that computing is everything, and then every way in which we live our lives is mediated through these devices. And that wasn't always the way. I mean, you and I, Harry, are men of a certain age, and we remember posting letters and receiving mail through the letterbox in the morning. And there was then, some 15 years later, there were, or 20 years later, there was a fax, right? I mean, that's what it looked like.Azeem Azhar: And the thing that's different now from the time of Gordon Moore is that that what he predicted and sort of saw out as his clock speed, turns out to be a process that occurs in many, many different technology fields, not just in computing. And the one that you talked about as well, genome sequencing. And in other areas like renewable energy. And so it becomes a little bit like...the clock speed of this modern economy. But the second thing that is really important is to ask that question: Where is the bend in the curve? And the math purists amongst your listeners will know that an exponential curve has no bend. It depends on where you zoom in. Whatever however you zoom, when you're really close up, you're really far away. You'll always see a band and it will always be in a different place. But the bend that we see today is the moment where we feel there is a new world now. Not an old world. There are things that generally behave differently, that what happens to these things that are connected to exponential processes are not kind of geeks and computer enthusiasts are in Silicon Valley building. They're happening all over the world. And for me, that turning point happens some point between 2011, 2012 and 2015, 2016. Because in 2009, America's largest companies wereAzeem Azhar: not in this order, Exxon, Phillips, Wal-Mart, Conoco... Sorry, Exxon Mobil, Wal-Mart, ConocoPhillips, Chevron, General Motors, General Electric, Ford, AT&T, Valero. What do all of them have in common? They are all old companies are all built on three technologies that emerged in the late 19th century. The car or the internal combustion engine, the telephone and electricity. And with the exception of Wal-Mart, every one of those big companies was founded between about 1870 and sort of 1915. And Wal-Mart is dependent on the car because you needed suburbs and you needed large cars with big trunks to haul away 40 rolls of toilet paper. So, so and that was a century long shift. And then if you look out four years after 2009, America's largest firms, in fact, the world's largest firms are all Exponential Age firms like the Tencent and the Facebooks of this world. But it's not just that at that period of time. That's the moment where solar power became for generating electricity became cheaper than generating electricity from oil or gas in in most of the world. It's the point at which the price to sequence the human genome, which you know is so much better than I do, diminished below $1000 per sequence. So all these things came together and they presented a new way of doing things, which I call the Exponential Age.Harry Glorikian: Yeah, in my last book. I, you know, I do state that the difference between evolution and revolution is time, right? If you wait long enough, things happen evolutionarily, but at the speed that things are changing, it feels revolutionary and in how it's affecting everybody. So let's rewind and talk about your background. You've been active as a business columnist, as a journalist, a startup founder, a CEO, a leader of corporate innovation, incubators at Reuters and a venture capital partner. Lately you've built what eems like a very busy career around books and talks and podcasts and all around this theme of accelerating technologies, I'd love to hear how you how you first got interested in all these themes about technological change. You know, how society can manage this change? I know you were in Oxford. You got your master's degree in the famous PPE program. The politics, philosophy and economics. You know, was it soon after that that you went down this road? Or is Oxford where it all started?Azeem Azhar: It started well before then in, in a weird way. So, so you know, my interest really is between sits between technology and an economic institutions and society. And I, I was born, like most of us are, to two parents, and my parents were working in in Zambia in the early 70s, and my dad was working on helping this newly independent country develop economic institutions. It didn't have them and it needed them to go through that sort of good institutions, make for healthy economies, make for social welfare and sort of civil politics. That's the argument. So he was out there doing all of that. And I was born the year after Intel released its 4004 chip, which is widely regarded as the sort of the chip that kicked off the personal computing revolution. And so, so in the backdrop of people talking about development and development economics and being curious about my own personal story, I was exposed to these ideas. I mean, you don't understand them when you're eight or 10 and you know, but you're exposed to them and you have an affiliation to them and so on. And at the same time, computers were entering into the popular consciousness.Azeem Azhar: You know, you had C-3PO, the robot and computers in Star Trek, and I saw a computer in 1979 and I had one from 1981. And so my interest in these things, these two tracks was start set off quite early on and I really, really loved the computing. And I did, you did notice, but you don't necessarily understand that, why computers are getting more and more powerful. My first computer only had one color. Well, it had two, white and black. And my second could manage 16 at some time, probably not 16. Eight out of a palette of 16 at any given time. And they get better and better. And so alongside my life were computers getting faster. I'm learning to program them and discovering the internet and that, I think, has always sat alongside me against this kind of family curiosity. I suspect if my parents had been, I don't know, doctors, I would have been in your field in the field of bioinformatics and applying exponential technologies to health care. And if my parents had been engineers, I would have been doing something that intersected engineering and computing.Harry Glorikian: Yeah, no, it's you know, it's interesting, I remember when we got our first chip, when I was first learning about, you know, computers like it was, you know, eight bits, right? And then 16 bits and oh my god, what can we do with them? And we were building them, and I actually have to get you a copy of my new book because I think if you read the first chapter and what you just said, you'll be like, Oh my God, we have more in common than we may think, even though you know you're where you are and I'm in the health care field to. But you were co-founder and CEO of a company, I believe that was called PeerIndex, which was a startup in the late 2000s. And even back then, you were trying to quantify people's influence on different social media platforms. And I'm trying to remember like, do I even know what the social media platform was back in 2000? It seems like so long ago, and you successfully sold it to Brandwatch in, like, 2014. What did that experience sort of teach you about, you know, the bigger issues and how technology impacts society and vice versa? Because I have to believe that you know your hands on experience and what you were seeing has to have changed the way that you thought about how fast this was going and what it was going to do.Azeem Azhar: Oh, that is an absolutely fantastic, fantastic question. And. You know, you really get to the heart of all of the different things that you learn as a founder. When we when I started PeerIndex, the idea was really that people were going on to the internet with profiles that they maintained for themselves. So up until that point, apart from people who had been really early on the internet, like you and I who used Usenet and then early web pages for ourselves, no one really had a presence. And these social apps like MySpace and Twitter and LinkedIn and Facebook show up and they start to give people a presence. And we felt that initially there would be a clear problem around trying to discover people because at the time the internet was an open network. You could look at anyone's page on Facebook. There weren't these walled gardens. And we looked down on them. So we thought initially that there would be a an opportunity to build some kind of expertise system where I could say, "Listen, find me something that someone who knows something about, you know, sushi restaurants in Berlin." And it would help me find that person. I could connect their profile and talk to them because it was the really early, naive days before Facebook or LinkedIn had advertising on them. And we could we kind of got the technology to work, but actually the market was moving and we couldn't land that.Azeem Azhar: And so we had to kind of pivot, as you do several times, ultimately, until we became this kind of influence analytics for marketers. But the few things that I learned. So the first one was how quickly new players in a market will go from being open to being closed. So it was 2011 when Facebook started to put the shutters down on its data and become a closed garden. And they realized that the network effect and data is what drove them forward. And the second thing was the speed with which what we did changed. So when we were getting going and doing all of this kind of analytics on Twitter and Facebook. They didn't really have data science teams. In fact, Twitter's first data scientists couldn't get a US visa and ended up helping, working with us for several months. And I think back to the fact that we used five or six different core technologies for our data stores in a seven-year period. And in that time, what we did became so much more powerful. So when we started, we had maybe like 50,000 people in this thing, it was really hard to get it to work. The entire company's resources went on it. At one point we were we had about 100 million people in the data in our dataset, or 100 million profiles in the data.Azeem Azhar: They were all public, by the way. I should say this is all public data and it was just like a search engine in a way. And in order to update the index, we would need to run processes on thousands of computers and it would take a big, big, big servers, right? And it would take a day. Yeah. By the time we sold the company, a couple more iterations of Moore's Law, some improvements in software architecture, we were updating 400 million user profiles in real time on a couple of computers. Yep, so not only do we quadrupled the dataset, we had increased its, sort of decreased its latency. It was pretty much real time and we had reduced the amount of computers we needed by a factor of about 400. And it was a really remarkable evolution. And that gets me to the third lesson. So the second lesson is really all about that pace of change in the power of Moore's law. And then the third lesson was really that my engineers learned by doing. They figured out how to do this themselves. And whereas I was sort of roughly involved in the first design, by the time we got to the fifth iteration this was something of a process that was entirely run by some brilliant young members of the team.Harry Glorikian: Yeah, I mean, you've got to actually cook something to understand how to do it and taste it and understand how it's going to come out. So your new book, The Exponential Age, came out this fall. You know, in the first chapter, you sort of identify two main problems, right? One is how do we perceive technology and then or the way we relate to technology and. Can you describe the two problems as you see them and maybe, maybe even hint a little? I don't want I don't want if people want to buy the book, I want them to buy it, but maybe hint that the solution?Azeem Azhar: Yeah. Well, I mean, there are there are a couple of issues here, right, in the Exponential Age. The first is that technology creates all sorts of new potentials and we live them. We're doing this over Zoom, for example. Right. And there are. But the arrival of new potentials always means that there's an old system that is going to be partially or entirely replaced. And so I describe that process as the exponential gap. It is the gap between the potentials of the new and the way in which most of us live our lives. And the thing is, the reason I say "the way most of us live our lives" is because our lives, even in America, which doesn't like its sort of government, are governed by institutions and by regulations. You know, when you when you start to cook, you wash your hands, right? There's no law. That's just an institution, its common habit. If you have teenage kids like I do, you're battling with the fact that people are meant to talk over dinner, not stare at their phones. In the UK there is an institution that says on a red light traffic signal, you never turn. You wait. It's not like the US where you can do that. Now some of these institutions are codified like our traffic laws, and some are not.Azeem Azhar: There are then more formal institutions of different types like, you know, the Fed or NATO or the Supreme Court. And the purpose of institutions, social, formal, legal, informal is to make life easier to live, right? Right, you don't have to remember to put our pants on. I will read a rule that says, put your pants on before you leave the house. It's like you just put them on and everybody kind of knows it. And there's no law that says you should or shouldn't, right. So they become very valuable. But the thing is that the institutions in general, by their nature, don't adapt to at the speed with which these new technologies do adapt. And even slower moving technologies like the printing press really upended institutions. I mean, Europe went into centuries of war just after the printing press emerged. So, so the central heart of the challenge is, on the one hand, we have these slightly magical technologies that do amazing things, but they somewhat break our institutions and we have to figure out how we get our institutions to adapt better. But there's a second complication to all of this, which is that which is, I think, more one that's about historical context. And that complication is that the way we have talked about technology, especially in the West in the last 40 or 50 years, has been to suggest that technology is deterministic.Azeem Azhar: We're a bit like people in a pre-med, pre-science era who just say the child got the pox and the child died. We say the technology arrived and now we must use it. The iPhone arrived and we must use it. TheFacebook arrived, and we must use it. We've gotten into this worldview that technology is this sort of unceasing deterministic force that arrives from nowhere and that a few men and women in Silicon Valley control, can harness it. We've lost sight of the fact that technology is something that we as members of society, as business people, as innovators, as academics, as parents get to shape because it is something that we build ourselves. And that for me was a second challenge. And what I sought to do in the book, as I was describing, the Exponential Age is not only persuade people that we are in the Exponential Age, but also describe how it confuses our institutions broadly defined and also explain why our response has sometimes been a bit poor. Some a large part of which I think is connected to putting technology on a particular pedestal where we don't ask questions of it. And then hopefully at the end of this, I do give some suggestions.Harry Glorikian: Well, it's interesting, right, I've had the pleasure of giving talks to different policy makers, and I always tell them like, you need to move faster, you need to implement policy. It's good to be a little wrong and then fix it. But don't be so far behind the curve that you, you know, some of these things need corralling otherwise, they do get a lot of, you know, get out of hand. Now in health care, we have almost the opposite. We're trying to break the silos of data so that we can improve health care, improve diagnosis, improve outcomes for patients, find new drugs. Harry Glorikian: So I'm going to, I'm going to pivot there a little bit and sort of dive a little deeper into life sciences and health care, right, which is the focus of the show, right? And in the book, you you say that our age is defined by the emergence of several general-purpose technologies, which I'm totally aligned with, and that they are all advancing exponentially. And you actually say biology is one of them. So first, what are the most dramatic examples in your mind of exponential change in life sciences? And how do you believe they're affecting people's health?Azeem Azhar: Well, I mean, if you got the Moderna or BioNTech vaccination, you're a lucky recipient of that technology and it's affecting people's health because it's putting a little nanobots controlled by Bill Gates in your bloodstream to get you to hand over all your bitcoin to him, is the other side of the problem. But I mean, you know, I mean, more seriously, the Moderna vaccine is an example that I give at the at the end of the book comes about so remarkably quickly by a combination of these exponential technologies. I'm just going to look up the dates. So on the 6th of January 2020, there's a release of the sequence of a coronavirus genome from from a respiratory disease in Wuhan. Yeah, and the the genome is just a string of letters, and it's put on GenBank, which is a bit like an open-source story storage for gene sequences. People started to download it, and synthetic genes were rapidly led to more than 200 different vaccines being developed. Moderna, by February the 7th, had its first vials of its vaccine. That was 31 days after the initial release of the sequence and another six days they finalized the sequence of the vaccine and 25 more days to manufacture it. And within a year of the virus sequence being made public, 24 million people had had one dose of it.Azeem Azhar: Now that's really remarkable because in the old days, by which I mean February 2020, experts were telling us it would take at least 18 months to figure out what a vaccine might even look like, let alone tested and in place. So you see this dramatic time compression. Now what were the aspects at play? So one aspect at play was a declining cost of genome sequencing, which the machines are much cheaper. It's much cheaper to sequence these samples. That means that the entire supply chain of RNA amplifiers and so on a more widely available. This then gets shared on a website that can be run at very few dollars. It can get access to millions of people. The companies who are doing the work are using synthetic genes, which means basically writing out new bases, which is another core technology that's going through an exponential cost decline. And they're using a lot of machine learning and big data in order to explore the phenomenally complex biological space to zero in on potential candidates. So that the whole thing knits together a set of these different technologies in a very, very powerful and quite distributed combination.[musical interlude]Harry Glorikian: Let's pause the conversation for a minute to talk about one small but important thing you can do, to help keep the podcast going. And that's to make it easier for other listeners discover the show by leaving a rating and a review on Apple Podcasts.All you have to do is open the Apple Podcasts app on your smartphone, search for The Harry Glorikian Show, and scroll down to the Ratings & Reviews section. Tap the stars to rate the show, and then tap the link that says Write a Review to leave your comments. It'll only take a minute, but you'll be doing us a huge favor.And one more thing. If you like the interviews we do here on the show I know you'll like my new book, The Future You: How Artificial Intelligence Can Help You Get Healthier, Stress Less, and Live Longer. It's a friendly and accessible tour of all the ways today's information technologies are helping us diagnose diseases faster, treat them more precisely, and create personalized diet and exercise programs to prevent them in the first place.The book is now available in Kindle format. Just go to Amazon and search for The Future You by Harry Glorikian.And now, back to the show.[musical interlude]Harry Glorikian: Let's step back here for just a minute. So I wonder if you have a thesis—from a fundamental technology perspective, what's really driving the exponential technological change, right? Do you think that that, is there a force maybe outside of semiconductors that are driving biology forward? What's your view? I mean, if you took the computational tools away from life sciences and drug developers, would we still see the same rapid advances in that area, and the answer could be no, because I can tell you my thoughts after you tell me yours.Azeem Azhar: Well, we wouldn't see the same advances, but we would still see significant advances and it's hard to unpack one from another. But if you look at the I mean, you worked on the genome sequencing stuff. So you know that there's a lot of interesting aspects to do with the reagents that are used the electrochemistry, the arrays and making little ongoing improvements in those areas. There are also key improvements in the actual kind of automation of the processes between each to each step, and some of those automations are not, they're not kind of generalized robots, soft robots, they are trays that are being moved at the right time from one spot to another, stop on a kind of lab bench. So you'd still see the improvements, but you wouldn't see the same pace that we have seen from computing. And for two reasons. So one is that kind of the core ability to store lots of this data, which runs into the exabytes and then sift through it, is closely connected to storage capacity and computation capability. But also even the CAD package that the person used to redraw the designs for the new laboratory bench to handle the new vials of reagents required a computer. But yes, but you know, so what? What's your understanding as someone who is on the inside and, note to listener, that was a bit cruel because Harry is the expert on this one!Harry Glorikian: And oh no, no, no, no. I, you know, it's interesting, right… I believe that now that information is more readily available, which again drives back to sensors, technology, computation, speed as well as storage is changing what we do. Because the information feeds our ability to generate that next idea. And most of this was really hard to get. I mean, back in the day, I mean, if you know, now I wear a medical device on my on my wrist. I mean, you know this, I look as a as a data storage device, right? Data aggregation device. And this I look at it more as a coach, right? And but the information that it's getting, you know, from me on a momentary basis is, I mean, one of the companies I helped start, I mean, we have trillions of heartbeats, trillions. Can you imagine the analytics from a machine learning and, you know, A.I. perspective that I can do on that to look for? Is there a signal of a disease? Can I see sleep apnea or one of the I could never have done that 10 years ago.Azeem Azhar: I mean, even 10, how about I mean, five maybe, right? I mean, the thing that I find remarkable about about all of this is what it's told me. So I went from I used to check my bloods every year and so I would get a glucose reading or an insulin reading every year. I then put a CGM on continuous glucose monitor and I wore it for 16 to 18 weeks and it gave me a reading every 15 months minutes. So I literally went from once a year, which is 365 times 96, 15 minute intervals. So it's like a 40,000-fold improvement. I went to from to that every 15 minutes, and it was incredible and amazing and changed my life in so many good ways, which I'm happy to go into later. But the moment I put the 15 minute on, I kid you not, within an hour I was looking for the streaming cGMPs that give you real time feed. No 15-minute delay. And there is one that Abbott makes through a company, sells through a company called Super Sapiens. But because suddenly I was like a pilot whose altimeter doesn't just tell them you're in the air or you've hit the ground, which is what happened when I used to go once a year, I've gone to getting an altitude reading every minute, which is great, but still not brilliant for landing the plane to where I could get this every second. And this would be incredible. And I find that really amazing. I just I just and what we can then do with that across longitudinal data is just something else.Harry Glorikian: We're totally aligned. And, you know, jumping back to the deflationary force of all this. Is. What we can do near-patient, what we can do at home, what we can do at, you know, I'll call it CVS, I think by you, it would be Boots. But what these technologies bring to us and how it helps a person manage themselves more accurately or, you know, more insightfully, I think, brings us not to chronic health, but we will be able to keep people healthier, longer and at a much, much lower cost than we did before because. As you know, every time we go to the hospital, it's usually big machines, very expensive, somebody to do the interpretation. And now if we can get that information to the patient themselves and AI and machine learning can make that information easier for them to interpret. They can actually do something actionable that that that makes a difference.Azeem Azhar: I mean, I think it's a really remarkable opportunity with a big caveat that where we can look at look historically, so you know, we're big fans of the Hamilton musical in my household. And if you go back to that time, which is only a couple of hundred years ago and you said to them, this is the kind of magic medicine they'll have in the US by 2020. I mean, it's space tech. It's alien space tech. You know, you can go in and we measure things they didn't even know could be measured, right, like the level of antibodies in the bloodstream. And you can get that done in an hour almost anywhere, right? Yeah. And it's really quite cheap because GDP per capita in the per head in the US is like $60,000 a year. And I can go and get my blood run. A full panel run for $300 in London, one of the most expensive cities in the world. 60 grand a year. $300. Well, surely everybody's getting that done. And yet and you know this better than me. Right. You know this better than me that despite that, we don't have everyone getting their bloods done because it's just so cheap, right, there are other structural things that go on about who gets access, and I think America is a great example of this because for all the people who read, we are aware of Whoop, and have, you know, biological ages that are 10 years younger than their chronological age, you've also got like a much, much larger incidence of deaths by drug overdose and chronic obesity and sort of diseases of inflammation and so on. And that's despite having magical the magical space technology of the 2020s. So the question I think we have to have is why would we feel that next year's optoelectronic sensors from Rockly or the Series 7 or Series 8 Apple Watch will make the blindest bit of difference to health outcomes for the average American.Harry Glorikian: Now, I totally agree with you, I mean, I think half of it is education, communication. You know, there's a lot of social and political and policy and communication issues that exist, and actually that was going to be my next, one of my next questions for you, which is: What are some of the ways that exponential change challenges our existing social and political structures? And you know, do you see any—based on all the people that you've talked to, you know, writing the book, et cetera—insights of how we're going, what those are and maybe some ideas about how we can move beyond them.Azeem Azhar: Hmm. Well, I mean, on the health care side, I think one of the most important issues is and this is I mean, look, you've got an American audience and your health system is very different to, let's just say everyone.Harry Glorikian: Actually, the audience is global. So everybody, I have people that all over the world that listen to this.Azeem Azhar: Fair enough. Okay. Even better, so the rest of the world will understand this point, perhaps more, which is that, you know, in many place parts of the world, health care is treated as not, you know, it's treated differently to I take a vacation or a mutual bond that you buy, right or a car, it's not seen purely as a kind of profit vehicle. It's seen as something that serves the individual and serves a community and public health and so on matters. And I think one of the opportunities that we have is to think out for it, look out for is how do we get the benefits of aggregated health data, which is what you need. You need aggregate population wide data that connects a genotype to a phenotype. In other words, what the gene says to how it gets expressed to me physically to my biomarkers, you know, my, what's in my microbiota, what my blood pressure is on a minute by minute basis and my glucose levels and so on. And to whatever illnesses and diseases and conditions I seem to have, right, the more of that that we have, the more we can build predictive models that allow for the right kind of interventions and pre-habilitation right rather than rehabilitation. But in order to do that at the heart of that, yes, there's some technology. But at the heart of that is how do we get people's data in such a way that they are willing to provide that in a way that is not forced on them through the duress of the state or the duress of our sort of financial servitude? And so that, I think, is something that we really, really need to think about the trouble that we've had as the companies have done really well out of consumer data recently.Azeem Azhar: And I don't just mean Google and Facebook, but even all the marketing companies before that did so through a kind of abusive use of that data where it wasn't really done for our benefit. You know, I used to get a lot of spam letters through my front door. Physical ones. I was never delighted for it, ever. And so I think that one of the things we have to think, think about is how are we going to be able to build common structures that protect our data but still create the opportunities to develop new and novel therapeutic diagnosis, early warning systems? And that's not to say there shouldn't be profit making companies on there that absolutely should be. But the trouble is, the moment that you allow the data resource to be impinged upon, then you either head down this way of kind of the sort of dominance that Facebook has, or you head down away the root of that kind of abuse of spam, junk email and so on, and junk physical mail.Azeem Azhar: So I think there is this one idea that that emerges as an answer, which is the idea of the data commons or the data collective. Yeah. We actually have a couple of them working in health care in in the U.K., roughly. So there's one around CT scans of COVID patients. So there's lots and lots of CT scans and other kind of lung imaging of COVID patients. And that's maintained in a repository, the sort of national COVID lung imaging databank or something. And if you're if you're an approved researcher, you can get access to that and it's done on a non-commercial basis, but you could build something commercially over the top of it. Now the question is why would I give that scan over? Well, I gave give it over because I've been given a cast-iron guarantee about how it's going to be used and how my personal data will be, may or may not be used within that. I would never consider giving that kind of data to a company run by Mark Zuckerberg or, you know, anyone else. And that, I think, is the the cross-over point, which is in order to access this, the benefits of this aggregate data from all these sensors, we need to have a sort of human-centric approach to ensure that the exploitation can happen profitably, but for our benefit in the long run.Harry Glorikian: Yeah, I mean, I'm looking at some interesting encryption technologies where nothing is ever unencrypted, but you can, you know, the algorithm can learn from the data, right? And you're not opening it up. And so there, I believe that there are some solutions that can make give the side that needs the data what they need, but protect the other side. I still think we need to policymakers and regulators to step up. That would cause that shift to happen faster. But you know, I think some of those people that are making those policies don't even understand the phone they're holding in their hands most of the time and the power that they're holding. So. You know, last set of questions is. Do you think it's possible for society to adapt to exponential change and learn how to manage it productively?Azeem Azhar: It's a really hard question. I'm sure we will muddle through. We will muddle through because we're good at muddling through, you know? But the question is, does that muddling through look more like the depression years. Or does that muddling through look like a kind of directed Marshall Plan. Because they both get through. One comes through with sort of more productive, generative vigor? What I hoped to do in the book was to be able to express to a wider audience some underlying understanding about how the technologies work, so they can identify the right questions to to ask. And what I wanted to do for people to work in the technology field is draw some threads together because a lot of this will be familiar to them, but take those threads to their consequences. And in a way, you know, if I if I tell you, Harry, don't think of an elephant. What are you thinking about right  now?Harry Glorikian: Yeah. Yeah, of course it's not, you know, suggestive.Azeem Azhar: And by laying out these things for these different audiences in different ways, I'm hoping that they will remember them and bear those in mind when they go out and think about how they influence the world, whether it's decisions they make from a product they might buy or not buy, or how they talk influence their elected officials or how they steer their corporate strategy or the products they choose to build. I mean, that's what you would you would hope to do. And then hopefully you create a more streamlined approach to it to the change that needs to happen. Now here's the sort of fascinating thing here, is that over the summer of 2021, the Chinese authorities across a wide range of areas went in using a number of different regulators and stamped on a whole set of Exponential Age companies, whether it was online gaming or online education. The big, multi sided social networks, a lot of fintech, a lot of crypto. And they essentially had been observing the experiment to learn, and they had figured out what things didn't align with their perceived obligations as a government to the state and to the people. Now, you know, I'm using that language because I don't want this to become a kind of polarized sort of argument.Azeem Azhar: I'm just saying, here's a state where you may not agree with its objectives and the way it's accountable, but in its own conception, it's accountable to its people and has to look out for their benefit. And it took action on these companies in really, really abrupt ways. And. If you assume that their actions were rational and they were smart people and I've met some of them and they're super smart people, it tells you something about what one group of clever people think is needed at these times. This sort of time. And I'm not I'm not advocating for that kind of response in the US or in Western Europe, but rather than to say, you know, when your next-door neighbor, and you live in an apartment block and your next-door neighbor you don't like much runs out and says the whole building is on fire. The fact that you don't like him shouldn't mean that you should ignore the fact that there's a fire. And I think that some sometimes there is some real value in looking at how other countries are contending with this and trying to understand the rationale for it, because the Chinese were for all the strength of their state, were really struggling with the power of the exponential hedge funds in their in their domain within Europe.Azeem Azhar: The European Union has recognized that these companies, the technologies provide a lot of benefit. But the way the companies are structured has a really challenging impact on the way in which European citizens lives operate, and they are making taking their own moves. And I'll give you a simple example, that the right to repair movement has been a very important one, and there's been a lot of legislative pressure in the in Europe that is that we should be have the right to repair our iPhones and smartphones. And having told us for years it wasn't possible suddenly, Apple in the last few days has announced all these repair kits self-repair kits. So it turns out that what is impossible means may mean what's politically expedient rather than anything else. And so my sense is that that by engaging in the conversation and being more active, we can get ultimately get better outcomes. And we don't have to go the route of China in order to achieve those, which is an incredibly sort of…Harry Glorikian: A draconian way. Yes.Azeem Azhar: Yeah. Very, very draconian. But equally, you can't you know where that where I hear the U.S. debate running around, which is an ultimately about Section 230 of the Communications Decency Act, and not much beyond that, I think is problematic because it's missing a lot of opportunities to sort of write the stuff and foster some amazing innovation and some amazing new businesses in this space.Harry Glorikian: Oh yeah, that's, again, that's why, whenever I get a chance to talk to policymakers, I'm like, “You guys need to get ahead of this because you just don't understand how quickly it's moving and how much it's going to impact what's there, and what's going to happen next.” And if you think about the business model shifts by some of these... I mean, what I always tell people is like, okay, if you can now sequence a whole genome for $50 think about all the new business models and all the new opportunities that will open up versus when it was $1000. It sort of changes the paradigm, but most people don't think that we're going to see that stepwise change. Or, you know, Google was, DeepMind was doing the optical analysis, and they announced, you know, they could do one analysis and everybody was like, Oh, that's great, but it's just one. And a year later, they announced we could do 50. Right? And I'm like, you're not seeing how quickly this is changing, right? One to 50 in 12 months is, that's a huge shift, and if you consider what the next one is going to be, it changes the whole field. It could change the entire field of ophthalmology, especially when you combine it with something like telemedicine. So we could talk for hours about this. I look forward to continuing this conversation. I think that we would, you know, there's a lot of common ground, although you're I'm in health care and you're almost everywhere else.Azeem Azhar: I mean, I have to say that the opportunity in in health care is so global as well because, you know, if you think about how long and how much it costs to train a doctor and you think about the kind of margin that live that sits on current medical devices and how fragile, they might be in certain operating environments and the thought that you could start to do more and more of this with a $40 sensor inside a $250 smartwatch is a really, really appealing and exciting, exciting one. Yeah.Harry Glorikian: Excellent. Well, thank you so much for the time and look forward to staying in touch and I wish you great success with the book and everything else.Azeem Azhar: Thank you so much, Harry. Appreciate it.Harry Glorikian: That's it for this week's episode. You can find past episodes of The Harry Glorikian Show and the MoneyBall Medicine show at my website, glorikian.com, under the tab Podcasts.Don't forget to go to Apple Podcasts to leave a rating and review for the show. You can also find me on Twitter at hglorikian. And we always love it when listeners post about the show there, or on other social media. Thanks for listening, stay healthy, and be sure to tune in two weeks from now for our next interview.

Drop The Weight with Elizabeth McGann
#14 - Your 2022 Reboot Challenge - Upgrade Your Metabolic Health with CGM

Drop The Weight with Elizabeth McGann

Play Episode Listen Later Jan 16, 2022 13:24


Listen in as Elizabeth McGann, Holistic Nutritionist & Coach + co-host comedian, Shelley Carling, dish on their 2022 REBOOT CHALLENGE. Find out why Elizabeth and Shelley are over the moon EXCITED to test drive LEVELS and the latest advances in biosensor continuous glucose monitoring (CGM) technology. Learn more about Elizabeth Mcgann's 3-month - Drop the Weight Metabolic Coaching program - launching February 14, 2022 REQUEST ACCESS  Elizabeth McGann Drop the Weight 3-month CGM Coaching Program  Drop the Weight - CGM Metabolic Coaching Program

Dr. Ruscio Radio: Health, Nutrition and Functional Medicine
The Impact of Lifestyle Factors on Glucose Levels

Dr. Ruscio Radio: Health, Nutrition and Functional Medicine

Play Episode Listen Later Jan 12, 2022 62:42


Health technology tools such as the Continuous Glucose Monitoring Device can help you improve your metabolic health by providing a picture of how your lifestyle factors – including diet, exercise, alcohol consumption, and sleep – affect your blood glucose levels. However, these tools are only as good as the user's mindset and basic understanding of the science behind the numbers. Dr. Ronesh Sinha explains how to regard the CGM as an opportunity to learn about your body rather than getting stressed about single data points, and how to cultivate healthy glucose levels through a balanced lifestyle. https://drruscio.com/glucose-levels-and-lifestyle-factors  My book Healthy Gut, Healthy You is available at https://drruscio.com/getgutbook  If you're in need of clinical support, please visit https://ruscioinstitute.com  Looking for more? Check out https://drruscio.com/resources 

Diabetes Connections with Stacey Simms Type 1 Diabetes
"Different every step of the way" - A Dexcom G7 Update (and more) with CEO Kevin Sayer

Diabetes Connections with Stacey Simms Type 1 Diabetes

Play Episode Listen Later Jan 11, 2022 32:24


This week, Dexcom CEO Kevin Sayer spoke to the JP Morgan Healthcare Conference about the G7 and beyond. We talk about information from that presentation and get to as many of your questions as time allows. This interview took place on Tuesday Jan 11 and much of what we discussed isn't FDA approved. Dexcom presentation info here Club1921 info here  Our usual disclaimer: Dexcom is a sponsor of this podcast, but they don't dictate content and they don't tell me what to ask their executives. Recent Dexcom episodes: CTO Jake Leach talks about Garmin, Dexcom One & more CEO Kevin Sayer talks about G7, Direct to Watch, Adhesive and more CEO Kevin Sayer talks about Dexcom in Hospital, G7, VA program and more Check out Stacey's book: The World's Worst Diabetes Mom! Join the Diabetes Connections Facebook Group! Sign up for our newsletter here ----- Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners! ----- Episode Transcription Below  Stacey Simms 0:00 Diabetes Connections is brought to you by Dexcom. Take control of your diabetes and live life to the fullest with Dexcom and by Club 1921. Where Diabetes Connections are made This is Diabetes Connections with Stacey Simms. Welcome to another week of the show. You know I'm always so glad to have you here. We aim to educate and inspire about diabetes with a focus on people who use insulin. And I'm talking with Dexcom CEO this week, it's Kevin Sayer, he is back to check in with us again. And in the interest of getting this episode out to you as soon as I could. It might sound a little different right here at the beginning. But Dexcom episodes are always so high interest that it really merits a quick turnaround. I didn't want to sit on this interview for a week. So here's the setup. Dexcom CEO Kevin Sayer gave a presentation to the JP Morgan healthcare conference, if you're listening as this episode goes live, that was just Monday of this week, January 10, the interview you're about to hear took place on Tuesday, January 11. My usual disclaimer Dexcom is a sponsor of this podcast, but they don't dictate content and they don't tell me what to ask their executives. I asked the Diabetes Connections podcast Facebook group for questions. And Whoa, boy, did you have a lot as always not a surprise. And I really appreciate you sending those in, I got to as many as I could, while also trying to include what the folks at Dexcom had really asked me to bring up there are some topics that they wanted Kevin to make sure to address. And I think we do a pretty good job of trying to reach a balance here. Kevin, welcome and Happy New Year, Kevin Sayer 1:46 and Happy New Year to you. Stacey Simms 1:48 Thank you. Well, this seems to have started out in pretty happy way on the headline, just from this week. Dexcom CEO touts unprecedented performance of G7 in clinical trial. This is after your talk at the annual JP Morgan healthcare conference. Tell me a little bit about that unprecedented performance data. Kevin Sayer 2:08 I'm happy to. And I just have to qualify it by saying no, I can't send it to all your listeners at the end of the call yet. We're still waiting for approval in Europe. And we have filed this with the FDA, I'm going to take you back a little bit, we made a decision when we were going through the G7 development process that we wanted to answer that performed better than G6. And all of our scientists looked at us and they go oh, really, you're sure because this is really good. And so we spent a lot of time new algorithms and new manufacturing techniques, there's a lot of things in G7 that make it different. We also wanted to validate that performance with a study that was so large, nobody could refute it. So as you look at the data that I presented at the conference yesterday, over 300 patients 39,000 Match pairs all across since one ranges and on the I CGM standard side, but with the 5% 95% lower bound, and even the absolute points, you can see we are well within all of the iCGM standards, which are very technical and actually are a very good measure of how a sensor actually performs in reality. And they were very thoughtful in developing these standards to try and pick the centers that don't work to put you statistically in a bind to whereby if you really aren't performing in the low range or wherever, you're not going to get that iCGM designation. We're very comfortably there. And the overall MARD in the study, Stacey is eight point, you know I it's in the low eight for adults and pediatrics. And if you start looking at the data, we gather the data sets in three periods, you know, days one and two, the middle days, four, or five and six, and the last days nine and 10. It's pretty low, I think it's below 10. In the first group a day, the first days, which are always a little bit higher, traditionally in our centers than the other days. But in those middle and end days, it's it's near seven, and strips for six. I mean, we have done something that I've been in this business for since 1994. I didn't think we'd ever do this when I started. As far as being this good. This is really, really good data. And we're going to continue to deliver the experience to our customers that they demand from us. So as you can as you think about an iCGM that's driving an automated insulin delivery system. And not only is the performance great, the user where it's 60% smaller, it's a 30 minute warm up. It's a new app. From our perspective, we've got a lot of the clarity data, your listeners will know about clarity. We've got a lot of your clarity data right on the app. There's new alarm configurations. Stacey Simms 4:48 I'm gonna just jump in with a couple of quick clarifications before we go on. You mentioned a number of there that went by quickly I apologize when you talked about the 300 people in this trial 39,000 match what I missed that one Kevin Sayer 5:00 matched pairs. That's where you compare the CGM value to the blood glucose value from the laboratory instrument. So the way our studies work is literally we draw blood samples from the individuals in the study at intervals, and then we actually match the CGM data to that laboratory blood instrument. So 39,000 points from these 300 people in this study were matched. Got it? Stacey Simms 5:27 And you mentioned the MARD mean absolute relative difference. Most of you, as you listen are very familiar with this, the lower the better for CGM G6, I, my understanding was G6 was in the low nines. This is 8.1 for peds. 8.2 for adults, as I'm reading it, that's right. I know you can't tell me I'll ask you anyway, why? What made the difference here? Is it sighs is it algorithm? Do you have anything you can point to? Or is that a trade secret Kevin Sayer 5:49 it's combination, I think the algorithm has been the most, the algorithm changes were really extensive here. And, you know, we always have manufacturing processes to get better, the way we build the G7 centers different in every step of the way. Literally, our G6 manufacturing processes go away and the G7 ones take over the summer, we're a little similar on the actual sensor wire itself, and that manufacturing, but everything else is different. We just think it it's smaller, it's a lot shorter than G6 was. And so it is it's going to be a completely different experience for everybody. Stacey Simms 6:28 So to go back to what you were talking about, before I jumped in there, you were starting to talk about alarms, is there something different for the alarm, Kevin Sayer 6:35 the app is different. And so access to them, and, and just how you use them, if we try to get to be more consumer, thoughtful, as we configured the alarms, we'll see how everybody loves him. It'll be interesting. The alarms are one of the things we get the most comments on when we launch a product initially, we try and please everyone, but we never please everyone. And then you get you know, the agency at one time. I don't know if your call. I think one of our other discussions, we had to make the mute override not work on the low end. Boy, we got a lot of people mad at us about that one. So we've tried to comply with what our users want, and also comply with what the FDA has asked us to do. But I think users will find the alarm experience. Good as well. I like I think it's just gonna be a home run. Yeah, well, I Stacey Simms 7:24 mean, my son would be happy if an alarm never made a noise again. And I know other people who put like it to alarm every time there's any movement. So I hear where you're coming from, can you give any insight into the G7 app in terms of what the differences that we may see as users? And I guess especially one of the questions I always get is about follow any changes of significance coming that you can share follows Kevin Sayer 7:47 on a separate software track. And so the G7 system, the app is just we tried to get more data in the app itself, versus what we have with G6. So a lot of the clarity data, or at least summary query data is sitting there right in your app. And that will be i we think people will like that just to see how they're doing over time you got your time in range data for, you know, three 714, you know, a month, 90 days, see how you're doing time in range wise and the app is other than that it's relatively similar. The startup is different and you know, in the interface is going to be different. I think over time, what you'll see with us is that app is now going to get more sophisticated, we changed the entire software platform for G7 and started over again, and we developed a software platform, we can now really change and add on to a lot easier than we could in the past. And so we're hoping to have more frequent software releases. But we've also learned that CGM is not like Battlestar Galactica game, a game where you want to get a new release every two weeks to fire everybody up. We can't do a release every two weeks, because people depend on this for their, you know, for their lives. And if you do too frequent releases, and you botch a release, you do some wrong, you remember what happened, if we ever make a mistake on the software, the data side, we can't do that. But we do want to add more features more quickly in this platform will enable us to do that. I think one of the things you'll see going forward on the software side, we really want to automate a lot of the tech support features. We've added some, you know, you can get FAQs right from the app now with respect to your sensor, but there are other things we think we can do tech support wise in the app that will you know, reduce everybody's burden. Nobody likes making a phone call and nobody likes picking up the phone. And when we have a sensor fail, and we do have sensors fail, it just doesn't make any sense that you have to call us if we've got data on a phone, it'd be much easier. For example, if we could diagnose that failure right on the app and go through a very quick process to why but where you could get one. I can't give a timeframe when all those things are going to come but the platform is robust enough that over time, we can add features like that. One of the other nice things about G7, since it's fully disposable, you know, every sensor has its own unique serial number. Whereas with G6, that same transmitters used with three months' worth of sensors. So it will be, it will be fun to be able to follow things like that and see how the sensors go through the channel where everybody gets attract things of that nature. So what we're really looking forward to the change in our business that G7 affords us. Stacey Simms 10:28 As usual, I have listener questions, I'm going to try to not repeat because you've been really accessible in the last year, we've talked to a couple of folks from Dexcom, besides yourself. So as you listen, if I didn't get to your question, or if you have a question, good chance, we actually answered it in the last year, year and a half. But given let me ask you about compression lows, because that's one of the things we had talked about, about testing the G7. Any update on that in these trials, if you lay on it, you know, circulation slows, and you can get a false reading any better with the G7 Kevin Sayer 10:54 part of the clinical study is in the compression, because you're pretty much sitting in a chair with a needle in your arm drawing blood. So I'm sorry, we can't really test that we'll learn more about compression when it gets in the field. My hope is that it isn't as much but I can't promise that because I don't know, we're not enough people. I think there are ways over time where we can manage compression better, I'm not going to get into all the science on the phone, believe it or not, I do spend a lot of time with the engineers on this specific issue. Because I have it happened to me from time to time too. So I will call them up say Hey, can we do X, Y or Z? And I think there are some some answers, but I can't give them away because I don't want to give away the playbook. So let's let's just see what we can do overtime on that one. Stacey Simms 11:42 Okay. All right. But you know, the next clinical trial just have them lean against the side of their bed. Kevin Sayer 11:46 We will we'll have to do well. Diffic very scientific. Stacey Simms 11:50 Another question came up, and I think I'm gonna knock wood. I think we've been very lucky on this. It's about new iOS launches from Apple. And I'll read the question and it'll tell you, briefly our experience. This person said Dexcom is part of the Apple Developer Network developers have access to new release such as iOS months before launch, why does Dexcom lag behind Apple iOS launches by months in terms of quote, approved use. And our experience, frankly, is that we have not had any issues Benny and I both have, we just got but as a 13. Plus, we both had very old phones. And we have a latest software and no glitches for us. But that's not everyone's experience, can you talk a little bit about that, Kevin Sayer 12:30 we do get the iOS versions in advance, and we do our best to comply with them, I would I would tell you that it isn't as simple as it's made out to be. And the iOS version that's launched isn't always exactly what we've worked on as they as they make tweaks, not big ones. But you also test for everything that you know about the new iOS versions, and sometimes are things that you don't know, that are in there that come back and may affect the app later on, which is why we delay a little bit, we try and go through every bit of testing that you can imagine. And I'll be honest with your users, Apple's made iOS changes, because of us, we have called up and said, Look, you got to do XY and Z here we have a problem. And they're very good to work with, they've not been difficult at all, you know, when you think about iOS and Android operating system and all the things that they impact. And it's very hard not to impact somebody adversely when you do a new iOS launch. And you know, the perfect example with us is the home you'd override journey that I brought up earlier. In the beginning, I believe the only app that can overcome the mute override within iOS is authorized manna in the beginning was Apple's alarm clock, but other people would go around it with their apps was a medical device, we can't do a go around, we have to make sure what we do is in compliance and known so they work with us very well to make sure we could do what the FDA wanted with respect to the mute button. And the same thing with Android on that, and that was a very difficult exercise. So if there's a delay, it's because we're taking time to see what might have been put into iOS that would change our app. And it just one more thing that will stop. new operating systems are often designed to minimize power usage to extend battery life. Oftentimes, minimizing power usage affects an app that has to be running continuously. And those are the types of battles that we fight are things that we have to make sure we test as a new iOS minimizes power usage. Just does that turn us off? Does it does that stop Dexcom? And we've had, we've discovered things of that nature where it could affect our app. So there you go. Long answers. All right. Stacey Simms 14:44 No, no, that's great. And you mentioned you've asked iOS you've asked Apple to make changes. I assume the alarm was one any others that you can share. Kevin Sayer 14:52 I know that nothing I could share. Nothing major that I like you said they're very cognizant of the Dexcom community there we are. You know, we're we're a very large part of the iOS, you know, we're pretty, it's pretty vocal group when it comes to iOS, Stacey Simms 15:06 pretty vocal group period, the whole community. Alright, we say that with love. So another question came from my group, which was about Sugarmate. This is a, I would describe it as a third party app that uses the Dexcom information. And now the real time API to display and and act on data in its own way, my understanding is that Tandem owns Sugarmate, just from way of background here. And you know, Dexcom owns a little bit of Tandem. So there's a relationship there. Can you speak a little bit about data sources, but the bottom line question here was using Sugarmate and the situation to ask you, does Dexcom feel like they own the patient data? Or do the patients still own their data, even when going through the Dexcom web API's, we believe Kevin Sayer 15:49 the patient's own their data, not us, let me rephrase that we believe the patient's control the use of their data, we are the stewards of that data sitting on our servers. And so we have a responsibility to maintain it and to keep it but where that data goes and where that data is used. We do believe, particularly if it's identified data, that the patient absolutely has complete control over that there's vector sugar made, it's interesting, it was not using API's before it was a like many and non authorized use of the data to display it in a different format that people quite candidly, mess, like better than looking at the Dexcom app. And that's fine. That's why we built the live API's, we made a server change to upgrade our server platform, again, more capacity, more safety, more redundancy. It's a project that's been going on for years. And we've come to the end of that project this year. And when doing so there were some technical issues with Sugarmate, they very quickly switched over to the live API's. And now this is an authorized use of the data based on platform and data pipes that we built. So we're willing to share the data with people when they want it. I think that's an attitude of Dexcom. That changed very much over the years, when we first started, we had a hard time with that concept. Because we worked so hard to invent this technology and gather this data, why would we share it with anybody and say, See, you remember the early days and Nightscout, they were mad at us, we were mad at that. Now, we're not mad at anybody anymore. I think it's important that the data sharing be structured and be used for good purposes. But you know, all in all, it's a, it's a good use of the data that we have, because these are still Dexcom customers. If you want to, you're still buying sensors and using them. It's not a bad thing. Stacey Simms 17:35 Let me ask you a question about the sensors. And this came up in the fall. I've seen it less since but it's still out there. And I don't know if this is something you can answer. But it seems that we have not received this. But it seems that some customers are getting the G6 sensors, the inserters brand new in the original packaging, but a new label on it that says this product meets shelf-life extension requirements. I'm your people I reached out to them in the fall, they told me the stickers, oh, you know, it's all legit. There are updated expiration dates. But I'm curious why this is happening. And you know, what is the shelf life of the G6, Kevin Sayer 18:10 I can tell you exactly what's going on, you do shelf-life testing for product as selling your product will last. And over the course of our product lifecycle, you trying to extend that shelf life through more testing to make sure the product still works for the same amount of time period, if you manufactured product with 12 months shelf life, and then extend that shelf life to 18 months. And it's still the same product and still same manufacturing process rather than unbox it, put it in a new box or throw it away, we put a sticker on the outside because it's same products been tested, it's been proven that it works for 18 months, that's not a problem. That doesn't mean that it's 18 months old, we never have inventory that sits around that long to my knowledge, but we do extend shelf lives, it's important for us to do that, with respect to the distribution channel, particularly as we go to the pharmacy, you know, in the drugstore and and our distributors, the longer they have, you know that they can keep product, the better. We don't want people throwing product away if they don't have to. So all that means is we've extended our testing and shown that the product still works for a longer period of time and wanted to to label the product accordingly. That's all Stacey Simms 19:17 Yeah, I think because it came at a time when there is nervousness just in general not just in diabetes about supply chain and, you know, scarcity concerns. It just seemed unexpected, if that makes sense. Kevin Sayer 19:30 Well I one of the reasons to extend life is in fact supply chain we don't have inventory issues with G6 you know G6 is a very very well running process right now and still, you know, the premier sensor on the market. In fact, we launched a G6 derivation product in Europe, these past three months called Dexcom. One a it's a cash pay product sold on the E commerce platform in four European countries say See now and it's a lower price and geographies. But we did a feature that we took away, share and follow. We're not connecting any devices. It's it's a simpler technology. And again, we have d six supply to be able to go and do things like that. And we are planning to have G7 capacity to do similar things. We are not shooting small on either front will have capacity on both sides. And, you know, listeners on a supply chain perspective, we have been extremely diligent with respect to components for our products. And right now we see things very good today. We my operations team has just been outstanding on this front. So knock on wood, no, no Dexcom problems today. Stacey Simms 20:40 All right, two more questions for you. As always, we're going to run out of time. And as you're listening, I would refer you again, we did have a conversation about Dexcom. One in a previous show. So I will link that up. This one is more of I've asked this, you answered it, but I still continue to get questions to please ask you please make sure when GS seven comes out that Medicare is taken care of? Kevin Sayer 21:00 Well, that is a great question. And I think we've learned from our mistakes in the past. So we will when we get G7 done, what we will do is we will file with CMS to get G7 reimbursement. That's a process that I've heard anecdotally takes three to six months. So if we can get it done in three months, we can't file with CMS until it's approved. But we'll file after approval, and then we'll go and it is our plans to have capacity for all of our US users. When we go it is not that Medicare delay for G6 was one of the most emotionally gut-wrenching things I've dealt with here, because you can't imagine how many emails I got. But we didn't have capacity, and we didn't have everything ready. We've learned from our mistakes. And we'll hopefully be ready to go to everybody. That's our plan right now. Stacey Simms 21:49 That's great. Okay, and my last question is, and I hate doing this to you, but I'm doing it anyways, look into the chapter, we're gonna look, we're gonna come at it sideways, because I did have one listeners and ask him what's planned for the g8? And I said, Come on, let's let him get the G7. Oh, you know what? I'm happy? You can answer that. Let's go for it? Kevin Sayer 22:07 Well, well, I'll give you two because we did lose some time in the beginning because my computer wasn't functioning properly. As we look to the future, we want performance to continue to be better. And then we ask ourselves, but we're getting to the point where as you get to an eight, Mar D, we're getting close to finger six, I don't know how much more of a gap there's going to be, as we look to the future, and even G7 derivatives, we want to go to a longer life, we want to go to 15 days rather than 10. We'll be running studies doing that over the next couple of years. We've got a couple of plans there. We're always looking to upgrade the electronics, and how much better electronics, you know, I know one of your bigger user complaints is connectivity and loss of data, how do we improve that experience for our customers to make that better over time? Because we can always be better. And phones change faster than medical devices? So what why do we put there, we're looking at ways how we can help the environment for future product launches again, and changes in the next platforms, G6 has a lot more materials than G7 does as far as just raw plastic. So how do we make an impact there? On the cost side, there's some form factor things that are pretty far out there that we look at that I won't go into that are really, really fun. We'll see if we had done that. And if they're feasible from a cost of manufacturing perspective, but again, we're now very much focused on customer preference, rather than can't we make this work well enough, you know, in my early days here, it's Can we can we just get this thing working well enough to whereby people can rely on it. Whereas now it's one of those features that are going to make it a more engaging experience. And the last one will be software and analytics and things like that, as I look out over time, do we end up with analytics to whereby we can offer our users a menu of choices on the software side to whereby they can get more if you want Dexcom when don't want to connect or talk to anybody? You can have that if you want something that literally literally analyzes every glucose measurement that you take and does something scientifically. How do you get there, I think there's a number of experiences we can develop over time for future product generations without changing the form factor. So I don't see any slowdown in investment on the r&d side. And on the product side, G6 is the best product out there now and G7 will just be better in every way. And then we just keep going from there. Stacey Simms 24:27 And I appreciate you answering that. Thank you. So if you keep going from there, this is the sideways kind of question I wanted to ask. Okay, go ahead. Okay. A couple of days ago, Abbott announced the idea of what they're calling Lingo, which is bio wearables that will track not only glucose, but ketones and lactate and alcohol. And they say these are not medical devices. You know, this is for people who want to be you know, ultra-marathoners and things like that. We're already seeing sensors used in that way right now. Any plans to do something like this? Kevin Sayer 24:56 You know what our electronics platform for G7 We could put any, if we could develop a sensor wire with membranes and analytes and such for to measure something else, it would fit right into G7. And we design G7. With that in mind, we have advanced technology work going on with the other analytes. But it's still an advanced technology phase, we have to answer a couple of questions. First, have we done all we're supposed to do on the glucose side? Before we run there, and we got a lot to do right now, Stacy, you've heard me talk on this call. And so we need to get done what we started, we need to get G7 launched, we need to scale it up and manufacture it in the 10s. And ultimately, hundreds of millions of products as we stand up a factory in Malaysia and get our Arizona facility built out even more. So we've got to get that work done. The second piece, I'm going to answer this in three pieces. The second piece is what is the commercial opportunity for each of those things. They did announce this line of sensors, but they're all individual sensors. So I've worn a lactate sensor, I'll be completely honest with you from the lab and seeing what it does to my workouts and it's very cool, I can see which workout is better than another one. But I'm not ultra-marathoner, I probably wouldn't change my life. But it was very interesting to look at. There are other scientific uses of black data, particularly in a hospital setting. But what is the market for those, and so we're gonna kind of take an approach, we'll continue to develop the science and if Abbott wants to go develop a market, I am happy to follow this time rather than create it, like we've done with glucose. The third piece of this is there are a lot of biosensors out there. Now, you have your Apple Watch, and Apple is continuing to gather more and more data or ranks, whoop bands, Fitbits, they're advertised on television all the time, I would love to incorporate data from these other sensing technologies into into Dexcom. And vice versa, share our data with those people, particularly as you head down the health and wellness path. And let's get some other people's sensors into our platform. In all honesty, if Abbott's really good at sensing these other things, we'll take that data on our platform and analyze it to if they want to, I guarantee you, that probably isn't gonna, gonna happen. But we would, you know, let's be open about this. We're going to get our glucose work done to because we've not seen an opportunity that exceeds this. Stacey Simms 27:13 Got it? Excellent. Well, thank you so much for answering that it really is so interesting to watch and to see if, as you say, if any of this really, really makes a difference commercially, if people do want to adopt it widely. You know, I think the jury's still out, so we shall follow. Kevin Sayer 27:26 Hey, thanks for having me again. Stacey Simms 27:27 Thank you so much. Have a great day. You're listening to Diabetes Connections with Stacey Simms. More information at the episode homepage, diabetes, Dash connections.com. I'll have the transcription up as soon as I can. But again, quick turnaround on this episode. Thank you so much, again, for sending in the questions. Obviously, I didn't get to all of them. And if you're not in the Facebook group, that's generally where I asked for questions for this kind of thing. It's Diabetes Connections of the group. I'll link it up in the show notes. As always, I know not everybody's on Facebook, please feel free to always email me if you email me now about Dexcom. I'll save those questions until the next time we talk to them. It's Stacey at diabetes connections.com. Again, it's in the show notes and it's on the website. But I get it not everybody is on Facebook these days. To that point, at the very beginning of the show, in that little sponsor tease before things even begin, I mentioned club 1921. So let me tell you a little bit more might be an update for some of you. Maybe some of you are hearing about this for the very first time. Briefly, club 1921 is a website. It's a project I've been working on for a long time. And it is a place where anyone with any type of diabetes can find events anywhere in the United States. We are in beta right now. I invite you to go to the website club 1920 one.com. Until around, check it out. Let me know what you think we've immediately identified we went into beta, late last fall several things mostly about the signup that need to be fixed, those could be fixed by the time you log in, my guess is closer to the end of January. There's a little bit of confusion there. I'll explain in a moment. But other than that, it's pretty well set. The idea here is that instead of a Google Calendar or something like that, this would be a website where you go, you sign up, you tell us what kind of events you're looking for, and then you never have to come back, we'll email you automatically. When events that meet your criteria are edit, very easy. So you pick your type of diabetes, you pick your location, you pick which type of events you want, you pick your age, I mean, you can just say I want everything in every category you can kind of go through, but whatever you pick, and you can change those if you want to come back and change your filters, but whatever you pick, we will email you when those events are added. If you want to add events. There are two types of events you can add one we're very creatively calling events. This is your JDRF walk. This is your friends for life conference. This is your hospital education for people with type two. It's an event by an organization a was a staff an event where they expect lots of people or it's regularly scheduled, or there's a fee, that kind of thing. The other kind of events we're calling Hangouts. These are my favorite types of events. I love what we're calling Hangouts. This is your mom, coffee, your kid play date at a playground, you know, you're going out to a bar, post COVID, with your adult friends with type one, hang outs are not put on by an established organization. They're put on by people like you and me, we don't have a staff, we just want to meet people in our area. When you're adding those. That's where a lot of the confusion came up in the registration process. Because if you want to add events or Hangouts, you actually have to sign up in a different way. So I'm going to talk more about that as the weeks go on. We're fixing that part of the website. But if you try to sign up and you see some confusion, it may be because you are trying to add an event or a Hangout. If you want to just sign up to learn about the events and Hangouts, it should be pretty simple. But if it's not, if you have any questions, any suggestions, please let me know. Email me Stacey at diabetes connections.com. Pretty soon you'll email me Stacey at Club 1920 one.com You're going to be hearing a lot more about this because I'm so excited about it. Yes, I know, we might not have a lot of events this year, that's fine. We're going to have events, eventually, in the diabetes space. Again, we're gonna have lots of events, and social media, Facebook, even things like Eventbrite are a terrible way to get the word out about them. And it shouldn't be work to find them, you should be able to just raise your hand and say, I want to know about this stuff. And it should automatically come to you. And that's what I'm hoping to do here. Okay, back to our regular schedule with the podcast. We will have our Wednesday in the news that's live at 430. Eastern on Wednesday on YouTube and Facebook, and then 445 on Instagram. And then that turns into an audio podcast episode for Fridays. And hopefully next week, we're back to Tuesday and Friday. And we won't do any of this nonsense of pushing episodes around. But I do appreciate your patience. Again, I didn't want you to wait a week for this interview. All right, thank you as always to my editor, the very flexible and understanding John Bukenas from audio editing solutions. And thank you so much for listening. I'm Stacey Simms. I'll see you back here in just a couple of days until then, be kind to yourself. Diabetes Connections is a production of Stacey Simms media. All rights reserved. All wrongs avenged

The Funk'tional Nutrition Podcast
189: Metabolism Series Part 3: Glucose Monitoring, Red Flags & Metabolic Health

The Funk'tional Nutrition Podcast

Play Episode Listen Later Jan 7, 2022 35:56


This minisode is Part 3 of a 3 part series Erin is doing on Metabolic Health, where she answers some of the most common questions she has received on all things metabolism! Tune in as Erin rounds out this series with topics like the red flags to look for with high and low blood sugar, glucose monitoring, lethargy after eating, how much hunger is “normal”, what stress/sleep have to do with blood sugar, and the best types of movement practices for your hormones. In this episode: -Without testing, what are red flags to look for? [3:12] - Low Blood Sugar Red Flags [4:12] - High Blood Sugar Red Flags [4:54] -Should everyone do glucose monitoring for a baseline? [6:30] -Do you recommend testing blood sugar every morning even if someone is NOT diabetic? [9:52] -Is lethargy normal after eating? [11:05] -How much hunger is normal? [11:55] -Do I have to be using a CGM to do the Carb Compatibility Project? (Hint: No! Here's why) [15:48] -Best things to prioritize to rein in glucose metabolism after a few days of heavy carb intake [21:30] -When trying to keep blood sugar balanced is it necessary to eat carb/fat/protein at every meal and snack? [25:38] -How to figure out your unique threshold for carbohydrates [27:49] -What are the basic principles that everyone should apply in regards to metabolic health [29:17] -What does stress and sleep have to do with blood sugar [29:33] -The best type of movement practices for your hormones [31:11] - Is healthy sleeping all due to diet/wellness work, or dedicated sleep hygiene? [33:41] FOR OUR FULL LIST OF LINKS + RESOURCES, HEAD TO: https://www.thefunktionalnutritionist.com/podcast/189-metabolism-3-glucose-monitoring-red-flags-metabolic-health

Diabetes Connections with Stacey Simms Type 1 Diabetes
In the News.. new glucose-regulating molecule discovered, eary CGM use helps kids, Lilly ends Journey Awards and more!

Diabetes Connections with Stacey Simms Type 1 Diabetes

Play Episode Listen Later Jan 7, 2022 6:42


In the News... top stories this week: A second glucose-regulating molecule discovered, CGM use closer to diagnosis helps T1D kids, Lilly discontinues "Journey Awards," study on Dexcom use in hospitals, and why does this concept car share a diabetes tech name? -- Join us LIVE every Wednesday at 4:30pm EST Check out Stacey's book: The World's Worst Diabetes Mom! Join the Diabetes Connections Facebook Group! Sign up for our newsletter here ----- Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners! ----- Episode Transcription:  Hello and welcome to Diabetes Connections In the News! I'm Stacey Simms and these are the top diabetes stories and headlines of the past seven days. All sources linked up on our Facebook Page and at Diabetes-Connections dot com when this airs as a podcast. XX In the News is brought to you by The World's Worst Diabetes Mom, Real life stories of raising a child with diabetes. Winner of the American Book Fest Prize for best new non-fiction. Available in paperback, on Kindle or as an audio book – all at Amazon.com. XX Our top story.. You know insulin helps regulate blood glucose. Now scientists have discovered a second molecule in the body that seems to do the same thing. It's produced by fat tissue but uses a different molecular pathway.. so it's hopeful this could get around insulin resistance. These scientists say the hormone, called F-G-F-1 suppresses breakdown of fat cells into free fatty acids and regulates the production of glucose in the liver. Because it does this in a different way from insulin, they're calling it a second loop. Very early here but very intriguing.   XX New study out of Stanford says setting children and teens up with a CGM shortly after a T1D diagnosis.. results in a lower A1C a year later. They looked at kids diagnosed in 2018 to 2020… and compared that group to other children diagnosed four years earlier. In that first group, about 90-percent started CGM in the first month.. in second group it was under 2-percent that started that early.  At diagnosis, the children in the newer cohort had higher A1c s. At 6 months and 12 months after diagnosis, the patients in the new cohort had significantly lower A1Cs than the other kids. These researchers say the news is more evidence to get insurers to cover the devices. https://healthier.stanfordchildrens.org/en/kids-early-use-of-diabetes-technology/ XX A new risk factor for type 2 mostly affects women, and it's in about 10-percent of the population. A new study says about one in 10 adults has a lump in their adrenal glands that, though otherwise harmless, increases production of certain hormones that increase the risk for Type 2 and high blood pressure. About 70% of those with them were women, most of whom were 50 years old or older. It's called mild autonomous cortisol secretion and these researchers say we should start screening for it. https://www.upi.com/Health_News/2022/01/03/adrenal-tumor-diabetes-blood-pressure-study/2471641237308/XX XX After almost 50 years of honoring people with diabetes with anniversary medals, Lilly Diabetes is phasing out the Journey Awards. Awards were given to patients for 10, 25, 50 and 75 years. A Lilly spokesperson confirmed the news to me today.. saying “We periodically need to re-assess and prioritize programs as the environment and our business shifts. We believe our decision will allow us to focus on programs that we hope bring the most value to people living with diabetes.” They encourage people to check out the Joslin Medalist program and I'll link that up. Joslin.org/research/our-research/medalist-program-study XX Movement on a couple of court cases involving insulin makers. Sanofi lost its appeals court bid to revive patents on Lantus. You'll recall that last year, Viatris got approval for Semglee, it's long-acting insulin, which is basically the same thing and is approved for the same indications as Lantus. Sanofi is facing an antitrust lawsuit accusing it of obtaining some 20 patents in an effort to delay competition. Viatris has been knocking out the patents in court. https://www.bloomberg.com/news/articles/2021-12-29/sanofi-loses-bid-to-revive-lantus-solostar-insulin-pen-patents XX A federal judge has pared down a class action lawsuit accusing the biggest insulin makers of racketeering. Novo Nordisk, Sanofi and Eli Lilly  are accused of scheming together to inflate prices. However, the US District Judge ruled that claims under the racketeering laws of several states (except for Arizona's) must be dismissed… because the laws do not allow claims by plaintiffs who bought the drugs through intermediaries, such as insurance companies, rather than from the drugmakers directly. The same judge did allow these RICO claims to proceed earlier this year in a separate class action against the companies brought by direct purchasers. https://www.reuters.com/legal/litigation/sanofi-lilly-escape-state-racketeering-charges-insulin-price-battle-2021-12-17/ XX New look at CGM accuracy in hospitals, mostly for people with type 2. This study looked at the Dexcom G6 and didn't measure how it influenced care, just whether the readings were accurate compared to finger sticks.  As you'd imagine, the readings were less accurate at the extreme highs and lows, but the researchers concluded CGM technology is a reliable tool for hospital use. The FDA allowed expanded Dexcom use in hospitals less than two years ago, so this is still very new. https://pubmed.ncbi.nlm.nih.gov/34099515/   XX Dexcom partners with another new company.. this one is called SNAQ.  Snaq is a diabetes app that is designed to track both your diet and your blood glucose… and can give you nutritional info of your food just by taking a photo with your smart phone. Good write up & review on that  from Diabetes Daily which I'll link up. Apparently, it works pretty well! The partnership means all US based SNAQ users can automatically view Dexcom CGM Data together with their meals inside the Snaq App https://www.diabetesdaily.com/blog/we-tried-the-snaq-diabetes-app-695058/   XX Hat tip to our friend Nerdabetic who spotted this ridiculous story. LG Electronics introduced a new in-vehicle infotainment concept tailored to autonomous vehicles. It's designed to blur the distinction between home and car .. This is a car cabin that can turn into a space where passengers work, watch TV, exercise or experience camping virtually. The name? LG Omnipod It was presented at the Consumer Electronics Show this week. No comment yet from Insulet, the makers of the Omnipod with which most of us are already familiar. http://www.koreaherald.com/view.php?ud=20220103000636 XX   Before I let you go, a reminder that the podcast this week is all about diabetes in media, a really deep dive into how representation on screen influences those watching. Listen wherever you get your podcasts or if you're listening to this as on a podcast app, just go back an episode. Next week's episode will be a little bit delayed.. released either very late Tuesday evening or early Wednesday morning. I'm set to talk to the CEO of Dexcom on Tuesday and I want to get that to you as soon as I can.. rather than hold it. So thanks for your patience on that. That's In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.

Well & Worthy Life Podcast
Monitoring Your Blood Sugar Levels

Well & Worthy Life Podcast

Play Episode Listen Later Jan 4, 2022 49:28


There are so many benefits to monitoring your blood sugar levels. Today I have Molly Downy on from NutriSense, sharing about what you can learn by wearing a continuous glucose monitor. Molly is a licensed dietician and nutritionist specializing in glucose control, metabolism and weight loss. She works as a dietician at NutriSense, a health technology company. At NutriSense they leverage continuous glucose monitors as a way to optimize diet, health and overall wellbeing. When you think of the word glucose, do you think people with diabetes or high blood sugar? Most people do! NutriSense works with people who have type two diabetes as well as the general healthy population. They support those who are curious about their health and want to know how to respond to different variables in their life. Using a continuous glucose monitor is one way to provide better insight into your body and metabolism. It lets you know how you're processing different foods, how you respond to different workouts and how you respond to stress and sleep. The continuous glucose monitor helps those at NutriSense identify anything that's going on within the users body. Staying up on any potential yellow flags early on allows modifications to made.  Down the road, any of these adverse issues or the progression of a specific disease can potentially be avoided. When you work with NutriSense using the CGM, you are connected with a dietician who can support you and guide you in your health journey. Believe me when I say, you'll want to tune in to this episode. You'll discover how meal sequencing can help regulate your glucose response, what happens when you eat throughout the day and how movement can helps maintain blood sugar. So many great hacks you'll want to incorporate into your life! Let me know what you think about this topic. DM me on Instagram or email me, I love to hear your feedback! Referred to in this episode: Quick and Easy Blood Sugar Balancing Meals for a Healthy Life Importance of Blood Sugar Stabilization Join me in Balance NutriSense on Instagram NutriSense website Use code Deanna25 to get $25 off at NutriSense  

Well & Worthy Life Podcast
Monitoring Your Blood Sugar Levels

Well & Worthy Life Podcast

Play Episode Listen Later Jan 4, 2022 49:28


  There is so much we can learn about our bodies when we monitor our blood sugar levels. Today on the podcast I have registered dietician, Molly Downey, on. She is a licensed dietician and nutritionist who specializes in glucose control, metabolism and weight loss. Molly works as a dietician at NutriSense, a health technology company, which leverages continuous glucose monitors as a way to optimize diet, health and overall wellbeing. I'm guessing when you hear the word glucose, you think of people with diabetes or high blood sugar. Not only does NutriSense work with individuals who have diabetes but also the general population. They seek to support those who are curious about their health and want to know how to respond to different variables in their life. Using a continuous glucose monitor is one way to provide insight into your body and personal metabolism. It lets you know how you're processing foods, how you respond to different workouts and how you respond to stress. The continuous glucose monitor helps those at NutriSense identify anything going on within the users body. Staying up on any potential yellow flags early on allows modifications to made.  Down the road, any of these adverse issues or the progression of a specific disease can potentially be avoided. When you work with NutriSense using the CGM, you are connected with a dietician who can support and guide you in your health journey. Believe me when I say, you'll want to tune in to this episode. You'll discover: how meal sequencing can help regulate your glucose response what happens when you eat throughout the day how movement can help maintain blood sugar There are so many great hacks and you'll want to incorporate them into your life after you listen to this conversation with Molly.  Let me know what you think about this topic. DM me on Instagram or email me, I love to hear your feedback! Referred to in this episode: Quick and Easy Blood Sugar Balancing Meals The Importance of Blood Sugar Stabilization NutriSense Website NutriSense Instagram Use code Deanna25 to get 25% off NutriSense Balance Program 

Diabetes Connections with Stacey Simms Type 1 Diabetes
(Un)Doing Diabetes Representation: What the media gets wrong (and what we can do about it)

Diabetes Connections with Stacey Simms Type 1 Diabetes

Play Episode Listen Later Jan 4, 2022 45:24


Diabetes on TV and in movies is rarely anything close to accurate. Turns out, those media misconceptions can be real-life harmful. This week, Stacey is joined by Dr. Heather Walker, the co-author of (Un)Doing Diabetes: Representation, Disability, Culture and Dr. Phyllisa Deroze, who contributed a chapter called “Laughing to Keep From Dying: Black Americans with Diabetes in Sitcoms and Comedies. Dr. Deroze & Dr. Walker both live with type 1 and both have difficult diagnosis stories that influenced their experiences with diabetes going forward. This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. More about Dr. Phyllisa Deroze More about Dr. Heather Walker ---- Check out Stacey's book: The World's Worst Diabetes Mom! Join the Diabetes Connections Facebook Group! Sign up for our newsletter here ----- Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners! ----- Get the App and listen to Diabetes Connections wherever you go! Click here for iPhone      Click here for Android Episode Transcription: Stacey Simms  0:00 Diabetes Connections is brought to you by Dexcom. Take control of your diabetes and live life to the fullest with Dexcom. This is Diabetes Connections with Stacey Simms. This week, diabetes on TV and in the movies is rarely anything close to accurate. And those media misconceptions can be real life harmful. Here's one from the sitcom 30 Rock.   Dr. Phyllisa Deroze  0:30 Tracy has diabetes there. And he does this skit where he replaces his foot with a skate. And he's like I'm practicing for when I lose my foot to diabetes. And that is the thing. There was a diabetes diagnosis and the next scene, he's already imagining himself with an amputation.   Stacey Simms  0:49 That's Dr. Phyllisa Deroze, who wrote a chapter in a new book we're talking about this week. The book is called (Un)Doing Diabetes Representation, Disability Culture. And it's authored by Dr. Heather Walker, Dr. Deroze and Dr. Walker both live with type one, and they join me for a great conversation. This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. Welcome to another week of the show, I am always so glad to have you here. You know, we aim to educate and inspire about diabetes with a focus on people who use insulin. This is our first show of 2022. So Happy New Year, everybody. I hope you're doing okay. Still stressful days for everybody. But hopefully you can kind of come along with me every week, as we talk about what we're finding interesting in the diabetes community. And I say that because 2021, I decided I was going to focus on technology for the year, I was going to try to do as many episodes as I could, talking about new technology talking to these companies. And I did that although I gotta say the log jam at the FDA made that a little difficult, right? I mean, we thought we'd have a lot more new technology. And a lot of companies will not talk about stuff until it is FDA approved. So this year, I'm going to stay with that because the technology episodes are what you have told me you are the most interested in, in fingers crossed are going to have some approvals pretty soon. But I gotta tell you, I've also decided that I'm going to do shows on just whatever the heck I find interesting. I started this show seven years ago, this coming summer, and honestly, this might be the last year of it in this form. I mean, I love it. I love doing this but seven years is a long time for any project. I have some new things that I'm working on. I'm not sure how much time all of it is going to take. I'm not abandoning the podcast by any means. I want to hear from you too. As we go forward. You know, as the year goes by, I will keep the lines of communication open. We will figure it out together. This episode does fall into the category of something I am fascinated by and I love to talk about and that is diabetes in media. And by the way separately. Both of my guests this week have bananas misdiagnosis stories, we get to that right out of the gate. Wait till you hear what one of their doctors ended up doing. I have never heard this happening before. It was pretty wild. And we will talk about the book I mentioned that it is (Un)Doing Diabetes Representation, Disability Culture. It is authored by Dr. Heather Walker and Dr. Dr. Bianca C. Frazer. It contains essays by other authors including Dr. Phyllisa Deroze a little bit more about the book in its public description. It says undoing diabetes is the first collection of essays to use disability studies to explore representations of diabetes across a wide range of mediums from Twitter to TV and film to theater fiction, fan fiction, fashion and more. In undoing diabetes Authors deconstruct assumptions the public commonly holds while writers doing diabetes present counter narratives community members create to represent themselves. And just a little bit more about my guests. Dr. Heather Walker is Associate Director of qualitative research at the University of Utah health. She was diagnosed with type one at age 11 in 2001, and Dr. Phyllisa Deroze began blogging at diagnosed not defeated almost immediately after being misdiagnosed. She found out later with type two diabetes in 2011. And now she has been correctly diagnosed with LADA. Dr. Phyllisa Deroze is also the founder of Black diabetic info after the interview, and it's a pretty long interview. And that's okay. They have a lot of great stuff to say, I'm going to come back I want to tell you about something that happened to me. It's not quite diabetes in media, but it is diabetes jokes. So I want to tell you how I handled something in a Facebook group. But I'll come back and do that after the interview.   Dr. Phyllisa Deroze, Dr. Heather Walker, welcome. I'm so happy to talk to you both. Thanks for coming on.   Unknown Speaker  4:50 Thank you.   Stacey Simms  4:51 So let's start if we could, I mean there's so much to get to and I was so excited to see you both at friends for life and see the presentations that you were doing but which You mind kind of backing up a little bit and kind of letting people get to know you? We could start just tell me a little bit about your diabetes diagnosis story. And Phyllisa, let me let me ask you to start with that if I could.   Dr. Phyllisa Deroze  5:12 Um, yes, I was diagnosed shortly after getting my PhD in English literature. I had moved to North Carolina, I experienced the classic symptoms of hyperglycemia. I had seen a physician who didn't check my blood sugar told me that I just needed to drink Gatorade because my electrolytes were off. A little later I was in the hospital. Blood sugar didn't register. Finally, I think first reading was like 597, or something like that. So I was told I had diabetes, and what type didn't get clarified until I was discharged. When I was discharged. I was told that I had type two diabetes, and I lived with that diagnosis for eight long years, it was inaccurate, I was misdiagnosed. I live with latent autoimmune diabetes in adults. And I was correctly diagnosed and joined the T1D group in 2019. I get this   Stacey Simms  6:06 question. Every time I speak to somebody like yourself who was misdiagnosed like that it happens so often. How do you live with what is really type one for all that time? I mean, I can't imagine you felt very well.   Dr. Phyllisa Deroze  6:20 I did. Okay, after diagnosis, I had a pretty long honeymoon phase, I actually lived about three years with just diet and exercise. I think one thing in the T1D community is that we don't talk enough about honeymoon phases and people who have latent autoimmune diabetes and adults, because so much of the common knowledge about type 1 diabetes is that everyone is insulin dependent. And that's not necessarily true, everyone will become insulin dependent. And that's an important message, because I never thought to have test done until I went into DKA. Again, so I myself didn't know that it was possible to have type 1 diabetes have a long honeymoon period and be misdiagnosed.   Stacey Simms  7:09 Yeah. The more I learned about Lada, it is so similar, but it's so different. There's a lot more to it, I guess, is what I would say, than I had realized for sure. Heather, what is your diagnosis story? When were you diagnosed with diabetes?   Dr. Heather Walker  7:21 So I was diagnosed at 11. And I also sort of have a misdiagnosis story. So I had diabetes, and I was in what I assumed to be a honeymoon phase for three months before my diagnosis actually came around. Because I was seeing a physician at the time who looked at me, skinny white girl, whose parents were really afraid because she kept losing weight, who was just about to hit puberty, and he thought eating disorder. No matter how many times I told him, I was eating everything in sight and drinking everything in sight. That's still what he firmly believed. Luckily, at about three months after I started coming in to see him for this and for the symptoms, he went on vacation, and I got to see his pa instead. And his pa John, you know, it's so funny. I don't even remember his last name. But just he's just warmly John to me, right? He just looked at my chart, and he knew right away, it's like, oh, you have diabetes, you know, so calmly, and I remember that freaking me and my mom out. We were in the appointment. It actually was my dad. But still, the first thing that we did was went and got me a doughnut because I think my dad was like, alright, well, maybe this is it. You know, he'll never eat another doughnut. Yeah, like, we really don't know about this, we don't know what's gonna happen. And so they didn't do a glucose tests on me. They just drew blood. So we didn't know right away anyway. And then it was like, you know, the next day, they called and said, You need to come to the hospital and for US history.   Stacey Simms  8:45 I'm guess I'm gonna get ahead of myself a little bit here. I don't want to start drawing conclusions too early in this interview. But it is interesting how both of you were misdiagnosed. Somebody else made an assumption, because of how you present it to them. I've got to imagine. So Heather, let me ask you. And then Phyllisa, I want to ask you the same question. But other how has that stuck with you? I mean, you you kind of set it so matter of factly they're like, Hey, he assumed I had an eating disorder. Did you kind of carry that with you?   Dr. Heather Walker  9:11 Oh, yeah, absolutely. I think I got a huge chip on my shoulder. From that. I mean, there's something about you know, being 11. And being in a world that already doesn't take you seriously, and then have a life threatening disease thrown at you. And your doctor doesn't believe what you say, even before diabetes. And Stacy, I've heard on episodes of your podcast you talking with with teens about or people who were teens with diabetes, about how fast it speeds your life up, right? Like you don't really get to have a childhood you don't really get to be a teenager and like, you know, carry on with reckless abandon because you just can't because there's all these safety things that you need to take into account. And so, but even before diabetes, I was kind of like that, like I was, you know, a 30 year old and a 10 year old body. I've been the same Age since then until now, but that, for sure gave me a big chip on my shoulder. It made me want to like, look into everything and see as it's happening to other people is like what's going on with this diabetes stuff.   Stacey Simms  10:13 Phyllisa, I'm curious for your experience too, because as you you kind of already said something interesting, which was like, Well, I didn't know how were you supposed to know? Right? The doctor supposed to know.   Dr. Phyllisa Deroze  10:23 Right. What's interesting is that when I was told that I needed to look into LADA because I had given a speech in Dubai to a roomful of doctors from the MENA region, Middle East and North Africa. And I was simply telling them my diagnosis story, very similar to what I share with you is a little more in depth, but pretty much that was the basics. And you know, I'm 31 years old at the time. And so during the q&a, some of the physicians from Tunisia, they raised their hand, and I was like, yes, they were like, well, your story kind of sounds more like LADA than type two. Are you familiar with it? And I said, not really. I mean, I know Cherise Shockley has it, but I don't know any more details than that. And it was at the lunch afterwards, one of the physicians came up to me and she said, you really ought to look into seeing if you have a ladder, and don't stop until you get the answer. And that kind of haunted me like, don't stop until you get the answer. But I just thought it was a simple request. So I asked my Endo, I got told no, I asked three months later, if I had ever been tested, the answer was no. Well, can I get tested? No. I saw a second opinion. No, you have type two. So I definitely think their view of me being an African American woman living with obesity played a lot into the constant denials. It took me over a year, another decay episode, and begging my gynecologist to run type one antibody testing for me in order to get it. So it wasn't easy. I literally had to not stop until I get the answer.   Dr. Heather Walker  12:11 For Phyllisa, it was your OB they finally gave you the testing you wanted?   Dr. Phyllisa Deroze  12:15 Yes. Because I told her, I can't get an endocrinologist to run this test. I know I'm in decay, a I'm losing weight rapidly. And she listened to me and she said, Okay, she said, I don't do endocrine, I do you know, OB GYN. So we were literally on her computer on Google trying to find the codes to request the testing. And so she was calling around, what do I put in to order this? And I remember when she called and she said, Listen, you know, this is out of my field. But come get these results, because your endo was going to need to see them. That was all on me. I got the results. I just remember seeing the get 65 should be below five. And mine was greater than 7500.   Stacey Simms  13:05 Oh, I'm almost speechless. I mean, I'm not I'm never actually speechless. I came in less than that happened. But the idea that you have to work so hard to get those answers, I've got to assume just like with Heather, that had to inform not only your experiences going forward, but the way you help other people because you both are extremely active in the community. You You're both very prolific writers, you both have, you know, studies and presentations that we're going to talk to, but Felicity, that whole experience with somebody else saying, Well, I think you have lotta to I got to get answers for myself to finally getting them. When you look back on that, how does it inform how you talk to other people about   Dr. Phyllisa Deroze  13:43 diabetes? I tell people definitely to be way more assertive than then imagined. Like, I honestly did not think it would take me constantly asking for the results. I thought it was like a simple test. I mean, you're testing my cholesterol, you're testing my a one C, like you're already getting a vial of blood, like just check off one antibody. So I thought it was something simple. And it turned out it was not, which was very frustrating for me. Because like in that I realized my education level didn't matter to them. I was literally like you are African American living with obesity. And that was what I believed to be their motivating factor to deny me testing. And what's so problematic about that, in addition to everything else you can imagine is as my physician Wouldn't they want to know that they're treating the right condition. Yeah, I'm asking so my records actually have a note from my endo saying, Melissa asked multiple times for type one antibody testing, and I denied it   Stacey Simms  14:55 literally says I denied it in your file.   Dr. Phyllisa Deroze  14:57 Yes. Wow.   Stacey Simms  14:59 I'm just sorry. I got to ask, did he show that to you as an apology? Or did you sit there in the room while you made him write it?   Dr. Phyllisa Deroze  15:05 What I did was I refused to leave the appointment. I love it until there was this moment of record, like, I need you to recognize that I have been asking you for over a year for this test. We just need to come to that because it was like, Oh, you need insulin, let's go. And, you know, I was kind of being escorted out of the room. And I said, No, I'm literally not going to leave this chair until we have this conversation. And so I didn't know that my endo would put it on my records. But I definitely refused to leave until that conversation was had, they did apologize. And there was a note and my files.   Stacey Simms  15:47 It just didn't have to be that hard. This could have been an episode in and of itself. Want to make sure to get to that the research or the publications that sparked my interest here.   Right back to our conversation and right was like kidding about the diagnosis stories, and then her doctor putting in her chart that he was wrong. Oh my god. Alright, Diabetes Connections is brought to you by Dexcom. I want to talk for a minute about control IQ, the Dexcom G6 Tandem pump software program. When it comes to Benny's numbers, you know, I hardly expect perfection, I really just want him happy and healthy. And I have to say control IQ, the software from Dexcom. And Tandem has completely exceeded my expectations, Benny is able to do less checking and bolusing. And he is spending more time in range. This is in a teenager, a time when I was really prepared for him to be struggling, his sleep is better to this is great for all of us basal adjustments possible every five minutes, the system is working hard to keep him in range. And that means we hear far fewer Dexcom alerts, which means everybody is sleeping better. I am so grateful for this, of course Individual results may vary. To learn more, go to diabetes connections.com and click on the Dexcom logo. Now back to the interview. And we are moving on to Dr. Walker's book. Heather, tell me about the book that's coming out.   Dr. Heather Walker  17:14 Okay, I'm so excited to be talking about this. So you might hear that excitement in my voice. So it's awesome. The title of the book is called undoing diabetes representation, disability culture, that's a full title. And it's going to be released very soon, by the end of the year, we hope it's a collection of essays that looks at diabetes in a new way, the volume or the volume as a whole. You know, it points out that all the stereotypes of diabetes that the public really buys into are like maintained through a lens of individualism, our society looks at diabetes as a problem of the individual person right of their choices. And so to respond to that public tendency, right to like focus on the individual, all of our authors in the book do the opposite. So in the collection, they ask questions like, What do individualistic stereotypes reveal about the social conditions for the diabetic person? So it like flips it on its head? And also what do they conceal, right? What is stereotypes hide? What do they prevent us from seeing? And how do these like harmful narratives, these harmful assumptions, these stereotypes that just break down our community? How do they reinforce ideas that the public already has, for what constitutes like a normal or a good body, which is just like, as a person who's living with diabetes, this makes me so excited. And then I'll just add one final thing about the book, which is our collection is really unique in that we use disability studies frameworks to unpack all of these questions. What are disability studies? So this ability studies is a field of study that looks at the social conditions of disability. So how is disability perceived in society? How is it represented on the screen, and all of those types of things. And so we have frameworks in the field that we use, it's kind of imagined, like a camera lens, right? That's kind of like a framework and the camera lens has a filter on it. And so when we look at this movie, or this film, we're looking at it through a specific lens with a specific filter. In our book, all of our authors are looking at different types of media, through these disability studies, frames or lenses, and sort of seeing how they operate in society and what they do, and then poking holes at what it does. And every chapter is brilliant, and Phyllisa is going to talk about hers, but as a volume, like I could not be more proud of this collection and all the work that it does. And all of like the change and the shifts it's going to make for readers.   Stacey Simms  19:43 It's so interesting to me because of the mediums that you use so let's let's ask Felicity if you want to if you could talk about what you presented friends for life, what you talked about you were looking at TV shows, right and not unfortunately not more current ones which sometimes get it right.   Dr. Phyllisa Deroze  19:59 Um, yeah, I was the title of my chapter is laughing to keep from dying black Americans with diabetes in sitcoms and comedies. So I was looking at television shows as well as movies, and focusing on how those representations make meaning of diabetes within African American communities. Part of this started, when I thought about the first time I heard you have diabetes, and I was in the emergency room, my first thought was, I'm going to die. Like that. Was it? Like, I just thought like diabetes meant death? And when I started unpacking that, to find out where did I get that messaging from? Because no one in my family has diabetes. I didn't personally know anybody with diabetes. It really came from television and film, and of course, our media. And I thought it would be really nice to look at some of these classic movies and TV shows that are very popular in African American communities to see what story is told when you focus on the diabetes characters. Can you talk about some examples? Yeah. So for example, like Soul Food is one of those classic staple in African American film, a memory just like the color purple is something that people cite quotes from all the time. But when you look at Soul Food, it really stems from Big Mama who has diabetes. We understand this because she burns her arm on a stove. And a couple of things later, she passes away, she has an amputation and then a stroke. And she's no longer with us. The Big Mama character also comes up in Tyler Perry's plays and his films in his television shows. And again, these are staple matriarch characters who have diabetes. Now Madea lives on because that's a part of, you know, Tyler Perry series, but she has diabetes Boondocks I look at and of course Blackish. So blackish, I would say is probably where we first see the the image turn, where we first see a character with diabetes, checking their blood sugar, and all the other stuff we don't. And so what that tells us is that diabetes is going to cause either a slow death or quick death, perhaps an amputation, if you're familiar with 30, Rock. Tracy has diabetes there. And he does this skit where he replaces his foot with a skate. And he's like I'm practicing for when I lose my foot to diabetes. And that is the thing, there was a diabetes diagnosis, and the next thing, he's already imagining himself with an amputation. So when we look   Stacey Simms  22:59 at something like this, what do we take from it now? I mean, we you can't go back and change those representations. What do you want us to kind of learn from them.   Dr. Phyllisa Deroze  23:08 But I would ideally like for the film industry, to change their portrayal of characters with diabetes, I mean, all characters, not just African American ones. But last year, there was the release of the Clark Sisters first ladies of gospel biopic on lifetime. The Clark Sisters are like a staple in African American culture. They were these gospel singers that were absolutely phenomenal. The Lifetime movie of them ended up being the highest rated Lifetime movie and four years. This comes out last year, the mother has diabetes. She is seen not taking her medication, not caring about her diabetes. And of course, there's all these tragedies that happen. And the thing is, when we don't see African Americans using CGM technology, insulin pump technology, we don't see checking blood sugar. What happens with those messages is that it becomes the common assumption. So when someone goes to the doctor, the doctor may think, Oh, well, black people don't check their blood sugar. And so then that begins to impact the individual prime example. I was in a setting once. And a woman said, Oh, I didn't think black people ate vegetables. What? Yes, yes, literally said this. And I was just so floored, but I thought, okay, she didn't think black people ate vegetables. And so I'm wondering like, what images you know, is she being fed? Right? Yeah. came from so the thing is, is we have to look at our television and our film, not just as sources of enjoyment for some people, but also as information that provides an understanding about certain people. So literally in all of the films and television shows that I look that there were probably two that showed the African American character with diabetes, actually living a rather fruitful life. Outside of that it was amputation and death. And so when someone is diagnosed with diabetes, like I was, and I didn't know anyone with diabetes, instantly, the first thing I thought about was death and dying. And that association that comes with it, when I hadn't seen people living well, with diabetes, I just want to say this. When I was first diagnosed, I went to Barnes and Nobles sat down in a bookstore with one of Patti LaBelle cookbooks, and I flipped to a page and she said, in this book, I had diabetes, but I wasn't going to let diabetes have in me, and I cried, right there in the Barnes and Noble, because that was the first time that I had ever seen or read or heard someone who looks like me diagnosed with diabetes, and they were determined to continue living their life. Like if you want to see that image, where do you go? Because our television and our films are not that place. And that's also the fertile ground for which black diabetic info on my website started and my blog, because I didn't know where to go for that. Like, I got it in Patti LaBelle cookbook, and I cry. But then where can I go to see it again? Yeah, didn't have an answer. Heather, I   Stacey Simms  26:53 want to come back to you and ask you something I saw you posted about on on Twitter. A couple of months ago, Pixar posted a teaser for their new movie turning red, which I think comes out in the spring. And there's like a split second shot of a kid wearing some kind of what looks like diabetes device. It's, you know, an insulin pump or a CGM. And they confirmed it. I actually talked to somebody behind the scenes at Pixar and fingers crossed, we'll have them on the show in a couple of weeks. But it is a diabetes. I'm so excited. But it is a diabetes device. But you were pretty adamant about one point, would you mind sharing that? And why? Sure.   Dr. Heather Walker  27:30 So when I saw that, you know, I came late to the show. Let me preface with that, right. Like, by the time I saw that trailer, the community was abuzz. Like they everyone was so excited. And what I saw was, Oh, my goodness, we see a character with type 1 diabetes. And as someone who is completing a chapter for a book of essays on representations of diabetes, you know, my antenna went up when I saw how the community was claiming that. And I just thought to myself, This is not a representation of type 1 diabetes, this is a representation of diabetes, because people with type two can and should have access to those devices as well. And so for the type one community to be exclusive, in this moment, in this grand opportunity for all of us to celebrate together, really sort of broke me down in a way, you know, I was like, Why? Why can't we just keep this open? Why can't we make this a win for everyone? Instead of saying, quote, unquote, type two people don't use these devices? And I think that the reason why it was like it was like a jab in my heart is I think that that claiming does something in society, right? It, it functions to show us that large groups of the diabetes are the type one community feel like, maybe type two diabetics aren't using that technology, because they're the ones who don't care. And they're the ones that the stereotype is about. And so that shows me that we have pockets in our type one community that buy into the stereotype just like the public does.   Stacey Simms  29:06 I'm looking at the description of the book in terms of the different mediums you use Twitter, to TV to film to theater to fiction, fan fiction.   Dr. Heather Walker  29:13 Yeah, we have a chapter, whatever author of your chapter covering a segment of fan fiction, and it's wonderful and actually, that author and she discloses in her chapter as well, so I'm not outing her. She also lives with diabetes herself. And I'm pretty sure she has a physical science PhD. So this genre and this discipline is new for her and she just like, Oh, she did such a great job having us understand how diabetes is being pulled into fanfiction. Alright, we   Stacey Simms  29:46 now should have set this up better if you're not familiar, and I'm going to do probably a terrible job of describing this. If you're not familiar. Fanfiction is stories, poems, pictures, it's fiction, written by people who are Fans have a genre or fans of a certain bunch of characters, and then they kind of make up their own stories using the established characters most of the time. So in other words, you love Harry Potter, you write yourself into Harry Potter or you write a different adventures that the characters might have had. And it's accessible to pretty much everybody. Is that how I feel about fanfiction? Yeah, I   Dr. Heather Walker  30:18 think it's kind of a, you know, once you get into it, you know where to look. You can probably Google it. And you know, I'm not even really in the world of fanfic, full disclosure and transparency. But I feel like I want to beat now that I've read, I've read that chapter. So   Stacey Simms  30:34 these are characters people are writing about that loop with diabetes, or they are the just bringing diabetes into exactly as it sounds. It sounds silly, as I'm saying it out loud. Like I'm explaining it. I'm trying to, you know, hit it over the head to the to find a point. But just to be clear,   Dr. Heather Walker  30:48 yes. So I think in the pieces that this author talks about in their chapter, it's situations where the characters themselves do not have diabetes, and the fanfic authors write them having diabetes. Oh, so they add that to their character.   Stacey Simms  31:04 You know what we were doing that a long time ago? Because I don't know if you know, Heather, and Phyllisa, but Bob, the builder definitely has diabetes, because why else? Would he have that big belt around his equipment? Because that's where his insulin. So anytime we saw somebody on screen with that, he was like, Oh, he's got diabetes. I didn't mean to interrupt Heather. But that clarifies it for me.   Dr. Heather Walker  31:23 Oh, yeah. That's a perfect example. Right is imagine that we had a fanfic author who loves Bob the Builder when they were a kid. And now they're writing the whole story about Bob, the builder and his diabetic life. It's wonderful. The book itself,   Stacey Simms  31:37 is this something that's accessible to people? And I asked that I mean, is it more of an academic book, tell me a little bit more about that.   Dr. Phyllisa Deroze  31:43 So one of the things that I like about the book is that it's assessable. For a large reading audience, if you are a casual reader, you can get through it, if you are an academic, you can get through it. So it's not laced with academic jargon. But again, we are using theoretical frameworks, but in a language that is accessible to everybody. So that's one I definitely enjoy about the collection, is there something in there forever?   Stacey Simms  32:13 And that's a great point, because I think we do get a little nervous about academic type books, Heather, right. I mean, it's, it can be a little scary and off putting it away.   Dr. Heather Walker  32:21 Yeah. And I'll just add, you know, we have, so we have several authors who are like myself, and Phyllisa, who are scholars and community members, which is very nice, and just like really brings it home. And so, you know, you kind of know, as a community member, that you're going to get authentic pieces by people who are living with this, in addition to having a couple of us who are scholars and committee members, we do have chapters from community members, from activists who don't have their hand in academia at all, and they're writing about their personal experiences. And, you know, they're still talking about representation in different media, but they're doing so from their lens existing in the community existing in the world with diabetes. And if nothing else, although I, I would also say what, you know, Melissa said was true, all of them are accessible, but especially those that are coming, you know, from the mouths of babes that are coming from our community members, who, who many people who do pick up the book already know,   Stacey Simms  33:20 before I let you go, let me let me pose this question to each of you in kind of a different way. And that would be you know, full. So you mentioned blackish, being a bit of a turning point, the show where people are shown, you know, a character shown checking blood sugar. I'm looking back over the last year and thinking of a more accurate depiction of diabetes, or at least type one with the Babysitter's Club on Netflix with we'll see with Pixar is turning red, but with Greenland, you know, written by someone who's married to Greenland, the movie Written by someone who is married to a person with type one, do you think things are getting better? And and I would ask you, as well to include the black community, because we don't talk about that enough. You know, I mean, I'm trying to think if all of those I mentioned they did not feature people of color. Do you think it's getting better? I mean, what would you like to   Dr. Phyllisa Deroze  34:06 see, I would like to see more diversity as we get better in the American film industry. When I look at all the films that I studied, type 1 diabetes is grossly under represented like none of these characters have type 1 diabetes, which again, if you think about myself, 31 years old, being diagnosed, I never knew type 1 diabetes could be an option. I'm still not seeing African American characters using technology wearing CGM. Often when I'm out in public. People are asking me about my devices. It's the first time you're seeing them. I'm explaining insulin pumps. And so while things are getting better, I would say within shows, television shows and films that are popular within African American characters. Progress is about Very slow on that. And   Stacey Simms  35:01 Heather, from where you stand. Could you share a little bit about what you think is going on in media? Are we getting better?   Dr. Heather Walker  35:07 Yeah, I think Phyllisa what you're speaking to right is incremental ism. It's like we are getting better slowly, like painfully, slowly, bit by bit. I mean, I'm inclined to say yes, only because the number of representations that we're seeing are increasing. But, you know, I'm hesitant at the same time to say yes, because we still have to ask, okay, if we even if we have more representation, are they representations that are doing good for diabetic people in society? Right, like, not necessarily, Are they accurate? Or are they you know, a direct portrayal of what people experience? But what is the public taking away from that representation? Like, what are they leaving that with? And if we have a lot more characters all of a sudden who have diabetes, but the audience still thinks, Okay, well, diabetes is still what I thought it was, right? It's like overweight people over eating, making bad choices not exercising? If that's what they're leaving with, then the answer, of course, is no, we're not making progress, even if we're having more characters. And what I find is, what I think we would need to make really big change would be to centralize a character with diabetes instead of making them a sub character, right? Yeah, like for the baby sitters club. And Stacey is not a new character with diabetes is has old, right, like we've known that Stacey has had diabetes for a long time, it just wasn't being produced at the quality it's being produced at. So that's not really even a new one. But we do have new ones, like there's a just a year and a half ago, or so there was a new series called Sweet magnolias. And one of the characters there has, or is about to be diagnosed with diabetes, and it's the same, it's the same story. It's like, you know, if you don't fix your habits, you're gonna get diabetes, and you're gonna die like your mom and all these fear tactics. And so and I really want to be hopeful, Stacy, I really want to be hopeful and say, Yes, we're headed in the right direction. But I just don't know i We need people in the writers room with diabetes, and other health conditions and disabilities, to have a direct voice and call things out before they're produced.   Dr. Phyllisa Deroze  37:19 I agree 100%, we have to be in the room. Because some things they don't make sense. For example, blackish, you do see him check his blood sugar. However, once he puts the strip in the meter, he starts talking to his wife, and anyone who knows how to use a meter knows that you have about 30 seconds before you have to put a drop of blood on that thing, or else you've lost it. So even little things like that.   Stacey Simms  37:46 I had indicated that was the last question, but I got one more. And that would be and II feel free. Either one of you jump in? Or both? What can the community do? You know, sometimes I feel like, you know, I stopped correcting people online a lot of the time unless it's really egregious, you know, but if they make a joke, or there's a hashtag diabetes with dessert, or things like that, like I'm tired, you know, and then you have no sense of humor, you know, gosh, what can we do to try to fix this? Or what can we do to to improve the situation?   Dr. Phyllisa Deroze  38:15 I think, this research, this book, this podcast, these conversations are so important. So for example, prior to writing my book chapter, I didn't see anything talking about the representation of African American characters in television and film. Whenever I talked about diabetes characters, there was maybe the one mention of soul food, but like, there was a dearth there. So this book chapter hopefully helped spark the conversation in wider circles. And so by talking about it more, and rallying around these things, hopefully, the attention like first recognizing that there is a problem, and then getting think tanks together to talk about them is probably the best plan of action.   Dr. Heather Walker  39:06 I love that. And I would just add, you know, I think what the community needs to prioritize is inclusion, right? Like, we need to give up on being exclusive, especially in the type one community, and we need to open our doors to people with type two people with Ladda. People with all like, there are so many different types of diabetes, that even saying type one and two is, is exclusive. I really believe that if we can do that, and if we can elevate the voices of people with diabetes of all types, who are also people of color, then we'll make a lot of progress in our community because we'll start seeing those perspectives that we've been missing that make us as a community really limited to our own perspective. To me, that's the only way to do it. I love the idea of a think tank Phyllisa I think that's brilliant, and just absolutely, and I'm sure you would agree needs to be diverse, right? Like it can't Be a bunch of like, white people. I don't know. There's a lot we can do. There's a lot.   Stacey Simms  40:08 Thank you both so much for joining me. This is amazing. I'm so thrilled to have you both on the show, you've got to come back on there. We just kind of scratched the surface here. So thank you for spending so much time with me.   Dr. Phyllisa Deroze  40:18 It's a pleasure. Thank you for having me.   Dr. Heather Walker  40:21 Yeah, this has been so fun. You're listening to Diabetes Connections with Stacey Simms.   Stacey Simms  40:34 More information about my guests and about the book on diabetes all at diabetes connections.com. As you know, every episode has its own homepage with transcriptions and show notes and all that good stuff. The transcription started in January of 2020. And we're working our way back here in there, hopefully filling in all the blanks. But right now, not every episode before 2020 has a transcription. And I should tell you just I don't want to get ahead of myself here. That Pixar movie that we talked about turning red. Since our conversation, they put out another trailer and it showed more diabetes gear, another child in the movie is wearing a Dexcom. So it looks to me I mean, really can't tell yet. But it looks to me like one kiddo has some kind of pump. And another kiddo has a Dexcom. So as I said, I had a contact at Pixar. And I've got another one now. And it looks like there might be an actor, a voice actor in the movie who has diabetes. So we're to sort this all out. And I should be able to have somebody on about this. I don't want to over promise. But the folks at Pixar have been really receptive. So that looks like they won't do it too far in advance because the movie comes out in March. So as we get closer, I'll keep you posted for it. And I had mentioned a story before the interview about not necessarily diabetes in media, but about jokes. And I don't know about you, but years ago, I was on high alert for diabetes jokes, you know, I can't eat that, or the the hashtag of my dessert is diabetes. And I don't know, I got burned out. And I don't talk about it as much. I don't police it as much, certainly, but I couldn't help myself last week, at Christmas, I'm in a group. It's a very clever group. It's called fatten the curve. If you want to join it. It's a public group, a friend of mine in the Charlotte area started at the very beginning of COVID. Obviously, it's a play on flatten the curve. And as you would expect fatten the curve is all about food. And it's just become a place where people who cook and eat like to share their photos. And somebody posted around Christmas time, you know, it's my diabetic coma, and then all of this food. So I kind of did the do I want to go to I want to do this, or I want to get this person's face. So I just very nicely said, Hey, diabetes jokes are never cool. Not sure if you thought about that. But hey, the food looks absolutely delicious. You know, hope it was as good as it looked or something nice like that very casual and breezy. Just like Hey, dude, not cool. But moving on. And there's a couple of other people in the diabetes community who have joined that group, but it's not diabetes, it's just food. But you know how it is when when Facebook shows you something people, you know, jump in. So other people commented like, yeah, Stacey's right? Please think twice. And this guy apparently lives with type two posted like a non sequitur about his scientific studies and stem cells and all this stuff about diabetes. He did, obviously, not really sunk in I don't think, but he didn't respond negatively. And I just said, You know what, fine, I'm moving on, right? But then a couple of days later, somebody else popped in, it was like, nobody can make a joke anymore. You're too sensitive, and why we're just too easily offended. And that's when I was like, Alright, now I need to respond. So I very nicely, I think it was nice. You know, I wrote a response. And I said, Hey, you know, once the guy said he had diabetes, you'll notice I didn't clap back, I didn't get nasty. We are all entitled to say whatever we want. But it's important to understand that what we say does have meaning and impact. And as you listen, I know, you know, all this, I did the standard. When we joke about diabetes, we don't do this with other conditions. We don't talk about a cholesterol coma, or a high blood pressure problem when we're eating big meals like this. Why is it only diabetes? And did you realize that actually, you know, the blame and shame that can be encountered here prevents people from seeking treatment or makes them feel like it's all their fault, and nothing they do will matter. I posted all that waiting for the response. There was none, which I'm really glad about. Because I don't want to argue I just it's exhausting. But everyone's not something like that pushes my buttons and I have to save something. Hopefully that group will just go back to posting yummy pictures of food because it's been two years and we haven't had any issues like that. I mostly post pictures of what my husband cooks. Because I don't like to cook and what I do cook isn't really Facebook, really. So I guess we're often running for 2022. We are back to the Wednesday in the news episodes. I hope you'll join me for that either live on Facebook, YouTube or Instagram, or as an audio podcast which comes out on Fridays. Thanks as always to my editor John Bukenas from audio editing solutions. Thank you so much for listening. I'm Stacey Simms. I'll see you back here soon, in a Couple of days until then, be kind to yourself   Benny  45:07 Diabetes Connections is a production of Stacey Simms media. All rights reserved. All wrongs avenged

iForumRx.org
Top Ten Things Every Clinician Should Know about Continuous Glucose Monitors (CGM)

iForumRx.org

Play Episode Listen Later Dec 31, 2021 21:13


Continuous glucose monitors (CGMs) are now commonplace, and every clinician should know the basics about who can benefit from CGM use and how to address common questions and problems.  Authors:  Brianna Patacini, PharmD, BCACP, CDCES and Dawn Fuke, PharmD, BCPS Special Guest: Jennifer Trujillo, PharmD, BCPS, CDCES, BC-ADM Music by Good Talk

Diabetes Connections with Stacey Simms Type 1 Diabetes
In the News.. Medicare CGM changes, Beta Bionics update, wearables to predict T1D and more!

Diabetes Connections with Stacey Simms Type 1 Diabetes

Play Episode Listen Later Dec 31, 2021 4:59


Our top stories this week include Medicare further expanding CGM coverage, Beta Bionics has an iLet update, ADA announces new Standards of Care, a new study looks at using Fitbits to predict the risk of type 2, and more! Join us LIVE on Facebook every Wednesday at 4:30pm EST   Check out Stacey's book: The World's Worst Diabetes Mom! Join the Diabetes Connections Facebook Group! Sign up for our newsletter here ----- Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners! ----- Get the App and listen to Diabetes Connections wherever you go! Click here for iPhone      Click here for Android Episode transcription below: Hello and welcome to Diabetes Connections In the News! I'm Stacey Simms and these are the top diabetes stories and headlines of the past seven days. As always, I'm going to link up my sources in the Facebook comments – where we are live – we are also Live on YouTube and in the show notes at d-c dot com when this airs as a podcast.. XX In the News is brought to you by The World's Worst Diabetes Mom, Real life stories of raising a child with diabetes. Winner of the American Book Fest Prize for best new non-fiction. Available in paperback, on Kindle or as an audio book – all at Amazon.com. XX Our top story.. another adjustment for CGM coverage under Medicare. All types of continuous glucose monitors will now be included. The difference here is that it includes CGMs that aren't approved for making decisions about insulin dosing – at this point, that's really just the Medtronic brand. This follows another decision in July that covered CGM use with any insulin – including inhaled insulin - and got rid of the four times per day fingerstick testing requirements. The new rule goes into effect in two months. https://www.healio.com/news/endocrinology/20211222/cms-expands-medicare-coverage-for-all-cgms XX The American Diabetes Association is out with its annual Standards of Medical Care in Diabetes. Notable updates include: Screening for prediabetes and diabetes beginning at age 35 for all people; Changes to gestational diabetes recommendations regarding when to test and who to test. Updated recommendations on technology selection based on individual and caregiver considerations, ongoing education on use of devices, continued access to devices across insurance companies, support of students using devices in school, use of telehealth visits, and early initiation of technology. https://www.prnewswire.com/news-releases/latest-ada-annual-standards-of-care-includes-changes-to-diabetes-screening-first-line-therapy-pregnancy-and-technology-301448533.html XX Little bit of news from Beta Bionics, makers of the iLet Bionic Pancreas System. They've completed a randomized controlled trial for their insulin only pump.. this included 440 adults and kids over the age of 6 with type 1. The iLet is different in that you only put your weight in and the system learns you. No carb ratios or basal rates. You do still announce meals, but no carb counting.. just meal size. Public presentation of the clinical data is expected in the first half of 2022. They're now enrolling into the screening protocol for the next step, the pivotal trial for their Bihormonal pump that would use insulin and glucagon. https://www.globenewswire.com/news-release/2021/12/22/2356645/0/en/Beta-Bionics-Announces-Data-Lock-of-the-Insulin-Only-Bionic-Pancreas-Pivotal-Trial-and-Enrollment-into-the-Screening-Protocol-of-the-Bihormonal-Bionic-Pancreas-Pivotal-Trial.html XX You probably know there is a terrible shortage of endocrinologists in this country.. an estimated 80% patients with diabetes use their primary physician's office for their diabetes care. There's a new push for more endo fellowships.. These 1-year programs, with funding and accreditation, train interested family and internal medicine clinicians in intensive diabetes management. There are several in existence but there's a new white paper on this getting a lot of buzz. However, critics say it would be a drop in the bucket and couldn't graduate enough endos to make a difference. Everyone agrees that the problem needs to be addressed. https://www.healio.com/news/endocrinology/20211229/endocrinologists-propose-diabetes-fellowship-programs-to-address-growing-gap-in-care XX Interesting study on the use of health wearables and changes in blood sugar. Wearables here refers to Fitbits, so they're tracking activity not blood glucose. These researchers say their models can accurately identify changes in glycemic control among prediabetic adults, and this could be used to better allocate resources and target interventions to prevent progression to diabetes. Interestingly, the wrist wearable seemed to work better for people than the waist kind. Not a big surprise when you think about which is more popular for use outside of studies. Anybody use a waist wearable anymore? Let me know. https://www.nature.com/articles/s41746-021-00541-1 XX And finally.. a Tennessee man who'd never heard of JDRF just won a 2021 Ford Bronco in that organization's long-running fundraising contest. Every year JDRF and Ford give away the truck – Henry Ford's great grandson has T1D – and they've raised about half a million dollars with the contest. Derek Bonzagni entered the day before it closed this year.. he learned about it through an online forum for people who love Ford Broncos – not the diabetes community.. AND.. he and wife just bought a Bronco for her – before he won. So now they match. https://www.healthline.com/diabetesmine/jdrf-ford-bronco-diabetes-sweepstakes#6 XX Before I let you go, a reminder that the podcast this week is with Peloton star instruction Robin Arzon – she's got great motivation to get us moving whatever your fitness level. Listen wherever you get your podcasts or if you're listening to this as on a podcast app, just go back an episode. Next week we're talking about diabetes in media with the authors of a new book. Hoo boy.. That's In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.

The Healthy Rebellion Radio
Vaccine Hesitancy, CBD and Testosterone, Omega 3:6 While Reducing Sat. Fat | THRR096

The Healthy Rebellion Radio

Play Episode Listen Later Dec 31, 2021 49:44


Make your health an act of rebellion. Join The Healthy Rebellion Please Subscribe and Review: Apple Podcasts | RSS Submit your questions for the podcast here News topic du jour: Pre-pandemic cognitive function and COVID-19 vaccine hesitancy: cohort study "Vaccination is central to controlling the present pandemic, with success reliant on a sufficiently high uptake to achieve herd immunity (Omer et al., 2020). 1. CBD and testosterone [35:01] Jonathan says: Hello I am a 42 year old male, to the best of my knowledge, in good health. I strength train 4 times a week and am looking to keep my testosterone levels optimal. I have no reason to believe my testosterone levels are not good, but am cautious about taking supplements that have a known negative impacts on testosterone. I am hearing a lot of positive claims for CBD, and believe that you've talked about personally using it. Two that are most prominent is: 1. to reduce inflammation and 2. To reduce anxiety. Do you know what the effects of CBD on testosterone? How does this differ from THC? Thanks! Jonathan https://gaiaguru.co.uk/does-cbd-affect-hormones/#:~:text=CBD%20has%20been%20suggested%20to,break%20testosterone%20down%20(4). "CBD has been suggested to reduce testosterone production by inhibiting the enzyme 17α‐hydroxylase, which makes Testosterone in leydig cells of the testes (4). However, CBD also inhibits specific cytochrome p450 enzymes in the liver which break testosterone down (4)." 2. Omega 6:3 Ratio When Lowering Saturated Fat [38:19] Nathan says: Hi Robb, First discovered your work in 2009 when podcast episodes were still single digits. My lungs had collapsed 14+ times, I had 3 lung surgeries, and long story short: I put a super rare autoimmune disease into remission thanks to you! In an effort to make this message easier to process, I've tried to ask the question first, then included context below if it's helpful. QUESTION: Dr. Cromwell recommended that I try lowering saturated fats to less than 15% of total calories, keep total fat around 60%, retest in a couple months, then chat with him again. Seems like a good next step. I've been mostly eating low-carb paleo + full fat grass fed dairy (keto at times, for mental performance) so I've been getting lots of what I've considered high quality animal fats...but this recommendation has me scratching my head regarding where I should be getting my ~60% of calories from fat from. I'm planning to increase fatty fish like salmon in my diet, but I'm a bit worried about getting omega 6:3 ratios all out of whack if I cut out much of the grass fed beef, grassfed full fat dairy, wild game, etc I've been eating. Egads! Thoughts? ### CONTEXT: After listening to your episode with Dr. William Cromwell, I ordered Cardiometabolic Risk Assessment and just got off a great call with him. Incredible person and amazing work he's doing. Anyway, everything looks good/great except for my cardiovascular risk, which is high (thanks to LDL-C at 174, non-HNL-C at 189, and ApoB at 136). I also have a family history of heart disease at a relatively young age, and though I'm only 34, I've been told that cardiac surgery in the future isn't much of an option on account of the fact that my lung surgeries essentially fused my lungs to my chest wall...so I basically need to just prevent cardiovascular disease in the first place. Given that I tested as highly insulin sensitive on his risk assessment, Cromwell said he'd expect me to do fine with up to 75g of carbs per day (currently doing 40-ish). p.s., my sister is a fishing boat captain and runs the only all-female crew (badasses) up there. If you and the family ever make it up there, we could get you the family discount (free) to go out on the boat and catch hundreds of pounds of incredible fish to bring back! Great for little girls to see women doing such badass work as well! You've made a pretty indescribable impact on my and my family's health over the years, and it's hard to thank you enough! 3. CGM sensor and BJJ [45:40] Jared says: Hey Robb, I'm making 2022 the "year of the data" and plan on spending time monitoring sleep, stress levels, etc with a wearable, testing ketones with finger pricks and tracking my blood glucose with a CGM (for at least a month). Any advice on where to place the sensor and how to secure it while rolling? I'm on the mats 4-6 times per week and I plan on using the Freestyle Libre 2 unless you have a better suggestion so ideally the sensor would stay stuck to me for 14 days. Thanks in advance for the insight and also for being a strong voice of nuanced reason during this covid shitshow. Jared   Sponsor: The Healthy Rebellion Radio is sponsored by our electrolyte company, LMNT. Proper hydration is more than just drinking water. You need electrolytes too! Check out The Healthy Rebellion Radio sponsor LMNT for grab-and-go electrolyte packets to keep you at your peak! They give you all the electrolytes want, none of the stuff you don't. Click here to get your LMNT electrolytes Transcript: Can be found at: https://robbwolf.com/2021/12/31/vaccine-hesitancy-cbd-and-testosterone-omega-36-while-reducing-sat-fat-thrr096

Pixels & Ink
Pixels & Ink Podcast: Episode 375 — So Long 2021

Pixels & Ink

Play Episode Listen Later Dec 30, 2021 77:18


On this week's Pixels & Ink Podcast: as 2021 comes to a close, Brendan, Chris, Dayna, and Jordan look back on the year; the highs, the lows, and CGM's new GOTY nominations as voted on by our wonderful audience. The gang talks about their favourite reviews from the year, and their own personal Game of the Year choices. Happy New Year from CGM and here's to another year of friends, family, safety and of course videogames!

CGM Presents: Wives In the Word Podcast
Episode 6, "God Will Bless You in 2022!"

CGM Presents: Wives In the Word Podcast

Play Episode Listen Later Dec 30, 2021 9:01


This episode is about expecting God to bless you in 2022. So we are now ending the year 2021. And I am thinking of the tears that have been shed by many people in 2021. Some of you have cried some bitter tears. I know I have on a few occasions, but listen to me, there is something about crying out to God and shedding your tears. God hears us when we cry out to him. God sees the tears that we have shed and your tears are not in vain. Your crying out is not in vain because when you love the Lord, he sees, he knows he hears and he answers. He takes your tears that you shed in 2021, and he is getting ready to pour them out in 2022 , pour out a blessing and water a garden of blessings for you in 2022. Just remain faithful to him, continue to trust him and continue to believe in him.This is  Apostle Charles G. Wright and Stephanie Wright. Until next time, may God's love, peace, and protection be with you.If you would like to be a guest on our podcast, email us at cgmpresents@gmail.com - We can be reached on Facebook at CGM Present: In the Word Podcast and our handle for Twitter and Instagram is @cgmissions, and  for YouTube is cgmissions. CGM is a 501(c)(3) nonprofit. Donations may be sent through CashApp to: $cgmissions

Diabetes Core Update
Special Edition: Explaining Time in Range Data to Patients – December 2021

Diabetes Core Update

Play Episode Listen Later Dec 29, 2021 21:00


In this special episode on continuous glucose monitoring (CGM) and time in range Dr. Wettergreen joins our host, Dr. Neil Skolnik to discuss how to simplify and integrate CGM and time in range into primary care office practices.    This special episode is supported by an independent educational grant from Abbot. Presented by: Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health Sara Wettergreen, PharmD, BCACP,  Dr. Wettergreen is an Assistant Professor in the Department of Clinical Pharmacy at the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences and is a clinical pharmacist at UCHealth Lone Tree Primary Care. For more information about CGM and Time in Range, please go to: www.professional.diabetes.org/timeinrange  

LEVELS – Metabolic Insights
What is a continuous glucose monitor?

LEVELS – Metabolic Insights

Play Episode Listen Later Dec 27, 2021 9:16


A continuous glucose monitor (CGM) can help you track your blood sugar in real-time. So how does a CGM work, and who should use it? Author: The Levels Team Link to article: https://www.levelshealth.com/blog/what-is-a-continuous-glucose-monitor Become a Levels Member – levelshealth.com Learn about Metabolic Health – levelshealth.com/blog Follow Levels on Social – @Levels on Instagram and Twitter

The Keto Kamp Podcast With Ben Azadi
Angela Foster | How to Overcome Depression, Fix Your Gut, Reverse PCOS & SHIFT Into A High Performer KKP: 354

The Keto Kamp Podcast With Ben Azadi

Play Episode Listen Later Dec 27, 2021 60:16


Today, I am blessed to have here with me Angela Foster. She is a functional nutrition practitioner and executive health & performance coach. Angela is host of the top rated High Performance Health Podcast where she interviews the world's top experts in health optimization for high performance. Angela is available as a keynote speaker and corporate trainer on the topics of physical and mental health optimization, stress, resilience and longevity. For more information on Angela's talks and training, click here. Angela creates step by step solutions for individuals – through coaching and consulting and public speaking and media – to optimize every aspect of their mind, body and spirit to live a fulfilling and limitless life. Whether you want to enhance your longevity and reverse your biological age or optimize your energy, productivity, cognitive and physical performance, Angela will create the uniquely bioindividual plan to help you do this. After rebuilding every aspect of both her mental health and physical health, Angela understands what is needed to optimize your physical, mental and spiritual fitness and become the resilient human who can have it all – the health, wealth and relationships. In this episode, Angela speaks about getting diagnosed with polycystic ovary syndrome and discovering the connection between her brain, body, and immune system. After having three children, Angela fell into a depression; she gives tips on treating your mental health today. Then, we dive into the brain and gut connection and how you can heal naturally. Tune in as we chat about the importance of sleep, hormones, and improving your health. Free 7 Day Keto Challenge: http://www.ketokampchallenge.com 90 Day Detox Program: http://www.ketokampdetox.com Order Keto Flex: http://www.ketoflexbook.com -------------------------------------------------------- / / E P I S O D E   S P ON S O R S  PureForm Omega Plant Based Oils (Best Alternative to Fish Oil): http://www.purelifescience.com Use ben4 for $4.00 off. Paleo Valley beef sticks, apple cider vinegar complex, organ meat complex & more. Use the coupon code KETOKAMP15 over at https://paleovalley.com/ to receive 15% off your entire order. Text me the words "Podcast" +1 (786) 364-5002 to be added to my contacts list.  [01:15] Angela Speaks About Her Journey To Health Angela was diagnosed with polycystic ovary syndrome (PCOS). She was being prescribed Metformin, and Angela had insulin resistance. After doing research, Angela started to understand that there was a connection between PCOS and what she ate. When Angela had the surgery for PCOS, she found out about her endometriosis. After having three children, Angela realized there is a connection between the brain, the body, and the impact on your immune system.   [06:30] Advice For Dealing With Depression The first thing you need is acceptance. In life, the only thing you can be certain of is change. Anything you can do to create peace in your life will be helpful to you. If you want to run away from yourself, how are you going to sit with yourself? Work on dealing with small moments first.   [10:40] The Brain and Gut Connection: Depression Is Linked To Leaky Gut About 90% of serotonin is made in the gut. You can help your gut to create more serotonin. Aligning with your circadian rhythm will also improve your brain. Natural light from the sun will significantly improve your circadian rhythm and allow you to get more sleep at night. Women are depleted of vital nutrients, particularly things like DHA in the brain. It takes a woman two years to recover from pregnancy.   [14:10] How You Can Reverse Your PCOS For Good PCOS is a syndrome and is related to insulin resistance. Carbs, stress, and not sleeping will raise your blood sugar. Some people are genetically more carb sensitive. Having protein and healthy fats are really key things that make you feel better. If you have too many carbs, you will feel quite foggy. Another thing that improves insulin sensitivity is strength training.   [21:30] Sleep Is An Essential Pillar of Health   Sleep is going to make everything else in your life easier. In Angela's corporate job, people would brag about only getting three hours of sleep at night. Most people need seven or eight hours of sleep. You are compromising your health and the way you look when you get less than six hours of sleep at night.   [25:35] Tips For Getting Better Sleep At Night How well you sleep tonight is going to be changed by what you did this morning. Get outside early in the morning. That way, you're really regulating the cortisol and melatonin cycle. Red light therapy is also a beneficial tool. Another tip for getting better sleep at night is limiting your exposure to blue lights.   [31:10] Hormones: Know When To Dial Back Your Stressors Make sure you have a nutrient-rich diet and you are not constantly stressing your body out. Everyone should fast for at least twelve hours every day. For women, there's a time when you can push and stress your body, and there are times when you should not. Before your period, you're naturally going to have higher levels of inflammation, so it's time to do less high-intensity exercises and start dialing things back.   [35:00] The Importance of Insights On Your Health Journey You need to know how you feel when you wake up in the morning. If you don't have a way of tracking, then it will be challenging to know when things start to change. If you can't afford trackers, just start with pen and paper. A CGM is probably the best thing you can get to really fine-tune your eating behavior and lifestyle behaviors.   [37:45] Fuel: There Isn't A Perfect Diet That Fits Everyone   There isn't one diet that works for everyone; however, there is a perfect diet for you. You can test some of your genetics to understand your sensitivities around carbs and fats. Eating a more ancestral diet is really important; take out processed foods. How you treat your body is the greatest gift you can give yourself.   [42:30] Train Your Body and Train Your Mind You need strength training to maintain and build muscle mass. Also, you want to do some cardiovascular training. The more muscle mass you have, the better insulin sensitivity you're going to have as well. Walking is underrated; you need to get up and get your steps.   AND MUCH MORE!   Resources from this episode: Check out Angela's Website: https://angelafosterperformance.com/ Your Total Health Check: https://www.yourtotalhealthcheck.com/ Follow Angela Foster Instagram: https://www.instagram.com/angelasfoster/ Facebook: https://www.facebook.com/AngelaFosterPerformance/ LinkedIn: https://www.linkedin.com/in/angela-foster-/ YouTube: https://www.youtube.com/channel/UC7ygt0Kro_Mqax2nLtz-yqQ Join the Facebook Group: https://www.facebook.com/groups/femalebiohacker Listen to High Performance Health: https://podcasts.apple.com/gb/podcast/high-performance-health/id1470595534 Join theKeto Kamp Academy: https://ketokampacademy.com/7-day-trial-a Watch Keto Kamp on YouTube: https://www.youtube.com/channel/UCUh_MOM621MvpW_HLtfkLyQ Free 7 Day Keto Challenge: http://www.ketokampchallenge.com Order Keto Flex: http://www.ketoflexbook.com -------------------------------------------------------- / / E P I S O D E   S P ON S O R S  PureForm Omega Plant Based Oils (Best Alternative to Fish Oil): http://www.purelifescience.com Use ben4 for $4.00 off. Paleo Valley beef sticks, apple cider vinegar complex, organ meat complex & more. Use the coupon code KETOKAMP15 over at https://paleovalley.com/ to receive 15% off your entire order. Text me the words "Podcast" +1 (786) 364-5002 to be added to my contacts list.  *Some Links Are Affiliates* // F O L L O W ▸ instagram | @thebenazadi | http://bit.ly/2B1NXKW ▸ facebook | /thebenazadi | http://bit.ly/2BVvvW6 ▸ twitter | @thebenazadi http://bit.ly/2USE0so ▸clubhouse | @thebenazadi Disclaimer: This podcast is for information purposes only. Statements and views expressed on this podcast are not medical advice. This podcast including Ben Azadi disclaim responsibility from any possible adverse effects from the use of information contained herein. Opinions of guests are their own, and this podcast does not accept responsibility of statements made by guests. This podcast does not make any representations or warranties about guests qualifications or credibility. Individuals on this podcast may have a direct or non-direct interest in products or services referred to herein. If you think you have a medical problem, consult a licensed physician.

Pixels & Ink
Pixels & Ink Podcast: Episode 375 — Holiday Spectacular 2021!

Pixels & Ink

Play Episode Listen Later Dec 24, 2021 77:18


On this week's Pixels & Ink Podcast: It's our official Holiday Spectacular as Brendan, Chris, Dayna, and Jordan sit down for a late night, fireside chat about Embracer Group purchasing Dark Horse Comics—because nothing says Christmas quite like some corporate mergers.  Afterwards, the gang sits down to talk about all things Christmas, both the weird and the wonderful. From their favourite Christmas movies, holiday traditions, and the weird lyrics of some Christmas songs, CGM is here to fill you with Christmas cheer! Afterwards, the gang talks a little reviews—Chris has been trying a new Kindle, Brendan has a bit to say about The Matrix: Resurrection and Jordan talks a bit about the EKSA e910 headphones. Merry Christmas, and Stay Safe from Pixels & Ink and the entire CGM crew! If you have any questions or want to write in to the podcast, just send an email to podcast@cgmagonline.com and we'll read and answer your questions on air!

CGM Presents: Wives In the Word Podcast
Episode 5, "Jesus, Emmanuel Everywhere With You"

CGM Presents: Wives In the Word Podcast

Play Episode Listen Later Dec 22, 2021 7:30


Episode 5,  “Jesus, Emmanuel Everywhere With You"Hello and welcome to Episode 5, of our Christmas podcast entitled, “Jesus, Emmanuel Everywhere With You."Today, we are blessed with a dynamic and timely message from Pretoria, South Africa, delivered by Pastor Aggy Kgasoe. Her presentation is based on her favorite Christmas verse, Isaiah 7:14, "Therefore the Lord himself shall give you a sign; Behold, a virgin shall conceive, and bear a son, and shall call his name Immanuel."This is a powerful message especially for a time like this.  Pastor Aggy reminds us that God is with us. Jesus is the answer. His name is Emmanuel, He is with us. He is with us wherever we go, whatever situations in which we find ourselves even in the midst of a pandemic.Stay with us to the end of this Christmas message. We will close with the amazing voice of Delores Tingle singing “O Come, All Ye Faithful,” from CGM's Christmas Album, “We Love Christmas.” Order it from Amazon, Apple Music, Spotify, and other platforms. This is Stephanie Wright with Apostle Charles G. Wright. Until next time, may God's love, peace, and protection be with you, and remember, don't let anything steal your Christmas.If you would like to be a guest on our podcast, email us at cgmpresents@gmail.com - We can be reached on Facebook at CGM Present: In the Word Podcast and our handle for Twitter and Instagram is @cgmissions, and  for YouTube is cgmissions. CGM is a 501(c)(3) nonprofit. Donations may be sent through CashApp to: $cgmissions

The Keto Diet Podcast
#348: Food Combos for Better Glucose Control with Casey Means

The Keto Diet Podcast

Play Episode Listen Later Dec 19, 2021 51:23


Struggling with managing your glucose? Let's chat about proper food combining, the key to reducing your glucose levels and, being able to eat more variety as a result. RESOURCES 21-page guide to achieve weight loss on your keto diet: http://ketoforwomen.com/ Get The Keto Beginning use code, KETOPODCAST for discount: http://healthfulpursuit.com/begin/ FREE guide on how to start keto: http://healthfulpursuit.com/free Keto question? Need help? Send me a message: https://www.healthfulpursuit.com/contact/ Get Levels CGM: https://levels.link/kdp PARTNERS LMNT electrolyte powder $5 sample pack - and get 8 packets: http://drinklmnt.com/kdp Paleovalley non-binge protein bars + whole food vitamin C + apple cider vinegar get 15% off your first order with code KETO: http://paleovalley.com/

Diabetes Connections with Stacey Simms Type 1 Diabetes

This week… something completely different! It's an episode all about my favorite things. With apologies to Oprah, this isn't about the holidays – it's a little late for that! And while some of this might make good gifts, this more of a season-less list. Just good stuff I like. Couple of rules I set for myself: Nothing that needs a prescription. Nothing that I'm getting paid for. No one on this list will even know they've been mentioned until the episode goes live! Hope you enjoy! -Stacey Here are the links to everything I mention: Keep it cool: Frio wallets Tempramed VivCap Sticky stuff/application: Skin Tac wipes Stay Put medical patches Benadryl spray and Flonase spray Nexcare waterproof bandages Cases/accessories T1D3DGear (warning, profanity) Casualty Girl pouches  Disney-themed pouches  Dia-Be-Tees shirts and stickers Books: Think Like a Pancreas Raising Teens with Diabetes Sugar Surfing When I Go Low Just for fun: Heroic Kid (play d-tech for toys)  I Heart Guts New Rufus the Bear! Misc. The Useless Pancreas (marketplace) Highs and Lows Ring Guitar Pick Check out Stacey's book: The World's Worst Diabetes Mom! Join the Diabetes Connections Facebook Group! Sign up for our newsletter here ----- Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners! ----- Get the App and listen to Diabetes Connections wherever you go! Click here for iPhone      Click here for Android Episode transcription below:   Stacey Simms  0:00 Diabetes Connections is brought to you by... Dario Health – Manage your blood glucose levels. Increase your possibilities.By Gvoke HypoPen, the first pre-mixed autoinjector for very low blood sugar. And By Dexcom. Take control of your diabetes and live life to the fullest with Dexcom This is Diabetes Connections with Stacey Simms. This week, something completely different. It's an episode all about my favorite things. With apologies to Oprah, this isn't about the holidays, it's a little late for that. And you know, some of this might make good gifts. This is more of just something I've been thinking about doing for a long time. So I would consider this a bit of a seasonless list, just good stuff that I like. And unfortunately, unlike Oprah, I haven't hidden everything I'm talking about here under your seat as a gift. So I can't do that. But I did set a couple of rules for myself, you're not going to hear me talk about anything today for which you need a prescription. Right, I'm not gonna talk about medical stuff, and nothing that I'm getting paid for. I will put the links for all this stuff in the show notes, but they're not affiliate links. So that means they go right to the product where I think it's most easily available. They don't go to a special link, you know, which tallies you up and then pays me. I mean, there's nothing wrong with that as long as everybody knows what's going on. And a couple of these folks may sound familiar, I've worked with them before, we have had partnerships and sponsorships with the mostly the booked clinic program. But I really just wanted this to be a fun way to share my thoughts. If you have a product that I mentioned. And the link is wrong or doesn't go exactly where you want it, please reach out. I want to make this great for you and easy for my listeners. So drop me a line Stacey at diabetes connections.com. And maybe we'll get a thread going in the Facebook group to find out some of your favorite things. Because you know, Benny is older now and the products that we really needed, you know, like the super cute insulin pump pouches that he used when he was three years old, he does not use anymore. So I don't have recommendations for stuff like that. Maybe we can kind of get a list going and I can do a follow up in a couple of weeks or months for listeners but you really should be in the Facebook group. Anyway, if you're on Facebook, I know not everybody is so if you're there, come on over. Alright, so here are a few of my favorite things   let's talk about keeping insulin at room temperature. A couple of products I really like for that we don't have a ton of issue with this day in and day out. I do live in North Carolina and Benny of course is  outside quite a bit in the summer, he does go to summer camp. When we've needed to keep something at room temperature. We use a Frio generally these Frio wallets pretty standard in the diabetes community you probably know about them. What's nice is you can get them at CBS. Now, I think Walgreens carries them used to be online only. They're really easy to use. Please follow the directions. Don't be like me and oversaturate and then you can't get anything in the wallet. You have to just read the directions. You'll figure it out better than we did. But Frio doesn't keep it cold. It just keeps it cool. But we love Frio. Close to edging it out. And the only reason it doesn't here is because of the price. And because it doesn't yet cover vials. But that's coming is the VIVI Cap. These folks reached out to me middle of last year, probably spring of last year and sent us a sample we decided to try it on Benny's trip to Israel. If you'll recall, my son went to Israel with his non diabetes camp last summer for a month. This included tons and tons of outdoor activity in temperatures that were in excess of 100 degrees. Quite often, he packed two bags, one was like the go bag, three days worth of supplies. And then the other bigger bag that stayed inside or in a refrigerated area, at least the insulin part of it did on the bus or you know, wherever they went, I have my suspicions as to whether it's stayed perfectly refrigerated the whole time, but only a little bit of insulin went into the desert with. But the idea was he would take a pen, we would use the VIVI Cap, and then he would just change the pen out continuing to use the VIVI Cap in his backpack. Whenever he needed more insulin. He had vials he had pens we use both in his pump. And it's always nice to have a pen in case you need to give yourself a shot something like that. So when he came home and this is so typical of my son went through his bag, for he did a great job with diabetes, but there must have been like a communications problem because he never changed out that insulin pen. He never needed to give himself a shot, which is probably why but he just always used the vials that I'd sent him with. I sent him with way too much insulin for a month but you know, you know mom's What am I gonna do? So upshot of this long story is that the one insulin pen that we sent to Israel with stayed in hot temperatures definitely in excess of probably 75 degrees around the clock, and certainly in excess of 100 degrees for several days at a time during the daytime. And what happened to it right it was with the VIVI Cap the whole time so we decided to test it out. You know how he supervised setting right? I wasn't going to let him use this pen and then jaunt off do overnights or whatever he was with us. And look, we would know right away if that insulin was no good. And guess what? It worked perfectly. It was fantastic. He was in range. I mean, he was really we were really watching obviously, right. But he was in range pretty much the whole three days. So it was fantastic. And I was definitely converted to VIVI Cap. That should be their tagline guys call me if you can stand the Israeli desert heat, right, you can certainly hang out a day camp in North Carolina this summer. They often have promo codes, discounts. It's more expensive than the Frio wallet. But it's also really durable and lasts for a whole year. And it has different sizes. So it will fit whatever insulin you're using. My understanding is that they are working on a similar bit of technology for insulin vials, and that would be great.   Let's talk a little bit about getting stuff to stick. I have a whole document about this. If you haven't seen it, it's been a pop up for a couple of months. It's been incredibly popular. So I haven't taken it down yet. But I'm probably going to move it over to the bookstore section. Do you don't have a bookstore section on the website, we're kind of creating a place to put documents a lot of stuff is free. There are PDFs, so we're gonna move that over there. But of course there there's my book to buy and there will be more later this year. But the getting stuff to stick is so personal. I think it's really hard right? Everybody's skin is so different. So here's what we have liked over the years could not keep anything on Benny skin with a Skin Tac that is the brand that we like we get Skin Tac from Amazon. Over the years we've gone from just using the little Skin Tac wipes to using the liquid bottle we used to liquid for many years. I think gosh, Benny was like 13 or 14 and he was like no more. I don't want that it's not portable enough. He's never home. So he uses the wipes. Now. He uses nothing to dissolve it. So I have no favorite product for that. He literally just rips things off his skin. I cringe every time but hey, it's not my body. We like Stay Put Medical patches. That's the brand, Stay Put Medical just foyer for years and years. We had trouble in the water. I tried vet wrap I tried all the stuff that all the moms tell you to try. The Dexcom overlays that come free from the company are great, but it didn't work as well in the ocean, or with sweat, that kind of thing. So Stay Put patches really were fantastic for us. The story I always tell is Benny with a diabetes camp for a full week, right Saturday to Saturday. And then we went to the beach and we restarted the ducks calm. This was a couple of years ago. And it survived to Stay Put and the Dexcom survived a week of diabetes camp where they swim and sweat and you know, they're pretty gross for a whole week. It's hot. Again, as I said we live in North Carolina, and then three days at the ocean, sand and ocean. All that stuff that you get and it really did stay put. So I really love that they're big. He got an incredible tan line. That's one of the only downsides of it. We used Benadryl spray, Benny had a brief time of having a mild allergic reaction. I think this was to the Dexcom G5 years ago and my husband came back from the store with over the counter Benadryl spray not Flonase requested, and it worked fine. So it's kind of a weird, favorite thing, but I haven't heard a lot about Benadryl spray, but I'll mention it here. I also really really like next care waterproof Band-Aids, the brand doesn't really matter. I mean, it's just a Tegaderm bandage, but I'd like to mention it because you can get it at the drugstore or the grocery store. It's over the counter. Unlike a lot of the stuff that has to be ordered from your medical company or from Amazon, you can take a waterproof bandage and in a pinch, slap it over your Dexcom or slap it over an infusion set. I mean, you have to cut a hole into for the infusion set. But sometimes you can just slap it on top. We've done that and then gently pulled it off later to reconnect to the tube to pump. And it works great. I've heard a lot of people say they're afraid of doing that because they don't want to block the signal from the Dexcom people. We have done this many, many, many times I can show you photos. When we went to the Dead Sea in Israel, I did not want to take a chance of the salt. Right. It's so salty, corroding the transmitter. So we put a waterproof bandage over the Dexcom. And he left it on for a couple of days. I don't know the probably wasn't very comfortable, but he didn't seem to care. And it worked fine. So that's my in a pinch favorite thing at the beach   let's talk about cases and organization something that my son doesn't care about at all. And if I if this were me, I'm the kind of person that I love pouches and organization and cool stuff like that and he really doesn't care. But I will go through and tell you what I like. I am a huge fan of T1D3DGear. This is just a fantastic family in the diabetes community to begin with, and their stuff is awesome. So as you can imagine T1D3DGear, they're making stuff right they're printing it out on their 3d printer and it's everything from trays, which we do use, I love those makes your supplies really easy to find. And they've got different sizes for different brands to insulin protection vials, which I like a lot, and they will do custom colors as well, we've been so lucky, where's the wood that I can knock that we've never actually like dropped a vial, but I always put the vial we're using in the case. And that makes me feel so much better. It's just a really easy, it kind of looks like R2D2 in a way. I don't think that's by design, but it's really helpful and really handy and they're making super useful products. They also make the cutest ones like if your kid wants a unicorn or different options. I'll link up their website, as I mentioned, Benny doesn't really like pouches, but I make him use them anyway because otherwise his diabetes bag is just a complete mess. So we like the ones from casualty girl, some of these have a bit of profanity, you know, all my diabetes stuff. You can fill in the blank there, but they have a bunch of really clean ones, obviously, you know, for younger children, even for my kid I don't like him carrying stuff in public that that has profanity on it, but they have some really cute stuff specific to diabetes, also personalized. They put names on it, and they were so nice. A couple of years ago we gave away a bunch of their stuff at friends for life, so I always like to recommend them. I also will recommend and link up Disney themed pouches that don't look super Disney. I know a lot of you especially friends for life people you're big Disney fans. I am too but I don't like to have like Mickey Mouse on my purse. I like it to be a little bit more subtle. And at red bubble. There's a bunch of people who will put together pouches you can see the samples. They just kind of hint at Disney so I have the small world pouch but it's just like a pattern that is featured in small world. It's not actually it doesn't say small world. I got Lea my daughter for Hanukkah. This year. I got her one that has the Haunted Mansion wallpaper on it. You'd never know unless you knew. So very cool stuff. It doesn't have anything to do with diabetes. But I love red bubble. They also have a fun bunch of diabetes stickers there. Oh, speaking of stickers. The best is Dia-Be-Tees This is my friend Rachel. And she has amazing T shirts. She is so creative. She's got great stickers, she made an ugly Hanukkah sweater for diabetes, because a couple of years ago, she makes these great, ugly Christmas sweaters for their diabetes steam. They say funny stuff on them. But I pointed out to her like, hey, everybody celebrates Christmas and she was immediately on it. My favorite stickers are the Tyrannosaurus Dex, get it and the Banting fan club that she made this year for Dr. Banting. Very, very cool stuff. And I'll link up to her Etsy shop.   Let's talk about books. I promise I won't talk about my book here. I talk about it enough. But I really would like to recommend some books that have helped us a lot over the years. My favorite, the one that I always recommend is Think like a pancreas A Practical Guide to managing diabetes with insulin. And that is by the amazing diabetes educator Gary Scheiner. He is out with an updated edition. So he did this book, it's got to be I don't know, Gary, I'm guessing 10 years old, but he does update it frequently. I think it's the third edition now. It's really a great source and resource to understand your diabetes and your child's diabetes better and more thoroughly, let's say then perhaps you might get these quick endocrinology visits, definitely better than the information you're getting on Facebook. I of course love raising teens with diabetes, a survival guide for parents by Moira McCarthy that has not been updated for the technology that has come out since its publication. However, I don't think that matters. I think that there are so many wonderful ideas, thoughts and ways to recognize how tough a time it is for teenagers and come through that time with your relationship with your child intact. So I really recommend that I know Maura is working on updating it. But even still, it's so good because I think so many people with teenagers, even as we say all the time Oh, it's such a tough time. It's they feel so alone. I still I mean gosh, you guys I always wonder and I call Moira. She would vouch for me. And I'm like I'm not doing this right. It's hard. It's really hard. I also love Sugar Surfing how to manage type 1 diabetes in a modern world by the amazing Dr. Steven ponder, I would be lying if I said we are perfect sugar surfers. But we have used a lot of the principles that are in this book. And it does help you understand so much about how everything works and the dynamic way of managing. You know before CGM. It's incredible to think how much Dr. Ponder was able to do. And now with the monitoring, it's really, really helpful. But I will say you can get this for free. If you're newly diagnosed, I believe it's the first three months it might be six months, I will link it up. But I'm telling you right now, if you get this for free when you're newly diagnosed, put it away for a couple of weeks at least maybe put it away for six months, because it's it's pretty advanced in my opinion, and you got to learn diabetes, you got to learn a little bit more about it before you start worrying about the Delta and other stuff that's in here. But I love Dr. Ponder and highly recommend that one. I get asked a lot about children's books. And you know Benny and I read so many diabetes children's books, so many I mean how many are there in the market but we read them so often when he was little And my favorites probably aren't even available anymore. You know, Jackie's got game was about this kid who was trying it for the basketball team. And then he goes low. We loved Rufus comes home, which is about the JDRF. Bear, there were a couple of that diabetes kind of popped up into lots of picture books that we read if the person in them didn't have diabetes, or the animals in them. But I gotta be honest with you, I struggle to recommend children's books, because I'm not reading them with little kids anymore. And I think they're a really good judge, right? I do. Like when I go low, a diabetes picture Guide, which is a terrific book by ginger Viera. And Mike Lawson. And this is a terrific book, because both of those people live with type one, we had them on the show, you know, I've known them for years I full disclosure, but I think it's so valuable because as a parent of a child with diabetes, who doesn't live with diabetes herself, I don't have that kind of insight. And I really trust those authors to share that information and help a child kind of give voice to how they're feeling when they go low, that sort of thing. It's a fun, cute book, it's, you know, it's not serious. It's not scary. It's really great. And I'm just gonna say, and don't be mad parents, if you're thinking of writing a children's book, just carefully consider it. Look at what was already out on the market. I talked to a lot of people who spent a lot of money to put these books out, you know, most of them are not published by a traditional publishing house. Some are but most are self-published. And that's great. But you know, gosh, there are so many out there right now that are very similar. So you know, we don't need a general explainer, please think about what the need in the community is, what's the unique need, you can fill? And I would say, you know, that's why I like when I go low, because it's written by people with type one, we do need them. I mean, the children's books are great. And there's some wonderful ones out there, but I'll tell you, what I'd like to see is some elementary school and tween level books. That's what we really need around here. We don't need another picture book, we need something that an 11 year old or an eight year old could read and see themselves in, you know, baby sitters club is the only thing I can think of where diabetes is there, but it isn't always the focus, it would be really nice to have something else like that. Frankly, I'd like to see that adult level book as well. There's a couple of authors that have written books were diabetes featured but isn't like the main point. But boy, it would be really fun to see that in like a blockbuster bestseller kind of book if they got it right of course.   Alright, let's talk about some just for fun stuff. years ago, Benny got his years ago on his 10 year diaversary. So five years ago, we gave Benny the I heart guts, stuffed pancreas. I heart guts is a company that makes they're so funny. They make stuffed animal type body parts, I'm sorry, they call them plush organs. And since we purchased a few years ago, they have a few more options on their website. They have socks, they have pouches, I was talking about pouches earlier, there's one that says party in my pancreas. But what I really like about this is you can get something for your kiddo with type one. But you can also find something for a sibling who doesn't have diabetes, right? If you're if you're just looking for something silly, I gave my daughter the heart, right? I mean, knock on wood, thank God, there's nothing wrong with her heart. But it was a symbol of my love for her. And while she thought it was kind of silly, you know, it's a way to include her. So diabetes isn't always you know, the middle of everything. And they I mean, this place absolutely cracks me up. There is so much here. They've got puns as far as the eye can see. So if your kid needs their tonsils out, if your wife is having a knee replacement, these are just really fun. And I may have to go and order a huge amount of the stickers. One of the things I absolutely love is that a lot of businesses have popped up to make toy accessories for kids with diabetes. So you know, you've probably heard like Build A Bear has a diabetes kit, you can get that online. years ago, the American Girl doll kit kind of kicked this off. But there's a bunch of people in the community making this stuff. So I recommend heroic kid, and they make tiny little CGMs for your Elf on the Shelf. If you're into that, or you can put it on an American Girl doll. You can have a libre, they now make a bunch of insulin pumps. It's awesome. I love this stuff. I mean, I can't even imagine if we'd had a real real looking insulin pump for Benny when he was two years old that he could have stuck on his Elmo. Holy cow. So heroic kid is fantastic. And the other thing for kids I wanted to share. And I I tell if you saw my newscast last week, we talked about this I broke this story in 2019. Jerry the bear, and Rufus the bear are now one, there can only be one, there was only one bear. And we talked about this when beyond type one and JDRF announced their alliance in 2019. I kind of jokingly asked like what happens to the bears? And they answered it with a straight face and said only one. We're gonna figure this out because it doesn't make any sense to have to, you know, we don't want to be spending money on this kind of stuff. So what happened is Rufus is now $22 which is a lot less than the starting price of Jerry. And if you're not familiar, I probably should explain. So Jerry, the bear is an interactive toy made by the folks at Sproutel, they have gone on to make things like my special AFLAC duck. They have, I think it's called a purrburl. It's like a little stuffed animal that kind of helps kids kind of calm themselves. It's interactive that way. And but they started with Jerry, the bear was their first product developed when these guys were in college. It's a really smart team. But Jerry is a teaching toy. And there's an app on he's evolved over the years and really looks great. And of course, now he looks like Rufus. So this is Rufus on the outside Jerry on the inside, and it's available for $22. I'm gonna call this next category, miscellaneous, because these were just a couple of things that I wanted to make sure to tell you about. But they don't fit into many of these categories. And the first one popped up into my Facebook feed. But it looks beautiful. It's a ring. It's kinda like a zigzaggy ring. But it's called to my daughter highs and lows ring, it is only $36. It is cubic zirconia. It is sterling silver plated with 18 karat gold. So this is not a you know, super expensive super valuable ring. And that's fine. I think it's great for what it is, makes it a terrific little gift. And it comes with a card that says the ring stands for the highs and lows in life, wear it as a reminder that I will be there for you through all of them. That's pretty cool. And hey, moms, I mean, you can buy it for yourself. Even though we go through some highs and lows, they don't all have to be diabetes related. I want to mention, this is very silly. But this is our miscellaneous category. And these are my favorite things. I think everybody who uses a Dexcom should have a guitar pick lying around. Because you've probably seen the trick to use a test strip to to pry the Dexcom transmitter out of the sensor for a couple of reasons doesn't work for us. I don't know if our test strips are weak or our transmitters are strong. But we have found that a guitar pick does the trick very easily. And I'll tell you the number one reason why we have to remove Dexcom transmitters, it's because then he will start a dead transmitter, or I'll start a dying transmitter. And he'll ignore all the notifications, we'll put the sensor on and clip the transmitter and then the transmitter is dead. So yeah, the guitar pick comes in handy to pry that out and then put the new transmitter in. I also want to recommend a website not a product here but Useless Pancreas.com is a clearinghouse for so many products. They've done an amazing job. We had them on the podcast earlier this year. But since I talked to them, they've added so much. So if you're tooling around and you're not sure even what you're looking for, like I need to get something that'll make stuff stick or I need something that'll they have these two categories, like what will make my kid happy. It's just a neat place to go and find a diabetes marketplace. So I'd like to recommend that because, you know, you go on Amazon, there's so many choices. But they've done a nice job of really trying to narrow it down and give us one place to go. Alright, before I wrap it up here, I did ask Benny if he had any favorite diabetes, things to recommend. And he looked at me like I hit three heads. After thinking about it for a minute or two. He said, The silent button on my pump and Dexcom. So I can't say I blame him for that. I am happy that he has the vibrate only we wish every alarm could be silenced. We understand why they cannot be. So there you have it. That's my very first favorite things episode, I will put a link in the show notes. For every item that I talked about here, I want to make it easy for you to find. Again, if you are haven't mentioned and you have a product and you're not crazy about the link I use, feel free to email me Stacey at diabetes connections.com or ping me on social media and we will figure it out. I want to make sure that people can find your stuff. And if you have your own favorite things that you'd like to list, I think I will put something in the Facebook group and maybe we'll share that in the weeks to come. Thank you as always to my editor John Buchanan from audio editing solutions. Thank you so much for listening. A couple of weeks left in December, we are going to have these Tuesday episodes, as I mentioned, including kind of a look ahead to next year some predictions possibly. And I'm really hoping to get one more technology update for you in before the end of the year trying to get someone from Tandem to come on and talk about that R&D update that I spoke about in the news episode. Last week. They laid out their five year plan for new products and software. But I will see you back here on Wednesday for in the news or if you listen on podcast. That'll be Friday. All right. I'm Stacey Simms. I'll see you back here soon Until then be kind to yourself.   Benny  24:43 Diabetes Connections is a production of Stacey Simms media. All rights reserved. All wrongs avenged

The Simplicity Sessions
Continuous Glucose Monitor with Cheri Bantilan

The Simplicity Sessions

Play Episode Listen Later Dec 13, 2021 43:47


Welcome back to The Simplicity Sessions, I'm delighted that you've joined us today. My name is Jenn Pike, your host, registered holistic nutritionist, medical exercise specialist, the best-selling author of the Simplicity Project, and the creator of the women's revolutionary health program, The Hormone Project. In this episode, we will be joined by Cheri Bantilan, a registered dietician at Nutri Sense. Nutrition is her passion and she loves sharing that passion with her community in every way. She shared what Continuous Glucose Monitor (CGM) is and what factors affect your glucose levels that can, in turn, affect your overall health. CGM is a small device that lasts up to 14 days and it is painless to use.  Cheri discussed the vision behind Nutri Sense and how she wants to help her clients interpret CGM results to get a better understanding of how glucose works in their body.  Tune in for more information about the CGM and what are its benefits to people that are and will be using it. Check out the Nutri Sense website here: https://www.nutrisense.io/ If you have a question for me and my team, send it over to hello@jennpike.com or via Instagram at @jennpike and I'll do my best to share helpful insights, thoughts and advice.  Here are the main topics of today's episode: Fasting Daily movement Your food intake What does a CGM do? How often should a CGM be used? What is different about Nutri sense? What is a continuous glucose monitor? Factors that play a role in glucose management What are the basic guidelines for stable blood sugar? The impact of sleep, exercise, nutrition, and stress in our glucose Connect with us - Thank you for joining us today. If you could do me the honor of hitting the subscribe button, leaving a review, sharing this podcast with a friend, or tagging me on social media when you visit The Simplicity Sessions Community on Facebook or @jennpike on Instagram, I would be forever grateful. You can connect to this episode on iTunes, Spotify, or Stitcher by searching The Simplicity Sessions, or visiting www.jennpike.com/podcast. Join our growing community via Facebook The Simplicity Sessions Community. Connect with Cheri Bantilan -  Linkedin: https://www.linkedin.com/in/cheri-bantilan-ms-rd-cd-14816367 Facebook: https://www.facebook.com/cheri.bantilan Instagram: https://www.instagram.com/cheribantilan/?hl=en Online work with Jenn -  Register for my signature program The Hormone Project and work with my team and me 1:1 to support your health, hormones, and more via the following link www.jennpike.com/thehormoneproject. Sign up for The Synced Program to learn how to tune your body to the lunar cycle and acquire a multidisciplinary approach to balance your body in less than 30 minutes a day!  Interested in registering for the upcoming Audacious Women mentorship? Send us a message via our website at https://jennpike.com/contact/  To learn more about the products mentioned in this episode, visit the link I've shared on my Instagram @jennpike. There you can discover where you can purchase these products and how you can start to make them part of your everyday simplicity approach. Learn more about the products and supports I recommend from some of our amazing partners - Eaton Hemp is my favourite CBD and hemp company. They are a hundred percent organic, they're unfiltered, and they are third-party tested. To experience Eaton Hemp, use the discount code JENNPIKE20 at eatonhemp.com/jennpike to save 20% off your order. St Francis Herb Farm education includes webinars, blogs and articles on important topics including the plant medicines that they create to promote women's health by targeting digestion, allergies, immune support, heart health, brain health, and sleep. I use and recommend their products and you can use the code JENNPIKE15 at checkout to save 15% off your order. GoodJuju makes all-natural, plastic-free home & body products that are good for you and good for the planet. Use JENNPIKE10 for 10% off your order. Skin Essence is Canadian-founded, organic, non-GMO, and does not test on animals; this company is one that we love and have around the house. You can even talk to the company to get advice on which products may be right to try first. Save 15% off your first order with the code JENNPIKE15 and use code JENNPIKE10 to save 10% off every order after that. Quotes -  “I like the analogy that a CGM is like a movie. You see a full picture of what's happening in your day versus a lab draw or a fingerprint is really just a snapshot, it's just a picture of that moment in time.” “..... fasting in general is a type of stress on the body and stress isn't necessarily a bad thing. It can be if it's out of control.” “What people don't realize is that, sometimes when we say yes, exercise, they expect that I need to exercise for one hour during this huge CrossFit workout in order to get a benefit. And that's not true, any type of movement is helpful, even if you have a high carb meal or a bigger portion size.” “Depending on what you hear when you hear the word carb, because if you hear carbon, you think like bread, pasta, rice, those types of things, maybe you need to tell yourself fiber, so that you go towards things with color.” “.... even if you take a couple bites of your chicken before you eat, you know, your key or your rice or whatever it is that that makes a difference. So prioritize protein for sure.”  

LEVELS – Metabolic Insights
Celebrity holistic nutritionist Mona Sharma wants everyone to connect with how food makes them feel

LEVELS – Metabolic Insights

Play Episode Listen Later Dec 10, 2021 7:46


The mind/body coach looks like the picture of health, but a CGM helped her find the foods behind her lagging energy levels, mood, and brain fog. Author: Jessica Migala Link to article: https://www.levelshealth.com/blog/celebrity-holistic-nutritionist-mona-sharma-wants-everyone-to-connect-with-how-food-makes-them-feel Become a Levels Member – levelshealth.com Learn about Metabolic Health – levelshealth.com/blog Follow Levels on Social – @Levels on Instagram and Twitter

Diabetes Connections with Stacey Simms Type 1 Diabetes
In the News... Tandem's tiny pump, more stem cell progress, a new Rufus the Bear & more!

Diabetes Connections with Stacey Simms Type 1 Diabetes

Play Episode Listen Later Dec 10, 2021 8:03


Our top stories In the News this week... Tandem Diabetes shares a big R&D update, laying out their product pipeline for the next 5 years. More stem cell progress, this time from Viactye, a look at another non-invasive CGM claim, big news for Rufus the Bear from JDRF and Stacey spends some time remembering Beyond Type 1 CEO Thom Scher. -- Join us LIVE every Wednesday at 4:30pm EST Check out Stacey's book: The World's Worst Diabetes Mom! Join the Diabetes Connections Facebook Group! Sign up for our newsletter here ----- Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners! ----- Get the App and listen to Diabetes Connections wherever you go! Click here for iPhone      Click here for Android Episode transcription below: Hello and welcome to Diabetes Connections In the News! I'm Stacey Simms and these are the top diabetes stories and headlines of the past seven days. As always, I'm going to link up my sources in the Facebook comments – where we are live – we are also Live on YouTube and in the show notes at d-c dot com when this airs as a podcast.. XX In the News is brought to you by The World's Worst Diabetes Mom, Real life stories of raising a child with diabetes. Winner of the American Book Fest Prize for best new non-fiction. Available in paperback, on Kindle or as an audio book – all at Amazon.com. You can also get a big discount right now at diabetes-connections.com – use promo code celebrate to save $4 XX Our top story, big news from Tandem as they lay out their product line for the next 5 years. Still waiting for FDA approval for bolus by phone.. once that comes through next up is Mobi, that's brand name for what we've all been calling T-Sport until now. Then there will be an X3 pump, then Mobi goes tubeless, then a true disposable patch pump. They also mentioned some software upgrades. A lot can happen in 5 years but exciting to see it laid out. A lot more to come here, we're working on having Tandem on the show soon. https://investor.tandemdiabetes.com/events-and-presentations XX Over at Insulet, CEO Shacey Petrovic says they no longer expect FDA approval for Omnipod 5 in 2021. After all, that's in just a couple of weeks. She spoke at a NASDAQ investor conference and said it's not any kind of problem, just the COVID backlog at the FDA. Petrovic says she is – quote – “eminently confident in our submission.” https://www.medtechdive.com/news/insulet-omnipod-5-delay-fda/610981/   XX More stem cell research news, this time from Viactye. University of British Columbia and Vancouver Coastal Health.  showing that a tiny implant infused with stem cells can help the body produce insulin on its own. Fifteen patients living with Type 1 diabetes participated in the study, which included the insertion of a device the size of a quarter in their abdomen. Each device contained millions of lab-grown cells that were “coached” into becoming insulin producing beta cells. Six months later, the cells had started producing tiny bits of insulin. Next year the team plans to do the procedure without immunosuppression drugs. The ultimate goal to have somebody who stops taking insulin and not have to take any anti-rejection drugs. We first talked to Viactye about this in 2016 – I'll link up that episode. https://www.ctvnews.ca/health/stem-cell-based-treatment-may-help-type-1-diabetes-patients-produce-insulin-canadian-study-1.5694725 XX The White House continues it's push to pass Build Back Better.. focusing a lot this week on the insulin co-pay cap. It's passed the House and if the Senate approves..  government and private insurers have to cap the cost to the patient at $35 for a 30-day supply of insulin. Nothing in the bill for those without insurance. Btw 20 states and DC have passed similar copay limits. I did see late this afternoon on Twitter a few reps who want to change the language to include the uninsured. We shall see.. XX The Free Style Libre 2 App is now available for Android. Approved earlier this year, it's now actually available for download. The Libre 2 version features optional real-time alerts for both low and high glucose levels, without the need to manually scan the sensor to trigger those alarms. You do still need to scan to see the actual number.   https://www.abbott.com/corpnewsroom/diabetes-care/freestyle-libre-2-now-connected-to-your-iphone.html XX Dueling lawsuits from Abbot and Dexcom. Abbot filed suit last week – it's sealed but has to do with a 2014 settlement agreement. That agreement gave the companies cross-licenses to patents related to glucose monitoring. It also included agreements lasting through March 2021 not to sue each other for patent infringement or challenge the patents' validity. We told you back in June of this year that Dexcom filed the first suit, Abbott countered the next day. This seems like an additional legal maneuver in the same case. https://www.reuters.com/legal/transactional/abbott-sues-dexcom-over-glucose-monitoring-patent-settlement-license-2021-12-02/ XX Another entry for the non-invasive blood sugar monitor rumor mill.. K-Watch Glucose smartwatch has a disposable part underneath that features something called “micro-points” that will measure blood glucose. The company says, “Although the wearer might feel some slight pressure, there is no breaking of the skin and therefore no pain.” Not sure those two thoughts really go together – enough pressure can be uncomfortable enough.. but we shall see. The coverage here talks about clinical trials and getting this on the market late next year. I went to the actual clinical trial recruitment site – and I'll link that – it says the trial started in November but it also says it hasn't started recruiting. I know I'm the dream killer with the non invasive monitoring stuff. I do believe it'll get here I promise! But I think the coverage of most of these items Is irresponsibly based on rumors. https://clinicaltrials.gov/ct2/show/NCT05093569 https://www.notebookcheck.net/Painless-continuous-blood-sugar-monitoring-on-the-horizon-for-US-199-thanks-to-the-K-Watch-Glucose-from-PKVitality.582622.0.html XX there's a follow up to a fun story I broke back in 2019 – the merger of Jerry the Bear and Rufus the Bear with Diabetes. Rufus is getting a big  it looks like the Rufus outside with the Jerry the Bear educational interactive stuff and the app. The price is 22-dollars! A far cry from the first version of Jerry which we gave away a few years ago and cost hundreds of dollars. This is really great and I would have absolutely bought it for Benny if it was out when he was little. How'd I break the story? I interviewed the heads of JDRF and Beyond Type 1 when they announced their alliance– and I asked what was going to happen to the bears almost as a joke. They said, nope – they told me then.. only one bear would make it. https://www.prnewswire.com/news-releases/jdrf-announces-the-relaunch-of-rufus-the-bear-with-diabetes-301437309.html XX I want to take a moment and remember Thom Scher – the CEO of Beyond Type 1 who died earlier this week. I went back and listened to that interview we did back in 2019 – the one where he and JDRF told us about Jerry and Rufus… and a lot more. It was one of many times we talked on and off the podcast. I didn't know Thom as well as many others in the diabetes community. We only met in person a few times – first in 2018 at the Diabetes Mine conference and again in 2019 at FFL – where we talked about working together more.. sort of noodling out the possibility of bringing the podcast into the Beyond Type 1 content. Thom was a terrific interview – not afraid to go on the record and very accessible. I remember once I warned him that I had some tough questions from the community about get-insulin dot org because beyond type 1 takes money from the insulin makers. He welcomed it and answered the questions other people would have avoided.  I just read that Thom was 33 when he died. So incredibly young.  He believed in what he did.. he wanted to make life better for people with diabetes. And the world is little emptier without him today. XX Before I let you go, a reminder that the podcast this week is with the executive team at ConvaTec – the people who make infusion sets for tubed pumps, including the new 7-day set for Medtronic. you can listen to wherever you get your podcasts or if you're listening to this as on a podcast app, just go back an episode. Next week it's a first for me, I'm going to do a “favorite things” episode. That's In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.  

CGM Presents: Wives In the Word Podcast
Episode 3, "The Perfect Gift" Christmas 2021

CGM Presents: Wives In the Word Podcast

Play Episode Listen Later Dec 8, 2021 8:15


Today, Apostle Charles and Stephanie ask, what is "The Perfect Gift" for Christmas?Join us for this brief discussion of Christmas, Christ, and "The Perfect Gift." You can always access additional Christmas podcasts from 2020 at: www.cgmissions.com/podcast/christmas-podcasts-1/If you would like to be a guest on our podcast, email us at: cgmpresents@gmail.com We can be reached on Facebook at CGM Present: In the Word Podcast and our handle for Twitter and Instagram is @cgmissions, and  for YouTube is cgmissions. CGM is a 501(c)(3) nonprofit. Donations may be sent through CashApp to: $cgmissions

MoneyBall Medicine
Impact of Artificial Intelligence on the Doctor-Patient relationship

MoneyBall Medicine

Play Episode Listen Later Dec 7, 2021 49:24


We've learned from previous guests that machine learning and other forms of AI are helping to identify better disease treatments, get drugs to market faster, and spot health problems before they get out of hand. But what if they could also help patients find the best doctors for them, and help doctors frame their advice in a way that patients can relate to? This week, Harry's guest, Briana Brownell, talks about the computational tools her company Pure Strategy is building to find patterns in people's personal preferences that can lower cultural barriers, enable better matchmaking between patients and doctors, predict which patients are most likely or least likely to go along with a treatment plan, or help doctors communicate their recommendations better. "Not everybody makes decisions in the same way," Brownell says. "Not everybody values the same things. But by understanding some of those psychological and value-based drivers, we can get better health care outcomes."Please rate and review The Harry Glorikian Show on Apple Podcasts! Here's how to do that from an iPhone, iPad, or iPod touch:1. Open the Podcasts app on your iPhone, iPad, or Mac. 2. Navigate to The Harry Glorikian Show podcast. You can find it by searching for it or selecting it from your library. Just note that you'll have to go to the series page which shows all the episodes, not just the page for a single episode.3. Scroll down to find the subhead titled "Ratings & Reviews."4. Under one of the highlighted reviews, select "Write a Review."5. Next, select a star rating at the top — you have the option of choosing between one and five stars. 6. Using the text box at the top, write a title for your review. Then, in the lower text box, write your review. Your review can be up to 300 words long.7. Once you've finished, select "Send" or "Save" in the top-right corner. 8. If you've never left a podcast review before, enter a nickname. Your nickname will be displayed next to any reviews you leave from here on out. 9. After selecting a nickname, tap OK. Your review may not be immediately visible.That's it! Thanks so much.Full TranscriptHarry Glorikian: Hello. I'm Harry Glorikian. Welcome to The Harry Glorikian Show, the interview podcast that explores how technology is changing everything we know about healthcare.Artificial intelligence. Big data. Predictive analytics. In fields like these, breakthroughs are happening way faster than most people realize. If you want to be proactive about your own health and the health of your loved ones, you'll need to learn everything you can about how medicine is changing and how you can take advantage of all the new options.Explaining this approaching world is the mission of my new book, The Future You. And it's also our theme here on the show, where we bring you conversations with the innovators, caregivers, and patient advocates who are transforming the healthcare system and working to push it in positive directions.If you're a regular listener you know I've had dozens of guests on the show who've explained how machine learning and other forms of AI are transforming healthcare They've talked about the ways AI can find better disease treatments, or help get drugs to market faster, or spot health problems before they get out of hand. In a way, that's what the show is all about.But my guest this week, Briana Brownell, thinks there are some gaps at the very core of our healthcare system where the power of AI is only beginning to be tapped.And one of those gaps is the relationship between patients and their doctors.Brownell is a data scientist and the founder and CEO of a consulting firm in Saskatoon, Saskatchewan, called Pure Strategy. The company works with all sorts of clients and industries. And it's known for a package of computational tools called ANIE that uses forms of AI such as unsupervised learning and natural language processing to find patterns in data.In the healthcare sector, Pure Strategy collects that data in the form of patients' responses to behavioral surveys. And then it looks for patterns in people's personal preferences or cultural identities that can help match them up with the best doctors for them.These patterns can also predict which patients are most likely or least likely to go along with a treatment plan. That can help doctors communicate their recommendations better and raise the chances that patients will stay out of the ER or the ICU.Brownell argues that medicine should never be completely data-driven, since doctors always need to account for patient's unique life stories and preferences. But with AI, she says, providers can gather more input that helps them understand where patients are coming from and what challenges they're facing.All of which echoes one of the themes of The Future You, which includes several chapters about how technology is changing the relationship between us patients and our doctors.By the way, the book is out now in paperback and ebook formats at Barnes & Noble and Amazon. So check it out.And now here's my full conversation with Briana Brownell.Harry Glorikian: Briana, welcome to the show.Briana Brownell: Thank you so much for having me.Harry Glorikian: So, Briana, I've, like, read about what you've done. I've watched the TED talk you had given and seen you win awards and so forth. But I want to step back for everybody here and sort of, so they understand who you are or where you came from. And if you can give a sort of high level biography of yourself how you got to this point in your career, where you're building computational tools to help doctors and patients -- how did all of that start? Where did you grow up? What did you study? You know what? What are the experiences sort of shaped you to go in this direction? Because you didn't start off in health care.Briana Brownell: That's true, yeah. I've had a really kind of a roundabout career, certainly. The first job that I got after my undergraduate degree in mathematics was in finance, which was wonderful. But I started in 2006, which I'm sure you know what's happening next. The global financial crisis happened next, right? And so that was my very first start in the work world. And after that, I actually got into more of the data science area, which was amazing for me because I was always interested in data, always interested in mathematics. But at the time, nobody had ever really heard of data science. Nobody had ever really been all that interested in analytics. And so I found that my job was so bizarre to just about everybody that I met. And so you can't imagine how excited I am when now data science is on everyone's mind. And, you know, artificial intelligence is, you know, a huge industry now. So I feel like, you know, I started somewhere very strange. But, you know, the world kind of came back to realize how interesting it really was.Harry Glorikian: Yeah, it's interesting. I mean, when I was when I came up with the idea for my first book, it was, you know, at least five years before it published, maybe even six where it was like, Oh my god, . It's the data fixation of health care like. Once we get that data like, oh my God, we're going to be able to analyze it and then find opportunities and see patterns and longitudinal, and I was like, "But I don't hear anybody talking about that." So that's what I got me excited to write that first one. But tell us about your company. It's called Pure Strategy, which reminds me of Strategy Consulting, which was, you know, one of my last companies that I had. But you know, what do you you do for your clients? What do you sink your teeth into?Briana Brownell: So, you know, first of all, the name Pure Strategy is a game theory reference. So I actually have a master's in economics. And so it's a little bit of a nerdy game theory reference. And so every time I meet someone else who took game theory, you know, we have a little bit of an eye-to-eye with the name of the company. But so the reason we named it that is a pure strategy gives you a way forward regardless of what your opposition does. So you always know the best thing to do next. And so, you know, with that philosophy is how we approach all kinds of different problems. So what kind of data, what kind of information do companies need to make decisions about how to better serve their customers, what markets to enter, how to invest their money properly? All of those kinds of things.Harry Glorikian: I need to study pure strategy just to manage my wife and kids that so I know what to do every time something happens. But your core product at Pure Strategy is something you call automated neural intelligence engine or ANIE. What is Annie built to do?Briana Brownell: So ANIE has a few different components to it. The reason that we built this intelligence system is because what I found was as a data scientist, a lot of the things that I was doing by hand could be much better done with an automated AI system. And so I began to look at the sort of time intensive but lower value tasks that could be tackled by artificial intelligence. And so we have a suite of four modules within that system that makes data analysis easier, faster, better. All of those good things. And so, you know, working with language, for example, working with prediction, working with choice modeling and then working to find emergent patterns and data that you didn't even know to look for.Harry Glorikian: Ok, so NLP-based predictive capabilities. But step back for a second, so focus in a little bit on on, say, the clients in pharma and health care, because that's the constituency that generally listens to this. What kind of problems are you helping them solve? So if you had a few concrete examples.Briana Brownell: Sure. So one of the areas that we find it's extremely useful is to understand typologies of patients and physicians and understanding how their values and attitudes impact their decision making. So not everybody makes decisions in the same way. Not everybody values the same things. But by understanding some of those psychological and value based drivers, we can get better health care outcomes. So we can look at what are the motivating factors in the patient group. Why are they being readmitted? Why are they not adhering to their treatment plan? Why are they doing things like delaying appointments, canceling appointments, those kinds of things? And then we can understand why they're making those decisions and hopefully sort of break the negative patterns and encourage the positive patterns so that they are healthier, they live longer, healthier lives and that their everyday life is improved as a result.Harry Glorikian: Interesting. When you first started explaining it, my brain was going towards a dating app like making sure I put the right doctor and the right patient together.Briana Brownell: So that's that's a big part of it, actually. Because certain physicians have a world view of their role as a health care provider, they need to be able to match their sort of delivery and their communication with a patient with the way that the patient can best understand it. So some physicians are very science-based and focusing on what are the cutting edge things that are happening in my field? And do I want to sort of use those with my patients to add to their treatment plan, for example. Whereas some other physicians are more looking at these sort of holistic care aspect where the patient is the center of a huge ecosystem of other health impact factors. And so how do they treat that patient as sort of an entire person? Right. And so definitely matching. You can imagine certain patients want certain kinds of doctors, right? So I'm the kind of person that I want to get in there and get out and give me the information. And that's fine, right? But that's not for everybody. And so by treating both the patient group and the physician group as having their own individual sort of beliefs and nuances within their worldview can really, really help things.Harry Glorikian: So essentially, like, I'm simplifying dramatically, but we are talking about the fundamental functions of a sort of a dating app, at least for that application area.Briana Brownell: That's right. Yes, it is a lot like a dating app. Yep.Harry Glorikian: But so if I understood, because I was trying to listen to some of the things you had done and you've guys have written around it, basically you're trying to help lower the cultural barriers between patients and the medical system to make sure they get better care.Briana Brownell: Yes, exactly. Yeah, that's a great way to put it.Harry Glorikian: That sort of feels like a somewhat -- other than the dating aspect of it, right -- that feels like an unconventional problem for a computer science approach to tackle. I mean, we've had a lot of startup CEOs on the show talking about machine learning to sort genomes or chemical libraries, or to discover new drugs. But I don't think I've ever had anybody on, necessarily, that's trying to use AI to bridge a cultural gap. So I'd love to hear more abou that issue, like did you set out from day one to do this? I mean, you know, you've said in past interviews, it feels like you've been building a case that there are effective or emotional cultural issues at stake in the way doctors and patients communicate, and that if medical providers don't know about these issues or if they get them wrong, it can get in the way of achieving the best outcome for the patient. I mean, just summarizing. So if I'm wrong, you feel free to tell me,Briana Brownell: No, that you know that that's a really interesting way of putting it. And so why did we realize that this was an important way to go? Well, part of the answer to that is because early in my career after the GFC [great financial crisis], before I started the company, I did a lot of work understanding the motivating factors in encouraging technology adoption for people who needed to mitigate climate risk. So that's a huge mouthful. But basically, we wanted to see what could encourage people to adapt to climate variability in farming and mining and wineries and grape production, that kind of thing. Because being able to understand how people perceive risk to their business, how people understand technology in terms of it being a business investment, how people sort of copy or don't copy other people in the community who seem like savvy business people in their own right, and then adopt because of the social factor. And so we have seen a huge amount of success using that methodology to understand technology adoption. And so it wasn't too far afield to say, OK, this same kind of technique that's so successful in this other area would have a huge impact in the health care area. If we could understand some of those value-based and behavioral elements to understand why people are making the decisions that they're making. Health care is such a deeply personal thing that you really can't treat it at that surface level, and that's really what we've been doing for generations. We've gotten so far away from that doctor and in the community who knows everyone and their family and who has that close connection. Now we've sort of taken a step back, tried to scale it up, but what we've lost is understanding how those core values impact the decisions that you make around your own health care.Harry Glorikian: Yeah. Well, in the doctor's defense, it's sort of tough to do that in 10 minutes, right?Briana Brownell: Absolutely, it is. And that's that's the problem, is, you know, maybe we can eliminate some of those pressures and bring that right.Harry Glorikian: Yeah. And I and I look at sort of if I think about your system plus, you know, all the new technologies that are coming like wearables and so forth. So if you go to a doctor, they can get a longitudinal view of you, plus maybe the way that you're thinking about how you want your health care from the system that you're creating. But you mentioned you're solving these problems through machine learning or natural language processing. Why did you feel that these were the best tools in the AI toolbox to sort of help you with this?Briana Brownell: So the typology creation is actually an unsupervised learning method. And so the reason that that's so effective is because it doesn't force a pattern on the data due to the bias of the researcher. So it finds emerging patterns that are in the data that someone might necessarily not know to look for that specific pattern. And so it's sort of it doesn't care about your or my preconceived notions about what kinds of attitudes and behaviors are important. All of that comes directly from the data. And so for me, that's a huge, really powerful reason that it's so effective. It's because it will find the patterns, even if it's not something you need to look for.Harry Glorikian: So what's an example of the training dataset or the because I'm wondering like, you've got this system, but it's looking at certain sets of data. What would those be so that it can find those patterns?Briana Brownell: Right. So usually it's a series of attitudinal and behavioral questions that the individual is sort of rating on, let's say, a seven point scale. And the way that we come up with that sort of battery of questions is a whole lot of conversations with the patient group. So usually you talk to a large number of folks and then patterns emerge using the natural language, understanding that you can then quantify in order to find the typologies. So we have partners to find patients and physicians in specific regions with specific conditions. All of that so that we can target people to get their sort of attitudes on these different areas.Harry Glorikian: How do you distill all these squishy things like patient life stories, emotional states, cultural backgrounds, beliefs down into something that can be coded and categorized as data? I keep thinking about as spider graph, right? Yeah, yeah.Briana Brownell: So so that's the hard part. You know, and I fully admit that it's a very challenging area because on the one hand, you have the sort of individual story that needs to be understood in context. And then in the other area, you need to have sort of quantitative data that you can actually make real decisions on. And so moving from that one part to the other is sort of a combination of experience of folks working with patients within that specific treatment area. It's a combination of the sort of cutting edge understanding of psychology, of how people interact with the health care system. There's a huge amount of cultural factors. We, you know, work with patients and physicians all around the world. And so that's always a huge sort of elephant in the room, to make sure to add context to it. And so by combining all of these things together, then you essentially get closer and closer to the right answer.Harry Glorikian: So I'm almost thinking like, there's got to be this graphical interface, right, that somebody can look at quickly. I mean, I don't know why all of a sudden a Myers-Briggs popped into my head. So you get an idea of what that person is like and how to manage them. But so, I've heard you talk before, and you fundamentally believe, and you can correct me if I'm wrong, that it's the data plus the physician that takes it to a different level. It's not just the data itself.Briana Brownell: Mm hmm. And I mean, it's the data and the physician in partnership with the patient because, you know, at the end of the day, we all have a role to play in our own health care maintenance, in our own sort of world through journey through this world, I guess, right? And I think that by empowering the physicians to, as we say, practice at the top of their license, that's really a positive thing for everyone, right? So instead of focusing on tasks that can and should be automated, you're really focusing on making sure that those outcomes are as good as they can be. And so the support system around the patient is also extremely important. So you had mentioned wearables and some of those things. So that is another area that we're involved in as well, is making sure that we have some of that data that can feed into understanding the world view of the patient. And then in turn, so the physician can understand where that patient is coming from and identify whether they may be having challenges with their maintenance, for example, or with something at home.Harry Glorikian: Yeah, I mean, I've got my new book is coming out soon, and I, you know, by putting it together, I almost feel like the technology plus the physician can almost bring get the patient to have a concierge medicine level experience without the cost of concierge medicine, right? And so I'm assuming your system is trying to give them that elevated level of care by giving the physician the insights that they need. But does the patient also get the same insights to get to know themselves? I'm just curious.Briana Brownell: They do, yes. And so we're actually looking at, rather than sort of -- you mentioned the concierge level medicine. We're actually looking at the most vulnerable people, rather than saying who needs the concierge service on the high end. We're saying, whose outcomes can we most impact? And so looking at the people who are more vulnerable, who struggle a lot more with their health care, where we want to make sure that we avoid them having to seek acute care. Because at the end of the day, nobody wants to end up in the emergency room, nobody wants to end up in the ICU. And so anything that we can do to sort of prevent that for those people is, you know, a huge positive for that individual and not only just them, but their whole support system, their family, their friends, everybody in their community.[musical interlude]Harry Glorikian: Let's pause the conversation for a minute to talk about one small but important thing you can do, to help keep the podcast going. And that's to make it easier for other listeners discover the show by leaving a rating and a review on Apple Podcasts.All you have to do is open the Apple Podcasts app on your smartphone, search for The Harry Glorikian Show, and scroll down to the Ratings & Reviews section. Tap the stars to rate the show, and then tap the link that says Write a Review to leave your comments. It'll only take a minute, but you'll be doing us a huge favor.And one more thing. If you like the interviews we do here on the show I know you'll like my new book, The Future You: How Artificial Intelligence Can Help You Get Healthier, Stress Less, and Live Longer.It's a friendly and accessible tour of all the ways today's information technologies are helping us diagnose diseases faster, treat them more precisely, and create personalized diet and exercise programs to prevent them in the first place.The book is now available in Kindle format. Just go to Amazon and search for The Future You by Harry Glorikian.And now, back to the show.[musical interlude]Harry Glorikian: So you grew up in Canada, you went to school in Canada. You operate a business in Canada. And so I'm picking on this sort of cross-border thing, right? Because our health care systems are just a little different. So, you know. But I also imagine you've worked with, you know, clients here in the U.S. and some based in Canada. I'd love to get your -- how do you think about the two systems when it comes to the implementation of a technology like yours? Because they feel like they come at health care from different vantage points.Briana Brownell: Absolutely. So interestingly enough, we actually do work not just in the U.S., but also in Europe and also in Asia. And so for that reason, there's a lot of really interesting cross-cultural differences in how different health care systems work. And so, you know, Canada, we have a single payer system. And so for some, for some areas, it's a huge positive. People aren't going broke paying their medical bills. There's sort of more access in certain areas. But there are struggles. So things like remote communities, being able to have access to health care from places. For example, here in northern Saskatchewan, it's a real challenge for patients to get care from some of those remote areas. Each system, I think, has some challenges and some benefits. And then same with the American system, the advantage being that preventative care is actively incentivized, right? And so in Canada, that's not the case. So I think it's just really a different balance and a different tradeoff.Harry Glorikian: So, so the system is designed -- I almost think you need to use the system to figure out your own clients so that you you can you can understand what their drivers are. But you've you've described yourself as a data scientist, a tech entrepreneur. But I've also heard the word futurist. So I'm super curious about, you know, let's talk about the future. So what do you think about the cutting edge ideas in AI? And, you know, do they really have the potential -- and I know what my bias is, so I don't have to cloud your thought with my bias -- but you know, whether it's in health care or business or other areas, what are you most excited about right now?Briana Brownell: So for me, a lot of the interesting AI applications bring in decision making and sort of data analysis that is completely new and different. So if you look at things like diagnostics, the diagnostic tools using different styles of AI make their decisions in a way that's different than the physicians do. So you could have an AI system that's extremely accurate, but then it misses certain things that a physician will catch and then vice versa. And I think that that, to me is one of the most interesting and most important parts. Because now all of a sudden, you can have a sort of augmented system where the physician can work with the technology in order to get better outcomes for everyone. So that's one area where I'm really excited. The other area is being able to have that personalization at scale. So, you know, we talked about, you have the community physician that knew everyone's family and everyone's coming and going, and so you could have that personalized care. But then we've sort of moved towards a more kind of data-driven system where you didn't have that personal connection. I think we're going to go sort of back. I think we're going to be able to look at ways that we can personalize interactions, treatment plans, even specific medicines at a scale that it can really help a lot of people.Harry Glorikian: Well, it's interesting because I was talking to someone at Facebook in their AI group and it was like, their system already knows so much about you, right? And so people don't realize like how that system truly does probably know them, better than they know themselves in a certain way. So I always think like, wow, if they could really start applying that to health care, you could really make a serious difference in the lives of these individuals, because most of health care is how you make your decisions and how you manage yourself. And did you take your meds? Did you go for that walk you were supposed to go for? Those sorts of simple things, right, that that we all struggle with on a daily basis. But so another futurism question. So you gave a TEDx talk in Calgary a couple of years ago where you talked about research done in pareidolia, just making sure I pronounce it correctly, which is the human brain's tendency to see faces and random things like in the environment, where you look in the I think you look in the clouds and you see a dog or something, right? But but you you tested computer vision. You found that that that doesn't happen. With the computer vision, they recognize different patterns, I guess, but not things like faces. And so from a philosophical question, how do you compare like the human mind and sort of the pattern recognition that we do? Because most of what we do in medicine is a certain form of pattern recognition. I'm just trying to figure out, is that what differentiates an intelligent system versus a conscious system?Briana Brownell: So I would say in that case, it wouldn't be necessarily consciousness, but certainly the human brain works differently from the artificial intelligence systems that we've built so far. Most of the AI systems that we're building are sort of focused on one specific narrow task, and it does really well at one thing. But as soon as it moves outside of that, or as soon as you add sort of additional kinds of media to it, it's really, really challenging. So I think, you know, speaking futurism, the next wave of really good AI applications are going to widen. So we're really, really narrow right now. But we're going to start to widen more and more in order to sort of combine some of this information and be able to sort of get greater insights. So I'll give you an example. So when people do sort of codifying datasets for image recognition, what they do is they link it to what are called synsets. And so what a synset is is a meaning, right? So if you have, let's say, like a coffee mug, right? So you have a picture of this, you know, you say, OK, it's a mug, right? But then what if somebody else codes it as a cup? Well, so there are two different things, right? But they're similar enough that most humans would recognize.Briana Brownell: Well, that's probably sort of really similar, right? But yet when we're doing image recognition and we're training on these huge data sets, that similarity is not always taken into account. So more and more we're able to make multiple linkages like that in order to improve the outcomes. But right now, in a lot of cases, that's not taken into account. And so that'll be I think the next step is, we're going to sort of widen some of the applications of artificial intelligence. And then after that, it's really about proactive and automated systems. So we right now are looking into this, being able to have a system that understands, adapts, and then makes a recommendation in order to improve health care outcomes. So this person is, let's say, their heart rate is constantly elevated. Maybe we need to send them a push notification and sort of ask them, Hey, how are you doing? Is everything OK? Right? Something like that. And so those proactive systems, I think, are going to become even more important in the next five or 10 years.Harry Glorikian: So it's interesting. I was reading a paper yesterday or the day before about how there's, when you make, to speed up memory there's breakages that happen in the DNA in the neurons that sort of helps the system adapt more quickly to a new memory. And so. I want to say, like you're talking about systems that have to be able to change part of the code to be able to then adapt to what it's now looking at. So sort of learning, but not learning the way that we think about learning.Briana Brownell: Yeah, so definitely, I mean, there's also challenges with those systems because you can have them quickly move away from where the original prediction was, right? And so being able to have that monitoring is extremely important. So this this is not a new idea. This is an old idea from the eighties about how you need to make like AI systems as collections of agents, right? So we're just digging up some of the old thought around this. But I think whereas it was extremely difficult to do 40 years ago, now it's actually relatively straightforward. And so I expect a lot of breakthroughs in that area.Harry Glorikian: Well, and I think what you know, some of the other areas that I see is sort of where you turn AI on itself to figure out how to improve what it does, like Google's doing with new chipsets and so forth and so on. Which I think most people aren't factoring in -- the dramatic improvements that could be made when you turn these things on themselves. So the shifts are, what I like to call the turns, are happening much faster than most people anticipate. Let's go back to health care for a second. So try taking today's, you know, trends in AI, looking forward a couple of decades, say 2040. Shit, I'm going to be really old by then. But how do you think technology will change the way patients interact with the health care system, and maybe it's earlier than 2040, so don't let me. You know, that might be too far out, but what do you predict is going to happen at that point?Briana Brownell: I think that there's going to be a much higher-touch system in place. So right now, most people go to the doctor for, maybe they'll go for an annual checkup, maybe not, depending on who you are. They'll go see a doctor when they have something go wrong, where they feel sick or they have an injury or that kind of thing. They might go to minor emergency if they had a sort of more serious injury or something happened there. But the truth is, it's not an everyday sort of a thing, or probably it's not an every week or every month kind of thing for most people. I see that changing. I think that there's going to be sort of a continuous back and forth. There's going to be a much more sort of low-friction way that anyone can communicate with a health care provider or even an AI system to get their health care questions answered. So, you know, I'm sure everybody has been in this situation where you either you feel sick or you have hurt yourself. There's something going on with your health care and you have to make a decision whether or not you're going to actually call and book that appointment and you're going to actually go down to the doctor's office and you're actually going to talk to some somebody about how you're feeling. I think that's going to disappear. I think it's going to be a lot of the sort of seemingly minor things are going to be sort of taken care of by high-touch technology system that can sort of direct people to a physician's care when they need to, but can handle sort of most other things that that happen. And so that drastically reduces sort of the load for things that are people are avoiding for months and months and months. And then all of a sudden it gets really bad and they end up in the emergency room. So I see that being completely eliminated from the system.Harry Glorikian: Yeah. Well, that would be wonderful. It's funny because in my brain, I was going to, OK, the serious movie that lays all this out and it looks totally cool. And then the comedy where the person is totally revolting against the system. But I do agree, like, I truly believe that we're moving towards health care and hopefully away from sick care. Or we sort of push the sick stuff out much further. But like I mean, you can't see it, it's under my shirt, but I've got a CGM [continuous glucose monitor], right, that I'm wearing under my shirt here. And so, you know, why am I wearing a CGM? I'm not diabetic, but I'm sort of monitoring, you know, don't eat -- like, what was it we went to? I think I had bibimbap at a Korean restaurant, and man, whatever was in the rice made that blood sugar spike and totally stay up. So I'm like, OK, no bibimbap. Or if I do it, it's going to be once in a blue moon. But I think the systems are going to be monitoring. I don't think there's anything we buy anymore, your car, your computer or whatever doesn't have a monitoring system in it to sort of do preventive maintenance or alert you before, you know, here's the mean time between failure. And that's what I see happening and what we're doing.Briana Brownell: Yeah, we even get, you know, I get my notification on screen time, like where I was spending time on my iPad, which app I was doing right. And so I feel like that's exactly where we're going to go to is where, you know, maybe every week you actually get a little sort of health care report or you get some some kind of information.Harry Glorikian: Yeah, that the delivery of that information is going to have to be there. We're going to need a few geniuses on how to deliver that to people because I can just see a few people having fits, right? Because my kids don't like the monitoring app. When I say, how long have you been on Instagram or Snapchat? And they're like, Oh, not very long. And then you can see the time. And they don't like that. But do you believe, like every doctor or nurse physician assistant is going to have sort of an AI assistant working alongside them sifting through patient data? Highlighting what the doctor needs to focus on or translating cultural gaps? You're working on a system that sort of is trying to understand people, bridge that gap and sort of make things better, so I just see you're sort of at the beginning stage. And I'm trying to go forward in the future to say, would that just be the natural progression as it goes forward?Briana Brownell: Yeah. So I definitely see multiple AI systems running behind the scenes that can sort of crunch the numbers and understand some of the macro level patterns that can then inform the physicians with information that might be relevant. So one of the areas that we've done some work in is with rare diseases. So you probably have heard the saying: If you hear hoof beats behind you, what do you think it is? Do you think it's a horse or a zebra? Right. So, you know, if you're a doctor and you see symptoms that match extremely rare disease, a zebra or something much more common, you're going to assume you're going to guess that it's a horse. But for the patient, you know, going through that rigmarole when you have a rare condition, when you are that zebra, that's a really difficult thing for the patient. And so if you can say, you know, this actually might be a zebra based on all of these other factors and all of these other sort of subtle cues, I think that that makes it better for everyone. I mean, for the physician who has access to pattern data that they would never be able to do by just sort of seeing patterns in their own patients and being able to look at that on just a much greater scale. And so that's an area where I think that there's going to be a huge, huge boon.Harry Glorikian: Yeah, I mean, I'm a firm believer in genomic sequencing, to cut to the chase. And then, you know, I just interviewed Matthew Might, who looks at the genetic sequence and then helps identify already-approved drugs that might actually impact that disease state. You know, there's a number of things that are out there. I just wish they moved faster into the existing environment. And that's what drives me. I mean, I think at some point, I don't know how any of the systems can function without implementing these tools that sort of are assistive in nature. I've heard some venture guys say, "Oh, this is going to take the place of the doctor," and I'm like, "Oh my God, you're nuts." Like, that's not going to happen. But I think because I think every piece of data I've seen is the two together result in better outcomes rather than one or the other by themselves.Briana Brownell: Yeah, absolutely. I think you're exactly right on that. The idea is that maybe you have a sort of larger system of people that can support people in their health care. So instead of focusing on doctors and nurses and then things like physiotherapists, et cetera, I see a role for sort of other support people within the health care system that can sort of guide patients to lead healthier lives. Aside from that, so if anything, I think that it's going to be we're going to need more people involved in doing some of these things.Harry Glorikian: Yeah, I think, you know, I keep trying to encourage my brethren in the tech world to come to health care because it has more impact on on everything and we need more people. There's just not enough people to do the computational work or the real hard math, sometimes that's what is required. I find people being pretty lazy at that stuff that moves the needle. But it's been great talking to you. This is fascinating. I would, you know, I almost wish I could turn your system on myself to find out what my biases are. You know, you may want to come up with a consumer facing thing so that people can learn things about themselves and maybe even relay that back to their own physician about how they want to be communicated with.Briana Brownell: Yeah, I love that. I think that right now we are actually working with a consumer facing application within the US system, so hopefully someday you'll be able to have access to it and you can learn all about yourself.Harry Glorikian: Yeah, like I said, I mean, I'm simplifying it, but sort of like a Myers-Briggs. When I was younger, I was ENTJ and now ENTP. But, you know, always good to know yourself. Great to speak to you. I wish you incredible success in your endeavors. And we want to see systems like this making impact on patients and bringing hard data to the table to get even the system itself to sort of change the way that it operates.Briana Brownell: Wonderful, well, it was great to talk to you, and, you know, it's always something that I am excited to chat about, so thank you for having me.Harry Glorikian: Thank you.Harry Glorikian: That's it for this week's episode. You can find past episodes of The Harry Glorikian Show and MoneyBall Medicine at my website, glorikian.com, under the tab Podcasts.Don't forget to go to Apple Podcasts to leave a rating and review for the show.You can find me on Twitter at hglorikian. And we always love it when listeners post about the show there, or on other social media. Thanks for listening, stay healthy, and be sure to tune in two weeks from now for our next interview.

Naturally Nourished
Episode 269: Blood Sugar Variability and Understanding Your CGM

Naturally Nourished

Play Episode Listen Later Dec 6, 2021 67:11


Are you ready to take the plunge into wearing a CGM? Or maybe you've already been playing with one but want to hone in and understand your data? Want to know how variables like fasting, caffeine, stress, and alcohol impact your blood sugar? Tune in as we interview Kara Collier, fellow RD and Co-Founder of Nutrisense, a company that provides real time glucose data and an easy to use app. Learn how a CGM can help you identify a food sensitivity, how OMAD and other forms of fasts could impact your blood sugar, and why a CGM can be useful even in non-diabetics.    In this episode, we interview Kara on the use of continuous glucose monitoring (CGM) technology, particularly in non-diabetics for the purposes of health optimization, disease prevention, and reversing metabolic dysfunction. We discuss what to look for in your blood sugar trends, how and when to implement tools like berberine or adaptogens, and how to set up experiments while you're wearing a CGM to best understand your own body!    Also in this episode: Episode 209: A Week of my CGM Experiment Why Use a CGM? Identifying Food Sensitivities Blood Glucose Variability Berberine Boost How Stress Impacts Blood SugarGabaCalm Calm and Clear Relax and Regulate Fasting and Meal Timing CaffeineSanta Cruz Medicinals CBD use code ALIMILLERRD Setting Up Blood Sugar Experiments How Alcohol Impacts Your Blood SugarEpisode 266: Why is my A1c Elevated? Troubleshooting Your CGM   More about Kara: Kara Collier is a Registered Dietitian Nutritionist and Certified Nutrition Support Clinician with a background in clinical nutrition, nutrition technology, and entrepreneurship. After becoming frustrated with the traditional healthcare system, she helped start the company NutriSense where she is now a Co-Founder and the Director of Nutrition. Kara is the leading authority on the use of continuous glucose monitoring (CGM) technology, particularly in non-diabetics for the purposes of health optimization, disease prevention, and reversing metabolic dysfunction.   Sponsors for this episode:  This episode is sponsored by Nutrisense, providing Continuous Glucose Monitors (CGM) that provide you with real-time glucose data and an easy to use phone app that helps you combine and visualize your glucose data with all of your daily activities as well as personalized recommendations on how to improve your health. Use the code ALIMILLERRD at nutrisense.io/alimillerrd   This episode is also sponsored by FOND Bone Broth Tonics, Your Sous Chef in a Jar. FOND is slow simmered and lovingly tended from simmer to seal. They partner with organic farms and hand-pick and pair ingredients to optimize absorption and taste. Use code ALIMILLERRD to save at fondbonebroth.com. 

Diabetes Connections with Stacey Simms Type 1 Diabetes
In the News.. oral insulin tested for T1D, FDA looks at new tubeless pump, Bigfoot Clinic Hub & more!

Diabetes Connections with Stacey Simms Type 1 Diabetes

Play Episode Listen Later Dec 3, 2021 6:16


It's "In the News..." the only diabetes newscast. Top stories this week include: #T1D oral insulin study moves ahead, FDA gives breakthrough designation to new SIGI tubeless pump, study shines light on PBM profits, China demands huge drop in insulin prices and Bigfoot Biomedical launches their Clinic Hub -- Join us LIVE every Wednesday at 4:30pm EST Check out Stacey's book: The World's Worst Diabetes Mom! Join the Diabetes Connections Facebook Group! Sign up for our newsletter here ----- Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners! ----- Get the App and listen to Diabetes Connections wherever you go! Episode transcription below:  Click here for iPhone      Click here for Android   Hello and welcome to Diabetes Connections In the News! I'm Stacey Simms and these are the top diabetes stories and headlines of the past seven days. As always, I'm going to link up my sources in the Facebook comments – where we are live – we are also Live on YouTube and in the show notes at d-c dot com when this airs as a podcast.. XX In the News is brought to you by The World's Worst Diabetes Mom, Real life stories of raising a child with diabetes. Winner of the American Book Fest Prize for best new non-fiction. Available in paperback, on Kindle or as an audio book – all at Amazon.com. You can also get a big discount right now at diabetes-connections.com – use promo code celebrate to save $4 XX Our top story this week.. More good news for mice.. and maybe some day for people. Yale researchers are looking at an oral medication for type 1 diabetes. These lucky mice had metabolic function restored and inflammation reversed. There are a lot of studies going on to make oral insulin work – liquid insulin is destroyed in the stomach before it hits the bloodstream. This research involves a nanoparticle drug vehicle that can not only bring insulin to the pancreas safely, but the casing itself has therapeutic benefits. It's made out of an acid that seems to reduce the rogue immune cells that destroy the beta cells in the first place. The team says that the nanoparticles could also be used to carry other molecules, which could help with other conditions. https://newatlas.com/medical/oral-insulin-pill-prevents-type-1-diabetes/ XX A new tubeless pump is making its way through the US regulatory process. The FDA gives breakthrough device designation to AMF Medical's Sigi (SIG-ee) Insulin Management System. This is a patch pump, like Omnipod, but it's rechargeable and re-usable – you get two so you don't have to go without while it's charging. It's also an ACE pump, that's alternate control enabled which means it can interact with CGMs and controller devices like smartphones. This designation isn't FDA approval, but it should speed up the review. In the press release the company says, “Clinical study data has shown that Sigi™ is delightfully easy to use.” Which is kind of a nice thing to see in a write up like this. https://sigipump.com/amf-medical-receives-fda-breakthrough-device-designation-nbspfor-its-sigi-insulin-management-system/ XX Big news from the UK this week – they announced everyone in England with type 1 will be eligible for CGMs covered by the National Health Service there. This was preceeded by coverage for the Libre flash glucose monitor. That program was supposed to start at 20% but almost 50% of people with type 1 have opted in and the results in terms of better health and lower a1cs have really been outstanding. Next up, leaders there say they want CGM covered for anyone using insulin, regardless of diabetes type. https://pharmaceutical-journal.com/article/news/nice-proposes-wider-use-of-glucose-monitoring-devices-for-type-1-diabetes XX New research into insulin pricing is shining a light on the middle men.. many of us have known about PBMs for a long time. Researchers at USC found that drugmakers' share of revenue from insulin sales has dropped in recent years — and a greater share is being siphoned off by pharmacy benefit managers, drugstores, wholesalers and insurers. In 2014, 30% of insulin revenue went to PBMs. By 2018, those same middlemen were receiving 53%. Terrific write up as usual by David Lazurs in the LA Times – he lives with type 1 and I always love his stuff. I'll link this one up. The researchers here say since the PBMs are getting a greater share, there's pressure on the drug's manufacturers to keep raising prices so their own profits don't suffer. It's worth noting that these findings were possible because of newer state laws bringing greater transparency to insulin sales. https://www.latimes.com/business/story/2021-11-30/lazarus-healthcare-insulin-prices XX What works to bring down the price of insulin? Ask China. They decided a round of price cuts is due and as a result, 42 insulin products from companies in China and abroad took an average 48% price drop. Otherwise, they wouldn't have been used in that country's public hospitals. Lilly gave up the largest discount: After a 75% reduction, the price of Humalog went down to about $3 per pen. China has been making pharma cut prices for the last few years for other medications. This is the first time insulin has really been affected. https://www.fiercepharma.com/pharma-asia/novo-nordisk-sanofi-eli-lilly-cut-insulin-price-china-s-latest-vbp-off-patent-drugs XX Bigfoot releases some information and reaction to their Clinic Hub. This is how endos and clinics use the data from the Bigfoot Unity System to support patients. Unity launched this summer – it's their smart pen program. When you think about multiple daily injections whether it's for type 1 or type 2.. it's hard for health care providers to see what's going on day to day.. are doses correct, when they're giving, etc. Unity can also include CGM data. This is the launch phase of Clinic Hub.. Bigfoot says they've also added streamlined patient onboarding and more flexibility for patient updates and prescription management. https://www.drugdeliverybusiness.com/bigfoot-biomedical-touts-cloud-based-program-for-managing-diabetes/ XX I'm including the Vertex news here.. we reported this back in October but you probably had everyone you know send you that New York Times article about a cure for type 1 – at least in one guy.. I won't rehash everything here..  it's about stem cells, one patient off insulin but on immunosuppressive drugs..  Personally, I'm very hopeful, but the Times write up overly simplified a lot of this, in my opinion. Good write up in Healthline that I'll link to. https://www.healthline.com/diabetesmine/vertex-type-1-diabetes-research XX In the UK lots of attention on their Strictly Come Dancing competition… when it became apparent contestant Nikita Kuzmin wasn't hiding the Libra glucose monitor on his arm. He wasn't hiding much.. he took off his shirt for this performance. Loads of social media comments applauding him.. for both. By the way, his dance partner, Tilly Ramsey is the daughter of professional chef Gordon Ramsey.. and they were eliminated from the show this round. https://www.express.co.uk/life-style/health/1528577/strictly-come-dancing-nikita-kuzmin-health-diabetes-type-1-symptoms -- quick reminder that the podcast this week is with the UK co-lead on diabetes, Dr Partha Kar. We had a great chat about access and their Libre program and his whole philosophy.. really fun episode. Next week you'll hear from the folks at ConvaTec, they make almost all the pump insets and they have some great info for us all. you can listen to wherever you get your podcasts or if you're listening to this as on a podcast app, just go back an episode. That's In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.

Losing Weight with Fasting & Mindful Eating.
46 | Rouba Chalabi: Breaking up with your Food Addictions & Emotional Eating.

Losing Weight with Fasting & Mindful Eating.

Play Episode Listen Later Dec 1, 2021 35:25


Today's guest is Rouba Chalabi, food addiction counselor, a biodynamic breath work and trauma release practitioner and author of "Beyond the Emptiness: how I found fullness outside of food." If you've been struggling with Food Addictions & Emotional Eating, you do not want to miss this episode! Monika & Rouba discuss why overeating is not the problem, but the consequence of "something else", how to break your obsession with food, eating real food and learning to love yourself. Connect with Rouba: IG: abstinent.salads Get the book "Beyond the Emptiness: how I found fullness outside of food"

CGM Presents: Wives In the Word Podcast
Episode 2, "He Left Home for Christmas"

CGM Presents: Wives In the Word Podcast

Play Episode Listen Later Dec 1, 2021 5:47


Charles George Missions Presents: Day 1 – Christmas Podcast – “He Left Home for Christmas"These Christmas podcasts are brought to encourage you as we celebrate the birth of Jesus.Hello and welcome to Day 1, of CGMissions Christmas Podcast. Today's podcast is entitled “He Left Home for Christmas.” This podcast is about Jesus and how He left His heavenly home and came to this earth to bring us the first Christmas and the first Christmas gifts. Today, our scripture comes from Hebrews 4:15. “For we have not an high priest which cannot be touched with the feeling of our infirmities; but was in all points tempted like as we are, yet without sin.” We will explain later in today's presentation why we chose this scripture.You can always access additional Christmas podcasts from 2020 at: www,cgmissions.com/podcast/christmas-podcasts-1/If you would like to be a guest on our podcast, email us at: cgmpresents@gmail.com We can be reached on Facebook at CGM Present: In the Word Podcast and our handle for Twitter and Instagram is @cgmissions, and  for YouTube is cgmissions. CGM is a 501(c)(3) nonprofit. Donations may be sent through CashApp to: $cgmissions

The Fitnessista Podcast: Healthy In Real Life
092: Postpartum healing and Injury recovery with Natasha Caleel

The Fitnessista Podcast: Healthy In Real Life

Play Episode Listen Later Dec 1, 2021 37:04


 Hi friends! So excited to be chatting with my friend Natasha on the podcast today! We're talking about so many important topics and I hope you take the time to listen to this one! Here's what we talk about in this episode: - Her background and how she helps postpartum clients - The postpartum recovery journey and adapting your life for diastasis recti - How to get back into your workout routine when you're rehabbing an injury - What makes occupational therapy so awesome - and so.much.more Here's a little bit more about Natasha: Natasha is a Women's Personal Trainer specializing in prenatal and postpartum fitness. Natasha started her career as an Occupational Therapist where she helped older adults regain their independence through therapy. In 2014, after the birth of her daughter, Natasha founded Fit Mama Santa Barbara and focused her energy on improving women's health. She works with clients both in Santa Barbara and worldwide through her online platform. She is passionate about educating others and loves using her expertise to provide valuable information on various health and fitness related topics. Natasha graduated from McMaster University in Ontario, Canada with a degree in Kinesiology. After graduating she decided she wanted to pursue a career in Occupational Therapy and went on to obtain her Masters of Science in Occupational Therapy. She has since obtained many additional certifications to better serve her clients. Natasha is also a seasoned freelance writer and has been features in publications such as Healthline.com, Fitness magazine, Oxygen magazine, and Huffington Post. You can find her on Instagram @fitmamasb or Facebook @fitmamasb Resources from this episode: Check out Lumen! This is the metabolism tracker I use and recommend. It customizes your nutrition plan based on whether you're predominantly burning carbs or fat. The goal is to make your metabolism more flexible - you want to be able to switch between using carbs and fats as an energy source - and you can customize the track based on your personal goals. Check it out here and use FITNESSISTA for an extra 10% off.  I love love love the meals from Sakara Life. (Also, none of my Sakara meals spiked my blood sugar while I was wearing my CGM. Even the delicious breakfast vegan pastries, like the roasted apple pancakes or the Chocolate Love Muffin). Use this link and the code XOGINAH for 20% off their meal delivery and clean boutique items. They have so many great gifts (for others and yourself!) for holiday!!! Get 15% off Organifi with the code FITNESSISTA. The green juice and gold powder are my favorites! I recently fell in love with Harmony and drink it like a hot cocoa in warm almond milk or add it to my smoothie.  Thank you so much for listening and for all of your support with the podcast! Please leave a rating or review if you enjoyed this episode. If you leave a rating, head to this page and you'll get a little “thank you” gift from me to you. 

Diabetes Connections with Stacey Simms Type 1 Diabetes
Think big (and don't be an idiot) - Dr. Partha Kar on the future of diabetes care

Diabetes Connections with Stacey Simms Type 1 Diabetes

Play Episode Listen Later Nov 30, 2021 32:53


When you have a national lead on diabetes who really seems to listen to patients and delivers on some big ideas, you get our attention. Dr. Partha Kar is the diabetes co-lead of NHS England. We talk about access, getting more out of your doctor's visits and what he sees in the future of diabetes tech. Dr. Kar's announcement (after our interview was taped) that CGM or Flash Glucose Monitoring will be available to all people in England with type 1 diabetes  This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. Check out Stacey's book: The World's Worst Diabetes Mom! Join the Diabetes Connections Facebook Group! Sign up for our newsletter here ----- Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners! ----- Get the App and listen to Diabetes Connections wherever you go! Click here for iPhone      Click here for Android Episode Transcription Below:   Stacey Simms  0:00 Diabetes Connections is brought to you by. Dario Health – Manage your blood glucose levels. Increase your possibilities. By Gvoke HypoPen, the first pre-mixed autoinjector for very low blood sugar. And By Dexcom. Take control of your diabetes and live life to the fullest with Dexcom This is Diabetes Connections with Stacey Simms. This week when you're a national leader on diabetes, and you really seem to listen to patients and you deliver on some big ideas, you get our attention. Dr. Partha Kar says it shouldn't be that unusual.   Partha Kar  0:39 And I also feel that clinicians sometimes believe that people living with type 1 diabetes won't be able to handle the truth, so to speak, oh, you can't tell them when you can. They're all adults are surrounded by adults, and they deal with tough calls in their lives all the time. You know,   Stacey Simms  0:57 Dr. Kar is the diabetes co-lead of NHS England. Yes, this is a US centric show. But I've followed him on social media for a long time. And I've loved what he has to say. We'll talk about access, getting more out of your doctor's visits, and what he sees in the future of diabetes tech. This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. Welcome to another week of the show, I am your host, Stacey Sims, and we aim to educate and inspire about diabetes with a focus on people who use insulin. If you're part of our mostly American audience, I hope you had a really good Thanksgiving, I hope the travel was safe. If you had to go anywhere, I hope the food was great. And I hope the family was okay to really hope you had a great holiday. If you're part of our international audience, which is still pretty big, I would expect it to be bigger this week, just because of who we're talking to. And that is Dr. Partha Kar, national specialty advisor for diabetes with NHS England. And this is one of those times where I just was interested to see what somebody had to say, as I mentioned in that the opening teaser, I followed him online for quite a while. And I thought you might be interested as well. And boy, when I put it in the Facebook group, you all were thrilled. So I hope you enjoy the interview. He didn't have a ton of time to talk to me. But that is to be expected. But I'm really happy with the questions I was able to ask. And you know, just the fact that he was able to share some information with us, even though his his health system is is markedly different than ours here in the States. Before we jump in, I do want to take a moment this is a little self promoting. But gosh, guys, I got such exciting news recently. And that is that I won this huge book price. Yes, I know the book came out a while ago, but I won best new non fiction in the American Book fest. This was of course for the world's worst diabetes mom real life stories of raising a child with type 1 diabetes. And it kind of took me didn't kind of it really took me by surprise. I had entered it earlier this year, I had forgotten about it. When we got the email, my publisher kind of emailed me quickly and said, you know, being a finalist is really nice. And then she said no, no, wait a minute, you. That was kind of my reaction to it was laughing. But I won. So I know you're asking, Okay, the world's worst diabetes mom came out in 2019. How did we win an award in 2021. The book fest the American Book, festival boards are kind of rolling. So you're eligible for almost three years. So this year's books were from certain dates in 2120 20 in 2019. This was our first time entering the book, and it was actually our last chance to enter. So boy, I'm so excited. I'm really proud of the book. And I have some news coming in December. I have some more book news that was already planned before this award. But thank you for letting me indulgent, do a little patting myself on the back. It was not easy to write and get it out and do everything we needed to do for it. And boy, you all have been so supportive, considering I haven't been able to do any kind of book tour at all right? I mean, it came out at the end of 2019. I think I went to two or three places. And that was it. And just like everybody else in 2020. It hasn't been the same since I'm hardly alone in that. So more book news coming up, and Dr. Partha Kar in just a moment I should probably tell you just a little bit more about him if you're not familiar. He has been a consultant in Diabetes and Endocrinology on the national level there in the UK since 2008, clinical director of diabetes from 2009 to 2015. And here's the full title national specialty advisor diabetes with NHS England. And there are so many things that he's been involved with, most recently, very prominently getting the FreeStyle Libre being available across the country over there and I will talk about that specifically. Being very involved in language matters. Getting CGM available to all t one D pregnant patients. And he hinted this week that a big announcement was coming. So I will link that up in the show notes so you can find out we talked The week before Thanksgiving here in the States, so timing wise full bit tricky, but he was announcing something big and I will include that to the best of my ability. Okay, Diabetes Connections is brought to you by Gvoke Hypopen. Almost everyone who takes insulin has experienced a low blood sugar – and that can be scary.  A very low blood sugar is really scary. And that's where Gvoke HypoPen comes in. Gvoke is the first autoinjector to treat very low blood sugar.  Gvoke HypoPen is premixed and ready to go, with no visible needle. That means it's easy to use. How easy is it? You pull off the red cap and push the yellow end onto bare skin – and hold it for 5 seconds. That's it. Find out more – go to diabetes dash connections dot com and click on the Gvoke logo. Gvoke shouldn't be used in patients with pheochromocytoma or insulinoma – visit gvoke glucagon dot com slash risk. Partha Kar Welcome to Diabetes Connections. Thanks so much for making some time for me and my listeners. Absolute pleasure. Thank   Partha Kar  5:55 you for asking.   Stacey Simms  5:56 I gotta tell you, I'm a little nervous. I'm a huge fan. I'm just following you on social media. And then I put into my Facebook group like I always do. You know, do you have any questions for this guest? We've got a part of the car coming up. I have very few questions from the group. But I have lots of oh my gosh, I love him. Tell him we love him. Tell him. Thank you. Thank you. And I'll tell you specifically why they're thanking you in a moment. But you do have a quite a big fan club over here. So going in, I guess I'm trying to butter you up. But going in, you should know that.   Partha Kar  6:24 No, it's very quiet, very kind. I always see this, you know, at the end of the day, it's my job to do as well. But you know, the love and blessings you get is just makes it stronger. So yeah, no, absolutely. Thank you.   Stacey Simms  6:35 You're welcome. Let me just start off by asking you, you do not live with diabetes? How did you get into the position that you were in today? Why this field for you. So I think   Partha Kar  6:43 a lot of it was, you know, when we are when we are training, you pick your subjects as you go along. And then I sort of gravitated towards Diabetes and Endocrinology because I thought there was an opportunity here to talk to a lot of people, you know, be a part of their journey throughout life. So it was quite good. And I like talking, and then sort of more towards type one, because I think I get got to realize the more senior I got a lot of attention, quite understandably, was into type two diabetes. And that's, you know, the bigger volume number, etc. But I think what I found that there's not a lot of things being done for type one as a trade back of that. So it's been more of a, let's see what we can do in the space. Let's try and help people. And I think just being an advocate, so to speak. So yeah, that's probably how it's graduated over the course of time. One of   Stacey Simms  7:31 the things that we've observed, just following your social media here in the US, is the adoption and use of libre for many more people, can you talk a little bit about how that came about?   Partha Kar  7:41 So I think Libre, I'm in freestyle Libre first came into the market on 2014 2015. And I think it started to sort of gradually make its way into the UK setting and the sort of people would buy it funded. And I think it sort of started taking off in 2016 2017. And that's when I sort of got into the job. And for me, people are always asking why this particular device, I think it's not the device, I think it's more of a mass device. And I think there'll be more competition coming along. But to me, it's be a very good example of what self management can do. I mean, simply put, if you see more of your numbers and more of your trends, you tend to intervene more and do better. So that's been the device and it's been a battle to try and get it into people's lives as you go along. As you're the system here is slightly different. You have to justify every single thing you do, because you're saying, Well, this is why we're trying to do it. And it's a funny place to be in because you know, you're you're sort of fighting, so to speak against other conditions, that doesn't feel right, either trying to justify why you needed more compared to X or Y. And I think that's the challenge. And then people start looking at well, actually, there isn't a randomized control trial, which showed y or Zed and I can't fund it. And I try and explain to people it's not just about the RCTs, or the randomized control trials all the time. It's not just about doing one see, it's about the quality of life and what it does do so yeah, I think I think that's how it came about. And then driving it through, pick up or take up around the country sort of battling with regions. So yeah, it's it's been a journey in the half, so to speak. Can you   Stacey Simms  9:14 get a little bit more specific in terms of how many people now in your system do have access and do use the freestyle?   Partha Kar  9:20 Yeah, I mean, I think we got I mean, given round, figure wise, we've got about 200, we got a quarter of a million people with type 1 diabetes, and I think about 53% of them are on it right now across the country, and of all our cards land. Well, I think it should be available, either, you know, Libre or its equivalent should be available to everybody, everybody, very soon.   Stacey Simms  9:42 So yeah, I mean, the reason I wanted to ask that is because first of all, it's already such a big number comparatively speaking too much for the rest of the world. Certainly, I've got to imagine you're starting to see better outcomes too. Yeah,   Partha Kar  9:53 absolutely. I mean, it's coming through your h1 HB ones is a better I mean, I can tell you from my own clinical practice, people are huge changes. We're seeing it across the country and the data we're collecting and guess what admission levels are down. People feel happier your HP once he's down, it's doing what it says on the tin.   Stacey Simms  10:08 What would be the ultimate goal? Is it with that device? Is it then moving on to other CGM? Or do you want to kind of get as many people as possible in this one?   Partha Kar  10:15 Oh, no, absolutely. I've always maintained I'm a Libre or freestyle Libre is has been the tip of the spear. I think there was a lot of things there, which was about showing people the what is possible, because before that, in the world of the NHS technology has always been seen as a Okay, well, let's see what we can do. I mean, for example, insulin pumps have been around for so long. We even had nice guidance on it available since 2008. But the pickup rate really low 15% 16%. Really many reasons behind it. And CGM for isn't traditional CGM like Dexcom. Really low again, 4% 5%, or there abouts. But I think this was about showing what could be done if you really pushed on it hard. And I think it's opened up many, many doors. You know, subsequently, because of that, we're looking at competition coming along, we're looking at every single pregnancy with type 1 diabetes not having access to a Dexcom, or Medtronic device, we're doing trials and closed loop, suddenly, it has become a flagship, and due to luck, serendipity or default, it's worked out as one of the projects, which has really, really played out well in the NHS. And so a lot of people are looking at it. And for me, that was always the purpose. It's the tip of the spear. If you can show you could do it with one, there's no reason you can't. And it's definitely not the end goal never has been. I think the end goal would be that every every person with type 1 diabetes, irrespective of the age has the ability to choose whatever technology they so can, whether it's flash, whether it's traditional CGM, whether it's a pump, or whether it's a closed loop, partnership salutely.   Stacey Simms  11:44 And I'm just a little bit more about the Libre, I'm curious to obviously the biggest objection many people would have had would have been cost. But inside your organization or external critics, what were their objections thinking going into something like this,   Partha Kar  11:57 I think the NHS always is a very traditional setup. And I think they're very good when it comes to drugs to pharmaceutical products. For example, pharmaceutical companies will do massive randomized control trials to show Okay, here is the drop in HBO and see, and thereby you can calculate it. The problem is with technology company, they necessarily haven't done that. If you look at Frisco Librem, the initial studies that came out, they never showed any change in HB one C, primarily because they chose a lot of people's age 20 with the excellent to begin with. And you're sitting there going, Well, that was a mistake, I think, for companies not to take up the trials, because straightaway to a lot of policymakers, you don't have any room to maneuver, because you're banking yourself completely on the ability that will show improvement of hypos and quality of life. Now, the other problem, I suspect has been there nice, which is our governing body, so to speak, who you know, looks at evidence, they're quite slow at coming off the blocks. Sometimes it can be too late in the technology world by the time you assess, you know, right now they're assessing Libre one you are Libre 123 out. So what are you assessing? There's got to be nimble and quick. That's been that was the obstacle people saying that. So I think there were that level of obstacle Well, nice having said so so why should be, there's also a lot of people who fundamentally believed that this was just a gizmo and this was just shiny toy, and we shouldn't give it to people with diabetes, they should or for example, they had to earn it, you know, they have to either have complications to have it, or they should be testing 10 times a day to get it, which I think is pretty silly. Because you know, the whole point of doing this exercise is to target people are finding it difficult to test and find giving it to people to stop them from having complications. But there you go, it's a very traditional set of thinking, which is what has been the challenge trying to break through?   Stacey Simms  13:39 Yeah, do we have similar issues in the states where they're doing trials? And you always see like, well, they're a one see went from 7.3 to 6.9. And that's wonderful. But you know, we need to reach the people who's a one sees our 10.5 100%, right, because of either education or access, or whatever it is. I know, I know, you're struggling with that as well. Yeah,   Partha Kar  13:58 So, for example, you know, we have learned from that, you know, we, when we collected the real world data with Libre, we showed exactly what he said, the higher the higher your starting age, we want to see the better your outcomes. And you're like, Well, that's obvious. So what we're doing with those with Kevin, so what you're doing with closed loops right now, so we're running a real world trial evaluation throughout the country, it's about 34, five centers around the country, adults and pediatrics doing it. And guess what we see, again, the higher your agency, the better you're a flattening of your agency. So it's not rocket science. And I always am flabbergasted when people doing trials go like, no, let's just pick the people's controller really good. And as you said, but that goes against the whole deprivation thing that we discuss about because we know people who come from very deprived backgrounds will have worse control. So if you really want to tackle deprivation, you need to control that and you need to tackle that. So the thinking needs to be far more refined than what it is at the present moment. And hopefully we're trying to show some ways of doing so.   Stacey Simms  14:54 So one of my listeners said, I want you to please let parked the car know how much I appreciate In his posts, she goes on to say, there's not much I appreciate more than medical professionals who treat us like real people and don't talk down to us. Where did you learn your bedside manner your style or what you know what we as as not your patients see on social media because that's one of the things I think that very much resonates with people is that you're you're very plain spoken and you don't talk down to people with diabetes   right back to our conversation, but first Diabetes Connections is brought to you by Dario health. And you know, over the years, I find we manage diabetes better when we're thinking less about all the stuff of diabetes tasks. That's why I love partnering with people who take the load off things like ordering supplies, so I can really focus on Benny, the Dario diabetes success plan is all about you, all the strips and lancets you need delivered to your door, one on one coaching. So you can meet your milestones, weekly insights into your trends with suggestions for how to succeed, get the diabetes management plan that works with you. And for you. Dario is published studies demonstrate high impact clinical results, find out more go to my dario.com forward slash diabetes dash connections. Now back to Dr. Kar, talking about how he has developed a good bedside manner and respect for his patients.   Partha Kar  16:20 I think it's come with time, if I'm very honest, and most likely, it's not like a suddenly over a bed. And one day I decided to become like this. And I think what I've realized over the course of time is their Medical School doesn't teach us consultations, kills diseases, a lot of stuff, right? It's just teaches us what the book said, which is my Insulet physiology, how it works, doesn't really teach us a lot about interaction with human beings, which is what we did with some things like the language matters and stuff and people found language matters. Interesting. I found that just human sense, you know, common sense, human, it's not that difficult to be nice to people. And we somehow are not we somehow, and I think social media teaches me a lot of stuff. I think my patients teach me a lot. And I don't say that in a glib way, because things like, you know, I will do transitional or young adults clinic. And I remember these words from this young girl who sat there looked at me and said, If he took an exam sometimes, you know, and I want to watch that. And she said that, I don't know. It just feels like I'm going to be asked what I'm doing with judgment, what I'm doing, you know, when I sat down, but like, that's not right, that's wrong. Why are we making people feel like that way? And then we are wondering why they're not coming back to our clinics. So a lot of my consultations were very honest, not about diabetes, with my patients they're very much about could be a football or movies. I mean, yesterday, when just watch the internals and today in clinic, we were talking about one of my patients, and that was the conversation, what did you think about that paid the post credits, what was it, and I think you build a rapport with people, they trust you more, you get along more. So I like to keep it very plain. And I also feel that clinicians sometimes believe that people living with type 1 diabetes won't be able to handle the truth, so to speak. Oh, you can't tell them when you can. They're all adults and or, or in or surrounded by adults, and they deal with tough calls in their lives all the time, you know, how to get a mortgage, you know, how to get your car or dealing with ups and downs, or the Why wouldn't they be able to they live with it. So I've always benefited that by turning around and saying I can't do this for you. It's outside my expertise. And I think finally, I'm also trying with my other role trying to deconstruct the myth, and the and the whole thing that doctors are built around them so that there's some sort of, you know, material human beings here for to burn themselves to the altar, normally not, you know, we trained professionals, like a fireman or a policeman and trying to do my best. And sometimes I'll get it wrong, sometimes I'll get it right. But at least I want to portray across that I'm trying and trying my best. And we'll see where we go from there.   Stacey Simms  18:50 You know, it brings up an interesting point, because I consider myself a very strong advocate with my doctors, for myself and for my children. But I still hear you get intimidated, you do very much respect my doctors, any advice for patients who who want to have a difficult conversation with their physician who want to start broaching that, hey, treat me like a partner and may not know how to start?   Partha Kar  19:12 Yeah, I mean, I think it's really difficult. It's really difficult to do that. Because I think this is why it's a bit like I always give the example of let's say, sexism. Now. It's not the it's not just the job of women to go and solve sexism, is it. I mean, it's men have got an equal part, you will not understand nuance as a man or a woman goes through, but you know, when it's wrong, and you can turn around and say, Nah, guys don't do that. Right. So I think what I would encourage rather my clinical colleagues to say that, look, it's not tricky to sort of have that feedback and saying your approach may not be the right thing. And I think this younger generation coming through which does that. So my advice to patients who would like to do that would be to, I think doctors feel very challenged as soon as you challenge them. It's an ego thing. Don't forget that we have been taught in medical school that we are the top of the top there is no Nobody better than us, right? When you're told that for five years, seven years, eight years, 10 years of your life that there was nobody better than you, it's very difficult to then sit in a space. And if somebody challenges you to actually take that on board, so there is a bit of that complex that has happened over the course of time. So the way to approach that would be to probably do it from a slightly different angle. And rather than pointing out the mistake and say, What would you say? What do you think if we did this? Do you feel like so I think you try and do that there'll be some people who are open to the idea of saying, I don't agree with that, and you go with it. But I think the biggest advice I can give is find an ally, was also a clinician who will do that for you. So in meetings, when I go to, I always see myself as that sort of advocacy role return rentable. And now I don't agree with that. Because I know I've spoken to a lot of people who want to agree with that. So that is the sort of fine balance to strike, it will change, doctors are changing. And you know, if you've been long enough in the system, the 90s, were different to 1000s were different, and now is different, but doctors are evolving slowly takes a long time to get you got good get rid of you got complex.   Stacey Simms  21:02 Another question from one of my listeners who wanted to know, Brexit to will, or already has had an impact on diabetes care or supplies,   Partha Kar  21:11 hasn't affected supplies, because we actually knew there was going to be a problem. So we planned and we worked with the industry to make sure we had good suppliers. And there will always be teething trouble as we go along with this. But no, we don't expect, he says Fingers crossed. We have some plans in place in case of anything, but Brexit is one of those political things in life, isn't it? So we just have to ride the storm with it as we go along. So   Stacey Simms  21:34 this is an American based podcast, mostly because I'm American, we do have listeners all over the world, which I'm very, very grateful for. But our healthcare systems are so different. I'm curious if you have any advice, or any lessons that you think we could learn from how how you all do it?   Partha Kar  21:53 Yeah, I mean, so I think the debate about healthcare becomes incredibly emotive on both sides of the Atlantic. I think that's the problem. So when you turn around, people start saying, so for example, if you challenge the NHS, people go like, well, you don't like the NHS, because you want to make it privatized to you. And you will? Um, no, not really, I'm just saying that there are gaps in the prison system as we fund it, for example, we say it's equal to all well, not really, if you come from a deprived community. Right, now we've got issues with race. So as I've said, if you're a black child, your chance of getting a continuous glucose monitor is half of that of a wide shot. This isn't the NHS which professes to be equal to everybody. It's not right. So the challenge is there, even however, the funding is, I think my advice to in the US setting would be it's so vast and so big. Taking aside the politics, which is so difficult to do, obviously, I think too much attention is focused when it comes to chronic disease on the to the three parts, which I think of type 1 diabetes, I think I see it as self management, peer support, and access to train professionals. That's the three things on which good type 1 diabetes care sets. And the US system is incredibly good about doing number three, too, it makes it more and more expensive, because we don't have any trained professionals. And so you end up having to really top load that bit. If you switched a lot of the attention to one and two, self management with technology of peer support, you probably will have better outcomes, I don't think it's about the make of the system. And it's insurance based or public funded. And that's where the politics comes in. It's about the switching of that mentality where you get peer support and self management as being a main key focus and investment into but the US system, partly the UK as well. But the US system hinges heavily on number three. And that's why you the costs are so out of control. That's my view, at least   Stacey Simms  23:38 we've seen it in our own experiences. And people who listen to this podcast know that that peer community matters immensely with camps and communities and meetups. And it's incredible. It makes such a difference. Absolutely. You mentioned language matters. Can you speak a little bit about that for people who aren't familiar? Yeah, I   Partha Kar  23:55 mean, I think there's a fair few versions of that. I'm the principal of that was built in Australia in 2012. And again, it's nothing dramatic. It's not I mean, became it basically saying just be nice to people. You know, I think you've got embroiled in this whole debate for a bit of time. Because it was done in the States. There was papers out of him that we picked up in the UK, different countries have done it and people get stuck up in the Oh, is it is it about calling somebody a diabetic or a person with diabetes, it's not lots of people don't mind being called diabetic, some people do mind being called diabetic, that's not about that what the document is about. The document is very, very simply about trying to be less judgmental about people whose lives you don't leave. Right? If you're saying to somebody, or you know, I'm not sure you're you should be doing that in the morning, when you don't know what like the lead. You don't know that they're having to, you know, rush to drop off their kid to school and do this and do that. It's not easy to then go you should have a very structured breakfast and take your insulin on time. Well, that's fine for you to say, but that for that individual. They might have two kids to drop off and then go to work while trying to make sure you know their husbands had their work. It's It's not easy. So I think that's what it's about don't don't try and judge others whose lives you don't leave lid. So that that was pretty much it.   Stacey Simms  25:08 I think that the libre goal that you have I know you're not done with and you wouldn't call it a an ultimate success yet has been tremendous. What is next? Is it trying to get more pumps covered? Is it trying to get more equality as you've already mentioned, racial and economic lines,   Partha Kar  25:23 closed loops, I think I think is, is the is the next target, I think more more access to closed loops, more access to all the types of different loops that are available, and you touched upon it, irrespective of your deprivation, ethnicity, that's going to be huge for because going ahead, I want more people to have access to technology, because I think technology is an enabler sort of ticks, that box of self management, it also encourages more peer support. So if we did that, together well, and did more standardized training for healthcare professionals that I think that's the sort of ultimate goal. But I think closed loops are going to be the thing I suspect the focus and target on as we go ahead.   Stacey Simms  26:01 Fabulous. And I'll let you go. I know you got to run. But we are speaking during Diabetes Awareness Month, and you put out a video very plain spoken as you do, saying, basically, be nice. Don't judge, don't be an idiot. And you have a two minute long video explaining this. What was the reaction? I mean, it's a very plain statement, but at the same time, it's quite blunt. Yeah, I   Partha Kar  26:21 mean, I think I see the debates between and it's so silly, some of the stuff that goes on, on social media and wider and I can understand people do it because they have a book to sell, or a podcast or blog or whatever they want to do, or Twitter likes, but the simplistic narratives and never helped people, you know, we could we could turn around and say, Well, if you eat too many cakes, you will have type two diabetes, there is not a single evidence base that will support that statement. Yes, people say that right? You know, and I think that's the problem. And then that rolls into how did your child have diabetes? You give them too many cakes, and you sitting there going like what how uneducated Are you didn't come up with a statement like that. And it's so frustrating to see that. So I think the reaction has been good. I mean, I've always been known for my and I genuinely think when people don't know something, I'm very happy to explain it to them in today's day and age. If people say that, Oh, I didn't know that type 1 diabetes is an autoimmune disorder has got nothing to do with your diet or your lifestyle, then I'm sorry, you were just uneducated. And that's my bottom line to that. So you haven't even made the simple effort to open Google. So things like that. And I think that was the that was the idea of that is Diabetes Awareness Month. Just be aware of different types. Be nice to people don't judge others and you know, at least at least do some research and you've got Google on your smartphone. So simple.   Stacey Simms  27:41 Okay, last question. You mentioned the eternal is no spoilers. I haven't seen it. But I know you're a big Marvel fan. How was the movie?   Partha Kar  27:47 Oh, it's good. I really enjoyed it. It's as a standalone, it works really well. And my only big tip also is mistake for the after credits. Very good, especially the last one. Very, very good. All right.   Stacey Simms  27:58 Well, thank you so much for spending so much time with me. I really appreciate you being here. Thanks very much. Partha Kar Pleasure.   You're listening to Diabetes Connections with Stacey Simms. More information at diabetes connections.com. Of course, there's always a transcript as well. I will link up how to follow Dr. Kar on social media, I highly recommend his Twitter feeds. And he is just very informative, very straightforward. And he's always willing to admit when he makes a mistake or something funny happens. I mean, he's just let's face it. He's just a human being online, which is why I think so many of us respond to him so well, that I liked a lot of the advice he gave there for us to take to our doctors, we really have to be straightforward with them. So many times they don't even realize what they're doing or how they're talking to us. Sometimes they do and they're they're just jerks. But most of the time, I think they want to have a good relationship with us. At least that has been my experience. There's only been one doctor, in my my experience. I'm not talking about Benny, because we've been very lucky with him. There's only been one doctor that I have fired. And I fired him from my hospital room because oh my gosh, was he talking down to me? So don't be afraid to do it. Alright, Diabetes Connections is brought to you by Dexcom. And we were watching TV the other night. My husband and I are really into the expanse now, which is a sci fi show that's been out for a while. We are totally binging it, we're going through every season. So we're watching that. And the Dexcom went off the alert on my phone and Benny was upstairs in his room. And you know, for some reason, it took me back to the days when we basically had blood sugar checks on a timer. If you're of a certain age you remember this we would check doing a finger stick the same time every day at home and at school and whenever extra we needed to. It's really amazing to think about how much our diabetes management has changed with share and follow. I didn't stop the movie to check on him. I knew what was going on. I mean, I could decide whether to text him or go up and help out for this instance. I did absolutely nothing because I didn't need to using the share and follow apps have really helped us talk less about diabetes. which I never thought would happen with a teenager. Trust me Benny loves that part too. That's what's so great about the Dexcom system. I think for the caregiver or the spouse or the friend, you can help the person with diabetes manage in the way that works for your individual situation. Internet connectivity is required to access Dexcom follow separate follow app is required. learn more, go to diabetes connections.com, click on the Dexcom logo. If you're listening as this episode goes live, Happy Hanukkah, we will be marking night three as you're listening again, if you're listening when the episode first airs, and Paul hits early this year, that my daughter's already packing school, but that's how it goes. I hope your life because they're yummy and your Hanukkah guilt is delicious. And you're not stressing out too much about diabetes, and you're able to enjoy what the holiday has to offer. Looking ahead. I mean, what am I going to say? Here? We are December. Oh my goodness. So we've got some great shows coming up. We've got a conversation next week with the folks at convatec. They make all of the insets except for Omni pod. But if you use a Tandem Medtronic, yep, so mid, those pumps, they make your insets. So we had a really good conversation about how to make those better, some good information for the community from them. And I'm hoping that'll be an ongoing conversation. And we have a lot of good stuff in the works for the rest of this year. Going into January, does he I would ask is if you have listened to this far and you are not signed up for our newsletter, please make sure to do that I send out an email every week along with the show. And quite often there is more information in there than just a week's episode. We do surveys, we do research opportunities that I get from companies. There's a lot of info in that. And as we move forward next year, and I'm branching off into other projects, I'm gonna be using that newsletter to communicate more and more about things, not just the podcasts that I think are of your interest, but I don't spam you or anything dumb like that. So go ahead, you go to diabetes connections.com a little pop up will come up. If you don't see it, just scroll down. There's a little newsletter thingy that'll help you sign up there. Thank you to my editor John Bukenas from audio editing solutions. Thank you so much for listening. We are back on track for our newscast this week. So I will see you back here Wednesday on Facebook or YouTube Live for in the news. And then on Friday, we turn that into an audio, podcast whatever works better for you. Feel free to join me in whatever way is the best. I'm Stacey Simms Until then be kind to yourself.   Benny  32:24 Diabetes Connections is a production of Stacey Simms media. All rights reserved. All wrongs avenged

Work Hard Play Hard
399. Fri-Date: How We Are Unexpectedly Losing Weight In Italy

Work Hard Play Hard

Play Episode Listen Later Nov 26, 2021 29:42


We are lab rats. We're constantly experimenting on ourselves to find the optimal way to make ourselves fitter, skinnier, healthier, happier, whatever it is we're trying to do that day. We've tried everything – including the CGM, or continuous glucose monitor, which we've come back around to. What it does is monitor your glucose levels throughout the day, particularly how your levels rise the two hours after eating something. Now that we're in Italy, we really wanted to give this thing a test run. We spend this episode digging into what we found and why it shocked us. In This Conversation We Cover:  [02:10] Testing our glucose levels [05:53] What Italians eat and how it affects their health [12:30] What's done differently in Italy [22:01] Digging into the metrics Resources: Text "Dream Life" to 310- 388-9724 to get our FREE dream life course Mastermind: https://workhardplayhardpodcast.com/mastermind/ (workhardplayhardpodcast.com/mastermind) Connect with Rob on Instagram: https://www.instagram.com/robmurgatroyd/ (@robmurgatroyd) Connect with Kim on Instagram: https://www.instagram.com/kimmurgatroyd/ (@kimmurgatroyd) To learn more, and for the complete show notes, visit: https://workhardplayhardpodcast.com/ (workhardplayhardpodcast.com) Work Hard Play Hard is a production of http://crate.media (Crate Media)

The Keto Kamp Podcast With Ben Azadi
Dr Robert Cywes | Effectively Treating Diabetes, Calories In vs Calories Out BS, & The Problems With Too Much Fat on Keto KKP: 340

The Keto Kamp Podcast With Ben Azadi

Play Episode Listen Later Nov 24, 2021 84:13


Today, I am lucky to have here with me, a specialist in Weight Management and Bariatric Surgery for adults and adolescents, Dr. Robert Cywes. He has been doing bariatric surgery for 18 years, performing over 8,000 surgeries. This is an episode that originally aired on March 2020, and it was so good we decided to re-release it here today.  Dr. Cywes' medical training began in Cape Town, South Africa, where he received his medical degree from The University of Cape Town. In 1989, Dr. Cywes moved to North America and completed a year-long residency in Pediatric Surgery at Ohio State University's Columbus Children's Hospital. After completing his pediatric surgery fellowship at the University of Michigan's C.S. Mott Children's Hospital, Dr. Cywes was appointed as an Assistant Professor of Pediatric and Fetal Surgery at Vanderbilt University in Nashville, Tennessee where he did hepatic stem cell research. During this time, Dr. Cywes became increasingly interested in adolescent obesity and the impact of the liver and metabolic syndrome on young patients. Dr. Cywes' research led to a comprehensive understanding of the toxicity of chronic excessive carbohydrate consumption as the primary cause of obesity and so-called obesity-related co-morbidities, and he became interested in developing a clinical program to treat obese patients using this knowledge. Dr. Cywes relocated to Jacksonville, Florida where he joined the Department of Pediatric Surgery at the Nemours Children's Clinic and Wolfson Children's Hospital. This led to a national meeting in Jacksonville where guidelines for adolescent obesity surgery were established. Dr. Cywes established JSAPA to continue his work in both adolescent and adult obesity treatment and surgery, and in 2013 opened a practice in Palm Beach County, Florida. He now works with a highly experienced team of professionals from a variety of medical sub-specialties to better care for obese patients. He has developed the practice into an internationally recognized Center of Excellence for obesity surgery. The practice uses a cognitive behavioral therapy approach that addresses carbohydrate addiction, along with bariatric surgery, to help patients manage their obesity long term. In this episode, Dr. Cywes opens the show discussing the correlation between carbohydrates and toxic drugs. Our bodies do not need to run on sugar; our bodies prefer a keto lifestyle. Also, Dr. Cywes explains effective methods of treating diabetes and what's wrong with conventional treatments. Stay tuned, as Dr. Cywes discusses dopamine fasting, serotonin loading, and how our feedback controls for survival work. BiOptimizers Special November Deal: www.magnesiumbreakthrough.com/ketokamp  and use code ketokamp to get your discount and free gifts today! 

CGM Presents: Wives In the Word Podcast
Episode 1, "Thank You and Christmas Launch 2021"

CGM Presents: Wives In the Word Podcast

Play Episode Listen Later Nov 24, 2021 5:21


Hello and welcome to our “Thank You and Christmas Launch for 2021." Psalm 136 says, “O give thanks unto the Lord; for he is good: for his mercy endureth forever. Oh, give thanks unto the Lord.” This is Apostle Charles Wright and this is Dr. Stephanie Wright. As we approach Thanksgiving, Christmas and the New Year, we want to thank you, our listeners, for tuning in to this podcast. We have reached more than 40 countries and over 630 cities around the world thanks to you!  We also thank you for your financial support, letters, texts, emails, and phone calls that have inspired us to press on with passion in our purpose. That purpose is to encourage and uplift you to live an abundant life in Christ through each season in your walk with Him. You are a blessing to us. Most of all, we thank God for his blessings this past year and for giving us His direction on each podcast. If you would like to be a guest on our podcast email us at: cgmpresents@gmail.com We can be reached on Facebook at CGM Present: In the Word Podcast and our handle for Twitter and Instagram is @cgmissions, and  for YouTube is cgmissions. CGM is a 501(c)(3) nonprofit. Donations may be sent through CashApp to: $cgmissions 

Mastering Blood Sugar
Continuous glucose monitoring for blood sugar control with Casey Means, MD

Mastering Blood Sugar

Play Episode Listen Later Nov 23, 2021 49:41


Casey Means, MD is a Stanford-trained physician, Chief Medical Officer and Co-founder of metabolic health company Levels, and Associate Editor of the International Journal of Disease Reversal and Prevention. Her mission is to maximize human potential and reverse the epidemic of preventable chronic disease by empowering individuals with tech-enabled tools that can inform smart, personalized, and sustainable dietary and lifestyle choices. Dr. Means's perspective has been recently featured in the New York Times, Men's Health, Forbes, Business Insider, Techcrunch, Entrepreneur Magazine, The Hill, Metabolism, Endocrine Today, and more. She has held research positions at the NIH, Stanford School of Medicine, and NYU. In this episode, Dr. Casey Means talks about the importance of understanding your glucose levels with the help of the continuous glucose monitor device (CGM), and how the change of the glucose levels throughout the day affects different areas of everyone's life. She talks all about the metabolic disfunction that most American adults deal with, and how those conditions are actually preventable with the right diet and lifestyle choices.  Dr. Casey explains why this knowledge is important to people who don't have any metabolic conditions, and how it can help people prevent developing them in the future. She goes over different areas of life, including diet, sleep, exercise, and activity levels, and how they can affect the overall health and specifically the glucose levels.    Dr. Casey Means mentions metabolic flexibility and goes over what it actually is, and how it works. She explains how our bodies switch between using glucose for energy to using fat based on different availability. Then she covers why the personalization of a diet can be very effective, and how everyone's body responds differently to the same foods. With the use of the CGM you can actually optimize your own dietary preferences to make it most healthy for you. And lastly, Dr. Casey means explains how the Levels app works and how to use the data collected by the continuous glucose monitor. Key Takeaways: [ 2:08 ]  Continuous Glucose Monitor (CGM) for personalized dietary lifestyle. [ 4:06 ]  Why it is important to understand glucose levels even if you don't have diabetes.  [ 8:42 ]  One to one relationship between what you are eating and what happens to your body. [ 14:40 ]  Sleep deprivation and stress. [ 23:10 ]  HIIT has a paradoxical effect on glucose. [ 24:53 ]  Metabolic flexibility. [ 29:40 ]  Diet personalization. [ 36:48 ]  If I have a CGM on and I am not a diabetic, what should my glucose levels look like over 24 hour period? [ 39:30] The dawn phenomenon in people who are non-diabetic. Mentioned in this Episode: Dr. Casey Means' Instagram: https://www.instagram.com/drcaseyskitchen/ Dr. Casey Means' Twitter: https://twitter.com/drcaseyskitchen/ Levels Health Website: https://www.levelshealth.com/ Levels Health Instagram: https://www.instagram.com/levels/ Levels Health Twitter: https://twitter.com/levels/ Enjoyed the Podcast? Subscribe on iTunes and leave a review! For more Dr. Mowll, check out his  website drmowll.com For Dr. Mowll's high quality nutritional supplements visit https://sweetlifenutritionals.com/ For more information on this week's episode, visit: Mastering Blood Sugar Podcast   

Podcast Notes Playlist: Latest Episodes
#194 with Justin Mares - The 4 Types of Side Hustles and how to launch a $100M DTC brand

Podcast Notes Playlist: Latest Episodes

Play Episode Listen Later Nov 22, 2021 70:26


My First Million Podcast Notes Key Takeaways Strategy 1: Buy an existing assetYou need the most upfront money here but there can be an incredible value to capture by simply owning and upgrading an asset better than the current holderStrategy 2: Provide supply to a marketplace with existing demandFind deviations of keywords on google search that lack supply to fulfill the demanded and desired searchIf you understand what makes supply marketable and what the marketplace algorithms prioritize, you can drive more demandStrategy 3: Launch a unique product where you can buy customers through paid acquisitionBuy the top Google-searched word in a unique product categoryGoogle search is a magic lamp and you can be the genie, give them what they wantStrategy 4: They didn't discuss a 4th but Justin has an awesomeblog/substack where he gives the latest knowledge on side hustles, D2C businesses, market opportunities, and moreOther awesome D2C Ideas discussed:AirBnB camping properties: more affordable and less maintenanceNon-alcoholic wine: booming product category with limited optionsPhthalate-free products: health > price & convenienceAnd more….Read the full notes @ podcastnotes.orgJustin Mares (@jwmares) joins Sam (@TheSamParr) and Shaan (@ShaanVP) on this episode. Justin breaks down his most popular blog post, the 4 types of side hustles, and brings all kinds of ideas for how you can start your own. They also talk about Justin's DTC businesses - Kettle & Fire, Perfect Keto, and Surely Wines. They end the episode with a few ideas around camping, a new dating app, and how to leverage VAs & no code tools. --------- * Want to be featured in a future episode? Drop your question/comment/criticism/love here: https://www.mfmpod.com/p/hotline/ * Support the pod by spreading the word, become a referrer here: https://refer.fm/million * Have you joined our private Facebook group yet? Go to https://www.facebook.com/groups/ourfirstmillion and join thousands of other entrepreneurs and founders scheming up ideas. --------- Show notes: * (1:23) How Sam & Justin know each other * (5:17) Justin's DTC bone broth company * (10:00) Frameworks for side hustles * (13:22) Side Hustle 1: Buying an asset * (17:51) Side Hustle 2: Launching on top of a marketplace with demand * (22:08) Side Hustle 3: Unique product that grows through paid acquisition * (25:31) How Justin balances all his projects * (30:38) The $30K/year CGM experiment * (39:09) The skinny on Duck Duck Go * (42:32) Ideas: Airbnb camping * (45:27) Idea: Non alcoholic wine * (51:10) How to naturally boost your T levels * (1:01:04) Idea: Dating app based on your credit card usage * (1:03:49) Idea: The no code automation officer * (1:07:28) How to follow Justin

Losing Weight with Fasting & Mindful Eating.
45 | Holiday Group FAST & how to navigate the Holiday Season Like A BOSS!

Losing Weight with Fasting & Mindful Eating.

Play Episode Listen Later Nov 17, 2021 20:18


Holidays seem to be a very stressful time for most people, not only because of going off of your diet, but also the stress of being around family, anxiety around social settings, food, exercise, travel, and straying away from your normal routine. In this episode, I will give you some suggestion on how to navigate through the holidays like a BOSS. I will also be starting a group fast (highly requested) one week before Thanksgiving (November 17th), so if you would like to participate in this challenge be sure to check back on my instagram stories for more info @monikabanachofficial Episode 19: How to Avoid “Special Events” Weight Gain | 10 Tips to Help You Get through the Holidays

The Fitnessista Podcast: Healthy In Real Life
091: Balancing your blood sugar and making healthy swaps with Kara Collier

The Fitnessista Podcast: Healthy In Real Life

Play Episode Listen Later Nov 17, 2021 35:23


New podcast up with Kara Collier, chatting about balancing blood sugar and making healthy swaps.  Hi friends! New podcast episode is up on the blog and I'm so excited for this one, because I'm chatting with the co-founder of a company that I love: Nutrisense. I first found out about Nutrisense from my friend Mia, and wanted to try it because I had some borderline high fasting glucose levels last year. She walked me through the whole process of inserting my first CGM, and I was so excited to analyze all of the data I received from Nutrisense. You can check out my full blog post here! You can also use the code GINA50 for $50 off if you want to give it a try! (Not an affiliate link; they asked me if I wanted one, but the discount would be lower for you guys. I wanted to give you the max discount, so I do not make any money from these referrals. Just want to share the love!) Today, I'm chatting with Kara Collier about: - Why non-diabetics can benefit from continuous glucose monitoring - Nutrisense and how it works - The importance of meal timing - Easy swaps for more balanced blood sugar - and so much more  Here's more info about Kara: Kara Collier is co-founder and Director of Nutrition at NutriSense - the leading personalized nutrition company that uses new technology to monitor the body and create personalized diets and optimized fitness routines. Kara oversees the health team and product development so she is at the cutting edge of using technology to make health advice based on real data from our bodies. Kara is also a leading authority on the use of continuous glucose monitoring (CGM) technology, particularly in non-diabetics for the purposes of health optimization, disease prevention, and reversing metabolic dysfunction. You can connect with Nutrisense on their website, Instagram, and with Kara on Instagram here. Resources from this episode: Check out Nutrisense here and use the code GINA50 for $50 off!  I love love love the meals from Sakara Life. (Also, none of my Sakara meals spiked my blood sugar while I was wearing my CGM. Even the delicious breakfast vegan pastries, like the roasted apple pancakes or the Chocolate Love Muffin). Use this link and the code XOGINAH for 20% off their meal delivery and clean boutique items. They have so many great things for holiday!!! Get 15% off Organifi with the code FITNESSISTA. The green juice and gold powder are my favorites! Thank you so much for listening and for all of your support with the podcast! Please leave a rating or review if you enjoyed this episode. If you leave a rating, head to this page and you'll get a little “thank you” gift from me to you.   

CGM Presents: Wives In the Word Podcast
Episode 7, "In the Heart of God" Season 7: Empowered Through Jesus, Our Living Hope

CGM Presents: Wives In the Word Podcast

Play Episode Listen Later Nov 16, 2021 19:52


Hello and welcome to Episode 7, entitled, “In the Heart of God” in our series, “Empowered Through Jesus Our Living Hope." Today, Stephanie and I will share an impromptu conversation we had one morning about four events in our lives that we believe were ,“In the Heart of God.” And after we spoke in agreement to what was in God's heart, each of these events became reality and it happened quickly. This is Apostle Charles, let's go to conversation, “In the Heart of God.”If you would like to be a guest on our podcast email us at: cgmpresents@gmail.com We can be reached on Facebook at CGM Present: In the Word Podcast and our handle for Twitter and Instagram is @cgmissions, and  for YouTube is cgmissions. CGM is a 501(c)(3) nonprofit. Donations may be sent through CashApp to: $cgmissions

Diabetes Connections with Stacey Simms Type 1 Diabetes
Ask the D-Moms Holiday Edition - More Fun, Less Stress (we promise!)

Diabetes Connections with Stacey Simms Type 1 Diabetes

Play Episode Listen Later Nov 16, 2021 40:15


With Thanksgiving almost here and the winter holidays around the corner, we know that diabetes stress is about to ratchet way up. The D-Moms are here to help! Moira McCarthy joins Stacey to talk about everything from holiday travel, long car rides, well meaning relatives and holiday gifts centered on T1D. And of course, FOOD! Get advice to keep your children with T1D safe and happy so you can make terrific memories without freaking out about "perfect" blood sugars. Previous D-Mom Holiday advice here Adults with T1D give their take on the holidays:  This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. Check out Stacey's book: The World's Worst Diabetes Mom! Join the Diabetes Connections Facebook Group! Sign up for our newsletter here ----- Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners! ----- Get the App and listen to Diabetes Connections wherever you go! Click here for iPhone      Click here for Android Episode Transcription below:  Stacey Simms  0:00 Diabetes Connections is brought to you by Dario health. Manage your blood glucose levels increase your possibilities by Gvoke Hypopen the first pre mixed auto injector for very low blood sugar, and by Dexcom, take control of your diabetes and live life to the fullest with Dexcom.   Announcer  0:20 This is Diabetes Connections with Stacey Simms.   Stacey Simms  0:26 This week, Thanksgiving is almost here and many holidays just around the corner. Ask the D moms is here to help more McCarthy and I answer your questions and share our own stories to help you make more wonderful memories with less stress, even if that means doing things differently for a special occasion.   Moira McCarthy  0:44 And the reality is in this long, long, long, long, long lifetime marathon diabetes, you need to just chill a mile here and there. And by doing this and saying to your children, we're going to turn this off. This is okay. Don't worry about it. You're fine. You're modeling that for them and you're giving them the confidence and the courage to know that they can be okay. Yeah,   Stacey Simms  1:06 she said turn this off. She's talking about something I dare to say and do about Benny's CGM. We also talk about long car rides well-meaning relatives and holiday gifts centered on diabetes. This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. Welcome to another week of the show. I'm your host Stacey Simms always so glad to have you here. You know, we aim to educate and inspire about diabetes with a focus on people who use insulin. And yes, this time of year. I mean, it's the holidays are stressful without diabetes, right. But I'm already seeing in my local group, the stress ratcheting up, somebody said to me the other day that they feel like even though they're not necessarily doing more than they did before the pandemic as more people are venturing out and traveling. They feel like they're really busy. And I think a lot of it has to do with the fact that we haven't been very busy for the last year and a half, really. So there's gonna be more pressure on this holiday season. There's going to be more travel, there's going to be I don't know, it'll feel like higher stakes and especially if you are new to type one, that first year those first holidays, those first milestones are incredibly stressful. So Moira and I are here to help you out you probably already know. But just in case Moira McCarthy is a dear friend of mine. She is the author of many books about raising kids with diabetes, including the amazing raising teens with diabetes, which has that fabulous photo of a teen rolling her eyes right on the cover. I love that cover. You'll hear how long her daughter Lauren has lived with type one. She's a very successful adult now living on her own. And if you are brand new, my son Ben, he was diagnosed almost 15 years ago. He is almost 17, which is really hard to believe so most of my stories have to do with the early years. We're not out of the teens yet, and Moira will help kind of pick it up from there. And I always look to her for guidance as well. One funny thing about Thanksgiving this year, we have a set menu, right? We have our traditions. My husband is the cook in the family and we've always hosted Thanksgiving. He does something a little different every year, but it's really up to him. But Benny has been working in a grocery store for the past six or seven months now. And he is really jonesing for a sweet potato casserole with marshmallows, which we don't usually do nothing do with diabetes. It's just not our style. We generally save the marshmallows for dessert. But my mom who makes our sweet potato casserole every year has valiantly stepped up and says she will make one for him. Because at the grocery store. He has been seeing the display and he's like Mom, it's just sweet potatoes, brown sugar, sweet potatoes, marshmallows, sweet potatoes, brown sugar, like they have this. And he took a picture that I saw the last time I was there. I mean, it's one whole side of a produce display. So this poor kid, he is really dying for that that marketing worked on him. He wants those marshmallows. My daughter is the canned cranberry sauce person, right. You know you make that beautiful, homemade cranberry sauce with the whole cranberries. Are you you boil it down? No, we have to have it in the can with the jelly lines on it. I prefer that as well. I have to admit. Alright, Moira and I talking about real stuff just a moment. But first Diabetes Connections is brought to you by Gvoke Hypopen. Our endo always told us that if you use insulin, you need to have emergency glucagon on hand as well. Low blood sugars are one thing – we're usually able to treat those with fact acting glucose tabs or juice. But a very low blood sugar can be very frightening – which is why I'm so glad there's a different option for emergency glucagon. It's Gvoke Hypopen. Gvoke HypoPen is premixed and ready to go, with no visible needle. You pull off the red cap and push the yellow end onto bare skin – and hold it for 5 seconds. That's it. Find out more – go to diabetes dash connections dot com and click on the Gvoke logo. Gvoke shouldn't be used in patients with pheochromocytoma or insulinoma – visit gvoke glucagon dot com slash risk.   Moira, welcome back. I am so excited to talk to you What a week. I didn't even think about this when we planned. This is a big week for you and Lauren,   Moira McCarthy  5:04 it is yesterday, October 28. At 2:35pm was exactly her 24th diaversary. My daughter has had type 1 diabetes for 24 years. I can't even believe it. It's crazy.   Stacey Simms  5:22 But I have to ask you the time had you know the time.   Moira McCarthy  5:25 So I don't know why I know the time. We were at a doctor's appointment, and I know what time the appointment was. And I know what happened when I got there. So I don't know. It's just drilled into my head. And then there's people I meet that are like, I can't even tell you what day my kid was diagnosed. But for some reason, it just stuck with me. And as a little kid Lauren, like celebrating every year, so I sent her flowers yesterday. No, I don't care. 24 hours or so give us Do you   Stacey Simms  5:51 mind, maybe just a little bit of how she's doing maybe a little update. If this is someone's first time joining us for Deimos.   Moira McCarthy  5:57 I'd be happy to so my daughter Lauren was diagnosed. Well, I just said the date. So basically the beginning of kindergarten when she was six years old, right after her sixth birthday. I can remember feeling like the world was gonna end. But we had a really great medical team from the beginning who were saying to us, you are going to live the life you lived before. We're just going to add steps to it. And Lauren at six years old was saying I'm gonna lead you're not gonna, you know, let this hold me down. Now has it been all rainbows and butterflies? Absolutely not. We have had challenging days. We've had challenging weeks, we've had challenging years in her teen years. But right now, I think, well, first of all, what everybody cares about most is her physical health. She is 100% healthy. She has the labs that a person without diabetes would have if you checked, you know, her kidney and her eyes and everything else. Emotionally, she's really doing great. She has a long struggle with burnout. But I think she really has figured out a way to deal with that when she recognizes it coming up. And the most important lab of all I always say is she's incredibly happy. She has an amazing career and lives in the middle of Washington, DC all by herself, and I don't follow her on share. And I never worry about her. She has 8 million friends and I couldn't be prouder of her and the life that she is building as a young adult. So that's where she's at pretty good. Right? Despite diabetes, that's fine.   Stacey Simms  7:28 I love hearing that, as you know. And as you listen, you may know, I have followed Moira and Lauren story for many, many, many years since before more and I knew each other. So I always kind of look ahead. It's like my time machine of what could happen with us. Where could he go? And of course, he's never leaving our hometown, going to a scary place far away like DC he's gonna He's going to live here. And   Moira McCarthy  7:51 Sunday dinner every week   Stacey Simms  7:53 is nice. That's so nice. So I'm glad she's doing so well. Like you're doing so well. And you know, gosh, I heard something recently about diversity that made me smile. Instead of the diversity you're you're on the new level. So Lauren has reached level 24.   Moira McCarthy  8:08 I like that. That's really funny. And her boyfriend is a big video gamer so he'll like that.   Stacey Simms  8:13 Oh, that's good. Yeah, Benny's approaching level 15. And I am one of those people who I always have to look up the date. I just know it's the first weekend of December, but I never. Yeah. Alright, so we are in that time of year where it's not just our kids diver series. It is holiday time. And after I rewound the Halloween episode that we did a couple of years ago and I got a lot of questions and people asked us to do a follow up for Thanksgiving and looking ahead to the winter holidays. And I got some great questions. So I was wondering more if you wouldn't mind sharing though, you know, the first holiday season that you and Laura and your whole family had to address this you guys want a very different routine? Yeah, we can be a little more difficult but would you mind sharing what that was like that first year?   Moira McCarthy  8:59 I will and and I think it's good to hear because it can help people see how far we have come daily care for this disease. We may not have a cure yet, but what it looks like on a day to day basis is completely different. So Lauren was diagnosed in October so Thanksgiving was our first big holiday and I remember we were going to my in laws and back then you took a moderate acting or we called it long acting, but it was really middle acting insulin called NPH that peaked a bunch of times during the day and then you took regular which you had to take it wait 30 minutes and then eat exactly what you had dose for it exactly 30 minutes which was super fun with a six year old child I will tell you and no waiting in between. So I had reached out to my in laws ahead of time and asked them if they could work the meal around the time that it would work best for her to eat and they said yes and I I move some things around with A doctor to kind of compromise with them, you know, so we changed what time we gave everything starting, like two days before to be ready for Thanksgiving. And then we showed up and they were like, oh, yeah, we decided on a different time. Oh my gosh, the world is ending. But the world didn't end. You know, we figured it out. We got through it. What I will say for these holidays, for people who are new to it, it's not always going to feel this scary and confusing and daunting. I think the first 12 months, you go through every holiday, every special event, every family tradition for first time. And then the second year, you're like, Oh, I remember this from last year, and it gets a little better. And then the third year, you're, you're sailing. That's my theory, and I'm sticking to it.   Stacey Simms  10:43 I would absolutely agree with that. I also kind of suffered and I'll say suffered from this feeling out of the box, that it had to be perfect. Because I remember one just show everybody that we were okay. Especially my mom, I wanted her to not worry. And know that we were we were just fine. And for some reason that got tangled up in my brain by thinking this has to go perfectly and I can't make a mistake. And of course that lasted about three   Moira McCarthy  11:06 seconds. Yeah, we're really with a toddler with type one, and you want to put together a perfect Thanksgiving. Why don't we do that to ourselves, though, you know, but feelings of control at a time when you feel like you've lost control?   Stacey Simms  11:21 Night? Exactly. Alright, so let's get to some of the questions that came in. I got one in my local group. And this was about travel. And the question was, we're driving along distance. And I guess we could talk a little bit about flying or other modes of transportation. But this particular case, we're driving along distance, you know, six or seven hours to a relative's house. Any ideas or tips for helping me and the question here was about stable blood sugars. But I'm also going to kind of throw in there. How do I make this trip? easier on the whole family? Yeah, I'm I have a lot of ideas that maybe you do too.   Moira McCarthy  11:56 Well. So I guess my first idea would be for special occasions and events, stable blood sugars aren't the most important thing ever. I don't think there's anything wrong with trying, of course, we want to try but the first thing I'd say is if it doesn't go perfectly, that's perfectly fine. I am quite sure if you ask your medical team to help you with the plan. That is one of the things they will say to you. That's the first thing. So I mean, what did you do on long car rides? For us it I don't remember it impacting her blood sugar that much, you definitely have to have snacks in the car and like more than you ever think you're going to need in your life, because you never know when you're going to get stuck in a traffic jam from a car accident or something like that. You know what it is be prepared, and then you don't need it. We tend as a family, not just for the person with diabetes, but for everyone to try to stop every 60 minutes and get out of the car and stretch and move around and breathe fresh air and then get back in. I think that helps   Stacey Simms  12:56 us How about depressive we don't my husband would have fit? No. So in my   Moira McCarthy  13:01 father, he would never do that. That's probably why I do it. I grew up driving from Minnesota to Massachusetts and like never being allowed to get out of the car. So   Stacey Simms  13:10 I would say for us we actually did struggle a lot with long car rides, because we did a lot of trips, especially to my parents in Florida, which is like a nine or 10 hour road trip. And we found that Benny's blood sugar would go very high. Just you know, an hour or two in the car and looking back, it's probably because toddlers never stopped moving. So his insulin dosage was all based on constant activity. So when he was sitting still, just looking back that's my assumption. Also, as you mentioned, you know everybody's eating in the car   Right back to our conversation, but first Diabetes Connections is brought to you by Dario health. And, you know, we first noticed Dario, a couple of years ago, we were at a diabetes conference, and many thought being able to turn your smartphone into a meter. It's pretty amazing. I'm excited to tell you that Dario offers even more now, the Dario diabetes success plan gets you all the supplies and support you need to succeed, you'll get a glucometer that fits in your pocket unlimited test strips and lancets delivered to your door and a mobile app with a complete view of your data. The plan is tailored for you with coaching when and how you need it. And personalized reports based on your activity. Find out more go to my dario.com forward slash diabetes dash connections. Now back to the D mom's and I'm talking about what we did when we realized Benny's blood sugar would always go pretty high in the car. What we did was talk to our endocrinologist about adjusting doses giving more insulin when he was in the car, giving more insulin for food when he was in the car. And that was a real trial and error for us because, you know we have to be really conservative about that you're not going to be changing basal rates by enormous amounts and so it may not quote unquote work the first time you do it, but I think you know we're doing Talking about stable blood sugars, I hope that this person means is like maybe kind of sort of in range. You know, when I see somebody talking about stable blood sugars, I usually think like, it's not going to be a steady line at 95, right? We're just trying to keep them from skyrocketing and staying there. And even if that happens, which happened to us a ton, it's fine, and you fix it. When the baby was younger, and the kids were younger, I was much more mindful about healthy eating. You know, they're 19 and 16. And it's like, they buy half their own food. Now anyway, I don't know what they're eating. But we used to get coolers the big cooler, and fill it with, you know, healthy fruits and veggies and hard boiled eggs and carrot sticks. And you know, and then of course, everybody would want to stop for fast food and ruin everything. Right?   Moira McCarthy  15:39 So I made the assumption, and perhaps I shouldn't have that by stable, she meant within that range. If this mom is suggesting that her child should have a straight line across my answers quite different. I have no idea going on the assumption that what she means is within their range. And my answer was based on that what I meant was, if you go above your range, or below your range, I think it's okay. I don't think that if you're going to celebrate with a family, the most important thing is, is staying in your blood sugar range, I think the most important thing is enjoying the time and loving your cousin's and running around and having fun and staying within a an area that is safe. And by safe. I mean, you're not you don't need to get in an ambulance, I guess. And maybe my advice would be talk to your medical team, take some ideas that we have on your idea, I think that's a great idea. My only caveat would be the doctors probably going to want you to err on the side of your child being hired. The first time you do this, as you mentioned, you did it after some trial and error, I'm not sure a new parent to diabetes should just, you know dial way up on their kids insulin because they're going to be in the car for nine hours, I think you should take it slowly and go a time or two or three and see what happens. And then make decisions like that after that. But for now talk to your team. They're they're going to say what I said, and they're going to support you and say, Don't worry about going out of range. You know how to do corrections, here's when and here's why to do a correction and then take it from there.   Stacey Simms  17:12 And like you said, some kids sit in the car and nothing happens. Right? They don't go super high. That's why can't do   Moira McCarthy  17:17 assumption, right. That's why you have to wait and see what happens. One quick   Stacey Simms  17:22 thing about the car that I learned the hard way you mentioned about you know, be prepared for traffic be prepared for you know, delays, if you have and we all do I think have a you know a diabetes kit. Make sure it's where you can reach it, especially if your child is very young, right? I mean, there's a lot of kids, they're older, they can have it the backseat with them. I'll never forget packing everything we needed and leaving it in the trunk or like the way back of the minivan. And then we were delayed. And I'm like I need a new inset like says it was leaking, or we'd like crawl through the car.   Moira McCarthy  17:54 That's a really good tip. So put it   Stacey Simms  17:57 up to the front seat with your pack, even if you just pack a couple of things. And we had so many car adventures. Okay, the next question, I loved this one, because this just I could picture this one I know you can do more. So Deborah said we are in the first year of diagnosis, I just realized I don't know what to do about our Christmas cookie tradition. We make a bunch and give them to relatives we usually eat as we go. Can we still do this with diabetes child is eight and is on multiple daily injections, so no insulin pump yet.   Moira McCarthy  18:26 So my answer is eat all the cookies, bake all the cookies, visit all the friends have all the fun, click your fingers if you want to. But then wash your hands, have all the fun and check in with your child's doctor. And what they're going to say is go do all that check at the end of all the fun. If you need a correction, here's what we'd like you to correct. And here's what we'd like you not to correct for they may not want you to correct because sometimes these things involve a little adrenaline high. And again, first times you have to see what's going on. But just have all the fun. Fix it later. If your child gets high during it, it's no big deal. If they get low, you've got cookies. There's an old saying it started with Kelly crewneck, who's a very well known person on the diabetes world on the internet. And she said people with diabetes can't have cookies, dot dot dot with poison in them. Right? The only cookies you can't have.   Stacey Simms  19:26 I think that's fantastic. And it took me back listening to that about we know we don't have a Christmas cookie tradition. But we certainly you know, I think most people with little kids love to bake. And it's just such a fun activity to do with them. And in the first couple of weeks with shots, it was so difficult. You know, Binney ran away from us. He didn't want anything to do with it. But after a little while, he didn't really care as long as we didn't make a big deal and make him stop what he was doing. So and we bought after, which I know is like bananas that people admit to bolusing after these days, but I think it's so much less   Moira McCarthy  20:00 Streisand gets really super smart, particularly with a small child.   Stacey Simms  20:04 And so for something like this, like we would bake, and then I would kind of try to estimate like, what did he licked the spoon? Did he eat the crumbs? You know, when you do a guess? And in my case, I would always get a little less because he was teeny tiny. And then we would eat the cookie, and a couple hours later, we would correct and move on. Now. I don't know, I feel like the fun as you said, the memories of that time, you know, outweighed the quote, unquote, out of range blood sugar, I'm sure his blood sugar went out of range. And he might have been low, because they sometimes they just get really excited. And you know, he might have been high, but he's, they're healthy.   Moira McCarthy  20:39 You know what, I think this, this mom, and anyone who's considering these kind of questions over the holidays should think about too, when I look back on Lauren's life, these 24 years with type one included, I don't remember that her blood sugar went higher low. I don't remember what her diabetes did one day, I remember that the cookie swap was fun. And so that's why I think it's important to focus on the fun, within reason with a kid with diabetes, you know,   Stacey Simms  21:12 oh, yeah, that's a great way to put it. And I'm realizing as he gets older, I have a lot of those same feelings. I'm so glad it didn't stop us. I'm sure at the time. My heart was pounding, right, especially at first, I'm sure I was worried. I'm sure I was thinking, Am I doing this the right way. But look, you know, you have those fabulous pictures and those great memories. So that's a great way to put it. Alright, so let's talk about well meaning relatives. More Hi, Moira. And Stacy. My aunt thinks she knows everything about diabetes. She has type two and is always lecturing me about not letting my second grader eat, quote, bad foods. Holidays are the worst. I'm sorry to laugh, because she wants us to have sugar free desserts. There's so much going on. In that question.   Moira McCarthy  21:59 Bless her heart, right. You know, I mean, what do you do? It would depend on what kind of person she is. And if they have, if they have a relationship that she could, I would call her ahead of time and say, Look, we're working on adjusting Stevie's life, whatever the child is, and, and there's a lot of things he's dealing with right now. So I'm just asking you, if you have anything you want to say about it? Could you say it to me now over the phone before we go, and let's just avoid talking about diabetes other than Hey, how you feeling? I'm really glad you're doing well at the holiday because I don't want him to feel sad when he has all this on his mind. That's a great way to put it. Who knows what she'll do. Right, right.   Stacey Simms  22:45 I mean, you have you have well meaning relatives who want to help you have nosy relatives who think they're helping, it all depends on my mother for the first year or two she wants to make she makes one of those sweet potato casseroles, not always with marshmallows, but it's got a ton of sugar in it. And so she made it sugar free. And I didn't really notice but it's not something Vinnie was going to eat much of anyway. Yeah, when he was he was three at his first Thanksgiving with diabetes. But she meant well, but what I found worked over the years, and I still use this, even though he's his own advocate. Now, I really found that saying, Our doctor says, which I made up, but our doctor says helped everything. So I would say to somebody like this. Oh, you know, thank you so much for thinking about my son. I really appreciate it. I gotta tell you things with diabetes have changed so much now. And our doctor says that he can eat these foods and as long as we can dose with insulin, you know, we know what we're doing. He's helping us or our doctor says that Thanksgiving should be a date, like every other day or whatever it is. But people would never listen to me. Listen to what my doctor   Moira McCarthy  23:46 says my my words for that was always her medical team. Yeah. sound very official, our medical team is me. But they don't need to know that. The one thing I'll say, though, is it's also okay, if it's not super aggressive, and really out of line. I think it's also okay to teach our children to show some people a little grace. And sometimes and all this even when people are wrong, maybe at the family thanksgiving, or Hanukkah, or whatever party isn't the time to say, Do you know what I mean? Great. And so if someone makes a sugar free thing, and your kid hates sugar free, you say to your kid, please just put a tiny slice of that on your plate and then push a couple pieces around under something. And it'll be fine. They met Well, yeah, you know, yeah, say and then afterwards, you can say hey, he really liked that. But FYI, next time, you don't even need to do that make the same delicious pie, but you don't need to make it sugar free. Right   Stacey Simms  24:41 on everything. And that's a good point. Because we're so in our society today, we're so ready to fight. We're so ready to be on the defensive. And so I think that that's a great point just to be able to say we really appreciate it. We know how you meant it, you know, just thanks and then have the discussion later on. Yeah,   Moira McCarthy  24:57 but if they're over the top aggressive about about telling your child what they do wrong with their diabetes, then you need to have a conversation ahead of time. That's right.   Stacey Simms  25:04 Or you know, even in the moment if this sometimes you see, you know, I made this for these kids who don't have diabetes and look at this wonderful vegetable plate I made for your child like they're having cupcakes, but you could have the carrot that it's okay.   Moira McCarthy  25:17 It just jello Jaguars. My daughter was locked up. I always have to bring a tray of jello jugglers This is before acting. And   Stacey Simms  25:25 that is so funny. I'm so sorry for sugary jello. jigglers Woohoo. Oh, my gosh. Okay, another question. How do I dose for all of the grazing that goes on during Thanksgiving and holiday gatherings? This is kind of similar to the Christmas cookies, or I would think our answer is going to be but in some homes, right? It's not just one set meal. It's we showed up and we're starting to eat and we don't stop for seven hours. Oh, yeah.   Moira McCarthy  25:51 My house isn't that yours?   Stacey Simms  25:53 Isn't? No, no, no.   Moira McCarthy  25:57 Not every house was like that on a holiday. Seriously, this is interesting. All right, well, I guess I'll answer this first, then talk to your medical team. Ask them about planning different times during the day for check ins. And then just let your child have what they're going to have. And at the check in times that you agree with your doctor, it may be every two hours, it may be every three hours, it may be twice I don't know. They'll they'll help you decide. You see where they're at. You look at what's going on what they're going to be doing next. And then you do a correction of corrections needed. That's it.   Stacey Simms  26:31 Go, I'm going to add a layer to that. Yes, please do. For those who are addicted. I don't know anyone like this. I certainly have never been like this anyone who's addicted to their Dexcom. So if you're listening to more thinking, how am I supposed to check every two hours when the Dexcom or wherever three hours, whatever the most no more thinking how am I gonna check at those intervals, when my Dexcom is blaring every five minutes, okay, stay with me, people consider turning your Dexcom high alarm off, and then look at your child's Dexcom High Alert off, and then only looking at it as recommended by your care team. It will take away an enormous amount of stress. Even if your child goes high. And you bolus it's not going to happen right away. You know this, it takes a long time for insulin to work, right. So you're not really doing yourself any favors by checking it every five minutes. I know it's hard. Ask your doctor. But that has helped me more than the years when I was glued to it listening for this a lot.   Moira McCarthy  27:34 And you know, I think that's really wonderful advice. Because there's nothing wrong with freeing up the family to enjoy a good time. If it's so important to you that you keep them in a certain range and you want to watch it all day, then go ahead. But I think what you suggested and what you just said you do is such a good model for your child, because as you care for your child, you're modeling how they should care for themselves later. And the reality is in this long, long, long, long, long lifetime marathon diabetes, you need to just chill a mile here and there. And by doing this and saying to your children, we're going to turn this off, this is okay. Don't worry about it, you're fine. You're modeling that for them. And you're giving them the confidence and the courage to know that they can be okay. If they're not doing, you know, 150%. So I love that answer. Stacy, you get a gold star. Yeah,   Stacey Simms  28:34 it's funny to think about, but that's actually how we use Dexcom. And how everyone use Dexcom intil. Gosh, I'll probably get the year wrong. But until, let's say 2015 Because Dexcom share did not exist, right? So at school, our child would like many others basically used his Dexcom receiver as a no finger stick monitor. Right. So at the time of day were Benny would normally have done a finger stick, he just looked at the receiver showed it to his teacher. And that was it. We started using it like that. So I think it makes it a little easier if you come home from the hospital, like a lot of families do attuned to every alarm. These things may seem like an astronomical ask, but you really can do it. And I would also add with the grazing, we you know, we were grazing experts, because I had a two year old with type one who was diagnosed. I mean, a few years after Lauren, so you know, was not on that very regimented timing. So Benny could pretty much eat all day, like a normal two year old. I mean, obviously not all day, but you know what I mean? Several times a day, and we just had to give them fast acting. So it makes it it does make it a little more difficult, right? It's not but it's not something you do every single day, either. So I think that you know, you've got to kind of let go a little bit, but it's not harmful and it can make these ladies have these wonderful memories. Alright, and finally, this question, I'm a little stymied by this one. What's the Christmas present for a child with die? beedis   Moira McCarthy  30:01 Okay, a good Christmas present for a child with diabetes is what they put on their Christmas list. If you want to give diabetes related gifts for Christmas, that's all good and fine. I knew someone who gave their child quote unquote, their insulin pump for Christmas and like, their heart was in the right place, and the child felt great, but it just made me a little sad. I guess if your child puts insulin pump on their Christmas list, though, that's different. But even then I think I'd say no, Santa doesn't need to bring you medical stuff, we can just get that went whenever you need it. There are toys and animals and things like that. If someone's interested in actually, diabetesMine is having me do a list of them that's going to run in late November, early December. We can link that on this after Oh, that would be great. Like   Stacey Simms  30:54 the American Girl doll stuff and road kid kits. Fabulous.   Moira McCarthy  30:59 And then I don't mean that there's anything wrong with that stuff. I just think that you should give your child gifts that they want as a child, not as a child with diabetes. Yeah,   Stacey Simms  31:09 I think a lot of that depends on how your family celebrates and what gifts you're giving. We are We joked in our family for Hanukkah, when I was growing up, you would get everything from the toy that you really, really wanted to the dictionary that you did not ask for to the socks that you need it right so if your gift giving is like that mixed up, and it's you know, if your family expectation is that kids will get super useful stuff in all the kids not just the kid with diabetes, then I guess I could see it. But I'm with you, I think unless it's something really fun like one of those add on what your list is going to be made up but like, what are those stuffed pancreas like? silly things like that. And yeah, accessories for dolls and fun stuff. It's just like a useful medical thing. I think you've got to be very careful and know, the child like especially a parent to a kid is one thing but if you're like the fun and or you're the family friend thinking this will be a big hit. I just be a little careful. One of the things I saw in another group was you know, there's a newly diagnosed child which they get the family and the most popular response was don't get them anything quote diabetes related, get them fuzzy slippers, and a gift certificate for babysitting or you know a trip to the movies and get them something fun and engaging.   Moira McCarthy  32:22 Get them something normal and and pushing back on what you said I still even if my family did that stuff, I still wouldn't give my child like a box of syringes. So core. I like if you're giving your kids toothpaste for Christmas, because that's what you do, then give your kid with diabetes toothpaste for Christmas treats the same way you treat your other kids when it comes to gifts.   Stacey Simms  32:42 That's a good point. I think if anybody ever gave Benny any diabetes related gifts, and no one would ever mind my family would have ever done that. But   Moira McCarthy  32:49 one time in our family Yankee swap, I used a syringe box, like for the gift and whoever opened it thought it was syringes and we're like, I don't get it. And I'm like, Oh, for goodness sake. It's just a box.   Stacey Simms  33:03 Open it up. Is a Yankee swap like a Secret Santa.   Moira McCarthy  33:07 Yeah, kind of but you you could take gifts away from like a one white elephant. I don't know. I'm sorry. That's a white Jewish lady. It's like we're from different worlds, Stacy.   Stacey Simms  33:21 Oh, you New Englanders.   Moira McCarthy  33:24 Bless my heart.   Stacey Simms  33:26 We do have one funny story. So on Christmas day in Gosh, I'm looking back already. This was this is eight years ago. So on Christmas Day, we started the Dexcom. The very first time we ever used the G four platinum. Vinnie was nine. Oh no, the g4 Platinum pediatric. So Vinnie was nine years old. And we were sitting around a Christmas day at my mom's house like you do. And we said, let's start the Dexcom. Why don't we will put it on we had been instructed on how to do it. Of course, again, I don't know if I can emphasize this enough. We do not celebrate Christmas. I don't think I would do this. Christmas. So but we put it on and I will never forget because that was you know, Christmas Day. Gosh, so yeah. Merry Christmas kid. That was the big horrible insert or two.   Moira McCarthy  34:14 But then it could have Chinese food before the movie, right?   Stacey Simms  34:18 Really my house.   Moira McCarthy  34:21 I know you.   Stacey Simms  34:23 That's great. So normally at the end here, we talk about where we're going in the diabetes community. Of course, you know, there's no diabetes events going on now. And I'm really, really hoping they come back next year. But I mean, I'm doing some virtual events. I'm reaching out, but I cannot wait to be in person again more.   Moira McCarthy  34:39 I feel you. I can't believe I was just thinking about this the other day because my Facebook memory was, I guess right before the pandemic I was in Buffalo, New York speaking at a big diabetes event at this time and they were all these pictures and people posting about interesting things they learned and how happy they were going to be and I was like, oh, I want to go back somewhere. I think we're We're gonna see things start bubbling up I do believe friends for life is going on this summer I'm hoping I'll be there I haven't heard yet but um I know that's probably happening and I think JDRF is going to start doing some smaller half day programs in the near future knock on wood so I hope we're in the same place to Stacey that's what I hope not only we get out and speak but you and I are in the same place.   Stacey Simms  35:22 Yeah. Oh my god,   Moira McCarthy  35:23 it's all about us.   Stacey Simms  35:26 Why not? I was kind of pausing because I don't remember when we saw each other live to look that up. At the end of the show.   Moira McCarthy  35:33 I think it's been at least two years Stacy that's really weird.   Stacey Simms  35:37 It has to be it has to ah, I miss you.   Moira McCarthy  35:40 Me too. We talk every day practically. I miss you as a as a human life form.   Stacey Simms  35:50 Well, the next time we get together we can we can do a Yankee swap.   Moira McCarthy  35:52 Yeah. And and a white elephant, white elephant.   Stacey Simms  35:57 Well, if I don't speak to you have a wonderful Thanksgiving, enjoy your family and your adorable grandchildren. And give Lauren my best and tell everybody we said hi. Same here   Moira McCarthy  36:07 and make sure those kids yours know that I still think they're awesome.   Announcer  36:16 You're listening to Diabetes Connections with Stacey Simms.   Stacey Simms  36:21 I will link up some information, including to an episode we did with adults with type one and their take on Thanksgiving. I'll put that in the show notes along with the transcription for this episode, you can always go to diabetes connections.com. Every episode starting in January of 2020 has a transcription. And there's lots more information there. I got to tell you more. And I make it sound pretty easy now, right? But those first couple of years, it's so stressful because you're trying to have a nice holiday. You're trying to project confidence, you know, we're doing great. Diabetes won't stop us. And then you're freaking out, you know, what did you eat? Should we pre bolus what's gonna happen now? Am I gonna be up all night? You know, it's, well, you know, who's got the carb count? Is it accurate? Spoiler, the carb count is never accurate. It's never accurate. I hope you know that. We're estimating everything, even packaged foods. Even somebody who weighs in measures, everything is a total guess, on carbohydrates. So just do the best you can. And it's you got to get through that I think you've just got to get through that experience. There is no other teacher like experience and diabetes, you've got to make mistakes, you've got to kind of be upset, you gotta be worried you got to get through it. But if you let yourself I think as a parent, you really can get to a place where you're like sure marshmallows on sweet potatoes, we can figure that out and go from there. And if you hated my advice to turn the Dexcom off, let me know I would love to hear from you. You can yell at me all you want. Let me know if you try it though. And if it works for you, I don't want to cause more stress. I promise. Diabetes Connections is brought to you by Dexcom. And hey, listen, I'm all about using the technology in a way that helps you thrive with diabetes. So when I say turn it off, it's not a knock on Dexcom. It's sharing how we use it to help us make great choices. Live well and be happy. I stand by that you know we have been using the Dexcom system since he was nine years old. We started back in December of 2013. And the system just keeps getting better. The Dexcom G six is FDA permitted for no finger sticks for calibration and diabetes treatment decisions, you can share with up to 10 people from your smart device. The G six has 10 Day sensor where the applicator is so easy. I have not done one insertion since we got it but he does them all himself, which is a huge change from the previous iteration. He's a busy kid, knowing that he can just take a quick glance at his blood glucose to make better treatment decisions is reassuring. Of course we still love the alerts and alarms and that we can set them and turn them off how we want. If your glucose alerts and readings for the G six do not match symptoms or expectations use a blood glucose meter to make diabetes treatment decisions. To learn more, go to diabetes connections.com and click on the Dexcom logo. A couple of quick housekeeping notes we will have a regular episode next week. Our regular episodes are on Tuesdays. So we will have one for you next week. We will not have an in the news edition of Diabetes Connections. Thanksgiving week though. I will not be doing that live on Wednesday and there will not be an episode Friday the 26th I will say if anything really big happens if we get an FDA approval, you know something like that. I'll probably pop on and give you an update. I you know, I know we're all waiting for something so I can't promise I won't do it. It's not it's like the news person in me I was in you know, I've been doing this since I was 19. So if something breaks, I'm gonna have to jump on. Even if Slade is like, you know, making turkey behind me. We'll figure it out. But right now again this week, the week of the 16th. We will have the regular in the news on Wednesday, which will become an audio only podcast on Friday. The following week. We will have a regular episode, but there will be no in the News episode Thanksgiving week. All right. With that thank you to my editor John Bukenas from audio editing solutions. Thank you so much for listening I'm Stacey Simms I will see you back here for in the news this week until then be kind to yourself Diabetes. Benny  40:10 Connections is a production of Stacey Simms media All rights reserved. All wrongs avenged

Essentially You: Empowering You On Your Health & Wellness Journey With Safe, Natural & Effective Solutions
320: Top 10 Worst Foods for Blood Sugar + How Blood Sugar Impacts Women's Hormone and Metabolism w/ Dr. Casey Means

Essentially You: Empowering You On Your Health & Wellness Journey With Safe, Natural & Effective Solutions

Play Episode Listen Later Nov 16, 2021 63:55


If You Want to Take Back Control of Your Metabolic Health, You Should: Start monitoring your bodies reaction to foods through a CGM or other methodology Ensure that you are moving your muscles after eating to stabilize your glucose Focus on your dietary patterns and get back to basics to see the results you are searching for   One of the biggest root causes of hormone imbalance facing over 130 million Americans is metabolic dysfunction. Metabolic dysfunction can lead to insulin resistance, inflammation, and a host of other chronic illnesses that you may not even realize are linked to your metabolism. The good news is that with a few mindset and lifestyle changes, you can improve your metabolism, overall health, and long-term longevity.   Take Back Control of Your Metabolic Health Dr. Casey Means is a Stanford-trained physician, Chief Medical Officer and Co-Founder of the metabolic health company Levels, and Associate Editor of the Internation Journal of Disease Reversal and Prevention. Dr. Casey works to maximize human potential and reverse the epidemic of preventable chronic disease by empowering individuals with tech-enabled tools. Her philosophy combines smart, personalized, and sustainable dietary and lifestyle choices to help others take their metabolic health back into their own hands.   Looking at Your Metabolism Like Never Before Through her work at Levels, Dr. Casey and her team are able to access nutritional data in a way that has never been seen before. By getting to the bottom of which foods affect you and your glucose on a personal level, you can figure out what is best for you and your body.  Knowledge is power when it comes to a lot of things, especially when it comes to your metabolic and hormonal health. Foods you may think are healthy for you could actually be causing a significant glucose response, which is why it is important to equip yourself with the information to serve your body in the best way possible.   The Key to Longevity Is Your Metabolism As women, we need to be on top of our blood sugar more than anything. Your metabolism can impact everything from how you feel to how you age, which is why it is so crucial to identify your root causes and get them under control in order to increase your overall health and longevity. While your average doctor may not know about the importance of focusing on metabolic health, this episode is your sign to get down to the basics and focus on your daily patterns in order to preserve your health through all stages of life. Are you ready to focus on creating more resilience for your metabolism? Let me know which of Dr. Casey's tips resonated the most with you in the comments section of the episode page.   Quotes: “There is a mismatch between the effort and the outcomes, and I think a lot of that lies in the fact that we are eating these food products that we don't really know what they are doing to our bodies.” (15:01) “It is kind of this magical part of the body that can help you bring down your blood sugar all by itself. And that is why a walk, even though it is gentle, you are moving all these major muscle groups, the quads, the hamstrings, it all has to be activated.” (32:00) “We are flipping the switch from glucose burning to fat burning intentionally, and we are pushing our body to utilize its long-term storage, and we are mobilizing fat. And that is metabolic flexibility.” (35:54) “It is nothing crazy; it is nothing out of control; it is just timing things in a way that is going to optimize all aspects of my blood sugar but isn't taking more than cumulatively an hour during the day.” (41:14) “A lot of these things I think we can feel like it is totally out of our control or we have to go towards hormones or whatever it is to manage these things. So to at least know there is something, a knob we can turn, a lever we can pull, to at least in some way impact these things, I think that's pretty empowering in its own right.” (45:47)   In This Episode Why adopting a routine of monitoring your response to food is key to understanding your body (14:39) Learn about the Coca-Cola experiment and how it can help you blunt a blood sugar response (25:39) The role of muscle movement and strength training when it comes to metabolic health (32:10) How stabilizing your blood sugar levels can impact your hormones and symptoms overall (42:20) Tips for creating swaps for the things that you love that will leave you wanting more (54:12)   Resources Mentioned: Use Promo Code drmariza for 15% Off Your Organifi Order Here Join Levels Here Levels article about common dietary patterns for good health Levels Health Website Levels Health Blog Follow Dr. Casey on Instagram Follow Levels Health on Instagram   Other Resources: Check out the full show notes page Keep up with everything Dr. Mariza Follow Dr. Mariza on Facebook | Instagram | Twitter | Youtube Podcast production & marketing support by the team at Counterweight Creative   Related Episodes:  Essentially You Episode #236: The Truth About Metabolic Dysfunction and How To Address It Head-On with Dr. Casey Means Essentially You Episode #268: The Number One Hormone Imbalance Connected to Stubborn Weight Gain

Diabetes Connections with Stacey Simms Type 1 Diabetes
In the News.. Tandem & Omnipod updates, T1D kids & COVID and more!

Diabetes Connections with Stacey Simms Type 1 Diabetes

Play Episode Listen Later Nov 12, 2021 6:06


It's "In the News..." the only diabetes newscast. This week we find out about: SGLT2 inhibitors, more evidence this T2D med works for T1D, Tandem & Insulet earning calls: what you need to know, Which kids with T1D did even better during COVID? How you sleep could increase risk of gestational diabetes, what's going on for Diabetes Awareness Month and lots more! Have 5 minutes? Give it a listen! -- Join us LIVE every Wednesday at 4:30pm EDT Check out Stacey's book: The World's Worst Diabetes Mom! Join the Diabetes Connections Facebook Group! Sign up for our newsletter here ----- Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners! ----- Get the App and listen to Diabetes Connections wherever you go! Click here for iPhone      Click here for Android Episode transcription below:   Hello and welcome to Diabetes Connections In the News! I'm Stacey Simms and these are the top diabetes stories and headlines of the past seven days. As always, I'm going to link up my sources in the Facebook comments – where we are live – we are also Live on YouTube and in the show notes at d-c dot com when this airs as a podcast.. XX In the News is brought to you by The World's Worst Diabetes Mom, Real life stories of raising a child with diabetes. Available in paperback, on Kindle or as an audio book – all at Amazon.com -- XX Our top story, evidence that SGLT-2 inhibitors can help kidney and heart health in people with type 1. These are diabetes drugs that are already shown to lower blood sugar levels – they have brand names like Invokana and Jardiance – but they are not approved for T1D in the United States. The problem is that they can lead to DKA even with normal glucose levels. However, they are approved in Europe and many advocates say they can be used safely if people no to monitor closely. https://www.news-medical.net/news/20211107/Study-examines-benefits-of-SGLT2-inhibitors-in-individuals-with-type-1-diabetes.aspx XX Some tidbits in Tandem's third quarter investment call last week. CEO John Sheridan says they plan to ask the US FDA this year to approve Control IQ down to age 2 – right now it's only approved to age six. Also asking for expanded labeling for people with type 2. Mobile bolus or bolus by phone still out there waiting for approval – Sheridan says the FDA last asked them any questions in August. He says they have three initiatives for 2022: filing for the Tsport pump, integrating the upcoming Dexcom G7 and moving ahead with their partnership with Abbott's Libre. Sheridan thinks it'll be a matter of a few months before Tandem pumps integrate the G7 saying, “When it comes to Dexcom, we've integrated three generations of their sensors already. We're on the fourth. We know how to do this” I hadn't heard this, but Sheridan says the Libre had a bit of a hiccup with the FDA approving it as an iCGM, that's a newer designation… because taking vitamin C can throw the readings off.. but he believes they've addressed that. We'll follow up. https://www.fool.com/earnings/call-transcripts/2021/11/03/tandem-diabetes-care-inc-tndm-q3-2021-earnings-cal/ XX Insulet also had their quarterly call – CEO Shacey Petrovic says she's still optimistic about Omnipod 5 being approved this year.. she says they've had a lot of back and forth with the FDA in the last few months and that's what makes her more confident. Other tidbits.. Omnipod reports that 80% of their customers were previously on multiple daily injections only .. no prior pump experience. They think when Omnipod 5 comes out there will be more competitive switchers from other pumps. They reiterated that it will be a limited release when approval comes with a gradual rollout in the US. https://www.fool.com/earnings/call-transcripts/2021/11/04/insulet-corporation-podd-q3-2021-earnings-call-tra/ XX Really interesting news about some children in the US with type 1 during the pandemic – they had more time in range and lower A1Cs during the first year of the pandemic compared to the year before.  They also saw their doctors more, even though 90-percents of the visits were virtual. This was a group of kids ages 1-17 all of whom use a CGM. The researchers say they want to take a closer look to try to figure out why this was the case: speculation ranges from more oversight from parents to flexibility in schedules. I can say this definitely happened in my house.. however I'll also throw in that my son started on his first hybrid closed loop system in Jan 2020 just before the pandemic– Tandem's CIQ - and that made a huge difference, especially when we were stuck at home and he was eating at 2am. They don't mention the insulin delivery system here.. just that every kid had a CGM. https://www.healio.com/news/endocrinology/20211108/metrics-improve-for-us-children-with-type-1-diabetes-using-cgm-in-first-year-of-covid19 XX Something called sleep-disordered breathing may play a role in gestational diabetes and insulin resistance. There isn't a lot of research here.. This study looked at women who had risk factors for obstructive sleep apnea, a form of sleep disordered breathing that has been linked with high blood pressure, heart disease, and Alzheimers. The data suggests those with it may enter pregnancy at higher risk for gestational diabetes and recommend more screening. They added further investigation is needed to see if treating the breathing issue in early pregnancy could improve glucose levels. https://www.contemporaryobgyn.net/view/women-with-sleep-disordered-breathing-linked-to-insulin-resistance-and-gestational-diabetes-risk XX Fun story in football this week: Mark Andrews and Blake Ferguson will face each other in the big Thursday night NFL game. Andrews is with the Baltimore Ravens, Ferguson plays for the Miami Dolphins. They both live with type 1.  It's thought this is the first time two NFL players with T1D have faced each other. They each use Tandem pumps, btw, so expect to see some posts from that company promoting the game. XX Big grant for Beyond Type 1's DKA Awareness Campaign. The Helmsley Charitable Trust is giving them more than $300-thousand dollars for their grassroots messaging movement. This provides posters to schools and communities and sends literature to pediatricians. Almost 50%  patients under the age of 18 in the U.S. are in DKA when diagnosed with Type 1. https://beyondtype1.org/beyond-type-1-receives-300985-helmsley-charitable-trust-grant-for-dka-awareness-campaign/ XX Lots of good stuff happening for Diabetes Awareness Month.. Dexcom is partnering with Nick Jonas and Patti LaBelle… they say to help the diabetes community feel seen and heard, while  advocating for improved access to diabetes care. Nick Jonas has been sharing people living with diabetes on Instagram and that's been really fun to see. Patti LaBelle lives with type 2.  She spoke to Congress earlier this month to talk about better access for people with Type 2 diabetes, especially in communities of color. XX Great round up of this kind of stuff – what the big organizations are doing for Diabetes Awareness Month over at Diabetes Mine.. I'll link that up in the show notes; https://www.healthline.com/diabetesmine/diabetes-awareness-month-2021#dexcom XX quick reminder that the podcast this week is our first ever tech roundtable. Really great discussion with two guys who follow this stuff very closely – Kamil Armacki better known as Nerdabetic and Chris Wilson. We go through everything in front of the USA FDA, some stuff that's approved in Europe and talk about what's coming next. you can listen to wherever you get your podcasts or if you're listening to this as on a podcast app, just go back an episode. Next week: holiday help – ask the Dmoms is back to help you through what can be a stressful time of year. That's In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.  

Diabetes Connections with Stacey Simms Type 1 Diabetes
Diabetes Tech Round Table: What are we waiting for?

Diabetes Connections with Stacey Simms Type 1 Diabetes

Play Episode Listen Later Nov 9, 2021 53:32


At this point in 2021, we thought there would be several new pieces of diabetes technology on the market. COVID delayed several FDA submissions and approvals so where do we stand? Stacey sits down with Kamil Armacki, AKA Nerdabetic, and Chris Wilson to talk tech. Both Kamil and Chris keep a close eye on everything from filings to clinical trials to investor calls and neither is affiliated with any diabetes company. There is also video of this if you prefer to watch over on the YouTube channel. Check out Stacey's book: The World's Worst Diabetes Mom! Join the Diabetes Connections Facebook Group! Sign up for our newsletter here ----- Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners! ----- Get the App and listen to Diabetes Connections wherever you go! Episode transcription below Click here for iPhone      Click here for Android Stacey Simms  0:00 Diabetes Connections is brought to you by Dario Health. Manage your blood glucose levels increase your possibilities by Gvoke Hypopen the first premixed auto injector for very low blood sugar, and by Dexcom, take control of your diabetes and live life to the fullest with Dexcom. This is Diabetes Connections with Stacey Simms. This week, I wanted to try something a little different as we enter the end of 2021. And look ahead to next year, I thought it would be a good time to sort of take stock of diabetes Technology. Welcome to another week of Diabetes Connections. I'm your host, Stacey Simms. And we aim to educate and inspire about diabetes with a focus on people who use insulin. And while this community likes to say we are not waiting, frankly, there was a lot of stuff that we are waiting for right now, I asked a couple of friends who really have their finger on the pulse of this stuff to come on and share their thoughts. The only problem we really like to talk. So this is a longer episode than I expected. And frankly, it's not just that we'd like to talk there's just a lot of technology that we are waiting for. So to that end, I'm just going to jump right in, we'll do the quick add that we always do at the top and then we'll get to the panel. There is also video if you prefer to watch our conversation that's over on the YouTube channel. I'll link it up in the show notes but we are not showing any product. So it's really just about whether you prefer audio or video. Alright, Diabetes Connections is brought to you by Dario health. And the bottom line is you need a plan of action with diabetes. We've been lucky that Benny's endocrinologist has helped us with that and that he understands the plan has to change as Benny my son gets older, he wants that kind of support. So take your diabetes management to the next level with Dario health. Their published studies demonstrate high impact results for active users like improved in range percentage within three hypoglycemic events. Try Dario's diabetes success plan and make a difference in your diabetes management. Go to my dario.com forward slash diabetes dash connections for more proven results and for information about the plan. And as always, this podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. All right, welcome. We're trying something new on Diabetes Connections. And that is the first of its kind kind of tech panel. And I am joined in this conversation by Chris Wilson and Kamil Armacki . And these are two guys that I'm gonna let them introduce themselves a little bit, but that I follow for technology news, as well as for some analysis. So thank you both for jumping on with me. You're not industry people. But let me ask you to kind of describe yourselves first, Chris, you are somebody that I always turn to for the insight and information about technology. But this is not what you do for a living?   Chris Wilson  3:00 No, not really. I sort of jumped into the online diabetes online community when I reached a point where I had access to insurance and could actually look at diabetes technology because it became affordable. And at that point sort of started jumping into a lot of the groups and online discussions tried to figure out what I was interested in for myself at the time. And then over time, I wound up being asked to join the admin team of a couple of the bigger Facebook groups getting involved on Twitter and other platforms. And so now i is part of that role. I sort of find and analyze listen to the investor calls that the companies do, you know, sort of keep an ear to the ground here what people's sales reps and endos are whispering about to to their patient populations and glean some information from that. I've also been a frequent participant in research, especially in clinical trials. I was in the clinical trial for the G6 that prove that acetaminophen didn't interfere with it. I was in the clinical trial for the Xeris Gvoke. I was in the clinical trial for the Ilet, which is still apparently ongoing. I've got a fair amount of experience for playing with stuff that isn't necessarily out yet. And sort of seeing things from a different perspective than just the end product that people see when they finally get a prescribe from their doctors.   Stacey Simms  4:23 That's great and comedic view or better known as Nerdabetic. On social media, many people probably recognize your Omnipod. Those are Omnipod pods lit up right behind you.   Kamil Armacki  4:34 That is absolutely right. That is 550 inch LED Omnipods. Most of them this is very DIY. Most of them actually placed with LED lights and painted and we saved them on a temporary wall kind of thing and we glued them off. So we had this is one of the proudest things I've ever done as Nerdabetic I also can't really take credit my dad that 95% I only paid a couple of walls, and I feel like I'm taking all the credit. So massive shout out to him.   Stacey Simms  5:07 I love it. I love it. And as Nerdabetic, you are known for interviewing CEOs getting all sorts of tech information out there. And we'll probably mentioned this at least once later on, you do a lot of both, you do some 3D printing, right to see what the items might look like. Yeah, so   Kamil Armacki 5:23 I've been running my YouTube channel for I think four years at this point, just when I started university, and I just graduated this summer. So it kind of it was over four years ago. So you just been trying out different things within within that channel. One of them was 3D printing. I'm absolutely fascinated by that technology. I don't own a 3D printer. But I think it is a very interesting way of giving an idea, a bit of a tangible feel to it. So for doing that, and all of those things they mentioned. And most recently, I had the honor of speaking to some pretty pretty important people in the industry to see what's been happening over there as well.   Stacey Simms  6:01 Cool. All right. And Kamil is in the UK, obviously, you sound like you're based in the UK, but you are there now, which means some of this discussion will include information from the US FDA, or at least we're gonna speculate about that same thing, European CE mark, but some differentiation of products there. But I just thought it'd be fun to talk to you guys. So all right, we've got it out there. And I'm a diabetes mom, I read stuff, I listen to stuff, I don't think quite as much as Chris, or Kamil, but that's my knowledge base. So just to be clear, nobody who works for the FDA, nobody who works for diabetes company, we are just observing and birth speculating, which I think would be some pretty fun and interesting conversation we'll see. So let's start by talking about what is in front of the FDA right now, because this year, and last year had seen some big delays due to COVID. So we're waiting. I mean, it's been a long time. Let's start with Omnipod 5. And that is, of course, still as we are speaking, I mean, who knows what will happen today or tomorrow, but it is still in front of the FDA. But what's interesting is when they submitted and Phil, I know you talked to their CEO recently I talked to her I believe right before they submitted, it was going to be very different from the other commercial hybrid close loops in that the range was going to be lower. In other words, your blood sugar range, initially, I believe, was supposed to be able to get below 100 As a set point, but now it's 110. And they do have all sorts of really interesting other features. What did Shacey Petrovic, the CEO of Omnipod share with you recently, when you talk to her anything changed, or anything that stood out to you?   Kamil Armacki 7:36 Yeah, so I've spoken to her a couple of weeks ago at this point. And the product that they've submitted to the FDA, for my understanding, has a target glucose, which goes as low as 110, and can be customized up to 150 milligrams per deciliter. In terms of the actual product, I think I'm very excited about Omnipod 5, because it will be the first product, the first pump, which actually talks directly to the Dexcom G6 continuous glucose monitor. So there'll be no need to carry a physical controller, which obviously, I think makes sense for a product like Omnipod because you know, you wear it on your body. And so it will connect directly in terms of actual updates to submission as of a couple of weeks ago, she said they still expect an A by the end of the year, with a limited release in the US. And during that interview, which was slightly kind of European focused. We talked about many things including Omnipod on the runway during Italy's Fashion Week in Milan. But she also mentioned that they are hoping to bring that technology to their to Europe to the UK, once they get their FDA approval.   Stacey Simms  8:48 When you said the first one or the only one do you mean in the UK? Because we've got Dexcom talking to Tandem, at least here in the States.   Kamil Armacki 8:55 First one where you don't need so where the pod talks wearable talks throughout behind okay. Yeah, I thought directly to the G 610.   Stacey Simms  9:05 Is control IQ approved in the   Kamil Armacki 9:06 UK stupid question. Yes, we have. So at the moment, we have control IQ and seven ATG which we will I'm sure mentioned Oh, yeah. Okay. I didn't come EPS actually. So we have three other countries across Europe. They have other systems like dialup as well, France, Germany, but we don't have that one here. Yeah. Hashtag Brexit.   Stacey Simms  9:28 I was gonna say show off, but then right. It's not in the UK. Lots of and there's other systems coming to that we may get to, Chris, anything that you have heard over the last year in terms of Omnipod? Five. I mean, I just feel like we're kind of waiting.   Chris Wilson  9:40 I mean, just from my view on the outside. I think that insolence estimates of hopefully getting it before the end of the year, probably right. I know that it did qualify as a breakthrough device. So it's supposed to have a faster review at the FDA, but we're still dealing with the COVID backlog with all kinds of stuff. For me, there's things that we probably expected six months ago, there's still pending. And I know there's always rumors circulating that this got approved, but it hasn't been released yet. And so half the time I'm going and checking the FDA database for what approvals were announced in the last week.   Kamil Armacki 10:16 Only Chris does this kind of stuff.   Stacey Simms  10:20 I did have an interesting question from a listener who was talking about Okay, so as we're taping, Dexcom g7 has not yet been submitted to the US FDA, it has been submitted in Europe. And her her thought was like, Oh, my gosh, if Omnipod has been sitting there all this time, and Dexcom hasn't even submitted, how much longer is it going to take? And my point to her was, it's not as though Omnipod and these other submissions are just sitting in a file cabinet. Right? I mean, they are actively being looked at. You're both nodding. Can you tell me a little bit about what we know I mean, these submissions again, they don't just land on a desk and then one day someone opens them and rubber stamps them. Back to our conversation in just a moment, but first Diabetes Connections is brought to you by Gvoke Hypopen and you know, low blood sugar feels horrible. You can get shaky and sweaty or even feel like you're going to pass out there are a lot of symptoms and they can be different for everyone. I am so glad we have a different option to treat very low blood sugar. Gvoke Hypopen is the first auto injector to treat very low blood sugar. Gvoke Hypopen is pre mixed and ready to go with no visible needle before Gvoke people needed to go through a lot of steps to get glucagon treatments ready to be used. And this made emergency situations even more challenging and stressful. This is so much better. And I'm grateful we have it on hand, find out more go to diabetes connections.com and click on the Gvoke logo. Gvoke shouldn't be used in patients with pheochromocytoma or insulinoma visit Gvoke glucagon.com/risk. Now back to Chris answering my question about FDA submissions.   Kamil Armacki 12:00 Yeah, so for the pandemic, the main reason as to as to why we have a backlog is that regulators that used to regulate that were in charge of regulating medical devices like continuous glucose monitors, hybrid closed loop systems. And this is across actually Europe and US it's very similar, simply because of the pandemic, they were actually responsible for overseeing all of the medical queries related to the pandemic from, you know, vaccines emergency authorizations. So that's what we call when a product is used in a slightly different way to kind of simplify it. And so using a CGM and hospital was a good example of that we seen an emergency authorization of that, so they've kind of, you know, dos thinks took priority. So too, you know, that's where we have a backlog, but now they from my understanding, kind of back on on track, and, you know, four hands on that backlog, working their way through it.   Chris Wilson  12:57 There's just only so many people to do the work. And I mean, even when stuffs in development, there's always a lot of back and forth between the company that's developing it and the FDA, what are you going to require us to do, and so then they alter the product design sometimes to make it fit what the FDA wants, and that can even go into is as deep as the training modules. And the other information that gets given to patients when the product is prescribed, they're looking at all of that they're looking at human factors testing are people you know, able to follow the directions and use it the way that it's intended to be used, are they going to do something stupid and mess it up? They're looking at all of that. And then they're going through all of that data on all the different aspects of the devices and needing to decide, okay, is this safe enough to actually be effective? And there are different standards in Europe versus in the US? The FDA has much higher safety thresholds, whereas the European standard is basically does it do what it says it's going to do?   Kamil Armacki 13:58 And just to close up Omnipod 5, I think FDA has added it Chrissie would agree this is just my personal opinion. I think FDA has been pretty scared of going to full control. And the biggest today there isn't an insulin pump, which offers, you know, remote bolus capabilities. And that's part of Omnipod 5, you know, that's what they've submitted to them. So, you know, my speculation would be that if actually they didn't submit full control within that first submission, maybe we already you know, maybe it would be here already. You know, it is an area that FDA has been very cautious about. So I guess that's a significant factor contributing to to the to the backlog as well to the delight.   Stacey Simms  14:40 Well, and that brings us to our next item that's in front of the FDA. Thank you for setting that up. So Tandem has also submitted in the last year and is waiting for bolus by phone. You know, that's not the official name of it. But I agree with you. I think the FDA is really taking a very, very careful look at that bit of technology. And Tandem, you know, I believe, to your point, Chris, there has been some back and forth. You know, they don't issue press releases. Every time they asked for that, but it is happening, I think, to me, you know, as a mom of a kid who takes his phone everywhere, you know, this is something that I cannot wait for. I mean, bullets by phone just seems like such a basic capability in 2021. But of course, it's a medical device, and it's your phone. Chris, are you hearing anything? Or do you have any opinion on that?   Chris Wilson  15:29 I mean, at least as far as Tandem goes, I think there's less of a risk because you still actually have the physical pump that can be used to do something if for some reason, there's a problem with the phone. If you're relying exclusively on the phone, you've got to worry about what happens if it gets lost. What happens if they're dead batteries? What happens if you unlock it and hand it to your kid to play a game and the kid goes into your bolus app and accidentally gives you 15 or 20 units of bolus while they're chatting around? I mean, all of those things need to need to be taken into consideration and mitigated as much as possible.   Stacey Simms  16:01 I wonder Kamil, it's interesting to think about Omnipod because they've when I've talked to them, I've always asked like, why can't you put some buttons on the pod. And their point was, and I think this leads to Chris's point from the phone, their point has always been well, it's for safety with the pediatric patients, they don't want the kids touching the pod pressing buttons, this makes perfect sense. I was a parent of two small children, they're gonna touch everything. But it's kind of the flip side now on the phone, right. So it's an interesting look to see what you trade off in a way.   Kamil Armacki 16:31 So actually, to that point, in the UK, we do have an insulin pump from rush called accucheck. Solo. And on the high level, it's kind of like a nominal pot, where the pot like device that you put on your body and actually has two buttons on it. So you can actually bolus from the patch itself. And the way they've actually engineered it is that you need to press both buttons at the same time, ensure that you don't kind of you know, lean on the you know, you could very easily lean on a button and just press it, you know, other companies have gone down that route as an Omnipod. To use that I do use a monopod. So I use Dexcom and Omnipod in a DIY setting. And yeah, I love the simplicity of it. So yeah, massive, massive fan.   Stacey Simms  17:14 I think it's just all trade offs. Right. I mean, there's no perfect system, I don't think but people want to perfect. Exactly. Right. Exactly. Chris, what do you use? If you don't mind me asking?   Chris Wilson  17:25 I am on a Tandem with control IQ, although I don't use it exactly as designed. I've been working with better bullet strategies and playing with the modes that have put that it gets put in be an exercise or sleep that change some of the the targets that it's trying to hit to get it to behave a little bit more like I think it should.   Stacey Simms  17:47 So you're using Ctrl Q and Kamil, you're using   Kamil Armacki 17:50 loop? Yeah, that's right. Yeah. on any iPhone. Yeah.   Stacey Simms  17:53 All right. I don't want to move on from Tandem quite yet. But I want to talk about loop in a moment. So we've got bolus by phone in front of the FDA, which we also think could come approval could come by the end of the year, but Tandem moved their submission for TSport. Right. They were going to submit that in 2021. Chris, they are moving that to 2022. Right.   Chris Wilson  18:12 That was the last that I heard. Yes. To me.   Stacey Simms  18:16 I see you nodding.   Kamil Armacki 18:17 Yeah, I agree that that's what my understanding of the T sport is, I think they had some communication with FDA with the phone control, which obviously plays into T sports as well. Like the point Chris was making, you know, there's no display I don't think on the although, you know, it's a patch, you know, it's kind of moving into that kind of tubeless to pipe bridge mode kind of pump. So yeah, I'm pretty sure they've decided it's pushed back further.   Stacey Simms  18:48 And I should have set that up better if you're not familiar with a tee sport is a very tiny version of the T slim it is been to me it looks kind of like a beefed up cartridge and it sticks somehow to your body. There is still a tube and there is still an inset, but it kind of I don't know if it dangles off, or it sticks some I don't know. So they haven't they haven't released that I've asked a bunch of people when Lily a while ago was coming up with its own pump and it was supposed to be inset and sticky. I'm still trying to figure out how it supposed to stick to your body with an inset and they haven't really explained that. So maybe at some point, but clearly you made a 3D version of this yourself right? Didn't you like mock up a Teesport at one point and freak everybody out? Because we thought you had one?   Kamil Armacki 19:27 I did. So just on that entire idea in general, there's actually a pump in it's been kind of out here in Europe and has been taken off the market and I think it's coming back at some point called collider which uses a similar idea of where three colors bright colors. Yeah, so So that's kind of it's an interesting concept because you have an infusion set and like a sticky dye upon your body. And I think it that's what Tandem has gone off as well. But yeah, I did. It's very interesting how people often will look at especially on YouTube because it's a very visual form, they will look at a picture without watching the video. And yeah, a lot of people thought I had some insider info on the T spot, which was a very interesting experiment and a lot of comments about that go like, where did you get this? And I'm like, I didn't Freeview print hello, it's 2020.   Kamil Armacki 20:19 Be careful, be careful, hey,   Chris Wilson  20:21 I need to take some of the blame, actually, I think for potential delays on the other Teesport, I was involved in some of the Human Factors testing. And based on some of the questions that I got asked afterwards, I think I may have done some things that they weren't expecting it some stupid things or something that was not dissipated. So that may actually be the source of some of the   Stacey Simms  20:45 Alright, well, if you can't answer I understand what the heck could you have done? What   Chris Wilson  20:52 I think it was, it was just in case of directions weren't necessarily clear. Or I was expecting, you know, think about this, rather than actually do it. I obviously can't go into specifics. But needless to say, I clearly wasn't doing everything that they expected as part of the tasks in the testing. So who knows that may be part of the the reason that things got delayed, but hey, if it prevents somebody else from doing the stupid things that I did, and having a problem later on, then that's actually a good thing. And actually,   Kamil Armacki 21:24 I'm so glad that you did, Chris, because so many companies have tried this idea of you know, having a patch and in a short tube. So novo, they went out of business Kaleido also really struggling, we don't really know if they're gonna come back. And Tandem is now trying, they're kind of stab at it. No one has really made this idea work. So   Stacey Simms  21:43 yeah, it's a good point. But one thing I do like, again, I don't have diabetes, I don't wear the devices. But the idea I like is that with an inset, you do have a choice of how it connects angled or what the cannula length is, or steel, you know, with Omnipod, or you don't have as many options in terms of how it connects. Now, many people will say to counter that, well, you have many more options of where you can put it, you know, so it really just depends on how you wear it where you're comfortable with. But I think that's why they keep trying cumulus because there's that different kind of inset that people can use. So who knows? But I think that's a really good point.   Chris Wilson  22:18 Well, it's a great example of how your diabetes may vary. Yeah, no one solution is going to work for everyone. So that's why it's important that we have these options.   Stacey Simms  22:27 Alright, so let's talk about loop. One of the other submissions. This is such a laundry list in front of the FDA is tide pool loop. And that was submitted earlier in 2021. It's been very quiet, but it is it's hanging out there. Anybody here anything? Anybody know anything? Any comments?   Chris Wilson  22:45 I really haven't heard anything. I mean, it's so pure speculation. Obviously, this coming from the open source community is going to be subject to a lot probably more scrutiny than if it's coming from an established player. And I was not entirely clear on exactly what the trials for approval looked like. It sounded like some of the DIY data from DIY loot may have actually been used as part of the submission. So I would imagine that that's probably at least one of the things that may be taking a little bit extra time because I'm feeling the FDA is probably going to look a little bit more closely at that than they would if it was coming directly from Insulet. Or someone else.   Stacey Simms  23:28 That's a good point and was used I believe, that's what they told me earlier this year was a lot of that open source a lot of that DIY community data was put in so you wonder what then the FDA came back and asked for no, no, what we really need is or no, that is enough. I mean, we'll find out later, but it's very interesting stuff.   Kamil Armacki 23:46 And in some ways, it is a perfect storm, because it is using, you know, using that DIY technology, which is just absolutely amazing. I mean, the whole title team has been so tremendous in this project. So it's you know, taking that DIY, but then also the phone control point that we mentioned earlier, where it's an Omnipod. So actually, you know if your battery dies, I'm sure everybody's asking those questions. You know, if your iPhone dies, how is the child going to bolus? I'm sure that those are the questions that you know regulated system has to they need to have that usually answers for that. So I'm sure they face in similar scrutiny on the phone point just like Omnipod 5 does with eventually   Stacey Simms  24:26 this just occurred to me and again, I don't use the system so that's probably way to think about it, but these DIY systems that already use the phone can you use your watch to control them to Kamil, I wonder if that's something that's done? Yes.   Kamil Armacki 24:39 It's it's just like with Dexcom you still need your phone. So phones like the the house the home of the of the whole system, you can remotely you know, bolus and enter carbohydrates and Al's meals etc. Using your Apple Watch. Bought a phone is still required to actually do all of the calculations the brain behind all of it on Omnipod, five doc, this all happened on the pod both title loop that's all happening on the phone just like with a DIY system. Oh, yeah, that's a really good point. So you really need that to to make this system work. And there are all of those you know, your phone die in, you know, someone's stealing your phone cases that you know, I'm sure FDA is wants answers for   Stacey Simms  25:22 it to be clear, because a lot a lot of information there. I think this is a good point Omnipod 5, as you said, controlled by the pod. So you lose your phone, it keeps on trucking, it's going to deliver basil, the loop will continue a tide pool loop and loop DIY, whatever it's called right now is all controlled by the phone. So if your phone dies, the system won't continue.   Kamil Armacki 25:40 Well, so by design, it will always deliver background insulin in the way that it's intended. I mean, my phone dies, sometimes you know, it's live, right? I'm a 23 year old. Me because it is difficult to keep it charged in the pub. So you know it does happen. So and those are kind of a real world cases that you know, I'm sure FDA is also asking about. So with the DIY system, and I would assume with Title loop as well. But that is just my speculation. When your phone dies with the DIY system, it automatically goes to the default background rates for you kind of bolus because you need your phone to do that. And I would assume it would be relatively similar of tide pool loop, because I don't think there would be making a separate backup device like Omnipod just doing with Omnipod 5. Okay,   Stacey Simms  26:31 thanks. Alright, last item that is in front of the FDA, I think is the Medtronic 780, which is already available in Europe.   Right back to our conversation, but first Diabetes Connections is brought to you by Dexcom. And if you're a veteran, the Dexcom G6 continuous glucose monitoring system is now available at Veterans Affairs pharmacies in the United States. qualified veterans with type one and type two diabetes may be covered and pick it up your Dexcom supplies at the VA pharmacy may save you a lot of time to connect with your doctor for more information. Dexcom even has a discussion guide you can bring with you I know it can be hard to know what questions to ask, get that guide, find out more about eligibility at dexcom.com/veterans. Now back to Kamil answering my question about whether the Medtronic 780 is available in Europe?   Kamil Armacki 27:34 That's right. Okay. So 780 G has been here for it's been approved last summer. So kind of just as COVID was kind of a couple of months in, and it's been rolled out across various countries in Europe. I think we got it in the UK earlier this year. Well, I think the 770 G's, the newest version that you guys have in the US. So the 700 pumps, they all have Bluetooth built in. So you can have your pump alarms, all of that on your phone, no control. But you can view everything by the 780s, kind of the newest pump in that line, which has a new brain new algorithm. In my view, it is completely different. Because actually, it's not really made by Medtronic. It's made by an Israeli company called Dream met.   Stacey Simms  28:23 So that's free. That's right. The algorithm is from Dream Med, I've interviewed them, I forgot to actually   Kamil Armacki 28:28 said that in one of my videos, and Medtronic wasn't really happy with me. So   Stacey Simms  28:32 I feel like we have it's ours. Now. It's been,   Kamil Armacki 28:35 they officially said something like it's built by a dream met with Medtronic engineers. So you know, it is a partnership. And that's apparently true. You know, I have no reason to deny that. So I'm sure they work together on it. But you know, the the foundation of seven ATG is actually completely different. It's not like they took 670 and added a couple of capabilities. You know, it's a great we design I mean, on the outside, it looks the same, but actually the the actual brain inside is completely different. And I guess one of the one of the key things that we mentioned is actually the ability to have your glucose set as low as 100. You know, people have diabetes across Europe, they've they've been really kind of enjoying that. And it has automatic corrections as well. So a lot of people listening to this might not be as techie as we are. So just in simple terms, it kind of matches control IQ, I would kind of say in terms of the feature set, maybe slightly better, because you can reduce your target to 100, which I know a lot of people have been asking about. I don't know if you agree, Chris, without saying it's kind of at the same level as control like you   Chris Wilson  29:37 from a tech perspective. Yeah, they both the the key difference or the key feature there is the automated correction boluses, which is what differentiates what they call an advanced hybrid closed loop from just a standard hybrid closed loop, which is what the 670 and 770 were, it's nice to see more high tech options coming to the market from more players. says it gives people more options.   Stacey Simms  30:01 That's interesting, though about any kind of criticism for mentioning dream, Ed, because I mean, control IQ was developed by type zero technology, right? Wasn't it like a University of Virginia thing that then Tandem bought? Yeah, well,   Chris Wilson  30:14 it got bought by Dexcom Dexcom, bought type zero and then license the tech to Tandem. So   Stacey Simms  30:22 interesting times. And we should also mention that all the Medtronic systems use their sensors. This is not yet a mix and match world, I believe the Medtronic sensors, and I keep hearing that they're much better, but still need to be calibrated. So even the latest version No, your shake your head, Kamil tell Oh, that's right. We're waiting for that approval in the US.   Kamil Armacki 30:42 Well, so. So guardian for has been approved in three guardians. And so that's the no calibration version. And it's I know, like one person who's using it. So it's not I think they slowly roll in and out. They haven't really started shipping it yet. But it's basically what we all know, as guardian free just with with no calibrations. As far as I'm understanding the accuracy is not improved. It's kind of the same, if not slightly worse, from a margin perspective with Guardian four, compared to Guardian three. And yeah, I think it's in the FDA backlog as well. I'm gonna go ahead and   Stacey Simms  31:21 just double check that on my end only because it'll be good to know the actual mark from their studies and things like that. So we'll pop that into the show notes. But I think you're exactly right, because I was just doing the time. It'll be interesting to see what the time shift is, in terms of episodes being released, because we were just doing our game show. Wait, wait, don't poke me for friends for life. And I actually I can't believe I forgot I asked this question about Guardian four. Because the codename for it or at least the in house name for it was Zeus. So we had been talking about Zeus for Medtronic for a long time, no calibrations I know this is the I get in the weeds of the trivia and then I forget what I know. So thanks for correcting me. Alright, and then Alright, let's talk about Dexcom. Because Dexcom g7, as we're taping g7 has not been submitted to the US FDA, but it has been submitted for European approval. Kamil, you had Dexcom CEO on your show, wearing and showing off the device. I was so jealous when I saw that I'm gonna yell at Kevin Sayer. Next time I talked to him. But yeah, tell us what that was like and what you thought of it when you saw it.   Kamil Armacki 32:27 You know, I've been the massive Dexcom advocate, I pay for my own decks because I'm not an ambassador, I just genuinely it's been a life changing product for me. And yeah, it's been it's been an honor speaking to him. So you've spoken to him a couple of weeks after they announced that they submitted for the for the European European approval. I mean, it looks tiny, as I'm sure you've seen, if you've seen the video, I'm incredibly excited to see kind of how that one develops, and from literally a couple of days. So they kind of in the investors call, like Chris was saying, I also sometimes tune into those, and they confirmed that the expecting to get that approved in Europe by the end of the year.   Stacey Simms  33:07 It's interesting. And Chris, maybe you could speak to this, for people who might not be that familiar, the Dexcom technology, while it is very different from the G6, the speed at which it might get approval, Europe is one thing, right us is another this is not like an insulin pump, we don't expect it at least to take quite as long as insulin pumps are different systems because it's not putting insulin into your body, right? It's just measuring,   Chris Wilson  33:28 but it is being used to calculate doses of a high risk medication, which is insulin, there's definitely still some concern as far as how accurate it is. And if it's off it, how off? Is it? Is it going to cause a problem? But I'm really excited with the clinical data that they presented. I think it was at EASD Earlier this year, showing that the g7 the marred the that measure of accuracy that they use is actually now under 8%. With the g7 which I mean we're getting into how much more accurate can we reasonably get just because there's so much variation in human body that I mean, you can take six fingerprints from six different fingers and get six different answers from his standard meter. The fact that we're really dialing in the accuracy is as tight as we can and actually ever since is almost in the same boat with their new Wow, what any product they had. I think two versions I recall, but that's coming as well. And the the 180 day version as long as we're talking CGM. Yeah, there is no absolute answer for anything. This is actually I was in a study last Thursday, where they were seeing how long I could go without insulin. But as part of it, they're they're monitoring it with a y si, which is this reference grade laboratory meter that they actually do a blood draw and they centrifuge it down. And then they measured the glucose level in the plasma without any of the blood cells in it. And that device in the lab was actually not putting out the correct numbers, there was some sort of hiccup, they had to restart it to get it to come up. But my Dexcom was matching, and then they compared it to multiple Ultra accurate fingerstick meters and set to figure out what was going on. But, you know, nothing's perfect. This was, you know, elaborate reference glucometer. That's the most accurate one that you can get. And they don't even make them anymore.   Stacey Simms  35:23 I will never forget, when Betty was little like poking the same finger, you said six different fingers, who put the same finger three times in a row because it was confusing or something. And it was always three different numbers. It's crazy.   Chris Wilson  35:33 I just think it's important that people keep in mind that you know, nothing is ever going to be perfect. whatever device you're wearing, however, you're measuring your stuff, there's always going to be variation, it's never going to be exactly the same number every time on every device   Stacey Simms  35:46 you mentioned ever since that's the CGM that goes under your skin. And then the transmitter goes on top. And Kamil, you are you've got a little bit are you using the libre as well like to test it out? Or did you? What did you show us earlier,   Kamil Armacki 36:00 I am trying the free celebrate free, which is like the newest version. It's not available in the UK, I should make it very clear. But someone bought it for me in Germany. And they imported it over to the UK is actually it's actually been a very interesting over here. Because obviously it's it's not available in the UK. So I had to enter freestyling briefly, there was no physical receipt, but you need to get an app. So only use your phone, you can only use your phone, there's no physical reader, there's no physical device, which I don't know how that's going to work with, you know, children going to school and you know, having to carry phones, but anyway, but it's not available in the British App Store. So I had to create a German Apple ID. And everything on my phone is German. So I gem Apple Music, German podcasts, everything is in German, it's still English. But other than that I have been enjoying my German lifestyle over the last I've had it for four days now. So it's been it's been fun.   Stacey Simms  37:03 What are the different features like what's I'm not as familiar with the Libre system. So what is new with the three,   Kamil Armacki 37:08 it's much smaller, it's much smaller compared to the first two. And on a high level, it works exactly like you would expect a CGM to work like Dexcom web, no scan and it just always shows the value and the glucose your trends alarms ever found on your phone. So they kind of made it work in exactly the same way as at the center of Dexcom. But most importantly for me, they keep them the same price. And I think that's very important for a lot of people have diabetes here in Europe because I mean, Libra has been a giant success in the UK for example, just because actually, because of its price point it is accessible to the National Health Service. So it is you know reimbursed to you know, vast majority pretty much every single person of type one who wants it to get can get it. And libre two is the same price point is libre one and now libre free. In Germany, when they did launch, it's also the same price. So they keeping it the same, which is which is very reassuring   Stacey Simms  38:08 process, we'll see what happens in the US. But that is very reassuring for our friends in Europe. I went device I meant to ask about and didn't but I don't think it's been submitted. And that is beta bionics and the iLet. And Chris, you kind of alluded to this much earlier in our talk, because you were I believe in one of those trials,   Chris Wilson  38:25 I was at least told that I was patient number one at the trial site that I was at.   Stacey Simms  38:33 But we don't think we don't know for sure they have not submitted down or have they?   Chris Wilson  38:38 Well, I keep hearing parents and other patients still people diabetes, still saying, you know, I just finished my time in the primary phase of the trial for the eyelids, or now my kid is going into the extension phase, things like that. So if the trial is ongoing, clearly, I don't think they've they've submitted yet. It's definitely more hands off. I won't lie my time and range did go down a little bit when I was on it.   Stacey Simms  39:03 But your your time and range we should specify is extremely high.   Chris Wilson  39:06 Right? My 90 day average right now is 94% a week going into the current trial, the arm of the trial that I just finished was actually 97.   Stacey Simms  39:20 So it's all relative, but otherwise. Yeah. But it's a good point in that, you know, the eyelid is much more hands off, as you mentioned,   Chris Wilson  39:32 right? It's you know, no correction boluses there's not even mechanism to do it. All you can really do is tell it when you're eating and give it a rough guesstimate as to the meal size. So I would imagine especially for people who want to be more hands off with their diabetes and have good control because of the control wasn't bad by any stretch of the imagination, that it'll be a very good option for a lot of people once it does get approved. And this is the Insulet only version. We've still got The version with insulin and glucagon having both a gas and a brake will definitely make it easier to drive the car going forward in the next version. So we're looking forward to, to them starting the trials on that as well.   Stacey Simms  40:13 Yeah, it is all relative. I mean, I just think about my son, you know, he misses a couple of meal boluses a week for sure. And I think he would happily trade off control, you know, to just have that kind of stuff be taken care of. It's so interesting to see how I mean, I'm, I'm, I know, we're gonna get somebody questions as Chris gets so much time and range, what is he doing with control IQ? So that'll be another episode tips and tricks from Chris to or maybe the maybe the tips and tricks, Kamil is just spent a lot of your time in diabetes trials? Yeah. I mean, I kidding. I know. That's not it. But   Kamil Armacki 40:48 well, you're my time and ranges, but it's knowing me about? Very, very happy with it. I like to say that my time and happiness, though is 98. If not 100%?   Kamil Armacki 41:00 Go? And that's what matters. Yeah, right.   Stacey Simms  41:04 Absolutely.   Chris Wilson  41:05 I mean, that we joke about doable, do a lot of trials. And it helps. But there is definitely some truth to that. I mean, I get to talk to and interact with some of the top endocrinologist in the world, right? Sometimes, you know, on a weekly basis. So I'm going into the clinic to have an injection of something that they're testing out or to check in and let them download the data from the device that I'm testing in half the time we're chatting while they're doing other stuff. And you know, discussing the theories that underlie a lot of this stuff. And it definitely deepens your understanding, if you want to really understand diabetes, more and more like an endocrinologist does that say, it's a great way to gain some experience?   Stacey Simms  41:49 Let's talk a little bit. We've talked about what's happening and what we're waiting for. So let's talk a little bit about what we're excited for. And not just the products that we mentioned. But if there's anything else that's on your mind, I'm curious what you guys who live with diabetes, you use these devices, you follow this tech? Chris, what are you looking forward to? And I mean, it could be something that we talked about, or something that's like maybe 10 years from now,   Chris Wilson  42:10 I think probably the thing that that's most interesting, I mean, to a certain extent, the tech we even if it's not there yet, we know where it's going. Yeah, where it's sort of the end point is the point is you were a sensor, you were a pump, and it does everything for you, and you don't need to worry about it. But beyond that, I think one of the things that I'm most excited about is seeing the medications that were originally designed for type twos being used in more type ones. Yeah, since most type ones do have some insulin resistance, it's actually you know, a known thing that happens, it's partly just due to the fact that normally, insulin gets made on in the middle and spreads out to the edges, and we're infusing it from the edges and having it go into the middle of the circulation. But things like I know, Stacy, you've mentioned in the past the SDLT, two drugs that help us her pee out the excess sugar from your blood, those have shown really great improvements in kidney health, cardiovascular outcomes, and making those safer for type ones, since it can cause an issue with going into DKA even though your blood sugar's stay relatively normal. That was actually the the test that I was last Thursday was checking a new drug that as an add on to help reduce the chance of that happening if you're a type one on one of these medications, but there's lots of different classes of medications that are coming out things that not only enhance the function of insulin, but potentially block some of the functions of glucagon to help improve things since they've documented that. A lot of type ones the the sort of regulation and counter regulation in insulin, the insulin glucagon axis, I guess, it does happen with a fair amount of frequency in people with type one. So that may be something moving forward. And actually, it's not even necessarily just diabetes. They're testing this medication that they were trying to lay on me as an enhancement for cancer immunotherapy. Wow. In North Carolina, I somebody was asking me about something. And so I went on the clinical trials website, it was digging into what said he's looking at this drug and found a study that they were looking at it to see if it'll enhance the ability of some immunotherapies for breast cancer. So I mean, a lot of this stuff may even have ripple effects outside of diabetes.   Stacey Simms  44:33 That's really amazing. All right. That's a great point. I love that. All right. You know, you don't have to go outside of technology. I mean, that is still technology gets medication, but can we what are you looking forward to? Are you looking at down the line? I'm   Kamil Armacki 44:46 going to keep this one very, very simple. I'm just looking forward to seeing more access to all of this. I feel like in terms of getting incredible technology. I feel like we could summarize all of this all of today's talking Massive tech, right? We have incredible continuous glucose monitors even better on the market. And even better versions of them are common over the next year or so with g7, libre free etc. Same with pumps, that technology so sadly, isn't really accessible to so many people. And this applies to so many regions, so many countries in the UK, we now have an a trial of 1000 people with diabetes trial in closed loop technology to hopefully have our national proof that it does work is self restraint and actually seeing all of this because, you know, it's like every single country wants their own proof even though you know, there are so many trials from all over the world proven that yes, actually, it does help people. But you know, it is a very bureaucratic process. So I'm just looking forward to actually see in 1000s, if not millions of people have access to CGM. And then if they choose to hypertrophic therapy.   Stacey Simms  45:55 That's wonderful. All right. Before I let you go, this last question, it's not really a great follow up to our discussion about access. But this is one that it just honestly, it drives me bananas, and I want to get your opinion on and that is this every other day, I feel like someone is asking me when the Apple Watch is going to monitor blood glucose with non invasively. Right, that I know, right? You're gonna get the watch, it's gonna read your blood glucose and then move on. And I get these questions all the time by people outside the diabetes community, frankly, who read about it or hear about it. What's your take? I mean, I know what's coming. I hope it's coming. I don't want to I feel like I'm the hope killer. I go on these threads. And I'm like, unless you see a clinical trial, right. It's not going to happen. But I feel like it is coming it will be useful to some people sometime, right?   Chris Wilson  46:44 I think, absolutely. I think there's a couple of companies that are pretty far along. In the process of actually doing non invasive glucose monitoring. I think you had an episode recently, where you mentioned one where they look at the eye, yeah, within the eye, which is cool. I've heard of a couple of different texts that are technologies that are being introduced, using either heat at low levels infrared, to potentially sense it, or radio signals, believe there's a company in Israel that's working on that as well. Yeah, they're probably not good enough to necessarily dose insulin from yet, but they're getting there and the tech keeps getting smaller and more portable and stuff, I think there's a company in Germany that's got the tabletop scale right now, where you can just basically put a finger into on the sensor and it will give you an estimate of your blood sugar in there hoping to scale that down to being a portable device that will be non invasive, and then eventually a wearable device that will be non invasive. So it's, it's definitely coming, but the stuff takes time, there's so figuring out serve a lot of the ways that the various sensing technologies interact with the body and figuring out exactly how best to estimate your blood sugar from the readings that they get back. So it's coming. I've seen presentations with actually impressive accuracy, especially considering that it's non invasive, but I don't see it any time at least probably not in the next couple of years, but especially integrated into a consumer device like an Apple Watch.   Kamil Armacki 48:13 I completely agree with Chris I think especially as someone living with diabetes we tend to look at this from a you know, kind of a medical point of view but if this ever were to happen, it's really a health companion and I think that entire trend have actually seen a lot of what I would consider mainstream technology companies you know, Apple Samsung, you know, those kinds of players becoming more involved in health is a good thing because I think you know, we've heard of so many stories of you know, people using you know, Apple watches and you know being alerted that actually your heart rate is too low or too high and actually you know, if you deploy that kind of capability on you know, a population scale you know, with with millions of people using Apple Watches, it really drives you know, big changes and cold drives colossal impact on you know, general population you know, how we live our lives for if ever does happen I mean, we hear about this all the time and literally this year I think it was six or seven days after Apple Watch Series seven came out there was already a rumor saying the Apple Watch Series eight Yes. Well habit and I saw on Twitter and I just went I just did this emoji six days, six days the longest amount of time we can have without any rumors about Apple Watch.   Stacey Simms  49:39 It just shows you how much money is in it   Kamil Armacki 49:43 It's click bait, interesting topic because you know it is the next frontier that you know everyone is trying to tackle. Yeah, so I understand the excitement bore and sometimes I'm probably causing it because I have talked about as well. In my in my printer diabetic days, I I was excited about it. I've been excited about as Nerdabetic, and we can't not be excited.   Stacey Simms  50:05 Well, even this episode, someone could clip out what Chris said it's coming.   Kamil Armacki 50:09 Yeah. But we do need to be realistic about it that even when it comes in, you know, 1015 years, it probably won't really have any tangible impact on any buyer lives.   Chris Wilson  50:21 Maintaining being realistic, that's a very good point. Because it reminds me of the vertex announcement a couple of weeks ago, with the the first patient of their trial, got infusion of stem cell derived Ilet cells, and is, you know, 90% reduction in insulin use. And everybody went nuts over that. And I wound up posting a big, long thread on Twitter explaining that really like this isn't the hard part yet. It's great that they're this far, it's awesome that people are pursuing different avenues, I hope they succeed. But this isn't going to be something that people are going to have in the next couple of years to just go in and get your eyelid infusion. And then you don't need to worry about measuring your blood glucose or worrying your pump or taking injections anymore.   Stacey Simms  51:10 I heard a great point on that, which was if they've sent a press release, it's quite different than if they've submitted a for publication in a clinical journal. It was a little bit, I'll say a little meaner than that. I think the quote was something like, you know, if it's a press release, they're looking for money, if it's a journal they're looking for, you know, approval. There's some truth to that, though. And I think that that's a good thing for us to keep in mind as we stay very hopeful is a very hopeful crowd. And as we stay realistic, as well, I think we've run the gamut. There's always so much more to talk about. So I hope you'll come back on when these things maybe we hear more, they start to get approved, or we just talk about different things. But this was great. Thank you both so much for jumping on.   Chris Wilson  51:50 It's always fun to talk to you, Stacey.   Stacey Simms  51:51 Oh, thank you, thank you. It's always great to get caught up on this stuff and kind of speculate and talk about it. So thanks so much. I appreciate you guys both being here. And we will put lots of links in the show notes and everywhere else we can find them so that people can find you on social and follow your musings and your thoughts, but I really appreciate it. We'll talk to you soon.   You're listening to Diabetes Connections with Stacey Simms. Lots of information there. I'm going to link up a couple of articles some things we referenced at diabetes connections.com. At the homepage for this episode, there is a transcription as well as always, what do you think? I mean, I know it was long, and there were a lot of things to get through. But I'd like to do that on a more regular basis, maybe with some different people in the community. Love to hear feedback from you what questions you have, what topics you'd like us to tackle. But man, those guys, really they know the ins and outs of all of this, they really keep their finger on the pulse. So we'll follow up. We'll do more on that. This was taped, as I said the very first week of November 2021. So in a couple of days between now and when the episode comes out, maybe something else was approved. If it happened, we will follow up on it here. All right, thank you, as always to my editor John Bukenas from audio editing solutions. We've got in the News Live every Wednesday now 4:30pm Eastern Time, on YouTube and on Facebook Live on both channels, and then we turn it around into an audio podcast episode that airs Fridays. So I hope to see you back here for that until then be kind to yourself. Diabetes Connections is a production of Stacey Simms media. All rights reserved. All wrongs avenged

Losing Weight with Fasting & Mindful Eating.
44 | How to STOP weekend over-eating and over-boozing

Losing Weight with Fasting & Mindful Eating.

Play Episode Listen Later Nov 3, 2021 19:10


If you engage in frequent weekend overeats and drinking like a boss, then keep listening. I will discuss why this happens, and how to avoid sabotaging your weight loss and health goals on the weekends. I will tap into how you can work towards decreasing and eventually stopping this cycle of weekend overindulgence.

Inspire Healthy Harmony.....  Health Transformation, Functional Medicine, Mindset Coaching for Women
Why can't you Lose Weight? Discussing Insulin Sensitivity with Dietitian, Cheri Bantilan

Inspire Healthy Harmony..... Health Transformation, Functional Medicine, Mindset Coaching for Women

Play Episode Listen Later Oct 27, 2021 35:49


It's so frustrating when you feel like you are doing the right things and you still have no energy and can't lose weight! What's the deal? Last week I introduced you to the concept of blood sugar management and why it's important for everyone, not just diabetics. If you want to lose weight, balance your hormones, banish those sugar cravings; you need to pay attention to your blood sugar. This week we are continuing that conversation and going deeper to discuss the role of insulin, insulin sensitivity and how to turn around insulin resistance. If you have been curious about continuous glucose monitoring, my special guest and I chat about that as well. Grab a glass of water, listen in and be empowered my friend. That's what's happening today on the Healthy Harmony podcast. This podcast is chock full of info including... Blood Sugar Balance The Role of Insulin How to know if your Body is Insulin Resistant Normal vs. Abnormal Metabolism Carbohydrate Threshold Continuous Blood Glucose Monitoring (CGM) 7 Tips to Turn Around Insulin Resistance As you heard, Nutri-Sense is the continuous glucose monitor (CGM) that I've been wearing and I love the insight that it has been giving me. I have found the app to be very easy to use and I love having the support of a Dietitian. If you are ready to try a CGM...Nutri-Sense is offering my listeners a discount on the first month. The promo code HEALTHYHARMONY25 gives you $25 off. Go to www.https://www.nutrisense.io/ Don't forget…on the FB group page we are in the middle of a Break Up with Sugar Series. You know he is no good for you. Join us, girls only at bit.ly/FMwomenswellness Need personalized coaching from the comfort of your home? Book a discovery call here https://calendly.com/coachjennpickett/15min_discovery_call to learn more. The next two weeks, we are diving into the topic of Gut Health as I interview a leading Functional Medicine doctor. You will be shocked at all you learn! Oh my word! Stay tuned. --- Send in a voice message: https://anchor.fm/inspirehealthyharmony/message

Diabetes Connections with Stacey Simms Type 1 Diabetes
"Amplify the Value of CGM" - Dexcom's Jake Leach talks about Garmin, the G7 and Dexcom One

Diabetes Connections with Stacey Simms Type 1 Diabetes

Play Episode Listen Later Oct 26, 2021 36:38


With Dexcom announcing a big new agreement with Garmin this month, it seemed like a good time to check in on a few issues. Stacey talks with Dexcom's Chief Technology Officer Jake Leach about Garmin, the upcoming Dexcom G7 and Dexcom One. She asks your questions on everything from G7 features to watch compatibility to the future and possible non invasive monitoring. Just a reminder - the Dexcom G7 has not yet been submitted to the US FDA and is not available for use as of this episode's release. This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. Previous episodes with Jake Leach: https://diabetes-connections.com/?s=leach Previous episodes with CEO Kevin Sayer: https://diabetes-connections.com/?s=sayer Check out Stacey's book: The World's Worst Diabetes Mom! Join the Diabetes Connections Facebook Group! Sign up for our newsletter here ----- Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners! ----- Get the App and listen to Diabetes Connections wherever you go! Click here for iPhone      Click here for Android Episode transcription below:   Stacey Simms  0:00 Diabetes Connections is brought to you by Dario Health. Manage your blood glucose levels increase your possibilities by Gvoke Hypopen the first premixed auto injector for very low blood sugar, and by Dexcom take control of your diabetes and live life to the fullest with Dexcom.   Announcer  0:20 This is Diabetes Connections with Stacey Simms.   Stacey Simms  0:26 This week Dexcom announced a big new agreement with Garmin this month seemed like a good time to check in on a few issues, including what happens to the watches and insulin pump systems that work with G6, when Dexcom G7 it's the market.   Jake Leach  0:41 We're already working with Tandem and Insulet. On integrating G7 with their products have already seen prototypes up and running, they're moving as quickly as possible.   Stacey Simms  0:49 That's Chief Technology Officer Jake leach who reminds us that the G7 has not yet been submitted to the US FDA. He answers lots of questions on everything from G7 features to watch compatibility to the future and possible non invasive monitoring. This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. Welcome to another week of the show are we so glad to have you here I am the host Stacey Simms, and we aim to educate and inspire about diabetes with a focus on people who use insulin. You know, my son Benny was diagnosed with type one right before he turned to my husband lives with type two diabetes. I don't have diabetes, I have a background in broadcasting. And that is how you get the podcast. And when I saw the news about Garmin, and Dexcom. I knew you'd have some questions. And I thought this would be a good chance to talk about some of the more technical issues that we're all thinking about around Dexcom. These days. I should note that since I did this interview with CTO Jake Leach on October 19. And that's exactly one week before this episode is being released that Dexcom released some new features for its follow app. I did cover that in my in the news segment. That was this past week, you'd find the link in the show notes. And as I see it for that news that release in the update, the big news there is that now there is a widget or quick glance on the followers home screen, it depends on your device, you know, Apple or Android, there's no tech support, right from the follow up, and a way to check the status of the servers as well. And I think that last one should really be an opt in push notification. If the servers are down, you should tell me right, I shouldn't have to wonder are the servers down and then go look, but that is the update for now. And again that came out after this interview. So I will have to ask those questions next time. And the usual disclaimer Dexcom, as you've already heard, is a sponsor of the show, but they only pay for the commercial you will hear later on not for any of the content you hear outside of the ad. I love having them as a sponsor, because I love that Vinnie uses the product. I mean, we've used Dexcom since he was nine years old. But that doesn't mean I don't have questions for them. And I do give them credit for coming on and answering them. Not everybody does that. I should also add that this interview is a video interview, we recorded the zoom on screen stuff. You can see that at our YouTube channel. I'll link that up in the show notes if you would rather watch and there always will be a transcript these days in the show notes so lots of options for however it suits you best. I'm here to serve let me know if there's a better way for me to get this show to you. But right now we've got video audio and transcript. Alright Jake leach in just a moment. But first Diabetes Connections is brought to you by Dario health and you know one of the things that makes diabetes management difficult for us that really annoys me and Benny, it's not really the big picture stuff. It's all the little tasks that add up. Are you sick of running out of strips do you need some direction or encouragement going forward with your diabetes management? Would visibility into your trends help you on your wellness journey? The Dario diabetes success plan offers all of that in more you don't the wavelength the pharmacy you're not searching online for answers. You don't have to wonder about how you're doing with your blood sugar levels, find out more, go to my dario.com forward slash diabetes dash connections. Jake leach Chief Technology Officer for Dexcom thanks so much for joining me. How are you doing?   Jake Leach  4:22 I'm doing great, Stacey. It's a pleasure to be here.   Stacey Simms  4:24 We really appreciate it. And we are doing this on video as well as audio recording as well. So if we refer to seeing things, I don't think we're sharing screens or showing product. But of course we'll let everybody know if there's anything that you need to watch or share photos of. But let me just jump in and start with the latest news which was all about Garmin. Can you share a little bit about the partnership with Garmin? What this means what people can see what's different?   Jake Leach  4:49 Yeah, certainly so I'm really excited to launch the partnership with Garmin. So last week we released functionality on the Dexcom side and Garmin released their products, the ability to have real time CGM readings displayed on a whole multitude of Garmin devices by computers, and a whole host of their watches. So they've got a lot of different types of watches for, you know, athletics and different things. And so you can now get real time CGM displayed on that on that watch. So they're the first partner to take advantage of some new technology that we got FDA approved earlier in the year, which is our real time cloud API. So that's a a way for companies like Garmin to develop a product that can connect up to users data through the Dexcom, secure cloud and have real time data, we've had the capability to do that with retrospective data that three hour delayed, many partners are taking advantage of that. But we just got the real time system approved. And so Garmins, the first launch with it.   Stacey Simms  5:50 Let me back up for just a second for those who may use these devices, but aren't as technologically focused. What is an API? When you got approval for that earlier in the summer for real time API? What does that what does that mean? Yeah, so   Jake Leach  6:03 it's a API is an application programming interface. And so what it really means is, it's a way for software applications, like a mobile app on your phone, to connect via the Internet to our cloud with very secure authentication, and pull your CGM data in real time from from our cloud. And so it's basically a toolkit that we provide to developers of software to be able to link their application to the Dexcom application, and really on the user side, to take advantage of that feature, you basically enter in your Dexcom credentials, your Dexcom username and password. And that is how we securely authenticate. And that's how you're basically giving access to say, for example, Garmin, to pull the data and put it down onto your devices. What other   Stacey Simms  6:51 apps or companies are in the pipeline for this. Can you share in addition to Garmin? I think I had seen Livongo Are there others?   Jake Leach  6:58 Yeah, so Livongo so Tela doc would purchase the Lubanga technology, they've got a system. They're also in the pipeline for pulling in real time CGM data into their application. And so they're all about remote care. And so trying to connect people with physicians through, you know, technology, and so having real time CGM readings in that type of environment is a really nice use case for them. And so and for the for the customers. And so that's, that's where they're headed with it. And we've got kind of a bunch more partners that are in discussions in development that we haven't announced yet. But we're really see this, the cloud API's are interfaces as a way to expand the ecosystem around a Dexcom CGM. So we really like to provide our users with choice. So how do you want your data displayed? Where do you want it? And so if you want to right place, right time for myself, have a Garmin bike computer so I can see CGM readings right on my handlebars, I don't have to, you know, look down on a watch or even thought phones, it's really convenient. That's what we're about is providing an opportunity for others to amplify the value of CGM.   Stacey Simms  8:06 This was a question that I got from the listener. What happens to the data? Is that a decision up to a company like Garmin, or is that part of your agreement, you know, where everybody's always worried about data privacy? And with good reason?   Jake Leach  8:19 Yeah, data privacy is super important area when when you're handling customer information. And so the way that it works is, when you're using our applications at the beginning, when you sign up, there's some consents, you're basically saying this is what can be done with my data. And the way we design our systems is, for example, with the connection to the Garmin devices, the only way they can access your data is if you type in your credentials into there, it's like it's almost like typing your username and password into the web to be able to access your bank account. It's the same thing, you're granting access to your data. And each company has their own consents around data. And so we all are required by regulatory agencies to stay compliant with all the different rules to Dexcom. We take it very seriously, and are very transparent about what happens with the data that's in we keep it in all of our consent forms that you click into as you as you work through the app.   Stacey Simms  9:13 But to be clear to use the API or to get the Dexcom numbers on your garmin, you said earlier, you have to enter your credentials,   Jake Leach  9:19 you have to you have to enter your Dexcom username and password. And that's how we know that it's okay for us to share that information with Garmins system because you are the one who authorized it.   Stacey Simms  9:30 Right. But that's also how you were going to use it. You just said you have to enter your name and password for them to use the information. So they just have to read individually like okay, Garmin or Livongo or whomever. Yes. Your individual terms of services.   Jake Leach  9:42 Yeah, for each each application that that you want to use you it's important to read the what they do with the data and how to use it.   Stacey Simms  9:49 That's really interesting. And Has anything changed with Dexcom? It's been a long time since we've talked about how you all use the data. My understanding is that it was blinded, you know, you're not turning around over to health insurers and saying yeah, done on this day this or are you?   Jake Leach  10:03 No, no, not at all, we basically use the information to track our product performance. So we look at products there. So it's de identified, we don't know whose product it was, we just can tell how products are performing in the field. That's a really important aspect. But we also use it to improve our products. So we when we see the issues that are occurring with the use of the product, we use it to improve it. So that's, that's our main focus. And the most important thing we do with it is provided to users where, where and when they need it. So you know, follow remote monitoring that the reason we built our data infrastructure was to provide users with features like follow and the clarity app and so forth.   Stacey Simms  10:36 Do those features work on other systems? Can I use Garmin to share or follow?   Jake Leach  10:41 Not today? So right now, it's, it's basically intended for the the person who's wearing the CGM. It's your personal CGM credentials that you type in to link the Carmen account. And so for today, it's specific around the user.   Stacey Simms  10:57 I assume that means you're working on for tomorrow.   Jake Leach  10:59 There's lots of Yeah, lots.   Stacey Simms  11:02 Which leads us of course to Well, I don't have to worry about that right now. Because you can't use any of this without the phone and the Phone is how we could share it follow. So it's not really an issue yet. Jake, talk to me about direct to watch to any of these watches. Yeah, where do we stand? I know G6. It's not going to happen. Where are we with G7? Right back to Jake answering my question, you knew I was gonna bring that up. But first Diabetes Connections is brought to you by Gvoke Hypopen. And when you have diabetes and use insulin, low blood sugar can happen when you don't expect it. That's why most of us carry fast acting sugar and in the case of very low blood sugar, why we carry emergency glucagon, there's a new option called Gvoke Hypopen the first auto injector to treat very low blood sugar Gvoke Hypopen is pre mixed and ready to go with no visible needle. In usability studies. 99% of people were able to give Gvoke correctly find out more go to diabetes connections.com and click on the Gvoke logo. Gvoke shouldn't be used in patients with pheochromocytoma or insulinoma. Visit Gvoke glucagon.com/risk now back to Dexcom's jake leach answering my question about direct to watch   Jake Leach  12:19 That's a great question and a really exciting technology. So direct to watch is where through Bluetooth, the CGM wearable communicates directly to a display device like a watch. So today, G6 communicates to the phone and to insulin pumps in our receiver are the displays. With G7, what we've done is we've re architected the Bluetooth interface to be able to also in addition to communicating with an insulin pump or a receiver and your mobile phone, it can also communicate with a wearable device like a Apple Watch, in particular, but other watches have those capabilities, with G7, reducing the capability within the hardware to have the direct communication director watch. And then in a subsequent release, soon after the launch to commercial launches of G7, we'll have a release where we bring the director watch functionality to the customers, there's the Bluetooth aspect, which is really important, you got to make sure it doesn't impact battery life and other things. But there's also the aspect of when it is direct to watch, it becomes your primary display. And so being able to reliably receive alerts on the watch was something that initially in the architecture wasn't possible. But as Apple's come out with multiple versions of the OS for the watch, they've introduced capability for us, so that we can ensure you get your alerts when you're wearing the watch. And so that was a really important aspect for us. And it's also for the FDA to ensure that if that's your main display, you've walked away from your phone, you have no other device to alert you that it's going to be reliable. And so that's exciting progress of last couple years with Apple making sure that can happen. You know,   Stacey Simms  13:56 we're all excited for Direct to watch. Obviously, it's a feature that many people are really clamoring for. But you guys promised it first with the G five in 2017. Do you all kind of regret putting the cart before the horse that way? Because my next follow up question is why should we believe you now?   Jake Leach  14:15 Yeah, you know, it Stacy's a good question. So we are hand was kind of forced because Apple actually announced it before we did. So they basically said we're opening up this capability on the watch to have the direct Bluetooth connectivity. And of course, we were excited to have someone like Apple talking about CGM on that kind of a stage. But then as we got into the details of actually making it work, we, you know, continually ran into another technical challenge after another technical challenge, and I totally agree. I wish it would have been two years later that they talked about at the keynote, but I'm comfortable that we've gotten past those types of issues. And so and it is built into G7. So we've got working systems and so it will introduce it rather quickly with G7   Stacey Simms  14:56 and to confirm G7 has been submitted for the CE mark Because the approval in Europe, but has not yet, as you and I are speaking today has not yet been submitted for FDA approval in the US.   Jake Leach  15:06 Yeah, we're just we're just finishing up our submission, we get some validations that we're running on some of the new manufacturing lines to make sure we can build enough of these for all the customers, we want to focus to move over to G7 as quick as possible. And so we'll we'll submit you seven to the FDA before the end of this year,   Stacey Simms  15:22 just kind of building off what you mentioned about Apple and making these announcements or, you know, sometimes Apple lets news get out there. Because they I don't know if they seem to enjoy it. I'm speculating. I don't have any insight track at Apple. But I wanted to ask you, I don't know if you can say anything about this. For the last year, every time I talk to somebody who's not getting the diabetes community, but they're on a technology podcast, or they're, they're hearing things about non invasive blood glucose monitoring, right, the Apple, Apple series seven or some watch this year, we're supposed to have this incredible, non invasive glucose monitoring was gonna put Dexcom and libre out of business, it was gonna be amazing. Of course, it didn't happen. But a bunch of companies are working on this. And Apple seems to be really happy to say maybe, or we're working on it, too, is Dexcom listening to these things. I mean, obviously, they're not here yet. They they are going to come. I'm curious if this is all you kind of happy to let that lay out their speculation. Or if you guys are thinking about anything like this in the future,   Jake Leach  16:17 we pay a lot of attention to non invasive technologies. We have a an investment component of our company that looks at you know, early stage startups. We also have many partnership discussions around CGM technologies. And so when it comes to non invasive, I think we'd all love to have non invasive sensors that are accurate and reliable. You know, for many, many years since I've been working on CGM, and many years before that, there has been attempts to make a non invasive technologies work. The challenge, though, is it's just sensing glucose in the human body with a non invasive technology is not been proven feasible. It's just there's a lot of different attempts and technologies have tried, and we pay close attention. Because if if something started to show promise, we become very interested in it. And basically making a Dexcom product that uses it, we just haven't seen anything that is accurate and reliable enough for what our customers need. That's to say, there could be a use case where a non invasive sensor doesn't have to be as accurate and reliable as what what Dexcom does. And so maybe there's a product there. But we're very focused on ensuring that the accurate, the numbers that we show, the glucose readings that we present to users are highly accurate, highly reliable, that you can trust them. And so when it comes to non invasive, we just haven't seen a technology that can do that. But I know that there's lots of folks out there working on it. And we're, we stay very close to the community.   Stacey Simms  17:40 Yeah, one of the examples I gave a guy who doesn't he does an Apple technology podcast, and he was like, you know, what, what do you think? And I said, Well, here's an example. He would a scale, and you have no idea if it's accurate. But you know, that once you step on it that that number probably is is stable, then you know, okay, I gained 10 pounds, I lost 10 pounds. But I have no idea if that beginning number makes any sense at all, you might be able to use that if you are a pre diabetic, or if you're worried about blood glucose, but you could never dose insulin using it because you have no idea where you're starting. So I think that's I mean, my lay person speculation. I think that's where that technology is now and to that point, but other people outside the diabetes community are looking to one of the more interesting stories, I think, in the last year or two has been use of CGM and flash glucose monitoring for people without diabetes at all, for athletes, for people who are super excited and interested in seeing what their body's doing. So we have companies like levels and super sapient. And you know, that kind of thing using the Liebreich. I'm curious of a couple of parts of this question. If you think you want to answer it is Dexcom. Considering any of those partnerships with the G7, which is much more simple, right? fewer parts and that kind of thing.   Jake Leach  18:46 Yeah, that's a great point, Stacey. So yes, G7 is a lot simpler. It was designed to be to take the CGM experience to the next level. And part of that is just the ease of use the product deployment the simplicity, someone who's never seen a CGM before, we want to be able to walk up approach G7 And just use it. There's a lot of opportunity we feel for glucose sensing outside of diabetes. Today CGM are indicated for use in diabetes, but in the future, with 30% of the adult population in the US having pre diabetes, meaning the glucose levels are elevated, but not to the point where they've been diagnosed with diabetes. There's just so much opportunity to help people understand their blood sugar and how it impacts lifestyle choices impact their blood sugar. In the immediate feedback you get from a CGM is just a there's nothing else like it. And so I think, you know, pre diabetes and even as you mentioned, kind of in athletics. There's a lot of research going on right now in endurance athletes, and in weight loss around using CGM readings for those different aspects. So I think there's a lot opportunity we're today we're focused on diabetes, both type one and type two and really getting technology to people around the globe. That can benefit from it. That's where our focus is. But we very much have programs where we look at, okay, where else could we use CGM? It's such a powerful tool, you could think in the hospital, there's so much opportunity around around glucose. Alright, so I'm   Stacey Simms  20:13 gonna give you my idea that I've given to the levels people, and they liked it, but then they dropped off the face of the earth. So I'll be contacting them again. Here's my idea. If somebody wants to pay for a CGM, and they don't have diabetes, but they're like paying out of pocket because they like their sleep tracker, and they like this and they like that, or some big companies gonna buy it and give it away for weight loss or whatever. You know, the the shoe company toms, where you buy a pair of shoes and they give one away. People are in the diabetes community are scrimping and saving and doing everything they can to get a CGM. Maybe we could do a program like that. Where if you don't quote unquote medically need a CGM. Your purchase could also help purchase one for an underserved clinic that serves people with diabetes.   Jake Leach  20:54 Getting CGM to those folks that didn't need them, particularly underserved areas, clinics. It's so important. I like the idea. It's a that's if there was a cache component that then provided the CGM to those that are less fortunate. I think that's, I like the idea. Next month is National Diabetes Awareness Month. And one of the things we're focused on for the month of November is how can we bring broader access to CGM? It's something we've been working on, you know, since we had our first commercial product, and there's still, you know, many people in the United States benefit, you know, 99% of in private insurance covers the product. You know, a lot of our customers don't pay anything, they have no copay. But you know, that's not the case for everybody. And so there's, there's definitely areas that we need to we are focusing on some of our non profit partners on bringing that type of greater access to CGM, because it's such a powerful tool and helping you live a more normal life.   Stacey Simms  21:50 In the couple of minutes that we have left. I had a couple more questions, mostly about G7. But you mentioned your hospital use. And last year, I remember talking to CEO Kevin Sayer about Dex comes new hospital program, which I believe launched during COVID. Do you have any kind of update on that or how it's been going?   Jake Leach  22:06 Yeah, so it was a authorization that we got from the FDA to raise special case during COVID, to be able to use G6 in the hospital. And so we had quite a few hospitals contact us early on in COVID, saying, Hey, we've got these patients, many of them have diabetes, they're on steroids. They're in the hospital, and we're trying to manage their glucose. And we're having a hard time because their standard of care in hospitals is either labs or finger sticks. And so we got this authorization with the FDA, we ship the product, many hospitals acquired it, and they were using it pretty successfully. What we'd say about G6 is really designed for personal use your mobile phone or a little receiver device, designed integrated with a hospital patient monitoring system or anything like that. You could imagine in the future that that could be a real strong benefit for CGM, the hospital, you can imagine you put it on, you know, anybody who has glucose control issues comes in the door. And then you basically can help ensure where resources need to be directed based on you know, glucose risk. I've always been passionate about CGM at a hospital. It's one of the early projects I worked on here. Dexcom. And I think it there's a lot of promise, particularly as we've improved the technology. So there's still hospitals today using G 600 of the authorization. And we're interested in designing a product for that market specifically, instead of right now. It's kind of under emergency years. But we think there's there's a great need there. That CGM could could help in basically glucose control in the hospital.   Stacey Simms  23:28 That's interesting, too. Of course, my mind being a mom went to camp as well. Right? If you could have a bunch of people I envision like a screen or you know, hospital monitoring that kind of thing. You wonder if you could do something at camp where there's 100 kids, you know, instead of having their individual phones or receivers at camp, it would be somewhere Central?   Jake Leach  23:46 Well, you know, what, between with the with the real time API, there are folks that are thinking about a camp monitoring system that can basically be deployed on campuses right now with follow. It's great for a family, but it's not really designed to, to follow a whole camp full of campers. But with the real time API, there's opportunities for others to develop an application that could be used like that. So yeah, there you go.   Stacey Simms  24:08 All right, a couple of G7 questions. The one I got mostly from listeners was how soon and I know, timelines can be tricky. But how soon will devices that use the G6? Will they be able to integrate the G7 Insulin pumps, that sort of thing? Sure. It's only Tandem right now. But you know, Omnipod, soon that that kind of thing?   Jake Leach  24:26 Yeah, I mean, that's coming. So I'll start with the digital partners like Garmin and others, that is going to be seamless, because the infrastructure that G6 utilizes to move data to through the API's is the same with G7. So that'll be seamless. When you talk about insulin pumps, so those are the ones that are directly connected to our transmitters that are taking the glucose readings for automated insulin delivery. So those systems were already working with Tandem and Insulet. On integrating G7 with their products have already seen prototypes up and running so they're moving as quickly as possible. So once We have G7 approved, then they can go in and go through their regulatory cycle to get G7 approved for us with their AI D algorithms. Really the timing is dictated mainly by those partners and the FDA, but we're doing everything we can to support them to ensure this as quick as possible.   Stacey Simms  25:17 Take I should have asked at the beginning, I'm so sorry, do you live with type one I've completely forgotten.   Jake Leach  25:21 I don't I made a reference to where I wear them all the time. Because, as you know, kind of leading the r&d team here, I love to experience the products and understand what our users what their experience is. And I just love learning about my glucose readings in the different activities I do. So I don't have type one. But I just I use the products all the time.   Stacey Simms  25:42 So to that end, have you worn the G7? And I guess I'd love to know a little bit more about ease of use. It looks like it's, it just looks like it's so simple.   Jake Leach  25:51 It is. Yeah. So I've participated in a couple of clinical trials where we use G7, it is really simple. One of the most exciting things though, I have to say is that when you put it on, it has this 30 minute warmup. So the two hours that we've all been used to for so many years, by the time you put the device on and you have it paired your phone, it's there's like 24 minutes left before you're getting CGM. So it's like it's it. That part is just one of the things that you it sounds awesome. But then when you actually experience it, it's pretty amazing. But yeah, the ease of use is great, because it's the applicator is simple. It's a push button like G sex where you just press the button and it deploys. But there's other steps where you're not having to remove adhesive liners, the packaging is very, very small. So we really focused on low environmental footprint. And so it's really straightforward. But probably the most the really significant simplification the application process is because the transmitter and the sensor all one component and sterilized and saying altogether, there's no pieces, there's no assembly required, you basically take the device and apply it and then it's up and running. There's no transmitted a snap in or two pieces to assemble before you you do the insertion.   Stacey Simms  26:59 I think I know the answer to this. But I wanted to ask anyway, was it when you applied for the CE mark? And I assume this would be the same for the FDA? Are there alternate locations? In other words, can we use it on our arms?   Jake Leach  27:11 And yeah, that is that is a great question. Yeah, our focus with one of our phones with G7 and the revised form factor, the new new smaller form factor and sensor probe was arm were so yeah, arm wears is really important part of the G7 product.   Stacey Simms  27:26 I got a question about Dexcom. One, which seems to be a less expensive product with fewer features that's available in Europe. Is that what Dexcom? One is?   Jake Leach  27:34 Yeah, so there's a product that we recently launched in Europe in European countries. That is it's called Dexcom. One. And what it is, is it's it's a product that's designed for a broad segment of diabetes, type one, type two, it's a lower price point. It has a reduced feature set from G6. But what it's really about is simplicity. And so in you know it's a available through E commerce solutions. So it's really easy to acquire the product and start using it. It's really to get into certain markets where we either weren't didn't have access to certain customers. And so it's really designed for get generating access for large groups of people that didn't have access to CGM before.   Stacey Simms  28:20 What does e commerce solution mean? No doctor   Jake Leach  28:23 there. So outside the United States CGM isn't no prescription required for many, many countries. So the US is one of the countries that does require prescriptions, other some other countries do too. But there's a large group outside the US that don't, but it's really around, you can basically go to the website, and you can purchase it over a website. So really kind of nice solution around think Amazon, right. You're going you're clicking on add the sensors and you're purchasing it. It's a exciting new product for us that we are happy to continue developing.   Stacey Simms  28:53 I think it might come to the US don't know. Yeah, that's   Jake Leach  28:56 good. Good question. Don't don't know. I mean, I think right now we see CGM coverage is so great access is great for CGM in the US it can always be better and extend your focus on that. But it's really for countries where there wasn't access,   Stacey Simms  29:08 I would think tough to since we do need a prescription differently. Yeah, Jake, you have been with Dexcom, almost 20 years, 18 years now. And a lot has changed. When you're looking back. And looking forward here at Dexcom. I don't really expect you to come up with some words of wisdom off the top of your head. But it's got to be pretty interesting to see the changes that the technology has brought to the diabetes community and how I don't know it just seems from where I sit and you're probably a couple of years ahead. It seems that the last five years have just been lightspeed. It has   Jake Leach  29:39 been things are speeding up in terms of our ability to bring products to market and there's a lot of things one is the development of technology. The other component is working with your groups like the FDA on you know, how do we get products to the customers as fast as possible and that that's been a big part of it right moving cheese six to class to becoming an IC GM that That was a huge part of our ability to get the technology out quickly and also scale it. I think there's a lot of aspects that has been faster. And you know, when I started Dexcom, we had this goal of designing a CGM that was reliable didn't require finger sticks that could make treatment decisions. All that and we were 100% focused on that. And as we got closer and closer, and now we have that which you six and also what you seven, then the opportunity that that product can provide, you start to really understand how impactful CGM can be around the world. And that's what I'm excited about now is I'm still excited about the technology always will be and we still have lots to do on making it better, more reliable and more integrated. But just how much CGM can do around around the globe. There's just so many things. It's beyond diabetes to so very excited about the future.   Stacey Simms  30:47 Many thanks, as always, and we'll talk soon, I am sure but I mean, I could never get to say it enough. I can't imagine doing the teenage years with my son without Dexcom. You guys, I know you did it just for me. You did it just in time. Appreciate it very much. He is doing amazing. And I can't he would not be sticking his fingers 10 times a day. So thank you.   Jake Leach  31:05 That's great to hear. Thanks, Stacy.   Announcer  31:12 You're listening to Diabetes Connections with Stacey Simms.   Stacey Simms  31:18 As always more information at diabetes connections.com. And yeah, but that last bit there, I can say nice things. I mean, I really do feel that way. And I can still ask not so nice questions. Like if you're new, quite often, I will open up a thread in our Facebook group. It's Diabetes Connections of the group to gather questions for our guests. And I did that here with Dexcom, there's usually quite a lot of questions, I do have to apologize, I missed a big one. Because of the timing of the interview, I promise I will circle back around next time I talk to Dexcom. And that is all about the updates for iOS and for new phones, and how you know, sometimes Dexcom is behind the updates. What I mean by that is that they lag behind the updates. So you can go to the Dexcom website, I'll put a link up for this for Dexcom products that are compatible in terms of which iOS and that kind of thing. And they are behind. And Dexcom will always say they've said very publicly that they are working hard to catch up. But I guess the question that a few people really wanted to know was why, you know, why do they lag behind? What can be done about that? So they know, but I think it would be a good question to ask. So Sarah and others. I appreciate you sending that question. And I apologize that I didn't get to it this time around. And I'll tell you, you know, it's not something we've experienced, but I think it has to do and I'm speculating here more with the phone with the the newness and the the model of the phone sometimes then for the updates, especially if you don't have your updates on automatic. So I guess I'm kind of saying the same thing. But what I mean by that is Vinny, and I have very old phones. I have an eight. I'm not even sure he has the eight. We are terrible parents and I don't care about my phone, I would still have a Blackberry if that were possible. So I can't commiserate. I'm so embarrassed to even tell you that I can commiserate with the updates, because it's just not something that we have done. Benny, definitely if he were here, trust me. It's like his number. I would say it's his number one complaint that it's really high up on the list of complaints to the parenting department in our house. And yes, Hanukkah is coming. His birthday is coming. There will be some new phones around here. I'm doing an upgrade. I'm sure both of us have cracked phones. Were the worst. Oh, my goodness. All right. Well, more to come in just a moment. But first Diabetes Connections is brought to you by Dexcom. And this is the ad I was talking about earlier in the interest of full disclosure. But you know, one of the most common questions I get is about helping kids become more independent. I get asked this all the time at conferences for virtual chats in my local group. These transitional times are tricky. And we've gone through this preschool to elementary elementary to middle middle to high school. I can't speak high school to college yet, but you using the Dexcom really makes a big difference. For us. It's not all about sharing follow, although that's very, very helpful. Just think about how much easier it is for a middle schooler to look at their Dexcom rather than do four to five finger sticks at school, or for a second grader to just show their care teams a number. Here's where I am right before Jim. At one point, Ben, he was up to 10 finger sticks a day, he didn't have Dexcom until the end of fourth grade not having to do that made his management a lot easier for him. It's also a lot easier to spot the trends and use the technology to give your kids more independence. Find out more at diabetes connections.com and click on the Dexcom logo. I don't know about you, but I am getting a ton of email already about Diabetes Awareness Month and that is November this time of year I usually get I'd say 120 emails that are not snake oil, right one in 20 emails that maybe make sense for something we want to talk about on the show here that I would share on social media and I'm just inundated with nonsense. So I hope you are not as well. But I gotta say Diabetes Awareness Month this year. I've been pulling in My local group and talking about what to do because usually I highlight a lot of people and stories and I'll I'll still do that, I think, but I got to tell you people are, um, you know, this, we're all stressed out. And while it's a wonderful thing to educate, I always think Diabetes Awareness Month is not for the diabetes community, right? We are plenty aware of diabetes, this is a chance to educate other people. And that's why I like sharing those pictures and stories on my page, because the families then can share that with their people. And it's about educating people who don't have diabetes. But gosh, I don't know this year, I'm going to be just concentrating on putting out the best shows that I can I do you have a new project I mentioned last week that we're going to be talking about in the Facebook group. By the time this airs, I will have the webinars scheduled in the Facebook group. So very excited about that. Please check it out. But what are you doing for Diabetes Awareness Month? If you've got something you'd like me to amplify, please let me know. You can email me Stacey at diabetes connections.com. Or you can direct message me on the social media outlet of your choice. We are at YouTube, Facebook, Twitter and Instagram. That's where Diabetes Connections lives. I'm on Tik Tok, or Snapchat or Pinterest. Oh my gosh. All right. Well, that will do it for this week. Thanks as always to my editor John Bukenas from audio editing solutions. Thank you so much for listening. I will be back on Wednesday. live within the news. Live on Facebook and now on YouTube as well. Until then, be kind to yourself. Benny: Diabetes Connections is a production of Stacey Simms media. All rights reserved. All wrongs avenged

Naturally Nourished
Episode 263: Healthy Halloween and Listener Q&A

Naturally Nourished

Play Episode Listen Later Oct 25, 2021 75:23


Are you looking for ways to make Halloween healthier this year? Want to avoid the dreaded sugar hangover but still have some family fun? Curious about our perspective on baby formula, supplements after hysterectomy, and tips for managing hashimotos? Tune in to hear about our Halloween plans as well as answers to your burning questions!    In this episode, we discuss updates on Stella's new school and how Ali is navigating classroom treats and events. With Halloween this week, we cover our favorite wholesome treats, how to navigate Trick or Treating with your littles, and ingredients to absolutely avoid in conventional candy.   Also in this episode: Next Level Keto Starts 10/27! Women's Wellness Workshop 12/4 Tickets on Sale Now Ali and Becki are Taking New Clients Find Ali on Patreon  Healthy Halloween OptionsHu Kitchen Chocolate Gelatin Gummies Peanut Butter Cups  Almond Joys Cutout Cookies “Bloody Thumb” Hotdogs Arame Salad Tips for a Healthy Halloween Listener Q&ABest Baby FormulaDonor Milk Resources Weston A Price Recipe Serenity Kids Toddler Formula Kendamil Holle Hipp Supplements for HysterectomyInflammazyme Super Turmeric BroccoDetox Relax and Regulate Post Surgery Protocol How to Keep Being the Light Tips for HashimotosThe Stress Thyroid Connection Relax and Regulate Cellular Antiox Adaptogen Boost Thyroid Optimizer Adrenal Rehab Program   Sponsors for this episode:  This episode is sponsored by Nutrisense, providing Continuous Glucose Monitors (CGM) that provide you with real-time glucose data and an easy to use phone app that helps you combine and visualize your glucose data with all of your daily activities as well as personalized recommendations on how to improve your health. Use the code AliRD for savings at nutrisense.io. Check out our YouTube where we discuss wearing a CGM, show you how to put it on, and interpret your results here.    This episode is sponsored by FOND Bone Broth Tonics, Your Sous Chef in a Jar. FOND is slow simmered and lovingly tended from simmer to seal. They partner with organic farms and hand-pick and pair ingredients to optimize absorption and taste. Use code ALIMILLERRD to save at fondbonebroth.com.   

The Cabral Concept
2088: Mewing, Teenage Anxiety, Stress & Progesterone, Persistent Psoriasis, Nighttime Hypoglycemia, Iodine & Hashimoto's (HouseCall)

The Cabral Concept

Play Episode Listen Later Oct 24, 2021 20:01


Thank you for joining us for our 2nd Cabral HouseCall of the weekend! I'm looking forward to sharing with you some of our community's questions that have come in over the past few weeks… Let's get started!    Darren: Good day Dr Cabral. Hope all is well with you and family. I read James Nestor's Breathing book on your recommendation and after hearing him on your show. What are your thoughts on "mewing" as recommended in the book. If it's something you believe has benefits (or drawbacks) is it possible for you to discuss it further? Thank you Anonymous: Hi dr cabral, thank you infinitely for all you do and your passion for sharing your knowledge with us.. i love listening to the podcast. My question is for my daughter who is 18. She is in college and is busy. She enjoys exercising and is on the cheer team so lots of tumbling and is active but she suffers from anxiety. Some days worse than others, especially these days. I too have it. I take the adrenal soothe. Would that be something that she could take as well ? Any other suggestions ? Thanks so much again - take care Nicole: Hi Dr Cabral! First off, thank you for all of the time and effort you put in…it is GREATLY appreciated! I have been struggling with severe cramping, bloating and back pain about 7 days before my period starts. I've also had lab work done over the years and it has shown that my progesterone typically peaks within a high range during first half of luteal phase but then drops off “earlier than desired” (a quote from my RE). My question is, could my low progesterone be solely due to high cortisol (which I already know is one of my issues) or could it be caused by insufficient egg quality/premature ovarian failure? Is there any way to know for sure? Can the two be related? Any other advice on how to increase egg quality would be greatly appreciated! Carrie-Ann: Thank you a million times over for all that you do for this world. 12 months ago I did the big 5 labs and in the last 12 months I have done the 21 detox, CBO protocol with finisher and citrocidal drops, intestinal cleanse, heavy metal detox, 7 day detox, another 3 weeks of citrocidal drops (as symptoms hadn't cleared) and I continue to take your DNS, DFVB, magnesium, zinc, probiotic, vitamin C and D, fish and fish oil daily. I am IHP level 2 certified and also I have been a chiropractor for the last 20 years. I've lived a natural healthy lifestyle for the last 15-20 years. After having my first baby 10 years ago I developed psoriasis and now also have high grade cervical dysplasia. Since starting your protocols I've had some great things change. My two fungal toenails are almost all grown out normal and I've had 2 plantar warts on the soles of my feet for years and they are both gone. I'm thrilled about both these changes as it really lets me know things are improving internally. Although I have seen no change in my psoriasis and I still have high grade cervical dysplasia (confirmed 2 weeks ago with biopsy and colposcopy). So finally to my question, what more can I do? I have no other symptoms. Digestion is great, I sleep well, my stress levels are low and I love my life. Lilly:  Hi doctor Cabral, After you talked about your experience with a CGM, I started wearing one and am learning so much about my diet. Thank you for that great tip! I've noticed that my sugar drops extremely low a few times a night and I usually wake up when that happens. I think I know what's causing it: I eat a very early dinner and fast until breakfast. And I know that in order to prevent the nighttime dips, it would be good to eat something before sleep, but I really don't want to break my (clean) fast. Is there anything you could recommend to prevent the nighttime hypoglycemia, without using food? Thanks so much! Lilly Richard: Hello Dr. Cabral, First off I want to say thank you for all that you do. Your passion for helping people is truly remarkable and it is much appreciated! My question is regarding the use of iodine with autoimmune diseases, particularly Hashimotos. I have done a lot of research on this and listened to some of the top autoimmune specialists and most of them seem to agree that taking iodine, whether from foods or supplements, can do more harm than good. Their argument is that an autoimmune condition is basically and overactive immune system and Iodine can also increase the activity of the immune system, which in turn increases the autoimmunity. They claim there are numerous research papers in scientific literature that shows when Hashimotos patients are given iodine, their autoimmune condition can flare up. I would love to hear you thoughts on this and whether or not you recommend iodine for your patients that have Hashimotos. Thank you so much!! Thank you for tuning into this weekend's Cabral HouseCalls and be sure to check back tomorrow for our Mindset & Motivation Monday show to get your week started off right!  - - - Show Notes & Resources: http://StephenCabral.com/2088 - - - Get Your Question Answered: http://StephenCabral.com/askcabral   - - - Dr. Cabral's New Book, The Rain Barrel Effect https://amzn.to/2H0W7Ge - - - Join the Community & Get Your Questions Answered: http://CabralSupportGroup.com - - -  Dr. Cabral's Most Popular At-Home Lab Tests: > Complete Minerals & Metals Test (Test for mineral imbalances & heavy metal toxicity) - - - > Complete Candida, Metabolic & Vitamins Test (Test for 75 biomarkers including yeast & bacterial gut overgrowth, as well as vitamin levels) - - - > Complete Stress, Mood & Metabolism Test (Discover your complete thyroid, adrenal, hormone, vitamin D & insulin levels) - - - > Complete Stress, Sleep & Hormones Test (Run your adrenal & hormone levels) - - - > Complete Food Sensitivity Test (Find out your hidden food sensitivities) - - - > Complete Omega-3 & Inflammation Test (Discover your levels of inflammation related to your omega-6 to omega-3 levels) - - - > View all Functional Medicine lab tests (View all Functional Medicine lab tests you can do right at home for you and your family)

The Cabral Concept
2080: Toxic Laxatives, Virus Depression, Reactive Hypoglycemia, Mom Baby Gut Issues, Immune Reaction Individuality, Detox After Shot (HouseCall)

The Cabral Concept

Play Episode Listen Later Oct 16, 2021 21:34


Welcome back to our weekend Cabral HouseCall shows! This is where we answer our community's wellness, weight loss, and anti-aging questions to help people get back on track! Check out today's questions:  Vabona: Hi! I recently found out that miralax has ingredients in it that are found in antifreeze. Said ingredients are said to cause many problems including neuropsychiatric and kidney problems. I have miralax to my son for a while from my drs recommendations. I'm terrified of all the damage I have done. What can I do to help my 5 year old detox that is safe. Thank you Dana: I had a moderate case of covid a month ago and feel depressed ever since. I am 48 and perimenopausal and am wondering if covid causes any vitamin/mineral deficiencies or hormonal changes that may contribute to depression? Prior to getting covid I was taking vit d, c, b complex, magnesium and occasional zinc as well as methylfolate for mthfr def. (one copy). I am prone to seasonal affective disorder but always feel great in summer so this is unusual for me. Thank you! Love your podcast! Anonymous: Hi Dr. Cabral. Thanks for taking the time to answer so many questions. I have a question about non-diabetic reactive hypoglycemia. I searched old episodes & found a brief explanation on episode 218 but I think my question is more specific. I have not been officially diagnosed. No matter the amount of carbs I eat or don't eat, my blood sugar drops an hour after I eat a meal to sub 70. At times sub 60. But then 2-3 hours later it spikes. During the day the spike is generally 100-120 but after dinner its 120-150. Fasting BS is below 70-90. I dip into sub 60 during the nights a lot. My sugars are relatively low most of the day until my dinner meal & that is when I get 120-150. It still goes back under 100 before bed. I am wearing a CGM to try to see if I can identify the issue & so far no luck. Like I mentioned the same meal can cause little to no drop/spike & then the next time I have it it does. I have heard that Reactive Hypoglycemia is a precursor to diabetes so I would really like to fix the underlying root cause before that becomes an issue. I eat whole foods 95% of the time, I intermittent fast 12-14hours. I work out 2 cardio 3 strength per week. I try to walk at least 30 minutes each day. Drink lots of water. Thanks for your help! Megan: Hi Dr. Cabral, I absolutely love your podcast!! I've learned so much and implemented many of your suggestions while healing my body. My question is about my 18 month old son. I now know that when I was pregnant I had Candida, SIBO, and parasites. I'm worried I have passed these conditions on to my baby. I nursed him for 16 months and during that time I unknowingly detoxed some of the Candida. I believe the toxins got into my breastmilk, as my baby had really bad eczema during this time and has had a hard time eating solids as well. I feel awful. I'm concerned about gut issues developing as he gets older. How can I help my baby get as healthy as possible moving forward? Thank you so so much for your passion & sharing your wisdom! Maria: Hi Dr! I have been curious about this for some time. Both my parents have received the AZ vacc, and their reactions were entirely different. My father felt absolutely normal the following days whereas my mother had severe fever, chills, headache for about 24hr. Would this be due to bio individuality or have something to do with the strength/over reactivity of their immune system, if so, is there a favourable response? Thanid: I had the jab and l regret it. How do l detox it from my body. Thank you for tuning into today's Cabral HouseCall and be sure to check back tomorrow where we answer more of our community's questions!  - - - Show Notes & Resources: http://StephenCabral.com/2080 - - - Get Your Question Answered: http://StephenCabral.com/askcabral   - - - Dr. Cabral's New Book, The Rain Barrel Effect https://amzn.to/2H0W7Ge - - - Join the Community & Get Your Questions Answered: http://CabralSupportGroup.com - - -  Dr. Cabral's Most Popular At-Home Lab Tests: > Complete Minerals & Metals Test (Test for mineral imbalances & heavy metal toxicity) - - - > Complete Candida, Metabolic & Vitamins Test (Test for 75 biomarkers including yeast & bacterial gut overgrowth, as well as vitamin levels) - - - > Complete Stress, Mood & Metabolism Test (Discover your complete thyroid, adrenal, hormone, vitamin D & insulin levels) - - - > Complete Stress, Sleep & Hormones Test (Run your adrenal & hormone levels) - - - > Complete Food Sensitivity Test (Find out your hidden food sensitivities) - - - > Complete Omega-3 & Inflammation Test (Discover your levels of inflammation related to your omega-6 to omega-3 levels) - - - > View all Functional Medicine lab tests (View all Functional Medicine lab tests you can do right at home for you and your family)