Podcasts about lantus

It's In the News.. a look at the top headlines and stories in the diabetes community. This week's top stories: New drug is looked at for T1D prevention, a new stem cell method is tested for beta cell transplanation without immunosuppresion drugs, the FDA okays the first fast-acting biosimilar insulin, Lilly lowers price of Zepbound, and more! Find out more about Moms' Night Out  Please visit our Sponsors & Partners - they help make the show possible! Learn more about Gvoke Glucagon Gvoke HypoPen® (glucagon injection): Glucagon Injection For Very Low Blood Sugar (gvokeglucagon.com) Omnipod - Simplify Life Learn about Dexcom  Edgepark Medical Supplies Check out VIVI Cap to protect your insulin from extreme temperatures Learn more about AG1 from Athletic Greens  Drive research that matters through the T1D Exchange The best way to keep up with Stacey and the show is by signing up for our weekly newsletter: Sign up for our newsletter here Here's where to find us: Facebook (Group) Facebook (Page) Instagram Twitter Check out Stacey's books! Learn more about everything at our home page www.diabetes-connections.com  Reach out with questions or comments: info@diabetes-connections.com Episode transcription with links:   Hello and welcome to Diabetes Connections In the News! I'm Stacey Simms and every other Friday I bring you a short episode with the top diabetes stories and headlines happening now. XX New research in type 1 diabetes prevention launches. Nektar Therapeutics and TrialNet will evaluate a drug currently used for exzema for patients with new onset stage 3 type 1 diabetes The drug is RezPeg – that's a shortened version of the name (rezpegaldesleukin)   This will be a study of about 70 adults and children and will launch this year. The new study will use a mixed meal tolerance test (MMTT) to measure the efficacy of rezpegaldesleukin or placebo for preserving C-peptide area under the curve over a 12-month duration comprised of a 6-month treatment period and a 6-month follow-up. Secondary objectives include pharmacokinetics, pharmacodynamics, and additional disease assessments including HbA1c levels and patient insulin requirements. Rezpegaldesleukin is being developed as a self-administered injection for a number of autoimmune and inflammatory diseases. https://www.prnewswire.com/news-releases/nektar-announces-clinical-trial-agreement-to-evaluate-rezpegaldesleukin-in-patients-with-new-onset-type-1-diabetes-mellitus-302383052.html XX NLS Pharmaceutics (NLSP) and Kadimastem announced successful completion of a pre-IND meeting with the FDA for iTOL-102, a potential diabetes treatment. iTOL-102 combines Kadimastem's IsletRx cells (stem cell-derived pancreatic islets) with iTolerance's immunomodulator iTOL-100, aiming to cure Type 1 Diabetes without requiring life-long immune suppression. The treatment was evaluated at the Diabetes Research Institute at the University of Miami School of Medicine, where it demonstrated functional insulin release and disease reversal in animal models. Based on FDA feedback, the companies are updating plans for safety toxicology studies and First-in-Human clinical trials. IsletRx is a clinical-grade product comprising human pancreatic islet-like cells capable of secreting insulin, offering a scalable source of insulin-producing cells to address donor islet shortages. The technology can detect glucose levels and produce required amounts of insulin and glucagon.   XX FDA has signed off on a rapid-acting insulin biosimilar for the first time. The agency has given a thumbs up to Sanofi's Merilog (insulin-aspart-szjj) as the first biosimilar to Novo Nordisk's NovoLog for patients with diabetes. Merilog will be provided by prefilled pen in a 3 mL dose or in a multiple-dose 10 mL vial. It is for adults and pediatric patients age 6 and older.     NovoLog and Novo Nordisk's other rapid-acting insulin follow-on Fiasp are among the drugs subject to government price negotiations under the Inflation Reduction Act. The new prices will be enacted at the start of next year. In July 2021, the FDA approved Biocon and Viatris' Semglee (insulin glargine-yfgn) as the first biosimilar to Lantus. Five months later, the U.S. regulator endorsed Eli Lilly's version of the drug, called Rezvoglar (insulin glargine-aglr). https://www.fiercepharma.com/pharma/fda-signs-sanofis-biosimilar-first-novo-nordisks-rapid-acting-novolog XX Eli Lilly said Tuesday that it will offer more doses of its obesity drug Zepbound in vials and lower the prices of the doses it already sells, as the pharma giant seeks to draw patients away from cheap, compounded copies of weight loss medications. The company launched 7.5 mg and 10 mg vials of tirzepatide, sold under the brand name Zepbound, which typically cost $599 and $699, respectively. However, they are now available for $499 per month for patients paying without insurance. This applies to the first fill and all refills that are delivered every 45 days. Additionally, the company lowered the prices of the 2.5 mg and 5 mg vials to $349 and $499 per month, respectively. The company, which has seen a significant boost in profits from Zepbound and Mounjaro – essentially the same drug with different FDA-approved uses – announced that the new vials and pricing are exclusively available through the company's self-pay pharmacy, LillyDirect Self Pay Pharmacy Solutions. https://www.bloomberg.com/news/articles/2025-02-25/zepbound-cost-for-vials-cut-to-battle-cheaper-copycats XX Medicare spending on 10 diabetes drugs, including popular GLP-1s, more than quadrupled over a five-year period and could reach $102 billion next year, an analysis by Health and Human Services' inspector general found. The findings also come as the Trump administration weighs the fate of a Biden administration proposal that would require Medicare and Medicaid to cover GLP-1s for weight loss. The biggest spikes in usage were for Rybelsus, Novo Nordisk's once-daily GLP-1 tablet, and for the company's weekly injectable Ozempic, whose spending about doubled every year under review. https://www.axios.com/2025/02/25/medicare-spending-surge-diabetes-drugs XX Tandem Diabetes Care has secured a new FDA clearance for its insulin dose-calculating algorithm, opening up Control IQ for use in adults with Type 2 diabetes. The expanded label was based on data from a pivotal, randomized trial of more than 300 people with Type 2 diabetes, comparing its use to manual multiple daily injections. Tandem said it plans to present the study's results at the annual Advanced Technologies & Treatments for Diabetes meeting scheduled for next month in Amsterdam. https://www.fiercebiotech.com/medtech/tandem-diabetes-care-insulin-dosing-algorithm-nets-fda-clearance-type-2-diabetes XX Drugs approved for diabetes and obesity might be useful for the treatment of cognitive and mental health disorders, according to a new paper published in Nature Mental Health.   The study reviewed and integrated data from both preclinical and clinical studies to gather evidence on the possible effects of these drugs GLP1s and semaglutide  in conditions such as dementia, substance use disorders, psychotic disorders, mood and anxiety disorders, and eating disorders.     The study found promising but still preliminary evidence that GLP-1RAs could be beneficial over a range of cognitive and mental health disorders. These drugs have shown potential in improving cognition, reducing addictive behavior, and alleviating depression and anxiety. More data from robustly designed studies (i.e., randomized controlled trials) are needed to better understand GLP-1RAs' prospective efficacy and safety profile, especially with long-term use. https://medicalxpress.com/news/2025-02-diabetes-drugs-mental-health-treatment.html XX The FDA  issued draft guidance that includes recommendations to support the development and marketing of safe and effective AI-enabled The guidance, if finalized, would be the first guidance to provide comprehensive recommendations for AI-enabled devices throughout the total product lifecycle, providing developers with an accessible set of considerations that tie together design, development, maintenance, and documentation recommendations to help ensure the safety and effectiveness of AI-enabled devices. FDA is requesting public comment on this draft guidance by April 7. The agency also released draft guidance for the use of AI to support regulatory decision-making for drug and biological products. https://www.mddionline.com/artificial-intelligence/fda-issues-draft-guidance-for-ai-enabled-devices-seeks-public-feedback XX Congrats to Mila Clarke who some of you may know better as Hangry Woman on social. She has developed a great app called Glucose Guide and the Nutrition Assistant portion of that app went live this week. Glucose Guide is a web and mobile app that offers diabetes meal tracking, coaching, resources, recipes and community to those looking for help managing diabetes. MEAL AND BLOOD SUGAR TRACKING FEATURES.

Skip's Retatrutide Experience, Lantus, Fruits As Main Carb? What is Muscle Maturity?Blood Sweat & Gear Coaching QA w/ Coaches Skip Hill, Andrew Berry, Scott McNally 0:00 Introduction and Sponsors 2:30 Defining and Discussing Linear Squat 5:06 5000 Units of Lantus 13:04 Single-Leg Leg Presses 16:00 Cues for Back during Exercises 17:40 Discussing GLP-1s and Recent Popularity 21:10 Skip's Personal Experience with Retatrutide 29:29 Practical Applications of Retatrutide in Bodybuilding 34:18 Getting Most Carbs from Fruit 42:29 Client Adherence to Plans 47:16 Handling Clients Who Don't Adhere 50:50 Taking Breaks from Low-Dose GH 56:00 Defining Muscle Maturity and Considerations in Bodybuilding

Send us a textWhat if artificial intelligence could help eradicate discrimination and foster a more inclusive workplace? Tune into Politically High Tech as we sit down with the inspiring Dr. Frank Douglas, who takes us through his incredible journey from Guyana to becoming a leading figure in the pharmaceutical industry. Despite his remarkable achievements, including the development of drugs like Lantus and Allegra, Dr. Douglas shares the racial discrimination he faced and introduces his current mission with Safe Haven Dialogues to address systemic discrimination through personal narratives and cultural sensitivity.Explore the transformative potential of AI in combating systemic discrimination and enhancing creativity and teamwork in educational settings. Dr. Douglas and I discuss how Diversity, Equity, and Inclusion (DEI) initiatives have been pivotal, not just in his career but in driving innovation and opportunities across various fields. Real-life stories, including a career-changing incident at Xerox, highlight the vital role of meaningful DEI projects and the power of resilience and strategic problem-solving in overcoming workplace challenges.Dive deeper into the multifaceted perspectives on DEI, from appreciating its potential to recognizing the importance of execution over mere concepts. We wrap up with a thought-provoking discussion on the intersection of technology, social issues, and politics, and how platforms like Safe Haven Dialogues can facilitate these crucial conversations. Don't miss this enlightening episode that champions resilience, strategic solutions, and the undeniable power of inclusivity.Follow Dr. Frank Douglas at...https://safehavendialogues-llc.com/Facebookhttps://www.facebook.com/safehavendialoguesYouTubehttps://www.youtube.com/@SafeHavenDialoguesLLCLinkedInhttps://www.linkedin.com/in/dr-frank-l-douglas/Instagramhttps://www.instagram.com/safehavendllc/If you want to be a guest on my podcast, please Join podmatch, it is the best way to be organized to be in many podcasts without some sending some much messy e-mail threads.https://www.joinpodmatch.com/politically-high-techSupport the Show.Follow your host atYouTube and Rumble for video contenthttps://www.youtube.com/channel/UCUxk1oJBVw-IAZTqChH70aghttps://rumble.com/c/c-4236474Facebook to receive updateshttps://www.facebook.com/EliasEllusion/Twitter (yes, I refuse to call it X)https://x.com/politicallyht

It's In the News! A look at the top diabetes stories and headlines happening now. Top stories this week: A weekly basal plus semaglutide is in the works, but not for the US right now, Tandem updates it's app recall, liver targeted insulin study, a weird walking story, and Lance Bass educates about LADA.  Find out more about Moms' Night Out  Please visit our Sponsors & Partners - they help make the show possible! Learn more about Gvoke Glucagon Gvoke HypoPen® (glucagon injection): Glucagon Injection For Very Low Blood Sugar (gvokeglucagon.com) Omnipod - Simplify Life Learn about Dexcom  Edgepark Medical Supplies Check out VIVI Cap to protect your insulin from extreme temperatures Learn more about AG1 from Athletic Greens  Drive research that matters through the T1D Exchange The best way to keep up with Stacey and the show is by signing up for our weekly newsletter: Sign up for our newsletter here Here's where to find us: Facebook (Group) Facebook (Page) Instagram Twitter Check out Stacey's books! Learn more about everything at our home page www.diabetes-connections.com  Reach out with questions or comments: info@diabetes-connections.com Episode transcription with links: Hello and welcome to Diabetes Connections In the News! I'm Stacey Simms and every other Friday I bring you a short episode with the top diabetes stories and headlines happening now. XX Novo Nordisk moves ahead with a new combination: once-weekly insulin icodec and semaglutide. Called IcoSema, Novo plans to submit for approval in Europe, Canada, Japan and Australia but NOT the US. As we told you earlier this summer, icodec – once weeky basal insulin – was not approved by the US FDA. Semaglutide is the molecule underpinning Novo's immensely popular GLP-1 drugs Ozempic and Wegovy. Icodec has been approved as Awiqli in places like Europe, Canada, Japan and Australia but was snubbed by the FDA last month. The FDA has left the door open for another application, but Novo says they don't expect to iron it out this year. In studies, the combination worked well to lower A1C for people with type 2 and they lost weight. They also had fewer lows. https://www.fiercepharma.com/pharma/corrected-after-icodec-rejection-novo-nordisk-wont-file-application-once-weekly-insulin-and   XX An update from Tandm on their app recall. Back in March they notified users of the recall because of an issue that can cause rapid depletion of a user's t:slim X2 insulin pump battery. This battery depletion can result in the pump shutting down sooner than expected, which some customers have continued to experience even after an updated version of the app was released. Notices were emailed to impacted customers on August 9, 2024 with updated information and recommendations for helping avoid pump battery depletion. Tandem plans to release a new version of the app to address the remaining issues and will notify all users by email and app push notifications following its release. Impacted customers in the U.S. with questions about this recall can contact the Tandem Diabetes Care Technical Support Team 24 hours a day, 7 days a week at techsupport@tandemdiabetes.com or (877) 801-6901. https://www.businesswire.com/news/home/20240812040222/en/Tandem-Diabetes-Care-Provides-Update-on-March-2024-Nationwide-Recall-of-tconnect-Mobile-App-for-iOS-Devices XX If you are an adult who has type 1 diabetes, you may be eligible to participate in a trial examining the impact of an investigational liver-targeted insulin on blood glucose control, A1C, and nighttime lows. This study is researching whether administering a liver-targeting insulin called HDV-L insulin (Hepatocyte-directed Vesicles-insulin lispro), will improve glycemic control. HDV-L insulin is designed to act on the liver to enhance glucose storage and decrease the frequency of severe hypoglycemia in individuals requiring insulin. It is not currently approved for use. For this trial, researchers are recruiting roughly 230 adults with type 1 diabetes aged 18-79 who are on multiple daily injections (MDI). This study is recruiting in California, Colorado, Florida, Georgia, Illinois, Indiana, New York, North Carolina, Ohio, and Texas. To enroll or learn more about this study, contact Todd Hobbs, MD at Diasome Pharmaceuticals at thobbs@diasome.com or call 216-780-9324. Clinical Trials Identifier: NCT06238778 https://diatribe.org/diabetes-research/new-study-tests-liver-targeted-insulin-type-1-diabetes XX Sanofi is investing heavily to boost insulin production. They opened a new facility in Germany for the basal insulin Lantus and they announced they will invest over one billion dollars to expand production capacity in France. Sanofi's considerable investment in insulin production is especially important given that other insulin companies appear to be focusing their efforts on production of GLP-1 medications like Mounjaro and Ozempic, rather than insulin. This has left some patients worried that Novo Nordisk and Lilly will leave them behind to pursue more lucrative products for weight loss, especially after Novo Nordisk decided to discontinue the basal insulin Levemir. https://diatribe.org/diabetes-medications/sanofi-build-new-state-art-insulin-plant   XX Hoping to talk to Abbott and Medtronic soon about their partnership announced earlier this month. The companies announced that Abbot will create an integrated continuous glucose monitor that works only with Medtronic's diabetes technology and be sold exclusively by Medtronic. Along with announcing the partnership, Medtronic said Wednesday it received FDA approval for its Simplera CGM, which does not require fingersticks or overtape, unlike the company's previous sensors. The Simplera Sync sensor, which is designed to work with Medtronic's automated insulin delivery algorithm, is under FDA review separately. https://www.medtechdive.com/news/abbott-medtronic-partnership-automated-insulin-delivery/723600/ XX Researchers have developed a novel computer algorithm that can predict various diseases like diabetes or stroke, just by analysing the colour of the human tongue with 98 per cent accuracy. The imaging system developed by Middle Technical University (MTU) and the University of South Australia (UniSA) in Australia can diagnose conditions such as diabetes, stroke, anaemia, asthma, liver and gallbladder issues, Covid-19, and other vascular and gastrointestinal diseases. "The colour, shape, and thickness of the tongue can reveal a litany of health conditions," said Ali Al-Naji, adjunct Associate Professor at MTU and UniSA. The paper published in Technologies describes how the system analyses tongue colour to provide real-time diagnoses, demonstrating that AI can advance medical practices significantly. The breakthrough was achieved through a series of experiments using 5,260 images to train machine-learning algorithms to detect tongue colour. Researchers received 60 tongue images from two teaching hospitals in the Middle East, representing patients with diverse health conditions. The AI model matched tongue colour with the correct disease in nearly all cases. https://www.ndtv.com/world-news/new-algorithm-analyses-tongue-to-predict-diabetes-stroke-with-98-accuracy-6327124 XX Big roundup article from the UK Guardian all about 6 projects all around smart insulin. Not a lot new here, but it caused a lot of chatter. I'll link it up – good summary of all of the research happening in the space right now. Glucose-responsive insulin is the idea that you could give one injection and the insulin would respond to the rise and fall of glucose levels without further action by the person.   https://www.theguardian.com/society/article/2024/aug/11/scientists-hail-smart-insulin-responds-changing-blood-sugar-levels-real-time-diabetes XX Edgepark Commercial XX Lance Bass (like glass) continues to keep the public posted on his recent LADA diagnosis. The boy band singer showing his IG audience more about what's also called diabetes 1.5 and explaining how he was first diagnosed with type 2. XX Ok, brace yourself – I promise this is a real story. The Fart Walk is actually good for you. Ok.. stay with me. This is really just a great silly reframing of something we all know, and I couldn't resist putting it in here. A wellness influencer put this out – you may have seen it – claiming the after dinner stroll can limit your risk of type 2 diabetes. A lot of studies confirm that – along with it having benefits if you already have diabetes. The flatulence part – or a release of gastric pressure – is also a known benefit of moving more after meals. So it's funny, farts are always funny, but if it gets more people to walk after they eat I'm all for it.   https://people.com/fart-walk-benefits-what-is-it-type-2-diabetes-8694630#:~:text=Wellness%20influencer%20Mairlyn%20Smith%20has,of%20day%20you%20do%20it XX Join us again soon!

From Fast Acting Insulin like Humalog to Long Acting Insulin like Lantus, What Insulin Bodybuilders Use, When and How - Coaches Skip Hill, Andrew Berry & Scott McNally explain insulin in Bodybuilding TIME STAMPS BELOW - Only Use Insulin Under the Direct Guidance of a Medical Doctor Chapters: 00:00:00 - Insulin dosing and timing during cardio 00:03:02 - Managing blood sugar levels during meals 00:05:43 - Adjusting Insulin Dosage for Blood Sugar Levels 00:08:11 - Understanding Different Types of Insulin Used in Bodybuilding 00:10:55 - Combining Lantus with Humalog 00:13:56 - Optimizing Blood Sugar Levels with Insulin 00:16:29 - Understanding Insulin Dosage 00:19:09 - Strategies for Insulin Dosing 00:21:46 - The Importance of Patterns 00:24:12 - Tips for Insulin Dosing and Meal Timing 00:26:53 - Insulin Timing for Workouts 00:29:39 - Timing Your Carbohydrate Intake 00:32:19 - The Effects of Yohimbine on Blood Sugar Levels and Cardio Performance 00:35:16 - Using Insulin for Fat Burning 00:37:51 - Extreme Measures for Blood Sugar Control 00:40:21 - The Importance of Safety in Experimental Practices 00:43:05 - Building Mental Toughness in Fitness 00:45:27 - Extreme Fat Loss Scenarios 00:48:03 - Paying Attention to Patterns for Progress 00:50:46 - Using Insulin Post-Workout 00:53:20 - Insulin Carbohydrate Ratio 00:56:01 - Managing Carb Intake on Load Days 00:59:03 - Adjusting Insulin Sensitivities 01:01:40 - Contact and Information for Further Inquiries ✅ Presented by TRUE NUTRITION. Code : THINK http://www.truenutrition.com 3rd Party Tested, Discover the source that bodybuilders trust ! ✅ Amino Asylum code THINK for 20% off research chems, peptides, l-carnitine and more https://aminoasylum.shop/ref/122/

The episode highlights Jack's success in managing a tricky meal, and addresses challenges like coping with hypos in the summer heat. Mike and Jack discuss culinary adventures and practical tips, from adjusting Lantus dosage to staying hydrated. Mike is off work this week and he has been busy!! Find out in this episode! Also about a free access card to places like Merlin's Thorpe Park. Listener stories, including better time-in-range percentages and switching to insulin pumps, demonstrate the diabetes community's resilience. Upcoming plans, like a trip to Thorpe Park, show their proactive approach to managing diabetes. This episode emphasizes community support and valuable insights into the highs and lows of living with type 1 diabetes. 00:00 - Intro 01:13 - Chit chat 01:25 - Jack's Wins and Struggles 06:40 - Mike's Wins and Struggles 08:16 - Get a free access pass for Merlin 09:35 - Come see us in London 12:31 - Whats your average 14:32 - Did somebody say Just Food? 25:39 - Listener Wins Join the conversation and share your stories with the T1D community. Don't forget to rate, review, and subscribe to help others find the podcast. Follow The Podcast https://www.instagram.com/wearet1d Follow Mike https://www.instagram.com/t1d_mike Follow Jack https://www.instagram.com/t1d_jack Share your stories at https://wearet1d.com New episodes are released every Sunday & Wednesday PS. If you would like to be a guest on the podcast, please go to the website https://wearet1d.com/guest-booking and fill out the form.    

In this week's episode, Eoin answer some of your questions from Instagram. Some of the topics covered include:Dealing with hypos and dieting."Lantus lows".Dealing with eating the same foods but having different bloods.As always, be sure to rate, comment, subscribe and share. Your interaction and feedback really helps the podcast. The more Diabetics that we reach, the bigger impact we can make!Questions & Stories for the Podcast?:theinsuleoinpodcast@gmail.comConnect, Learn & Work with Eoin:https://linktr.ee/insuleoin Hosted on Acast. See acast.com/privacy for more information.

Rewind episode: The pressure to tackle pollution and climate change is increasing, as countries worldwide are eliminating greenhouse gases and moving away from fossil fuels. This shift towards a cleaner future has a lot of moving parts, especially as it relates to cleaning Canada's energy sector. Merran Smith, founder and Chief Innovation Officer at Clean Energy Canada, joins us to talk about whether Canada can affordably and realistically accelerate our clean energy transition to reach our net zero goals.   Related links LinkedIn, Merran Smith: https://www.linkedin.com/in/merran-smith-64603b63/  LinkedIn, Clean Energy Canada: https://www.linkedin.com/company/clean-energy-canada/ Clean Energy Canada: https://cleanenergycanada.org/   To subscribe using Apple Podcasts:  https://podcasts.apple.com/us/podcast/thinkenergy/id1465129405   To subscribe using Spotify: https://open.spotify.com/show/7wFz7rdR8Gq3f2WOafjxpl   To subscribe on Libsyn: http://thinkenergy.libsyn.com/ --- Subscribe so you don't miss a video: https://www.youtube.com/user/hydroottawalimited   Check out our cool pics on https://www.instagram.com/hydroottawa   More to Learn on https://www.facebook.com/HydroOttawa   Keep up with the posts on X: https://twitter.com/thinkenergypod ---- Trancript: Dan Seguin  00:06 This is thinkenergy, the podcast that helps you better understand the fast changing world of energy through conversations with game changers, industry leaders, and influencers. So join me, Dan Seguin, as I explore both traditional and unconventional facets of the energy industry. Hey, everyone, welcome back. Today, we're coming clean about what clean energy could look like in the near future. That's right. And with the help of our guests, we're going to define what clean energy means, specifically for Canada and the future of electricity. There is a rising pressure around the globe to transition away from fossil fuels, eliminate greenhouse gases, and challenge the status quo when it comes to pollution and tackling climate change. What does that mean for Canada and our place in a clean energy world? Obviously, there's a lot of moving parts when it comes to cleaning Canada's energy sector, particularly when it comes to transportation, and heating of our buildings. But there's more to it than just that. There's renewable energy, revamping and expanding the electricity grid and conserving energy. Not to mention innovation and technology that doesn't exist yet. That will all play a role in getting us to Canada's Net Zero targets. So here's today's big question. Can Canada affordably and realistically accelerate its transition to clean energy in time? Our guest today is Marren Smith, Founder and Chief Innovation Officer at Clean Energy Canada is a leading Think Tank, advancing clean energy and climate solutions. Marren has won numerous awards for her work and also serves as co chair of the BC government's Climate Solutions Council. Okay, Marren, let's kick things off by telling our listeners about yourself, your work, and what Clean Energy Canada is.   Marren Smith  02:23 Yeah, so I'll start with Clean Energy Canada, we're a think tank based at Simon Fraser University's Center for dialogue. And we focus on solutions to accelerate the transition to a clean energy economy. And so what do we actually do? You know, we do think tank things like analysis and policy advice. But what makes us really different is that one, we focus on the solutions, not the problems, all about solutions to we really like to bring together business industry unions, get everybody in the room and see if we can get consensus around the advice to governments so that they can move solutions forward faster. And thirdly, what we do is we do a lot of talking to Canadians about the energy transition, how it links to jobs, to a nick strong economy and more affordability. And so we think of ourselves actually as a do tank and not a think tank. And myself, I'm a fellow at Simon Fraser University, I founded Clean Energy Canada, I'm now moved on, I'm no longer the Executive Director. I'm the Chief Innovation Officer. And I had been asked over the years, in the last 10 years doing this work, to co chair a number of Climate and Energy advisory bodies for both the federal and British Columbia governments. And I think that's because I have a pretty long track record of bringing together unusual allies around solutions to environmental energy and economy problems. So that's a bit about me.   Dan Seguin  04:09 Now, I'm somewhat curious, how does Clean Energy Canada define clean energy? Is it in relation to zero emissions? Or is there more to it than that?   Marren Smith  04:22 Yeah, so for us, we talk about clean energy spanning both energy supply. So renewable electricity, for example, solar, wind, thermal, but also demand. And so our definition of clean energy includes, like, as I said, renewable electricity generation, but also energy storage, energy transmission, energy efficiency, and any of the technologies or services that decarbonize transportation buildings in these and other polluting parts of our economy. So we have a fairly large definition of clean energy. And you know it really, when you look at it, that is what energy is all about. It's not just about making the energy. It's about how you use it and the technology so that you can use it more efficiently.   Dan Seguin  05:18 Clean Energy Canada has been advocating for climate action since 2010; 12 years in what are three positive changes that have made the biggest impact in Canada? And what is one that has hindered success?   Marren Smith  05:37 Yeah, this is a great question. So the three positive changes that I see is, one, the cost of these clean energy technologies have dropped significantly. So the the solutions are cheaper. Secondly, is that we've really moved past the climate debate in Canada. And thirdly, is electric vehicles. And I just want to talk a bit about each of those if that's okay, so the costs of clean energy technologies, many people don't understand that. Over this last decade, the cost of solar has dropped yet again, it's dropped another 90%. Over those last decade, the cost of batteries, which are the heart of an electric vehicle have dropped about 90%, wind has dropped about 40%. And so, you know, a dozen years ago, clean energy Canada was talking about this is coming, we need to prepare Canada needs to be aware as an oil and gas producer, we need to be looking at this clean energy transition. But now, it's here, these technologies are ready for primetime. And the eccotemp economic opportunities are there to create jobs here in Canada around those clean energies. So that's significant. Um, the second one is I think we've all lived through and seen in the news, this debate about whether Canada should be acting on climate, whether it's real, whether Canada has any responsibility, whether it's feasible. And that's now become a real global conversation. And there's a clear message globally that we need to act now. And, you know, we've had over this last six years, federal government, with the leadership that's aligning with those global efforts to act on climate. And in fact, this federal government has created the first climate plan that Canada's had to meet our climate targets, and they're now really putting it into action. And so that's been a significant and positive shift that we're actually moving to action. And thirdly, is around electric vehicles. And, you know, I just have to say them specifically. Because, in my observation, they really show Canadians what the transition looks like. It kind of looks like what it used to be, you know, an electric vehicle and a gas fired vehicle, they look pretty similar. But people are seeing how much better they are that they are more affordable to drive, and especially the today's price of gas, you know, if you're plugging in and charging your car, you know, your Chevy Bolt and getting 400 kilometers for somewhere, you know, depending on where you live in Canada, five to ten dollars versus what it's costing to fill up your car that's significant. So electric vehicles and how fast they have come online, how we have seen, the manufacturers shift is to go from, we're resisting this to this as the future we want to be out in front and competing to be the ones who are going to be producing them. So that dramatic shift, it's really showing how we can link this decarbonisation climate action with the economy, that our industries can be successful and that we can really move forward towards netzero towards decarbonisation towards cleaner energies. And, you know, continue with a strong economy if we do at night, right if we act now. And I guess Lastly, about electric vehicles, it's for anybody who hasn't gotten in one yet, you really should, because they're pretty fun to drive. And that's what we want this energy transition to be. We want it to be make life better. And I think electric vehicles are just one way that people can see how, you know, once you get over the hurdle of purchasing one, it does make life better, cleaner air, more affordable to drive. Now, you asked the other question, what's hindered success? And I would say what's really hindered Canada's movement on all of this has been the debate and the governments that have really ripped up climate action or refused to move forward on climate action. And, you know, that's created uncertainty. So we've seen various governments in Ontario in Alberta, you know, federally across the country, I shouldn't just name those provinces, because across the country, governments who come in and who are not willing to take action on climate and really want to stick with the static quo. And that really creates a lot of uncertainty for business and doesn't drive the change. I'm really hopeful that we're not going to see that anymore. You know, now that we've seen this new inflation reduction act out of the United States, it is sending a clear signal that this is the biggest economic opportunity that there has been, you know, in this generation, absolutely. To drive and build this clean energy economy, they are investing heavily in it. And we're going to see in the United States, those kinds of investments happening all over the country, you know, in red states and blue states, blue collar workers are going to be you know, being employed in plants, white collar workers, rural urban, this, this is going to be a massive, massive growth for industries and the economy, in producing electricity producing batteries and producing all the component pieces towards them hydrogen, retrofitting buildings. So there is a huge boom coming. And I hope that in Canada, we actually see our government picking up on that as well and linking this decarbonisation with our economic strategy.   Dan Seguin  11:55 Marren, what do you mean when you state that the Clean Energy Transition is a once in a generation opportunity for Canada to build a resilient, growing and inclusive economy?   Marren Smith  12:10 Yeah, so we've just talked about how we're really seeing around the globe, you know, the United States, but we've been seeing this in the EU and the UK and China, this, you know, linking up their industrial strategy, their economic strategy, to their economic strategies. And so Canada really has what it takes to make this shift as well to, you know, take action on climate decarbonize and really shift from fossil fuels oriented economy to a clean energy or renewable energy economy. So we have the natural resources that are going to be needed, you know, those metals and minerals, for example, we're going to be needing that steel, that cobalt, that nickel to be building the transmission lines, the solar panels, and in particular, the batteries, which are really the heart of the clean energy system. So Canada has what it takes. And then secondly, we've got the clean electricity or grids about 83% clean or zero mission right now. We've got a skilled labor force. So that's what the opportunity is, it's going to be a massive effort for us to retool our existing industries and build some of these new industries. But we've got the potential to do it.   Dan Seguin  13:40 Next question. Now, what makes Canada well positioned to be a global clean energy leader?   Marren Smith  13:48 So Canada's got the natural resources that we talked about metals and minerals, forest products, agricultural products, we've got great solar and wind resources and a grid that's already at 3% zero emission. We have great potential for green hydrogen. And, you know, we've got great trading relationships with the US as well as Europe and Asia. So we are positioned to be creating clean energy and one of the things that we are uniquely positioned around our batteries. Batteries are going to be the heart of the energy system. So they're obviously the heart of the electric vehicle. But also, large scale batteries are going to be what backs up that intermittent or variable wind and solar and renewable energies, they're going to be a part of the system as well. And so Canada is the only country in the Western world. It's actually the only democratically elected country that has all the metals and minerals needed to produce batteries. So In addition, we've got the good clean electricity to actually manufacture those metals and minerals and turn them into, you know, refine them, turn them into cells and ultimately batteries. So we've got the key components there. And that one huge opportunity for Canada. And we're seeing you know, this federal government has been working with Ontario and Quebec and landing some significant battery company investments, you know, GM and Bay calm for this year, LG and still Lantus in Ontario. So that's I some of the key parts of why Canada is so well positioned to be a clean energy leader.   Dan Seguin  15:45 Next question for you. What are the strategies you employ to achieve your mission to accelerate Canada's transition to a renewably powered economy?   Marren Smith  15:56 Yeah, so one, I think that we work with businesses, industry unions, to understand what their needs are, you know, we're positioned at the Center for dialogue at Simon Fraser University. And so we use dialogue, bring people together, structure it so that we can have a deliberate conversation that gets us to advice for government. So that's one of the strategies we employ. A second one is, you know, we look around the world and we find out what policies are working elsewhere, what programs, what are other countries doing that's working? And what can we glean out of that, and use in the Canadian context, and feed that kind of information to governments and to industry about what they can do next? Because Kevin does not the only one doing this, and there's a lot of countries that are ahead of us on this. So let's learn from them, and Canadian eyes it. And then lastly, we really have an eye to bringing the public along with us in this conversation, ensuring that they understand the Clean Energy Transition exactly what does it mean, understand some of the policies when they get controversial? And understand what's in it for them? You know, and right now we're seeing a public that is got, you know, a lot of insecurity going on with the global state of affairs, the war in the Ukraine, you know, this energy prices escalating, there's a lot of misinformation going on. And so, actually having the public understand and see how they fit into the energy transition, and how it's going to make life better for them, is, I'd say, a very important part of the transition. And so we do what we can we actually study how to communicate with the public and study language, what works with them, what resonates and how to get the stories to them that are going to help them understand this energy transition, what they can do, and what they can support.   Dan Seguin  18:06 Marren wondering if you could unpack for our listeners, what are some of the ways clean energy Canada has contributed to our country's progress in the last year or two?   Marren Smith  18:19 Yeah, so we have been working hard over the last couple of years. And I'll tell you about some of the significant achievements that I think we've been part of making happen. So first is about electric vehicles, or zero emission vehicles, as they're called in some circles. We see these as a key part of the solution, and one that is getting ready for primetime. They're a key part of the solution, because one quarter of Canada's carbon pollution is from transportation. So we've got to tackle this and about half of it from passenger vehicles, half of it's from trucks and buses. And so we've been working on both sides of that equation. And one of the things that had become the barrier has been supply of cars. At this point, people want them and we're seeing the uptake of those cars, you know, double and triple year over year. And so how do you get the supply here and how you do that through a policy called the zero emission vehicle mandate that requires the automakers to sell them in, in Canada. And so that's one that we've been working on. We actually were successful in getting one in British Columbia. And you know, and I have to report to you that so far in 2022 17% of new car sales have been electric vehicles. So that just far outpaces what people predicted. I think we were trying to get to 10% by 2025. We've blown through that we've now increased our targets because clearly for Colombians are ready to buy them. And there's similar types of stats from Quebec, who also has a zero emission vehicle mandate. The challenge for the rest of the country, and you know, if you're in Ottawa, you're probably going and putting your name on the list. And it's multiple years, you might not even be able to get on the list anymore, because there just aren't any cars. And so we need a federal zero emission vehicle mandate that requires the companies to the automakers to sell electric vehicles in Canada, or they're penalized. So that's one thing that we've made good progress on and contributed to. One that I haven't talked much about, that I'll mention here is about the steel sector, the cement sector, these heavy industries that are also heavy polluters. And, you know, so that's another area we've been working on and looking for solutions. We're looking at, okay, much of this steel, cement, aluminum, it's all being used in the construction industry. So how do we get those who are building things and buying things to demand low carbon steel, low carbon cement, which will really help these industries put it'll push them to to decarbonize and so that program is called by clean. The biggest purchaser of steel and cement and, and these types of things in the country is the government and we've been working to get the government to commit to a bike clean policy. The really interesting thing is that the steel sector, the cement sector, the aluminum sector V, these sectors are really on board to decarbonizing, this is globally happening. We're seeing all of these industries recognize that they cannot be admitting the scale of pollution, they are right now they've got to reduce that carbon pollution get to net zero. And so, again, we're seeing progress on reducing emissions in that sector. And we're seeing, you know, the United States and Canada have actually said that they are going to work together on this bike lanes so that both countries are pushing that they will procure, they will only purchase low, lower carbon, steel, cement, etc, for building our hospital, roads, schools, and all those good things. So that's another one that I'd say we could say we've been involved with, and batteries, I've already talked about it. We've been involved in the batteries for the last few years, and bringing together that sector, from the mining sector, all the way up to battery producers and electric vehicle, you know, the automatic factoring companies like GM, and all the way to the recyclers, and working with government to get, you know, a battery strategy for Canada to really ensure that we lock in and land the most jobs and the most opportunities for Canadians across the country. And these would be jobs in different provinces and opportunities for different provinces, you know, rural urban jobs, etc. So it's a big opportunity, but Canada's got to act quickly if we really want to get the most benefits from it. And by the most benefits, I mean, we could be creating a quarter of a million jobs by 2030 in this sector, which would be good for the country and will help us as we're transitioning, you know, out of other job sectors.   Dan Seguin  23:36 Okay, Marren, are you able to expand on some of Clean Energy Canada's short term goals?   Marren Smith  23:44 Yeah. So I would say right now, our top short term goal is around public awareness and understanding how shifting to clean energy is going to help affordability for Canadians. I think this is critical and important, because you know, this electrification, people are very sensitive to the price of electricity and increasing costs of electricity. And so there's a piece of work to ship to understanding what your overall energy costs are. So as we move off of fossil fuels, that means you're not spending as much on gas anymore. You know, for your gas fired car, but your electricity bill is going to go up. As you shift off of the having gas to heat and cool your home and shifting to an electric heat pump, their electricity bills can go up. We did some research earlier this year. Report called the true cost looking at some of the top models of cars in Canada, what it costs to purchase one plus run it over eight years, and we'll probably talk a bit more about this letter later. So just to say having Canadians under stand that this shift, while it's gonna have some costs in the short term is a more affordable and a better option for Canadians.   Dan Seguin  25:11 You recently contributed to a white paper with Electric Mobility Canada, on how Canada can design an effective zero emission vehicle mandate. I'm curious, what are some of your recommendations?   Marren Smith  25:27 Yeah. So, I'd say trying to do this in a nutshell. So first of all, is accountability. So we need to ensure that automakers are accountable and keeping pace with demand. And we need to do that with legally binding annual sales requirements so that they have to sell X percent of cars that are electric, and that there's serious financial penalties for non compliance. And that's, that's really the nuts and bolts of a good zero emission vehicle mandate. There's a whole bunch of details in there. Some provinces, like you mentioned, Quebec, and BC, they already have one, so we just need to use this in provinces that don't have them. And then our other key aspect of the recommendations was speed, we need to really finalize this regulation next year, so that it takes effect with model year 2024. There's really no time to wait on this. And we can see the demand for cars is there. We really need to be able to get them into the hands of people right now while they want them.   Dan Seguin  26:37 Now, for my first follow up question, we all know that the lack of supply is a big issue when it comes to zero emission vehicle sales. What's driving that? Are automakers prioritizing other markets? Where they're required to sell more EVs?   Marren Smith  27:00 Yeah, well, that's exactly what we're seeing here. In Canada, the majority of the electric vehicles are going to British Columbia and Quebec, because they're required to sell them there. And, you know, they're going to other states in the United States that have similar types of mandates California at one, but there's a button doesn't down there. And so they're sending them where they need to, you know, in the past, they have been making more money selling, you know, SUVs, for example, those bigger, heavier cars are where they've been making most of their profits. And so they're trying to get rid of those in Canada while they can. But this world is accelerating so quickly. You know, I think once we get the zero emission vehicle mandate, that rules so that the automakers have to sell the cars, we're going to start seeing them arrive in Canada, and we've seen, you know, the Detroit three have all been doubling and tripling their commitment for how fast they're going to start getting cars going and coming off the line. And I think we're going to only see that accelerate in the future. So I'm hoping that, you know, it looks like the automakers are more and more committing to be producing the cars. So the next obstacle is going to be the supply chain and whether they can get the batteries and get the other materials to make them.   Dan Seguin  28:34 Okay, another follow up question for you, Marren. Are there provinces in Canada that get prioritized for EV over others for example, Quebec, or maybe BC?   Marren Smith  28:46 Yeah, absolutely. That's why there's there certain car makes and models that you can only get in BC and Quebec, and that will be related to the zero emission vehicle mandate, you know, they, they get, there's a stick and if they don't sell enough cars, they get penalized. So they make sure the cars are in BC and Quebec and that's really the best selling feature for why we need this to be a national program and have a federal zero emission vehicle mandate.   Dan Seguin  29:16 Now hand in hand with that, you convened a select group of industry stakeholders and other experts to develop a report on advancing the Canadian evey battery sector. What were some of the key takeaways from those consultations?   Marren Smith  29:34 Yeah, so the report we produced which you can find on our website at talks about this opportunity, and it is huge to produce batteries. We're talking upwards of 250,000 jobs by 2030 and $40 billion annually going to the Canadian revenues. So that's a great opportunity, but it's not going to happen without you. No creating a strategy to get there. And that is the top recommendation from this group of industry and other experts. The Canadian battery Task Force is what they're called, the top recommendation is we need to have a Canadian battery strategy, which is going to ensure that we target and focus the investment dollars in the right place, that we get the workforce setup. Because, you know, while we do have a great workforce in Canada, we're going to need more workers and with the right skills, and that we make sure that we get the infrastructure, we get the electricity, the clean electricity to the right places, and then we've got enough of it. You know, we've seen almost every battery Manor battery manufacturing plant, that set up so far, has mentioned the zero emission electricity that you can get in Canada. And that's one of the reasons why they chose to build in Canada. And these are big global companies that are choosing to land in Ontario and Quebec so far. And so we just, we need that kind of strategy to ensure that we can get the most out of this battery opportunity.   Dan Seguin  31:16 I like that. Okay. Let's move on. Can you tell us about your recent analysis that found electric vehicles are in fact cheaper, often by a lot than their gas counterpart? What models were you comparing and what factors were considered?   Marren Smith  31:38 Yeah, so we looked at some of the best selling cars in Canada. Things like the Chevy Bolt as the electric versus its gas counterpart, the Toyota Corolla, the Hyundai Kona versus the electric Kona, the Nissan LEAF versus the Honda Civic etcetera. So we did this for a number of the top selling cars, we looked at purchasing it, as well as operating it and maintaining it over an eight year period. And, you know, what we found is that in almost every case, you were saving money. And you know, we've had to update this because the price of gas has gone up so much. But the total costs savings are going electric range from 10 to $15,000, over eight years. That's significant savings. And, you know, as you talked about, you know, you notice that there's almost no maintenance costs for an electric vehicle. And that your cost of fueling is, you know, so much cheaper. And this was before gas was at $2, a leader. So roughly back the envelope, you know, those savings are going to jump in, for example, the Kona to about $18,000 or more, a lot of people don't understand how much more affordable an electric vehicle is. And they look at the sticker price of buying a new car. And that's what turns them away. At you know, so we're encouraging people to really understand, look at the long term. And we know that not everybody can go buy a new car, I didn't buy a new car ever in my life till I bought an electric vehicle. I always bought used cars. But the savings are significant. And of course, the added bonus is the you know, zero emissions, you're part of the solution and helping with climate change.   Dan Seguin  33:42 Okay, a follow up question here. Were there any expectations here?   Marren Smith  33:47 Yeah, so the Ford electric F-150. It was pretty close. Probably now if we did it with the the price or cost of gas now, you would actually be more affordable on the Ford F-150 We haven't gone back to it. The other thing to note on this is that electric vehicles are really holding their value. So if you're someone who likes to buy a new car and sell it in eight or so years, your electric vehicle used car sales are much higher than when you buy a new gas fire vehicle and then sell it off.   Dan Seguin  34:27 When it comes to the electricity grid Canada is 83% emission free and with lower electricity rates than many other countries. We seem to be in an enviable position. But in your report underneath it all. Your findings show that Canada may not be as prepared for a carbon neutral world, as we may think. Now, for the big question, why is that?   Marren Smith  34:55 Yeah, we are ahead. But it's not just about Getting from 83% zero emission to 100%. If that was the only challenge before us, you know, it would take some work, but that's extremely doable. But this energy transition is really the whole sale, reengineering of many of our supply chains, almost the entirety of the energy system that powers the economy, it's huge. And we are going to need to double the amount of electricity we produce by 2050, as we shift our cars or homes or businesses off of fossil fuels and onto the grid. So that's the main message of our report is, you know, we need we have great opportunity here. But we need to double the size of the grid so that we are able to plug our cars and our home heating and cooling and our industries into that zero emission grid.   Dan Seguin  35:53 Okay, follow up question here. What are four reasons Canada needs to achieve 100%? clean electricity supply? And what are some of your recommendations?   Marren Smith  36:06 Yeah. So, you know, first off, it's so that we can effectively combat climate change. And that's, you know, top reason why we're doing this, it's also going to diversify and strengthen Canada's economy. You know, as I said, companies are looking to be powered by zero emission electricity. We've seen those battery plants coming here, one of the reasons cited, and there's more opportunities as more of the the world's industries really focus on how are they going to be net zero, for example, we see Walmart and Amazon, those companies are looking for supply chains that are zero emission, they're counting their carbon, and that includes their transportation. So it's, it's about making Canada competitive and ensuring that we are an attractive place because we can power our economy and our communities with clean electricity. The third reason is around the potential for indigenous reconciliation efforts in clean energy ownership. I think this is a very exciting opportunity. There's already a lot of indigenous communities that own or are partners in clean energy, and we can expand that as this moves forward. And then lastly, is we started talking about affordability on this podcast. And, you know, once you get over the purchasing of the new technologies, it's really more affordable to be plugged into a zero emission grid. And that's going to create more certainty, more security around energy supply.   Dan Seguin  37:51 Marren, what are some of the other benefits to increasing Canada's clean electricity supply?   Marren Smith  37:58 So you know, one, we need clean electricity to meet our climate targets. Secondly, it's around affordability. This is going to help make energy more affordable for communities. And then another benefit. It's clean air, of course, you know, once you shift off of diesel buses, for example, to electric buses out of diesel trucks to electric trucks, you're really cleaning up air quality in cities in particular, but in all communities. And then there's another potential benefit. You know, Canada, most people don't know this, we actually export 8%, for electricity right now to America, that brings in $2.6 billion. And you know, the US has the same commitments around getting to 100% clean electricity grid by 2035. There's a lot dirtier than ours, they've got a lot of catching up to do. And there's a potential for Canada that has an enormous wealth of potential for renewable electricity across the country. Places like you know, Alberta and Saskatchewan have incredible solar resources. We have wind opportunities, you know, offshore onshore. So there's potential for us to be investing in clean electricity, not just for our own needs, but as a immensely valuable export that's going to be in demand in the United States. And then link to that economic opportunity is green hydrogen. We're hearing more about hydrogen can something that Europe's looking at shifting off of natural gas onto green hydrogen, which is made you know, with water getting split with electricity and turned into hydrogen so that's a good clean energy source and something that candidate could also be a leader in.   Dan Seguin  39:56 Okay, tough part is over. We always end our interviews with some rapid fire questions. We've got some for you. Are you ready?   Marren Smith  40:07 I am. I'm ready. Okay,   Dan Seguin  40:09 So for the first one, what are you reading right now?   Marren Smith  40:12 So I just read picked up a book that I read a number of years ago, The Hearts Invisible Theories by John Bowen. It takes place in Ireland in the starts in the 40s, and follows the life of the other boy, that a man as he's going through, really coming into his own and discovering himself, and it's just beautifully written really great book.   Dan Seguin  40:40 Okay. What would you name your boat if you had one? Or do you have one?   Marren Smith  40:45 Well, you know, I lived on one for 11 years. And that boat was called Potential, but I thought about this permanent name of boat. Right now. I might name it unplugged, you know, because it would be the the ticket to just taking off and, and having some fun.   Dan Seguin  41:03 Who is someone that you admire?   Marren Smith  41:06 Yeah, I don't know, if you've heard of Christiana Figueres she was, for a number of years, the United Nations UNFCCC, which was the framework on climate change in the UN, she was the executive secretary there, she is just a fantastic climate leader, she is always positive. She continues to be optimistic in spite of all the challenges in this world, and so it got a smile on her face while she continues to do this work.   Dan Seguin  41:43 Next question, what is the closest thing to real magic that you've witnessed?   Marren Smith  41:50 Maybe 15 years ago, I used to work up in what's called the Great Bear Rainforest off the coast of British Columbia, we're taking our group of people out to go see the place and experience it the beautiful ancient rainforest, an area the size of Ireland. And we were whalewatching, watching humpback whales, and they go around in a circle, and they blow their bubbles and make a net out of it. And then they all go down, and they come up in the middle. So there was four of them doing this and they come up in the middle, they make that net around a little school of fish, and they open their mouths and come up and and scoop up all the fish. And we were watching them do that. And then suddenly, I looked off this side of the boat, and there was all these little fish leaping out of the water. And suddenly, the whales picked up our boat and lifted it out of the water. And so it was just amazing. And there they were, then they just kind of sit around at the top, we could have just reached over and pat them. And then I was like, oh my god, I just I wonder if they're hurt. And as we sat there, they all sort of swam away. And they completely breached came out of the water from nose from tip to tail, you could see them all, they hadn't done this before, one after the other all for them. So you could see that they were just fine. And then they swam away.   Dan Seguin  43:24 Okay, moving on to the next one here. What has been the biggest challenge to you personally, since the pandemic began?   Marren Smith  43:32 Yeah, it's been this plethora of Zoom meeting staring at a screen hours after hour. And I'll tell you that I zipped out and got myself a stationary bike. And so during those zoom calls, everybody at first was laughing at me because I'd be kind of wiggling back and forth as I rode the bike slowly, just to keep myself going. And now all kinds of colleagues have now purchased stationary bikes as well.   Dan Seguin  44:09 Okay. We've all been watching a lot more Netflix and TV lately. What's your favorite movie or show right now?   Marren Smith  44:17 You know, a number of months ago, my family and I went to see The Last City with Sandra Bullock just like a ridiculous funny comedy and I was laughing out loud. And I was just like, you know, it was after the depths of COVID. It just felt great to laugh out loud at something that was just completely goofy and frivolous.   Dan Seguin  44:43 Lastly, what's exciting you about your industry right now?   Marren Smith  44:49 It's the potential for the speed of change. You know, things are moving quickly. And it's that things can move quickly now Technology is ready for primetime. public understands that we need to take climate action. And governments and business are really seeing that economic strategy is going, you know, is is so linked to climate action. They see them as one in the same decarbonisation is what the economic future looks like.   Dan Seguin  45:25 Well, Marren, we've reached the end of another episode of the thinkenergy podcast, if our listeners want to learn more about you and your organization, how could they connect?   Marren Smith  45:37 Yeah, you can find us at cleanenergycanada.org. And you can also sign up on that for the Clean Energy Review, which is an email we send out every Monday morning that I hear from people in all walks of life from CEOs and ministers to receptionists and friends who don't even work in this. It's got the top 10 upbeat, optimistic solution based stories of the week, you can scan it in two minutes, or you can click on things and dive into these things in more details.   Dan Seguin  46:11 Again, Marren, thank you so much for joining us today. I hope you had a lot of fun. Cheers.   Marren Smith  46:16 I do. Thanks a lot for having me.   Dan Seguin  46:19 Thanks for tuning in to another episode of the thinkenergy podcast. And don't forget to subscribe and leave us a review wherever you're listening. And to find out more about today's guests, or previous episodes, visit thinkenergypodcast.com. I hope you'll join us again next time as we spark even more conversations about the energy of tomorrow.  

Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name Insulin detemir, Insulin glargine Trade Name Levemir, Lantus Indication hyperglycemia with diabetes type 1 and 2, diabetic ketoacidosis Action stimulates uptake of glucose into muscle and fat cells, inhibits production of glucose in the liver, prevents breakdown of fat and protein Route Onset Peak Duration Detemir 3-4 hr 3-14 hr 24 hr Glargine 3-4 hr none 24 hr   Therapeutic Class antidiabetics, hormones Pharmacologic Class pancreatics Nursing Considerations • assess for symptoms of hypoglycemia or hyperglycemia • monitor body weight over time • may cause decreased inorganic phosphates, potassium, and magnesium • monitor blood sugars every 6 hours, monitor A1C every 3-6 months

It's In the News, a look at the top stories and headlines from the diabetes community happening now. Top stories this week: Insulin-maker Sanofi lowers its prices and also acquires Provention, clinical trials begin on an out-patient surgery that could help treat type 2 diabetes, a swimmer DQ'd for the tape on his CGM gets the systemic changes he'd pushed for and more! Please visit our Sponsors & Partners - they help make the show possible! Take Control with Afrezza  Omnipod - Simplify Life Learn about Dexcom  Check out VIVI Cap to protect your insulin from extreme temperatures Learn more about AG1 from Athletic Greens  Drive research that matters through the T1D Exchange The best way to keep up with Stacey and the show is by signing up for our weekly newsletter: Sign up for our newsletter here Here's where to find us: Facebook (Group) Facebook (Page) Instagram Twitter Check out Stacey's books! Learn more about everything at our home page www.diabetes-connections.com  Reach out with questions or comments: info@diabetes-connections.com Episode Transcription: Hello and welcome to Diabetes Connections In the News! I'm Stacey Simms and these are the top diabetes stories and headlines happening now XX In the news is brought to you by Athletic Greens ● AG1 is way more than greens. XX XX Provention Bio's been in a news a lot lately after the approval of Tzield to delay the development of type 1. Now French insulin-maker Sanofi has agreed to acquire it. The deal builds on an existing co-promotion agreement and gives Sanofi full ownership of the drug. Sanofi makes long acting Toujeo and Lantus. Interestingly, Sanofi has said they're gong to stop further work on type 2 diabetes and obesity drugs. They also joined Novo Nordisk and Eli Lilly in dropping the price of insulin in the US. https://www.reuters.com/markets/deals/frances-sanofi-acquire-us-based-provention-bio-29-bln-2023-03-13/ XX Insulin pricing staying in the news as Senators Bernie Sanders and Cori Bush introduced legislation to cap the price at 20-dollars. They point out the recent prices cuts don't apply to everyone and are still at the whim of the manufacturers. XX California signs up with Civica Rx to produce its own insulin and sell it at an affordable price. The $50 million investment will allow California to produce insulin to be sold at prices capped at $30 per vial and $55 for a box of five prefilled pens, Civica Rx said (PDF) in a release. The agreement is part of the state's CalRx Biosimilar Insulin Initiative. Utah-based Civica Rx is a nonprofit, social welfare manufacturer of generic drugs. This is a long way off.. Civica Rx still needs to gain approval for its biosimilar versions of Sanofi's Lantus (gargline), Eli Lilly's Humalog (lispro) and Novo Nordisk's Novolog (aspart). The cost of insulin would be same for all patients regardless of their insurance situation https://www.fiercepharma.com/manufacturing/california-invests-50m-partner-civica-rx-insulin-manufacturing XX XX (skip?) Millions of Americans with diabetes have cheered as drugmakers slashed the price of insulin, the lifesaving medication that treats the chronic disease. But those lower prices, which came amid government pressure to cap insulin costs and more competition from generics and biosimilars, are only one part of the cost of treating the disease, which causes elevated blood sugar that can damage the heart, eyes and kidneys if untreated. Over-the-counter medical supplies to monitor glucose levels and administer medications can make up the largest portion of a patient's costs. A 2020 JAMA Internal Medicine report found that children and adults with private health insurance spent more out-of-pocket on diabetes-related supplies than on insulin A person with diabetes who uses insulin typically spends $4,882 a year on treatment if they have insurance. Of that, $3,992 is spent on supplies, according to an analysis by GoodRx, or more than 80% of the annual expense of managing the disease https://www.usatoday.com/story/money/personalfinance/2023/03/19/cost-diabetes-supplies-worse-than-insulin/11472381002/ XX New trial of a technique to slow the progression of type 2 diabetes. It's a simple outpatient surgery conducted in the early stages of diagnosis. The procedure targets the doo-oh-DEE-num duodenum, the first section of the small intestine just past the stomach. This organ plays a key role in digestion, including regulating insulin and blood glucose levels. In patients with type 2 diabetes, the cells that line the duodenum have become damaged, and the trial's hypothesis is that removing these cells helps healthy ones to grow back, improving the regulation of blood glucose levels. Patients in the clinical trial would undergo an endoscopy to insert a device into the doo-oh-DEE-num duodenum, which removes those dysfunctional cells with a series of electrical pulses. The procedure itself is only minimally invasive – it takes about an hour, it's conducted under a general anaesthetic and the patient is discharged the same day. Early results seem encouraging. Patients who have undergone the procedure in recent months have already seen their blood glucose levels drop. BTW if you live near L-A they're still recruiting for this. You have to have a type 2 diagnosis and not yet need insulin injections. https://newatlas.com/medical/diabetes-prevent-slow-progression-procedure-clinical-trial/ XX Another study showing automated insulin delivery systems work well and are safe, this one the Tandem Control IQ in little kids. That's only approved right now for kids as young as six.. this study looked at children ages two to six. The hybrid closed-loop system added an average of about 3 hours in ideal blood glucose range over the 13 weeks, compared to no change with standard care. Standard care here meant either an insulin pump or multiple daily injections plus a separate Dexcom G6 CGM. https://www.medscape.com/viewarticle/989673 XX Follow up! Two years ago we told you about Ethan Orr, a Colorado high school swimmer disqualified at a state meet because of the tape over his CGM. Orr's family filed a complaint with the department of justice and the US Attorney in Colorado took up the case. They weren't seeking any financial damages, just a change in policy, which they got. The changes include allowing medical tape with documentation, a way to evaluate requests from students with disabilities who might need reasonable modifications of rules, and a way for refs or coaches to seek on the spot reasonable modifications. - “I knew I'd have to fight my disease to swim, but I never imagined I'd have to fight discrimination to swim,” Ethan said, according to the news release from the law firm. XX Athletic Greens XX Today, JDRF, the leading global type 1 diabetes (T1D) research and advocacy organization, presented the inaugural Mary Tyler Moore Awards to three women leaders in Congress who have been instrumental in the fight against T1D. U.S. Senators Susan Collins (R-ME) and Jeanne Shaheen (D-NH), co-chairs of the Senate Diabetes Caucus, were honored alongside Representative Diane DeGette (D-CO), co-chair of the Congressional Diabetes Caucus, for their longstanding support of the T1D community. The ceremony, held during JDRF's annual Government Day, honored the legacy of screen icon Mary Tyler Moore, who was diagnosed with T1D at the age of 33. As international chairman of JDRF from 1984 to 2017, Moore used her influence to bring government, scientists and people living with diabetes together to further T1D advocacy and innovation. JDRF (PRNewsFoto/JDRF) JDRF (PRNewsFoto/JDRF) One of Moore's most significant achievements as JDRF international chairman was increased Congressional funding for the Special Diabetes Program at the National Institutes of Health that has accelerated the pace of type 1 diabetes research. This long-term investment in diabetes research has led to significant scientific breakthroughs including Tzield, the first disease modifying treatment for T1D which can delay the onset of the disease by over two years. JDRF Government Day volunteers, more than 175 T1D advocates from across the country, will encourage members of Congress to renew the Special Diabetes Program when they visit lawmakers later today on Capitol Hill. https://finance.yahoo.com/news/jdrf-presents-inaugural-mary-tyler-110000226.html XX On the podcast next week.. . That's In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.

En el caso de la soldado muerta, el ejército dice que hasta el momento no hay nada sospechoso y que se podía tratar de un suicidio.Tormentas severas en Dallas.Un tren derramó 5 mil galones de diesel tras descarrilamiento.En California las fuertes tormentas ayudan a combatir la sequía.Las familias de bajos recursos de Nueva York cuenta con una nueva herramienta para acceder a un apoyo financiero.Sanofi redujo el precio de Lantus.Pfizer retira del mercado 4 millones de envases de medicamentos para la migraña.¿Adiós al tacto rectal para el examen de próstata?EE.UU. emitir una orden para el uso de la aplicación en dispositivos del gobierno. 

Join me in todays episode where I discuss the differences between Novorapid and Lantus. I go through as and when I use them with clients and the benefits they both bring to the table. I specialise in athletes in their 1st to 3rd year, if you are looking to step on stage in 2023/2024 then enquire today.  Drop me a follow on instagram: @vwphysique

Working together towards health equity. In this episode, Kyle talks with Kati Sadiwnyk, Head of Lantus and Biosimilars at Sanofi, about how she's advocating for patients and what the partnership with DarioHealth seeks to bring. She explains some of the advocacy programs that Sanofi is working on, focusing on insulin affordability and behavioral modification. Finally, Kati shares her thoughts on value-based contracts and a personal anecdote that made her see the value of being a vulnerable leader. Listen to what Kati says about patient advocacy and Sanofi's work to improve health equity! Click this link to the show notes, transcript, and resources: outcomesrocket.health

Here are the links for everything discussed in Episode 86. Times are also below so feel free to skip around and get to the updates that interest you.  (1:17) FDA approves Tzield for Type 1 Diabetes (5:45) Rezvoglar approved as interchangeable biosimilar (6:32) New EUA for Kineret for COVID19 CDC website for COVID information - get boosted!FDA monkeypox response websiteConnect with The Rx Daily Dose:Twitter      Instagram      YouTube      Linkedin       WebsiteEmail: therxdailydose@gmail.comConnect with Ian Parnigoni PharmD. on social media:Twitter       Instagram       Linkedin  ★ Support this podcast on Patreon ★

Newly approved gynecologic cancer treatment; Zejula has it's use restricted; intrauterine system use extended; a second insulin product is approved as a biosimilar to Lantus; and an FDA Advisory Committee take a vote on tenapanor.

The pressure to tackle pollution and climate change is increasing as countries around the globe are eliminating greenhouse gases transitioning away from fossil fuels. This shift towards a cleaner future involves a lot of moving parts, especially as it relates to cleaning Canada's energy sector. Merran Smith, founder and Chief Innovation Officer at Clean Energy Canada, joins us to talk about whether Canada can affordably and realistically accelerate our clean energy transition to reach our net zero goals.    Related links LinkedIn, Merran Smith: https://www.linkedin.com/in/merran-smith-64603b63/ LinkedIn, Clean Energy Canada: https://www.linkedin.com/company/clean-energy-canada/ Clean Energy Canada: https://cleanenergycanada.org/   To subscribe using Apple Podcasts:  https://podcasts.apple.com/us/podcast/thinkenergy/id1465129405   To subscribe using Spotify: https://open.spotify.com/show/7wFz7rdR8Gq3f2WOafjxpl   To subscribe on Libsyn: http://thinkenergy.libsyn.com/ --- Subscribe so you don't miss a video: https://www.youtube.com/user/hydroottawalimited   Check out our cool pics on https://www.instagram.com/hydroottawa   More to Learn on https://www.facebook.com/HydroOttawa   Keep up with the Tweets at https://twitter.com/thinkenergypod   Transcript   Dan Seguin  00:06 This is thinkenergy, the podcast that helps you better understand the fast changing world of energy through conversations with game changers, industry leaders, and influencers. So join me, Dan Seguin as I explore both traditional and unconventional facets of the energy industry. Hey, everyone, welcome back. Today, we're coming clean about what clean energy could look like in the near future. That's right. And with the help of our guests, we're going to define what clean energy means, specifically for Canada and the future of electricity. There is a rising pressure around the globe to transition away from fossil fuels, eliminate greenhouse gases, and challenge the status quo when it comes to pollution and tackling climate change. What does that mean for Canada and our place in a clean energy world? Obviously, there's a lot of moving parts when it comes to cleaning Canada's energy sector, particularly when it comes to transportation, and heating of our buildings. But there's more to it than just that. There's renewable energy, revamping and expanding the electricity grid and conserving energy. Not to mention innovation and technology that doesn't exist yet. That will all play a role in getting us to Canada's Net Zero targets. So here's today's big question. Can Canada affordably and realistically accelerate its transition to clean energy in time? Our guest today is Marren Smith, Founder and Chief Innovation Officer at Clean Energy Canada is a leading Think Tank, advancing clean energy and climate solutions. Marren has won numerous awards for her work and also serves as co chair of the BC government's Climate Solutions Council. Okay, Marren, let's kick things off by telling our listeners about yourself, your work, and what Clean Energy Canada is.   Marren Smith  02:23 Yeah, so I'll start with Clean Energy Canada, we're a think tank based at Simon Fraser University's Center for dialogue. And we focus on solutions to accelerate the transition to a clean energy economy. And so what do we actually do? You know, we do think tank things like analysis and policy advice. But what makes us really different is that one, we focus on the solutions, not the problems, all about solutions to we really like to bring together business industry unions, get everybody in the room and see if we can get consensus around the advice to governments so that they can move solutions forward faster. And thirdly, what we do is we do a lot of talking to Canadians about the energy transition, how it links to jobs, to a nick strong economy and more affordability. And so we think of ourselves actually as a do tank and not a think tank. And myself, I'm a fellow at Simon Fraser University, I founded Clean Energy Canada, I'm now moved on, I'm no longer the Executive Director. I'm the Chief Innovation Officer. And I had been asked over the years, in the last 10 years doing this work, to co chair a number of Climate and Energy advisory bodies for both the federal and British Columbia governments. And I think that's because I have a pretty long track record of bringing together unusual allies around solutions to environmental energy and economy problems. So that's a bit about me.   Dan Seguin  04:09 Now, I'm somewhat curious, how does Clean Energy Canada define clean energy? Is it in relation to zero emissions? Or is there more to it than that?   Marren Smith  04:22 Yeah, so for us, we talk about clean energy spanning both energy supply. So renewable electricity, for example, solar, wind, thermal, but also demand. And so our definition of clean energy includes, like, as I said, renewable electricity generation, but also energy storage, energy transmission, energy efficiency, and any of the technologies or services that decarbonize transportation buildings in this Three and other polluting parts of our economy. So we have a fairly large definition of clean energy. And you know it really, when you look at it, that is what energy is all about. It's not just about making the energy. It's about how you use it and the technology so that you can use it more efficiently.   Dan Seguin  05:18 Clean Energy Canada has been advocating for climate action since 2010; 12 years in what are three positive changes that have made the biggest impact in Canada? And what is one that has hindered success?   Marren Smith  05:37 Yeah, this is a great question. So the three positive changes that I see is, one, the cost of these clean energy technologies have dropped significantly. So the the solutions are cheaper. Secondly, is that we've really moved past the climate debate in Canada. And thirdly, is electric vehicles. And I just want to talk a bit about each of those if that's okay, so the costs of clean energy technologies, many people don't understand that. Over this last decade, the cost of solar has dropped yet again, it's dropped another 90%. Over those last decade, the cost of batteries, which are the heart of an electric vehicle have dropped about 90%, wind has dropped about 40%. And so, you know, a dozen years ago, clean energy Canada was talking about this is coming, we need to prepare Canada needs to be aware as an oil and gas producer, we need to be looking at this clean energy transition. But now, it's here, these technologies are ready for primetime. And the eccotemp economic opportunities are there to create jobs here in Canada around those clean energies. So that's significant. Um, the second one is I think we've all lived through and seen in the news, this debate about whether Canada should be acting on climate, whether it's real, whether Canada has any responsibility, whether it's feasible. And that's now become a real global conversation. And there's a clear message globally that we need to act now. And, you know, we've had over this last six years, federal government, with the leadership that's aligning with those global efforts to act on climate. And in fact, this federal government has created the first climate plan that Canada's had to meet our climate targets, and they're now really putting it into action. And so that's been a significant and positive shift that we're actually moving to action. And thirdly, is around electric vehicles. And, you know, I just have to say them specifically. Because, in my observation, they really show Canadians what the transition looks like. It kind of looks like what it used to be, you know, an electric vehicle and a gas fired vehicle, they look pretty similar. But people are seeing how much better they are that they are more affordable to drive, and especially the today's price of gas, you know, if you're plugging in and charging your car, you know, your Chevy Bolt and getting 400 kilometers for somewhere, you know, depending on where you live in Canada, five to ten dollars versus what it's costing to fill up your car that's significant. So electric vehicles and how fast they have come online, how we have seen, the manufacturers shift is to go from, we're resisting this to this as the future we want to be out in front and competing to be the ones who are going to be producing them. So that dramatic shift, it's really showing how we can link this decarbonisation climate action with the economy, that our industries can be successful and that we can really move forward towards netzero towards decarbonisation towards cleaner energies. And, you know, continue with a strong economy if we do at night, right if we act now. And I guess Lastly, about electric vehicles, it's for anybody who hasn't gotten in one yet, you really should, because they're pretty fun to drive. And that's what we want this energy transition to be we want it to be make life better. And I think electric vehicles are just one way that people can see how, you know, once you get over the hurdle of purchasing one, it does make life better, cleaner air, more affordable to drive. Now, you asked the other question, what's hindered success? And I would say what's really hindered Canada's movement on all of this has been the debate and the governments that have really ripped up climate action or refused to move forward on climate action. And, you know, that's created uncertainty. So we've seen various governments in Ontario in Alberta, you know, federally across the country, I shouldn't just name those provinces, because across the country, governments who come in and who are not willing to take action on climate and really want to stick with the static quo. And that really creates a lot of uncertainty for business and doesn't drive the change. I'm really hopeful that we're not going to see that anymore. You know, now that we've seen this new inflation reduction act out of the United States, it is sending a clear signal that this is the biggest economic opportunity that there has been, you know, in this generation, absolutely. To drive and build this clean energy economy, they are investing heavily in it. And we're going to see in the United States, those kinds of investments happening all over the country, you know, in red states and blue states, blue collar workers are going to be you know, being employed in plants, white collar workers, rural urban, this, this is going to be a massive, massive growth for industries and the economy, in producing electricity producing batteries and producing all the component pieces towards them hydrogen, retrofitting buildings. So there is a huge boom coming. And I hope that in Canada, we actually see our government picking up on that as well and linking this decarbonisation with our economic strategy.   Dan Seguin  11:55 Marren, what do you mean when you state that the Clean Energy Transition is a once in a generation opportunity for Canada to build a resilient, growing and inclusive economy?   Marren Smith  12:10 Yeah, so we've just talked about how we're really seeing around the globe, you know, the United States, but we've been seeing this in the EU and the UK and China, this, you know, linking up their industrial strategy, their economic strategy, to their economic strategies. And so Canada really has what it takes to make this shift as well to, you know, take action on climate decarbonize and really shift from fossil fuels oriented economy to a clean energy or renewable energy economy. So we have the natural resources that are going to be needed, you know, those metals and minerals, for example, we're going to be needing that steel, that cobalt, that nickel to be building the transmission lines, the solar panels, and in particular, the batteries, which are really the heart of the clean energy system. So Canada has what it takes. And then secondly, we've got the clean electricity or grids about 83% clean or zero mission right now. We've got a skilled labor force. So that's what the opportunity is, it's going to be a massive effort for us to retool our existing industries and build some of these new industries. But we've got the potential to do it.   Dan Seguin  13:40 Next question. Now, what makes Canada well positioned to be a global clean energy leader?   Marren Smith  13:48 So Canada's got the natural resources that we talked about metals and minerals, forest products, agricultural products, we've got great solar and wind resources and a grid that's already at 3% zero emission. We have great potential for green hydrogen. And, you know, we've got great trading relationships with the US as well as Europe and Asia. So we are positioned to be creating clean energy and one of the things that we are uniquely positioned around our batteries. Batteries are going to be the heart of the energy system. So they're obviously the heart of the electric vehicle. But also, large scale batteries are going to be what backs up that intermittent or variable wind and solar and renewable energies, they're going to be a part of the system as well. And so Canada is the only country in the Western world. It's actually the only democratically elected country that has all the metals and minerals needed to produce batteries. So In addition, we've got the good clean electricity to actually manufacture those metals and minerals and turn them into, you know, refine them, turn them into cells and ultimately batteries. So we've got the key components there. And that one huge opportunity for Canada. And we're seeing you know, this federal government has been working with Ontario and Quebec and landing some significant battery company investments, you know, GM and Bay calm for this year, LG and still Lantus in Ontario. So that's I some of the key parts of why Canada is so well positioned to be a clean energy leader.   Dan Seguin  15:45 Next question for you. What are the strategies you employ to achieve your mission to accelerate Canada's transition to a renewably powered economy?   Marren Smith  15:56 Yeah, so one, I think that we work with businesses, industry unions, to understand what their needs are, you know, we're positioned at the Center for dialogue at Simon Fraser University. And so we use dialogue, bring people together, structure it so that we can have a deliberate conversation that gets us to advice for government. So that's one of the strategies we employ. A second one is, you know, we look around the world and we find out what policies are working elsewhere, what programs, what are other countries doing that's working? And what can we glean out of that, and use in the Canadian context, and feed that kind of information to governments and to industry about what they can do next? Because Kevin does not the only one doing this, and there's a lot of countries that are ahead of us on this. So let's learn from them, and Canadian eyes it. And then lastly, we really have an eye to bringing the public along with us in this conversation, ensuring that they understand the Clean Energy Transition exactly what does it mean, understand some of the policies when they get controversial? And understand what's in it for them? You know, and right now we're seeing a public that is got, you know, a lot of insecurity going on with the global state of affairs, the war in the Ukraine, you know, this energy prices escalating, there's a lot of misinformation going on. And so, actually having the public understand and see how they fit into the energy transition, and how it's going to make life better for them, is, I'd say, a very important part of the transition. And so we do what we can we actually study how to communicate with the public and study language, what works with them, what resonates and how to get the stories to them that are going to help them understand this energy transition, what they can do, and what they can support.   Dan Seguin  18:06 Marren wondering if you could unpack for our listeners, what are some of the ways clean energy Canada has contributed to our country's progress in the last year or two?   Marren Smith  18:19 Yeah, so we have been working hard over the last couple of years. And I'll tell you about some of the significant achievements that I think we've been part of making happen. So first is about electric vehicles, or zero emission vehicles, as they're called in some circles. We see these as a key part of the solution, and one that is getting ready for primetime. They're a key part of the solution, because one quarter of Canada's carbon pollution is from transportation. So we've got to tackle this and about half of it from passenger vehicles, half of it's from trucks and buses. And so we've been working on both sides of that equation. And one of the things that had become the barrier has been supply of cars. At this point, people want them and we're seeing the uptake of those cars, you know, double and triple year over year. And so how do you get the supply here and how you do that through a policy called the zero emission vehicle mandate that requires the automakers to sell them in, in Canada. And so that's one that we've been working on. We actually were successful in getting one in British Columbia. And you know, and I have to report to you that so far in 2022 17% of new car sales have been electric vehicles. So that just far outpaces what people predicted. I think we were trying to get to 10% by 2025. We've blown through that we've now increased our targets because clearly for Colombians are ready to buy them. And there's similar types of stats from Quebec, who also has a zero emission vehicle mandate. The challenge for the rest of the country, and you know, if you're in Ottawa, you're probably going and putting your name on the list. And it's multiple years, you might not even be able to get on the list anymore, because there just aren't any cars. And so we need a federal zero emission vehicle mandate that requires the companies to the automakers to sell electric vehicles in Canada, or they're penalized. So that's one thing that we've made good progress on and contributed to. One that I haven't talked much about, that I'll mention here is about the steel sector, the cement sector, these heavy industries that are also heavy polluters. And, you know, so that's another area we've been working on and looking for solutions. We're looking at, okay, much of this steel, cement, aluminum, it's all being used in the construction industry. So how do we get those who are building things and buying things to demand low carbon steel, low carbon cement, which will really help these industries put it'll push them to to decarbonize and so that program is called by clean. The biggest purchaser of steel and cement and, and these types of things in the country is the government and we've been working to get the government to commit to a bike clean policy. The really interesting thing is that the steel sector, the cement sector, the aluminum sector V, these sectors are really on board to decarbonizing, this is globally happening. We're seeing all of these industries recognize that they cannot be admitting the scale of pollution, they are right now they've got to reduce that carbon pollution get to net zero. And so, again, we're seeing progress on reducing emissions in that sector. And we're seeing, you know, the United States and Canada have actually said that they are going to work together on this bike lanes so that both countries are pushing that they will procure, they will only purchase low, lower carbon, steel, cement, etc, for building our hospital, roads, schools, and all those good things. So that's another one that I'd say we could say we've been involved with, and batteries, I've already talked about it. We've been involved in the batteries for the last few years, and bringing together that sector, from the mining sector, all the way up to battery producers and electric vehicle, you know, the automatic factoring companies like GM, and all the way to the recyclers, and working with government to get, you know, a battery strategy for Canada to really ensure that we lock in and land the most jobs and the most opportunities for Canadians across the country. And these would be jobs in different provinces and opportunities for different provinces, you know, rural urban jobs, etc. So it's a big opportunity, but Canada's got to act quickly if we really want to get the most benefits from it. And by the most benefits, I mean, we could be creating a quarter of a million jobs by 2030 in this sector, which would be good for the country and will help us as we're transitioning, you know, out of other job sectors.   Dan Seguin  23:36 Okay, Marren, are you able to expand on some of Clean Energy Canada's short term goals?   Marren Smith  23:44 Yeah. So I would say right now, our top short term goal is around public awareness and understanding how shifting to clean energy is going to help affordability for Canadians. I think this is critical and important, because you know, this electrification, people are very sensitive to the price of electricity and increasing costs of electricity. And so there's a piece of work to ship to understanding what your overall energy costs are. So as we move off of fossil fuels, that means you're not spending as much on gas anymore. You know, for your gas fired car, but your electricity bill is going to go up. As you shift off of the having gas to heat and cool your home and shifting to an electric heat pump, their electricity bills can go up. We did some research earlier this year. Report called the true cost looking at some of the top models of cars in Canada, what it costs to purchase one plus run it over eight years, and we'll probably talk a bit more about this letter later. So just to say having Canadians under stand that this shift, while it's gonna have some costs in the short term is a more affordable and a better option for Canadians.   Dan Seguin  25:11 You recently contributed to a white paper with Electric Mobility Canada, on how Canada can design an effective zero emission vehicle mandate. I'm curious, what are some of your recommendations?   Marren Smith  25:27 Yeah. So, I'd say trying to do this in a nutshell. So first of all, is accountability. So we need to ensure that automakers are accountable and keeping pace with demand. And we need to do that with legally binding annual sales requirements so that they have to sell X percent of cars that are electric, and that there's serious financial penalties for non compliance. And that's, that's really the nuts and bolts of a good zero emission vehicle mandate. There's a whole bunch of details in there. Some provinces, like you mentioned, Quebec, and BC, they already have one, so we just need to use this in provinces that don't have them. And then our other key aspect of the recommendations was speed, we need to really finalize this regulation next year, so that it takes effect with model year 2024. There's really no time to wait on this. And we can see the demand for cars is there. We really need to be able to get them into the hands of people right now while they want them.   Dan Seguin  26:37 Now, for my first follow up question, we all know that the lack of supply is a big issue when it comes to zero emission vehicle sales. What's driving that? Are automakers prioritizing other markets? Where they're required to sell more EVs?   Marren Smith  27:00 Yeah, well, that's exactly what we're seeing here. In Canada, the majority of the electric vehicles are going to British Columbia and Quebec, because they're required to sell them there. And, you know, they're going to other states in the United States that have similar types of mandates California at one, but there's a button doesn't down there. And so they're sending them where they need to, you know, in the past, they have been making more money selling, you know, SUVs, for example, those bigger, heavier cars are where they've been making most of their profits. And so they're trying to get rid of those in Canada while they can. But this world is accelerating so quickly. You know, I think once we get the zero emission vehicle mandate, that rules so that the automakers have to sell the cars, we're going to start seeing them arrive in Canada, and we've seen, you know, the Detroit three have all been doubling and tripling their commitment for how fast they're going to start getting cars going and coming off the line. And I think we're going to only see that accelerate in the future. So I'm hoping that, you know, it looks like the automakers are more and more committing to be producing the cars. So the next obstacle is going to be the supply chain and whether they can get the batteries and get the other materials to make them.   Dan Seguin  28:34 Okay, another follow up question for you, Marren. Are there provinces in Canada that get prioritized for EV over others for example, Quebec, or maybe BC?   Marren Smith  28:46 Yeah, absolutely. That's why there's there certain car makes and models that you can only get in BC and Quebec, and that will be related to the zero emission vehicle mandate, you know, they, they get, there's a stick and if they don't sell enough cars, they get penalized. So they make sure the cars are in BC and Quebec and that's really the best selling feature for why we need this to be a national program and have a federal zero emission vehicle mandate.   Dan Seguin  29:16 Now hand in hand with that, you convened a select group of industry stakeholders and other experts to develop a report on advancing the Canadian evey battery sector. What were some of the key takeaways from those consultations?   Marren Smith  29:34 Yeah, so the report we produced which you can find on our website at talks about this opportunity, and it is huge to produce batteries. We're talking upwards of 250,000 jobs by 2030 and $40 billion annually going to the Canadian revenues. So that's a great opportunity, but it's not going to happen without you. No creating a strategy to get there. And that is the top recommendation from this group of industry and other experts. The Canadian battery Task Force is what they're called, the top recommendation is we need to have a Canadian battery strategy, which is going to ensure that we target and focus the investment dollars in the right place, that we get the workforce setup. Because, you know, while we do have a great workforce in Canada, we're going to need more workers and with the right skills, and that we make sure that we get the infrastructure, we get the electricity, the clean electricity to the right places, and then we've got enough of it. You know, we've seen almost every battery Manor battery manufacturing plant, that set up so far, has mentioned the zero emission electricity that you can get in Canada. And that's one of the reasons why they chose to build in Canada. And these are big global companies that are choosing to land in Ontario and Quebec so far. And so we just, we need that kind of strategy to ensure that we can get the most out of this battery opportunity.   Dan Seguin  31:16 I like that. Okay. Let's move on. Can you tell us about your recent analysis that found electric vehicles are in fact cheaper, often by a lot than their gas counterpart? What models were you comparing and what factors were considered?   Marren Smith  31:38 Yeah, so we looked at some of the best selling cars in Canada. Things like the Chevy Bolt as the electric versus its gas counterpart, the Toyota Corolla, the Hyundai Kona versus the electric Kona, the Nissan LEAF versus the Honda Civic etcetera. So we did this for a number of the top selling cars, we looked at purchasing it, as well as operating it and maintaining it over an eight year period. And, you know, what we found is that in almost every case, you were saving money. And you know, we've had to update this because the price of gas has gone up so much. But the total costs savings are going electric range from 10 to $15,000, over eight years. That's significant savings. And, you know, as you talked about, you know, you notice that there's almost no maintenance costs for an electric vehicle. And that your cost of fueling is, you know, so much cheaper. And this was before gas was at $2, a leader. So roughly back the envelope, you know, those savings are going to jump in, for example, the Kona to about $18,000 or more, a lot of people don't understand how much more affordable an electric vehicle is. And they look at the sticker price of buying a new car. And that's what turns them away. At you know, so we're encouraging people to really understand, look at the long term. And we know that not everybody can go buy a new car, I didn't buy a new car ever in my life till I bought an electric vehicle. I always bought used cars. But the savings are significant. And of course, the added bonus is the you know, zero emissions, you're part of the solution and helping with climate change.   Dan Seguin  33:42 Okay, a follow up question here. Were there any expectations here?   Marren Smith  33:47 Yeah, so the Ford electric F-150. It was pretty close. Probably now if we did it with the the price or cost of gas now, you would actually be more affordable on the Ford F-150 We haven't gone back to it. The other thing to note on this is that electric vehicles are really holding their value. So if you're someone who likes to buy a new car and sell it in eight or so years, your electric vehicle used car sales are much higher than when you buy a new gas fire vehicle and then sell it off.   Dan Seguin  34:27 When it comes to the electricity grid Canada is 83% emission free and with lower electricity rates than many other countries. We seem to be in an enviable position. But in your report underneath it all. Your findings show that Canada may not be as prepared for a carbon neutral world, as we may think. Now, for the big question, why is that?   Marren Smith  34:55 Yeah, we are ahead. But it's not just about Getting from 83% zero emission to 100%. If that was the only challenge before us, you know, it would take some work, but that's extremely doable. But this energy transition is really the whole sale, reengineering of many of our supply chains, almost the entirety of the energy system that powers the economy, it's huge. And we are going to need to double the amount of electricity we produce by 2050, as we shift our cars or homes or businesses off of fossil fuels and onto the grid. So that's the main message of our report is, you know, we need we have great opportunity here. But we need to double the size of the grid so that we are able to plug our cars and our home heating and cooling and our industries into that zero emission grid.   Dan Seguin  35:53 Okay, follow up question here. What are four reasons Canada needs to achieve 100%? clean electricity supply? And what are some of your recommendations?   Marren Smith  36:06 Yeah. So, you know, first off, it's so that we can effectively combat climate change. And that's, you know, top reason why we're doing this, it's also going to diversify and strengthen Canada's economy. You know, as I said, companies are looking to be powered by zero emission electricity. We've seen those battery plants coming here, one of the reasons cited, and there's more opportunities as more of the the world's industries really focus on how are they going to be net zero, for example, we see Walmart and Amazon, those companies are looking for supply chains that are zero emission, they're counting their carbon, and that includes their transportation. So it's, it's about making Canada competitive and ensuring that we are an attractive place because we can power our economy and our communities with clean electricity. The third reason is around the potential for indigenous reconciliation efforts in clean energy ownership. I think this is a very exciting opportunity. There's already a lot of indigenous communities that own or are partners in clean energy, and we can expand that as this moves forward. And then lastly, is we started talking about affordability on this podcast. And, you know, once you get over the purchasing of the new technologies, it's really more affordable to be plugged into a zero emission grid. And that's going to create more certainty, more security around energy supply.   Dan Seguin  37:51 Marren, what are some of the other benefits to increasing Canada's clean electricity supply?   Marren Smith  37:58 So you know, one, we need clean electricity to meet our climate targets. Secondly, it's around affordability. This is going to help make energy more affordable for communities. And then another benefit. It's clean air, of course, you know, once you shift off of diesel buses, for example, to electric buses out of diesel trucks to electric trucks, you're really cleaning up air quality in cities in particular, but in all communities. And then there's another potential benefit. You know, Canada, most people don't know this, we actually export 8%, for electricity right now to America, that brings in $2.6 billion. And you know, the US has the same commitments around getting to 100% clean electricity grid by 2035. There's a lot dirtier than ours, they've got a lot of catching up to do. And there's a potential for Canada that has an enormous wealth of potential for renewable electricity across the country. Places like you know, Alberta and Saskatchewan have incredible solar resources. We have wind opportunities, you know, offshore onshore. So there's potential for us to be investing in clean electricity, not just for our own needs, but as a immensely valuable export that's going to be in demand in the United States. And then link to that economic opportunity is green hydrogen. We're hearing more about hydrogen can something that Europe's looking at shifting off of natural gas onto green hydrogen, which is made you know, with water getting split with electricity and turned into hydrogen so that's a good clean energy source and something that candidate could also be a leader in.   Dan Seguin  39:56 Okay, tough part is over. We always end our interviews with some rapid fire questions. We've got some for you. Are you ready?   Marren Smith  40:07 I am. I'm ready. Okay,   Dan Seguin  40:09 So for the first one, what are you reading right now?   Marren Smith  40:12 So I just read picked up a book that I read a number of years ago, The Hearts Invisible Theories by John Bowen. It takes place in Ireland in the starts in the 40s, and follows the life of the other boy, that a man as he's going through, really coming into his own and discovering himself, and it's just beautifully written really great book.   Dan Seguin  40:40 Okay. What would you name your boat if you had one? Or do you have one?   Marren Smith  40:45 Well, you know, I lived on one for 11 years. And that boat was called Potential, but I thought about this permanent name of boat. Right now. I might name it unplugged, you know, because it would be the the ticket to just taking off and, and having some fun.   Dan Seguin  41:03 Who is someone that you admire?   Marren Smith  41:06 Yeah, I don't know, if you've heard of Christiana Figueres she was, for a number of years, the United Nations UNFCCC, which was the framework on climate change in the UN, she was the executive secretary there, she is just a fantastic climate leader, she is always positive. She continues to be optimistic in spite of all the challenges in this world, and so it got a smile on her face while she continues to do this work.   Dan Seguin  41:43 Next question, what is the closest thing to real magic that you've witnessed? Maybe 15 years ago, I used to work up in what's called the Great Bear Rainforest off the coast of British Columbia, we're taking our group of people out to go see the place and experience it the beautiful ancient rainforest, an area the size of Ireland. And we were whalewatching, watching humpback whales, and they go around in a circle, and they blow their bubbles and make a net out of it. And then they all go down, and they come up in the middle. So there was four of them doing this and they come up in the middle, they make that net around a little school of fish, and they open their mouths and come up and and scoop up all the fish. And we were watching them do that. And then suddenly, I looked off this side of the boat, and there was all these little fish leaping out of the water. And suddenly, the whales picked up our boat and lifted it out of the water. And so it was just amazing. And there they were, then they just kind of sit around at the top, we could have just reached over and pat them. And then I was like, oh my god, I just I wonder if they're hurt. And as we sat there, they all sort of swam away. And they completely breached came out of the water from nose from tip to tail, you could see them all, they hadn't done this before, one after the other all for them. So you could see that they were just fine. And then they swam away. Okay, moving on to the next one here. What has been the biggest challenge to you personally, since the pandemic began?   Marren Smith  43:32 Yeah, it's been this plethora of Zoom meeting staring at a screen hours after hour. And I'll tell you that I zipped out and got myself a stationary bike. And so during those zoom calls, everybody at first was laughing at me because I'd be kind of wiggling back and forth as I rode the bike slowly, just to keep myself going. And now all kinds of colleagues have now purchased stationary bikes as well.   Dan Seguin  44:09 Okay. We've all been watching a lot more Netflix and TV lately. What's your favorite movie or show right now?   Marren Smith  44:17 You know, a number of months ago, my family and I went to see The Last City with Sandra Bullock just like a ridiculous funny comedy and I was laughing out loud. And I was just like, you know, it was after the depths of COVID. It just felt great to laugh out loud at something that was just completely goofy and frivolous.   Dan Seguin  44:43 Lastly, what's exciting you about your industry right now?   Marren Smith  44:49 It's the potential for the speed of change. You know, things are moving quickly. And it's that things can move quickly now Technology is ready for primetime. public understands that we need to take climate action. And governments and business are really seeing that economic strategy is going, you know, is is so linked to climate action. They see them as one in the same decarbonisation is what the economic future looks like.   Dan Seguin  45:25 Well, Marren, we've reached the end of another episode of the thinkenergy podcast, if our listeners want to learn more about you and your organization, how could they connect?   Marren Smith  45:37 Yeah, you can find us at cleanenergycanada.org. And you can also sign up on that for the Clean Energy Review, which is an email we send out every Monday morning that I hear from people in all walks of life from CEOs and ministers to receptionists and friends who don't even work in this. It's got the top 10 upbeat, optimistic solution based stories of the week, you can scan it in two minutes, or you can click on things and dive into these things in more details.   Dan Seguin  46:11 Again, Marren, thank you so much for joining us today. I hope you had a lot of fun. Cheers.   Marren Smith  46:16 I do. Thanks a lot for having me.   Dan Seguin  46:19 Thanks for tuning in to another episode of the thinkenergy podcast. And don't forget to subscribe and leave us a review wherever you're listening. And to find out more about today's guests, or previous episodes, visit thinkenergypodcast.com. I hope you'll join us again next time as we spark even more conversations about the energy of tomorrow.  

Bodybuilding Podcast Oct 3rd Dan Bodybuilder From Thailand ULTIMATE GUIDE TO ROIDS 109pg E-BOOK BY DAN THE BODYBUILDER FROM THAILAND. PUTTING THE TRUTH OUT. DARK SECRETS OF BODYBUILDING LINK FOR IMMEDIATE DOWNLOAD - https://www.e-junkie.com/i/yovb?card 0:00 Back in Asia 2:45 Best Bodybuilding Friendly Countries for Vacation 5:00 Andriol Test Undecanoate Capsules 6:00 Stereotypical Effects of Testosterone are from the Propionate Version 6:50 "Shedding Hair" from gear 8:35 MK-677 Blood Sugar - Diabetes 10:30 Metformin anti diabetic effect 14:00 HGH adding a super charger to the steroids, but it needs to be dressed up. 18:39 Why does the speed of delivery of Testosterone Propionate change its effects in comparison to long acting testosterone 20:30 someone wants to use Lantus insulin as their base hormone and never come off. Insulin and Visceral Fat 24:09 Deca Heart Toxic - Cardiovascular Disease and Bodybuilding 31:00 Resting Heart Rate in Bodybuilders - My Observations 35:00 Diuretics Antidote 36:00 Asking Doctors for what you want 38:00 Perfect Estrogen Levels 44:00 Aspirin for bodybuilders 46:30 Ratios vs. Dosages that Work 49:00 How to Cut successfully if you "Can't Lose Weight" This Podcast is for entertainment and conversational purposes only. Serious Injury and Death can occur from utilizing chemical performance enhancement. This author does not support the use of illegal performance enhancing drugs. If any substances mentioned in this video are illegal in your country do not use them. The purpose of this podcast is not to glorify the use of PED's but to bring to light the reality of what athletes are doing privately. Consult a doctor before beginning any exercise or supplement routine. Do not take anything mentioned in this video as advice. It is simply conversation, not advice.

Thapi (she/her) and Zoe (she/they) are back with Episode 2 to talk about crowdfunding, the problems with diabetes nonprofits, inaccessible technology, and the similarities between South Africa and the US. Thapi is collecting funds to insure 16 diabetics in a rural part of Polokwane, Limpopo continue to get the insulin and supplies they need. These diabetics are unable to access clinics and many insulins are out of stock in their area. Shipping takes months at a time and is not an option for obtaining insulin. Thapi is asking for $300 each month to purchase NovoRapid, Lantus, syringes, and testing supplies. You can send funds to Thapi on PayPal: paypal.me/thapisemenya Thapi's Social Media: Twitter & Instagram You can go to MutualAidDiabetes.com to request help obtaining insulin and supplies, request crowdfunding, learn more about MAD, donate, or subscribe to our Patreon! MAD Online is produced and edited by Zoe Witt.

It's “In the News..” got a few minutes? Get caught up! Top stories this week: Tandem Diabetes announces a limited launch of their mobile bolus feature (signup below), researchers look at how Basaglar stacks up, new guidelines for diabetes in the hospital, a T1D extreme athlete bikes across the USA and more Learn about the T1D Exchange! 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 (or coming soon!) Please visit our Sponsors & Partners - they help make the show possible! *Click here to learn more about OMNIPOD* *Click here to learn more about AFREZZA* *Click here to learn more about DEXCOM* 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. we go live on social media first and then All sources linked up at diabetes dash connections dot com when this airs as a podcast. XX In the news is brought to you by T1D Exchange! T1D Exchange is a nonprofit organization dedicated to improving outcomes for the entire T1D population. https://t1dexchange.org/stacey/ XX Tandem's mobile bolus feature is in limited release. Approved earlier this year, they've released the feature to a very small number of users and are expecting a wider, still limited, release in the next few weeks. This is the feature that allows you to bolus by phone and use the t-connect app to see pump data on your phone as well. It's not full pump control via phone, but it's a big step forward in terms of convenience for users and for Tandem' next product, the MOBI pump – which won't have a screen and will have full phone control. I'm asking Tandem to come on the show and share more about the features and how it works. It's interesting that you can't dismiss alerts and alarms from the app and must do so on the pump itself. I'll link up the site you need to sign up for the limited release. You will need to update the software on your tslim x2 pump and take some additional online training. This is US only. https://www.tandemdiabetes.com/landing-pages/remote-bolus XX The Eversense E3 gets European approval. This is a partnership between Ascensia diabetes care and Senseonics. The E3 is the six month version of the implantable CGM system. It's also approved for insulin treatment decisions, which is a switch from the XL version already available in Europe. The E3 was approved in the US earlier this year and should be distributed in Europe in the fall. https://finance.yahoo.com/news/ascensia-diabetes-care-announces-european-060000125.html XX XX New guidelines for treating diabetes in the hospital. This is from the Endocrine Society, which last updated their guidelines ten years ago. New this time around, hospital use of continuous glucose monitoring and insulin pump therapy, providing inpatient diabetes education as part of a comprehensive diabetes discharge-planning process, use of noninsulin glucose-lowering therapies, and more. Adult patients with diabetes or newly recognized hyperglycemia account for greater than 30% of noncritically ill hospitalized patients. https://www.clinicaladvisor.com/home/topics/endocrinology-information-center/endocrine-society-issues-new-guidelines-for-hospitalized-patients-with-diabetes/ XX Works just as well and costs less.. that's the upshot of a new study on Basaglar, the copycat insulin to Lantus when it comes to type 2 diabetes. The findings come from 14 commercial health plans and Medicare Advantage plans. Basaglar was approved as a biosimilar insulin glargine by the US Food and Drug Administration in 2015. This was a large study of thousands of patients and also showed that there was better adherence to Basaglar, no reason for that was given, but it could be the lower cost. https://www.medscape.com/viewarticle/975440 XX Right back to the news in a moment but first As I mentioned, The T1D Exchange Registry is an online research study, designed to harness the power of individuals with type 1 diabetes. It's a research study conducted online over time, designed to foster innovation and improve the lives of people with T1D. Personal information remains confidential and participation is fully voluntary. Once enrolled, participants will complete annual surveys and have the opportunity to sign up for other studies on specific topics related to T1D. By sharing opinions, experiences and data, patients can help advance meaningful T1D treatment, care and policy Sign up at T1DExchange.org slash Stacey (that's S-T-A-C-E-Y). XX Very early but Swedish researchers have now identified a molecule that helps stimulate the growth of new insulin-producing cells, and uncovered how it works. These researchers looked at a molecule known as CID661578 and found that it binds to a protein called MNK2. In doing so, it allows two other proteins to interact at higher levels, which ultimately leads to greater beta cell regeneration. The team tested their molecule in zebrafish, and found that it lowered blood glucose levels when compared to a control group. In pig pancreas cells grown in the lab, the molecule was shown to trigger the formation of new beta cells, while human pancreas organoids given the molecule produced more insulin. Long way to go, but still interesting. XX Type 1 Endurance athlete Sebastien Sasseville is taking part in the race across American this week. Called the world's premier ultra endurance race, it's literally a cycling event from the West Coast to the East Coast with a maximum lenthg of 12 days. That mean they have to cover about 275 miles every day. The original concept runs all the way back to 1887 when newspaperman George Nellis rode across the country via railroad routes in 80 days. The more modern version began in the 1970s, when John Marino decided to see how fast he could get across the country on a bicycle. The first head-to-head race came in 1982, and there were four starters. It's been called a brutal version of the tour de France. Sasseville has been on the show before and I'll catch up with him after he recovers here. He's been up Mt Everest, ran across Canada and did the brutal race across the Sahara Desert. He's sponsored by Tandem. https://cyclingtips.com/2022/06/how-to-watch-race-across-america-raam-route-map-elevation-live-dot-watching/ XX On this week's long format episode, you'll hear my conversation with Sernova's CEO all about their cell therapy and the search for a functional cure for type 1. Next week, a little less technology.. a fun conversation with a woman frustrated with the limits of wearing her pump, especially with skirts, so she found a new solution. Listen wherever you get your podcasts That's In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.

It's "In the News.." got a few minutes? Get caught up! Top stories this week: The Federal Trade Commission probes the prescription drug middleman industry, once a week basal insulin moves forward, DIY insuln dosing systems get a thumbs up at ADA Scientific Sessions, Sernova's stem cell system releases great findings and more! Learn more about the T1D Exchange 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 (or coming soon!) Please visit our Sponsors & Partners - they help make the show possible! *Click here to learn more about OMNIPOD* *Click here to learn more about AFREZZA* *Click here to learn more about DEXCOM* 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. we go live on social media first and then All sources linked up at diabetes dash connections dot com when this airs as a podcast. XX In the news is brought to you by T1D Exchange! T1D Exchange is a nonprofit organization dedicated to improving outcomes for the entire T1D population. https://t1dexchange.org/stacey/ XX The Federal Trade Commission will launch an inquiry into the prescription drug middleman industry.. requiring the six largest pharmacy benefit managers to provide information and records. They're looking at PBMs such as CVS Caremark; Express Scripts, Inc.; OptumRx, Inc.; Humana Inc and more. The largest PBMs are now vertically integrated with the largest health insurance companies and wholly owned mail order and specialty pharmacies. In these roles, pharmacy benefit managers often have enormous influence on which drugs are prescribed to patients, which pharmacies patients can use, and how much patients ultimately pay at the pharmacy counter. https://www.ftc.gov/news-events/news/press-releases/2022/06/ftc-launches-inquiry-prescription-drug-middlemen-industry?utm_campaign=https://www.ftc.gov/news-&utm_content=1654622484&utm_medium=social&utm_source=twitter XX Confirming what many of you have known for years.. an open-source automated insulin delivery system -- also known as a do-it-yourself system -- was both safe and effective for patients with type 1 diabetes. This is from the CREATE trial, designed to test DIY system, presented for the first time at the ADA Scientific Sessions. This system was made up of the OpenAPS algorithm from a version of AndroidAPS implemented in a smartphone, paired with the DANA-i insulin pump and Dexcom G6 continuous glucose monitor. The researchers previously published additional information in the Journal of Diabetes & Metabolic Disorders. https://www.medpagetoday.com/meetingcoverage/ada/99109 XX Stem cell study showing great results. Sernova says the first three patients of six total continue to be insulin independent following treatment. One of the patients has been insulin-free for more than two years, while the other two have been free of the need for medication injections for six months and three months, respectively. At this point, the other three patients in the study have not had the device long enough to determine measurable results. The first three all have A1Cs in a normal, nondiabetic range. Sernova's Cell Pouch is an implantable device that releases the primary donor islets. The device is implanted under the skin in a minimally-invasive procedure. We're talking to Sernova for next week's show; long way to go here but another good result for stem cells. https://www.biospace.com/article/sernova-cell-pouch-device-keeps-type-1-diabetes-patient-insulin-free-for-two-years/ XX Getting closer to once-a-week basal insulin. New study says Novo Nordisk insulin icodec achieved better results than Lantus in some aspects of the study and that overall it was – this is interesting wording – non-inferior. Another previous study showed it also matched well to Tresiba, but that Tresiba caused fewer lows than the once-weekly basal. This study was about type 2 diabetes but insuln icodec is in other trials for people with type 1. https://www.biospace.com/article/novo-nordisk-scores-phase-iii-insulin-win-strengthening-market-position/ XX New partnership between Diabeloop – which makes an automated insulin algorithm - and SOOIL which makes pumps. These are two French companies that have been working together since 2020 but this new announcement was delayed by COVID. They want to bring the product – Diabeloop's DBLG-1 I controller and SOOIL's Dana ACE Pump to the US, Europe and Korea. https://www.drugdeliverybusiness.com/diabeloop-sooil-automated-insulin-diabetes/ XX Civica continues to move ahead with the development of its affordable insulins. They've announced they'll partner with the German company Profil for the clinical trials. Civica plans to set a maximum recommended price to the consumer of no more than $30 per vial and no more than $55 for a box of five pen cartridges. Contingent on FDA approval, Civica anticipates that its insulins will be available for purchase beginning in 2024. https://www.healthcarepackaging.com/supplier-news/news/22262909/civicarx-civica-selects-profil-as-clinical-trial-partner-for-affordable-insulin-initiative XX New study out of Israel shows that obesity in teenagers may lead to type 1 diabetes a few years later. The study, of nearly 1.5 million Israeli teenagers, found that those who were obese were twice as likely to develop type 1 diabetes by young adulthood, versus those in the normal weight range. The senior researcher on the study says it's not clear why obesity would raise the risk of type 1. They think it may the a trigger in people with genetically susceptible. Obesity also has other effects — including vitamin D deficiency and alterations in the gut's bacterial makeup — that could impair immune function. https://www.usnews.com/news/health-news/articles/2022-06-06/obesity-in-teen-years-might-trigger-type-1-diabetes XX Right back to the news in a moment but first we've got a new sponsor. As I mentioned, The T1D Exchange Registry is an online research study, designed to harness the power of individuals with type 1 diabetes. It's a research study conducted online over time, designed to foster innovation and improve the lives of people with T1D. Personal information remains confidential and participation is fully voluntary. Once enrolled, participants will complete annual surveys and have the opportunity to sign up for other studies on specific topics related to T1D. By sharing opinions, experiences and data, patients can help advance meaningful T1D treatment, care and policy Sign up at T1DExchange.org slash Stacey (that's S-T-A-C-E-Y). XX XX XX On this week's long format episode, you'll hear my conversation with Dexcom's CEO Kevin Sayer. We get more information about the G7 launch, after FDA approval of course and I asked him your questions about everything from IOS issues to airport scanners. Next week, Sernova joins me to explain their stem cell pouch technology Listen wherever you get your podcasts That's In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.

Download the cheat: https://bit.ly/50-meds  View the lesson: https://bit.ly/Insulin–LongActingLantusNursingConsiderations  Generic Name Insulin detemir, Insulin glargine Trade Name Levemir, Lantus Indication hyperglycemia with diabetes type 1 and 2, diabetic ketoacidosis Action stimulates uptake of glucose into muscle and fat cells, inhibits production of glucose in the liver, prevents breakdown of fat and protein Route Onset Peak Duration Detemir 3-4 hr 3-14 hr 24 hr Glargine 3-4 hr none 24 hr   Therapeutic Class antidiabetics, hormones Pharmacologic Class pancreatics Nursing Considerations • assess for symptoms of hypoglycemia or hyperglycemia • monitor body weight over time • may cause decreased inorganic phosphates, potassium, and magnesium • monitor blood sugars every 6 hours, monitor A1C every 3-6 months

Icecream seems to be our solid weekly talking point, we make the crucial decision to order 2 elite tier icecreams to accompany our post pod baked goods, we hit up all the questions, chat food, class A's and answer the cliff hanger question from last weeks episode, what games consoles and games do we rate from ‘back in the day'Don't forget we now have a Gym Pin discount code: triplestack for 10% off and be sure to check out our baked goods provider @doyouevenbakedough using code: TSP15 for 15% off.Remember to follow us and share our episodes on your Instagram stories.@sarahparker_bb@jopo_nutrition

Talking Craft while Being Tattooed This is a K D O I rebroadcast and that's of my old show. KDOI Podcasting I love putting these on for you because we had some great conversations back in my old show, and it would be a shame if they just lived on my external hard drive and we didn't get a chance to share them with you in this episode, talking with my good friend and tattoo artists, Ashley Hutchins, and we're talking about craft, but now here's the thing in this interview. I'm actually getting a tattoo by her while I'm interviewing her. I've never done that before. I haven't done that since. And it was a interesting time to say the least. So I hope you enjoy this and I hope you get something out of it. If you do email me timothy@createartpodcast.com and I'd love to hear from you.   Reaching Out To reach out to me, email timothy@createartpodcast.com I would love to hear about your journey and what you are working on. If you would like to be on the show or have me discuss a topic that is giving you trouble write in and let's start that conversation. Email: timothy@createartpodcast.com YouTube Channel: Create Art Podcast YT Channel IG: @createartpodcast Twitter: @createartpod   [podcast_subscribe id="207"] Transcripts of the Show Intro KDOI Rebroadcast Conversations on Craft with Ashly Hutchins Timothy: Create art podcast. K D O I rebroadcast talking craft with Ashley Hudgins. Hi there, friends. This is Timothy Kimo, Brian, your head instigator for create art podcast where I use my 20 plus years of experience in arts and education to help you tame your inner critic and create more than you consume in this episode. This is a K D O I rebroadcast and that's of my old show. KDOI Podcasting I love putting these on for you because we had some great conversations back in my old show, and it would be a shame if they just lived on my external hard drive and we didn't get a chance to share them with you in this episode, talking with my good friend and tattoo artists, Ashley Hutchins, and we're talking about craft, but now here's the thing in this interview. I'm actually getting a tattoo by her while I'm interviewing her. I've never done that before. I haven't done that since. And it was a interesting time to say the least. So I hope you enjoy this and I hope you get something out of it. If you do email me timothy@createartpodcast.com and I'd love to hear from you. So without further ado here is the KDOI rebroadcast. Craft with Ashley Hutchins. Start of KDOI Intro I am your head instigator, Timothy Kimo. Brian. This episode will focus on craft now out of all the subjects this season, this is probably the one that is the most tangible we can put our hands or witness craft in action. And maybe that's why it's the easiest to talk about. Perhaps it's going to turn out to be the hardest our friends over at Merriam-Webster defined craft as skill in planning or executing dexterity and occupation or trade requiring manual dexterity, or artistic skill skill in deceiving to gain and end members of a trade. To make or produce with a care skill or ingenuity. Now our two quotes come from gene Fowler writing is easy. You only need to stare at a blank piece of paper until drops of blood form on your forehead. And Stephen King amateurs, sit and wait for inspiration. The rest of us, just get up and go to work. Now, gene Fowler was a writer with the Detroit post and a syndicated manager of king features. His later work included over a dozen screenplays, mostly written in the thirties, 1930s folks, not the 2030s and a number of books, including biographies and memoirs. Stephen King. Well, Hey, there we go guys, author of horror, supernatural fiction, suspense science fiction, and fantasy, his books. And this is interesting, has sold more than 350 million copies. Many of which have been made into feature films, mini series, television series, and comic books. And from what I understand, he hates most of them. Stephen King's has published at least 58 novels, including seven under the pen name, Richard Bachman and six non-fiction books. He's also written about 200 short stories and most of which have been published in book collections. So obviously the question is why aren't we discussing craft for me? This is the most concrete topic yet. It's also a bit nebulous. Some people can fake craft with shortcuts or YouTube videos. Craft takes study craft takes doing craft takes failure and picking yourself up and pushing forward. Craft takes vision and research about where you want to go and what you want to incorporate into your work. The two quotes, I chose really speak to me about the hard work that comes with being artistic. This stuff just doesn't drop into our lap. We aren't waiting for some invisible friend in the sky to give it to us, or to give us a clue about how to complete something or overcome a barrier craft is the action of getting up when you are sick and blowing chunks, getting into your space and making something happen. When it's the last thing in the world that you want to do, craft separates the wheat from the. It's not meant to handcuff us. It is, it is there to help us to push through whatever blockages we may have that prevent us from creating our net from being our creative, natural selves. So, Hey, let's get this conversation going. Start of Interview All right. So we are recording live here in Sesame street. We have Ms. Ashley. She has been with us third time term. First time to get the perfect score on these seven questions. I'm just saying, well, you're the first one. Ashly: You're the first one Timothy: to get well so actually put this up on Facebook and I thought it was pretty cool. It is the sword. Oops. Ashly: Switch with switchblades. Timothy: it looks nice. Like it's a sword in somebody's Ashly: hands. That's how you say it's a mouse where it would be lacrosse or Timothy: I'm just saying we've got moon and of course we have skull on. It has been with us as, as per request and some lady face and a lady face. This is my, one of my first lady with you. We've got the the tiger could be considered a lady. It's on my heart. It represents, you know, my, my tiger at home. And then the minions they think they do represent the girls. So there could be women. Ashly: I mean, honestly, any of these supposed to be, Timothy: I have a lot of women on me. Ashly: Okay, Polly. Now let's Timothy: take a look at this. Okay. We're not going to Facebook poll on this guy's piece. You guys gonna do a choose what I did on my arms. Let's rock it out, make it happen, make some magic, right? Yeah, it was really good when I got into her. Some young lady, I think she might've been 19, but she wanted to get a face of an angel or something like that. And one of your guys out there saying, okay, we've got to do this really big, really bad. So she was trying to get as small as she could, you know, the whole thing. And I'm just like, oh, I get it. You want to get something small? So that way you can hide it. Ashly: Things like portraits. Yeah. Think that faces definitely need to be a certain size. And that is also why, which has crafted us because that's something that people it's for the longevity of your tattoo. And not because we just are trying to talk him into doing something larger. Exactly. So you're going to be hidden. Timothy: Fantastic. Ashly: Come on. We're here to the table. Timothy: I mean, towards me towards, yeah, those are the second table. Ashly: Oh yeah. Timothy: And I'm getting a massage on Friday night, so, you know, I'm just getting all the therapy on this. Awesome. Ashly: All right. So Timothy: right. Ashly: Yeah. When I was getting the Jim's put on my tooth and she was like, put it like Monday. I'm sorry. And I was like, I do this to people every day. Timothy: I like the idea that it's a subordinate switchblade, even though it is a Switzerland, Ashly: it can be whatever you want. It's like an impression is painting. It's it's whatever. There Timothy: we go. Nearly. No one says anything different. We just poke your head balls out. Like we normally do. We're actually talking Ashly: about Timothy: sweet and I promise not to ask so many basic questions. The answer to not everyone knows Ashley. Like I know actually, oh, I didn't pay the power bill. Yeah, that was the shortest tattoo I've ever. Ashly: No worries. That's another reason why we should talk about crap. I had to learn some things that shift in your program to forget is that, Timothy: oh no, no, we can, yeah, we can mark this as an explicit a okay. Well, I, you know, I did the one with my my nephew when I was no, we didn't do it in Chicago. We did it over a squad cast, but you know, he was dropping the F bomb, never got the vert, so we're good. We just mark it as explicit and we can park. Ashly: I was listening to . I said to my daughter, you talking about she's like, dad, you used to have tattooed, starts describing it, dealing with the sword, a crystal ball. And I was like, that sounds sweet. And he's like, no, I got saved. And I was like, oh, playing. Would you just state really can hear and understand? And I was like, Timothy: these guys are saved by somebody else. Ashly: That's like, fuck, it's sweet. Timothy: It's like, yeah. Well ask the song, my archive it's called up. Fuck you. I'm going up next to some nuns, you know? Yeah. Ashly: That's the way to do that. All right. Now. Timothy: Now, just let everybody know Ashley's using the painless needles, the non-permanent each. And this is her very first time tattooing this isn't a Ashly: very first hologram. Timothy: This isn't more Ashly: So Timothy: you're going to families. Ashly: All of you might say, Timothy: well, he posted something on RVA. Podcasts was about, I'm doing a panel discussion for the galaxy. So I was like, yeah, I'm doing for that dude. Ashly: And everybody was talking to me, not talking to you about Timothy: talking to me, talking to you. We're talking about everybody, but no, I've been trying to hook up with him for awhile. Kind of get like a meetup down here, somebody podcasts, that sort of stuff. Okay. Fantastic. Well, I was going to let you get a little bit warmed up in there. You're good. All right. So let's see here, let's start off with something basic. So like I know for me, you know, podcasting, I got into in like 2006, I had no idea what I was doing had no no apprenticeship or anything like that. And I seem to recall in college, you getting the sense too? That was on your neck, wasn't it? It was your shoulder. Okay. Geometrical. And so when was that bars or how did that hit you of, Hey, you know, I might want to do this. Ashly: I have been wanting to do that since I first learned about what they were when I was about six or seven Timothy: years old, Ashly: much to the chagrin of my mother. I started drawing all over myself with the Sharpies. So I've always wanted to be Kind of have to have the right set of circumstances, but yeah, I've always wanted to learn how to do it. That's definitely one of those things where it's like one of the labs beside being like the trade, like a carpenter or something like that. It's one of the last professions where you really do like one-on-one training specifically, just, you know, And sentence and you have to be committed to it. No. Timothy: Now did you have to learn these secret handshake and the door knock and the quaint nudge, nudge and all that we don't talk about? No, but Ashly: the guy guys all behind that, you definitely want to do a, have some sort of like may Sonic S ceremony. When I got my license Timothy: incessantly on my own, Ashly: which does not a full verse about migration and migration. A lot of history is that doing in there, which is really fascinating. And there was a lot of slate. He has to be all of those things. You have to be a technician. You're not just an artist. It's not some sort of like rockstar attitude to it as well, but you have to be humble mechanics. I just don't go about learning. Like, I love that new machine. It's about learning about your equipment, you know, Timothy: so you're not just, you know, well, I hate to say you're not just an artist because you know, people have a bad connotation of what artists do. Sometimes you're a mechanic as well. You have to have some mechanical apps as well as have that eye for detail and that skill and counseling or advising your, your clients on what they should get. Or, Ashly: yeah, there's definitely being able to draw. A lot of people don't realize. I mean, you can get that Timothy: and your canvas, you know, jumps out at you sometimes and switches and. Ashly: Yeah. Moving is, you know, that's another bird that you found to learn about it as you go along. So I'm not knocking anything about art. I love art, but I also like, I love the equipment issues, but like, I don't find that to be something that should be in the foreground is important. And you shouldn't be. It shouldn't ever seem like it's beneath, I'm fortunate to work with a bunch of people that like, something like that or warning them up again. I don't really follow stuff like that because it's unrealistic representation out there doing it. It's a game show which I used to do Timothy: earlier today. We were talking, you were not aware though, that the world is a weird, Ashly: strange, strange world. And even like not to get too technical about stuff, they didn't even have a whole lot of moving parts in it. They basically, they didn't have to even assemble all of it, like before they had to set up string, just not complicated. People are like, oh, I always get mine repaired. I haven't done that in years. You know? It's like, like it's something that you just, you know, like if I find that to be ridiculous, Timothy: we kinda, you know, buy a new tattoo machine every week and then open it up out of the box. It's all pre sterilized and everything like that. Well, well now for you that, I mean, for the show though, it's just kind of like, everything was all pre setup for them. They didn't have to do on their own set up. Yeah. Ashly: Or having a hard time doing some filming with the easy word of putting up a tattoo as you. But just talking about working on one, like it's the meat, you know what I mean? Yeah. You know, I'm the best on the east coast and whatever, you know, like, I, I haven't done this forever. I just send it out. I used to work with someone who I will not name who was like, that would just like, you know, could just immediately anything went any sort of way. And he's like, oh, well, if I try to repair my filter and I can't send it back to him, like, it's just an excuse for not liking Timothy: well, I mean, I think you have to know whatever tool that is that you're working with. No matter what what discipline you go into like a painter needs to know their brushes, the canvas that they're using. And you know, how the paint interacts and then the different mediums that they could add subtract from your existing, same way. You need to know how that machine works and how it's going to do the things that you put in it. I was going to react to certain skin and all that jazz. Ashly: Yeah. It's basically you wouldn't, you know, knowing your stuff, which is why in my version of it was a big deal. The guy who me on the tattoo to emphasize the business prep before the night. So often, Timothy: oh, I'm doing okay. And B you know, on the other side of the of the, of the machine, you know, you have to prep for. What's going to happen because we got that one long as you get up. And I did not eat that day, but afterwards I was like, and I went down, but that's another aspect of your craft that you need to know how to deal with somebody like that. Ashly: crashing, but yeah, you gotta be prepared for something like that. You're actually officially tattooed. Timothy: Well, you're the only person that I've interviewed doing their art while I'm interviewing. Ashly: This is just getting the sending. Cause last time we went and got and Timothy: exactly, exactly at a restaurant of which we're not going to name because it's a cool place and we don't want it to get all his Stearns for people to go there and try to get our autographs and all that kind of jazz. You have to be very protective of that. Ashly: Yeah. It's an hour thinking, thinking your show on, Timothy: well, you know, you, it's easy to do so I think you kind of mentioned this, but for you, the attraction is more the craft versus the arts say, or Ashly: I enjoy. Yeah. If I'm having like blocks working on packing machines as fulfilling as well, it sounded like, and I'm not saying that he is not a crap, cause obviously it is, but it's kind of like, like a pottery, you know, where you, there's another apparatus that you're using and not just like a pencil or a paintbrush, there's some, a whole other mechanical aspect of something that you use to create art. Lends it more to a craft for me. Timothy: Well, and you have your client, your patron, your desk, wherever you want to call them. Right there you get, you're getting the immediate feedback while it's happening. So, I mean, if something doesn't come out right, and just like bullshit or, you know, when it comes out fantastic, which, you know, not tooting your horn for you. That's what I do. But this is number 12, Ashly: really? Timothy: No, no. There's number 12 on my body. No, no, let's see the frame of chess. 1, 2, 3, 4, 5, 6, 7, 8. I'm losing count. That's okay. This is what happens when I get my a fifth core math skills become even worse. Majority of my tattoos are done by we'll just say that. Yeah. Cause I only had four done by somebody else and then you've done the rest. So I had the the Texas the chemo and then the dagger up here, the diagram, the scope of which, you know, it's, so it's like a dagger and a still after set that 92 94, Ashly: you Timothy: know, air force base. That's what city that was just down in San Antonio. That's right. Yup. If I was going to move to Texas and it tells you the town I'd go to, it's a good place. I went to a big old comic book store there it's right next to a Chinese buffet, Chinese buffet. It was first perfect match. so getting back on the crash site. So no, like in my, because I have a day job, this is your day, this is your job. And I put air quotes. So that way everyone can see the air quotes. That's what I do. Audio air quotes there, but it's your job for the work that I do. I do a lot of counseling with my clients and all that, but I do realize. There are some days that I do phone it in. Now when I do my art, I'm usually not phoning it in because that is something that, for me, it's a treat that I get to be. I don't necessarily get to do my art with every client. And I'm with you, you are doing your, with every client that you have with using your skills, you're using your craft and all that. I'm not doing Ashly: my art with everybody. I am definitely doing my craft with everyone. And that's yeah. That's why that's the craft or tattooing versus the art and tattooing. I'm doing my art with my tattooing right now because I drew this and, you know, it's something that I wanted to tattoo. I care about every single one that I do and I do the best job they can with everything. And I don't judge other people for what they get because not everybody, you know, I'm not you, you're not me. Not everybody wants to get a giant riding horse called tattooed on their thigh or two people making out tattoo on their throat. That's me. If, whatever you want to get the bond to the person, or you really like it, then that's cool. But that's not, that is an exercise in craft and not art. Timothy: So we're not going to talk about the, my shoulder, Ashly: but yes, I feel like that's kind of, that's where the difference is, you know, like it is an art, but my art and not in a derogatory way, but my personal art would be more than something that I've drawn out of my mind or, you know, like, like from a complication or something like that, you know, Saigon and. See, I feel like I put a different, neither one is awesome. I love that doing so it's like, even if I'm doing something, it's not that I don't like it, but even if I'm doing something that's not like for my book or something, that's not like out of my mind or drawing from my wall, I'm still practicing the craft. Gotcha. Yeah. In my women earlier today, you just did easily, like we got call it a remix around here tattoo. Sure. And it was really, really, really faded and you just kind of wanted to have it re reworked. That would be another thing that I spend my time with that thing. And I like did my best to make. I believe you possibly could. You know, so that's, again, it's not my art. I'm not even like, that's not even a Debbie that I didn't initially, you know, but the craft side of it is bringing it back to its fullest potential. Gotcha. That's another aspect of where, you know, I feel like tattooing comes to the craft first and second. Timothy: So when would that, that thread going on there? You're a craftsperson first artists second Ashly: say custom, you know, like a couple of years, whatever I knew, then I might call it an art first. But you know, if you're just doing your thing, we'll also, you know, Walk in and anything that comes in the door, but yeah, I feel it should be because otherwise I've worked with people who act like, you know, movies of my arts and I was not going to deal with the rest of us. And then they always end up having some kind of rockstar attitude. Cause you kind of pump yourself up in your head or your social media once yourself up in your head. Like, you know, the majority of the time, if you weren't tattooing your friends. Yeah. Yeah. So, you know, Timothy: I think the kids used to call it way back in the day in the late eighties, early nineties don't believe the hype. I could be wrong on that. I am older than her, but don't believe the hype, Ashly: you know, I don't feel like anybody, especially. Year or two tattoos should believe that there any sort of rocks are beneath them to do a walk in. And that's just my personal opinion, but I also worked with people like that before. So Timothy: what's, what's going to turn to some of the aspects of your craft. So it's kinda some of the intangibles that you have so bedside manner or chairside manner. However you want to call that, I guess depends. If somebody's sitting in the chair or laying on a table, tableside married, there we go. How important is that for you? I mean, you get all walks of life coming in here. Is it important for you to connect with that person that you're tattooing. Ashly: Okay. I don't feel like you are forced to necessarily, but my feeling on that, even the blood I went, I would just go with my friends who were older than me. So I would go with them to get tattooed. And I mean, tattooers working with people I haven't met, you know, just joking around and having a good time and you know, like, oh my God, I want to do that. Cause it just looked like you were worried, you know? And so I feel like, especially when somebody first I will say, I feel like it's, you know, you have to, and sometimes you have to check your shit at the door, you know, because the person has kids and it's getting their first tattoo from you. They might not know. Just got ghosted by someone or, you know, you add some sort of breakup and you're upset or that you got to put your dog down or whatever else, because they don't know your life. And sometimes you just interact and it's just a job and you just, you know, you can't, but I feel like it's kind of important for people that you pull it together because I feel like you're doing them a disservice, you know, like they should have the experience that I have. They should, you should be the coolest person I've ever met. You should pull out some stories and be weird or be funny or whatever, because they're going to remember that forever. Oh yeah. You know, I remember, I, first time I got tattooed, so so yeah, I feel like it's important a lot of the times, it just like you pull it together and be that for them. Cause they're already nervous know. We tend to forget. Sometimes I feel like that we're in tattoo shops more than. Sometimes that aren't home, you know? So I am very comfortable as you shop, but these people only buy them. Haven't ever been in one, or they only haven't been many years because they were about to be hurt or they're Timothy: using the painless. Well, yeah, those are like, Ashly: woo. But you know, like it just, you should be that should be able to like, hold it together and be that person. And that's sometimes, I mean, like I'm talking, I just finished lining your tattoo and I'm talking during it. I usually don't talk a whole lot my money. No, but I Timothy: knew I was going to, well, this is a a special treat for everybody. Ashly: Yeah. But so yeah, sometimes people don't want to talk and that's fine. That's also fine. Timothy: No, you know, when you've tattooed me in the past, there's been times when it's just been, we've sat here for an hour or two hours and sends out five words, not the word mad at each other. Well, no, we can do our own Headspace. Ashly: It's going to take me like a couple hours too. Cause when I start talking a lot of buttons, cause I talk with my hands. And so a lot of times when I started talking and then I stopped doing gesturing with my hands. So but yeah, so I guess that answered the question. I do. I feel like it's important to be that for them it's not being disingenuous. And honestly it kind of, if I'm having a bad day, just gets me out of my head. Well, you know, making somebody laugh, cracking a joke, is that telling them a funny story Timothy: because you never know what you're going to run into with, with them. You know, they might have a funny story for you. Ashly: Yeah. You know, and it's disarming for people that are nervous, not just sitting there in silence, you know, Timothy: you can have the mascara. Where you can have a good time and have a couple of lives Ashly: doing this. Non-stop reasonably for everyone in case you leave this in there, I just broke a glove and smack myself in the hand with it. Oh, that's Timothy: not fun. Ashly: It doesn't leave a little mark. I used to work with this guy who will remain nameless a lot or name was Timothy: people Ashly: Being a diplomat that's Timothy: okay. Ashly: Who he thought he was such a rock star and he was one of those. He literally said, I'm just going to focus on my art one time. But I thought he was such a big deal in such a rough sort of the most important thing to him when he was tattooing was listening to his own God damn music. And I don't mean music that he made. I mean, just music that he likes and if anything else was happening, he would wear headphones. He would like freak out about having to listen to what you wanted to listen to. Sure. Yeah. Yeah. Now you're I have my room. It's hot and you can listen whatever I want. Yeah. But it's not the biggest fucking deal on the planet as far as like what comes to tattooing, right? Yeah. Just driving videos. Timothy: So if I popped in here and said, you know what, we have to listen to some Johnny Cash. You wouldn't be offended by you just be like, Hey Tim, I'm going to put in the needle. Set hurt now. Ashly: Yeah. That guy was weird. He also had a weird perception of time and thought that they had found Atlanta. So, oh, okay. Timothy: Yeah, that's a that's next episode. We'll talk about the Atlanta's and the movie, the fake moon landing. Yes. That's the next thing. Ashly: He would always do this thing where he'd be like, well, you know, every time he would say something completely non-factual he would started out like that. And one day he just walked in the shop and his, well, you know, he's like found it Lantus, Timothy: all right. Some other non-changeable thing. So we, we've kind of talked about, you know, kind of your your, your bedside manner. You're a chairside manner with folks how you feel like it goes with you. Oh for me, well, that's, well, you're the person with the SharePoint, the object. So it's fantastic. Absolutely. Don't hurt me please. Ah, no, but I think it's important. I mean, because I dabble in a lot to a lot of different disciplines as do you, as. But know, I think, you know, when you're talking to your customers or you talk, you're not yet, I hate to call it customers, but clients or whatever, you know doesn't have to make me sell except for, but exactly. I am by the way, but you know, I retired back on no, actually September it was May 10th, 2013 is when I retired. Hey, sorry. I had to get married kids. That's what happened? Well, a Decker, a very decorated. Yeah. I mean, there's the come as your favorite porn star party, which I didn't know you at the time. I apologize. You know, that was a classic party. There is a picture of me wearing tassels and the trenchcoat not much else, but that was, and I came to the party. You saw that some people stayed, some people didn't who cares. We're going to ask you, oh my God. To me. And I'm just like, my brain goes, oh, no, you had actually turned the question around on me. And how has your bedside manner? And, you know, I think for me, when I do, like, when I meet people on the road, on the road, like here's the band back together, man. But when I'm on the road, I, you know, if somebody is talking to my, a podcast or something like that, or 15, one of my paintings, which I'm like, why are you in my basement? Why are you in my man cave? It feels cool. And I don't necessarily want to give them an experience per se, but, you know, I want to let them know that I appreciate the time they took. There's a ton of other things that people could be doing well, I'm not aware of these other so-called establishment. I'm sure they're fine. But this is the only one that I can officially recommended. This is the official, a tattooer and Bessie shop of the KT team and crew. We get all of our tattoos here. And if you would like to be on the show, you know, you can always email us at Katie DOI, podcasting, gmail.com. I will send you 11 topics. And if you have a topic or topics you'd like to talk to us by all means, feel free to email me and we'll go ahead and get you on the show. I will come to where you're at or we'll do it on slack. If you're attending. I have signed a assignment contract here, so you won't even be able to look at my skin, but that's, I know for me, your church I've met her has always been well. I mean, we've been friends forever the week and I'm bad with math, so I'm going to go with her. I'm going to go with a hundred years. Why not? So as far as your craft goes and I think, you know, when we did our very first interview for a year and a half Ashly: ago Timothy: Art portion of your stuff we talked a little bit about your inspiration on that. Are you finding it with today's technology? You know, you go on the internet and get any. I mean in use, if you want all that kind of jazz, is that making your ideas, closet or idea board easier to fill up harder to fill up with it so easy to kind of, you know, people out there copying other people's stuff. Yeah. Ashly: That's not it, you know, once you get energized, not like a copier, but but now you are putting a separate on this tattoo, right? When see it as a tool for good, you know, I still collect books, looking at references books, but it does make it easier. Thinking about drawing something that I can look up reference on my phone and use the internet or something or whatever is when people, you know, if somebody brings me an image on their phone and it's the first thing that they use. And I know there's another one that you can't ever have enough tattoos. You never have enough skull tattoos just because it's something it's popular. Doesn't mean it's wrong. If it's the first thing, if you Google searches, generally not wholly unique to you. Right? So the physics of tattooing, which I feel like goes into the craft and tracking there are some things that are possible that are not a good idea. And it's for the longevity of your tattoos, because it's not a painting, you know, and it's going to grow and it's going to change with you. And so if you use, you know, it goes together over time. And if not anybody trying to talk to you and just trying to get money on you or anything like that, It's just so that you can have a me just because it's possible. It's not a good idea and everybody fucking knows it, but there are people that will do tattoos like that, and they will be on the internet, mostly a site, especially for you that I won't name. Why they shouldn't be doing something and they're holding up their phone on a picture of exactly what they're trying to get. Same. It's right here and it's already done. You just can't do it. You know? So that's when it gets frustrating, Timothy: that's when you want to hit the hit time machine and go, okay, let's fast forward 10 years and see what that thing looks like. You can hear. So Ashly: we have a binder here that has tattoos in it from that are kinda like that, that show people what it looks like. So yeah, I try to speak for good, but it does get your, Timothy: so I guess that's another aspect of your being an advocate for the person or their future selves. You know, you're trying to love looking ahead for them and go, Hey, listen, you know, I've got 355 tattoos. I think I know what I'm doing. You're coming to me a professional that knows what they're doing. Like you wouldn't walk into your doctor's office and go, you know what, just take out the right house to live the last one, you know? And they're both insensitive. You don't do that to your medical doctor. Why would you do that? Catch a of it. Yeah. Ashly: Yeah. A bit of saving people from themselves, you know, and I either choose to listen or not honestly, like, it's kind of, it goes both ways. Sometimes people just frustrated and, you know, whatever. But most of the time I feel like people listen to what you're saying, even if they don't completely understand why. Well, I was just talking about physics and tattooing's like, there's art from a long way. The materials put a long way, but there's certain things that we can't just get by. And that's the way that it's going to work in your skin. It's just physics. It's science. Timothy: Like, I think I remember we had a conversation one time I was talking about doing daisies over my scar, on my left, on my back hand. And that's just not going to work. It's a great idea. It's a tribute to my mom. However, it's probably gonna hurt like, hell, it's not going to turn out. Right. Ashly: Yeah. And it's like that. Talk about going back to like people say the compensation too, because even if I'm talking to someone she know it's important to understand, sometimes you have to, sometimes you have to certainly, won't just, they understand what you're saying. And then other people, when you. When it's something like really important to them, or it's very personal, it's very emotional for them is not gonna work as a tattoo. And so you're like, okay, well that's not gonna work as a tattoo, or we've got to do this and that. And sometimes people will understand, and then sometimes people get really upset because they take it like you're trying to tell them that their idea's stupid, as opposed to just saying your idea is great. It just doesn't work as a tattoo. And it's, you know, that goes to the physics and the graphic, the whole thing. Yeah, I've definitely been in consultations with people that got started getting mad at me. They're like, oh, well, you know, I know it's not what normal, you know, I don't like, no, no, no, no, no. Let's say Timothy: there is no normal. Once you cross the threat, So again with me, you know, I got the day job air-quotes going here and hardcore, except on my left hand, I'm not moving my left arm at all. So for me, I know my time is limited in the art that I can do and practice and rehearse and all that. And I think practice is a big thing for you. Are you finding all right, so, you know, you're not allowed to catch you. You take an hour, two hours, three hours to, so in your eight hour Workday, shall we say, which you probably know of you, you don't have an eight hour Workday, but 40 enough at the time that you're not tattooing, you're doing the research, you're doing the consultation. You're doing, thinking about the business aspect of it. It's not just, Hey, we're sitting around here having a good time. You're actually doing research and practicing your frown. To get better at it. Ashly: Yeah. We all get along, around joke around too, you know, because it's important, in my opinion, especially when you do something, some people would see it as being cause it's permanent, you know? So she has to be able to laugh about things and not, if you take, I take this seriously, don't get me wrong. It completely seriously. But if you freak out about every tattoo that you're gonna do, then you won't be able to do it. Right. So we have to, there has to be a lightness involved as well. Timothy: I know I could never do a cashew because you don't have an eraser on the other end of that machine. Not a permanent non-painful. Yeah, exactly. Ashly: Yeah. I'm getting laser. It takes a long time. Yeah, no thanks. Yeah. Timothy: I don't want lasers in my eyes. I don't want losers on the body, Tom Brady, on the other hand, I'm fine with that. And I know, I know you don't care about no, you do care about sports. You care about hockey. Cause that's the only sport that's left. The guy was fine. He scored another goal later on in the game. Ashly: I actually thought about my beginning last night on the worst idea. Well, I didn't go watch it. So it was on draft. So at least halfway the half of one. Timothy: Well, I mean, they really need to bring the Richmond renegades back when they read here the Coliseum, they just, they just need to do that. My mom Ashly: told me over the holidays that she did not get. Yeah. She used to date a dude who went to the Wildcats and he, someone was playing a character based on him when she told me that I was like, Timothy: I I've never dated a hockey player. Ashly: I guess anyway, there we go. Somebody else will understand that Timothy: that's when we can pull it out for the Christmas show. So I know I've been guilty of this forever in a week by saying tattoo artist. So for you, is that kind of saying the same thing twice? Ashly: It's fine. I mean, it's kind of like when I'm talking about myself, I refer to myself. I don't have a problem Timothy: and everybody knows me cause I am just like, everybody's in August. And of course she has to be, if you know who I am, you've got to be an artist in some way, shape or form. You don't have the options. It's just a requirement because if you're not, I'll make you one. Ashly: Yeah. I guess for me, it just goes to like the for that ground. But you know, I don't care and I don't think offense to it. You know, like when people tell me, I look like Kat Von D I know they're giving me a compliment, but it's like it doesn't make me feel like they don't see me as an individual. So on my training. And also sometimes when you say tattoo where people understand, they don't understand what you're saying. So kind Timothy: of walk us through your Ashly: well, you mean like I'm a Leo, I like long walks on the beach and cannulate Laden. Well, Timothy: no, that's a material. No, I don't like somebody walked in Joe blow walks in it's either flashing them all. It comes in with an idea. What's, what's the process that you go through or he's like, Hey, listen, I want a tattoo. Don't care. What? Talking to this. Ashly: Well, they can't always say I'm not, you know what I mean? Like, let me know what you want to do. We had time to do what we have time to do it. If it needs to, if it requires an appointment, then it requires an appointment. Usually when I set up appointments, I do whatever it is. Usually I have people come in from complications, a lot of different variables and a lot of time to be able to do a tattoo. You know what I mean? Like it's all so subjective. It's just easier to do that in person. Yeah. You make a folder from there is when you set the time for an appointment. Okay. Timothy: And so let's say somebody, you know, wants to come to you and get a set to what, what should they bond? So I've cash. Cash is good. But no seriously though, what should they read? What's going to make it easier on you to give them what they lost. Ashly: Well reference for something. Does that sound like the first step? Like what people want to do? It doesn't have to be a completely, fully formed idea, but yeah, he got to know what you want yet. When you walk in the door and you gotta be serious about wanting to do it, he's like, I don't ever want anybody to feel like they are unwelcomed because that's not true. But you know, if you're going to beat up on back and forth, that's fine. But once you kind of come in and you're going to spend like 45 minutes talking to somebody about getting tattooed, that you're just mulling over. There's a better way to go about that hundred ideas, just a general idea of what you're trying to do. And that's when we can talk about all the options of how to, how to make that come to fruition and we're gonna work with not gonna work. And then there's some people that are like, oh, okay, well, I have another idea, a basic idea of what you want, because we're not sitting around telling people what to get tattooed, and I'm not trying to trick anyone in anything, you know, that's the best way to go about it because we can sit here and stare at each other and be like, okay, so you're laying in here is this habit. So I have that and wall over there. I ended up doing on my best friend So before I did that, I had to sit in the long. So if you have a general idea, you know, step one, it's not from a point of trying to be a jerk or anything like that, but you know, people don't want. Someone coming into their work and just like making them stand there while they, you know, Timothy: well, you wouldn't take your car into a garage and go, I don't know, maybe an oil change. I don't know, break. Ashly: I'm going to think about it for half an hour, but I don't want you to go anywhere. I need you to stand here with me. So when I think about something, I can tell it to you and then go, but I don't know, you know, and you don't act like you think, you know everything about it, right? A buddy of mine. I've heard of mine and I've ever had stickers made before. I also don't know how it works. Timothy: I forgot to bring stickers Ashly: and we're just like going over the design. I just told him, I was like, listen, I have never done this before. I don't know what I'm doing. I don't want working what doesn't work. So I was like, if I am asking for something that's realistic or by mapping for something, that's going to be gigantic pain in your ass. Just tell me, I don't know. And I don't want to actively try to do that. And that's how I feel most of the time when people are. When it's a difficult situation. And most of the time it's just, they don't know what's going on. I don't know why that doesn't work. You know? So that's why I always make a point. If I am going to tell somebody, no, I told them why Timothy: good deal. Now, as far as like, when you're in that consultation points and you get somebody that has a pretty good idea, and it is a feasible idea at that, I guess I'm kind of getting towards the whole I don't want to say ownership part cause it's, you know, You own that work, you put your, you know, your heart and soul and sweat and tears into this is why Ashly: talk about having someone or any, it's always a weird thing. You work on them, even as I say, Timothy: I see. That's something that I've learned that you don't have to recall catchy with you. I'm like, oh, I never noticed that Ashly: I got to do. Timothy: I mean, I've seen you put it on Instagram or I seen you put stuff out there. Ashly: It does sound that I can make it sound a lot, like, well, Timothy: but you know, it is a thing that you do get through together because there's a certain amount of pain on this side of the house because we're using the no pain needles, but I know your hands. Ashly: When you're done. Yeah. But yeah, it's definitely not just a physical thing on the angle of the person getting tattoos. I definitely wonder if my hand Timothy: and that's why it's always good to hear here, tattooist. And I'm going to start sending text cards to a massage therapist. Never happened. Okay. Well, I have a massage service. She works. Oh, yeah, I was there kind of like a certain degree of, I don't want to say sadness that a loss, especially when you designed your own, like this one is, you know, a, you designed it, but is there a certain certain sense of loss? Like, you know, after I get done here and walk out the door, that case is now gone. Not necessarily, because all you gotta do is guys, you can take a picture of that. You know, you got visitation rights to it, but is there a certain kind of a feeling that you have with that one? When we walked out. Ashly: You always want to get richer and then she's always nice of like the way it's going to look when it's all settled, trying to get a good picture of it. I don't really feel, it's not like a separate thing because what you're working towards is trying to get it on somebody else. So, no, it's not necessarily like that. It's not like I've definitely done drawings or paintings that I've her soul. And it's like, there's only, there's only one of those two, but I still have to drive weird. But there's kind of like a separation anxiety with that a little bit, because you've spent so much time on it, but we've spent a lot of time, like, I don't know. But it's a different thing Timothy: for me. So you get it more with the with the drawings and the paintings versus the tattoos. Ashly: Okay. That's Timothy: true. And I do plan on walking on my hand and you don't when you're done. Yeah, that would be hilarious. Well, no, I get that too. Cause I've, I've sold very few paintings, but you know, the the couple that I have sold, it's like, Ashly: yeah. Yeah, I guess for me, it's when something is in front of me, but if I've drawn something fully functional, if the drawing makes any sense, I think the ideas, I mean, just listening to Brian. That makes sense. Just like forever. Timothy: So we've touched a little bit on your drawing, painting and that kind of stuff. So with tattooing that's more France and art, but with like the drawings and the paintings and all that kind of stuff, is that more arts and crafts? I Ashly: would say. Yeah, not necessarily do a whole lot if I do. I don't, I don't do like, stuff like that, but cause that's the only, like the crapper has been drawing for you. You just know spatial relationships, as far as something that's going to be 18. And to me, it's not like you're wild artists, whether they come in, which is why, if you were like, I'm going to have my friend draw it for me, I'm like, no, it's going to have to redraw it anyways. Because a lot of the times it's like a lot of a lot of stuff in the foreground and then like, and it's just not, yeah. Timothy: So make sure you have a brush Ashly: or something. Just a hundred thousand. That's also aware in friendship in the future. So that's also Timothy: like with all that drawing in apprenticeship is it you're doing a lot of drawings and then you get to, do you get the secret chief into a tattoo or is it 15 versions of the same thing? And then, okay, you're gonna put it on yourself. You're going to put it on somebody else. Ashly: I mean, everybody does it differently. But I mean, for me, the first part about my version, which is basically learning how to keep everything clean. Yeah. You know, you don't actually have to work with it for a really long time, so you get everything else. Timothy: So what are you trying to tell me is if you want to be a tattooist every time I say I get 10 bonus points because I'm learning to change my vocabulary or some tattoos, tattoos, tattoos, that's 30 points and wood that I can buy three of my own books. But so th this isn't something that you can, you know, in five easy weeks when 1995 Ashly: be attached to it, people that that's, that's why. Because you can't teach someone how to be a decent tattooer. Good. We need decent tattooer in two months. It's just ridiculous. So, but people, you know, people buy in life, so that's just stealing people's money. Yeah. Timothy: And then a lot of that out there, and then you have a lot of your online schools or this, that, and the other thing, which for some things sure. You can do it, but I've seen, you know, stuff where they do online before. And you know, as people know you were, once my students in each class, I don't think you could really do that over the internet. Well, maybe you can do it with not even with Skype or maybe with squad gas. Thank you for the hundred bucks flat. You could kind of do it that way, but you know, actually to give us the, and I'm getting over the butterflies, you know, kind of plug stuff into the, into the sharp first day. Yeah. That's really gotta be done in person with somebody that can see what you're doing wrong, bad, bad habits and all that. Ashly: So many edges and every single one that he did that. And I watched them do it and I asked questions and you know, it has to be a hands-on thing that can not be something that's a commodity. Timothy: So now going from. Somebody who on apprentices right now? As far as I know, you're not, you're not doing that, but no, I don't no desire to do that. Ashly: It is so much work and it's such a commitment, Timothy: but that's not even a next stage thing. That's not going to look Ashly: into that. I don't have any, well, you've Timothy: dealt with me for how many years you have to have that kind of patience. Ashly: Yeah. Not that I want to be the guy who taught me basically. Timothy: And with that, you know, apprenticeship teaching where your craft is today, let's say six months out of that apprenticeship was it's, it's obviously you're doing the tattoos, but is there like a percentage breakdown of my instructor, you can see my instructor, you know, 60% of the work versus me, 40% of the work. And does that percentage kind of go down, whereas, you know, if we're looking, looking at your work today versus six months a year, apprenticeship, Ashly: Want me to like emulate the way that I draw. Gotcha. Which was good. It helped me to just like figure out what I like to do. You know, there's nothing wrong with. Timothy: He'll have a PBS TV show. Oh, there's got to be, my wife got me a Barbara Borgen. Totally different. So what was I listening to yesterday? It was on NPR. CBS made me think about NPR, which makes me think about PBR, which they were doing a thing on there. Talking about the Smith. She was working on the Emory and they had a little special on it, where they were talking about female artists. Her relationship with man Ray and all the abuse and all that kind of stuff. And then I guess she had a son that didn't know who she was in the art world. And I was like, mommy, I know, man, Ray, I know Lee Smith. And I'm like, how could he have not? I was thinking about that. I was like, oh, Ashly: okay. Well, I mean, it's kind of like, I don't like to, when I'm. Absolutely. Know you just have to put your head down, but I wanted it that badly that I wasn't going to get that Timothy: well, if it's something that you want to do with your life, if it's the calling that you have, and I'm not talking, like I'll put a special time for that, because that's what we do on podcasts. You know, you're going to get, you're gonna find a way. Ashly: Yeah. It was a very, very frustrating Timothy: well, and that kind of goes through one of the quotes that I found with craft that I thought was really cool is you know amateurs have writer's block writers, you know, and then the other one was you know, what crack is, is to be able to sit and look at the blank cage until you're sweating bullets and then write the story. Do the job and make that happen for yourself? Ashly: yes, we are a wild pack because I'm an adult, but when we need an adult Timothy: now, even when you're kind of doing the flash piece and, and let's say you've done it, you know, it's a. Let's go, mom, Ashly: are you burned on Saturday? Timothy: So even when you're doing one, you're still putting a little your own spin on it if Tweety bird, but you're not putting a, like a, like a subliminal upside down, cross on it. Ashly: No, I mean, I've only been to tattoo in the style of my tattoo, you know? Well, until that style changes. Cause that's what happens when you grow. And Timothy: it's funny, you mentioned that because our good friend miss Noreen barn she just emailed me back. Have you thought about style as a topic and I'm like, Ashly: you really want them to look the same. Wouldn't get them done by different people, which is also the other aspect is it's not about getting and then adding to that one tattoo over here next to it. I mean, it was like they wanted to do the whole same thing. They're trying to get five different people on the same tattoo. And I'm like, it's just like, you just went in to get this big tattoo. Which is something that I think, I feel like people forget to find everybody works in different style. If you want something to look like it was all done the same time, all at the same time, you know, otherwise. Timothy: Yeah. Because when I roll up my sleeves, people go, well, yeah. The other tattoos that I have have color in them and you know, with you, we do, we do the shadow work all the time, but people lacking gray was great. And I thought, I thought it was my hair. No. Okay. But but I I eventually all the body hair. Ashly: That's all we can make our riches, man. We'll just take a video of you Timothy: hanging out in the backyard with one adorable girls. Ashly: It was fun. It was like a little backbone. Oh, okay. Timothy: So being on this side of the needles, I know I was going to kind of that happy zone whenever I get tattoos for you. And now my regular job, I don't necessarily go into that happy. I'm turning up music really loud, you know, shutting my door on, know, cranking out Excel spreadsheets and TPS, cover sheets for my factors and all that good stuff. He goes, somebody did give me a red stapler told him, let's say for set off the space was one left will be split for you. Is there a point where you kind of get in that happy zone where your site get higher time and space kind of go away. And he was like, Symbiotic with the client, therefore the Ashly: past hour and a half, I don't understand what you don't want to bring a hundred people with them to watch them get tattooed. Because watching someone getting tattooed is incredibly wide, Timothy: they made, it's not like it is on TV. Ashly: It's like I also, because I told them, I'm like, it's the message television, man. It's like you ever seen a cooking show? Like they don't stand in front of the oven for 25 minutes and watch the oven. They bring out the little thing and we go, Hey, if we stood here and watched the oven for 25 minutes, here's what would come out of it. And same thing with tattooed TV shows, people were like, really? It's going to take that long. I'm like, yes, it's a very long process. Which is also, you know, I don't expect everyone to know that, but no the best way that I ever heard the lady to thrive, watching somebody getting back was that librarians. I did someone ask them, he just said to her and they asked them, what's it like watching? It's like watching two people sit close to each other for hours. Yeah. That's exactly what it is. Yeah. Timothy: Cause I'm weird. You're not weird Ashly: with the normal Timothy: one. Right? You're you're, you're the normal one. I am the purveyor of weirdness in the world. I would sit and watch people very closely for hours on end because I'd had my notebook right there and I'd make up a novel. I said, Ashly: yeah, I don't see you doing that. But it just makes me think of the, I've never seen, it's going to be a video of somebody walking up a hill for six. Yeah, I don't. Yeah. So unless you're like, watch myself getting tattoos, I like to watch the way other people got here. Sure. But interesting to people you don't even have that many people in can find the dressing room and not have the temperature. It can be really uncomfortable and ultimately. Ultimately one room. Absolutely. Timothy: That is why I will never have you Ashly: normally, normally, oh God, it's hard to do. I think a lot of distress, depending, if you want to make sure that. It's not funny. But But yeah, I have two names on me. I have my dog. And then I have my finger that he was going to use it as the front page of the portfolio. Timothy: No, I just had my name on me cause I figured I'm not going to break up with me anytime soon. Besides it's funny when people don't know me, they look for chemo, they looked for a little Oriental guy and I'm like, well, that's how it, that's how it started. Yeah. Have I told you the story of king? Oh my God. Okay. I, you know, we've known each other for a hundred years. Jesus. So my my brother Mike is four years older than I am. He went to college. I went to high school. Join the fraternity. There's a guy there from Thailand. His first name was 13 letters, long, 15 letters long. So they called him chemo, dragon. He and I got to be good friends cause, well, you know, I'm French Canadian. We can drink a lot. And so they call me chemo. So I'm in the air force. I'm writing poetry, go to my first poetry reading. And before that there's this bulletin board system, which was before the internet and I was putting poetry up there and sending it as chemo because I was unsure of myself. And so I'm like, Hey, I'll meet you guys at this, you know, poetry, that's in the coffee shop in town. And so I signed up his chemo and I'm standing in the back and I'm like, Hey, you know, we've got this new poet. Here's his first time out under the names chemo. Let's, let's bring them on up. So I pop up there and they're like, no, no chemo. No, that's me. They're like, you're not a little Chinese guy. I'm like, Nope, Nope. French Canadian button. You know, we looked Japanese if we were tall and really hearing. Yeah. So I used that you know, I had a good, you know, good turnout at that point. And so when I was in the airport working on aircraft, because I was a mechanic, we all have inferior inferiority complex to pilots, pilots have call signs. So we all had to give herself a call sign. So I gave myself. And that kind of stuff. So I started getting tattoos and I was like, oh, well I need to put that on my arm and make it stick. So that way I can tell people, no, really I am chemo. You don't want to go to Porsche. I have it on my arm felt the same way. And the skull kind of looks like me. I've been one time. I did have a full man. I used to wear sunglasses. These are transitions. They turn into sandboxes and that's about three minutes story. There's a 32nd story. And there's a three day story. I've only told the three day story twice. Ashly: The ceremony Timothy: involved with it. Oh yeah, there was, there was a fist fight afterwards. Cheated there. Like you could have told me, I had three minutes. I'm like, well, you asked for the three-day story. I gave you an option. So let that be a lesson to you. People, if you ask for it and you get it, you ask, can you do my hair too? With Ashly: highlights? Timothy: Also, we did we did the haircuts with the girl and her style. His name was Jennifer. They hit it off and equity. I had hit it off with her stylist to talk like they're old friends, I'm just, I'm sitting there going, there's going to be a nightmare. I'm going to Holland and crying and death benefit. They have their moments, you know, like when they wake up at three in the morning and you go in there and let the wife sleep and you go in there and now. I don't have to threaten any boy that's out there. Any girl that's out there. I have pictures. I have video audio. Thank God for Google photos, Google. That's a hundred dollars. Thank you very much. Ashly: We're done. Timothy: Oh, sweet. Ashly: All right. Timothy: Promise. I eat food Ashly: today. I know. Timothy: Oh yeah. That is, that is. That is done to my folks to get a tattoo, but not this one, this one's Ashly: wherever. Yeah. Timothy: Yes, you're right. It is a switch blade. Ashly: It can be a sword if you want it to Timothy: be a sword. Well, I mean, for, for a mouse, it's a broad sword, but for a tiny mouse, Closing Thank you for listening to this episode of create art podcast, KDOI rebroadcast. You know, it was a real pleasure talking with Ashley while getting a tattoo and interviewing her and getting her ideas and thoughts on craft. Do I recommend it for everyone to do now? I don't recommend it for everyone to do doing interviews while you're getting tattooed, but I do recommend you getting tattooed by Ashley, for sure. Now, if you are having issues with your practice, with your craft, reach out to me, timothy@createartpodcast.com may be able to help you out. Or I may be able to get you to some resources that will help you out. So until next time tame your inner critic, create more than you consume and go out there and make some art for somebody you love yourself. See you next time. This has been a gaggle pod, east studio production gaggle pod, where we've been helping creatives tell their story through podcasting since 2017, come on over to gaggle pod.com. Check out all of our network shows and let us help you tell your story through the power of podcasting. .

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.

This special edition episode is brought to you by AmerisourceBergen's Insights podcast. In part two of the insulin biosimilars series, host, Jennifer Kemper, Director of Content Strategy, continues the conversation with Sean McGowan, Senior Director of Biosimilars, Michelle Jesse, Director of Biosimilar Commercialization, and Brad Tallamy, Senior Director of Government Affairs. At the end of July 2021, the Biosimilars market expanded with the FDA approving Viatris Inc.'s (aka Mylan) Semglee (insulin glargine-yfgn) as a biosimilar, as well as approving interchangeability status, specific and only to Lantus. The team expands on what these new drugs could mean for the category, how new insulin biosimilars could deliver on the promise of cost-effective care, and how to prepare for interchangeability.

Top stories this week include: a new adjunct therapy is being tested for type 1, Dexcom and Garmin will officially work together (no more DIY needed), once weekly basal insulin study, can psychedelic drugs prevent type 2?! and Australia bets on Rugby for diabetes education 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 I am on location this week. I'm at the She Podcasts LIVE conference.. but the news doesn't wait. So.. 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 – and in the show notes at d-c dot com when this airs as a podcast.. so you can read more if you want, on your own schedule. XX In the News is brought to you by Real Good Foods! Find their breakfast line and all of their great products in your local grocery store, Target or Costco. XX Our top story.. There's a lot of buzz these days around adjunct therapy for diabetes.. basically another treatment along with insulin. Earlier this year, a drug so far just named TTP-399 got FDA breakthrough therapy approval. A new study shows it works well to keep people with type 1 out of DKA. This was small study, 23 people. They found that TTP-399 can help lower blood glucose without increasing the risk of DKA. It's important because other adjunct therapy.. such as S-G-L-T-2 inhibitors do help lower blood glucose, but the FDA has said they cause too much of a risk of DKA in people with type 1. Those are brand names like Invokana and Jardiance. Pivotal trials of TTP-399 begin later this year. https://www.biospace.com/article/vtv-therapeutics-type-1-diabetes-drug-shows-promise/ XX New partnership announced today - Dexcom and Garmin. You will still need your phone.. I knew you were going to ask.. but with the new Dexcom Connect IQ apps you can now see your Dexcom G6 info on your compatible Garmin smartwatch or cycling computer. Jake Leach, chief technology officer at Dexcom says.. Garmin is the first partner to connect through the real-time API, which we told you about a few months back. Basically, you'll be seeing more connectivity without having to use a third party, community sourced work around which a lot of people do now. The name here is interesting, right? Connect IQ, very similar to Tandem's Control IQ. But since Dexcom owns a bit of Tandem, maybe that's no coincidence. I've requested an interview with Dexcom so maybe we'll find out. garmin.com/newsroom, email media.relations@garmin.com, or follow us at facebook.com/garmin, twitter.com/garminnews, instagram.com/garmin, youtube.com/garmin or linkedin.com/company/garmin. XX New study about time in range, hybrid closed loop systems and faster insulins. The headline here is that using Fiasp with the Medtronic 670g system resulted in greater time in range. How much? The Fiasp group spend 82 point 3 percent time in range.. the Novolog group spent 79.6 percent time in range. This was over 17 weeks and the participants mostly bolused AT meal times, not before, no prebolusing. The researchers echo what I was going to say here, quote – “While the primary outcome demonstrated statistical significance, the clinical impact may be small, given an overall difference in time in range of 1.9%.” So just a heads up if you see headlines screaming about how much faster Fiasp is because of this study. https://www.endocrinologyadvisor.com/home/topics/diabetes/type-1-diabetes/fast-acting-insulin-aspart-versus-insulin-aspart-closed-loop-type-1-diabetes/ XX People who have tried a psychedelic drug at least once in their lifetime have lower odds of heart disease and diabetes. This is a University of Oxford study published in Scientific Reports. These researchers examined data from more than 375-thousand Americans who had taken part in an annual survey sponsored by the U.S. Department of Health and Human Services. Participants reported whether they had ever used the classic psychedelic substances including LSD, mescaline, peyote or psilocybin. They also reported whether they had been diagnosed with heart disease or diabetes in the past year. The researchers found that the prevalence of both conditions was lower among psychedelic users. While no one is recommending you start taking mushrooms to avoid diabetes.. there's a growing push to start serious research to investigate the link between psychedelics and cardio-metabolic health. https://www.psypost.org/2021/10/psychedelic-use-associated-with-lower-odds-of-heart-disease-and-diabetes-study-finds-61958 XX Update on the once a week basal insulin I've been reporting on for a while.. both Lilly and Novo Nordisk are testing their own version of this.. this most recent study looks at the Lilly version called Tirzepatide. These researchers found it to be safe and effective with lower rates of hypoglycemia and slightly lower A1Cs than daily basals like Lantus or Tresiba. Lots of studies ongoing here, for both brands of potential once a week dosing, including a large phase 2 program that includes people with type 1. https://www.healio.com/news/endocrinology/20211012/novel-onceweekly-basal-insulin-safe-effective-in-type-2-diabetes XX More to come, including how rugby and diabetes education may go together.. But first, I want to tell you about one of our great sponsors who helps make Diabetes Connections possible. Real Good Foods. Where the mission is Be Real Good They make nutritious foods— grain free, high in protein, never added sugar and from real ingredients—we really like their breakfast line.. although Benny rarely eats the waffles or breakfast sandwiches for breakfast.. it's usually after school or late night. Ugh.. do your teens eat breakfast? You can buy Real Good Foods online or find a store near you with their locator right on the website. I'll put a link in the FB comments and as always at d-c dot com. Back to the news… -- Getting out of the doctor's office and into something that people can actually relate to.. Diabetes Australia is using rugby to teach men about the risks of type 2 diabetes. League Fans in Training (League-FIT) is based on a Scottish initiative that used football teams to deliver exercise and nutritional advice to overweight and obese men. The program includes education and goal setting and a rugby league-based exercise session, delivered by coaches and some of the club's players. What I really like about this is that -from what I can tell - they're focusing on small changes and not telling these guys to give up everything they like to eat and drink or that they have to become professional players to get a little bit more fit. Imagine if NFL players had a clinic for fans to come and learn a little bit about fitness and nutrition? Again, not to be pros.. just to live a little better and lower risks of type 2. https://www.diabetesaustralia.com.au/news -- On Diabetes Connections this week, we're talking to a mom with type 1 who has had two children during the pandemic. One last summer and the other just a few days before our interview! That's In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.

Kevin Covais was one of the youngest contestants on American Idol; he was just 16 when he made his debut during season 5. He'll share some behind the scenes stories including managing low blood sugar during a live performance. Diagnosed with T1D at age 11, Kevin has been working steadily as an actor. We'll talk about working in Hollywood with diabetes – and what that's been like during COVID, more about American Idol, and how Kevin found himself mentoring other kids with type 1. 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! 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. Announcer 0:20 This is Diabetes Connections with Stacey Simms. Stacey Simms 0:26 This week, actor Kevin Covais was one of the youngest contestants on American Idol back in season five, he'll share some behind the scenes stories, including managing low blood sugar during a live performance. Kevin Covais 0:38 And I'm singing and I just like, I can't wait for this thing to be over. I can't wait to stop singing and get the critiques from the judges that I'm not even gonna really listen to you because I got to get off the stage and I got to get some juice or I gotta get some tablets. I gotta take care of this. Stacey Simms 0:49 He was fine. And since Idol , Kevin has been working steadily as an actor. We'll talk about working in Hollywood with diabetes and during COVID more about American Idol, and how Kevin found himself mentoring other kids with type one. He has advice for parents too. 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, always is so glad to have you here. Hi, I'm your host Stacey Simms. We aim to educate and inspire about diabetes with a focus on people who use insulin. And my guest this week is Kevin Covais, diagnosed with type one just as he turned 11. Kevin is best known for American Idol as you heard in the tease there and the Disney Channel show Good Luck Charlie, where he played the character Victor. He is a steadily working actor with roles in Transformers and this is us, the rookie, NCIS Los Angeles and more. I put some pictures of Kevin in the Diabetes Connections Facebook groups, you can kind of see him on set. And he is appearing in the new Netflix series on the verge, which is out this month. I thought it would be fun to just play a little clip of Season Five of American Idol where Kevin appeared and this was back in 2006. As I said he was one of the very youngest contestants. So here's a little bit of him from back then. (Kevin sings) https://www.youtube.com/watch?v=dc5ec3te75I Stacey Simms 2:44 used to watch idol all the time. And as I confessed to Kevin, it has been a while. But what a big show, right? And you'll hear Kevin during the interview mentioned Elliott Yamin who was also on season five and also lives with type one. I got to meet Elliot a couple of years ago at a touched by type one conference he is still performing writing music. He's now a dad, I'll put a link to Elliot stuff in the show notes as well. That of course will have tons of information about Kevin, but I just thought that was really interesting because to me, I don't know it seems like yesterday but of course 2006 was the year that my son was diagnosed, Benny was diagnosed right before he turned two. He is now almost 17 which is I mean, we've lived with diabetes. Now I've been part of this community for 15 years in just a couple of weeks. So 2006 kind of was a long time ago and kind of seems like yesterday to me. Alright, Kevin's interview coming up in just a moment. But first Diabetes Connections is brought to you by Gvoke Hypopen and 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 fast 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 is Gvoke Hypopen. Gvoke Hypopen is pre mixed and ready to go with no visible needle. You pull off the red cap push the yellow end onto bare skin and hold it for five seconds. That's it. 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 slash risk. Kevin, welcome to the show. I'm really glad to talk to you. Thanks for making some time for me. Kevin Covais 4:26 Stacey. Thank you for having me. I'm so excited to find we've been talking about this for a while I'm so I'm so happy to finally join the program. It's great. Stacey Simms 4:33 Awesome. Yeah, it's great that we finally connected Gosh, so much to talk about. We connected everyone We see each other every year add friends for life. Yeah. And I was so happy we were able to do that this year. We'll kind of see what happens going ahead. But before we get into all of that, do you mind if we just kind of take a step back and look back? I mean you haven't been on the show before and I'd love to kind of revisit the early days of Kevin Kevin Covais 4:59 Spacey. I would be disappointed if we didn't do that. So let's, let's dive in. Let's do it. Yes, please. Stacey Simms 5:04 As I was asking that I was thinking about American Idol but I should probably go back further. You were diagnosed when you were you were a kid. You were not even 11 years old yet, right? Yeah, it Kevin Covais 5:13 was just prior to my 11th birthday symptoms leading up. Yeah, my birthday is at the end of May. And I just remember that entire month of May so vividly. You know, obviously, you think back to childhood and, you know, memories here memories there. But that month just stands out in my mind so vividly. Symptoms throughout the month, parents wandering out what's going on with Kev? what's what's happening, you know, maybe an infection this that bring me into the doctor, several days prior to my 11th birthday to get the diagnosis of type 1 diabetes. Yeah. Stacey Simms 5:41 Did you spend your birthday in the hospital? Kevin Covais 5:43 I think it was. So it was it was several days after my birthday. So yeah, it was the entire month leading up to the birthday. And then it was, yeah, right. At the start of June, I was putting so this was several days after my 11th birthday that I was in the hospital. And just you know, you hear the doctor tell you and your kid and I, you know, I immediately I broke down and cried. I didn't know, I didn't know what I was dealing with. I you know, you hear the word diabetes and you know, your mind escapes, you starts running around all these different things. And then he you know, the doctor, you know, kindly explained to me, now this is something you're going to be able to manage your life. It's obviously going to be a great deal of work. But this is something you live with and something you manage. And then from there, I learned everything over the course of the next week and being in the hospital and getting treated. Yeah, it was. It was a month like no other though. Yeah, that's for sure. Yeah. Stacey Simms 6:27 So your kid, you're diagnosed at a time when frankly, it's the as I recall that time that early 2000s. It's the time right before everything really started changing. Absolutely. As I look at I mean, Ben, he was diagnosed in 2006. They were like, we've got this amazing thing called Lantus. That's just been approved for kids. Yeah, you know, and now everything seems so different with the technology. What was the first kind of technology or routine that you were on? Gosh, you Kevin Covais 6:54 got me thinking back to the pre Lantus days of time? Yeah, it's it's wild. For me. Taking the injections, taking the daily injections, I will go ahead and say I'm not currently on the pump, that I am one of these those rare rare people that uh, that takes daily injections. I have a CGM. But that's, that's my preferred way of doing it have been doing it that way for years. But yeah, starting out being diagnosed taking human and human log each and every day. Yeah. And those pre Lantus days. And, you know, they think back to those syringes before you have the pens and the newer technology and the things that make it so easy now, so, so accessible, and thinking back to a time before, you know, we had some of those advancements, it was definitely interesting at the start for those first couple of years. Stacey Simms 7:35 Well, is that the kind of and I say technology to encompass whatever you're using shots? Oh, of course. Yeah. So when you're talking humulin, you have a log, did you have to kind of eat on a set schedule? Or were you okay to kind of inject when you want it to eat, Kevin Covais 7:51 you know, that really came with adulthood, that sort of injecting when I wanted to eat and the accessibility I remember, as a kid, it was, it was the preference of my doctors to have that set routine. I remember going in and you have a regimented schedule of three meals, several snacks, a snack at an after school snack at roughly 3pm. And, and one prior to bed 9pm at night. And yeah, that was for a while. It's obviously insulin matching. Exactly what you're what you're ingesting exactly what you're eating and set times. It was all very regimented. For me those first couple years of my life. Yeah. Something. I bet. I bet it's a trip to think back on it really is. Yeah, Stacey Simms 8:30 it must be I mean, I just think, you know, it's there's no easy age to be diagnosed with diabetes. But 11 you're just starting out that like, tiptoeing into independence. Yes. Middle School. Do you remember? Did your parents kind of give you a long rope? Were they very protective? I don't want to be too personal. Kevin Covais 8:48 Please, please. They were unbelievable. I'm so blessed to have the mother and the father that I do. And the support system that I do, I think they handled it differently. I think, with my mother, I think not that there was more trust, I think, was maybe a little longer rope and trusting me to do the things I think my father was, you know, very concerned at times, but you know, rightfully concerned about, you know, what I was taking and this and that. So there were I think there were several different schools of parenting going on. But together, they complemented each other so well. And it was I just knew that they were always there for me during those frustrating moments, those highs, those lows, quite literally, obviously, where it's just they were there All the while, but just like an amazing support system site. I think they went about it slightly differently. But we're, you know, managed to still be on the same page because, you know, nobody handles You know, one set situation quite the same. So, I was just incredibly fortunate. We just got informed, it's like we figured out what it was and there was a moment of kind of bowing our heads and being frustrated being sad. And then we were like, Alright, what do we do about this and got in the hospital and took care of and met up with all the doctors and got assigned the endocrinologist and and took it from there. Yeah, Stacey Simms 9:53 your parents must have given you a long rope because five years later, you auditioned for American Idol right when you're 16 Kevin Covais 9:59 I was a baby I mean, I'm still a baby. I'm just an older baby. I'm still probably just as immature. But now I'm in my 30s so I don't really get away with as much. I I was 16 years old SJC when I did the show, I can't believe I did it at all. And I can't believe I did it when I was when I didn't know any more. I was just a child. Yeah. It's so Stacey Simms 10:17 funny. So okay, so you're my son's age. Kevin Covais 10:23 And your son's a child. I'm sure he's way more mature than I was. Stacey Simms 10:28 But, you know, you did let him just go. You know, he took an international trip for a month but he was with you. But he was with a bunch of people who, you know, we're we felt very safe with of course, what was the deal with American Idol because you didn't just go to one city, right? I mean, audition different cities take us kind of through what happened. Kevin Covais 10:45 It was just the journey of a lifetime at 16. I audition in New York. I'm from from Levittown, New York, Long Island, New York, and I audition up in Boston, I turned 16. And as I tell the story, my mom and I would watch idol from the Kelly Clarkson days. I ultimately was on season five. But you know, Kelly Clarkson wins the show, season one, my mom and I, it's must see TV. We tune in every week to watch the show. And my father was never a big fan. And I was a singer, around the same time that I was diagnosed with diabetes at the age of 11. That's kind of when I joined the chorus and developed a love for singing and acting in the school plays and whatnot. And he'd walked through the room and we'd be watching idol. And I would tell him, I said, you know, one day I'm going to do this show. And he's like, yeah, okay, we'll see. And I turned 16. And again, just to echo how incredibly supportive my parents have always been, they've always been by my side, I turned 16. I go up to Boston to audition for the show. When there were no tri state area auditions in the Greater New York area. They take me up to Boston, they take me up to Gillette Stadium where the New England Patriots play, they're having massive auditions. 15 tents set up on a field, a judge at each tent and forward a time that bringing us down and they say Sing, sing, sing, sing, you sing a little bit of a song, they cut you off whenever they feel like you either make it or they send you to the exits, we see a herd of people go into the exits. And I was one of the lucky few that day who they said you know what, we're gonna give you another audition, we'll come back and see the executive producers, so on and so forth all the way up to the main judges in the city of Boston, I see the original three of Simon cow, Paula Abdul, Randy Jackson. And eventually I make my way out to Hollywood. I get past that round, and made it to Hollywood. It was my first time ever on the west coast. I get to go and I'm one of maybe 180 people auditioning out in Hollywood to try to get on those live shows where ultimately I landed and Gosh, got to somehow got to the top 12 my seats I don't even know I don't even it was honestly Stacy, it was all blur. I don't even know how I did it. I don't know. I mean, I remember it. But it was just such a roller coaster and such an emotional ride in such an exciting ride my lights? Yeah. Stacey Simms 12:39 When I'm researching to talk to you, you know, going through the American Idol season five and kind of looking at what was written around that time. There's no mention of you having diabetes? Kevin Covais 12:50 No, no, you hiding it. Stacey Simms 12:57 Right back to Kevin finishing that thought. But first Diabetes Connections is brought to you by Dario health. And one of the things that makes diabetes management difficult for us that really annoys me and Benny isn't actually the big picture stuff. It's all the little tasks adding up. Are you sick of running out of strips, do you need some direction or encouragement going forward with your diabetes management, with visibility into your trends help you on your wellness journey? The Dario diabetes success plan offers all of that and more. No more waiting in line at the pharmacy no more searching online for answers. No more wondering about how you're doing with your blood sugar levels, find out more go to my dario.com forward slash diabetes dash connections. Now back to Kevin talking about why he didn't share his type one with the American Idol audience. Kevin Covais 13:46 Absolutely not hiding it. This is how little I just knew about I just wasn't aware of anything. I was so green to the experience that like now as an actor of 10 plus years as a mainly transition to acting at this point, which I'm sure we'll get to a bit in a little bit. I didn't think about it from a perspective of Oh, wow, what a stage to raise awareness for this thing. I was on the show. I made it to the top 12. And one of my best friends from the show is Elliot Yamin, fellow type one, and you know, great guy, great personality and just just a heck of a voice. Oh my god, the guy can sing the doors off the place. He's unbelievable. And we auditioned in Boston together. I was so nervous until my final few weeks performing live on the show. I just think I went in and I would do the interviews and I would do this and I would do that. And it wouldn't even occur to me like man, you should really bring this up. I wasn't hiding it. I wasn't ashamed. I think for me, it was just such a normal part of my life that I'd been accustomed to for five years. And I was like, Oh, yeah, well, I'm you know, I'm no different than anyone else. I'm just dealing with my type 1 diabetes, you know, all the while. And it's it's a regret not from a sense because again, I wasn't hiding it. It's a regret because I realized how big that platform was and Oh man, I should have said something. And it was and it wasn't until after the fact that I was like oh wow, there's like a lot of opportunity here and when I you know start to do very As events for the jdrf are really dive into work with the Diabetes Research Institute several years thereafter. It wasn't until that point, when I kind of got older. I was like, Man, this is an incredible opportunity to raise awareness. And, you know, use your platform. And I wish I could go back and tell 16 year old Kevin that I really wish I could. Stacey Simms 15:16 Well, I wasn't even thinking of it in terms of advocacy, which is a terrific point that you make, but I was thinking about it as your 16. And, you know, to say, Well, I need extra help, or I need you to know that. Although you weren't beeping at the time, you probably didn't have a CGM. No, not yet. Right. You might not just you know, and I think and I can totally understand that, because that's how my son is, you know, he'll tell people to be safe, you know, spending the night and we're not there. And he'll say, Here's to this and that, but he's not gonna say, hey, by the way, just as dropping into the conversation, yeah. I don't think a lot of 16 year olds who are let's just say it like that, I think. And you've already kind of mentioned it, it just seems like it was such a normal part of who you were. I think that's very commendable. I think that's great. Kevin Covais 16:01 Thanks. Yeah, I'd like to think so as well. I'll tell you, every staff member on idol, the producer, the up to the producers, up to the big time people behind the show, they knew I had type one. I always made it a point to you know, school teachers, obviously, you're telling them okay, hey, look, if I need to go to the nurse, this is why I'm not. I'm not trying to get out of taking this exam. It's because I have a legitimate low right now. So the people in my life I was telling, it never occurred to me when the cameras started rolling to bring it up, because it just didn't occur to me. I was like, Oh, yeah, no, I'm telling the people that are directly affected in my life about this. It didn't, it didn't even dawn on me to inform the audience about Stacey Simms 16:36 it. Did you have any issues on Idol with diabetes? And I did, Kevin Covais 16:40 yeah. There's a story that stands out. I don't mean to laugh. It's just some hilarious stories. When we were laughing. We This is how we do it. This is how we deal sometimes, you know, you know, you know better than anyone as to why it's, it wasn't an issue, up until the live shows. Really, I think, for me, it was always Okay, we're testing constantly, we're making sure we're correcting prior to getting up for big performances, or whatever I got to perform during Hollywood week, I'm making sure I'm good to go in preparation for those performances. It wasn't until the third live show there were three weeks of semi finals on the show. And I get up there on the third week, and I'm waiting in the wings to be the next one up and I I know where my blood sugar is, you know, without the CGM. I'm one of the lucky ones who can, you know, 21 years of this thing I can tell where I am. If I'm running high in the two hundreds, I feel lousy, and I know it. I know where I'm at. If I'm low, and I have the shakes, and you know, you feel a little disoriented. I know that too. And I could feel myself dropping and dropping quickly. But I'm up on stage and it's live television. So I go up and I perform I perform. Don McLean's stories of Vincent starry, Starry Night old ballad that one of my favorites, Josh Groban read it, and in more recent years, and I'm singing, and I just like, I can't wait for this thing to be over. I can't wait to stop singing and get the critiques from the judges that I'm not even gonna really listen to because I got to get off the stage and I got to get some juice or I gotta get some tablets. I gotta take care of this. It was the most surreal thing to be experiencing that in that moment. I got through it. And the performance wasn't terrible. I think it was, I think was one of my better ones. So I was on for five weeks. And I I put it up in the maybe on the top two or three of them. And yeah, but that did happen on live television, which was just the most surreal thing. Yeah. Stacey Simms 18:18 Wow. When you got off the stage Did you like eat everything? Oh, yeah. Kevin Covais 18:22 I went to town state. Oh, yeah. Are you kidding me? I was like, Yeah, let's go. I was just, it was bizarre. It was just a bizarre, but it was just a wild, wild thing to experience. And that's kind of telling for anyone who deals with this is that you can prepare to the best of your abilities. And that you know, that unexpected lower high could still come about, you just have to do your best but there's no there was no shame. I didn't feel any shame after that. I know. Look, we're all human. And this is this is a normal part of the day in and day out experience. It's just so unique that to be in the position that I was in to have experienced that at that moment was very unique. Yeah, yeah, that's Stacey Simms 18:57 interesting, too. That I forgot. Elliot. Yeah, I mean, was the same season. Kevin Covais 19:00 Oh, yeah. Yeah, yeah. Oh, man. He was I was rooting for him after I eventually got bounced and got kicked out. You know, after I got eliminated from the show. I was I couldn't get kicked off now. I was a good kid. After I got eliminated from the show. I was I was rooting for Elliot anyway not I mean, obviously the bond we shared as as he was a fellow type one and we you know, related and became fast friends over that, but I just thought he had the best voice that of anyone that sees and I thought his voice was you know, another league but it was a it was a heck of a year and a heck of a ride for it really was Stacey Simms 19:30 Do you still forgive me? I don't know if it's even on the air. Do you still watch Kevin Covais 19:33 idol please? It is not really Oh, no, it's been going on a while sometimes it's like sometimes you gotta know when to let go. I like emotionally said goodbye to the show. I think it was about five or six years ago now when when Fox had its last airing of the show. So I kind of had my emotional goodbye with the show. Then I had a bunch of friends over to my place and we watched it and we were you know we're they were laughing about stuff. Remember in my time on the show years ago, we had a we had a grand time and then you Goes via Idol s off the air and then ABC is picking it up. Because you know, why not? Why not pick it up? And they've had some successes with the ABC run and some some very talented people on the show but I think there's just there's so many options now so many things to watch. You got the voice you got to America's Got Talent, things of that nature. It's tough. It's tough to keep up with all of them now stuck to keep up. Yeah. Stacey Simms 20:20 So right. So after idol, you change from being a singer to acting? What What happened? Like, what were some of your first jobs. I know you were at the Disney Channel, and you've been guest starring spots. So if you could tell me, like when you started? Kevin Covais 20:32 Yeah, I saw I finish idol. And I'm really honest about these things. I thought, going into the Idol experience as everyone does. I want to be a recording artist, I want to make records and I want to do this. And my love for music. And my love for singing is never escaped. It's really I'm just being honest, it's more of a hobby. At this point. It's more of something for me. And if I record something, it's more for me or potentially to work, collaborate with friends or right with fellow musician, friends. But I got into the acting I remember I got done with idol and I got management back, I found representation back home in New York, there was a real interest, I think people really found me to be a bit of a character on the show. And in a good way, not a bad way, of course. And that led to auditions. And I started going out in my first movie was a real silly kind of raunchy comedy, I wouldn't recommend anyone listening to this podcast, watch it, it was a movie called college. It was with a Nickelodeon star by the name of Drake Bell and various other funny people. And, you know, really funny people in the cast. And we had a blast making it. And this was my first taste of a film. And I came to know that Deb Hagen, our director on that project, she was at home with her family reading the script of this movie, she'd just been assigned as the director. And she's watching idol with her family and I'm on the show. And she's reading the script. And there's this you know, kind of nerdy character named Morris super this kid with, you know, part of gold sweet kid, but you know, just kind of reserved and whatnot. She's reading the character, and she's looking at me on the TV, and she's like, Man, this kid would be, I want this kid to play this role. And I never knew this and takes a while to make a movie. And about a year later, I within that year, I get done with Idol I go back home, I'm doing my senior year of high school now, because I did Idol as a junior in high school. I'm back in Levittown, New York, I'm back at Island trees, high school over there. And, and I'm doing self tape auditions, I get a manager at home who starts sending me out for acting, saying there'd be quite a bit of interest if I were to pursue this. And I put myself down for this movie college and put a self tape down and I got the roll, I got the roll, which offers self tape, which is like, You're so lucky to get that it's a rarity. And I was very fortunate. And I had a fun time making that one. And then that led to a bunch of other opportunities got to work with Lindsay Lohan on a on a television movie called labor pains, which was a blast, a really stacked comedic cast. And that one, you know, that's silly movie, but a lot of fun. And then since then, the big one was good luck, Charlie, for me got to be on the Disney Channel and work on eight episodes of good luck, Charlie, in the early 2010s. And, and then from there, just a slew of fun guest stars. And I've just I love it. I love every minute of it. I don't know how it all came about. I think for me, I always love to act adjust as much as I love to sing. But I never I wasn't savvy enough at the time of doing idol at 16. Again, I was so green, I didn't even think like oh, you can use this idol platform to maybe swing a few meetings or this or that and try to try to get your way into acting. I don't even think like that. If again, if it was today, if I was doing that in my 20s or if I was doing that today in my early 30s. Like obviously I would have had that mindset but you know, I didn't know I didn't know anything like that. So but just so fortunate that it came about and I love it. I love being on set. I love playing these characters escaping into these fun people that are nothing like me. It's fun. Stacey Simms 23:35 Yeah. And you've been you know, you continually work I mean, yeah, it's as you said their guest starring roles and you know, but they seem so fun. You were This is us. 68 whiskey, you know, the Yeah, I think the last thing I saw was NCIS LA or Los Angeles. I saw you did like a theme during COVID. How is production been? Have you been able to do anything? That's Kevin Covais 23:57 You know what? That's a great question. My last two roles, which as you previously mentioned it NCIS Los Angeles I got to do a again small role but part but a scene with with great actors and Chris O'Donnell and LL Cool J the leads of the show. And that was just so trippy because you know, you grew up watching lol and then you get to do a scene with them. I like that. It's like I've done this for over 10 years and you still get in those situations and you play it cool, but it's like I'm working with frickin Oh, cool. J This is not. But that was interesting. I'll tell you as it pertains to COVID they were coming off a hiatus to show and this was I believe this was their first episode of production back since COVID. I don't think I'm making that up. We go and we film at the Paramount lot you know the famous Paramount live in Los Angeles and and they took so many precautions. It's unbelievable. When you have a small you know, co star role such as myself, they give you a tiny little trailer whatnot. And everything's placed outside the trailer, your wardrobe, your sides like there. Nobody's coming into your trailer. It was a whole new world. Obviously you're wearing a mask the entirety of the time. You're filming just a little funny story, my character is wearing like some sort of alligator costume. He's like a sign spinner on the corner of the street or whatever, who they take in for interrogation at the NCIS headquarters in LA. And so they take me in and I'm still wearing this thing. And for the purpose of the scene, I have the first line and I'm wearing a mask during rehearsal we get in and obviously, you're not shaking hands with anyone, you're just meeting you're there for a day. It's a quick day, and I'm wearing a mask in this like weird out, you know, this weird, like lizard costume or whatnot. And then when they they start rolling, they're like, Okay, everybody take your masks off. Kevin, you can take the mask off. I'm like, okay, so I, I don't know what's going on. I'm just following their lead. I take the mask off. And I'm like, Where do I put this thing? I don't pocket somewhere in a lizard costume. I just like kind of stick it under my button, keep going with the scene. And then they call action and I run a scene with a local j was nuts. It was crazy. I was like, but it's a whole new world, you know. So they take the precautions, but then they call to action and you're back in a fictitious world that apparently doesn't have COVID-19 in it. And it was just bizarre. I was fortunate I had a small role A few weeks later on a show that is yet to be released a show with Elizabeth Shue called on the verge which I believe is upcoming on Netflix. And I didn't get to shoot a scene with her unfortunately, because she's amazing. But I had a really fun scene as a whole as like a funny, wholefoods worker, and I got to shoot on on that set. And again, they're taking all the precautions, you know, no contact and you're getting COVID tested every other day, because they need assurances that everyone on that sets safe. Everyone on that said this was pre vaccination. This was at the end of last year when I worked at magic, so nobody been vaccinated. Yep, you have to have assurances that nobody is has tested positive for covid. Otherwise, you got to shut the whole thing down. It was wild. But you know, it's a whole new world out there. And we got to be we got to be safe. And we got to be cautious, especially those of us with pre existing conditions, like type one. Yeah. Stacey Simms 26:47 All right. So we're gonna list in the show notes. We're gonna put your IMDb so people can figure out that they've already seen you a bunch of times. Yeah. You know, like, my husband. And this is? Well, it's not really embarrassing, but my husband is a big Transformers fan. Like all the Transformers movie. So I know you've been in those. So now I got to go back and like freeze frame and find you. Kevin Covais 27:07 Yeah, I just did one of the transformers. I had a funny, memorable scene with I think memorable with Mark Wahlberg and he would have been the fourth one. So it was I can't even keep track of it. He would know. I don't know. It was called Transformers Age of Extinction. Oh, yeah. The Stacey Simms 27:22 one with the dinosaur. Yeah, there's Kevin Covais 27:24 been five total, I believe. Yes, there's dinosaurs. Because Why not? Because anything goes in the transformers. You notice out? Yeah. And I think Shiloh buff did the first three. And then Mark Wahlberg took over as the lead for the next couple. And I was in the fourth one. And yeah, that was nuts. I had, it was that was such a surreal experience to Stacey Simms 27:42 get working on a big, big, big budget. That was the hugest gi crazy. I mean, it must have been wild. Kevin Covais 27:48 That was the hugest thing getting to shoot a scene with Mark Wahlberg and being directed by the very, very animated Michael Bay who was was cool to me, but it was just like it was I felt like pinch. I was like, how am I here right now? How did I get here? Like working on this with like, huge names like This is nuts. Yeah, heck of a time. It was a lot of fun. That's awesome. Stacey Simms 28:07 Well, I first met you ever saw you it friends for life? Yeah. You were a special guest one year. I don't think we met the first year that I saw you speak. And then you know, you've you've basically Kevin, they kind of they really adopted you. You were on staff. They did. Tell me a little bit about how you found the folks at friends for life, which I'm sure as you're listening, you're familiar with. They talk about it all the time. But the largest family diabetes conference in probably in the world at this point. Kevin Covais 28:33 Amazing. And the amazing work that they do over children with diabetes. Yeah, I was like you said I was kind of a stray dog who they like led into the house. They're like, Alright, well, let's domesticate this guy. And maybe he can become a part of this. I'm so blessed. One of my, you know, dearest friends, is Tom Kalia from the Diabetes Research Institute diabetes dad, as he's known. And Tom is one of the sweetest most generous guys I ever met. And I did American Idol, not to take it back to Idol . But I did idol and he reached out to my father because I was still a kid at the time. And he was a fellow long Islander and said, You know, I take part in this conference, and they do amazing work. And I would love to bring Kevin down. I had the summer free. I didn't make the American Idol tour. So I had this summer for and, and he asked to if I would come down to perform at the banquet for the 2006 friends for life conference in Orlando, Florida. And I was very excited. But I didn't know what I was getting into. I didn't know what this conference was. I didn't know that such an amazing organization existed. So I go down and I sing You Raise Me Up which was the Joshua again to bring up Josh Groban. The song that I sang on idol audition with and I sing it and it was just amazing. I had such an incredible time. And I learned more about this, what this conference was and learn of the support system that people had. And I think I was just so naive. I didn't realize that something like this even existed. And it just opened up my eyes. It opened up my eyes to how many people care about people in this world that I knew, you know, to an extent you know, around home in New York, you know, when I met these People when I met Jeff Hitchcock, when I met Laura, and all these amazing Lord bility, and all these amazing people at the conference, I was instantly just felt like family, I would go back several years thereafter, I think, in 2009, and then again, maybe around 2012 2013 as a special guest. And I kept going back as a special guest. And it was fun, because initially, I was there as kind of a guest who was promoting Idol and then, and then a younger generation of the kids that would go, I'd get to be a special guest and talk about good luck, Charlie on the Disney Channel. And that was a great fun, but then I would go and I would take part in in the conference a little bit. And then I would just kind of find myself walking around and saying hi to people and popping into the, you know, the exhibition room and popping into sports Central and playing basketball, the kids and I was like, I want to do more here, I want to do more. I got in touch with Laura. And they ended up asking me the next year like we've had just a special guest, would you want to come back and be a staff member here? And I was like, absolutely. Like I just wanted to, I wanted a bigger role. And they were so gracious as to offer me one. And now I'm just like part of the gang, which is always more fun for me anyway, because I never feel important. I never feel special. Like it's just like, I'm just one of the gang. I'm just like you. I'm just like this kid who has it. I'm just like this, you know, it's unbelievable getting to go there. Every year, they asked me to be on the team staff. And I think this past summer, yeah, was my fourth, fourth year on the team staff and I just want to go back every year, every year, they'll have me I want to go back out. Stacey Simms 31:15 It is amazing when you don't have that community connection, and then you find it, we were kind of by ourselves. I live near Charlotte, but I don't live in Charlotte. And it seems like everybody I knew with type one with kids with type one lived further away from me. And then in 2010, children with diabetes brought a conference to Charlotte, amazing. They used to have these regional focus on technology conferences, and I went, and that was where I realized, oh my gosh, there's all these other people. There's this community, and it really inspired me to get more connected. And now I'm so lucky, we have people not, you know, you hate to have more people diagnosed, but we have four people in my area, we have, you know, more connections. So I hear you, but working with the teams, as you said, Yes, I think that's a pretty hard group. What do you do? How do you kind of get through them or talk to them? Kevin Covais 32:01 It can be it can be I love it. Personally, I think I'd be more nervous to work with the younger kids, just in terms of not just holding their attention or whatnot, I think back to being 16. And I think back to the time I did I don't it's such a vulnerable time in your life. I think that more than anything else is that teenagers might act out or whatnot. But it's just stemming from insecurities or feelings of vulnerability, but a vulnerability about certain things in their life. And it's like, you just kind of have to, you know, give them a pass for that and try to break through the best you can. I mean, that's what I do. I you know, I never grew up a camp counselor. I never did any of that. So when I go to this thing, I look to friends of mine who were in the team group. Now, some of my best friends now who are on the team staff with me that I've met at the conference throughout the years. And I watched them do and I'm like trying to take notes because some of them are really good. And I'm like, yeah, it's tough. But it's tough to break through sometimes I think, yeah. Stacey Simms 32:50 I'd be curious to as a parent of a team, I don't know, one parent of a kid with type one of a teenager with type one who says, Oh, my kid is perfect. Right? They're doing such a great job. I'm so happy with all of their marriage course. You know. And I, I'm wondering if there's any advice that you have as being somebody who is closer to being 16 than I am? Certainly, and who has worked with these kids, you know, what can we as parents do to support them? Kevin Covais 33:15 That's an incredible question. I think I was naive, going into all this to see not that I didn't have struggles, but to have a support system at home like I did, where I think my parents, they were always aware of what's going on in my life. But I think it's such a give and take where obviously, my father, my mother spend 24 hours a day worrying about me as a kid with my diabetes, but not letting it show all the time and giving your child the space to sort of operate and trusting them in a way take off the training wheels and trust them to make their own decisions. Obviously, if if they need you, you're there. But also give them space, but don't smother them. I guess I it's a tough road. You know, I'm not a parent. So I'm not one to really comment on it. I can only approach it from that former teen perspective with my parents was I think my parents always did an amazing job on idol as well. I saw stage parents on idol I saw, you know, parents who were like, oh, you're gonna sing this song you're gonna do that. My folks always said to me, you know, Kevin, we're here for you. We love you. If you need help with something, let us know. But this is your thing. Obviously, you can't maybe take such a lacks approach in a certain way with diabetes, but it's informing your child to the best of your abilities always being present, always being there, but also letting them breathe and make their own decisions. I think if you can find that balance, it's really important because you see kids who don't necessarily have that are unique kids and I was naive. I thought everyone was like me who had and I thought everyone was like, you know had their ups and their downs and but good days and bad. But sometimes it's a rough road. And I I'd open my eyes to that just like going to the conference and just like going around and meeting people who have it. It's Yeah, it's not easy though. That's for sure. Stacey Simms 34:47 Before I let you go, Kevin, your type 1 diabetes if I've got my math right, is about to turn 21. Oh, yeah. Kevin Covais 34:54 Yeah, it's about Yeah. I could go out and go to the bars. type one. Yeah, I won't. But Stacey Simms 35:02 I'm certainly not going to ask you to, you know, to sum everything up and tell us what you've learned or you know, anything like that. But I am curious, you know, you now as I said, you use a CGM, you use it, you still have injections, you use multiple daily injections, but it's different insulin. You know, things have come a long way you found the community to support you. Anything you would tell your 11 year old self, about my guts done, you know what you've been through, Kevin Covais 35:26 I'd say Congrats. I mean, it's been a wild ride. And like, I haven't done things perfectly, and nobody's perfect. I think you got to give yourself a break. I think I've spent a lot of times kind of hard on myself from like a career perspective, as a singer, as an actor. And especially with my type one, it's easy to be hard on yourself, it's easy to, I think we go through these like ups and downs with this with this thing that we live with every day of our lives. And I can recall, like low points of like a really bad low or, you know, episodes that we all sort of experienced with this thing from time to time. I recall, like the immediate thing you feel is ashamed, ashamed that you allowed it to get to that point, I think if I could tell my younger self something, it's like, don't be ashamed. This is a part of the ride. Some days are amazing, some day stink, it's just a fact. No one's gonna be perfect. 19 you know, 100% of the time, it's just not it's not possible. So I think I would tell my younger self, I would say congratulations on achieving some of the stuff you've done, but also like, where to go, just, you know, get getting through it. And getting through this grind, you know? Yeah, I do know that. You know what, you know. So well. Yeah. Yeah. Stacey Simms 36:28 I know it as a parent, which is different story. But that's fabulous. too. Kevin Covais 36:32 Huge way to know it. Yeah. Well, Kevin, thank you so much. But it just thank you for having me. Yeah. Oh, it's Stacey Simms 36:37 been wonderful to talk to you. I hope you'll come back. Keep us posted. Let us look for you. I will Yeah. And hopefully time will go fast. And we'll see you next summer friends for life. Kevin Covais 36:47 That'd be amazing. Thank you so much for having me on. I really appreciate it. You're listening to Diabetes Connections with Stacey Simms. Stacey Simms 37:01 More information about Kevin and links to what he's doing now. And links to some performances from idol back at season five at Diabetes connections.com. Every episode from 2020 on has a transcription with it as well. I'm trying to go back and fill in the blanks on the previous episodes, but boy, there are a lot of them. So I'm doing the best I can. But you can always find the information that you need. Hopefully, for each episode, they're at Diabetes connections.com and pop in the Facebook group. If you have any particular questions for me, you can always reach me at Stacey at Diabetes connections.com and Diabetes Connections is brought to you by Dexcom. And I was watching only murders in the building the other night. Are you watching this show? It's on Hulu. So not everybody gets that. But it's such a fun and interesting comedy. It's not quite as funny and silly as I thought it was gonna be. And that's not a bad thing with Steve Martin and Martin Short and Selena Gomez. And the reason I started watching it no surprise is because they have a podcast and some of the podcasting stuff is very silly. But it's fine. I love it. It's not really too far fetched. Let's just put it that way. And it's just a good show. But I got way off the subject. We were watching this I was watching by myself actually, when I got a Dexcom alert, and Benny was upstairs. He was playing video games or doing whatever he's doing upstairs. And you know, I was just thinking about how we had blood sugar checks on a timer, we had a schedule. I'm sure a lot of you did this too. Before CGM. We would check doing the finger stick the same time every day at home and at school. And whenever extra we needed to. It's amazing to think about how much our diabetes management has changed with share and follow. I mean, it didn't stop the show to get up and check him. I knew what was going on, I could decide whether to text him or if I needed to go upstairs and help them out using the share and follow apps have helped us talk less about diabetes, which I never thought what happened with a teenager, and he loves that part to trust me. That's what's so great about the Dexcom system. I think for the caregiver, the spouse, 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 up required, learn more, go to Diabetes connections.com and click on the Dexcom logo. Quick look ahead and a bit of a change in the schedule. I was set to go like many of you to the children with diabetes conference happening in White Plains, New York, the weekend of October 9, but they have moved that to a virtual conference. And I totally understand you know, you've got lots of kids uncertain situation with delta. So that will be in November. Now it is a virtual event. I will put information in the show notes. You can find out more about that we did virtual with them. Gosh, really all of 2020 of course, and it's a lot of fun. I think they do a great job. And one of the cool things they figured out early at friends for life and children with diabetes. You know children's diabetes is the organization friends for life is the event. They figured out how to help people socialize outside of the speeches and the reports and the talking which are all great. The presentations, I think are very valuable. But for me, the socializing is a huge part of why I enjoy these things. conferences, and they have these little virtual hallways where parents can drop in kids can drop in teenagers, young adults, that kind of thing. So worth checking out just for that. I'm disappointed, obviously, that we're not in person. But I'm still going to New York because this conference is 15 minutes from where my sister lives. And I haven't seen her in ages. So I'm going to go see her and hang out. And hopefully, Melissa, if you're listening, and I'm sure you're not, we're going to all the places where we ate in high school that weekend, so be prepared. We're going to Maria's pizza, we're going to diner, we're gonna make a list. So we grew up not too far from where she lives now. So that should be a lot of fun Later in the month, I'm going to be in Scottsdale, Arizona for she podcasts, which is a terrific female podcasting conference, as you would imagine, I'm really excited about that. And look, we'll just have to wait and see how these things go. Because certainly, events are touching go at this point, diabetes events, people are much more cautious and rightfully so. So we'll wait and see. But hey, that doesn't mean that we can't hang out. We can socialize. My Local Group is doing stuff online. I'm happy to come and speak to your group, virtually. I've still got my book to clinic program. I am working on Book Two. I am so excited. So still a lot going on. But man, I know I can't wait to read. We're gonna get back to normal. I don't know. But I'd like to get back to something else. Something we're socialized more. We hug more with each other more. Hang in there. Oh, my goodness. Thank you to my editor John Bukenas from auto editing solutions. Thank you so much for listening. I've got in the news every Wednesday live on Facebook, and then we turn that into an audio podcast episode every Friday. So please come back and join me for that. I'm Stacey Simms. I'll see you in a couple of days until then be kind to yourself. Benny: Diabetes Connections is a production of Stacey Simms Media. All rights reserved. All wrongs avenged

How much do you really know about the only inhalable insulin? This week, Stacey interviews the CEO of MannKind, makers of Afrezza. Mike Castagna talks about how Afrezza works, misconceptions about the product, the worldwide market, pediatric studies and lots more. This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. More about Afrezza Tim Street's blog Diabettech  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 This is Diabetes Connections with Stacey Simms. This week all about Afrezza How much do you really know about the inhalable Insulet. I had a great conversation with the people who make it   Mike Castagna  0:34 For me, it's about using the right product to meet your needs to get you in control. And if you're doing well, great, we're going to avoid the long term complications. But if you're not doing your health, and you gotta really try to find the best set of tools, they're gonna make you successful and fit your lifestyle.   Stacey Simms  0:47 That's mankind CEO Mike Castagna. We talked about how Afrezza works misconceptions the worldwide market pediatric studies and lots more. 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. We so glad to have you here we aim to educate and inspire about diabetes with a focus on people who use insulin. And this week, we're talking about the use of the only inhalable insulin, my son was diagnosed with type one right before he turned two, he is 16. My husband has type two diabetes, I don't have diabetes at all. But I have a background in broadcasting. And that is how you get the podcast, I have to say that personally, my family is very interested in Afrezza Benny really would like to try this seat. Of course, as I mentioned in that tease up there, they're looking at pediatrics, he is still under 18. So it's not proof for his age group. But we're watching it really closely. And I have a lot of friends. A lot of bloggers and people in the diabetes community have talked about this for years. And some things have changed. So I wanted to have them on the show and find out more. So a little bit of background for you. If you are brand new to all this, Afrezza was approved in the United States in 2014. And the company that makes it is mankind. For a while it was sold by Santa Fe, but then mankind took it back. It's one of those things where sometimes the business side seems to have gotten more attention than the product itself. So what is Afrezza it is a powder, it comes in cartridges, and you suck it in you inhale it with a special inhaler device. To me, it looks more like a whistle than a traditional inhaler like an asthma inhaler. It's not like a big tube. I'll link up some photos in the show notes. I'll also link up the Afrezza website so you can learn more and see their information. And my guest this week is Dr. Mike Castagna, the CEO of mankind now he has a Doctorate of pharmacy, he worked as a pharmacist behind the counter for CVS at the start of his career. But then he went back to school and he got an MBA from the Wharton School of Business. He's fun to talk to he doesn't mince words, and he truly believes in this product, I do have to tell you that Mike mentions monomeric insulin a couple of times, I'm going to come back after the interview and explain more about that give you a better definition. All you really need to know is that it's faster than how liquid insulin is made. And all of that in just a moment. But first Diabetes Connections is brought to you by Daario. And 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 on 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 on how to succeed, get the diabetes management plan that works with you and for you, Daria is published Studies demonstrate high impact clinical results, find out more go to my dario.com forward slash Diabetes Connections. Mike, thanks for joining me, I'm really excited to catch up. And look, I'm stuttering because I can't believe this is the first time we're talking to you. But thanks for coming on. Oh, thank you, Rodney. I'm super excited before we jump in and start talking about Afrezza Can you give us some perspective kind of dial back because mankind is not. It's not a name that came out of nowhere? There's really important history. Can you kind of talk about that a little bit first?   Mike Castagna  4:14 Sure. Mankind comes from our founder named after Al Mann and Al Mann was a true innovator. He started I think 17 companies and everything from the cochlear implant to the pacemaker to insulin pumps that many of us know today as Medtronic used to be called mini med. And Al Mann built the insulin pumps over the 80s and 90s and was very successful and sold that company to Medtronic. And then he took literally $1 billion of his own money and invested in mankind. And he had put this company together through three companies he owned the technology to make Afrezza was really a combination of companies and the reason he was so dedicated as he saw in the pump market, which we now see today on CGM was that the variability in mealtime control was so high and the fluctuations you see that the influence takes about an hour and a half to kick in. And it's hard to get real time control if you can't get a faster acting insulin. And so he set out to make a real time acting insulin, so phrases and hailed as monomeric. And that was really what the magic was in our technology making a dry powder was was free dryness, if you heard of dippin dots ice cream, we have basically large dipping machines in our factory, but we free dry the particles to make a freezer and under stabilize the monomeric form. So when you're inhaling, you're inhaling influenza, as soon as it's in your blood is active, or when you inject it has to hold hexamer and has to break down there were about 45 minutes. And that's how you can make it stabilize an injectable form. But it has to break down and then it starts working. And that's why there's always this lag effect between we see injectable and foam in and help us is very different products were categorized with real time rapid acting, but the name mankind comes from elmen and the guy who probably 60% of people on pumps have their own pumps that he created. So amazing gentlemen, huge contributions to diabetes and millions of people were alive today because of his work and his generosity and roven to take that forward here and kids and frozen inhaled insulin.   Stacey Simms  6:06 I mean, never look at dippin dots the same again.   Mike Castagna  6:10 I see a large factory of they don't like it, you know, we can always make different types of things don't go well.   Stacey Simms  6:15 I love it. Let me ask you to go into a little bit more detail about how someone who uses Afrezza would actually use it. Can you talk a little bit about like a daily routine?   Mike Castagna  6:25 Yeah, I mean, I know, you know, well, you're in this disease. I mean, people sometimes graze all day, and they just kind of ride their sugars and take a little bit some along the way or many boluses. And some people you know, eat once or twice a day, or some people, you know, carb restricted and everyone has a different way. And I think that you know, the big thing difference was for the patients that I see is, it's in the moment, meaning you don't have to time your meal and your insulin, when you're going to take it and where you're going to be. As soon as your food arrives. You take your first dose.   Stacey Simms  6:50 Most people I know who use Afrezza take a long acting insulin with it. Is that pretty standard for people with type one?   Mike Castagna  6:57 Yeah, I'll take one year, right? Yeah, you need a basal insulin of some sort, you know, and, and a meal time was held, we do have some patients on pumps where they will use their punches for their basil, for example, and use a phrase for real time corrections. So you know, the average patient is very different. We have some patients that are type twos, you know not not on any basil, you'll need to be on basil for if you're type two. But if you're type one, you need to basil, long acting insulin, and you need your meal time. And we know the biggest problem in this country is still mealtime control is the number one thing people with diabetes struggle with. And it's a big reason why, you know, six, or seven or eight, you know, eight out of 10 people basically are not a goal on insulin because of the mealtime control. So it's a daily challenge for everybody.   Stacey Simms  7:39 Can you talk a little bit about how Afrezza is kind of measured out? Because when we think of mealtime, insulin, everything's a carb ratios. And especially as I mentioned, if you're on an insulin pump, you're you're putting in the carbs that you eat. So how does that work?   Mike Castagna  7:51 Yeah, it's funny, I get into many debates with people because, you know, I'm a pharmacist by training, but I'm not the smartest guy. But I couldn't do all the work people do every day to influence sensitivity ratios and carb counting and timing. And all I can tell you is everyone's masks off by 50%, one direction or another. And so we have this false pretense that we're that accurate. And dosing are influenced by down to the half a unit or one unit. And the reality is your angle of injection can decrease, you know, change your absorption by 25%, your site of injection can change absorption, your your stress level can change your impact with your insulin, there's so many things that go into your daily dosing of insulin, that, you know, being that precise, down to the unit is not as accurate as we all think. And I think that's that's one of the misnomers of, you know, the timing is what you really struggle with when you're using injectable insulin, and you just don't know what's going to happen. You know, when people I guess doctors often you know, you don't have to carb count with Afrezza . And they give me funny looks. And the reality is, you know, we've never done a study where you're carb counting to get your dose of insulin, that's, you know, so becomes a four 812 dose linear all the way up to 48 units, it's additive, and you just got to be close enough. And so it's about a two to one ratio, you know, there's no direct pulmonary equivalent to injectable insulin, unfortunately, but, you know, people are taking five units of injectable insulin per meal, they're gonna need about eight units of Afrezza and maybe even 12. And you're gonna figure that out, it's your first meal or two what what the right dose is for you. But you just got to be close enough. And that's a big misunderstanding for people of how accurate the dose has to be. This is the sixth dose cartridge is a big problem. I know plenty of type one patients who take for a 1224 meal, especially they haven't Chinese food or sushi, they just they dose a lot. So I think that's something people have been comfortable, so dramatically different than anything they've ever been trained or taught in their history of living with diabetes.   Stacey Simms  9:36 I would assume that a prescription for Afrezza comes with a doctor's visit where someone whether it's someone who works for Afrezza, or the endocrinologist talks to you about how to do this dosing. You said you figure it out, but I've got to assume that you're not just sending people home with this inhalable and say, just test it, I mean, right somebody, you're at a ratio   Mike Castagna  9:59 and I think That's the key thing is, you know, having patients understand because it's odorless and tasteless. So you inhale, and you're like, what did I get it? And I'm like, yeah, if you inhaled, and I have the second, it's in your blood, it's in your lungs, it's breath activated. So you can't really, of course, you can try to mess up something. But we have something called Blue Hill, where we can show proper inhalation technique in the office on an iPhone app or an Android. And so you know, we hope that patients are being trained either by our trainers or the doctors offices, and will propagation technique looks like that's number one. And then number two is the right dosing. And as you know, individualized dosing is important and fun. And, again, that's why I say we take a lot of the math out because it's either gonna be a four or an eight, and all of a sudden, you're like, Oh my god, I'm gonna take an eight units, it's a lot it's really not when you're taking inhalation units versus injectable units and that's what people got to get comfortable with if their first or second dose so they really do figure out this meal did this or pizza is going to take longer so pick another dose and now our people do figure it out pretty much within the first week. And then there's one thing actually I want to mention because I often forget this is because injectable insulin is such a long tail it's in your body for four to six hours before it's out and that feeds into your basal rate your long acting and so when people switch over presence pretty much out of your body in a net roughly an hour and a half. Sometimes people need to adjust their basil and that's something to watch out for if you do switch to Afrezza enter you're struggling with with some of the basil rates. Some patients you know I hear people anecdotally you know, we don't want to study their the bump up their basil 10 15% on Lantus. And I've heard patients on to see that because it does have that long tail of down there in front sometimes on the basil. So there are the other metrics patients have to watch out for when they are switching to the product. It's not just the uptime, it's also something that basil where you look at   Stacey Simms  11:38 I have a question and I i apologize because it's a it's a bit ridiculous. I'm gonna ask it anyway. Right back to the interview in just a moment. But first Diabetes Connections is brought to you by Gvoke Hypopen. And 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 fast 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 pre mixed and ready to go with no visible needle, you pull off the red cap, push the yellow end onto bare skin and hold it for five seconds. That's it, 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 slash risk. Now back to my interview with Mike, where I will ask that ridiculous question.   You had mentioned it's tasteless, odorless, I recall hearing and I'll have to fact check this. But I recall hearing that years ago dandruff shampoo, they had to add like that tingly feeling because people didn't think it was working like it's totally fake. But people just didn't believe it was a medicated shampoo because it didn't have an unpleasant sensation. Have you thought or talked at all about adding like a flavor or a feeling to so people really know that they got it? Or is that just really bananas?   Mike Castagna  13:12 If somebody might company come and talk to you ahead of time? There's somebody internally who wants us to look at like cherry flavor Afrezza especially as they go into pediatrics? And the answer is, look, there's blueberry Metformin because the metformin smells awful and tastes awful, probably. So you know, those things are possible. We've never done them. And to my knowledge in this industry with dry powders, it is a question that came up recently. Is that should we be thinking about the cherry flavor Afrezza or some other flavor? And I think the answer is TBD. We I don't know what the date is on inhaling the food coloring dye or whatever. Yeah. But that's some of the stuff we have to justify that it's safe and effective. And along with FDA would want us to test but they come up recently and another internal discussion. And since you're asking, I think we'll look at it, even if maybe there's a way to even show a placebo, that's a cherry flavor or something right a one time dose to see what it's like. So I don't know. But now, but people like I said, it's sometimes you get a call, like you know, when you take a phrase of one out of four people will get a cough initially. And generally there were the first four weeks that cough goes away 97% of the people. So I always tell people, you're having a cough, like as long as not interrupting your life, it should slowly get to your first refill. And it should be mostly resolved by that your body's getting used to putting a powder in your lungs. But that's uh, you know, when people ask, what's the difference between injectable and inhaled in terms of safety, you know, you're putting a drug powder in for the first time in your body and your body could choose that. And the number one thing that's different, were injectable insulin. You know, you have other other things. You're dealing with injection sites and pump sites and scar tissue and things like that.   Stacey Simms  14:48 Does the body actually acclimate to the powder or is it just a question of someone gets better and used to the inhalation sensation?   Mike Castagna  14:55 You know, it's it's a good question. I don't know if I have a black and white answer here. bodies give. Yeah, my guess is the body's getting used to putting a dry powder in and just exit and you get used to like weed. You can drink a glass of water before and after and help you minimize it. But it's generally like that's what it feels like it's not a productive call frightening, there's not a call to happens 10 minutes later, it usually happens. We have to inhale.   Stacey Simms  15:17 You mentioned BlueHale , can you tell us a little bit more about what that is?   Mike Castagna  15:21 Yeah, so BlueHale  is to two different things. The first one that we're looking at is with the patient training device. So we can show you whether you had a good emulation or not a good emulation and show you that technique. The second version, actually, you can detect with those you put in the cartridge and hilar. So it has a proprietary software there that we can see what cartridge you put in for the adapter. And it'll tell you on your app, if you took a for a 12 or 16, how much you took in that session. And then we hooked integrate that with the CGM data. So now you can show those response curves on CGM one day and eventually I want to get into AI and predictive analytics. But we're not there yet. But we think that's the magic of what people really want, which is one that I use the thing when you live with diabetes, you just must remember and be that perfect to know exactly what those you did with them. You took it, what meal you were and then I simulated being a patient for a week. And I realized I could remember if I took a four and eight, I take a six or 620 is that 30 minutes or one hour like it was it was amazing. When you just think about life and people are human. They're there. They're human. So they're not keeping track. And they're not that accurate. They're just estimating. And that's when I talked about the dosing of insulin, like we're always estimating everything, we're estimating the time our food is going to come and how long it's going to work. You know, what the carbs are? How much am I gonna eat or drink? Like, it's all accurate? It's all off. None of it's that accurate. That to me is the thing I realized when I was thinking of doing one of those a disease, you don't you think they're perfect. They're not. They're human beings. And that's when I see one out of five doses of injectable insulin are intentionally missed. And the predominant one that's missed is actually lunchtime, which makes sense to wear out in a social environment. They don't want to inject. And by the time they get back, they forget it's probably too late. Or you're already high.   Stacey Simms  17:00 What do you mean by intentionally Miss? You mean? Like they people just forget?   Mike Castagna  17:03 No, no, they intentionally knew they should take a dose of insulin, but they're in a lunch conversation, or they forgot their insulin in the office. Or they'll have their CGM receiver on the bike, or they essentially don't they miss one of the five doses. So if you're missing 20% of your doses, it's really hard to get in control. And there's all kinds of reasons, but that's intentional omission versus unintentional. Which is I forgotten.   Stacey Simms  17:23 I'm curious what the sources on that that's, I mean, I don't doubt it. I'm just curious.   Mike Castagna  17:27 Yeah, I couldn't find it. follow up on that. I have your email, I'll look for it. Yeah, no, because I didn't believe it. And then there was a study done with one of the pens coming out that has digital connectivity. And I looked at it and I looked at the data and like, wait, if a person needs three times a day, seven days a week, that's at least 1721 doses, right? And I think the average person is taking like 1212 shots a week. And I'm like, Well, that doesn't make sense. But you realize, you know, again, we're human, people aren't always as compliant as we want, or they don't eat three times a day perfectly are the two big meals, you know, everyone does something different. So having insulin that meets your needs, and your lifestyle, I think is really important in the world. And you know, look, we like our products, obviously, we're here, we love the Afrezza. But But I also just for me, it's about using the right product that meets your needs to get you in control. And if you're doing well, great, you're gonna avoid the long term complications. But if you're not, you own your health, and you got to really try to find the best set of tools that are going to make you successful and fit your lifestyle. And, you know, obviously, we're not doing well when 80% of people on insulin on a boat. I mean, that's that, to me is the number one thing, I look at this country and say, well, despite all the adoption of pumps, and technology and CGM, we still have not made a meaningful difference in percent of people to go. And that's frustrating.   Stacey Simms  18:35 Way back in the beginning of this interview, we talked about Chinese food and pizza. And I'm just curious, you know, these are things that are hard to dos for, because they they kind of they come later, you know, what most people listening are very familiar with, and I think probably have their own system for dosing, whether it's an extended bolus or injecting more than once. How would you do something like that on a Friday? Is it a question of you would take what you think when you're eating, and then again, in a bit later, like, how do you account for those high fat foods?   Mike Castagna  19:02 Yeah, you know, I'm going to pick on Anthony Hightower, who I know you interviewed before. So I actually met Anthony on a bed over social media. And he had showed me your servers where he ate pizza. So I'll pick on him because I want the public discussion here, sir. He pizza and his sugars are basically flat over the two, three hours post meal. And I said, I'm like, shocked. He's like, this is something people cannot do naturally on the history of injectable insulin, they they always struggle. And when you eat pizza, you're going to struggle not just for hours, but potentially for the next day because just throws everything off. I think in his case, right? I've watched him he took a big dose up front, you know, let's say he's gonna take 12 units of injectable he took 24 units of Afrezza. And then he washed her wasn't an hour, and then an hour she was above where he started. He took another dose, maybe took a four and he has to tap it off. And then an hour later, just thought was too high or not right. But you can always keep your sugars in that kind of control. That's one of the studies we did back in 2018, called this test study was showing that you could do as soon as one hour with no more hyper risk. And that was a big concern of people, how can I do that one hour, well, pretty much hit its peak effect in one hour. So if your servers are still moving in the wrong direction, you can correct them at that point. And so that's where someone on pizza or Chinese food, like, yeah, it's a high dose up front and may manage it through the whole system. Or they may see an hour or two later, they're still high and to take another dose, that they can bring it down at some point.   Stacey Simms  20:20 Alright, let's talk about the big questions that people generally have. And that the one I hear the most is, Is it safe? Right? Is it? Is it okay to inhale this stuff into my lungs? Can you talk about the studies that you've done?   Mike Castagna  20:32 Yeah, I think if we were able to make inhaled insulin 100 years ago, we'd be scratching our heads those who would inject themselves three times a day. So I think it's just an unfortunate matter of 100 years of difference. But we studied a phrase that probably over 3000 patients 70, some trials $3 billion over 20 years, like, that's how much money time and energy is going into prove the safety and effectiveness of this product. And you know, and I tell people like you know, there is no data to say that it's not safe. We have all the rodent studies, all the CT scans that along looking for fibrosis looking for pulmonary issues, we found nothing. So it doesn't sit in the lung. There's an old product called exubera on the market years ago. And exubera was a sugar based manatal formulation which got absorbed over time into your lungs in a friend this case, the it's got water and human influence. So when we ask about what ingredients are you worried about the human influence, human influence, it's the whole AI base, but it's human influence characteristic, and water is purified. So we know that safe and the other only other carrier in our products SDK p which is a excluded product that is not metabolized in the body, it's just 100% extruded. So you know, there's three ingredients in our product. One is human insulin, one is water, and one is tkp. And SDK p comes out of the system. So I don't I don't think the body is afraid of human insulin. And what are so I think, you know, I always struggle with this topic. Because, you know, what happened is there was some lung cancer cases and Newser, were they there was a couple of our data. But you know, in the seven years since FDA approval, we've seen no safety signals come up in the postmarketing. We have almost 10,000 patients on the presidency. I know people in the drug for 1012 years. And so, you know, we don't see anything that gives us concern. And we're going into kids now, who would have to take the drug for 40 5060 years. So I think it's hard to prove something that you've never seen. But safety comes with time. And I think the good news is product has been approved by the FDA for seven years now. And we've not seeing any safety signals in our database, which we look every year, our rems program ended early by the FDA and and we've continued to show good data and all the studies we've done, we've not seen anything new come up in our anywhere safety issues. So if you're, you know, the populations, I would say if you have COPD, and asthma, this is not the right drug for you.   Stacey Simms  22:41 So a dumb question, though. If you have diabetes, and you smoke, can you get an Afrezza? prescription?   Mike Castagna  22:48 We would say you should not? Yes, we have a warning for that.   Stacey Simms  22:52 Well, I just wanted to be clear that there was an actual warning, it wasn't just a please don't because it's bad for   Mike Castagna  22:57 warning. Don't   Stacey Simms  23:00 tell me about the study with kids. Because I've got one, I've got a 16 year old who was quite interested in this product.   Mike Castagna  23:06 Yeah, no, I just found out Unfortunately, the dagga three year old cousin in the family have just come down with type one. And she will, she'll be four and our studies gonna go down to four years old to 17 years old, when we launch it. So I'm excited, we had to do a study to show that the pharmacokinetics and dynamics of inhaled insulin are similar in kids as it as adults. And so once that study was complete, we we wrote a protocol down to the FDA and said, We'd like to go into the next phase, and now run a larger study head to head against the standard of care. And the FDA has pretty much signed off on that protocol at this point. And we have contracted with a third party to now run that trial. And we'll be having our investigator meeting here in next month. And so hopefully, we'll see our first patient in the four to 17 year old range, probably here in September, October time frame. So super excited, long time to get here took too long from my perspective, but can't wait to help kids. But our founder Outman invested, he became very wealthy when he sold the insulin pump company. And he took $1 billion of his own money and made Afrezza inhaled insulin because he felt the problem with the injectable subcutaneous delivered insulin was it just took too long to work. And you know, somebody has an hour lag effects from food. That's real timing, it's always hard to catch those two even. And so he really wanted to make an inhaled insulin that really mimic a physiologic insulin that you see in the body. And he felt the only way you could get there was through a dry powder, lung delivered instantaneous insulin, you can also get there through an implantable pump. But that didn't work out when they tried that back in the 90s. I recall. So people got infections and things like that. So that would that didn't work. So they really were going to get a in my mind that physiologic inform that's gonna be monomeric stabilized is probably going to happen only through the inhaled route. So we have we have to get comfortable with this from overall efficacy and safety. Otherwise, you're not going to really ever get this control that people are looking for real time.   Stacey Simms  24:55 No man, he lived long enough to see Afrezza approved, didn't he?   Mike Castagna  24:59 He's All approved. And unfortunately, I'm here because he died on my daughter's birthday. So I was debating whether to come to mankind or not. And I'm very superstitious, the Al Mann pick the day he died. And he died February 25 2016. And then they made decision to join and help save the company and save a frozen kick on the market. Because I think, you know, I saw all these wonderful patients stories online. And I said, these patients like Anthony Hightower is one of them, what they did something that no one else did, they did something we never did in our clinical trials. And so I got to talk to them. And I realized we just didn't dose it properly. So you go back to the development of the product, a lot of the challenges were under dosing because everybody's trying to compare one to one to injectable insulin, and therefore one of underdosing patients, and therefore, they got equal outcomes didn't do any worse than injectable insulin per se. But could they have gotten better outcomes if we dosed improperly? Right? And I think that's, that's the state of we're now trying to generate to show that the kids buddy now be head to head, or if he knows him properly, what happens? Right, and that's we're really focused on right now.   Stacey Simms  26:01 Is there anything that you wanted to talk about that I haven't answered?   Mike Castagna  26:04 No. I mean, we're only available in the US, we're in the process of going to Europe. So I don't know if you have any. Yeah, we do. Though, so I know, we have patients on a name patient basis in Germany, and UK and Italy. So you know, their governments are actually important a president and pay for it. We're in the middle of filing for Australia. We were approved in Brazil, and we're going to India so so you'll see this more and more around the world. You have listeners in those markets. There's not gonna happen this year. And hopefully, the next year or the following year in some of these markets, we'll be looking at bringing it to more patients in those markets.   Stacey Simms  26:37 Well, and just got a big approval here in the United States for Medicare patients. Right.   Mike Castagna  26:42 Yeah. So that one, I, you know, we get a lot of questions on that one. And so you know, this market CGM patients were told you need to be injecting yourself, I think four times a day, we couldn't get your CGM. So then doctors were not getting patients Afrezza. And so we were able to ask CMS to change that, and they did to the year but rather haven't done they're not done. And so here we are a year later that that policy is now being updated. I want to thank CMS and all that you're helped make that happen. And I think it helps in people in CGN, because I understand that removes some of the other requirements to get CGM, even an injectable these patients so little mankind was the one who started that process. And then we're able to help a lot more people. So it's great. And we're trying to get Medicare $30 a month insulin. So we have Medicare listeners. And you know, we're trying to make sure we help get patients access that are on Medicare. I think that's important.   Stacey Simms  27:33 That doesn't stack up in terms of cost in the United States.   Mike Castagna  27:36 Yeah, I mean, you know, fortunately, the billion dollar debacle in this country is drug pricing, as we all know, and as a pharmacist, I know firsthand when people go through an LMS they're on how many co pays are on. And so we really have tried hard to make sure that no patients pay no more than $15. So we have copay card programs, we actually have a free drug programs, they really can't afford it, we'll give it to you for free. If you're going through the prior authorization process, we give it to you for free while you're going through that. So we all want payers and reimbursement to be the excuse of why a patient can't get access to our product, we think that people will do well on our product, we're willing to take that bet that they'll see good results. And if they see good results, the payers will usually pay for it. And it says you may or may not know that there's a monopoly in diabetes between two insulin players, and three payers, who are all working together to make sure there's no competition. You know, that's unfortunate, but they pay to make sure that patients have a difficult time getting Afrezza . And that's always one of my frustrations of competition or diseases. You know, 400 years, we've seen the precise the dispensing from 20 hours a while 95 and let's say miles, hundreds of dollars. You know, for me on the payer side, we want to make sure patients we try to bring it down to about $15 on commercial and Medicare, you know, they generally pay comparable to what they would and some Medicare plans a little bit higher I can you know, that's a hit or miss when you when you go to submit for reimbursement, but we try to do everything we can to make sure people will have access to our product   Stacey Simms  28:57 $15 for $15 for commercial patients, no, no, but what is it? What is it for? What do you get for $15? Is it a month? Is it a   Mike Castagna  29:05 my week? Yeah, whatever, whatever. You gave two boxes, three boxes, whatever is on that prescription for that month,   Stacey Simms  29:10 for the month. Okay, I didn't mean to interrupt you.   Mike Castagna  29:12 I don't think I know, I was gonna say I forgot we actually have a cash pay program. And people are paying cash for their insulin. And we do see several 1000 people a month paying cash for injectable insulin, we have influenced savings comm where it's $99 a month for frezza. And you know, can you a bigger box or more doses, you might pay 199 but we tried to make the cash price, you know, roughly $100 a month. If we if you had no insurance, for example.   Stacey Simms  29:37 I'm not sure you can answer this question. But I will ask it anyway, is the biggest challenge for you all the failure of exubera? Is it just people not knowing what this is? You know, as you move forward, you know, what is the big challenge to get more people to adopt us?   Mike Castagna  29:51 I mean, for me, the biggest challenge are the doctors. We created a program we basically gave it for free to patients for two years for 15 bucks. Like no no priority. Nothing, we just charge you $15. And that didn't change a lot of doctors from jumping on board. And doctors just don't know our data. And so they think this product doesn't have a lot of data behind it. And they don't know our data, they don't know. Like when I would ask a doctor, how fast from the time you inject your bolus, your pump to the time you look on a CGM, that your institute sugars are coming down, and I get in these endocrinologist, I'll get five minutes and mediate and 20 minutes an hour, the answers, I need 90 minutes, 220 minutes, that's the answer. And so they don't even know the pharmacokinetics and pharmacodynamics differences between injectable insulin inhaled, and then you have doctors, right, you know, calling some of these ultra acting drugs faster, we'll look at the package inserts, they're no faster than their old products. And there's a lot of misperceptions out there some of these newer launches of old tracking insulin, and to me they're, they're really not that much different than the predecessor and look at the data, you know, there's not a faster, there's not dramatically faster onset or offset or, you know, a one c lowering or weight gains on very much the same. So, no, I think it's just a matter of doctors trying to really understand the data.   Stacey Simms  31:02 Before I let you go, are there any plans in the future to change anything about the way it looks? or different colors? I mean, I know it sounds kind of silly, when you're just trying to get people to adopt the new technology, but from a user standpoint, and look, I know, you've heard all the jokes of my friends who use this will make you can't comment on designers. They don't say anything, they'll make comments like, you know, taking a hit or whatever, right? I mean, it's it's inhaling, it's this little thing that you're, you're inhaling, it looks a certain way. I'm curious if the cosmetics of it are anything that are on your radar, or needs to be improved even?   Mike Castagna  31:36 No, I mean, I think when you spend, you know, $3,000,000,000.20 years doing a new drug development or taking 100 year old product and reinventing it, you had to get that right in terms of device design and airflow dynamics and consistency. And those. And I think all that's really important because, you know, misperception that oh, my God, it's going to be less can be more variable than injectable insulin. And the data just doesn't support that statement. And so for us, we have one of the world's most unique installation platforms across the entire pharmaceutical industry, we deliver more power to the lung, the most technologies out there. So that's why you can get consistency, those two those, and you don't have a lot of variabilities, because our technology and our device is called a low velocity inhaler. And what that means is there's a resistor that helps slow the powders as they're coming out of the inhaler. So they get deep into the lungs. And that's why you get that nice absorption curves that we see. And we're most inhalers or high gloss inhalers. So it's just enough sucking air as hard as you can, and hoping you get you know, 20 30% of lung drug into your lungs, and mostly stuck in your teeth to device in the back of your throat. That's most dry powder inhaler technologies out there today. And so that's something unique to us and our technology and our device, they all work really well together, you couldn't just take our powder and put into another inhaler, and or just as well would not work. So yeah, we're pretty happy with the device I we are going to other diseases. So you know, we're we're going down to the FDA with our partner for an approval in October for pulmonary hypertension patients. And we have several other orphan lung areas we're going into to help more patients with lung disorders. So you know, I think that's important, like our, our technology, our inhaler, our platform is gonna be used in more and more patients over the next decade than just diabetes.   Stacey Simms  33:13 Well, that's what I was gonna ask is, if it works, so well, you know, will you partner with other medications? That's great to hear.   Mike Castagna  33:18 Yeah, you know, we're really busy, we probably have about 10 to 12 formulations of products working on this year and five marone products in the pipeline. And so it's it's a really good time of mankind, we're super excited to be here. And it was a turnaround, the company struggled for many, many years. And we're on our way to success. And I think, firstly, you'll be you'll be hearing more about it. So I know it's been a long time. And maybe you didn't talk to us yet. But hopefully you'll talk to us more and more as we continue to generate new data and more more patients start using it.   Stacey Simms  33:45 I'd love to, I'd love to, especially with the kids programs. And like I said, I've got a 16 year old who is very curious about this. And, you know, once once safe and effective. Once we get all that safety stuff in here. It's mom says, you know, I'll definitely I know, I would like to check it out. So I really appreciate you coming on and spending so much time with me and my listeners and explaining all this and we'll definitely talk again. Thanks, Mike.   You're listening to Diabetes Connections with Stacey Simms. More information at Diabetes connections.com. Always on the episode homepage. I also have a transcription as well, sometimes those podcast players don't display the show notes and the links. So if you have any trouble, just go back to Diabetes connections.com. And I just want to say that I did reach out to have Mike or somebody from Afrezza on the show. And you heard him say, you know, it's been a while, um, you know, it just took a while to connect to the right person. Let's just say that, and I will have them back on because lots of good stuff is happening. As you heard. I want to take a second and kind of explain Monomeric insulin and, you know, I'll be honest with you. The scientific points here are really not my strong suit. I'm a communications major, right. So I did what I always do, and I am People who know a lot more than I do to help me explain it. I went to the Facebook group Diabetes Connections as a group. And you know, I said, How do you explain monomeric insulin I know it's faster. And Tim Street, who is just wonderful and runs the diabettech.com page that's like diabetes tech diabetic, and I'll link that up as well. He provided this explanation, which really brought it home for me, and boy, I hope I'm pronouncing everything correctly. So Tim wrote, insulin naturally links its chains together to form stable molecules. Typically it connects two together and then links three of those two chains together. Additionally, to create six This is highly stable and described as hexameric. In order to use these chains, you have to break the molecules apart to single chains, which are monomers. Typically fast acting insulins are stored as dimers, two monomers connected, which are easier to split, then hexamers. by storing the insulin as a single chain, a monomer, the body doesn't have to break the chains to instantly use the insulin molecule it receives. And that is why Afreeza wraps the monomeric form in the capsules, to make it ultra fast. Thank you, Tim, that actually made a lot of sense. I gotta tell you, we have the smartest people and the kindest people in this Facebook group. If you're not there yet, and you want to join, come on in, I highly recommend it. You don't have to be a Tim Street. You don't have to be able to explain these concepts. You do have to be nice. And you do have to not post a lot of drama. I'm very tough on my diabetes groups. I run two of them. They're very nice and friendly places for a reason. But Tim, seriously, thank you so much. That was a great explanation. And I really appreciate it. Diabetes Connections is brought to you by Dexcom. If you're a veteran, the Dexcom g six continuous glucose monitoring system is now available at VA pharmacies in the United States. Qualified veterans with type one and type two diabetes may be covered. Picking up your Dexcom supplies at the pharmacy may save you a lot of time to connect with your doctor for more info Dexcom even has a discussion guide you can bring with you get that guide and find out more about eligibility. It's all@dexcom.com backslash veterans, and all the information is always at Diabetes connections.com. Before I let you go, just a quick note about back to school, I have never done less. I packed up a bag for Benny to bring to the nurse. He brings his daily supplies with him every day in his backpack. But of course, like most people, our nurse has backup supplies for him. So I put those together. He brought them in along with our plan or orders, you know from our endo. And that was it. I haven't set foot in the building. I'm not sure when I will go in or if I will go in probably when you forget something or they run out there. But I've never done less work. You know, I did a lot of work over the years to go to school and meet with people and he's got it. So not much to report. It feels very strange. All right. Please join me this Wednesday when we have our in the news live on Facebook every Wednesday at 430 and then we turn that into a podcast episode. I love doing that. It's been a lot of fun. I hope you're enjoying it. Give me your news tips. If you've got any from this week, just email me Stacey at Diabetes connections.com 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 in a couple of days until then be kind to yourself.   Benny  38:27 Diabetes Connections is a production of Stacey Simms Media. All rights reserved. All wrongs avenged

Here are the links for everything discussed in Episode 66. Times are also below so feel free to skip around and get to the drugs that interest you. And I apologize for the echo - need to find a better place to record in the new home :) (1:18) Approval of first interchangeable insulin called Semglee (6:13) Nexviazyme approved for Pompe disease (8:23) Approval of Rezurock for chronic graft vs host disease (CGVHD) Connect with The Rx Daily Dose:Twitter      Instagram      YouTube      Linkedin       WebsiteEmail: therxdailydose@gmail.comConnect with Ian Parnigoni PharmD. on social media:Twitter       Instagram       Linkedin  ★ Support this podcast on Patreon ★

Any level of exercise can be more challenging when you live with diabetes. When Eoin Costello was diagnosed with type 1 at age 19, he was worried that his love for fitness and sports would have to be put aside. Instead, he found a way to not only stay active but to coach other people with diabetes to do the same. Whatever level of fitness you're looking for, Eoin is all about having fun and making it work. He's also the host of The Insuleoin Podcast. Stacey appears on a recent episode talking about her parenting experience. Also this week, In Tell Me Something Good – type 1 diabetes and space force? Did we just see a big barrier – military service – come down? Link to the article here.  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 premixed auto injector for very low blood sugar and by Dexcom help make knowledge your superpower with the Dexcom G6 continuous glucose monitoring system. This is Diabetes Connections with Stacey Simms. This week exercise with type one can be a challenge. You know there are a lot of variables Eoin Costello was determined to make it work when he was diagnosed and says the key is don't expect perfection.   Eoin Costello  0:41 When I start something new, I'm probably gonna see some highs and I'm probably gonna see some lows. And I think being aware of that, first of all is very important because you're not going to be as frustrated or discouraged when you do inevitably see these highs and lows   Stacey Simms  0:57 Eoin was diagnosed as a young adult. He has his own podcast and we talk about managing different kinds of workouts, treating lows at 3am. And lots more in Tell me something good type 1 diabetes, and space force. Did we just see a big barrier US military service come down? 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. 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. I'm your host, Stacey Simms, my son was diagnosed with type one back in 2006, at the age of almost two, and he is now 16. My husband lives with type two diabetes, I don't have diabetes, I have a background in broadcasting. And that is how you get this podcast. I am just back from podcast movement, which is a really big podcasting conference. I've gotten to it in years past, but I haven't been in a while it was really fun to catch up just like diabetes conferences, you know, you see all your friends and you do learn stuff. And I was there in a different sort of capacity, not just learning about my own show. But I'm working a little bit with a group called sheep podcasts, which is of course, podcasting for women. And I bring all this up just to say, it was really interesting to see the difference between travel at the beginning of July, which was the first time I really went to any kind of conference or in person gathering that wasn't, you know, immediate family. And in July, we were certainly very cautious. And friends for life, the organization there did a great job at being smart about COVID and doing everything they needed to do. But the difference this time was just the attitude and the feeling because of the Delta variant. You know, it was very interesting. Many more people were masking indoors than in July, many more people were expressing concerns about traveling back and forth. And I don't bring this up to say anything other than it was an interesting observation. You all know as you listen, you know, this is a very educated audience What's going on? I don't have to tell you anything. If you follow me on social media, you might have seen that I was wearing a mask outdoors in downtown Nashville, I was kind of reluctant to go to downtown Nashville at all, but I'd never been there. And I wanted to see all the bridesmaid stuff myself. Because it is like the National Capital now in the US for bachelorette parties. And yes, it lives up to that hype. It was amazing. But I was wearing my mask outdoors. If you followed me on social you saw that. And I haven't done that before but it was crowded and a lot of young people and you know in the US the younger the less likely to be vaccinated. So we took more precautions than we know I say we then me than I normally would have also was so much fun to meet some diabetes friends just as an odd coincidence in Nashville last Wednesday. As you listen children with diabetes, the group that puts on friends for life had a very cool event with mankind, the people behind Afrezza inhaled insulin, and they sponsored a fun time at a go kart track with Conor Daly. He is an IndyCar driver who lives with type one. And he was in town because Nashville had their very first Music City Grand Prix. I will link that up. It was a very cool, very different kind of race. But Connor was very cool himself. He was super engaging with the kids. I will link up some coverage. There was a new story come up some of the local news stations came out and made some videos which was really nice. I got to meet Rachel Mayo, who is a very cool lady who lives in Nashville. And you know, we're we've connected on social media for years. She lives with type one. She works with the JDRF chapter there. And Ernie Prado who's been on the show before he works at NASA. I saw him with friends for life. And he told me if I was going to Nashville, I had to look her up. So Rachel, it was so great to meet you. And maybe next time we will get in the go karts. I don't know. It was really fun though. you know, one of the things I mentioned podcast movement, but one of the things that's really fun about going there is meeting other podcasters you know, we already have fabulous other shows in the diabetes community. There are lots of podcasts and more of them. keep popping up all All the time, I did sort of a swap with this week's guest, but we did it kind of backwards. I taped the interview you're about to hear with Eoin first. And then he interviewed me about a week later. But he has already aired the interview that he did with me. His turnaround time was quicker. So I'll put the link in the show notes to that Eoin Castillo's show is the Insuleoin podcast, it is great. Oh, and you can hear the name in the title there Eoin was diagnosed almost 10 years ago at the age of 19. And he was very active very much to sports at the time. And as you can imagine, very worried about whether he'd be able to continue. It's a bit hard to imagine now. But even 10 years ago, there wasn't the social media there was in the communication we have now in the diabetes community. I mean, it's taken off for sure. But when you think about it, 2011 was still at the very beginning. So there wasn't a lot of information out there for somebody who wants to run marathons or lift weights competitively, you know, that sort of thing. We had a great conversation about how Eoin you know, kind of found his way and he is now helping many, many other people. And he is Yes, he's from Ireland. I think his accent is much nicer than my my New York accent which occasionally comes out I know you hear it here and there. 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 fast acting glucose tabs or juice but a very low blood sugar can be frightening. Which is why I'm so glad there's a different option for emergency glucagon it is Gvoke Hypopen. Gvoke Hypopen is pre mixed and ready to go with no visible needle. You pull off the red cap and push the yellow end on to bare skin and hold it for five seconds. That's it. Find out more go to Diabetes connections.com and click on the Gvoke logo. Gvoke shouldn't be used in patients with via chromosoma or insulinoma. Visit Gvoke glucagon comm slash risk.   Eoin Welcome to the show. It's great to talk to you today.   Eoin Costello  6:59 Thank you, Stacey. Thanks for having me on. I'm actually a longtime listener of the podcast. I was a pleasure. So I appreciate it.   Stacey Simms  7:05 Thank you so much. I was just about to say I really enjoy your podcast. It's kind of funny talking to a fellow podcaster. This will be nice.   Eoin Costello  7:14 Absolutely. At least we were both used to speaking on a mic.   Stacey Simms  7:17 Oh, we see now you set it up. Now we have to like up the game. We really have to be good today. I want to talk about your show and what led you there. But let's just start at your story's beginning. You were diagnosed with type one at at 19. What's going on in your life during that time?   Eoin Costello  7:35 Yeah, so I was kind of transitioning from high school, we just call it regular school in Ireland into college. So I had done a year of like a portfolio course I was actually going to art college for animation. It was around Christmas time. And I had noticed some differences in terms of how I was feeling. Obviously, I was very tired. I had lost about a stone and a half in the space of a month. I was really thirsty all the time. I just didn't have any energy. And I suppose because I was 19. And I was kind of into fitness and train and and keep myself healthy. I had this I had this naive attitude of I'm 19 I'm invincible. How could there be anything wrong with me, therefore, I'll just brush it off to the side. And it was around Christmas time and and in Ireland, we like to go to bars, we like to have a good time around that. Obviously, in France, I was having a few drinks. And if I was tired during the day, I would say it's only because I was out last night or if I was thirsty. It's because I've had a few drinks the previous night. And it wasn't until my parents were kind of quietly concerned. What they had mentioned that I should probably go dEoin to the GP get a blood test and just to see if everything's okay. And I reluctantly agreed because I was kind of saying, Look, I'm fine. I'm fine. I'm fine. There's nothing wrong with me. But I I gave in, because I just wanted to keep my parents happy.   Stacey Simms  8:59 Let me just interrupt you real quick. Just to translate over here. A stone is 14 pounds. So you lost 21 pounds.   Eoin Costello  9:06 Yeah, it flew off me. Right? Yeah. And in a very, very short space of time was about a month, a month and a half. But the thing about it was because you kind of see yourself every day, I didn't notice it as much. And it wasn't until I'd seen a friend who I hadn't seen and maybe six months or so I just bumped into her in the street. And she said to me, You look really different. And I said how would you mean and she goes I don't know you just look different. And she she kind of blurted it out and was embarrassed nearly but from saying it, but it was obviously because I had lost so much weight in such a short space of time. So basically I went down to the GP got a blood test. And a couple days later I got a phone call saying this is all I said it is blood test come back. You have type 1 diabetes, you need to go to the hospital right now. And I went in and my bloods were like six 40 640 so very high. And then that led me to my new life.   Stacey Simms  10:05 Was there any confusion about which type it was? Because sometimes, as a young adult, they don't go type one initially,   Eoin Costello  10:11 no, straightaway, they they had told me it was type one. But I had barely even heard the word diabetes before. I obviously knew that it was a condition that people lived with. But I had no idea of the complexities of it, or just the, the detail that you have to now live your life by. But no, there was no confusion. It was type one straightaway.   Stacey Simms  10:31 And while I'm sure your parents were supportive, but very worried, I heard your brothers gave you an interesting well, while you were in the hospital, is that true?   Eoin Costello  10:40 Yeah, it is true. So I was I was in hospital. I think I stayed there for about three nights while I was on an IV and obviously getting the crash course and diabetes management. And my family, in a good way have a dark sense of humor. We're nice people we like to think what around difficult times like that sometimes it can be nice to try and keep things light hearted. So my two brothers got a cough my brother and or my my dad. And we're obviously informed that Eoin has been diagnosed type 1 diabetes is in hospital. And on their way to the hospital. They picked up bottles of CO sweet jellies, these kinds of things to bring in as a joke. It kind of sounds weird. If you don't if you don't know. It came, it came from a good place.   Stacey Simms  11:30 That's funny. Yeah, I think sometimes dark humor has its place for sure if you know it's coming with love. That's really funny. Exactly, of course. So you're already very involved, as you said in fitness. I assume you played sports all growing up. What were you thinking at the time about what was to come next?   Eoin Costello  11:47 Yeah, there was a lot racing through my mind, obviously. But one of the big things that stood out to me and one of my main concerns was, can I continue to play sport, can I continue to be active, and for my whole life, I, I played a lot of different sports. But at the time, I was playing football, or I was playing soccer at a very high level. And I wanted to continue doing that. And because I didn't know anything about diabetes, I had almost automatically assumed that this would prevent me from being as active or playing sport. So it was obviously a big adjustment in terms of how to manage blood sugar around exercises, as we all know. But as time went on, I kind of quickly realized that look, you can of course, still play sport, you can be active, as long as you're still prioritizing your diabetes health. But the first while I was I was very concerned.   Stacey Simms  12:41 It's interesting, when you were diagnosed, you know, almost 10 years ago. Now, this is a time before a lot of social media. I mean, it's kind of just starting. But I guess what I'm asking is, you have a huge Instagram following, and other social media following and you post advice, and you talk very openly about how to do what you do with type 1 diabetes, I've got to assume that wasn't available for you. When you were diagnosed? How did you figure it out? How did you know what to do?   Eoin Costello  13:07 Very, very good question. It reminds me of when I kind of first got back to college. Because when I was in class, obviously, I had just been recently diagnosed. And as you say, Stacy, there was no social media, there wasn't really any, any sort of community based support groups that I could kind of connect with online and learn from other diabetics. And as we know, it can be very isolating to live with diabetes, because it's sometimes are consuming in your life. So at times, I was thinking I only person in the world left with this thing. And obviously I wasn't, but sometimes you can feel like that because it is so just on your mind all the time I was in college, I remember, some days, I was supposed to be doing work, but I might be behind the computer or laptop, just researching diabetes, because I became obsessed with in a really good way. Because I knew that. Okay, this is a very, very serious condition. It's something that is out of my control. Now I have it, there's nothing I could have done to bring it on. There's nothing I could have done to prevent us. But it's in my best interest now to know as much as possible. And for any diabetic out there, the more that we know, inevitably the easier things can be. I kind of just became obsessed with obsessed with trying to understand how different exercise would affect me how stress would affect me how lack of sleep would affect me, how hydration, different foods, these kinds of things. And it was it was almost like a guilty pleasure. I was just constantly constantly looking at open research and   Stacey Simms  14:42 we're going to talk about what works and I'd love to get some advice for everybody from you know, the very casual athlete to somebody who's really, really more involved in fitness. But I got to ask, did you have any mishaps in the beginning? Did you try anything that you said that's not going to work?   All right back to Eoin answering that question. But first bottom line, you need a plan of action with diabetes. We've been lucky that Benny's endo has helped us a lot with that and that he understands the plan has to change. It's been he gets older, you want 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 rage percentage within three months reduction of a win see within three months and a 58% decrease in occurrences of severe 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. Now back to Eoin answering my question about whether he's tried something in his workout or his diet routine that just didn't work.   Eoin Costello  15:59 Thankfully, I didn't have anything dramatic. Thankfully, I highlight. But yeah, of course, there's so much trial and error with diabetes and from throughout throughout the last 10 years, I have just had thousands of highs, maybe not 1000s of lows, hopefully keep them keep them less. But the more that I tried different things, the more that I tried to get out there the more exercise that I did on a test and different foods with different amount of amounts of insulin. There's just so much trial and error. But hopefully, I didn't have anything like decay or I wasn't kind of rushed into hospital board. Well, fingers crossed. Yeah, let's keep let's keep it. So it was more so just the highs and lows as they call them rather than anything too serious. Thankfully,   Stacey Simms  16:47 well, and I'll be I'll be clear on I was thinking more like you ate a banana before a workout. And it was not the right idea or wasn't so much like DK. Okay, I'm not too worried about, you know, that kind of mistake. I was just thinking about something smaller. But that's up to you.   Eoin Costello  17:03 Yeah, of course, there's times where I remember when I, I think it was been a few weeks after I was diagnosed and I was kind of getting back into the gym. But I was also kind of coming into a honeymoon phase quite quickly after I was diagnosed. And I was taught and I was learning to carb count for one unit of insulin for 10 grams carbohydrates. And I remember, I finished the workout in the gym, I went down to the changing room to get changed up shower, and I had a banana. I weighed out the banana. It totaled 50 grams of carbs. So I thought, Okay, perfect. I've waited out I've done everything I'm supposed to do. I took five units of insulin and ate a banana. But I hadn't fully realized the impact of a potential honeymoon phase. So I quite quickly plummeted. And I now have to get two liters orange juice in quite quickly. But I'm just mistakes like that. Just where you think you're on the right track with an insulin dose of carb count or something as diabetes does. It sometimes surprises you?   Stacey Simms  18:06 No doubt. I hate bananas. That's funny. That's why I gave that as an example. I'm not surprised that you had an incident with a banana. No, no, don't. Not one of my favorites. What kind of technology do you use? Do you use a CGM? Do you use an insulin pump?   Eoin Costello  18:24 So I've always used MDI, my mom, Nova rapid and Lantus. But only this year, I've got a Dexcom G6. And as you can imagine, that's completely opened up my eyes to a 24 hour period with my blood sugar rather than just that snapshot in time with a finger prick.   Stacey Simms  18:41 What motivated you What led you to start using a CGM,   Eoin Costello  18:45 it was more so they had become available in Ireland. So thankfully, in Ireland, we are with something called the long term illness scheme. So if you're diagnosed with Type 1 diabetes in Ireland, all of your supplies are covered, which is unbelievable. But only recently they had included the Dexcom G6, so it was actually only offered to me almost a year to today. It's been a game changer. It's just and particularly with exercise, it gives you so much more freedoms or much more confidence when you are to go to the gym or you are to go for a run or whatever it might be. It's so   Stacey Simms  19:19 interesting with exercise because my son who lives with type one has played lots of different sports. And it's always amazing to see those rises in blood sugar that comes not from food, but from exercise and the different types of exercise you have to learn what to leave alone with treat for. Did any of that take you by surprise? Did you see those? I call them adrenaline highs?   Eoin Costello  19:43 Absolutely. Yeah, I suppose what really surprises me and still to the day What surprised me so much is the drastic difference between and this is obviously from my own experience, the drastic difference between heavy weight training and something like a rant So to give you an example, if I was to actually, only this morning, I was in the gym, and I was doing relatively heavy squats. And when I work with heavier weights, my blood sugar skyrockets. So I've now gotten to the stage where more often than not, I will have to pre bolus for a heavy leg workout, because I'm anticipating that big spike. Whereas if I'm to go for a run, I'll know that after, say, 2030 minutes, my blood sugar's are inclined to trend lower. So ideally, I always try and go for a run with little to no insulin on board. That's why I like to run first thing in the morning. And then we're training in terms of weights, depending on what it is. I'm training. Like, if I'm doing heavy squats, I may need to pre bolus as if I'm having a meal, which is strange.   Stacey Simms  20:52 Yeah, yeah. But you have to figure all that out. I mean, it's it's incredible. And I always feel like just when we have one sport figured out, he decides to change. keep you guessing, right. You can't quit baseball. We figured it out. Now. He's done baseball, and basketball, football, a little bit of lacrosse, and now he's really enjoying wrestling. So I think wrestling is going to take us through high school, we are still figuring it out. Because it is you know, practice is super intense with lots of cardio and then sometimes wait on alternate days. And then the meats are just a lot of standing around and then these bursts of energy. So you know, it's   Eoin Costello  21:27 what would Benny's blood sugar? How would it react if he was saved on an intense wrestling session?   Stacey Simms  21:34 Well, the practices are to the point where we have the example, the very first wrestling practice he ever went to he ate 85 uncovered carbs during the two hours, he just liked having to stop No way. It was real. It was unreal. He was he's an active kid. But at the time, this is two and a half years ago. Now. He wasn't as fit as he is. Now to be quite honest with you, he had taken himself on as kind of a project and between eighth grade, and now he's about to be a junior. So two and a half, three years, he's really transformed his body. He's gotten a lot more fit. He's lost weight, he's muscled up. It's been it's been fun to watch, and kind of inspiring as the mom who just like walks the dog and works out a couple times a week. But he's really done well. So that first practice, though, was amazing. So we knew we had to make some changes. So we you know, we adjusted insulin. And as he exercised and became more sensitive, right, he responded better to the insulin, we were able to make a lot of adjustments. So if we knew it was a heavy cardio day, he would change his basal rates going in, in having control like you with Tandem has kind of changed that. But still, if it was a heavier weight day, he actually he kind of wait, no pun intended, he waits out the high, he doesn't like to dose for it too much because he will drop. And then during a meet, he just tried to kind of ride it. But he's 16 on. So sometimes that means ignoring it. To be quite honest with you, I can imagine and just getting through. So as his mom, I'm like, you know, if you just gave yourself a little bit you could He's like, it's fine. It's fine. It's fine. And it's fine. He's doing very well. He's very healthy. Our endocrinologist is pleased. So I can't really criticize him. But I but I'd like to   Eoin Costello  23:23 as mother's ward. Well, I'm sure look, he's he's in fantastic hands, obviously. But it's it's amazing to hear that he has stayed so active. And as you say he changed his body and seeing the difference with even the insulin requirements. Oh, yeah. Amazing.   Stacey Simms  23:37 Yeah, it's been great. So let me get I don't want to talk all let us let me get back to you. Sorry. When you talk to people about diabetes and fitness, and let's be honest, you are you know, fitness seems to be kind of your job. This is something that you are really passionate about. I'll share some videos and some photos if you haven't seen Eoin he's he? Are you a model? You're a fitness model in some ways, right? Terrible question. You're   Eoin Costello  24:03 gonna laugh at regression? Well, yeah, I'm with a model agency in Dublin, but it's not my my full time job.   Stacey Simms  24:09 Okay, so you can imagine how fit he is to have that as even a part time job. So let's start though by talking about people who are moderately active with diabetes, right? They may not they may not expect to be on the cover of, you know, a Fitness magazine, but they want to get in better shape. What kind of advice do you have for somebody who is worried about going low? Or is hearing us talk about these highs and isn't quite sure what to do? Where do you start?   Eoin Costello  24:35 Yeah, absolutely. Good question. And it's, it's something that I always touch on too. I make it quite clear that because I am so into fitness, I would never expect anybody to, you know, go to the gym five or six days a week and go out for runs multiple times a week. It's what I do with what I love. It's not for everybody else. But it's important that as a diabetic, we have some sort of activity in our life. Whether that be Going for a short walk a day, whether that be playing tennis, whether it be going for a swim, anything that you enjoy is the first piece of advice. It's important that if you want to exercise or if you're trying to introduce a new sort of regime or routine into your into your life, it's important that you enjoy it. Because if you do, you're a lot more inclined to continue to do and continue to see the benefits from it. So if somebody is concerned about the highs that I was speaking about, or the lows that I mentioned, what Ron's there is so much trial and error. And it's important that people always remind themselves of when I'm starting something new. And this can be with any aspect of your life. But particularly with diabetes, when I start something new, I'm probably gonna see some highs, and I'm probably gonna see some lows. And I think being aware of that, first of all, is very important, because you're not going to be as frustrated or discouraged when you do inevitably see these highs and lows. But if I was to offer somebody advice, who is trying to start walking or trying to start, say, even a light jog a couple times a week, the first thing is always be prepared for a high or low blood sugar, particularly low blood sugar, because the impacts of a low can obviously affect you quite quickly. So the first thing is always have your low treatment and start small, you don't need to aim to run a marathon quite quickly, you can think, Okay, I'm going to start this week, walk around the block, see how my blood sugar react, I might do to walk around the block, see how my blood sugar reacts to that. So instead of that kind of all or nothing mentality, you really need to ease your way into it. Because when you ease your way into things, you can steadily see any patterns or trends which approach, it might not be the best idea for somebody to say, Okay, I haven't gone to the gym ever before, but I want to start going, therefore, I'm gonna go to the gym six days a week, yeah, it's gonna be very, very, very difficult to understand how your body and how your blood sugar reacts to that. It could be I'm gonna go to the gym one day a week, and I'm gonna see what my blood sugar's like before, I'm gonna see what my blood sugar is like, during, and after. And if you're aware of the trends and patterns, like I said, with your blood sugar, it gives you more confidence over time. And the more confidence you have with your blood sugar, the easier it is to continue to do more.   Stacey Simms  27:27 And then for the people who want to do more, because we have quite a few people who listen to this show who are very much dedicated to fitness activity, athletics, you know, for those high achievers, any tips to kind of stay at that high level or get there,   Eoin Costello  27:43 I think a lot of that would depend on what that specific person's goal is. But if it is, say, to change your body composition, for example, and you really enjoy going to the gym, you like lifting weights, you can see your body changing over time, and you want to continue doing that, because it's it's what you love. Again, it's about enjoying it. But the priority will always be your blood. And I think no matter who you are what you do in terms of your exercise, whether it be intense, or just kind of casual each day, the priority is always blood sugar. Always, always always, for me anyway, that's how I feel about. And I think if you have a good understanding of how you're reacting to these certain things, then again, it gives you the confidence to push further and further and further and further, if that's what you want to do. So, to give another example from from my own experience, since the lockdown in Ireland, the gyms high close now, they're opened back up, thanks, thankfully. But when the gyms closed, I got big into running. And the first few rounds that I went on, it was again, a lot of trial and error, I would see a few lows, I would see my bloods dropping at a certain distance or a certain time. But the more I did it, the more my confidence grew. And then the more you do, you can kind of see yourself setting yourself goals. So I did a running challenge, which was 48 miles over 48 hours. So you'd you'd run for miles, every Yeah. So it was four miles, every four hours for 48 hours. And before I started running, I was thinking arc like could I could I do that, like with my butcher we get in the way is that realistic foot The more that you do, you can kind of see yourself getting closer and closer and closer and closer to doing these things. So if there is somebody who, as you say Stacey is a high achiever, or really enjoys their training, if you have that goal that you want to work towards, you can tweak your training or, or even tweak your diabetes management towards that, if that makes sense.   Stacey Simms  29:50 Yeah, I'm curious though you said you know the blood sugar is your top priority. What do you mean by that? Do you mean staying in range just knowing where it is? You know? When you say your blood sugar is the most important part of your workout, can you just talk a little bit about what you mean by that?   Eoin Costello  30:05 Yeah, of course. So I mean, not even specifically with training just in general, I always went out obsessing about it too much, I always like to prioritize my diabetes health. And for me, that is trying to keep my time and range in range as much as possible. Because I know that if I'm fluctuating high and low, and my time and range isn't where I would like it to be, that can almost immediately affect my quality of life for that for that day. Because I know that my clothes are up and down, not gonna feel the best and gonna feel as if I'm on the backfoot to my blood sugar kind of chasing them. So I always like to be as prepared as possible, so that I can almost look ahead those 2345 hours into a time where I'm working out to see, okay, I've eaten I've eaten this meal, I've taken this insulin. How can I expect that to react when I say I prioritize as I prioritize it, because I know that I won't be in the best form or I won't be able to train as much as I would like, if I'm having difficulties with my blood sugar.   Stacey Simms  31:12 What do you like to use to treat Lowe's Do you have a go to   Eoin Costello  31:16 when I'm disciplined with Lowe's, my go twos are these lift glucose drinks, or else dextrose tablets was easier said than done. When you when you're not having low blood sugar, but it's a whole different story, when you're waking up at 3am with a low blood sugar. And if I wake up at 3am, with a low blood sugar, the kitchen is just raided. And it's I always say I'm like a bear going into a picnic sometimes just can't be stopped.   Stacey Simms  31:44 Let's you know, it's nice to know you're human. I mean, that's that that takes a lot of discipline to just go for the tabs.   Eoin Costello  31:51 It depends on how low I am. If I'm dipping just underneath the time and range, it's easy enough just to stick to the glucose. But if I know I'm going lower, it's game over in terms of the treatment. And I know that then I'm going to inevitably see that kind of rebound. Hi, yeah,   Stacey Simms  32:09 do you have any foods that you really like to indulge in every once in a while   Eoin Costello  32:15 there is chips or crisps? We call them over here. And they're like, we thought they're beautiful things really crunchy. You're making me think about them. They're just these really crunchy salt and vinegar chips, as you call them. And they do these massive bags in Ireland. So I always have a few of them in the house. Just I probably eat them too often. Maybe that's why I train so much.   Stacey Simms  32:42 You know, I did want to ask you about your podcast. I'm curious. You know, I mean, I was in broadcasting. I know why I started my show, gosh, many moons ago. Why did you start your podcast? How did that come about?   Eoin Costello  32:55 I had never planned on us to be honest. And I think when I initially set up an Instagram page two, as you said earlier, Stacey to kind of help give people advice that I might be able to offer or what just experiences from my own life, it was almost like a snowball effect where the more that I shared, I felt as if the more I had to say. And then it almost came from a sort of selfish standpoint because I really wanted to interview other diabetics. And like throughout the past 10 ish years, I've always learned more from other diabetics than I have anybody else. So I felt that having a podcast gave me an opportunity to speak to as many diabetics as I could and to hear from their experiences. So it was to get other people on to share their experiences. And some of the guests that I've had on have been amazing. And I know you're going to be on shortly, which I can't wait for, for as well. I call this the insulin podcast redefining diabetes. I call it that because, well, for two reasons. Number one is I feel that diabetes is so globally well known. Everybody knows that it exists. But it's so widely unknown, and people don't truly understand the the intricacies that you're just a normal day entails. So I call that redefining diabetes, because I want to hopefully redefine what society see diabetes as and also, more importantly, what a diabetic sees that IBS is, it's really important for me that any diabetic out there realizes that look, it's not an ideal situation to be in as we know, it's a difficult condition to live with. What if we can learn to redefine that in our own head and kind of scratch on the surface to see what positives can we take from this, it doesn't have to just be a negative impact on our life. There can be positives from it, and I feel from sharing some of my own experiences and more, I suppose particularly more with the guests. It helps get that point Cross I've had people who've climbed Mount Everest ran across Canada, Chris Rutan, who was a motivational speaker who has obviously been on your podcast too. And I just think it can offer a lot of people value as your podcast those you've, you've been going for years now. And I know there's obviously 1000s of people that get such a massive benefit from this. So I'm hoping that they do too from my podcast.   Stacey Simms  35:23 I'm sure they do. It's a great show. But before I let you go, I'm curious, you know, you want to redefine diabetes. So if you look back at Oakland, 10 years ago, right, in the hospital, your brothers are bringing you soda and candy. And, you know, giving you a hard time, would you say that, at least to yourself, the definition of diabetes that you got that day, that in these 10 years? Since that you, you've redefined that for you?   Eoin Costello  35:51 I would like to think so. Yeah, I think if I was to put myself back in that hospital bed that was that 10 years ago, and to see how far I've come even just in terms of my own management and how I view my own diabetes? Yeah, I think I've redefined it for myself, which I'm proud of, I have to say,   Stacey Simms  36:09 yeah, you shouldn't be It's okay. That's great. Eointhank you so much for joining me, it was a pleasure to talk to you. I'm looking forward to talking to you for your show. I'm always it's a little weird to flip the microphone around and be interviewed. But I'll try to behave myself. Thanks. Great. Thanks so much for joining me today.   Eoin Costello  36:27 Thanks, Stacey. I can I just quickly say, I just want to thank anybody who's listening. I know that anyone who listens to the podcast is obviously looking for value. And I know that your time is an important asset. So I hope you've been able to get something from this episode. And Stacey, I'd like to thank you because this podcast for me personally has has brought me a lot of value. And it's offering people 1000s of people out there huge support and reassurance around their diabetes. So from a type one diabetic. Thank you, and I appreciate you.   Announcer  37:03 You're listening to Diabetes Connections with Stacey Simms.   Stacey Simms  37:08 For more information about Eoin in my show notes, you can always find out everything at Diabetes, Connections comm if you're listening in the podcast player, it may be a little difficult to see everything. Some of them don't support the links or the transcript I put in you can always come on home to Diabetes connections.com I so appreciate talking to Eoin. It was so kind of him to say what he said there at the end. I never know what to say. But what a nice comment. And I really do appreciate that I do highly recommend his podcast, the insuleion podcast. It's a lot of fun. He's so engaging, as you heard, and it really is terrific. Please check it out. Up next, we're gonna talk about space force. Did you hear about this guy with type one made it in? What does that mean for military service in the US? We'll talk about it. But first Diabetes Connections is brought to you by Dexcom. Dexcom has a diabetes management software called clarity. Do you use this because for a very long time, longer than I'd like to admit, I thought it was just something our endo could see. But it's really helpful. Now I have it on my phone, you can use it on both a desktop or as an app. And it's an easy way to keep track of the big picture. I find I use it a lot when we're adjusting things you know, which felt for a long time like it was non stop at age 16. Any kind of seems to be leveling out on growth and basil rates, at least for now. But clarity really helps us see longer term trends and helps us not you know over react, the overlay reports help put context his glucose levels and patterns. And when you share the reports with your care team, it's easy for them to get a great idea of what's going on and then they can better help. managing diabetes is not easy. But I feel like we have one of the very best CGM systems working for us find out more Diabetes connections.com and click on the Dexcom logo. And an article from Stars and Stripes was making the rounds. This is a military publication. And you may have seen this really interesting. Tanner Johnson was due to graduate from the US Air Force Academy in Colorado. When he was diagnosed with type one. They allowed him to return but they referred him for counseling and they told him this is going to be the end of your military career. But he told the counselor, I want to stay in what if we could demonstrate that I could do it. He was able to get in front of the academy superintendent and talk to him. And apparently that personal meeting made a big difference because the 10 General Richard Clarke reportedly went to bat for Johnson. There's not a lot of detail in the article about the process here. But Johnson was allowed to graduate in 2021 and he was accepted into the space force. If you are not familiar. This is I don't blame you because it's very, very, very new. Us space force is the sixth independent US military service branch. Of course it is tasked with missions and operations. In the space domain, it was signed into law at the end of 2019. And honestly, I know a lot of people think that this is something that former President Donald Trump just kind of made up and put into existence. But the idea has been around since the 50s. And it was seriously considered in the early 80s by Reagan. So I only say that to say, this is part of the US military. I saw a couple of Facebook comments about Tanner Johnson questioning whether this was really a military service assignment for somebody with type 1 diabetes, I believe it is, is it combat? Ready, right? Because Can you be deployed when you have type 1 diabetes is still the question. And that certainly doesn't seem to be something that is being planned for with space for so I obviously have a lot of questions, as I'm sure you all do, as well. So I reached out to the reporter who wrote the story and said, you know, can you connect us I'd really like to talk to Tanner, and she reached back immediately. It was fabulous. I was so grateful for that. Thank you, Karen. And she said, I will ask him, I will reach out but he just started training with space force. And he will need authorization from leadership to talk to you she said quote, they tend to say no. So we'll see what happens. If you know, Tanner Johnson, or you could get me an interview with him. Please reach out. Let me know how to be connected. Because I have a lot of questions as I know you do, too. But what an inspirational story, what a big first step for the US military. We've talked to other people who have been diagnosed while they are already in the military, and they've been able to stay active. But I don't know anybody who was diagnosed during training, who was able to stay in. So we'll keep following this one. But I'm putting this under Tell me something good because man, that's the last big barrier. We've got, you know, airline pilots in last couple of years can be type one now. Military service is the one that we still, you know, after that it'll be astronaut. So I think it's fantastic.  If you have a Tell me something good story, please reach out Stacey at Diabetes connections.com or post in our Facebook group. I ask there periodically. I love sharing good news. Okay, before I let you go, just a reminder, join me on Wednesday, every Wednesday on Facebook Live. I do a very quick five to six minute newscast give you the headlines in diabetes of the last week all types of diabetes, not just type one. And then I turn that around. We make it a podcast episode on Fridays. But if you want to watch that Facebook Live, then it's on YouTube. And I you know I put it all out on social this week. If you're listening as this episode goes live on August 10, the Facebook Live is going to be earlier. I'm still actually making my schedule because Wednesday just is some kind of bananas day. And I have to do the newscast earlier. So watch the Facebook space. It'll probably be three o'clock in the afternoon 330 something like that. It's usually 430 and I am getting a great response. So I'm so glad you all seem to enjoy it. Thank you very much. If you have news tips, send them my way too. And that's it. Thank you so much 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 in just a couple of days until then, be kind to yourself.   Benny  43:11 Diabetes Connections is a production of Stacey Simms Media. All rights reserved. All wrongs avenged

It's "In the News..." the only LIVE diabetes newscast! Top stories this week: FDA hints on 2021 D-tech timeline, the Freestyle Libre 2 app is approved, interchangeable insulin to cost less, an "astonishing" type 2 teen study and a big fall-off in use of metformin in people with type 2. Join us on Facebook live every Wednesday at 4:30pm EDT This week I was on the road, at the Podcast Movement convention. Sorry about the setting! Back in the home studio next week. 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.  I'm on the road – again! This time I'm at podcast movement a big convention going on in Nashville.. so apologies if the audio and video are a little bit off but I think we're good enough. And As always, I'm going to link up my sources in the Facebook comments – where we are live – and in the show notes at d-c dot com when this airs as a podcast.. so you can read more when you have the time. XX In the News is brought to you by Real Good Foods! Excited to have them back as a sponsor – we're big fans. Real Food You Feel Good About Eating. XX Our top story this week… a brief comment about diabetes devices at the FDA might give a hint to some timelines we're all watching. FDA Center for Devices and Radiological Health head Jeffrey Shuren says COVID-19 remains a source of uncertainty. "Goal is to be back to normal as we roll into 2022," Shuren said. "But there are a lot of variables that could impact that… don't know if we'll get hit with another tsunami of submissions for full marketing authorization for a lot of the COVID products. Getting back on track, everything is moving for the diabetes submissions." Products in front of the FDA expected by year's end: Medtronic's 780G and Zeus CGM, Insulet's Omnipod 5, Tandem's bolus by phone and it's expected that Dexcom's G7 will be submitted soon. https://seekingalpha.com/news/3715640-fda-devices-head-says-progress-being-made-on-diabetes-devices-backlog XX The FDA did clear one diabetes product this past week.. Abott's Freestyle Libre 2 iOS app. The Libre 2 hardware was approved last year.. this is the app for Apple phones.. it gives users optional real time high and low alarms – still have to scan to see the actual values. It updates every minute – only CGM that does – and it lets caregivers remotely monitor. Freestyle Libre 2 has a 14 day wear.. no exact date on when the App will be available or when it'll be available for android users.   https://finance.yahoo.com/news/abbotts-freestyle-libre-2-ios-130000861.html XX Other side of the coin, Abbot will pay $160 million to resolve claims that two of its units submitted false claims to Medicare. The Justice Department said free glucose monitors were provided to get patients to order more testing supplies, and the companies routinely waived copayments. They were also accused of charging Medicare for ineligible patients and for more than 200 patients who were actually dead. https://www.reuters.com/business/healthcare-pharmaceuticals/us-says-abbott-units-pay-160-mln-resolve-alleged-false-medicare-claims-2021-08-02/ XX Back to the FDA.. for the first time, they're allowing a less expensive brand name insulin to be substituted for the original. Semglee – approved last year – is basically the same as Lantus but it's a lot less expensive. Semglee is now is the first-ever to earn the “interchangeable” designation Trusted Source, meaning it's fully approved to be substituted for Lantus at the pharmacy. No need to get permission from the doctor. This is the second copycat of Lantus; the first was Eli Lilly's Basaglar, launched in 2016. There is some new branding and labeling needed here, so expect a relaunch of Semglee by the end of this year. FYI the pens are a little different even if the insulin in them is the same. It's always a good idea to know what your doctor is prescribing and what your pharmacist is giving you.. even if it costs less. XX Big new studies focusing on children and teens with type 2 diabetes.. showing how different the disease can be in younger people. The studies, published July 29 in the New England Journal of Medicine, showed that within 15 years of a Type 2 diabetes diagnosis, 60% of participants had at least one diabetes-related complication, and nearly a third of participants had two or more. These Texas researchers call it astonishing and say it appears type 2 in youth is much more aggressive than in older people. These researchers say more treatment options are needed for younger people because lifestyle changes don't seem to be enough. The study also showed a lot of families don't have regular access to medication or health care providers. They say it was a diverse study representative of teens and kids in the US. https://medicalxpress.com/news/2021-08-young-adults-complications-diabetes.html   XX More to come, including new about people with diabetes who stop taking a very commonly prescribed medication..  but first, I want to tell you about one of our great sponsors who helps make Diabetes Connections possible. Real Good Foods! We've been fans for a long time – Benny especially likes their ice cream. Real Good Foods makes delicious food you'll feel good about eating; high in protein, grain free and always made from real, nutrient dense ingredients. The labels are easy to read – because the ingredients aren't chemicals and fillers. Whether it's waffles or burrito bowls or stuffed chicken or the pizza that started it all.. I think you'll really love Real Good Foods. Learn more with the link in the FB comments or as always at d-c dot com. Back to the news…   XX Interesting research using artificial intelligence to catch diabetes eye issues earlier – when they're easier to treat. Changes in the blood vessels in the retina cause diabetic retinopathy, the most common diabetic eye disease and a leading cause of blindness in US adults. There are several studies and institutes looking at the use of A-I here, but these folks at the Indiana University School of Optometry say they're using information that is often ignored for diagnosis and it's making a big difference. The National Institutes of Health's National Eye Institute funded the work. https://www.futurity.org/biomarkers-diabetic-retinopathy-blindness-vision-2604812/ XX Nearly half of adults prescribed metformin after a new diagnosis of type 2 have stopped taking it by 1 year. The fall off is most dramatic during the first 30 days. These researchers say it didn't matter how long the prescription was written for and most who discontinued still had A1C's high enough to still need glucose lowering medication. They say as physicians quote - A lot of times we're quick to prescribe metformin and forget about it...Physicians might write a script for 3 months and three refills and not see the patient again for a year...We may need to keep a closer eye on these folks and have more regular follow-up, and make sure they're getting early diabetes education." https://www.medscape.com/viewarticle/955893 XX That's In the News for this week.. if you like it, please share it! And quick note this is our 400th episode. I've been busy with some behind the scenes stuff and it caught up to me! A huge thank you to all of you.. incredible support from this community. Six years and 400 episodes is an accomplishment that I've only reached because of you. And join me wherever you get podcasts for our next episode -Tuesday –  I'm talking to Eoin Costello the host of his own diabetes podcast – about staying active or starting getting more fit with type 1. This week's interview – the one that's out right now – is a look at the features of Omnipod 5 – the newest hybrid closed loop system in front of the FDA. Thanks and I'll see you soon    

It's getting hot out there and it's vital we keep insulin at the right temperature. However, that's something health care providers say isn’t always front of mind. Stacey talks to Diana Isaacs, a Clinical Pharmacy Specialist and a CDE at the Cleveland Clinic. We’ll get the real deal about insulin temperature and suggest some ways to keep your supply safe. In Tell Me Something Good… glamorous inspiration and a grateful mom – plus babies! And a big anniversary. This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. Check out VIVI-CAP www.tempramed.com - use promo code DIACON21 to save 10% off your purchase! (promo code valid through 8/31/2021)   EPISODE TEXT HERE... 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, it's getting hot out there a conversation about keeping your insulin at the right temperature. It's something healthcare providers say isn't always front of mind when we're troubleshooting tough diabetes days.   Diana Isaacs  0:39 Why are the blood sugars out of range this day? Why was it in range this day? And why? What's the difference? And this is really one of those pieces to the puzzle. And I think we spend so much of our time worried about other pieces like food that sometimes this really goes neglected.   Stacey Simms  0:55 Diana Isaac's is a Clinical Pharmacy specialist and a CDE at the Cleveland Clinic, we'll get the real deal about insulin temperature and suggest some ways to keep your supply safe in Tell me something good, glamorous inspiration, a grateful mom and babies plus a big anniversary. 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 always so glad to have you here. We aim to educate and inspire about diabetes with a focus on people who use insulin. You know, My son was diagnosed 14 years ago, just before he turned to my husband lives with type two diabetes. I don't have diabetes, but I have a background in broadcasting. And that is how you get the podcast. I live in the southeast us in North Carolina. So it has been warming up for quite a while here. But pretty much all over the United States. We are seeing the warmer weather hot summer is coming. Shout out to our listeners in Australia and elsewhere in the world where summer is not coming please save this episode for a few months. But in addition to the advice here, I've got a thread going in the Diabetes Connections Facebook group about what to use not only to keep insulin cool, but to keep diabetes gear holding tight in the summertime CGM and pump sites as you know, tend to slide off in the wetness sweat. So please check that out. Lots of good suggestions. And as I mentioned, in my book, the world's worst diabetes mom, we really like stay put medical to hold stuff on. But I'll tell you in a pinch Benny will just slap a big waterproof bandaid over his Dexcom I really like the clear tegaderm stuff, but I mean he doesn't care yelled us anything and you can find that in a CVS. So if you're off to the beach and you don't have anything, it really comes in handy. Most of the rest of the stuff that's being suggested in that Facebook group thread has to be special ordered either Amazon or the website from the company that makes it okay quick housekeeping note, you will hear my guest mention a product called VIVI cap in this interview and I have a promo code for you if you want to buy it you'll get a discount if you use the code, but I'm not being paid by VIVI cap. Although we are talking about doing something together in the near future. My guest is not a paid consultant for VIVI cap. She really likes the product and they know that and they helped coordinate this interview that said this conversation is about a lot more than one product. So whatever you use, keeping insulin at the right temperature is really important that promo code for VIVI cap is DIACON21, which gets you 10% off the product@temperment.com I'm pretty sure you're not listening with a pen. So I will put that in the show notes and on the episode homepage at Diabetes connections.com. My guest this week is Diana Isaacs, she is a Clinical Pharmacy specialist and the remote monitoring program coordinator at the Cleveland Clinic Diabetes Center. She was the 2020 at CES Diabetes Care and Education Specialist of the year and a Cleveland Clinic. She does have a pretty unique CGM training program. And you'll hear about that during the interview as well. But first Diabetes Connections is brought to you by Dario health. And we first noticed Daario a couple of years ago at a conference and Benny thought being able to turn your smartphone into a meter was pretty amazing. I'm excited to tell you that Daario offers even more now, the Daario diabetes success plan gives 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 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 daario.com forward slash diabetes dash connections. Diana Isaac's welcome. Thanks so much for joining me. I'm really interested to talk more about this. Thanks for being here.   Diana Isaacs  4:46 Great. Thank you so much for having me.   Stacey Simms  4:48 Or it is getting hot. I know that not everybody lives like I do in the south where it's been hot for a while. But let's start by talking about what you tell your patients.   Diana Isaacs  4:58 Yeah, so many people don't really The storage and the storage of insulin is so important. It's actually very fragile. And if it's not stored correctly, it actually most commonly it loses its potency. So it ends up you know that 10 units of insulin that you inject doesn't work like 10 units to work like seven units, like six units, you just don't know exactly, it's just will not be as potent.   Stacey Simms  5:18 When we're talking about storage of insulin. I know if I leave it in my hot car, and it gets to be, you know, above 110 degrees, it's going to lose its potency, but day to day, just kind of throwing it in the bag or having it with you, how do you need to store it,   Diana Isaacs  5:33 it's recommended any unused insulin pens or vials or cartridges should actually stay in the refrigerator, once it's been opened, then typically, it's good at room temperature for either 28 days, or some of the newer insulins are good up to 56 days, when it goes above that room temperature, that's when you really can't guarantee the potency anymore, and that's when it can break down and it is not going to be as effective. And in terms of Well, what's the danger of that? Well, a you really have no idea how much you're giving yourself. Because like suddenly, you know, what you usually give yourself isn't going to work as effectively. And you know, the real risk or the big risk would be a complication like diabetes ketoacidosis, where you're just not getting enough insulin and that could be you know, a life threatening complication,   Stacey Simms  6:23 what is considered room temperature   Diana Isaacs  6:25 78.8 degrees, it should be it should not go over 78.8 degrees Fahrenheit or 26 degrees Celsius,   Stacey Simms  6:32 you mentioned that the newer insolence can be out of the fridge for 56 days which insolence.   Diana Isaacs  6:37 So specifically, the ultra long acting like tresiba, insulin degludec, and then toujeo, which is insulin collaging. You 300 those lasts a little bit longer at room temperature.   Stacey Simms  6:49 Do you have any idea why I know those are made up a little differently from like, you know, Lantus or levemir.   Diana Isaacs  6:54 Yeah, the you know, they're just, they're made a little bit differently, which allows them to act longer in the body. And that's how they were studied to show that the potency, you know, still really maintains a fact at that point. And I mean, it's good also, because there's larger pens that holds more units. And so you know, that way a person, if they needed it for 56 days could have that the reality is a lot of people with the doses that they're on, you know, will go through a pen, you know, much faster than been 28 days. All right,   Stacey Simms  7:26 we're gonna do some True Confessions here, because I gotta tell you, we have kept insulin a lot longer than 20 days. And we have, and again, I'm not a diabetes educator, and endocrinologist. So you know, I'm just telling you what we have done as you listen, not just for you. But for example, Benny had a vial of insulin, my son that he took in and out of the fridge at school for almost an entire year, it was like a backup. So he would use it if he needed it. And when he was in elementary school, he used like, drops of insulin. It's not like now and he's a teenager. So we would put it in the fridge at the beginning of the school year, and then he would like take it out, use it, put it back in, take it out music, put it back in. Now, I know that's not advised. But it does work. So I mean, how delicate really is insulin, if we can get away with doing something like that.   Diana Isaacs  8:08 So Oh, man, you're burning my ears as a pharmacist? Oh, I hear that. But yeah, I mean, we know that that is reality that people are doing that. I think, you know, as long as it has maintained its room temperature, or refrigeration, probably a lot of insulins have at least close to the near potency for longer. It's just it really can't be guaranteed beyond that point. Because how it studied, I think, where things become different, or when it's exposed to too much heat, like we know for a fact that when it's exposed to high temperatures, or direct sunlight, it mean it loses its potency almost immediately. And if you've ever had you know, the insulin just sitting in the sun and then try to inject it, I I'm willing to bet it would be different. It wouldn't it would not work as well.   Stacey Simms  8:53 Right? And I think with that example that I gave, it never got below the refrigerator temperature because it was out and in so quickly. But I give that example because I know people who once they take it to the fridge, they think that's it. And it's just it was probably out for less than three minutes.   Diana Isaacs  9:08 Yeah. So I mean, that's interesting, right? So it's still you use it, but right, it wasn't out as much. So obviously, it's not ideal. We can't confirm how you know that it's so potent, but it sounds like in your case it was I have seen a lot of situations though, where people use insulin for example, longer in their pumps, like usually we say to change it out, you know, every three days and an insulin pump and people go five days, seven days and a lot of people notice as they go further out from those three days that it seems like they are needing more insulin that it is losing some of its potency.   Stacey Simms  9:39 I will say one of the only times we had an I refer to it very scientifically, skunky insulin. The only time we had skunky insulin was we had come home from summer camp and had unpacked the car but we had not seen like one of the bags kind of worked its way into the corner. And of course that was the bag that had two vials of insulin and two or three days later in our house. Summer car. We this was years and years ago, we used it anyway, of course, it did nothing. It was like sailing, or it was really bad. So that was a realization like, oh, it really does get terrible.   Unknown Speaker  10:12 Yeah. All that precious insulin law. I know. I know,   Stacey Simms  10:17 well, once we know, it's been 14 and a half years, so it happens, it happens. What do you advise patients then to do I mean, obviously, we can change out pump insulin more often. But as you said, Nobody wants to waste precious insulin like that. What are the tips that you give people to keep their insulin cool in the summertime, whether it's in a pump in a vial, that kind of   Diana Isaacs  10:42 thing? Yeah, so I'm a really big fan of something called the Vivi cap. And this is actually can go over like, it can replace the cap of an insulin pen, and you put it on there, and it guarantees that it stays at room temperature, even if it's exposed to, you know, a really hot car, really extreme temperatures, that is something that I've really been recommending for my patients, because it's just, it's a simple tool. And that way, you don't have to stress about like trying to, you know, I see a lot of people trying to get ice packs and things and that, that's risky, because you could accidentally freeze your insulin. So some a tool like the vivie cap, I find is really, really helpful,   Stacey Simms  11:20 you want to take us through a little bit of what it does.   Diana Isaacs  11:23 Sure, basically, it replaces the cap. So essentially, you know, like, let's say you have a novolog pen, right that you're using for your meal time injection. So you would go ahead and you would take off the cap. And instead, you would go ahead and you would put this Vivi cap directly on it, and you would replace that. And then you honestly, you can just throw it in your purse, in your bag, or whatever. And when you want to be sure that the insulin, you know, let's say you were in extreme temperatures, it was in your 100 degree car, and you're not sure if this insulin is going to be effective or not, there's a button at the top of it, and you go ahead and you press it. And if that button becomes green, then you know that that insulin was stored properly, it is a safe temperature, and it is safe to be able to use it if the D button would turn red, that would tell you Oh, there was an issue, the insulin is not safe. Now the good news is the way it actually you know, through a thermal cooling mechanism is actually getting rid of the heat where the insulin is. And so it's saying, you know, keeping it at room temperature. And why this is important also is because a lot of other things out there will make insulin really cold or accidentally freeze it or just make a cold. And really once it's out, and once it's open, it should say every temperature and so this really ensures that it will happen.   Stacey Simms  12:52 That's interesting. So the V cap doesn't necessarily keep it cold. It keeps it like it doesn't keep it refrigerated.   Diana Isaacs  12:59 Right, it's keeping it at room temperature. So it's really meant for the pen that you're using you're actively using. You can throw this cap on you can put it on your long acting and your mealtime insulin, and you can go on a trip, you can go wherever do whatever and it will stay at room temperature.   Stacey Simms  13:17 Here's a dumb question. We don't use pens very often. So I'm curious, do all pins have the same caps would this fit on pretty much any insulin pen   RIGHT BACK TO DIANA in just a moment 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 comm slash risk. Now back to Diana answering my question about what type of insulin pen fits in the VIVI cap?   Diana Isaacs  14:25 No, that's a really good question. So they actually make different ones for different types of pens. So for example, if you're using like the novalogic products like novolog, and for siba are similar. There's a V cap for those. If you're using like human log products, they have a different Vivi cap. And so yeah, depending on the type of insulin that you're using, you would just go ahead and get the vivie cap that goes corresponding to the one that you need.   Stacey Simms  14:49 It's amazing that until now, I mean we're seeing a few more products address this, but it seems like you know insulin has been around for a long time and you know until recently cuz I've seen a few products like this until recently, the freo is the only thing I can think of that was really out there affordable, you know, easy to use, do you think people are just kind of catching on to the fact that this is really important?   Diana Isaacs  15:11 Well, I think this is just like a really neglected area. Like I spend a lot of my time like analyzing glucose levels, looking at CGM, and in blood sugars and all that kind of stuff. You know, often you're trying to figure out the puzzle. Why are the blood sugars out of range this day? Why was it in range this day? And why? What's the difference? And this is really one of those pieces to the puzzle. And I think we spend so much of our time worried about other pieces like food that sometimes this really goes neglected. And as it's summer, you know, summer is approaching is really a good opportunity to remind everyone that this is a really important for insulin. I mean, this is so so important and will affect it, if it's not stored properly.   Stacey Simms  15:52 It just sounds like common sense. But I'm curious, have there been studies of this? Do we have any idea how many people are having issues with insulin that's not stored properly, or using insulin that has, you know, been out of the fridge for too long? Is there any information on that?   Diana Isaacs  16:08 Well, I don't know, if we have, you know, we certainly don't have like randomized control trial data on that. I mean, how would you do it? Right? I can tell you anecdotally, I think it's just difficult to capture. Because you could ask people I mean, oh, with any person will say that they've had their insulin at high temperatures at some point. I mean, if you, you know, are a human being that goes outside, you know, it's likely that your, you know, your insulin was exposed to higher than room temperature. It's just a matter of how long and I think in the summer, it's really easy for it to, you know, when you meant for it to just be a couple of minutes, that ends up being hours. And then before you know it, you just don't know. And I think also it's difficult to classify, because there's so many reasons that blood sugars can go higher. And so in the moment, it might be hard for someone to be like, Oh, wait, oh, yeah, I was, you know, I left my insulin in the car for three hours. That's why my blood sugar is so high versus they might be thinking, Oh, was it the food I ate? Or am I under stress? So I think sometimes it's just difficult for people to make that connection that it really was the insulin that made their sugars higher,   Stacey Simms  17:11 because I'm kind of picturing people listening to this episode of had diabetes for a long time going, I don't need that. It's been fine. Right? And I'm kind of one of those people that I'm like, Oh, it's fine. I can't imagine this really happening all the time. But you're exactly right. How would we know?   Diana Isaacs  17:26 Yeah, I would just encourage people to reflect on it. I mean, it likely has happened. If you had diabetes long enough, it's probably happened at some point in your life where your insulin hasn't been stored perfectly, right. I am a really big fan of patient choice, and people knowing what's out there. So if you've come up with a perfect solution, or your insulin is always at home, and you never go out great. You don't need something like the Vivi cat. But you know, if you're out you're traveling or going on a trip, I think it's good to know what options exist out there.   Stacey Simms  17:54 I'm curious too. And this is kind of separate from vicap. My son is using insulin pumps since he was two years old. And he we live in the south, as I've mentioned, and it's always hot, the summer is ridiculous. But he has the insulin next to his body. His body is pretty warm all the time. Is there any Are there any issues with that three days in the pump? Do you see people having more issues in the summertime? And do you ever recommend, you know, changing the insulin at more often because of temperature?   Diana Isaacs  18:20 I do. Yeah. A lot of people have issues is especially in the summer. I'm like I've seen people with like Omni pod. And it's just like boiling in the sun. And it goes bad very quickly. So yeah, I am a fan of encouraging people to change more often, like every two days instead of every three days if they notice that it's wearing off sooner. So I think like a lot of people should consider that in the summer if they noticed that third day there. boluses are just not having the same effects on their blood sugar's.   Stacey Simms  18:46 We've also found that winter to summer, we always have to change basil rates. And that's probably because of activity, but it's also because of heat. And I know that that affects people differently. How do you advise your patients to look at the weather and how it affects their bodies?   Diana Isaacs  19:01 That's a good question. I mean, everyone is affected a little bit differently. I really like Adam brown from diatribe. And he talks about 42 factors that affect glucose levels. And actually a sunburn is one of the things that could affect levels, it could increase glucose. So I think, you know, weather can affect it any kind of stressor on the body can absolutely affect glucose levels, but it is very individualized. For many people, the weather won't be a huge deal. But for some they may be more sensitive. And I think the best thing is to really reflect on it to review data with a diabetes educator or diabetes care and education specialist and really try to determine what are the patterns and who knows, yeah, it could be whether it does create a pattern for someone that if you know that it's helpful, because then you can kind of preemptively prepare for it and give yourself more or less insulin as needed.   Stacey Simms  19:52 Can we talk about sunburn for a minute, because every year in the parenting groups, somebody comes in and says it's their first time can the sunburn I raise my kids blood sugar, and everybody kind of says yes, yes. Why is that? Is it just trauma to the body? Is it like being ill?   Diana Isaacs  20:07 Yeah, I think it's like anytime there's a stressor on the body that can affect it. So yeah, if it's causing stress, you know, sunburns can be pretty painful. And we know pain can increase glucose, so it's likely related to those factors.   Stacey Simms  20:21 I don't wanna change the subject too much, but I'm reading your bio. You know, in researching for this episode, he talks about how you run a CGM shared medical appointment program. Can you tell us what that is?   Diana Isaacs  20:33 Yeah, so I am a big advocate of CGM of continuous glucose monitoring. And in our program, we often introduce people to CGM for the first time. And so with our shared medical appointments, we have usually four to six people with diabetes, and we have a meeting. And then we also have a dietician, and it's a two part shared appointment. And the first part, we get everyone together we place the CGM, and we have a discussion about what are the glucose targets and what kind of things affect glucose levels. We also review how to treat high and low glucose levels. And then everyone comes back after seven days and we download the devices and we we actually show everybody's data on a big screen and we go through it together. It's really interesting because a lot of people there, you know, there's similar things like the overtreating Alo or learning you know how oatmeal affects your blood sugar's you know, like, there's a lot of similarities that kind of it's nice to have that group environment. Yeah, that's   Stacey Simms  21:30 I've so many questions, but my first one would be, you'll have to, you'll have to come back on and just talk CGM with us. I'm curious, how do you manage or handle when people are looking at everybody's CGM numbers? And some must feel like, Oh, that's bad? Or I didn't do that very well. You know, do you talk about that part as well, and kind of managing the data mentally.   Diana Isaacs  21:51 So my rule is data numbers are data, and they cannot be good or bad. So it's simply being in target or out of target. But it's not a judgment, there's no such thing as good or bad numbers. And I'm really careful about this. I mean, even you know, when someone is 100%, in range, and has an agency of 6%, I try really hard not to say, Oh, that's so good. Like, you know, do jumping jacks, because, you know, I don't want someone then to have a higher agency and to be less than range and then not want to come back for their appointment because they think I'm only be happy when it's, you know, in range. So it's really an important point to not be judgmental with with data.   Stacey Simms  22:27 Oh, all right. You're gonna have to come back on and talk to us more about that. I think that's,   Unknown Speaker  22:31 I'd love to Alright, good. Good. Good.   Stacey Simms  22:32 All right, back to the summer, though. So since you work with a lot of people with with CGM, do you find that there are ways for people to keep their gear better on in the summer? Do you have any advice for that? Because diabetes technology can be kind of slippy in the summer?   Diana Isaacs  22:45 Yeah, no, it can be. So I'm a big fan of skin tack and of overlay patches, like sin patch, and stuff for keeping on CGM sensors and sites for the pump. I think technique with everything is really important. Making sure the skin is clean and dry. You know, placing it right after a person has recently showered or bathed just to have the most success with it digging and staying on. But I think absolutely using products like skin tack mass assault, for people that sweat, it's just it's like kind of a must to have those extra, those things can really help.   Stacey Simms  23:17 Yeah, we found or at least just anecdotally, everybody's skin is so different that you know, overlays vary brand to brand. So unfortunately, you kind of have to keep trying until you see what works for you. And one of the nice things we did locally when we could meet up and we're going to start meeting up again, which I'm very excited about is I always tell people, like let's bring samples, right? Because you get like a 20 pack of sim patch, and I get a 20 pack of stay put medical patches and you know, people just bring different brands, and then we can kind of trade because I used four or five different brands on my son before we found what worked. So if you're listening and you have a local group, and you're meeting up again, that's just something you can try cuz it's so frustrating.   Diana Isaacs  23:55 Yeah. And sometimes like, right, you put something on over it, and then you know, it starts peeling off after a couple of days, you have to put another thing over it. So yeah, I agree trial and error. You know, we   Stacey Simms  24:05 spoke a lot about the temperature extremes with insulin on the warm end, we touched on freezing, but let's talk about that again. What's the danger of insulin freezing? I mean, we know it doesn't work well. But is there anything to say about that in terms of why? Or you know, is it just that you mean, obviously, if it's frozen, you can't put it in a syringe, but it does completely lose its potency? Right?   Diana Isaacs  24:26 Well, I don't know if it completely loses its potency, but it very much does. But also, I mean, particles may form to which could make it definitely more difficult injecting and then I mean, I guess it could cause pain with injection as well. So I mean, it's just another reminder to like anything, you should really always visually inspect the insulin as well. And most insolence should be clear. So checking for that is really important as well.   Stacey Simms  24:54 Yeah, that's the the hotel refrigerator syndrome. So many times the fridge In the hotel is not set to the correct temperature. So you put your vial of insulin and it freezes. I've heard that so many times. It's just terrible.   Diana Isaacs  25:07 Yeah, I mean, it's really, it's really a problem. And so yeah, I mean, that's a really good point, when you're traveling, it's often really hard to rely on the hotel refrigerator, which is often is not set correctly for temperature is the right temperature,   Stacey Simms  25:21 what we usually do is, if we're staying for more than one night, is we'll put something you know, water, we'll put whatever in that fridge and kind of see how it does in a couple of hours, to see if we trust the insulin. But that's only helpful if you're going to be there for a couple of days, and you have a way to keep your extra insulin, you know, at a cool temperature, because so much of what we're talking about is not even so much for the the insulin you're using at that moment, although you want to keep it at room temperature, exactly. But you know, we don't have to keep it refrigerated. But when you're traveling with extra insulin, that's really a problem.   Diana Isaacs  25:52 I just would encourage people to think about it and just be just plan. I mean, just have a plan for the summer, whatever that plan is. And just be aware that I think some of the traditional methods that people use, like using like a lunch bag and putting an ice pack in it can, you know, you don't really know that temperature that's going to be in there. So there is an option available that you can be assured it's going to stay at room temperature. And it's just it's really simple. And it doesn't take up all this extra space and everything. I think that's the key. It's just it's a super simple thing. And so I would just encourage people to kind of check it out and go to the website and learn more about it.   Stacey Simms  26:34 It's interesting too, because insulins not alone, I mean, so many medications are temperature sensitive, as newer insulins come out, do you think that the temperature sensitivity will ever be factored out of insulin? Or it's just it's just part of the component?   Diana Isaacs  26:51 It's a really good question. Because I I'm sure you know, there's research in this area to see can insulin be more stable, or it's not? I think the problem is, it's just it's a large peptide. And, like due to its nature, it's just really hard to get it to be stable for a long period of time. I mean, it's one of the reasons why we don't have oral insulin, at least not yet. Like we don't have it in pill form. It's just really, really unstable. I think it's going to be challenging. Maybe one day we'll have that. But it's definitely going to be a challenge to   Stacey Simms  27:19 have that. You mentioned the newer insolence, like the longer acting like to CBOE and toujeo. Is that considered an advancement? Or is it just different, it's not going to apply to the shorter acting?   Diana Isaacs  27:30 Well, I think it is an advancement, in that we have an insulin that they were able to alter to work longer in the body, which I think ultimately really helped to stabilize blood sugars. And when you think about like, where we progressed, we started off with NPH, which you know, only works like half a day. And then we got longer act insulins like lantis and lab Amir, and then now we have these, like ultra long ones, like TJ Oh, and receba. And there's actually a weekly insulin that's in development that hopefully will, you know, see in the near future. So I think we're definitely making advancements and insulin, which is really exciting. Although the other area where we need to make advancements, which is a whole other episode is the affordability of insulin as well. But there are definitely advancements that are are being made. So yes, maybe with the storage, those will be things that will get better. But I don't see it completely resolving, you know, anytime soon.   Stacey Simms  28:23 How do pharmacies Sue with this? I mean, as far as I know, we've never had a problem getting our insulin from the pharmacy at the right temperature, of course, then I have to bring it home. And we do a lot with mail order as well and knock on wood. It's always been delivered, I think at the right temperature. Is there a problem from that perspective as well, like in the supply chain,   Diana Isaacs  28:43 know, the supply chain is heavily regulated? So I mean, they are monitoring refrigerators constantly. And they have certain standards, there's inspection so you can feel really good about the supply chain. It's really once it gets to the person that it's not regulated. But yeah, in the pharmacy, it is very, very maintained to a tee to those temperature and they're like specialized refrigerators is not just your it's definitely not your hotel refrigerator that for storing Insulet   Stacey Simms  29:12 Yeah, it's good. That's good. That is good. Before I let you go, I'm just curious. I we have been lucky enough to see my son's endocrinologist in person for the last couple of visits when we did a lot of telehealth. Are you seeing people back in the office? I mean, how are you all doing through all this?   Diana Isaacs  29:29 I never stopped seeing people in the office. So I've been here through the whole pandemic, I've actually come to work every day. Now. A lot of our visits have been virtual out of convenience for people but we are open and people could come here you know, whenever they want. And some For some it's preferred because as much as we've made advances in technology, we you know, we've got some patients who really have challenges downloading their data at home and stuff and it's, it's good to have them in the clinic. So yeah, our doors are open and but I will Say telehealth has flourished. And for a lot of people, it just makes so much more sense. Like today this morning, you know, we trained a person on their new pump. And rather than like me having to have her come in next week, I can just do a virtual and just look at her data that way and make adjustments. That's kind of where we're at with it.   Stacey Simms  30:15 I would imagine your patients have been very happy to walk in and see you during this past year. Like it's very be very reassuring. I was surprised how when we were able to see my son's endocrinologist again. I'm kind of happy we were.   Diana Isaacs  30:29 Yeah, I think it's nice. And I mean, I feel especially now with like the vaccine now that we've all been vaccinated, I feel very, you know, I feel great. It was definitely a little stressful. Like, I'll tell you back in December, we were doing our CGM shared medical appointment. And I had a class of four people and I, you know, you see people starting to like, move their masks down, and you're like, Oh, my gosh, is this safe, like at this stage, because we're doing a class and that was right, when the numbers were really increasing? So we did, we did pause them for a few months till the numbers came down. But But yeah, I think overall, you know, it's good. It has been reassuring. And you know, it's care doesn't stop, like some people are getting new insulin pumps. And yes, while you can get, you could do virtual training. And for many people, we do like some people really want that hands on time, when that was their first time starting upon, they want to come in and see it.   Stacey Simms  31:17 I can't imagine the people who were diagnosed this past year or had children diagnosed and were more isolated than normal. It's isolating enough to have diabetes. And I just can't imagine. So thanks for doing that. And, you know, keeping in touch with everybody, I mean, I'm not your patient. You don't really know me, but I want to say thank you.   Diana Isaacs  31:34 Oh, you're welcome. I mean, I love doing it. I love working with people with diabetes. It's so rewarding. And it's like, I just, yeah, I just feel like I feel very optimistic. With all the new technology and the advances being made. I just feel like, yeah, there's so much opportunity to help people.   Stacey Simms  31:50 Well, thank you so much for spending so much time with me. And we'll have you back on to talk more about CGM and the shared medical stuff. I think that sounds great. Thank you so much.   Unknown Speaker  31:57 Oh, you're very welcome. Yeah, thanks for the opportunity.   Unknown Speaker  32:05 You're listening to Diabetes Connections with Stacey Simms   Stacey Simms  32:11 I’ve  got more information about the temperature at which insulin is supposed to stay. We touched on that. But if you'd like to learn more, and there's some more studies that really delve into this, I'll put that at Diabetes connections.com. Every episode has its own homepage there. If you're listening on an app for podcasts, there are always show notes, but some of them don't show these things very well, you can always come back to the main page, and I'll put it there with a transcript as well. And the promo code for VIVI Cap is DIACON21, like Diabetes Connections, di a co n di a con 21, which gets you 10% off the product. Alright, tell me something good. Coming up help prom photos provided some unexpected inspiration. But first Diabetes Connections is brought to you by Dexcom. So I was watching a movie with my husband the other night, and I got a Dexcom alert and he was upstairs in his room. And you know, for some reason, that took me back to the days when we basically had blood sugar checks on a timer, we would check doing a finger stick the same time every day at home and at school and you know, whatever extra we needed to. But it's amazing to think about how much our diabetes management has changed with share and follow. I didn't have to stop the movie to get up and check him. I knew what was going on, I could decide whether to just text him or go upstairs and help him out. 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, he 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 up required, go to Diabetes connections.com and click on the Dexcom logo.   Tell me something good this week, I don't know about you. I'm in a lot of moms groups. And I have seen a bajillion prom photos over the last month and it's really nice. But one of the things that happened that I didn't expect is that it provided diabetes inspiration to families, especially families with younger kids, I don't have permission to share her name. So I'm just gonna tell you the story here. But this woman posted that she was looking at all the pictures of the beautiful girls and their dresses and their Dexcom and their pumps and their Omni pods showing. And you know, she was excited to see that. But her little girl who's totally into the princess phase right now she's six or seven years old, loved seeing the photos of all these grown up girls with diabetes. And it really provided an easier way to get her little girl to feel better about the gear that she is wearing. And I just thought that after all these years was still kind of unexpected. Now let's be honest, not everybody wants to show their gear all the time. And that's okay too. And honestly, I highly doubt that these girls are going to the prom thinking. I'm gonna have my mom posted. On Instagram or Facebook and that's going to inspire somebody else. Right? But man did it ever. So thanks to all of you who did that, who posted the photos? What a cool thing I have to wish a happy wedding anniversary to Janice and Bill Grigsby they celebrated 50 years married in April. And Janice was cute. I was asking for good news in the Diabetes Connections group and she wrote that may not be what you were looking for, since it doesn't have to do with diabetes. But you know, Janice, we're all together because of diabetes. Janice and Bill's daughter marked 20 years with type one late last year, so I think that counts so congratulations on that amazing milestone. It doesn't all have to be diversities. 50 years married. That is fantastic. And a big congrats to Alison nim Lowe's, who had a baby last week, little Stellan joins Big Brother Henrik is still in it was a little impatient came into the world a little bit early. So he'll be staying at the hospital for a while. And they helped to bring him home by the end of May. But everybody's doing well. Alison is somebody I've known for years. She's been on the show before I will link up that episode. She's on social media as the diabetic therapist Of course, we talked about therapy and mental health in that episode, but congratulations all around really exciting stuff. If you have something good to share, please let me know Stacy at Diabetes, Connections comm or pop into our Facebook group and share when I asked on a regular basis. Just tell me something good. Before I let you go, quick reminder that on Wednesdays in May, I am doing in the news, a live diabetes newscast every Wednesday at 4:30pm. Eastern time. I hope you can join me for that. I'm also turning it around to then putting it out on different social platforms. And on this podcast. That episode right usually has been coming up Thursdays or Fridays. And it looks like we may continue this because people are really liking it. I definitely need to know how you feel about it though. So you can email me comment on the post itself. It's a little bit of different work than the podcast to be honest with you. Not necessarily more work, but I do have to brush my hair and put some lipstick on to go live on Facebook. That's just how I am if I continue this, maybe you'll see me eventually in the ponytail and opaque but I'm having a lot of fun doing it. And I think it's a need. We don't really have a diabetes newscast anywhere. So I may continue. I will be deciding probably between this weekend next week's episode, and I'll definitely let you know. Thanks as always to my editor 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.   Benny  37:42 Diabetes Connections is a production of Stacey Simms Media. All rights reserved. All wrongs avenged

We can't wait to travel again! Looking back on this episode really makes you want to hit the road. Jeremy Larsen is an American currently living in Japan but he's traveled the world. Jeremy started the 70-130 project (the “perfect” blood sugar range) to show that type 1 diabetes shouldn’t hold anyone back from travel. In 2017 he came back to the states to do a national parks trip and now he blogs and posts videos over at T1D Wanderer. This interview with Jeremy took place in October 2015. 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 Stacey Simms  0:00 This episode of Diabetes Connections is brought to you by inside the breakthrough, a new history of science podcast full of did you know? stuff.   Announcer  0:13 This is Diabetes Connections with Stacey Simms.   Stacey Simms  0:19 Welcome to a classic episode of Diabetes Connections. I'll be so glad to have you along, we aim to educate and inspire about diabetes with a focus on people who use insulin. These classic episodes are a chance to revisit episodes that aired in the first and second year of the podcast, when frankly, we didn't have quite as many listeners. And it's always fun to go back and check in with these folks. I spoke to Jeremy Larsen, back in 2015, he has traveled the world and he is currently living in Japan as he was when I first spoke to him. He started a project that he called 7130, the perfect quote unquote, blood sugar range to show that type 1 diabetes shouldn't hold anybody back from travel. Jeremy was diagnosed with type one when he was nine years old. And he says he got the travel bug from his parents and he's from America. He's an American citizen living abroad. And he says he spent a lot of his childhood seeing the US from the back of the family car. He has been all over the world. And you can see from his many, many videos, where he usually shows his blood sugar talks about his management, he's far from a perfect guy. That's not the point. He says, as you'll hear, it's more just about getting out there and living well. With type one little bit more on Jeremy is doing these days. I'll catch up in just a moment. But first, this episode of Diabetes Connections is brought to you by insight the breakthrough, a new history of science podcast created by Simon Simon is a group of Canadian researchers dedicated to changing the way we detect treat and even reverse type two diabetes. The latest episode features the question does snake oil actually contain snakes, it's a look into how this phrase snake oil came to be. And it was kind of surprising. It's a little gross. But it's also very interesting. I got a sneak peek of this show at the beginning of the year. I love it. I've subscribed to it. I listened to every episode. They're all terrific circuitry inside the breakthrough wherever you found this podcast. And if you're listening through the website or on social media, there is a link to inside the breakthrough at Diabetes connections.com. And this podcast, as you know is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. When I reached out to Jeremy Larsen back in 2015, he was because I was just really intrigued by his Twitter feed. He was traveling all over the place. And he was always showing his blood sugar. And he had interesting stories about everything that you would we would expect, right finding insulin language barriers. We talked about that a little bit, you know, talking about what sang type 1 diabetes in different languages. He was just as fascinating to talk to him as I had hoped. And we actually connected again a couple of years later, he did a huge road trip across the USA in 2017. Going to different national parks. I think he talks about that in this interview that he was planning that and when I caught up to him recently, he said hey, I'm actually still in Osaka, Japan still teaching although we're watching the Coronavirus numbers with concerning the canceled big Amtrak travel plans last year he has been biking to and from work every single day. And he has a big YouTube channel. So I will link to that now as well. So you can check out what he's been up to. One more quick thing I need to let you know, my intro to this interview. Initially, the beginning of my talking had a lot of music under it. I did things a little differently back in 2015. So it'll be really weird. If I play that now. It'll sound odd. So I will just set it up to tell you that at this point. Jeremy is talking to me from Japan. I am in North Carolina. And I'm starting out by mentioning the time zones here. I thank him for joining me today. Or maybe it's tonight.   Jeremy Larsen  3:57 Tonight, my time early morning, your time.   Stacey Simms  4:00 Let's start. When you were diagnosed, you were a kid you were living in the United States. You grew up in the southeast. How old were you when you were diagnosed?   Jeremy Larsen  4:10 I was nine. And I was living in Augusta, Georgia. I don't remember a lot about it, except that my parents say I was laying around on the couch a lot and had no energy and all that kind of stuff. drinking a lot of water going to the bathroom a lot. I think it was the lack of energy that really, really concerned them. And as I recall it, and I was only nine I'm not sure how accurate This is. But I recalled that they took me to the hospital on December 24. I know it was December 19 just a few days before Christmas. And I don't remember exactly what happened. But remember somebody probably my dad saying that you might have diabetes. And I had heard that word. I knew it was something but I didn't really know what it was right. So I was in the hospital for several days, you know, and of course it was diabetes. And I remember them saying The doctors were real good, never saying they weren't sure I was going to get out for Christmas morning. But they were trying to do that. And I didn't really care. I just wanted to get better. And finally, they let me get out on December 24. So I actually went home and had some kind of Christmas morning the next morning. So that's kind of all I remember, I remember a few things from the hospital, but it was just basically pretty, probably the pretty standard story from back then.   Stacey Simms  5:28 Yeah, when you're nine years old, you kind of just want to get back to your, your friends. And if you play sports, and just doing what you want to do.   Jeremy Larsen  5:36 I remember some of my friends at school had given like, Christmas presents to each other, and somebody had given me a box and I had like a giant candy cane in it. And I was kind of looking forward to getting back to that. And my parents had thrown it out about that.   Stacey Simms  5:51 Do you remember kind of life changing quite a bit? Or did your parents treat this as Okay, we're just going to go on, as we did before with diabetes?   Jeremy Larsen  5:59 No, that's exactly how it was. They just, they were really great. They were obviously very concerned and everything, but um, they kind of presented a just Well, that's how it is kind of face to me. And that's just how it was. I don't really remember a difference. I don't remember what life was like before it. You know,   Stacey Simms  6:18 we're going to talk a lot about travel today. Did you have that bug as a kid? Did you travel with your parents a lot?   Jeremy Larsen  6:24 Yeah, that's where it started. I don't I wouldn't say I had the bug. But we lived. I grew up in Nashville. Actually, I just moved to Augusta when all this happened. But when I lived in Nashville, Tennessee, and when I got when I lived in Augusta, we would take these long car trips once or twice a year down to Sarasota, Florida. And you know, especially from Nashville, that's whatever it is 12 or 14 hours, we do it one straight shot. So it was me and my sister and my parents, and we would just spend me and my sister in the backseat playing games and looking at license plates and all that kind of fun stuff. And we just got used to sitting for long periods of time and watching the world go by and we drove all around. We drove around the Mississippi once and just long, long car trips. I think that's where it started.   Stacey Simms  7:10 It's funny, you mentioned the license plate game and things like that, because I travel a lot with my kids who drive with the car, but they've got their movies in their iPads and they don't. I hope they look out the window sometimes.   Jeremy Larsen  7:19 I don't think they do. I still play the license plate game when I'm driving around America.   Jeremy Larsen  7:25 But you don't know,   Jeremy Larsen  7:26 Wyoming.   Stacey Simms  7:28 But you don't live in America anymore. How did you get to Japan?   Jeremy Larsen  7:32 Well, I had only I was still living in America. And I'd only left. The United States once now was for a month in Scandinavia. And that was a lot of fun just backpacking around, you know,   Stacey Simms  7:42 did you go by yourself?   Jeremy Larsen  7:43 Were you with friends? Yeah, by myself. Yeah. And that was just just kind of learning how to travel, how to be outside the US and how to find trains and how to find accommodation and stuff. And it was a lot of fun. But then I was back in the US. And I was working in Augusta, actually in Aiken, South Carolina. And I started I don't know what the thing what made me do this. But I started realizing I can I could not even not only travel overseas, I could live overseas somewhere. And I thought, well, how would I do that? So I started looking at websites and stuff. And I found that you could teach English. And you didn't really need any special qualifications depending on the country. There's a lot of different countries you could do it in. So I decided to go to Chile, because I was pretty good at Spanish in high school in college. And I still remembered most of it. So that I go to Chile, I'll be a teacher. And it turns out you had to have a teaching certificate or some kind of degree or something for GLA Chilean government's rules. So looked around. And then I kind of settled on either Japan or Korea because they had a good reputation for having a lot of jobs. And you didn't need special qualifications. And the salaries were pretty good even for introductions, introductory teachers. And then Korea kind of had a bad reputation. I don't want to smear Korea because I don't actually know they had a bad reputation for some of the schools didn't pay on time or wouldn't pay in Japan had no such reputation. Everybody thought Japan was pretty good. So. So I actually, I applied through a website to one of the big companies here in Japan and they flew I flew up to Toronto to have a an interview. And they hired me and a few months later, I came to Osaka for one year. My plan was one year, maybe two and that ended up being four years. And then I left Japan after four years went traveling a little bit and then I came back to Japan. I've been here another four years. That's where I am now.   Stacey Simms  9:40 What do you like about it? I mean, did you enjoy teaching or do you just like being in Japan?   Jeremy Larsen  9:44 My mother always told me that I should be a teacher and I always thought she was crazy because I never did anything like that. Like I was in I worked in newspapers I worked in like graphics and stuff like that. And just because that's what you do if you want to move here I started teaching English and it turns out I do I get it's, it's not really why I'm staying here. But it is fun. It's very, it's like, you know, most people have desk jobs where they just sit around and they're on a computer all day. But my job was just talking to people. And it's really a lot of fun for that. So the reason I stayed was kind of, it's just, to me, it's like traveling every day a little bit. Because as I don't read Japanese that well, I don't I'm not actually that good in Japanese, despite my time here. So whenever time every time I like walk down the street here, everything's kind of weird and new to me, still, it's still that way. And that's what I like about like a little sense of, I don't quite know what's going on. So I have to fight to you know, make my own way here. And I'm kind of used to it but still, it's it's an odd place to be. It's the people like me who thrive here are generally people who are probably more loners, or they probably, they just enjoy, they enjoy the challenge of trying to figure things out.   Stacey Simms  11:00 It must be just so fascinating, as you say, to feel like you're traveling every day. But we haven't really mentioned type 1 diabetes. Tell me a little bit about how you do it. Especially let's let's back way up. Tell me about your first trip that month of backpacking. It seems like this is second nature to you now, how did you prepare? And what do you do when you travel?   Jeremy Larsen  11:22 Um, it's kind of funny when I look back on my life, like because I was diagnosed at nine when I think of, you know, the rest of elementary school and junior high school high school, I don't really remember diabetes, like in high school, I don't remember if I took shots to school and took them or if I just took regular in the morning, I don't know what it was. Because I just had like a regular life. And I always, almost always tried to maintain diabetes, but I didn't really it wasn't like a huge, huge, huge thing. It was just something to deal with. You know, when I was in Scandinavia, all I really remember is that I had my glucose machine. And I was on human log and probably NPH. Yeah, human organ NPH at that time, and it was insulin pen with replaceable cartridges. That's what I was using. And I just, it was only a month. So I knew exactly how much I knew about how much I would need. And I made sure the doctor gave me probably two or three times that amount just to be careful, you know, right. And I kept it in a cooler pack, and just carried it around with me. I remember I carried a an empty Coke, coke bottle like an empty plastic bottle. And I would put my used strips and needles in it. Just carry them around month. And it got like all this bloody water and stuff. I remember crossing over from Sweden and Norway by train and some lady came by to check passports and stuff. And she saw that she just looked at it and didn't seem to care. Put it back in my bag. Sorry. But that's got to be the most suspicious thing she's seen all day. Exactly. As long as you have enough supplies, and all I have is insulin and blood sugar machine and strips. Just make sure I have enough I keep them in a couple different places like two different bags in case something happens to one. So it's not ever been in problem. Really.   Stacey Simms  13:09 You know, it's interesting to hear you speak about it. Because you're very low key about this. Obviously, you're taking care of yourself. You're doing what you need to do. But this I like that you don't remember what you did in high school to me that shows Hey, it's just life. We're getting through it. I mean, I don't remember all the stuff I did in high school. I don't have diabetes, it's just the way it seems to go for you. Is that attitude? You think something that is important as you live now in Japan?   Jeremy Larsen  13:31 Yeah, I think so. Again, it never really comes up here. Actually, the real I don't exactly know why. But I think one of the reasons and I don't know how cool of a story this is, but it is true. When I was in the hospital, and when I first got diagnosed, I remember you know, it's kind of a heavy atmosphere, like you've got diabetes a little bit. And I remember the doctors saying a couple times, well, you have diabetes, and that's not good. But the kid in the next room, he's got leukemia. Oh, geez. And another word I had heard that I didn't know what it was. And they explained that's much, much, much worse, you know? And I kind of think maybe because I eventually learned what leukemia was. And I kind of think maybe that's what gave me my outlook on diabetes. Like it could be much, much worse.   Stacey Simms  14:18 I think it's fascinating. You know, I'd love to talk to more people about their first impressions because I think it's very important. I don't doubt that that did affect you. When we were in the hospital with my son. There was a nurse who came by she wasn't our nurse. My son was not yet two years old when he was diagnosed, and we didn't know we were doing well. But what is this what's gonna happen? And she came in and she has type one, she was pregnant with her second child. And she said, I just wanted to come in and tell you everything's gonna be great. life's gonna be good. They told me I couldn't have kids. Here I am with my second. Don't baby Your son, get out of the hospital have a great life. You know, see you later. And it affected us to the point where we thought Oh, great. Look at that. I think if we had let ourselves kind of wallow in the world. mean nothing's going to be good ever again, it would have changed. But this great nurse came by and said, Dad, come on, it's gonna be okay. It really   Jeremy Larsen  15:06 a lot of people do follow it and they don't have anybody like that. And I think that sets them on a bad course this isn't a bad attitude. You know,   Stacey Simms  15:13 I think we were extremely lucky. So, Jeremy, now that you have traveled and you have traveled extensively, you started at really interesting project that I want to talk about. And that is how I saw you on on Twitter, this is your your Twitter handle and tell me about 7130. What is this all about?   Jeremy Larsen  15:36 7130 rows, really, because those are the numbers that the American Diabetes Association recommends for pre meal blood sugars,   Jeremy Larsen  15:47 right, that's the   Jeremy Larsen  15:48 best range, the best range for generally speaking, I think 70 is a little bit low for me personally, but that's what they say. So it's got a good ring to it. 7130. What happened is I knew another diabetic type one diabetic, and he didn't take care of his, I guess he took insulin a little bit, but he didn't. Like he got sick one night, like he felt really bad. And he called his father who is a physician. And he said, I feel really bad. And his father said, Well, can you check your blood sugar? And he said, No, I don't have any I don't own a machine. And I heard this story. And I mean, whatever that story is worked out. Alright. But I thought, and he's had a couple surgeries for like, diabetic retinopathy and stuff like that. Wow. I thought why do people do that? Why do people just not accept it like it life is so much better, if you take a few seconds, every, every few hours, whatever it is, check your blood sugar and try to get it right, you know, it's gonna be real high and low sometimes, but just try to try to learn more, you know, the the psychological barrier that some people have not being able to face, it is very unhelpful, and what 7130 is really to me, for one thing, it's way for me to brag about the traveling, I do, and I like that. And I like blogging and stuff, but um, it's a way to show people that you can go anywhere, diabetes doesn't have to hold you back. And if you watch your blood sugar, and really like, you know, accept diabetes, except that you have diabetes, and that's just how it is. And it's not that big a deal. It's not that hard. It doesn't always make sense. But it's a pretty simple process to take care of it. If you do that, you're more likely to do fun things, you're more likely to whatever your thing is, if it's traveling or if it's getting a certain kind of job or living in a certain place, or whatever it is you want to do sports or something like that. So it's really all about checking. I know a lot of people are, are knowing your blood sugar and maintaining, I know a lot of people are aching to find a cure, they just want to cure like I'm fighting to find a cure. And I like the work that people do, especially the jdrf. Like they all do really good work. But I think psychologically, I'm not so worried about a cure. If it comes, that's great. But there isn't one now so I have to deal with it now.   Stacey Simms  17:58 And this 7130 project is a video project a picture project to where you're basically taking pictures of yourself in your meter, whatever the number is, and sharing them what's what is the reaction been? I love the videos. I think they're they're really fun. And a lot of times, almost all the time you have a pretty good number, do you I shouldn't get ahead of myself here. But do you wait till you have a good number to stick it in the video?   Jeremy Larsen  18:23 It depends on which one it is there's different things. There's one I did called Osaka A to Z. The point of that one was I made a list of 26 places around Osaka This is while I was living here working so I couldn't be traveling. I was kind of stuck here. So I made a list of 26 places around Osaka from A to Z and I went to each one I took a picture of my blood sugar machine. And those I did do some cheating on if my blood sugar wasn't good. I would I would drink juice or take some insulin and wait a little bit or I just pull up a fake number. You would not? I would Yes. Because the point was the finished product. So I had like all these I think yes 26 places and I think they were all between 7130 that was the point right? After I did that I thought that what happened was the feedback I got from people people said they liked it and found it inspiring that I was getting out to these places and stuff. But people were saying how's your blood sugar always perfect like that. And I kind of realized was kind of annoying because it's not even true. So the next one or one of the reasons I did was when I was in Europe for four months, I just said well whatever it is, this is what it is. And I'm gonna go to the top of this hill in Budapest and take a video or picture and whatever it is when I get there that's the blood sugar but I'm still here and I'm trying to do my best with with my insulin and my food and exercise and everything and if it doesn't work, it doesn't work but I'm still here anyway.   Stacey Simms  19:46 I like those better because it's go right   Jeremy Larsen  19:49 just go right.   Jeremy Larsen  19:51 You can you can stay at home and have a blood sugar this 350 or you can be traveling through the Czech Republic now which is better.   Stacey Simms  19:58 What has surprised you With about traveling with diabetes and and living in Japan with diabetes, anything really surprised you?   Jeremy Larsen  20:05 While living here, the big difference between living here is how easy the healthcare system is. It's nothing like it is in America. And I remember we know when I was in America had insurance through my employer and all that, and the deductible and which doctor you can see and all that kind of stuff. None of that exists here. I pay monthly into the nationalized health surface health system, and I can go to any doctor, or they can write me a prescription, I can go to any pharmacy, everything's really like, the prices are all set. doctor visits are really cheap. And the insulin cost about the same as what it does in America. But it's just no worry. There's no health insurance worry.   Stacey Simms  20:43 It's fascinating, isn't it all the same supplies? I do have access to everything that you would have used in America.   Jeremy Larsen  20:49 Actually, somebody asked me today on Twitter, what kind of Insulet What kinds of insulin are popular here? And I didn't really know what to say cuz I only know what I use, which is human log and Lantus. Now, and those are actually manufactured for the Japanese market here, like my pins actually have are written in Japanese on the side. Oh, they're very, I mean, yeah, even if I go to a doctor, and then like a brand new doctor, and then they write a prescription and I go to the pharmacy next door, the pharmacy will probably have humalog and Lantus in the refrigerator there. And if not, they can get it within probably 1824 hours.   Stacey Simms  21:25 Have you ever been in a situation that you're traveling kind of led you to a difficult situation with diabetes, you have to forgotten a bag someplace?   Jeremy Larsen  21:37 Well, nothing like that nothing where I was just out of supplies and couldn't find any, because I'm so paranoid about it, that I always make sure something's gonna happen. I've like my longest trip so far was about 303 130, some days, but 11 months in Southeast Asia. And I took enough insulin with me for about maybe two or three months, so I had to buy it several times while I was on the road. And in those countries, like I was in, I ran out in Thailand. And I was in a small town in southern Thailand. And I thought, well, what am I going to do? And I went to the local like the prefecture or hospital, or whatever it was, and I talked to this doctor who spoke English for some reason. And she said, I said, I need a human log, just so you can't get human log here. You can get it. There's a private hospital over on the other edge of town, but it's whatever, like expensive was like $40, a pen or something like that for some reason. And I was really budget traveling, and I didn't have $40 for a pen. So she said, Well, you can buy this stuff called act rapid here. I said, What is it? She's Well, it's fast acting, it's probably good enough. And I said, Well, how much is it and she told me it was like dirt, dirt, dirt cheap. But it's a real kind of insulin. So I bought a bunch. And it was really cheap. And it was kind of a test. I said, if this works, okay, and if it doesn't work, I have to go home, back to Japan or something because I won't be able to continue this. I mean, if I can't find the insulin I need the trip is finished. And I have no problem with that. Because diabetes is priority number one. But it worked fine. And so I got lucky. So I had bought a bunch and I was good for another three or four months or something. And then I was in Cambodia. And I went to I was in the capital of Cambodia, Phnom Penh. And I needed some more insulin. And I knew in that region x rapid was most common. So I went to this pharmacy, I think it was like on August 31. Because they had pins, they had x rapid pins in the in the refrigerator, and to two boxes of five pins of 10 pins. So that's good for about three months or something. And I said, Great, I'll take them. And they said, Oh, and then I noticed the expiration date was that day, oh, these are expiring today. So I was kind of thinking he would go and go into the back and get some others, you know, right. And he me guy kind of looked at me. And he kind of lowered his voice and said, Would you take these for half price? And I said absolutely, I would. Again, it was just, I'll try it, you know, and those worked fine for the next three months. And just things like that. I've always, if I can't find what I need, I would cancel a trip. But that's only that's the closest it's come to happening. And that wasn't really a big problem. So I've been lucky or I just been careful.   Stacey Simms  24:26 I probably a little bit of both. I would think too. I mean, you know if you're packing that well, as you're traveling, and I think we also forget, diabetes is not an American experience. You can get flies around the world.   Jeremy Larsen  24:38 Right, right. Yeah, when I was crossing over from Cambodia and Vietnam, it was this strange little outpost of a border crossing and not many people used it and they were looking through my bags and stuff and they found a bunch of syringes and pens and stuff. And so what's all this and they didn't speak any English and I didn't speak any Vietnamese and it was kind of they were kind but they're they're friendly about it but there was obviously they weren't gonna let me through And finally I remembered I had a phrase book and I got it out and the word diabetes was in the phrase book. So I showed it to them showed him the Vietnamese version. And they all started like smiling going, Oh, okay. Okay. Okay. And they said, Well, you know, zipped up my bag and told me they told me to go ahead. Wow. So even even they were very, very suspicious. But as soon as they learned it was diabetes, they're like, fine, fine, fine. Go ahead.   Stacey Simms  25:22 That's great. Probably a better reaction to get from the TSA sometimes in this country.   Jeremy Larsen  25:27 But yes, hey, so   Stacey Simms  25:28 how I put you on the spot here. How do you say diabetes in Japanese?   Jeremy Larsen  25:33 diabetes is Tonio Bo, which means, I think it means urine sugar sickness. That's what they call it. Tonio Gill,   Stacey Simms  25:43 what's your advice for people who are worried about travel?   Jeremy Larsen  25:48 My advice is that almost all of the problems in the worry are psychological. And it has nothing to do with diabetes. I actually actually think to get a little philosophical about it for a second, I think diabetes is mostly a psychological condition. I mean, obviously, what it is, is an imbalance of sugar and glucose and insulin, yeah, take care of that, because you don't make your own insulin. But that's fairly simple. It doesn't always make sense. And like I checked my budget earlier today, and it was 360. I had no idea it was that I have no idea why. But it just happens. Like physically, it's easy to take care of, basically, you know, just balancing those two things, but all of the psychological worry, that's what takes a bigger toll. In some ways. Obviously, there are physical tools. But so when people are worried about doing anything, I understand the worry, because you're going to go to a strange place. You don't know what the food is, you don't know. Is there going to be like a refrigerator from insulin? Is there going to be what if I break my insulin pin? What How can I go to a clinic and buy a new one has all that work, but what I've found is that people will always help and there's no problem, there's not going to be any problems. People like health care as the same everywhere, no matter it might be good or bad quality, but the people behind it are the same everywhere. They want to help. And if they realize that you are if you can communicate somehow that you're diabetic, and you need this, you need that, they'll do something, something will work, you know. So I'd say just go, just don't worry about it. But you have to plan to make sure you have enough insulin and stuff if you don't feel like buying it overseas, but there's not much to really worry about. It's all in your head. That's kind of basically my advice. Diabetes is the same when you're in a little guesthouse in the middle of Laos, as it is when you're home, you still have to make sure that you had enough food and enough insulin and you have to check if you don't know and it doesn't really change when you're on the road.   Stacey Simms  27:39 What's next for you? You're in Japan right now. Are you planning any big trips are you going to stay there another four years,   Jeremy Larsen  27:46 not another four years.   Jeremy Larsen  27:49 Going back to Aiken   Jeremy Larsen  27:50 back to Aiken   Jeremy Larsen  27:53 would be an interesting change, I'd   Jeremy Larsen  27:54 love to visit Aiken. I don't know if I'm looking to move back to a   Stacey Simms  27:58 small town in South Carolina. I   Jeremy Larsen  28:00 should mention.   Jeremy Larsen  28:01 I just finished up a four month trip to Europe, which was a lot of fun kind of eastern and southern Central Europe. And then I was actually in the states for a couple months. And then I just came back here in April. So I'm kind of here. refilling my coffers. And teaching classes, you know, saving the next trip, which will probably I hope would start about a year from now. But I don't know Don't hold me to that. I would like to rent a car and just drive around the US for two or three months going to see the national parks.   Stacey Simms  28:33 Wouldn't that be great.   Jeremy Larsen  28:34 And I've seen some of them. And I've taken a few car trips across America with friends of mine, but I've missed a lot of like I saw the Grand Canyon, but I didn't see a lot of the great national parks Yosemite, I haven't seen Yellowstone, I haven't seen things like that. So I have a big list and have a big excel sheet with all of them. That would kind of be my next trip.   Stacey Simms  28:55 That sounds terrific. We did a small trip like that two years ago to the Grand Canyon and Bryce Canyon and Zion. And, um, we were really nervous about diabetes. And it worked out so well. And my takeaway from it has always been my son. We went on a mule ride on you know, we were we were all on the mules on in Bryce Canyon. And he was I want to say, seven or eight years old at the time. And I remember thinking, Okay, we're going to be in this mule for two to three hours. You know, what are we going to do? Go and logo and Hi, we weren't remote monitoring at the time. He wasn't even wearing a CGM. It worked out so well. We didn't worry about diabetes. We had a blast and the pictures from that trip. Were just incredible. And it was so much fun. So I love that idea of just realize that diabetes is the same whether you're in your house or you're on a mule in Bryce Canyon. It really is.   Jeremy Larsen  29:48 It's right.   Stacey Simms  29:49 Well, definitely keep in touch. This was really interesting. I'd love to talk to you again, especially if you wind up doing a trip to the States. That'd be great.   Jeremy Larsen  29:55 Yeah. Okay.   Stacey Simms  29:56 Gary, thank you so much for joining me.   Jeremy Larsen  29:58 Thank you very much. I enjoyed   Jeremy Larsen  30:05 You're listening to Diabetes Connections with Stacey Simms.   Stacey Simms  30:11 Lots more information about Jeremy Larsen. You got to watch his YouTube channel. I didn't set up at Diabetes, Connections com. He also let me know that he's got a lot of videos from that park trip. He's in the process of uploading a lot of that stuff to YouTube. Apparently he's redone a lot of his social media and as many of us have since 2015. So that's getting uploaded. So please go ahead and check that out. And he said he has a few things up his sleeve for the next couple of months or years, you know, after Coronavirus passes in Japan, which if you go just as an aside, if you go to his website, and I watched a couple of the videos, it's been really interesting to see how Japan has handled Coronavirus. You know, of course, they have had far fewer cases in the US they handled the virus itself differently in terms of better masking and that kind of thing. But they have been slower on the vaccines. And Jeremy talks about the Japanese culture and kind of why that is they're really just getting the vaccines rolling out now several months after the US. It's just so interesting to get that perspective. Right. I mean, travel is the greatest thing you just learned so much. You opened your mind. I can't wait to travel. Alright, thank you so much for joining me a couple of really fun and interesting episodes coming up if I do say so myself. I'm not exactly sure which one I'm going to go with next week. Because as I'm speaking to you now, schedule is a bit up in the air but here's what's coming up. I have a roundtable on sleepaway camp. This is non diabetes sleepaway camp. So we're going to talk to two adults who went to this kind of Camp when they were kids to adults with type one and two parents. I'm one of the parents who have children with type one that they have sent to regular sleepaway camp and kind of how to do it and what you can expect that kind of thing. And we're also talking to the man who just set a record a brand new Feat. He ran from Disney to Disney. He ran from Disney Land in California to Disney World in Florida. I am still working out the logistics, but Don promised me months ago that we would talk so I'm hoping that will be the episode for next week. But that's really up to him and boy, if anybody deserves a rest and we can hop, it's him. Alright, thank you, as always to my editor John Bukenas fom audio editing solutions. Thank you so much for listening. I'm Stacey Simms. I'll see you back here next week. Until then, be kind to yourself.   Benny  32:29 Diabetes Connections is a production of Stacey Simms Media. All rights reserved. All rounds avenged

Minority communities are underrepresented in healthcare leadership roles. By dismantling systemic barriers, the entire healthcare industry can benefit from talented professionals, scientists, and researchers from diverse backgrounds. To help with this effort, Dr. Frank Douglas discusses his project, Safe Haven Dialogues, which empowers individuals to push back against discriminatory environments and make impactful change. Plus, Kate speaks with Andrea Baer of Mended Hearts to mark American Heart Month and patient correspondent Carina Fuller shares her experiences encountering healthcare discrimination. Guest:Frank L. Douglas, Ph.D., M.D.Save Haven Dialogues LLCAn award-winning industry veteran with more than three decades of experience in healthcare, pharmaceuticals and entrepreneurship, Dr. Douglas has held leadership roles in both large and small biopharmaceutical companies. He led teams that were responsible for the development and marketing approval of many drugs, including Allegra, Lantus, Taxotere, and Actonel. Dr. Douglas has also held several academic positions. While at Massachusetts Institute of Technology (MIT), Dr. Douglas was the Professor of the Practice in the MIT Sloan School of Management and also held similar appointments in the departments of Biology, Biological Engineering, and the Harvard-MIT Division of Health Sciences and Technology and was the founder and first executive director of the MIT Center for Biomedical Innovation. Dr. Douglas holds a BS in Chemistry from Lehigh University, Ph.D. in Physical Chemistry, and a M.D. from Cornell University. Links:Dr. Frank DouglasSafe Haven DialoguesMended HeartsAndrea BaerNursing Home Disclosures Taint Cuomo’s Pandemic PerformanceICER to Assess Two Treatments for Lupus Nephritis Patients Rising Concierge Patient Correspondent: Carina FullerNeed help?The successful patient is one who can get what they need when they need it. We all know insurance slows us down, so why not take matters into your own hands. Our Navigator is an online tool that allows you to search a massive network of health-related resources using your zip code so you get local results. Get proactive and become a more successful patient right now at PatientsRisingConcierge.orgHave a question or comment about the show, want to suggest a show topic or share your story as a patient correspondent?Drop us a line: podcast@patientsrising.orgThe views and opinions expressed herein are those of the guest(s)/ author(s) and do not reflect the official policy or position of Patients Rising.

The Legend of Sam Fuld was born during his days in the minor leagues and when he played for the Oakland A's and in Tampa Bay. It involved his wild dives and seeming willingness to do whatever it took to make the play. Earlier this year, Fuld became the General Manager of the Philadelphia Phillies. Sam Fuld was diagnosed with type 1 at age ten and first spoke to Stacey in 2016. In this classic episode he shares his story, what he did as a player to manage his blood sugar, and a lot about the camp he's still organizing today. Video of Sam's plays from 2013 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:   Stacey Simms  0:00 This episode of Diabetes Connections is brought to you by inside the breakthrough. A new history of science podcast full of Did you know stuff like does snake oil actually contain snakes? If you're intrigued by science get excited about the process of discovery and one of the best stories that your next dinner party inside the breakthrough is the show for you.   Announcer  0:25 This is Diabetes Connections with Stacey Simms.   Stacey Simms  0:31 Welcome to a classic episode of the show where we take a look back at stories of connection that you may have missed the first time around. I'm your host, Stacey Simms, and of course, the emphasis is still on educating and inspiring people with diabetes with a focus on those who use insulin. This time around, you're going to hear from the legendary Major League Baseball player Sam Fuld diagnosed with type one at age 10. I first spoke to Sam in 2016, when he was playing with the Oakland A's. He retired as a player in 2017. And he was just recently named the general manager of the Philadelphia Phillies. If you're not familiar with Sam fold, I say legendary because and you'll hear us talk about this. There was a time when he was known for these incredible plays in the outfield where he would just throw his body into walls, he would make these dives that to me, the mom looked painful. And I linked up one of the many videos made by fans, you can check that out in Diabetes Connections, the group on Facebook, but Sam is a lot more than the legend. He also has a terrific program, a coaching program for kids with type one. I will let him tell you more about that. But I will link up the information in the show notes. And I will talk about that after the interview as well. Because you know of course in 2021, it looks a little bit different. Please remember this podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. This episode of Diabetes Connections is supported by inside the breakthrough a new history of science podcast, the 2021 is the 100th anniversary as most of you know of the discovery of insulin. It is arguably the biggest scientific discovery in Canadian history. This series examines that moment and many others through the lens of Canadian researchers trying to find what's next for the fight against diabetes. The host, Dan Riskin, has a great following you may know him from many years of hosting primetime Discovery Channel shows. He's also really funny. He's appeared on a lot of late night shows and he wrote the book, Mother Nature is trying to kill you. We've got a link to inside the breakthrough over at Diabetes connections.com. And of course you can find it wherever you listen to podcasts. When I'm doing these classic episodes, I have reaching back to the people featured in them for a comment and update, you know, to let them know that we're bringing the interviews back out and see if there's anything they can add and Sam Fuld was kind enough to correspond with me. And I did send to him congratulations on the amazing new job as General Manager for the Phillies. And I asked him if he could give us a diabetes update. So here's what he said, quote, “Hey, Stacy, I am really enjoying my new role. I am trying to learn and achieve as much as possible as we enter spring training. I'm surrounded by a lot of experienced co workers and have been leaning on them extensively throughout the past few weeks. Time is precious these days. So I'm really grateful for my Dexcom G6. Next up is a transition away from insulin pens, and toward an insulin pump. I'm really excited about experimenting with one of the hybrid closed loop systems.” So that's the update from Sam, as you'll hear the interview, he was not using an insulin pump. And of course I told him he can just jump in Diabetes Connections, the Facebook group and learn more from all of you. So let's see if he pops up. All right, here's my interview from February 2016. All right, my guest today is Sam fold. He was diagnosed type 1 diabetes at age 10. after he'd already made up his mind to play professional baseball, as you likely know, he got there playing first with the Cubs than at Tampa Bay. And now with the Oakland A's. It was while in Tampa that Sam started his weekend camp for kids with diabetes, teaching them as he's learned that diabetes shouldn't hold you back. As a mom of a kid who plays baseball has type 1 diabetes. I'm really excited to talk to you, Sam fold. Welcome to Diabetes Connections.   Sam Fuld  4:31 Hey, thanks for having me.   Stacey Simms  4:32 Can we start kind of by going back before you were even diagnosed? You were really into baseball is what I've read. Is that right?   Sam Fuld  4:41 Oh, yeah, yeah, baseball was. I really can't remember a time where I didn't love baseball. I was I was probably four or five years old when I realized like, oh, man, this is my favorite sport. I mean, I played every sport imaginable grown up but there was something about baseball that I just really loved and I think it was better Added to then the other sports was okay, the other ones. But for some reason I was better in baseball I think that probably helped contribute to my passion for but I think it worked hand in hand. I was good at it because I loved it. And I loved it even more because I was good at.   Stacey Simms  5:14 So not too many years later than you found out you had type 1 diabetes, what happened? Do you remember your diagnosis?   Sam Fuld  5:21 vaguely. I mean, luckily, it wasn't anything too scary. I mean, it was essentially an accumulation of a couple months of symptoms. And there's no type 1 diabetes in my family at all. So my parents didn't really know what was going on. They just something was going on. And, you know, I showed all the classic symptoms of going to the bathroom all the time and being thirsty and losing weight. You know, I was 10 years old and lost 10 pounds over the summer. So my parents didn't take them too long to figure out something was wrong. So I think I remember going into the doctor and you know, it was about a 480, which obviously is pretty high, but certainly not really high. When you when you compare it to some of the other numbers that diagnosed diabetics get. So you know, it wasn't anything too scary, luckily, and we all knew right away what what the deal was,   Stacey Simms  6:09 what was the deal? I mean, how did it change your life? And this was, I'll call it a generation ago, let's say your diagnosis, right, like 20 years ago. So how did it change your life? This wasn't a time when people were automatically going on an insulin pump and getting a Dexcom   Sam Fuld  6:23 No, not at all. No, I don't even think pumps were on the market. At that point. It was certainly not an option. And yeah, I just remember well, so I was at an age where I could be pretty independent with it. So I remember my parents helped me out with with my injections for the first few months after being diagnosed. And but shortly thereafter, I was really independent. And I you know, I had the old old school syringe and the vials and my meter. You know, I think it probably was like a 25 second countdown. So which is an eternity nowadays, but it wasn't too bad. I mean, it wasn't like reading the color of a urine sample. Right?   Stacey Simms  6:59 Nobody was sharpening the needles.   Sam Fuld  7:02 Yeah, so somewhere in between, like ancient diabetes and current diabetes treatment. I was so naive. I didn't know what I had. No, you know, I think my uncle had a cat with diabetes. And that was about all I knew about. So I really, in some ways, was naive and a little ignorant. And I just thought, okay, God, I figured it was kind of like having asthma. Like I had asthma at the time. And I was like, Okay, I guess it's another thing to deal with. And I guess that naivete kind of helped me in some ways.   Stacey Simms  7:29 Yeah. Well, it's good to not know what you can't do. Did you ever think you couldn't play baseball?   Sam Fuld  7:34 No, no, I was lucky. I mean, the the medical staff was really positive and supportive, and my family and friends are really supportive. So it really never crossed my mind. It would hold me back, I think I was lucky to be surrounded by some really supportive people. And I, you know, I think it wasn't until months or years after I was diagnosed, that I heard this stigma that maybe diabetes could hold you back, or that that was even a thing. So I think, again, I was lucky that the first thing that popped in my mind was okay, nothing's gonna change, you're gonna have to see me a big pain in the butt potentially. But, you know, ultimately, it's not gonna hold me back.   Stacey Simms  8:11 And you mentioned you had asthma. Do you don't have   Sam Fuld  8:13 to do that? No, I was kind of like an exercise induced as it was. I sort of grew out of it. My dad is as one goes. Yeah, I don't know. It's, um, I would put the time I was like, using an inhaler occasionally. But no, luckily, that's a non issue at this point.   Stacey Simms  8:28 Yeah, I was gonna say that's a lot to deal with. But you've mentioned that you had some great inspiration shortly after your diagnosis, because there have been other professional ballplayers with type one.   Sam Fuld  8:40 Yeah, there have not too many. But you know, I think in back then, when I was diagnosed, it wasn't like, you could just hop online and Google like type one diabetic baseball players, you know, kind of word of mouth. So I know about rod Santos, the Chicago Cubs. Great. And then I had a family friend, at the time was a pitching coach for the Boston Red Sox. And he knew of Bill gullickson, who was a longtime Major League pitcher. And so when I was about type one himself, and when I was about 12, you know, year and a half after being diagnosed, my family friends set up this sort of meeting on the field at Fenway Park, when when Bill was in town pitching for the Tigers, and I got to meet him and you know, it was like a two minute conversation and but that really kind of went a long way I was I knew he existed, but to really meet meet him face to face, it kind of gave me an extra bit of motivation.   Stacey Simms  9:29 I think that's so important. Because as you said, no one sat you down a diagnosis and said, well, son, your dreams of baseball are done. This is not going to happen for you. And a lot of kids in in my son's generation, don't worry about that either. They're not really told anymore. This is going to hold you back. But being you know, kind of hearing that and then seeing and meeting somebody who's done that is a big difference is that one of the reasons I would assume that talking to Bill gullickson really cemented it for you why you now talk to these kids.   Sam Fuld  10:00 No doubt, no doubt. I mean, I remember that moment. You know, it was 22 years ago, 2122 years ago, but I remember it like it was yesterday. And I definitely impacts the way I, you know, I go out of my way to meet other kids with type one. So I think yeah, that that moment was so invigorating to me, and I'll never forget it. Part of the inspiration for the camp that I do and and all the interaction I have with with young type ones.   Stacey Simms  10:26 Well, let's talk about the camp in a little bit. But I do want to focus on I mean, the way you play baseball, that crazy first season in 2011, when you had all of those, the jumping and the diving and the YouTube videos, Was that fun for you? Instead of crazy here, because I'd also like to talk to your mom, I was worried about you getting hurt. so silly.   Unknown Speaker  10:50 That like,   Sam Fuld  10:52 I can't speak for my mom. She was probably willing to deal with like the whiplash that I got on all those guys. I think she got a pretty good kick out of that whole run to know I loved it. It was an amazing, amazing part of my career in life. Really, it was, it happens so quickly, you know, I was kind of, I just come over to the rays from the Cubs in a trade. And, you know, I had a little bit of big time with the cubs. But this was like my first opportunity that first time making the team out of spring training, you know, but even at that point on opening day, I was like, essentially, the last man on the team, you know, it's like the fifth outfielder and didn't envision really playing a whole lot. I was just kind of thrilled to be on the team. And Manny Ramirez retired. And that kind of thrust me into like the starting role. And I just kind of ran with it. And the next few weeks, were just like this crazy, wild ride. And I guess I'm lucky I had the perspective, I guess I know enough perspective to try to enjoy the moment as crazy as it was. There were moments I was able to like, sit back and just go oh my gosh, life is crazy right now. But this is fine.   Stacey Simms  11:59 It's great. And I if as you listen, if you haven't heard about this, I will link up the legend of Sam fold and some of the videos that came out of that season. A lot of fun. But tell me about your your routine, if you could, I had a lot of questions from people who wanted to know as a professional athlete, how do you do it with type 1 diabetes? How do you take care of yourself? You don't if you don't mind getting a little personal here to kind of share maybe a game day routine or how you take care of at all? Sure.   Sam Fuld  12:27 Well, I mean, I'm sort of an old school diabetic I use my Lantus and novolog pens, and I don't use a CGM, nor pump obviously. And that's just worked for me. I've been I've been using these pins last 10 years or so. And I really, I find that they work well for me. So I do my lantis at night, once once a night, I wish I could draw up like a typical game day for you unfortunately, like they're not none of them are typical there every day is different. And, you know, we play seven o'clock games, we play one o'clock games, we play three o'clock games, you know, we play in New York on East Coast time we play in Oakland, obviously, we play you know, we're in different time zones throughout the year. So really, if, if there's a typical day, it's that I'm changing something. And you know, we're exposed to different foods in the clubhouse, you know, we get fed really well in a clubhouse, but there aren't exactly nutrition, nutritional labels on everything that we eat, you know, it's a lot of like, catered food that that's brought in, and you just, it's a lot of it is a guessing game. So that being said, You know, I do try my best to, you know, maintain some sort of routine and as best as I can. So if it's a night game, which I'd say about two out of three games that we play or night games, I'll just try to have like a, you know, oatmeal is like my go to in the morning. I love oatmeal, maybe a little fruit in the morning. And then sort of snack is needed until lunchtime. And I'll I love going to like a turkey sandwich with some fruit, maybe some vegetables and hummus, something like that pregame and then play at seven and then we eat after. I mean, we haven't crazy when you're diabetic or not. We are on a crazy schedule. You know, your launch is like five o'clock and your dinner is 11 o'clock at night.   Stacey Simms  14:20 My son would think that sounds fantastic. You definitely have dinner at lunch or dinner at five and then dinner lunch again. Yeah,   Sam Fuld  14:28 that's great. Until the next day, you have to wake up at like seven eight o'clock game and then you're back to like normal life. So yes.   Stacey Simms  14:35 Do you just test a lot more? Do you check a lot more?   Sam Fuld  14:37 Yeah, I tend to I mean yeah, whenever Yeah, I think I mean I test a lot regardless, but I particularly during games and yeah, just during the season, I'm checking quite a bit. So you know, typical game, I'll probably check at least three times during the game. I think. On average, I'm up about eight checks per day.   Stacey Simms  14:56 And this is totally nosy so tell me to buzz off is the no pump thing. Comfort thing, or is it also like your, you know, your diving and jumping and running around?   Sam Fuld  15:03 Yeah, I think it's a little of both. You know, I experimented one a couple years ago in an offseason and shoot every kid I talked to loves them, you know, and I hear nothing but great things about them. So I thought I'd give it a shot. I owed it to myself to try it. And I, I definitely found some benefit to it. But I also just didn't like that foreign body attached to me. And I was worried that if I were to wear one during a game, then it would become a bit of a hazard. So yeah, and I think if I were struggling more with my treatment, currently, I would be more compelled to change, but I just don't really comfortable the way.   Stacey Simms  15:39 One of the things I wanted to ask you about. And this is kind of silly, but it's from my son's perspective, I wanted to ask you during his baseball games, and he's 11 years old, we can see because he wears a CGM, that when he's at bat, or when there's a big play, you can watch the adrenaline spike. It's pretty wild. And I'm curious if you have dealt with that kind of thing. And how you deal with perhaps post game highs that are adrenaline highs?   Sam Fuld  16:08 Yeah. Oh, it's really one of the bigger challenges. I mean, especially I, I've had a lot of games where you know, I won't, I won't start, and I'll be on the bench. And all of a sudden, in the eighth inning, I'm called upon a pinch hit. And like, so you go from kind of very relaxed mindset, you know, you try to anticipate these changes being made. So your adrenaline gets going around the sixth seventh inning, you try to get your body loose in case you are called upon. And then but then you just can't predict that sort of that huge adrenaline spike and that blood sugar spike, when you're called upon to pinch it or even pinch Ron, or whatever it may be. And so I mean, I'll be right where I want to be in the low mid one hundreds. And then I got like, 20 minutes later, I mean, 300. And it's unbelievable. Can you just can't it's really tough to control. But yeah, you did you do the best you can. And it's one of those things that just in some ways, it's difficult to combat. And but I'd rather be a little on the high side and on the low side, obviously. So and then, you know, after the games are crazy, because then you get that letdown, essentially, you know, I'll eat an entire meal, a big meal after a game and not even need any novolog just because I've got all that adrenaline wearing off. And then you get those crashes. And you need carbs. Just to keep you aboveboard.   Stacey Simms  17:28 Yeah, it's been an interesting learning experience for us over the years of baseball as he's gone from Little kid playing to bigger kid playing and, you know, the different pressures and things. So he's like, you know, we're all walking science experiments. To some extent, I see   Unknown Speaker  17:42 a lot of data   Stacey Simms  17:44 in your data. And you know, you're the scientist as well. So it's pretty crazy. Let's talk about your camp. This is such a great program. This is the fourth year, you have a camp for kids who play sports, all different kinds of sports. And it's with one of the Tampa hospitals. Tell me about how this came about and what you like about it?   Sam Fuld  18:02 Well, so came about my first year at Tampa, I just got a invitation to come check out the University of South Florida's new Diabetes Center, they just built the center. And they were kind enough to extend an invitation for me to just come check it out and meet the meet the people associated with the, with the center. So I did so I think on an off day that we had, and in Tampa and met all the folks there and and you know, over the last few years, I kind of had it in the back of my mind, this idea of holding a camp diabetes campus sports camp, you know, obviously, what was familiar with the diabetes camps out there. And I thought maybe making it unique to sports, obviously, exercise goes, goes such a long way in regulating type one. So I thought this would be a good idea as I brought up the idea with the USF folks and they loved it. And so within months, we had this first annual sample USF diabetes sports camp. And it was wildly popular. It's like 100 kids, the first year and we did it. And I went out and kind of went on the recruiting trail. You know, it's amazing. I was using like Facebook and LinkedIn, and you name it to find these five coaches, because I wanted all the coaches there to be type one athletes themselves so that all those sports that we offer are coached by type ones themselves who have played at a pretty high level college or even professional. So that part was really fun. I felt like I was recruiting my own little team. And we've, that team has stayed together. Yeah, I think we haven't. We've expanded the number of sports we offer. We have more and more coaches every year. But those that took part in the first year have stayed with us because they know how inspiring the whole weekend is. So   Stacey Simms  19:46 did you look for coaches that were familiar with type one, or did you look for great people to take part and say, Hey, we can teach you the type one stuff?   Sam Fuld  19:52 No, I want to coaches that have type one so all workers have type one. Oh, wow. Yeah. I'd say a couple that we have our are parents of type ones. But other Otherwise, I'd say out of the 15 to 20 coaches that we have, you know, all but two or three are type ones themselves. So I mean, we have a basketball player who played overseas, he's type one we have a great tennis pro Jen king who played, she played in several years opens, and she's type one. And Bill gullickson, ironically, has come   Stacey Simms  20:21 out. Great.   Sam Fuld  20:23 Yeah, so we have an amazing, amazing staff. And we help we partner with the Florida diabetes camps who have been around for a long time and hold camps throughout the state of Florida. And they've been a tremendous help to. So it's been a huge team effort. And it's just been a really, really, it's one of my favorite weekend's of the year and we've grown and I was worried that when I left Tampa to go to Oakland that my camp following would diminish, but it's actually increased. So I think this thing is here to stay.   Stacey Simms  20:51 It's a pretty unique program to have all of those coaches with type one and all of the different sports, do you find that the kids are coming to maybe learn about their sport, but I would guess that there's a lot more going on than just how to take care of your adrenaline level? After Yeah,   Sam Fuld  21:08 yeah, it's everything. You know, I think there's something empowering about just being around so many other type ones. And then you combine that with just the amount of fun that you have playing the sports that you love, you know, the kids get to choose their three favorite sports, and then they play that those three sports all day. And so you have that amount of fun, and you share those stories with one another. And you learn from the coaches and you this, I think there's just like an intangible feeling you get by being around so many other diabetics, and I that's personally that's one of my favorite parts of the campus is being around learning from others. But just that feeling of comfort, you know, you can't really can't put a price on that.   Stacey Simms  21:50 I have a few questions, if you don't mind that I got from Facebook, i Diabetes Connections, because people are always interested in just different ways that you've handled certain situations. So I'm gonna throw a couple at you. But if these are not things you want to answer, you know, just let me know, they're not crazy, but just let me know. Okay. All right, ready? So Bill wanted to know, he said, I'm interested in how the college recruiting process was impacted by type 1 diabetes. Were coaches reluctant to recruit or was it a non factor? And I'll jump in and add that you played for Stanford? And to that question, then do you disclose that you have diabetes when you're going through shifts? I mean, that's kind of an interesting issue. So I'll let you answer the question.   Sam Fuld  22:30 Yeah, I was lucky enough. As far as I know, I don't think it was a concern. I mean, I was there recruiting a whole scene 15 years ago, or whenever it was, when I was being recruited, it was a little different than it was now. And by no means was I, you know, withholding any information. I was certainly open with my type one. And as far as I know, it was a non issue. It may have been, and I just didn't know about it. But I mean, Stanford recruited me and as far as I know, they they had zero experience with type one ballplayers. So you know, it wasn't like they had this great example of another type one player who was a perfectly great player with with no issues. I was a new experience for them. But it didn't prevent them from recruiting me. So I, again, there was one instance where when I was at Stanford, and I met with a Baltimore Orioles Scout, and this is my senior year in college, and for those of you don't know, in college baseball, you're eligible to be drafted by a major league organization after your junior year. And so I was drafted by the Cubs after my junior year and went back to school my senior year. But in talking with this Oreo Scout, he was saying, Yeah, we wanted to draft him last year. But you know, we were worried about the diabetes. That kind of threw me off a little bit. And that's kind of my one story of somebody like just outright telling me Yeah, we were had some reservations, because you're type one, but otherwise, I am free of any crazy stories.   Stacey Simms  23:54 That's good. That's weird that he would tell you why not just your mouth.   Sam Fuld  23:59 But I'm glad he did. Yeah.   Stacey Simms  24:02 Exactly. It does happen, obviously. And then the other questions, we had a bunch of questions about pumps, which we're not going to ask, but you know, mostly, how do I keep it on my body when I'm sweating? And then how do you manage the delayed hypo reaction to exercising and you mentioned, you're usually eating and not treating? Is that what you usually do?   Sam Fuld  24:20 Yeah, like I said, I mean, it sometimes it means I eat a big meal and don't even give myself any novolog until a little bit later, or it's kind of as needed. Yeah, it's, I'll have like a big plate of pasta and not need a single unit. So, you know, I like anything. It's, it's a matter of regular checks. And, you know, it's, like I said, every day every night is different. You know, the amount of food, the amount of exercise, the stress level, everything is there's always the variables change every day. So the way to combat that is to check as often as you can.   Stacey Simms  24:54 Well, we're talking to you before the camp we're talking to you in the beginning of February here and This podcast will air in a couple of weeks. And when it does, it'll be just about time if not just past time for pitchers and catchers to report on what are you looking forward to this season?   Sam Fuld  25:10 Well, I think I'm, I'm excited for, you know, bounce back here, I think individually and team wise, we had a down year, we had some expectations last year, and we didn't meet them, and we just couldn't seem to catch a break. So I'm looking forward to maybe catching a couple breaks on the positive side and individually just looking to contribute and have a better year individually. And yeah, it's a it's a good group of guys. And I think we're gonna sneak up on some people. We We definitely, we had a frustrating year last year, but I think we're gonna be what will surprise   Stacey Simms  25:40 some people this year. Cool. And let me just end by asking you, we started by talking about you at age five or six, you know, getting into baseball, and being excited about it. What's it like when you now and that first game of the season, or maybe that first practice when you walk on the field? Is it still a little unreal? Or is this just another day of work?   Unknown Speaker  26:01 No, there's   Sam Fuld  26:01 still a feeling of, wow, this is my job, I get to go out and play baseball. You know, there are definitely moments during the year where that wears off. Especially here in the years like last year. No, I think we remind we try to remind each other like, despite all the challenges that that playing presents, the stress and the travel and the expectations, I think we do remind each other we do a good job of saying Holy cow, we get to do this for a living. So this is never you know, that first day getting put on a uniform, be outside and you didn't sign a few hours, things like signing autographs and knowing that there are fans out there who are supporting you. It's a pretty cool moment, despite having this will be like my 13th year or 12th year in professional baseball so it doesn't get old.   Stacey Simms  26:49 Was there anything you wanted to mention anything about camp or anything else that I missed?   Sam Fuld  26:52 No, I think no, the camp obviously is near and dear to my heart. And the other event that I've got going on now is a partner with a nonprofit called slam diabetes who primarily old wiffle ball tournaments as fundraisers for for camps throughout the country. And so I partnered with them and we did a two was a lot of tournaments now in Tampa. And they're really cool. If you get a chance to check it out. It's slam T one D org. And we do some really cool tournaments. They do a bunch of the New England and have now expanded down to Florida partnering with me and we raise money for my camp so that we can keep our camp tuition really low and add to the many features that the camp provides. It's a really cool thing we've you know, last this last tournament we had in Tampa, we had 16 teams, so it's a big tournament we raised up to right around $60,000 so it's a pretty cool event. We had about 2020 big leaguers come out and play with us and it's pretty fun to see a major leaguer. You know, we had Josh Donaldson out MVP of the American League last year who's striking out against the 12 year old. So it's a pretty fun event. It's I definitely encourage you guys to check it out.   Stacey Simms  28:04 We will well Sam Fuld, thank you so much for joining me today. Really appreciate your time.   Sam Fuld  28:09 Thanks for having me. I appreciate it.   Unknown Speaker  28:16 You're listening to Diabetes Connections with Stacey Simms.   Stacey Simms  28:22 More information about Sam on the legend, the video at Diabetes connections.com. And, of course all about the camp as well. Quick note, it says on their website that the 2021 camp will be held virtually, and you never know what other celebrity tnd athletes will stop by. That's what it says on their website. So you can find out more at that link. I think this is fantastic. It's really too bad that everything's virtual right now. But it is a terrific way to connect. And as we've seen, listen to look on the bright side, you can connect with many more people who are available virtually, who may not have been able to travel to the camp. So that's one way to look at it. Listening back to that interview just kind of made me nostalgic for the time when Benny played baseball. That was his big sport when he was younger elementary school and I think the first year into middle school maybe into seventh grade but i think i think sixth grade was his last year of baseball. I mean diabetes wise, I loved baseball, there was so much downtime, so easy to treat if he needed to. He got his Dexcom in fourth grade I'll never forget this is before share. He had his receiver in you know case and we would hang it from the wire is called wiring, you know what I mean? Looks like netting but the wiring at the dugout and we would hang it on that with a clip. So I could walk over and check it. You didn't get shared till the end of fifth grade. So that was a different story in a different time for the things you remember. And baseball was just a lot of fun. I mean, not even memories of diabetes, just all the good times and the great friends that he made and you know still talks about and hangs out with to this day. Looking ahead next week. I am working on an episode that should be out next week. If not, it will be out shortly about COVID vaccine type one advocacy. We've been talking about this in the Facebook group, it is different in every state and many states are changing where they're tier type one, it's going up. It's coming sooner for many people in many places with the type one, but not everywhere. So if you are curious about this, we're going to talk about how to find the information where you live. And if you're not happy about it, what you can do to advocate for yourself or your family member, you know, and find out what's going on behind the scenes in terms of advocacy. So I'm really excited to bring that to you. And that should be here next week. Thank you as always to my editor john, because from audio editing solutions, thank you so much for listening. I hope you're enjoying these classic episodes. I'm having so much fun for me them to you. I'm Stacey Simms. I'll see you back here next week. Until then, be kind to yourself.   Benny  30:52 Diabetes Connections is a production of Stacey Simms Media. All rights reserved. All wrongs avenged

What is it like to actually give someone emergency Glucagon? What happens next? This week, Stacey talks to Bonnie O'Neil whose son was diagnosed with T1D at age 5 and is now 24. They had a scary situation while on vacation and out of the country. Everything worked out; Bonnie shares what she learned and what she wants other families to know. Bonnie is the author of a brand new book: Chronic Hope (learn more here). She has a unique family history of diabetes, losing a brother before she was even born and has a older sister who is still thriving today. In Tell Me Something Good this week, a big honor for one of our favorite frequent guests and fun news if your child plays Minecraft. This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider.   EPISODE TEXT HERE... 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 Daria health. Manage your blood glucose levels. Increase your possibilities by Gvoke HypoPen the first premix auto injector for very low blood sugar, and by Dexcom take control of your diabetes and live life to the fullest with Dexcom.   Announcer  0:21 This is Diabetes Connections with Stacey Simms   Stacey Simms  0:27 this week, what is it like, what really happens, when you need to use that emergency glucagon, I talked to a mom who found out while on vacation out of the country,   Bonnie O'Neil  0:37 I was just all I could do to stop my hands from shaking and mix that glucagon and get it in him. So point number one was when you go on vacation, make sure that glucagon doesn't stay in your hotel, keep it on your person you just never know.   Stacey Simms  0:52 Bonnie O'Neil's son was diagnosed at age five and is now 24. She has advice about using and carrying glucagon. She also has a unique story. She'll talk about growing up in the shadow of a family tragedy with diabetes, and how she and her sister have overcome that in tell me something good this week, a big honor for one of my favorite frequent guests. And does your child play Minecraft? Stay tuned. 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 where we aim to educate and inspire about diabetes with a focus on people who use insulin. My son was diagnosed with Type 1 14 years ago, my husband lives with type two diabetes. I do not have diabetes myself, I have a background in broadcasting. And that's how you get the podcast. longtime listeners will know that this show is not really about our experience my family's experience of diabetes week in and week out. I don't share a ton of personal information about Benny, but we do talk about our experiences. And I bring that up because I did a show recently with him to mark 14 years, which was a pretty big milestone. And we've done a couple of shows together over the years. I always say Benny is a big goofball. But you know, he's got good things to say I like to talk to him. I'm very proud of him, even though I give him a hard time. And I got a really nice review that I wanted to share. I don't ask for reviews very often. Maybe I should if you'd like to leave a review, you can send one to me at the email address at Stacey at Diabetes connections.com. You can leave them on whatever podcast app you're listening to. You can drop them in the Facebook group. But this one really was nice. And so I wanted to share it and say thank you to Ruth Ann, who posted it following that 14 year episode where I talked to Benny and she says “I listened to it yesterday and came away feeling understood. I've had type one for almost 45 years diagnosed at age 12. Then he was honest in the way teenagers can be when they don't feel pressured to spin things to make other people happy. I found him incredibly inspiring.” She goes on to write “To me The message was you can be upbeat about life. But don't succumb to pressure to sugarcoat the hard realities of managing type one. I think being real is the healthiest approach to coping with a challenging chronic illness. Please tell him thank you from a grandma in Utah, Ruth.” And I will say thank you to you. That meant the world to me. I agree. I think it's so important to be honest to write that line of diabetes can't stop you from doing the things you want to do. But it will stop you and slow you down sometimes right not to sugarcoat things too much. I really appreciate you taking the time to write that down and share it with me. And of course, I will share it with Benny and Wow, good luck to you. 45 years with type one, you're the inspiration. If you would like to tell us something always happy to get nice messages like this. I'm always happy to take constructive criticism as well. I do have a few people over the years who have yelled at me. But I think I'm pretty easy to find either on social media or via the email address. And you can always go to Diabetes connections.com and get all the contact information there. But Ruth boy you made my day All right, we're gonna talk about using glucagon what that is like, and Bonnie's really interesting story in just a moment. But first Diabetes Connections is brought to you by Dario health. You know, over the years, I find that we manage diabetes better when we're thinking less about all the stuff of diabetes tasks. And that's why I love partnering with people who take the load off on 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 has published Studies demonstrate high impact clinical results, find out more go to my radio.com forward slash Diabetes Connections. My guest this week is here to talk about using glucagon and I think we can all From that, but she has another important story that I don't want to gloss over. Bonnie O'Neil has been part of the diabetes community since before she was even born. bit of a warning, this may be hard to hear Bonnie's older brother died when he was eight, his type one went undiagnosed until it was too late. Now, this was back in the 1960s. But we know that's still gonna happen today. Her older sister was later diagnosed, she survived and is still thriving now. And Bonnie has a new book out. It's called chronic hope. So there's a lot to unpack here, including that very valuable information about her family's experience with glucagon. I found this to be a very valuable and eye opening conversation. And I hope you do too. Bonnie, thank you so much for joining me. Congratulations on your book. And I'm excited to learn all about you. Thanks for jumping on.   Bonnie O'Neil  5:48 Thank you for having me. I'm excited to be here today. Stacey,   Stacey Simms  5:51 tell me about your son. But he's doing now because he was diagnosed as a little kid. And he is all grown up now.   Bonnie O'Neil  5:57 Yes, I've lived all the stages with him. So he was diagnosed as a five year old and he is now 24. So he's living not too far away from me about 15, 20 minutes, which I guess is every T one D mom's dream when their kid grows up that they live independently, but yet, we can still get our eyeballs on them and our arms around them from time to time. So yeah, he's doing great.   Stacey Simms  6:22 You it's funny because being diagnosed, what does that 19 years ago? Isn't that long ago. I mean, my son was diagnosed 14 years ago. But in some ways, it feels like a different world. Do you mind taking us back to that time, if you could tell us the diagnosis story. And I'd love to also talk about what you all started in terms of management.   Bonnie O'Neil  6:41 Sure, yeah, that's actually an interesting story. So I have diabetes in my family. So my brother was unfortunately died in the diagnosis process when he was eight years old. And that was before I was born. And so my parents had me in their 40s, basically to, you know, replace the child that they had lost. And then my sister was diagnosed when she was 16. And I was eight years old. And so I just grew up with it. We grew up with this fear of it being there. So I was always on the lookout for it. And I remember my first pediatrician when I want to have my first child, I said to him, so how do we test for this thing? Because I don't want it to be in in my child. This wasn't Austin. This is my oldest son, Alexander. And, and he's like, oh, Bonnie, you know, it comes on acutely. We can't just run a blood test every every few months, but you'll know it if you ever see it, frequent urination, and intense thirst. And so I was always looking and so the day that I noticed that in my son, Austin, you know, obviously, there's the major panic, but I had grown up through my three pregnancies, I had done the urine testing for gestational diabetes. And so I knew exactly what to do. I went to the pharmacy, I bought a test kit, and I dipped Austin's urine in it, and it turns deep crimson. And so I diagnosed him at home freaking out going to the doctor and saying, they're like, calm down. This is Odile, like it, maybe it's not type 1 diabetes. I'm like, Well, do you know what else it could be? And so we, you know, I bundle up the three kids and we're living in Connecticut at the time, I took them over to the pediatrician. And he didn't have ketones, because we caught it so early. And so their practice was leaning into something that they told me was what Yale was practicing at the time, although I have an endocrinologist friend from Yale, who assures me they never offered, I suggested that, but the thinking was, if your child doesn't have ketones, you don't admit them to the hospital. Hmm. So we went home, we literally went home without so much of the shot of insulin. As you can imagine, I was just freaking out because my brother didn't make it through his diagnosis story. So I was like, you know if you can remember Terms of Endearment and Shirley MacLaine, like shaky over the crib. Yeah, that was me that night, just like leaning over my son and just making sure all night long that he stayed alive anyway, that the pediatrician, the endocrinologist that my pediatrician was able to find for us was one who really didn't work with pedes. The youngest children they saw were really about 15 or 16. So we saw him The following day, and the long acting insulin that he gave him was Lantus.   Stacey Simms  9:37 I was wondering if that was even approved, because I remember was not really 2000 so it was for little guys.   Bonnie O'Neil  9:43 Okay, it was not it was it was not under age 10 and so I don't I didn't know any of that you know, and so, so that was the first there's two things that were very interesting in our in our care different so that was the one and then when we got to CHOP the Children's Hospital. Philadelphia. A week later, I forgot to say all this diagnosis happened exactly one week before we moved house from Philadelphia. Oh   Stacey  10:07 my god,   Bonnie O'Neil  10:08 I never recommend that moving house be part of your diagnosis to be that as it may that was our case. And so when we got to CHOP our the endocrinologist there was actually very keen to see know what would happen to this child being on Lantus at age five, I'm pretty sure that it's going to work out well, I can't prescribe it. But he came to me that way. So I can leave him on his protocol. So that was interesting. And it worked beautifully. So my son never used NPH. And I had friends at that time, who were very familiar with that insulin and just told me how fortunate we were that he never had to be on that. So that was one thing. And the other was, so my sister, the reason I gave you the backstory on my sister was that I grew up in a family of using exchanges, where you counted your you didn't count carbohydrates, but you looked at food, in terms of whether it was fat, or protein, or carbohydrate. And you gave each one an exchange. And so I was used to that world. And I literally was given a counting book that had both on it, it was the exchanges and the carbs. And it was kind of you could do it however you wanted. They were recommending I just use the carbs, but the exchanges were there as well. So that was interesting. Oh, and then there's a third one.   Bonnie O'Neil  11:33 But I remember. So his diagnosis was shortly after the DCCT trial, results came out and talking about intensive insulin therapy and how important that was. And I remember several visits, going in and talking to my CDE and saying, I'd really like Austin to be on that intensive insulin therapy. And she would, she would look at me like I had 12 eyes and like to say something, and I didn't understand what she was saying. And she didn't understand what I was saying. And it was many months later that I realized that Austin was   Stacey Simms  12:11 using Lantus and short acting together. Yes, exactly, was   Bonnie O'Neil  12:14 exactly. So yeah. So I was sort of living in some a couple of old paradigms and had to get with the program pretty quickly. Yeah,   Stacey Simms  12:22 but what a transitional time. Here was that that he was diagnosed,   Bonnie O'Neil  12:26 it was 2002. Yeah. And I'm so thankful I that is it is that so spot on Stacey, because just a few years earlier, and and the story would have been very different. My sister's story is very different. Sure.   Stacey Simms  12:37 And let's talk about your family for a moment. If we could be there's so much information there. You mentioned your brother, gosh, I can't I'm not even sure what to ask. But he died before he was diagnosed or during his diagnosis story. Was   Bonnie O'Neil  12:48 this in the 70s? The 80s Yeah, it was 1962   Bonnie O'Neil  12:57 Yeah, yeah. So my sister was six years old, my my sister Barb, and my sister Johnny, my brother, Johnny was eight. And so it was Christmas week, and my sister had the stomach bug. And a couple of days later, after she got better, my brother started throwing up. And they assumed that he just had the stomach bug as well. And he may have had that, but it clearly he then slipped into decay. And so by the time he got to the hospital, which was actually New Year's Eve, what he was in a coma. And so he passed away three days later, to make the story even more unbelievable. My mother delivered my sister Betsy, just nine days after that.   Stacey Simms  13:43 Oh my gosh. Oh my goodness. Yeah. You know, DKA is I don't have to tell you this. You know, it is the most dangerous time for people with type one and it's amazing to me how now. Gosh, we are you know, more than 50 years after what happened with your family with your brother? Yeah, we are still having something like 30 to 40% of people who are diagnosed with type one diagnosed in DKA, I know you work a lot are you you've written a lot with beyond type one. You know, are you involved in efforts? Do you see the you know the DKA awareness that's something that you you talk about.   Right back to my conversation with Bonnie and we are going to hear her talk about glucagon in just a minute or two. And when you hear her talk about the emergency redbox, please remember, there are more options now and Diabetes Connections is brought to you by one of those 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. It's the first auto injector to treat very low blood sugar. Gvoke Hypopen is pre mixed and ready to go with no visible needle. That means it's easy to use. Find out more go to Diabetes connections.com And click on Gvoke logo. Gvoke shouldn't be used in patients with pheochromocytoma or insulinoma, visit Gvoke glucagon.com slash risk. Now back to my conversation with Bonnie and I just asked her about her family's tragic experience with DKA and how that's influenced her with what she does now in the diabetes community.   Bonnie O'Neil  15:22 Yeah, I mean, I do write for beyond type one, and I'm very active with JDRF. I'm on the board of the founding chapter, the greater Delaware Valley chapter. And I know that we're doing a lot of advocacy work around that and, and even just trying to get the shift in titling someone has type 1 diabetes, a JDRF, has done a lot of work around that, and is seeing that that shift so that it's, you know, reframing it, so it's not Oh, they got diabetes, or my son didn't get diabetes on June 19 2002. That was when we discovered that he would be insulin dependent for the rest of his life. He was developing the disease before that. And so we're trying to change that language. I think we're making progress. So that there's there's an understanding that you are, you know, certainly with some of the antibody tests, that testing that is being done now to be able to know that, you know, this person's body is being set up to get the disease, you know, if you have, I think it was three out of the four markers. It's, yeah,   Stacey Simms  16:31 well, and I was gonna ask you about that, about T one detect, we just did a show on that. We did an episode on that a couple of weeks ago. And when you think about something like that a person who has type one in their family, like you had and was so front of mind, I would imagine that you would have taken advantage of that with your kiddos, you know, years and years ago.   Bonnie O'Neil  16:48 Yeah. And, you know, back then, and that was something that I asked my endocrinologist was, so should we do any sort of testing and their response, and I had to agree with it was, well, there wasn't anything that they could offer. Other than Gee, I'm really sorry, it looks like your child is probably going to get type one. So the way I've handled it now, as a mother of two adult children who don't have diabetes, is that decision is yours. If you want to be tested, we can get you tested. If you don't want to, I have to respect your decision.   Stacey Simms  17:25 One of the things I really was looking forward to talking to you about and looking forward as a term I really should not use there. But I was very interested in is you were one of the few people I know who has had to use glucagon on their child, and then wrote about the experience. So I really appreciate you talking about this publicly. It is a fear that so many people have, you know, we have never had to break out that red box. And I'm so thankful for that. Would you share that story with us? You're even at home, right? You're on vacation?   Bonnie O'Neil  17:54 Yeah. And I'd be happy to because you know, it's a it's a story that still brings up a lot of emotion in me, but it does have a happy ending. And there are some good takeaway points for your listeners in terms of preparedness. So yes, I'm happy to share the story. My family went on vacation to Costa Rica. So it was my oldest son's first year in college, Austin, that would have made him a sophomore, I think in high school and my daughter would have been eighth grade. And we realized that all the spring breaks were aligning all three kids were in three different schools. And we're like, Yes, let's go and do something fun. So we plan this, this sort of dream trip, you know, where you're going to be renting, staying in a treehouse. And like, I'd have some time at the seaside all kinds of great stuff. So adventure, but fun. Yeah, so we get there and the very the very next day, I think we got there like late afternoon. So the next day, spent a little time poolside and then decided to go to this restaurant for lunch that was literally like an oasis on the seashore. So like in the sand cluster of trees and this restaurant was in these trees on the sand. And so it's just a walk up the beach, it was probably, I don't know, 20 minutes of a walk. We get up there. My son Austin actually ordered the only sensible meal he ordered a pizza which is cooked my husband and I ordered cbj which is raw and my other two kids ordered some sort of salad again raw and when you're in a developing country, you should go cooked rather than right anyway. So you know it was a big piece of pizza and or you know, personal pizza. And so we give this was before wearing a Dexcom so we have no arrows indicating the dress. In which his blood sugar is going, we just have a blood sugar of somewhere around 250 probably. So we have to give a nice correction dose, I have to give the combo bolus that we were doing for the pizza to accommodate for the, for the fat. So it's gonna be dripping in for a while. And I didn't factor in the walk that he had just had. So right after lunch, he and his brother asked to go into the sea and play. I'm like, Sure, that's fine. So they did about five minutes later, he came back and he said, I feel shaky. So I tested him and he was in the mid 60s. And we ordered him a coke. And he started to drink. And still his blood sugar wasn't going up. Eventually, he drank the whole big bottle of Coke, and still really wasn't going up. And I was getting a little suspicious. And then he said, I don't feel well. I feel nauseous. And then I knew we were in trouble. And your mind just immediately goes to like, the cheese was tainted. The basil on it hadn't been washed and was in was unclean. Something, you know. Yeah. And I knew that he had like, over 10 units of insulin on board. And then the next thing I know he he starts vomiting. And I mean, pardon me, but projectile vomiting. And this is one of those moments when you just snap into too high alert gear. And it's to my son, and my, my oldest son and my husband go back to the hotel, get the glucagon because of course the glucagon was with us. But it wasn't with us.   Unknown Speaker  21:39 Right? It was   Bonnie O'Neil  21:40 in the hotel, helping the pillows in case they had a low but now it was it was tucked away with all the other supplies. And so the two of them ran back along this shoreline. And I knew it would have to be at least 30 minutes before they would get back. Right? Because there and back. And actually my son got back before my husband did because the roads were so rutted and so circuitous, that it just took him forever, it seemed to get back in the car. So all the while I don't speak Spanish, I speak fluent French, I don't speak a lick of Spanish. And all of these people were trying to help me and they didn't speak any English. And they all they could do is bring towels and bags for my son. And you know, I knew that if he drank any more, he was just going to vomit it. So there was no point in trying to give him more to drink. And so we just waited. And I have never seen a sunset so fast in my life. Oh, I don't know if it was where we were located on the Costa Rica coast. I know we were having a late lunch. But anyway, it just started to get dim. And by the time my eldest son got back with the the glucagon and cuts all over his bare feet, it was just all I could do to stop my hands from shaking, and mix that glucagon and get it in hand. So point number one was, when you go on vacation, make sure that glucagon doesn't stay in your hotel, keep it on your person, you just never know. Point number two with practice that injecting or at least mixing up glucagon. Every year, when your glucagon expires before you throw it away. Don't neglect that gift of having the opportunity to practice drawing it up because I was going to ask you,   Unknown Speaker  23:27 did you ever do that?   Bonnie O'Neil  23:28 I did it every year, I never threw one away without mixing it up. Because I knew that if I ever needed it, I wasn't going to be able to stop and read the directions. I just needed to know what to do. Because the only reason you would use it is if you're in an emergency. And in an emergency. We don't think so clearly, or our hands are shaking, you might be thinking but your hands are shaking so much that you just need to go from muscle memory. So eventually my husband got their like gate. So I drew it up. I gave him the glucagon. My husband got there. And we're in the car. And I was just surprised Stacey, his blood sugar didn't come right back up. I expected it would come up to like, I don't know, a perfect 110 would have been nice. You can even give me a question 150 I'd be happy with and if it didn't, it was I don't even know if it hit at oh well. And so I remember being in the dark in the backseat of that car just like trying to get every little whiff of the glucagon out and into him. And, and then I just realized I don't have another glucagon. I brought one. I didn't bring two and he's not in a stable enough place. Like I we need a doctor. So thankfully, this was probably the nicest hotel we had ever stayed at. And and I'm really thankful because they had a doctor on call. So we as soon as we got back to the hotel, we asked the concierge to call for a doctor and he was there. Oh probably within 45 minutes, something like that. What did he do for you? Did he give him more like IV glucose? Yeah, so he unfortunately was this big, you know, had a big headboard, big posters on it, and like a poster board sort of thing. And he just hooked an IV up to him and tied it up to the to the bedpost. And so the following morning, when he came back, Austin had a fever by that point. And he said, You know, I can't rule out that this isn't appendicitis, you have to get an emergency surgery in Costa Rica, this was not what I had in mind. And long story shorter, what ended up happening was he said, You've got to get him down to the Capitol to San Jose, four hours back down the way we had come up, you know, just two days before. So we have to do that, you know, it could have been the fever could have been from the food poisoning, which it was, but he said, you know, we have to be safe, it couldn't be appendicitis or something else. And so that was the longest four hour ride I've ever had in my life.   Stacey Simms  26:02 Yeah, it was not appendicitis, it turns out to just be   Bonnie O'Neil  26:07 a lot it was it was just the food poisoning. And he spent three days in hospital. And there again, you, as a diabetes parent know more about diabetes than emergency room physicians do. And it's important that you know that and that you believe in yourself about that. My son, his freshman year in college had to go to the ER for the stomach bug. And there to the emergency room, physicians relied on me for what I knew about how to take care of his diabetes. And so when we were in Costa Rica, the attending physician gave me her cell phone number, and said, I want you to be in touch with me. If this doesn't come around, if his numbers don't go in the way we want them to, we're going to take the pump off. And we're going to do it our way. But I will give you it was basically I'll give you six more hours, I think this was like on day two or something. Because she was letting me manage his diabetes. Right? And but then she said, You know, we're gonna do it six more hours this way. And let me know how things go. And it did it worked out fine. So here's two more points coming to my mind when you're traveling. Don't just take one glucagon, you might need to use a second one when we were leaving the hospital. Among the other prescriptions that the doctor wrote for me. I said, Could you write me a prescription for glucagon because I use the only one I had. And clearly, my son didn't get a stomach bug. It was food poisoning. So food poisoning could happen again. And I want protection from that. And she looked at me with these beautiful, innocent eyes and said, Bonnie, we haven't had glucagon in this country in over 10 years. Wow. And so just don't imagine that it's going to be available for you. So travel with to glucagon when you travel. The other thing was, when we were in the hospital, the only ketone tests they were doing were blood ketone tests, they weren't doing any urine ketone test. So I had to wait until they would come back. You know, they weren't doing blood tests as frequently as we would expect to be doing our ketone tests. So again, don't just travel with a bottle that has maybe 10 ketone strips in it. I had a nearly new bottle of 50 ketone strips, and I was worried that I was going to run out   Stacey Simms  28:29 going forward. I assume you're filming like to travel? I mean, this was obviously a big trip and a big treat. Did you hesitate about traveling again?   Bonnie O'Neil  28:37 I don't think I'll go to Costa Rica. I'm nothing against Costa Rica. It's just the memories are. They're profound. I do try to pay attention to where there is a hospital, which is an easy enough thing to figure out. We have continued to travel that is for sure. In my book, I talk about another episode that happened after that, where he his insulin pump broke, and we were in France, and he had to get a we had to locate him a pump in a foreign country. So that's another fun story. But no, we've continued to travel, but I think it's just being safe, bringing your supplies with you and an abundance of supplies, checking to know where the hospital is. And I think it's it's just about being comfortable. Making sure that you feel comfortable where you are. Well, you   Stacey Simms  29:32 mentioned your book. Let's talk about that. Sure. Yeah. Oh, congratulations. That's Thank you.   Unknown Speaker  29:39 Thank you very excited.   Stacey Simms  29:40 Yeah. So why'd you call it Chronic Hope? Tell me about where that title comes from?   Bonnie O'Neil  29:44 Okay. Well, you might want to edit this out. I'm not sure so I was I was thinking about how much you know, I loved my my son and the care I give for him. This As a chronic condition and the title chronic love came to my mind. And that actually had been my working title for a little while. And as I was working on my book proposal, I did a little research little Google search on chronic love, and it was a porn site. So I changed the title. And actually, once I came up with the subtitle, chronic hope, is exactly what I'm writing about. We all love our kids, we do in a way that we show our love to them, especially as full time caregivers, that just cannot be disputed. But there's some times when we as the parents just lose our way on the hope journey. Because it's, it's so long and so complicated and can be so unforgiving. And we can be unforgiving of ourselves. The message really is hope for us.   Stacey Simms  30:57 I may have to lead with the chronic love, I think that forget about editing that out. That's pretty funny. Oh, my goodness. But you've had this story and you for a long time. I'm curious what caused you to kind of write it now to release it now?   Bonnie O'Neil  31:14 Yeah, good question. Well, I love to write. That's the first starting point. I've been writing for a number of years and have been honing that craft. And as I was thinking about what the next topic was, that I wanted to write about, it just felt like it needed to be a story that I've been living, something that was really true. And that it wasn't just something I'm going through now, which so many of my blog posts words like, you know, it's that short, quick blog post is almost like an instant word. It's like what you're going through at that moment, and you write, but I felt like I needed to write something where I had come out the other side, and actually had some wisdom to share. And once I sort of landed at that place, it was well, this is what I know better than anything else. And living this story out first with my nuclear family. And then with my family with my children, I just have been steeped in that for so long. I speak for the jdrf education conferences, that type of nation summit, and that one of the earliest ones that I did, I was speaking on the psychosocial impact of T one D on the family. And it was the first time I had delivered the that talk and I was I was sharing about, you know, my nuclear family and then Austin's diagnosis and how that impacted me. And I was just really honest, and, and raw, and I talked about my anger, you know, the disease coming back into my family, and just the challenges with my husband, when the two of us were not on the same page and the fear, I carried my need for control, wanting to control the disease, and all of these things. And as I'm looking up at the group that I was speaking to, like, everybody's dabbing their eyes, and sometimes, like really crying and at the end, one man said to me, So when's your book coming out? And I chuckled and kind of tucked that away. And it later, I think informed me very well as to what I should write about next.   Stacey Simms  33:32 What is your I mean, you have more than one son, and I'm sure they are your children are all featured in the book in their own way. curious what Austin? Right Austin? Is your son with time? Yes. I'm curious what what Austin thinks of this?   Bonnie O'Neil  33:44 Well, Austin is a man of few words that he's not   Unknown Speaker  33:47 going to do. Much.   Bonnie O'Neil  33:51 I made sure that in the advanced copies that I have, that he was, he received the first one. And he very graciously accepted it and then said, Thank you. He has congratulated me a few times and said he was excited. I did ask him before I really started the writing, and was just sort of outlining things. I asked how he felt about it. And he said he was fine. And I did say to him, and it's the Absolute Truth. If there's anyone who looks ugly in the book, it's me. It's never hand because I am raw with how I processed my emotions. Because one of the things I feel like in that for us, parents have a child that lives with such a complicated disorder. 24 seven, we take so little time to attend to how we feel, you know, because it's how can I complain when my child has to go through so much. And so we don't really ever name what it is that we're feeling and give ourselves permission to feel what we're feeling. And so then we can't really attend to it and move along from some of those stuck places and I really feel that the You know, the emotional health of a family begins with that center of the mom and the dad. And we need to get our stuff together so that we can create a healthy family emotionally.   Stacey Simms  35:14 I agree it's so interesting because we, as you know, an initial diagnosis. And though those first few years, we as moms, I think so define ourselves by diabetes, it almost seems like we have it like and you come to a realization that Yeah, do not be do not have diabetes, we do not have our child's experience. But it doesn't make the experience of being a mom of a kid with a chronic condition, any less valid. It's just a different experience. And I think I'm hoping, kind of saying the same thing you are in that once you realize that it's a mom, that it's okay to take care of what you are going through, knowing that's different from what your kid is going through, you kind of name it and take care of it and acknowledge it and talk about how tough it is. And right now until you can do that. It's so difficult. Yeah,   Bonnie O'Neil  35:58 it's a kid. It is. And I'm so glad now that there's such increased talk about soul care, because that at least is putting it into the forefront of everyone's minds now. But I think parents of a child with a chronic illness just really need that permission to say, I too need this soul care. I am going through mourning. This wasn't what I was expecting. I was expecting my child to have the freest life imaginable. And they still do. But especially in those early years, it's a lot, we have to mourn the loss of this perfect health we had envisioned for our child, and we have to deal with the fact that Yeah, we are tired,   Unknown Speaker  36:42 a lot.   Bonnie O'Neil  36:43 And it's okay to say I'm really tired. And I think even under, like coming to terms with the fact that a lot of our friends just aren't going to get it. And there's a loneliness that we carry here as the caregivers of our children. And it's okay, and it's not it's once we begin to name it and look at it and explore it a little bit, and how it's affecting us. That's the beginning of healing and freedom.   Stacey Simms  37:09 And I meant to ask you earlier, and it's okay, if you don't want to talk about this at all, how is your sister doing?   Bonnie O'Neil  37:15 She has struggled in the last few years with some complications. She has had, I believe gastroparesis for, I think it's close to 10 years that I think, went largely undiagnosed, and then has been quite problematic in the last few years. She's begun going actually to my son's retinal specialist for some treatments for her eyes. And her second or third treatment, this most recent one, they found that the retinopathy had had gone away. So I'm very thankful for that. So she just maintains the most positive attitude through shouldering this disease through the longest time, but I can see that it you know, it has taken its toll.   Stacey Simms  38:06 And so in your family, you know, you have two people diagnosed at different times, but still almost, it's hard to describe how different it is. We talked about Lantus And then off air, you and I were talking about control IQ,   Unknown Speaker  38:19 right? No,   Stacey Simms  38:20 just a guess of reflection before we go of the technology and the advances of not only I assume your sister has is using different tools than she did when she was first diagnosed.   Bonnie O'Neil  38:30 She is for sure. And I think that has been a great asset to her. So yeah, she's using now the Omni pod and the Dexcom as well. I am so grateful for the time in which we live and for the medical advancements that Austin has been able to take advantage of. I know one of the my friends through jdrf. She said recently, I am so thankful for all of you parents who came before our family did who paved the way because my daughter her daughter was diagnosed at age two or three. I've never known what you have known. She's had the Dexcom as long almost as long as she's had diabetes. I don't know the sleepless nights that you know, I'm confident now like that each generation or micro generation is going to be able to say that to the ones who came before them that we're going to continue to advance and are the lives of our loved ones are going to continue to get better. And that also just gives me a lot of hope.   Stacey Simms  39:36 That's great. Well, thank you so much for joining me, Bonnie. I really appreciate your time. Best of luck with the book. I'm really excited for you. There's nothing like a book launch. And I hope we could talk again soon.   Bonnie O'Neil  39:47 Thank you so much. This has been such a joy to be with you. Thanks,   Unknown Speaker  39:50 JC   Announcer  39:56 you're listening to Diabetes Connections with Stacey Simms.   Stacey Simms  40:01 Learn more about Bonnie and her book and her story at Diabetes connections.com. In the episode homepage, as always, I put lots of links and info there, you could read an episode transcript, if you prefer to. Some people just like to read rather than listen to that it's fine by me as long as you get the info. In conjunction with this episode, I have a contest on social media. This is on the Facebook page for Diabetes Connections, not in the group this week. This is just on the page. And you can win a copy of her book chronic hope. I also want to point out and I know we had a commercial in there, but I think it's really important especially for newer families to know that there are now options when it comes to using emergency glucagon because since the 60s, we've had the red box or the orange box, which were basically the same thing as you heard Bonnie talked about there mixing it up, and the big needle and all that stuff. There are new options. gfo hypopyon, is one that I spoke about, they are a sponsor of the show, they are a you know premixed ready to go shelf stable glucagon. And it's very easy. It's all in the panel ready, nothing to mix and you don't see that huge needle, it's very different. It looks more like an epi pen or an insulin pen and simple to use. There's also baxi me, which is a nasal spray. And that is also very easy to use, I will link up more information about that. I just think it is enormously important to know that these things exist, knock on wood, knock on my head, knock on anything I can find. We haven't ever had to use emergency gun with Benny in 14 years. But as Bonnie illustrated, you just never know. So it's so important to be prepared. I'm also really interested in the future of this stuff. Because I keep hearing more and more people say that we're gonna be using it not just for Super lows, right? I mean, like me, you were probably told if He's unconscious, you know, if you can't keep anything down, that's when you use it. But now there's a new school of thought about using these in much smaller doses for less severe lows. So I don't have a lot of information on that. So I'm not gonna talk too much more about that. But I think that is very interesting. And something to watch. And certainly glucagon in an insulin pump is something that, you know, companies are working on, most notably the iLet from beta bionics. So, as we say all the time, stay tuned. Tell me something good, a big honor for a wonderful member of our community. And that's about Minecraft to just ahead. But first Diabetes Connections is brought to you by Dexcom. And you know, when Benny was very little, and in the bathtub or in the pool, anytime his hands would get wet. I always noticed his fingertips. You know exactly what I mean. Right? We poked him so much. They were just full of these little pinprick holes. It looks horrible. I mean, you can really see it when he got wet at age 16. I am not inspecting his hands. I rarely see his hands anymore, but his endocrinologist does. And we went for a checkup in early January, his fingertips are normal. It's incredible. We've been using Dexcom for seven years now. And with every iteration, we've done fewer and fewer finger sticks G6 eliminates finger sticks for calibration and diabetes treatment decisions that we used to do 10 finger sticks in the past. It makes me so glad that Dexcom has helped us come so far. It is an incredible tool. If your glucose alerts and readings from the G6 do not match symptoms or expectations, use a blood glucose meter to make diabetes treatment decisions or more, go to Diabetes, Connections comm and click on the Dexcom logo.   Over the almost six years of this show, I have been so fortunate to have some guests that really made an impact on me, who I'm really lucky, I think to call friends now, but who I turned to again and again for information. I know I can rely on them. They'll give it to me straight and in a caring way. And one of those people is Dr. Stephen ponder. Many people know him because of his sugar surfing talks and books, but he's a practicing endocrinologist. He's right there in the thick of things in Texas when he can pray and hopefully post COVID runs a fabulous diabetes camp and has lived with type one himself for more than 50 years. He got a really great honor recently, and he says he was stunned to learn that he has been selected for a big honor at the University of Texas Medical branch in Galveston. This is where he went to medical school. And then he stayed there another nine years where he says he became a husband, father, pediatrician and pediatric endocrinologist and the award is the Asheville Smith Distinguished Alumni Award. He will receive that formally in June during the graduation ceremonies at Galveston and the to read his post about this was it was really inspiring he gave a lot of credit to others and he finished by saying never in my wildest dreams did I imagine an honor such as this so congratulations to Dr. Steven ponder for a great award well deserved that's just fantastic. Another Tell me something good comes from Samantha Merwin who is the mom of Logan the elbow bump kid we've talked to them on the show before she is working to roll out a national program about Minecraft. This is a Minecraft t Wendy play project. She says she had a successful pilot and She's working to roll it out nationally, working out a lot of logistics apparently to roll it out for people outside of her home state. So more to come on that. And she's also been working on a project with the college diabetes network along with Cigna. This is a really cool program all about mentorship applications are going to open in February, I will link up the page that is already there for college diabetes network. Basically, it's a program for junior and senior undergraduate students, you got to be current junior or senior, and it pairs you with a Cigna employee who has a similar career interest. So if you want to learn more again, I'll put a link in the show notes. But this was really great. Samantha love the work that you're doing here definitely going to help a lot of people and keep us posted on both of these programs. My son used to love Minecraft he still plays it but man when he was like 12 or 13 that was all they played. It was pretty wild stuff. I don't know what he's moved on to now. Although that's a lie. He his friends are playing Uno. They were screaming and carrying on get the card game Uno. I asked him I was like why are you so loud? Kind of Be quiet. I figured there's like shooting people or doing something crazy. They're playing card games on the computer? I don't know, is there any sign that you're getting older than you don't understand the games your kids are playing. If you have a Tell me something good story, please send it Stacey at Diabetes connections.com or posted in the Facebook group.   Little bit of housekeeping before I let you go, starting next week, I'm going to be doing something different. I'm going to be releasing an additional episode every week. So we'll have the regular interview on Tuesday, the long episode with segments like Tell me something good and innovations and all sorts of stuff. The regular episodes on Tuesdays will continue that way. I'm adding an episode on Thursday. And these are going to be what I'm calling classic episodes. If you're a sharp eared listener, you will know that I dropped in a couple of these last year kind of as a test. They are interviews from several years ago, as I mentioned, we've been doing the podcast for almost six years now. This is Episode 347. So there's probably a couple that you have missed along the way. And what I'm going to do is put context to the interview, you know, kind of catch up with the person let you know what they're doing now, and then replay the interview from several years ago, we have really great stories from a lot of really terrific people that you may have missed. And this way, if you're newer, and you haven't heard it, it's super easy enough to scroll back. I mean, Apple podcasts only shows you 300 episodes Anyway, you don't have to go anywhere. It'll be delivered right to you. And you can catch up with some of the really cool people and stories that I spoke to back in 2015 and 2016. So that starts on Thursday, February 4. Right now I am scheduled to do it for about half the year. We'll see how it goes. And you'll have to let me know what you think. Because after all, the show is here for you. If you don't like it, don't wait half the year. Let me know right away. If you do like it, of course I would love to hear about that as well. Next week, you'll be hearing from Lily I talked to the folks from Ypsomed a couple of weeks ago. Ypsomed and Lily are partnering to bring a new insulin pump to the United States. It's not a new insulin pump elsewhere in the world, but it could be here as early as 2022. We're going to talk about why Lilly decided to pivot and go in this direction. That is next week. And thank you 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 next week. Until then, be kind to yourself.   Benny  48:29 Diabetes Connections is a production of Stacey Simms Media. All rights reserved. All wrongs avenged

 Meet Leo Brown from this season of The Amazing Race! He lives with diabetes, but his story isn’t a typical one. Leo was born with congenital hyperinsulinism, where the body makes too much insulin, and had almost his entire pancreas removed. Leo will share his unique story and tell us about running the race with his girlfriend, Alana. Learn more about congenital hyperinsulinism In Tell Me Something Good, babies! Weddings! And a football first for someone who’s been kicking t1d every day for a long time. 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 new 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 One Drop created for people with diabetes by people who have diabetes by Gvoke Hypo Pen, 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  0:23 This is Diabetes Connections with Stacey Simms.   Stacey Simms  0:28 This week, meet Leo Brown, a contestant on this season of The Amazing Race who lives with diabetes. Now on the show, he's racing around the world with his girlfriend, Alana, but they had what could have been their biggest setback before the race even got started.   Leo Brown  0:42 I think I was actually on the flight to LA at the start line. When I realized I had left all my insulin at home. There was one thing I didn't remember it was in the fridge. It was lined up like little soldiers.   Stacey Simms  0:57 Oh my gosh. Well, Leo's story is not a typical diabetes one. He was born with congenital hyperinsulinism, where the body makes too much insulin and had almost his entire pancreas removed. He developed diabetes at age 19. And he'll share his unique story and tell us about the race In tell me something good babies, weddings, and a football first for someone who's been kicking T one D every day for a long time. 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 love The Amazing Race. I started watching when I was pregnant with my daughter Lea. And that was 19 years ago, I realized that talking to Leo and doing this episode Oh my gosh. Anyway, welcome. We aim to educate and inspire about type 1 diabetes by sharing stories of connection. My son was diagnosed almost 14 years ago, when he was a toddler. I have a background in broadcasting and that is how you get the podcast. It has been two years since the last version of The Amazing Race aired and I really have been excited to see it come back. It's just great to see people traveling again. As soon as the first episode of the season aired in mid October, my eagle eyed diabetes friends started posting photos of Leo at one point he's playing the steel drums and you can clearly see the Dexcom on his stomach. I like many of you jumped to the conclusion that he lives with type one. But it turns out his diabetes story as I've already teased a bit is very unique. And we'll talk about that with him in just a moment. But first Diabetes Connections is brought to you by One Drop. One Drop is diabetes management for the 21st century. One Drop was designed by people with diabetes. For people with diabetes. One Drops glucose meter looks nothing like a medical device. It's sleek, compact and seamlessly integrates with the award winning One Drop mobile app, sync all your other health apps to One Drop to keep track of the big picture and easily see health trends. And with a One Drop subscription you get unlimited test strips and lancets delivered right to your door. Every One Drop plan also includes access to your own certified diabetes coach have questions but don't feel like waiting for your next doctor's visit. Your personal coach is always there to help go to Diabetes connections.com and click on the One Drop logo to learn more. My guest this week is Leo Brown from Season 32 of The Amazing Race. His partner on the race is Alana Folsom, they have been dating for less than a year when the show started. And they're now married. So we don't know how they did on the show. But that's a great outcome already. Leo and I recorded this interview over zoom and there is a video version which I've put on the YouTube channel. And that's just Diabetes Connections over on YouTube. But there's two things you need to know as you listen, the audio is a bit sketchy here and there, Leo and Alana upgraded their Wi Fi during the interview. Literally during the interview, she called and got the Wi Fi upgraded we stopped and started a bit before that happened. I took all of that stuff out. But you can hear some stuff here and there. And if you see the video, you will see the shirt that I am referring to as we start out here. But if you're only going to listen, I promise you will get the gist. Leo, thank you so much for being here. I appreciate you spending some time with me tonight.   Leo Brown  4:23 Thanks for having me excited to have a chat.   Stacey Simms  4:26 All right. Well, first of all, I have to ask you about your shirt. Because I saw that hashtag on Twitter that you guys were using. What is beloved lovers? I wanted   Unknown Speaker  4:35 to hear you say it first.   Stacey Simms  4:37 Wait, let me do my radio voice! Tell me about – beloved lovers.   Leo Brown  4:41 Oh, absolutely. So Alana I got married over a month ago. And we have a Ketubah which is a Jewish wedding contract. And in a traditional Ketubah it says you know the man this and that husband this wife that right and We wanted our Ketubah to be egalitarian. And we didn't really see a need to indicate our gender. But that's not really what what relationship is about. And so we talked to our Rabbi who's extremely, you know, open minded and accommodating. And he came up with some text that is egalitarian. And the translation from Hebrew to English was beloved lover, and really like that. And so in the in the wedding, which we live streamed, because we couldn't invite most of the people we wanted to, because the COVID, he explained that and there was a live chat on the YouTube live stream that was happening, everyone was like, beloved lover, and then they started writing hashtag beloved lovers. And then I think somehow that got picked up by some news source that like follows Amazing Race, or it was like doing some promo about Amazing Race. And so when they were introducing the teams, and it was just this little this article that got that was going around, they said, Will and James dating Hung, and Chee married Leo and Alana lovers. And so our cast has all had already kind of decided since our wedding because they had all called into the wedding that we were having, like beloved lovers. And so we went with that. And this is our beloved lovers shirt on the back and says Leon & Alana, and a little globe, that is where beloved lovers came from our relationship and our wedding.   Stacey Simms  6:25 So okay, my husband and I have been married for 21 years. I'm making a note for our when we renew our vows for our tuba, maybe at 25. Oh, yeah, back and change the language   Leo Brown  6:35 as a couple that had to severely downsize our wedding. We are strong believers in renewing vows, or just having another wedding whenever you feel. Stacey Simms Well, you know, weird way you kind of put the honeymoon first with The Amazing Race. So let's talk about that. Because you both were I mean, I didn't know if I could ask you about your relationship, just because you're never sure on the show. I've seen I've watched the show for years and people are dating that they break up before the race even ends. Or maybe they stay together. Well, obviously, this had a really happy ending. But take us back to the beginning. When did you all decide to sign up for the race? You were just dating? Leo Brown Yep. So we met on Tinder in January of the year of the race. And then on our second date, I think we were watching The Amazing Race with my roommates at the time because they were fans and a lot. I was a fan and I hadn't seen an episode or two. And that was the first time when it was my roommates who said you better be great on the race. And I thought yeah, sure, I think we could be and, you know, nothing else really came of it. And then six months later, Ilana and I moved in together, I think it was our second night of living together when we had it. All right, let's make this video. Let's send it in. Let's see what happens. And that was in July. And then a couple weeks later, we got a call from casting. And then over the course of the summer and fall that we went to LA a couple times. And then the start line was our 10 month anniversary. So that was a that was a really fast and an incredible progression that we weren't expecting,   Stacey Simms  8:11 we will return to the Amazing Race to your relationship to your reading lots of questions there. But tell me about your experience with diabetes. Very unique. What happened? Tell us your story. Sure. So I   Leo Brown  8:23 can start long before I knew I had diabetes. Because I wasn't diagnosed with diabetes till I was 19. As an infant, though, I was diagnosed with congenital hyperinsulinism, which I always explain as kind of like the opposite of diabetes, instead of making not enough insulin, I made way too much. So it's a rare genetic condition that you're born with and usually presents at birth. And it's an emergency, once you're born, you have low low low blood sugars. And one of the biggest challenges is that doctors who delivered you and you know, like neonatal care doctors might not have ever heard of congenital hyperinsulinism. And to make matters worse, infants sometimes have low blood sugars, as like a natural and okay thing. And so many parents, including my own then are told initially some version of Oh, that's nothing really to worry about. And the story you hear time and time again from these congenital hyperinsulinism parents is I knew something was off like I'm not a medical professional, but my child needs help. And in my case, will that eventually led was to subtotal pancreatectomy ease. And so the first one was when I was six weeks old, and that was like 95% of my pancreas was removed a big scar across my stomach from that. And then when I was six months old, much of remained was also removed in a second subtotal pancreatectomy and after that, by the time I could remember, basically, I have like very early memories of my blood sugar being tested because my blood sugar was of interest at that point, everyone needed to know what it was and why it was okay. And for the first couple years, my parents had to do a lot to help manage that. And lots of doctors involved and try different drugs and eventually figured out something that could sort of stabilize my blood sugar and help me start to live a normal life. And by the time I could remember, I pretty much did live a normal life. You know, I went to kindergarten like any kid, I had a scar, I had a second scar from a feeding tube that was called my second belly button, because I have an outie. But then there was this any nearby. And as life went on, I felt very much like a normal kid who had this, you know, this complicated beginning, but I thought that was all kind of behind me.   Stacey Simms  10:56 But let me ask you before you go on, and I'm sure your parents have shared with you what actually happens when when a child is born with low blood sugar? Like you said, it's not as though something they're not often looking for that kind of thing. And it's extremely dangerous. Do they just are they poking your fingers when you're an infant? Or the you know what happened? Yeah,   Leo Brown  11:15 my parents may remember, even better memories than I do. But I know that you test a baby's blood sugar at, you know, most hospitals, good hospitals when they're born. So I mean, I think that tests This was 30 years ago. So longer, or like longer land sets, but generally a lot has remained the same in in that you test a baby's blood sugar. And if it's low, if you're lucky, someone says, Yeah, could be serious. It could be totally fine. But I think they had a lot of experience testing their tiny baby's blood sugar.   Stacey Simms  11:54 Did you go I guess my question is, did you go home? And then have these emergencies where you had to be re, you know, brought back your parents didn't know what's going on? Or did they know before they even left the hospital?   Right back to Leo, answering that question and explaining more about congenital hyperinsulinism. But first, Diabetes Connections is brought to you by Dexcom. It's hard to think of something that's changed our diabetes management as much as the Dexcom, share and follow apps. The amazing thing to me is how it's helped us talk less about diabetes, that's a wonderful thing about share and follow as a caregiver or parent, spouse, whatever, 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 required, Learn more at Diabetes connections.com and click on the Dexcom logo. Now back to Leo, who by the way, has a great Dexcom story later on in the interview. Oh my goodness. But here, we are talking about his parent’s early days of his very scary diagnosis.   Leo Brown  13:04 I believe my parents didn't have a clear diagnosis before I was discharged at the very beginning. And then within weeks, if not days, I was brought back, you know, they said he's having, you know, he had a seizure. He's not getting better, like this low blood sugar thing is, is here to say and I I'm again, my parents would have a lot more to say. But at some point, they were equipped with a blood sugar testing kit to you know, check me regularly at home. But I think that within those first couple of days and weeks, they quickly discerned that something was off. My parents used to have this box and at some point I said I need the box because once in a while I need to be able to explain to people not in an interview, but in a doctor's office what exactly happened. But yeah, it you know, it from what I know congenital hyperinsulinism and other stories I've heard from other parents, honestly, that I can tell you as much about that as my own early early story. The prevailing pattern is that the parents are told that the low blood sugar is not something they need to really worry about, because babies have that sometimes. And right, a large part of what the community and an organization I'm working with congenital hyperinsulinism International is trying to help medical community understand is you need a checklist saying this could be congenital hyperinsulinism. Obviously research for early diagnosis, treatment, but early diagnosis is in some ways more important because if people aren't looking for it, then it is a you know, it's a very rapid escalation. As you can imagine. It's just like if you were getting injections of insulin that you didn't ask for.   Stacey Simms  14:54 Yeah, scary stuff. Yeah. So you have these operations. You're growing up just fine. But you have been told your family's been told that you will eventually most likely develop type one diabetes or something that's very similar.   Leo Brown  15:06 Actually, that didn't become what people were told until more recently, this, I think, has to do with better research and sort of documentation about the progression of the disease also, as early treatments have become more effective, and there's still a long way to go there. I'm you know, most people don't get to go to kindergarten like I did without some sort of special needs. Or even just like having a continuous glucose monitor, right? You might not be I mentioned special needs, because like, as soon as your blood sugars are low, you could have that could affect your brain in some way. But also, even if you don't have that consequence of the low blood sugars, you might still have a lot of trouble controlling your blood sugar's early in life or throughout your life. And so the fact that I didn't have any of that, from nursery school, kindergarten and on through the beginning of college is sort of unusual. But to your question, my parents were not told that I would get diabetes, part of the reason, I think is because my pancreas was making so much insulin, there was a thought that removing just the right amount would lead to me being just fine. Or, you know, you might not remove enough like, I might still have low blood sugars, like there was no assumption that I would have diabetes, although my understanding is more recently, that's become more of a an assumption that like you do this type of operation. And then no one knows when, but eventually you will have diabetes,   Stacey Simms  16:38 or and now I have one more dumb question or the surgery for we move on. I know, everybody wants to know about you, and the Dexcom and The Amazing Race, right. But I'm so curious, we think about the pancreas, and I think most people in the diabetes community understands that it's not dead, you know, it didn't stop doing everything it's supposed to do. But we don't think about it as doing anything much more than producing insulin, you have like this much of a pancreas left, and you have been living this happy, healthy life, even though we're gonna talk about your diagnosis. Are people generally surprised when they hear that it's, it's more of an education for you to do? Because I gotta tell you, when you told me that, I thought that's not at all what I felt what happened?   Leo Brown  17:13 Yeah, I wish I could read the logs of my pancreas to tell you exactly what it's doing and what it's failing to do, like if you were trying to debug it. And, you know, there's not an easy way of getting in there. And and finding that information. I mean, you really would have to, you know, I engage any doctors I encounter and try to get those kinds of answers out of them. Like, what is it that my pancreas is not doing? Like, I know, it produces all sorts of hormones, other than insulin, I don't have the background to even ask the right questions, right. But all I can say is that with a little bit of pancreas, you can get a little bit of function. And I guess enough such that I don't I'm not diagnosed with anything other than diabetes. But it is a great question. And there's not a ton of patients to do this research on. Nor is it something that you'd want to interfere with someone's life to do research on, like, you were to poke around in there, like you could cause a problem. So on some level, you kind of just keep an eye on it. But one thing I do quickly want to add is that my parents and I, after I was diagnosed with diabetes, we were really kind of kicking ourselves like, doesn't it make sense? You took my pancreas out? Why didn't anyone mentioned that? This could just it seems like common sense. I mean, not I'd never thought about diabetes before. But my parents had certainly thought a lot about blood sugar. And they were like, course, like diabetes?   Stacey Simms  18:43 Nah, I gotta say, in everybody's defense, I think I would just be very happy that my baby who was going super low, all of a sudden, they figured out was wrong. They fixed it. You went to kindergarten, if the doctors aren't telling you why we're going to   Leo Brown  18:57 we think, clear. And you know, we weren't testing my blood sugar after I was, you know, in first or second grade, like and, and there's no indication that there was any need to at that time, no symptoms. Yeah.   Stacey Simms  19:10 So what happened? Did you go to college and start having issues or did it come suddenly. So   Leo Brown  19:14 I went to college, I look back and I wonder when the symptoms really began. But by the time I was diagnosed, I was working. I was with summer after my freshman year, I was working at like a family run vegetable farm in the Berkshires in Western Mass where I was in college. And I thought I was you know, I'm a pretty fit person. I'm not a college athlete. And I was with a couple of college athletes on on this farm. And so that was what made me kind of doubt that will maybe I'm not cut out for this. But long story short, I couldn't really make it through the day. There was a moment I remember where I was trying to get into the pickup truck that we were driving around, and I could get in but I had to like I would just like go put my hands on the wheel and just use my arms to just like, drag myself into the pickup truck. And that was odd. I'm not used to having that much trouble with something that seems simple. Why wasn't I using my legs? Right? I probably was, but it was I wasn't using my body the way I normally would. And then I also, again, no surprise to the community, I had to pee all the time. These guys I was working with were thinking like, what's wrong with Leo, like, all he does is go to the bathroom. And he's not very good at any of this manual labor. And I was starting to think maybe I just am sickly. I'm just someone who is not as fit and capable as I thought I was. You know, I'm not one of these college athletes. So who knows. So I went home for a couple weeks, I said it was a vacation, you know, I'd kind of plan to take two weeks off at some point in the summer anyway, I was at my girlfriend's house at the time hanging out with her and her family, just in the living room, really low key, like someone was watching TV, someone's reading the newspaper, we might have been playing board game, and I was just lying on the floor, basically, I would only get up to go to the kitchen and get like a tall glass of milk. And I think I went through an entire gallon of milk. And then I you know, I was like super comfortable in this environment. So I wasn't pretending to feel any better than I was. But I also wasn't, I wasn't unhappy. I just had no energy. I was like, I was completely down for the count. And her mom is a scientist. And she said, You're not well, and you should go to the doctor, you should go home and go to the doctor. And I did and they tested my blood sugar. And it was 650. And so that was you know, right away, they put me on insulin. And skipping forward a bit. I went back to the farm Two weeks later. And they were astonished by like, I'd gained 20 pounds back. I had an I could do stuff. Do you remember how different you felt? Once I was on insulin right away? I had, yeah, like 10 times the energy, things felt easy, I think is the biggest thing. Like I wasn't unhappy. I just was confused by why I couldn't do what the type of thing that I thought I would be able to do. And again, I'm not. I don't think of myself as physically fit first and foremost. So in the back of my mind, I was always thinking maybe I'm not as fit as I thought I was versus an athlete, student or professional, who would sort of automatically know my performance is going down like something's wrong. I didn't think that.   Stacey Simms  22:33 All right, well, that's a fun way to start talking about the amazing race. Because I have been watching this show for I realized recently 19 years. And I've always thought, oh, that'd be so fun to do. And then I remember each season, why would never succeed, because the athletic ability you need just to survive and run from place to place is unbelievable. So I have lots of questions from listeners. I have lots of my own questions about the race. But the really the biggest one we get is, you know, how do you manage diabetes in a situation like that with travel and running? So if we can ask, we all saw you with the Dexcom while you're playing his steel drums and episode one that got everybody's attention and diabetes,   Leo Brown  23:12 even I didn't notice that in the clip.   Stacey Simms  23:15 Do you do if you don't mind it? Again, this is kind of personal. Do you take insulin pens? Do you use a pump anything like that? Yeah,   Leo Brown  23:21 I've tried different things over the years. And again, because my diabetes isn't type one or type two, it's hard to sort of draw comparisons. But the number one thing I do to manage my diabetes is through diet. So I eat a very low carb diet. And that is something I've always tried to do as much as I can have over the years. And at times that's enabled me actually to get off of insulin. However, there are so many variables. And on the race, I was not on regular insulin prior to the race, but I brought insulin on the race and had to use it in particular, because I would encounter food situations that I would not have chosen. And I also just didn't know what I was going to encounter. And that was also why I had the Dexcom, which I had. Well, I shouldn't say that's why I had the Dexcom. I've been using the Dexcom for some time. And that is also part of what has enabled me to kind of use insulin as I need it more recently, just to provide a little bit of context. When I was diagnosed, I did use Lantus and homologue, kind of a traditional prescription of insulin, as I discovered that I could use less insulin, if I ate fewer carbs, I over time would sort of rebalance my insulin with my diet. There are times that I wasn't using the insulin that I should have been. And I would sort of tell myself that I didn't need it. And if I didn't test my blood sugar, then I couldn't prove that I needed it. And then more recently, since the race and I'm not sure if this is you know an age thing or like an age pancreas thing, I have found that it's sort of floating higher Even with like, when I'm sure I'm, and legitimately, perfectly executing a low carb diet, and it's higher than I would have, you know, not high like 121 3140. Like, I wouldn't see the numbers like that if I had everything else controlled, and yet, somehow I do. But then if I start running more frequently, it kind of goes back down. So there's all these variables. And for the race, when there's so much that I can't control, I knew the Dexcom would be a CGM in general would be crucial. And having insulin available would be crucial. So I didn't want to go with an omni pod, because I got a couple of infections, actually, from the site, not saying that Omnipod, but just in general, like, I don't have a ton of body fat. And so like, I think there was just the wrong spot. And that can happen with any device. But for the race, I really want to do avoid that kind of thing. That's the sort of thing that could have actually put me out of the race, you know, if I had like a real infection, and so what I ended up bringing on the race was syringes, like old fashioned syringes with a vial of human slug. And the reason I went that route, actually, is because oh, no, I actually think that was just all I had at the time, because I had the syringes around for the token like a true diabetic. Yeah, I had the syringes and they were around from the Omnipod. And then I have to include this, which I had forgotten about, but we were at the hotel ready to go, you know, we're not sure when this starts going to be. And I think I was actually on the flight to LA at the start line. When I realized I had left all my insulin at home. There's one thing I didn't remember, it was in the fridge, it was lined up like little soldiers. So there was a whole production of gold, having someone having a production assistant go to Walgreens, like paying out of pocket, months later figuring out reimbursement. So that was it was a major part of preparing for the race.   Stacey Simms  27:05 Okay, I have to tell you, I have so many friends with so many stories of forgetting insulin and for getting supplies you have just made our day. So thank you for acknowledging that you're human. Oh, yeah, that's crazy. Oh, you went over here. So the other question was, this question kind of comes from the food? I thought I knew the answer this after all the years, but I wasn't sure. How do they feed you on the race? We see the crazy food contests. What are you eating day to day? And then the question was, how did you manage that?   Leo Brown  27:31 Yep. So I only ate in between legs. Mainly because I didn't want the distraction the production, the possible possibility of a higher low blood sugar during legs. Now keep in mind, I was not using a basal insulin at this point. And so I didn't really need to worry about my blood sugar floating low unless I had a short acting insulin in my system. And with the adrenaline happening during the race, I did not feel the need to be eating. And then in between legs, teams stay in a hotel, the race provides food. I'm being a little careful, because we're not supposed to talk too much about behind the scenes stuff. But what I'll say is that, you know, the food I would ask for I would eat what I could have it. And if I needed more, I would ask for more. That brings me to the topic of what I generally which is if you gave me a slice of pizza, I would eat only the top. In fact, that's a business idea that one of the other teams and I the blondes and I want to start pizza tops. I know we haven't made any progress on that. But like pizza tops, very delicious. Sometimes you can even find someone who's lactose intolerant, and you split the slice of pizza horizontally. So that's the kind of food strategy or trick I would use. There was food available to all the teams and sometimes I would have to ask for a little bit more to make sure that I can eat enough. Okay,   Stacey Simms  28:57 I am a Jewish mother. You were not super hungry during the race. I mean, again, I know we can't we have to be very careful. We don't know how far you got. We know you've got through episode one. But I'm thinking even an episode when you were swimming. You were running around or playing the drums. It's a long day. We don't have to eat a whole lot of adrenaline.   Leo Brown  29:16 And I you know, I always had a bar. I always had sugar tablets with me. So I should point that out. But you know, your heart's racing. You're competitive. Your adrenaline's high. And on that note, you're probably going to ask me about this. My blood sugar went high from that. Yeah, right. So like my blood sugar shoots up when I play coed softball in a league, you know, that I pay to be here. Right? Like it's not a competitive situation. But like, you know, The pitcher winds up. I'm at third base and like my heart's racing, and then I look at my Dexcom later and my but the first time this started happening, I was so confused. I know. I didn't eat anything like and yeah, so that happened a ton during the race to the point where I didn't Security actually said the security staff was who was really tasked with sort of keeping an eye on me from a medical perspective. And they, they would say, like, you can't let your blood sugar get that high. And I would say, well, like, Yeah. Like, what? Also what do you want me to do take insulin? Like, I don't think you want that. It'll go back down pretty quickly when I calm down, but right now, yeah, like, I've always found it's not worth trying to treat the adrenaline highs, because then I don't really under like, I can't do the same calculation around eating something like, How high is it gonna go? How excited was I? Like, how long will it last? Honestly, I've thought about trying to control that sort of thing through mindfulness, or meditation and sort of just like slowing down my adrenaline in general, although I don't want to change who I am as a person and you know, being hated about things. So that's a trade off, I guess.   Stacey Simms  30:55 Yeah, I think adrenaline highs from sports is just something that most people with diabetes that I know learn to figure out and kind of work around and not dose for, as I said, because you it's it's so tricky tolerate, um, time zones came up, too. But since you're not dosing basal insulin, that's not really a question, right? I mean, time zones, I assumed would affect you, but not really in the same way as someone was dancing that way. What   Leo Brown  31:17 Yeah, I didn't go space all during the race. And I think time zones affected all of us in an odd way. But, you know, we weren't sleeping in 24 hour cycles, we were sleeping during breaks between the legs, and the legs were not, you know, they didn't start when the sun came up, and when the sun went down, so yeah, I don't know. I mean, I think if I had been dosing basal, I would have had to just, you know, set a timer and decide that's when the next day began.   Stacey Simms  31:46 All right, any tricks and tips to keep your Dexcom on? Did it stay on in the water? Did it stay on with the sweat? And the reason the whole thing? That was what I was thinking about?   Leo Brown  31:54 Yeah, incredibly, it did. Since the race, I've gotten more experience with using the Dexcom and have started to use three M tape. And at this point, I just put it on preemptively. And aggressively. So it's like all over the site. I was, I think, kind of lucky during the race, the biggest issue I had with a Dexcom. And this gives you some insight into like the level of excitement and my state of mind was, at one point, we were on an airplane, and I was checking my blood sugar on, I actually was using, not my phone, but the little device that it comes with, because we didn't have our phones. So I was fiddling around with this device. And my mind's racing a mile a minute, right, like probably the entire race. I mean, to like, say, exit out of the part of the app that I'm in. And I decommission the sensor. Oh, no. Unlike the I was installing the sensor, no, I installed the sensor. And then I said the sensor is over right. Now, it is not possible to reverse that. And I was so distraught. And olana pointed out at that moment, that I had brought four sensors for 30 days, because I brought an extra and that was when I used the extra. At that point. I didn't have an extra. But at least I had that one. That was like, I don't know if there was a moment in the race when I was more horrified then when I installed Dexcom and then immediately decommissioned it.   Stacey Simms  33:32 Oh my gosh, yeah. I think a lot of us have done that. You guys were very early in your relationship, as you said. Very brave thing to do. exciting thing to do. Did you have fun? I mean, you're married.   Leo Brown  33:44 Yeah, we had a lot of fun on the race. It was also I will say a very stressful experience in general. You know, our first time on TV, you know, we really wanted to keep racing. You might have noticed in the first episode, we were on the second flight, we were in 10th place at a certain point, the oil drums were huge and hard to handle. The fish numbers challenge was horrible. Try remembering for numbers and the numbers were okay. But the colors. The problem with the colors is that what are you reading the fish nose to tail left to right, like you flip it over upside down? Right? It's sort of like you can reverse the fish in all different directions. And we were just like, really, things were not getting any easier. And then the skill drum challenge Fortunately, I felt pretty comfortable with so that was Trinidad and Tobago, and we had a blast, but we also had a lot of anxiety. You know, as far as our relationship, I think we kind of knew what we were getting into, in a way. I mean, I suppose it was more intense in many ways than you could have imagined. But we knew we wanted to do this big adventure like we knew it was a once in a lifetime opportunity. We wanted to travel we wanted to get to know each other. We wanted to get away from our jobs like It was a no brainer. And I think that our relationship from day one has always been that we want to do things together, and not like shy away from experiences. And we're just both wanting the same thing out of life in so many ways. And so it would have been against our nature to hesitate to do this thing together.   Stacey Simms  35:20 So this was taped in 2018. This is pre COVID. But this is a long time ago. How hard is it been? I mean, I don't know exactly when it wrapped up, or if you know, when it ramped up production. But how hard has it been for you guys to sit on this for all this time? You can't say anything?   Leo Brown  35:35 Yeah, it's been a big secret. And it's been a huge relief to share. We were able to share with close family, initially, MBAs, everything we couldn't share with work, we couldn't share with friends, we couldn't share it, my friend who was house sitting for us. And we have been able to stay in touch with the cast. We're really close with the rest of the cast. The fact that it took so long to air is I think part of that, like we've had a chance to see each other go through stages of life together. A couple of them were at our wedding, everyone else was live streamed into the wedding. So having the cast as sort of a support system through this has been really huge. It's just a Yeah, it's a huge relief to be able to share that. That's unbelievable. And I have to say, just watching the first episode, and I haven't watched the show in a few years. And now I'm back in I'm very excited. Good. But it was a joy. Great season. Well, I'm glad to hear it. But I gotta tell you, it was a joy to see travel. It was exciting to see the world again. escapist is voyeuristic. Yeah, it's, it's what we need right now. Of course, being able to see myself through those things is a trip and feel so great. But also, you know, just being able to see people interacting, like we used to, I'm sure there's going to be some airplane footage. The first episode was notably absent airplane footage, which I think everyone was sort of would you know, that's what you want to see right now is like everyone like squeezing onto a plane. But there will be some of that the carnival in Trinidad. Imagine, you know that today? You want to see that back to the way it was, when it can be. But yeah, I do think it's the perfect show to be airing at this time, unlike Big Brother, where you're locked in a house. And it's kind of the same as you know, you get everyone tested, and then you can be in the house. But the race is obviously the opposite. And we are we're all hoping they'll be able to you know, keep running it again soon. You know,   Stacey Simms  37:39 I I would like to know, and I, again, I've watched the show for 19 years, you know, what's the crew? Like? What's it like traveling with those other people that we never see?   Leo Brown  37:48 Yeah, first of all, the crew is many in number. And they're an integral part of the experience. They are supportive. They're excited to be there. They do incredible physical things with you know, 50 pounds of equipment, trying to keep up with us. We're trying to go as fast as we can. And then they're, you know, jogging alongside us. They haven't a job that is would have been hard to imagine. I mean, now I've kind of seen them do it. But you know, they travel around the world. A lot of them work on other shows. Some of them have been doing the race since the beginning. And now we follow a bunch of them on Instagram, and they all post great photos of their non office jobs. Like to them   Stacey Simms  38:28 you've got the goats, right, and you're running to the mat. Where are they? They're behind you. They're in front of you. They're trying not to get trampled by goats. I mean, it's got to be an incredible skill on their part to   Leo Brown  38:37 Yeah, so also keep in mind that there's equipment like drones that they can deploy. So generally speaking, 90% of the footage, I would think is from a person carrying a gigantic camera, just running around. But if you think about like the water challenges, actually, I think they've had cameras on boats, you know, I probably shouldn't get too into that. You'd probably just do drones. Yeah, sometimes it's   Stacey Simms  39:06 drones. And what's Phil like, Phil is nice. Don't tell me if Phil isn’t nice.   Leo Brown  39:10 No, feels great. Phil is just like he is on the show. Except if anything quicker wittier than you might expect, like none of it's scripted. As far as I know. He's really fun, really warm, and he wants us to do our best. You know, one thing I did want to ask before I let you go, I found you on Twitter because someone in the diabetes community was talking directly to you and saying, Hey, we watched the show. My daughter just got to Jack's calm and saw you with yours on TV and it made our night. You are while of unusual case in the diabetes community. You are in the community now. And I'm curious what that's like for you. When you see people reacting so positively and so excited to see you on the show. I was definitely surprised that people picked up on it right away. You know, I didn't see the Dexcom in the episode. And it's an incredible feeling to have that be an inspiration for people. And I know how I felt when I was first diagnosed with diabetes. And I didn't know what I would be able to do, it took me some time to realize that I wasn't going to get a break from it. And to kind of there's the diagnosis, which was a relief, actually, because then I could do things that I wanted to be doing and thought I could be doing, I just, you know, they told me, I just have to do this and that, and then I can live my life. And then it was probably a couple months later, where it sort of hit me that, you know, I wouldn't be able to go back to the way it was before. And I remember my sister who's a couple years older, she was watching this happen. And I was a freshman in college, I just finished up freshman year of college. And I had to I realized, and especially because I was making such an effort to manage with diet, I realized like, I wouldn't be eating birthday cake, I wouldn't be eating a hot dog button. And the way she saw it was that I had to grow up really fast, because I have a sweet tooth. Like I love candy. And I don't eat cake. I mean, I eat dark, dark chocolate, but I don't eat candy. And oh, what I'm about to go make for myself after this interview is a hot chocolate, which is made of half and half and cocoa powder, no sugar, and I mix it together and I heat it up in a saucepan. And it gets like to be to me indistinguishable from like a chocolate syrup that I want to drink. But it's got no sugar. So I recommend that. Anyhow, I'm on a tangent. It's really exciting to me to be able to hopefully, give people who were in my shoes. I think the person who commented that was her daughter's first couple days with Dexcom. So I remember what that was like. And on one hand being really hopeful that I had a solution for myself. But on the other hand, accepting that, you know, there were real compromises. The solution was not one that I was always going to love. But for the race, those are solutions that helped me run the race. Yeah.   Stacey Simms  42:13 Well, I can't thank you enough for jumping on so quickly for sharing your story. And for being so open about everything. And thanks for hanging through the technical stuff, too. I appreciate.   Leo Brown  42:24 I think we got a lot I got us a Wi Fi upgrade in the course of this interview. So she's she's busy. Behind the Scenes love it.   Stacey Simms  42:32 Yeah, I appreciate you doing that so much. So look, we'll check in. We'll see how it goes. And maybe we'll follow up. But thanks again for spending so much time with me. Okay,   Leo Brown  42:42 thanks a lot, Stacey.   Announcer  42:49 You're listening to Diabetes Connections with Stacey Simms.   Stacey Simms  42:55 More information on the foundation that Leo talked about. I will also link up stuff on hyperinsulinism. If you'd like to learn more, all of that at Diabetes connections.com. Click on the episode homepage where there is also a transcription and I'll put a link into the amazing race because they've got some cute behind the scenes videos each week. And oh my gosh, I hope they win. You know as we're taping this, the second episode hasn't even aired yet. So I don't know if they've made it to the third episode. And but you know how this works. You've been with me with other contestants. We've had people from the Titan games and from the baking shows the Food Network kids baking show, American Ninja Warrior, you know, the Christmas light. We've had people from all different reality shows and you never know but it's always great to talk to them and just making it to the show is a pretty incredible achievement way. I hope they went Tell me something good coming up in just a moment. But first diabetes Connections is brought to you by Gvoke Hypo Penn and 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 GMO hypo pen comes in. It's the first auto injector to treat very low blood sugar Gvoke Hypo Pen is pre mixed and ready to go with no visible needle. That means it's easy to use in usability studies 99% of people were able to give Gvoke correctly. I'm so glad to have something new. Find out more go to Diabetes connections.com and click on the Gvoke logo Gvoke should not be used in patients with pheochromocytoma or insulinoma visit Jeeva glucagon.com slash risk.   Tell me something good. This peak is full of weddings and babies and celebrations. Congratulations to so many people in the community who took a big step this month. Rob Howe got married in early October so congratulations to Rob and to Erica. Rob is the founder of diabetics doing things the host of that podcast and and so much more. It is Rob that he's my Instagram guru, but I'm so bad at Instagram. I once I think I once was it Rob I once called him through Facebook messaging or Instagram messaging, I don't even know. I don't know how I did it. He was so polite. He was so nice. I felt like I was 75 years old. It was, it was not great. But congratulations to rob and Erica, who had a beautiful backyard wedding, you know, as we have to do these days, we wish them many years of health and happiness. Congratulations to Patrick Mertes, who had a baby with his beautiful wife, Patrick is one half of the team that made up 50 and 50. And these two guys who decided to go around the country last year, and climb the highest peak in all 50 states and try to do that in 50 days. And Patrick completed it Michael, his partner had an injury, halfway through and completed it. But later on, they did something else recently called race along the trace, which was three states. And 460 miles, it looks like a bike ride. He called it the last hurrah before fatherhood. So we'll we'll catch up with him and talk about that. But Patrick is also the director of the diabetes camp where my son goes every summer. So we are excited to see how a camp guy tackles fatherhood, I'm sure he's gonna do an amazing job because he's corralled all those kids for all those years. And finally, congratulations to Ken Rodenheiser, who also had a baby in October. He's a pediatric CDE in Philadelphia, and I think it's at the hospital where he himself was diagnosed years ago. But he has been a very big part of the children with diabetes organization and the friends for life conference. I believe he leads the tween program there, Ken and I have gone back and forth for years about getting him on the show. And we will work it out very soon. But I just wanted to highlight him in this segment and say congratulations to him and his wife and their babies name is Elliot, this adorable little girl. And I just realized as I'm reading this, I didn't put two and two together. But my next Tell me something good is also an Elliott. But this is Elliott Fry. He is the former kicker and all time leading scorer for the University of South Carolina, he lives with type one. And earlier this month, he kicked his first field goal in the NFL for the Atlanta Falcons in the Carolinas. Elliott is very well known for working with kids for being really out front with JDRF. And just being you know, out there as a great role model and example of somebody who plays sports and plays them at the highest level with type one. So it was really exciting to see him get that very first field goal in the NFL. And that's Tell me something good. Do you have something for me send it my way, Stacey at Diabetes connections.com. You can also post in the Facebook group, you don't have to have a baby or get married. It can be as easy as your son or daughter did their first sight change, without crying and running away oh my goodness, that used to be such an ordeal with Benny, anything that feels momentous anything you want to celebrate with the diabetes community, I would really love to know about you can go ahead and tell me something good.   It's hard to believe that it's going to be November in a couple of days. And I know we're all stressed out about the election and the possible aftermath. But it's also diabetes Awareness Month. And I don't know how that's gonna get any play this year with everything else that's going on in the world. But I'm gonna try and I always say diabetes Awareness Month is for the non diabetes community. I mean, we're aware every day of the year, this is our chance to educate. So I have a few things in mind to try to get the word out in other media. And I won't be talking so much about that here. But I'll share if anything exciting happens. But I am going to be doing two different things. If you're on Instagram, I will be having a contest I'm probably gonna start that the second week of November because I want to get past this election to that's just going to be a fun giveaway, to celebrate each other to be part of diabetes awareness. It's going to be fun and easy. I have some great companies lined up already that want to donate stuff and give it to you. I mean, you work hard all year round. Let's celebrate a little bit. And we have a big episode milestone, the numbers I'm so excited to share this with you. The second one is going to be on Facebook only. So we're going to have an Instagram only and a Facebook only. And the Facebook is going to be a little bit more work on your part. But the prize is going to be bigger, that one's going to be a cash prize. So I will keep you posted. The best way to keep track is to be in the Facebook group. Or to subscribe to the newsletter. If you're not already subscribed to go to Diabetes connections.com the cute little please sign up should pop up. But if it doesn't just scroll all the way to the bottom and you can sign up for the newsletter right there. So two contests coming up. I want to make it easy for you. I think it's gonna be fun. We just need a little brightness around here. And I hope I can provide some of that. All right thank you to my editor John Bukenas from audio editing solutions. thank you as always for listening. I'm Stacey Simms. I'll see you back here next week. Until then, be kind to yourself.   Benny  49:46 Diabetes Connections is a production of Stacey Simms Media. All rights reserved. All wrongs avenged

It's been a busy fall already for Medtronic; they've acquired Companion Medical and the FDA approved their 770G pump. Stacey catches up with Diabetes Group President Sean Salmon to talk about that and much more. Find out the difference between the 770G and the upcoming 780G, their plans for longer-wear pump insets and when they might have a no-calibration sensor. In Innovations this week, a new study showing the benefits of once a week basal insulin. It's called Insulin Icodec. 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 new 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 One Drop created for people with diabetes by people who have diabetes by Gvoke hypopen, the first remixed autoinjector for very low blood sugar, and by Dexcom, take control of your diabetes and live life to the fullest with Dexcom.   Announcer  0:21 This is Diabetes Connections with Stacey Simms.   Stacey Simms  0:27 This week, catching up with Medtronic, we're talking about the newly approved 770 G, looking ahead to the 780 G, their acquisition of In Pen and how they think they've cracked the code on longer where pump in sets,   Sean Salmon  0:42 the things that are in insulin to keep it from going bad. The preservatives, if you will, are behind a lot of that sort of site actions that you get. So we're able to take that stuff out and have just filtered Insulet. a queue will deliver to the site. That's really the magic behind getting the extension of use.   Stacey Simms  1:00 That's Sean Salmon. He heads up Medtronic diabetes group. In innovations this week, a once a week basal insulin, how would that even work? 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 so glad to have you if you are new welcome. Glad you found us We aim to educate and inspire about type 1 diabetes by sharing stories of connection. My son was diagnosed right before he turned to back in 2006. And we have his high school sophomore 504 meeting this week. Yeah, it's virtual. His whole school is virtual. I've shared on the show before he is part of a very large school district in the Charlotte, North Carolina area. And the whole district has been virtual. younger kids are starting to go back to school in October. They're staggering it right now High School won't go back in person until January at least that's the plan. So I'm really interested to see how they handle this 504 meeting. He's had one, you know, we've been diagnosed since he was two. So he's always had one. In our district. We have a separate DMMP a diabetes medical management plan that covers a lot of the basics that are maybe in your your child's 504, but I assume this will focus on testing. I don't know. I mean, he's home. So you know, he can go to the bathroom when he wants he can drink water when he wants. I'll share more about that though. Mostly, I think this is about keeping our place in the 504 for things like the ACT and the PSAT and all that testing and he is so thrilled, but it's going to be coming up. Another thing I want to tell you about real quick is Hey, in September, we saw a big boost of sales of the audio book of the world's worst diabetes Mom, you know, this is my book, it's part memoir, part advice, stories, real life stories about raising a child with type 1 diabetes. And the audible version has been very popular. And I'm telling you September, I don't know maybe end of summer and everyone decided to get an audiobook, but audible loves when that happens. And now I have two free copies to give away, you do not need to have an audible account, you don't even need to really start one here, you're not going to be signing up for something you can't get out of you do need an Amazon account. So if you want the copy, I'm not doing a fancy contest on social media, I probably should. But all you have to do email me Stacey at Diabetes connections.com put audio book in the subject line and I will give you the first two people who do so a free book will make it very simple there. If you're interested in perhaps the paperback or the ebook, you can head on over to Diabetes connections.com or it's on Amazon, whatever is easiest for you. One more thing and it's an apology. Last week I apparently mixed up when I was talking about Medtronic 770 and 780 G. We do clarify that in the interview here with Sean Salmon. But to be clear, the 770 g was recently approved in the US. It is basically the same as the 670 g except for the addition of Bluetooth connectivity for data sharing and remote monitoring. And as you will hear, you'll be able to update the 770 G and future Medtronic pumps at home just like your phone. Alright, Sean Salmon. With that and a bunch more we go down a laundry list, but first diabetes Connections is brought to you by One Drop, and I spoke to the people at One Drop, I was really impressed at how much they get diabetes. And it makes sense when you think about it. Their CEO, Jeff was diagnosed with type one as an adult. One Drop is for people with diabetes by people with diabetes, and the people at One Drop work relentlessly to remove all barriers between you and the care you need. Get 24 seven coaching support in your app and unlimited supplies deliver no prescriptions or insurance required. Their beautiful sleek meter fits in perfectly with the rest of your life. They'll also send you test strips with a strip plan that actually makes sense for how much you actually check One Drop diabetes care delivered. learn more, go to Diabetes connections.com and click on the One Drop logo. My guest this week is Medtronic Executive Vice President and President for the diabetes group, Sean Salmon. And we spoke just as the deal for Medtronic to buy companion medical makers of the In Pen was closing. So that is a done deal. Now, In Pen is a smart insulin pen, you're probably familiar with it, it keeps track of dosing and recommended dosing, sort of like what you'd get with an insulin pump, you still have to inject, but the dosing can be automatic, the app will tell you exactly what to do. And keep track just like an insulin pump does as well. We talk about that. And a lot more here. Here's my talk with Sean Salmon. Sean, thank you so much for joining me. There's a lot going on at Medtronic these days, I appreciate you spending some time with me and my listeners.   Sean Salmon  5:44 That's my pleasure. I appreciate the opportunity. Thanks, Stacey.   Stacey Simms  5:46 We're gonna go down pretty much a laundry list of technology and questions from listeners and things that they want to know. But let me start slow. And just ask you, how are you feeling about everything these days, we've got delays because of COVID. We've got, you know, a year like no other it's a cliche at this point. But you know, in your own words, how are things these days at Medtronic, and in terms of, you know, what you're looking at going forward?   Sean Salmon  6:09 Well, it's interesting, right? I think we're all living through some unprecedented times, just everywhere in the world right now. And it's certainly challenging. But at the same time across Medtronic, you know, I think we've got such a rich pipeline, and just about every single business, it's, it's exciting to see what you know, what the future is gonna bring, we get past some of these near term challenges. I've been here for 17 years, I can't remember a time where we had so much innovation all stacked up, ready to go   Stacey Simms  6:34 Well, let's jump in and talk about it. One of the first things I want to ask you about is the acquisition of companion medical. And this is the startup they've got the in pen. This is the I think my listeners are very familiar with it. And we've done episodes on it. So tell me a little bit about what the plan is, for companions in pen product with Medtronic, what are you gonna do with it?   Sean Salmon  6:59 Yeah, sure. Well, maybe I'll start out with, you know, why did we decide this was a good idea? And yes, I came into this role. Yeah, you whenever you start a new job, it's been about a year from now, the first thing you do is you formulate a strategy of how are you going to serve your patients in the market? And it's really, you know, strategy is really a question of, what are you providing for who, when you start asking those questions, it really narrows down what your focus should be in, and didn't take that long to sort of Peel apart? What is it that are people living with diabetes are seeking and how are they? How are they being treated today. And if you look around the world, it depends on the country you're in. But multiple daily injections is the most frequently chosen therapy, it's something that ranges between 60 and 90% of the treatments that are out there. So you know, really the philosophy app is that for us to know, what are provided for whom we need to know, you know, where do people where are they on their journey? And where do they want to go. So, you know, injection in and of itself is a fine therapy. But there's just really variable outcomes that patients are being able to get from that. And a lot actually about just the, it's made difficult by the fact that you really don't always know how vigilant you are, how much insulin you've taken, how much you have on board. And it's very hard to keep track of all that. And what companion has done with the implant system, of course, is to track that insulin, so you know exactly how much is given at the right amount of time and have some estimation for carbohydrates, the ability to load that up. And then of course, the CGM data is there. So when you have those components, a lot of that difficult math calculation about how much insulin Do I need to take at a given time is made simpler. And we can extend that by adding a lot of what we have within our automated insulin delivery systems, algorithms, personalization of those algorithms into that experience with a pen. So if you will, we're trying to close that open loop, or at least close it down some and what we do with automated insulin delivery systems as we have this track record, right, have you just recording CGM data over time, and knowing what the influent amount is, you can really get to an understanding of how individuals kind of respond to insulin, and more personalized, the amount of dosing that happens. So get an even tighter connection to how much insulin someone needs to take at a given point of time. Of course, on meal handling, that's the place, we're really pushing a lot of our technology, we have a very large and capable group that does data science and artificial intelligence. And all that really means is that we're able to take large data sets, and then put them into actionable insights that really simplify how people can get better control without having to do anything. And one of the really interesting areas we're investing in right now is around meal handling. So we can with our technology have a really good sense of when you're going to eat. And we can confirm that some gesture control technologies that come from a wearable like a Fitbit, or an apple watch or something like that. That tell us can confirm that some is eating. So in that instance, you could, for example, remind people, there's been no bolus given that it's time to bolus. And if you miss just two boluses a week in a meal, that equates to about a half point increase on the A1C. So obviously, outcomes can be made better. But the important thing is that it's done in a sort of an invisible way or helpfully in the background way. We're not asking somebody to anymore, which I think is really the sort of driving principle behind what companion medical set out to do within pen spec, this least burdensome as possible? Well, we can add a lot of technology that isn't visible to the user, for the most part, but can really drive a better experience and better outcomes. So what we're trying to do with a closed loop we can bring to this open loops, I said, and that's really, I think how the two fit together can help it a lot of ways.   Stacey Simms  10:58 A couple of questions about You just said you. You mentioned the gesture technology. That's Klue, right. You all acquired Klue this year.   Sean Salmon  11:03 Yes, exactly.   Stacey Simms Is that going to be part of a companion medical system?   Sean Salmon Yes. So the idea is, we're going to have that for any means of insulin delivery, right. So it's the ability to detect that somebody is in the process of eating. And the absence of any kind of bolus is a great opportunity to say here, let me give you a helpful tip here and remind you to bowls, whether you're pushing a button on your pump, or you're, you're reminding yourself to bolus we can drive some improvement there. And it was evaluated in a recent study that we did. It's a small study. But we showed that we could fact drop a one suit by a fairly sizable amount just by bolus reminder. Now, ultimately, I think we can use Klue and that technology in a way that can actually automate the delivery of bolus so nobody has to do anything within a sort of closed loop system. But you know, that's, that's some more work than where, or whatever to do it. Absolutely. It's   Stacey Simms  11:53 you heard me laugh, because, you know, just by bolus reminder, parents around the world have children with Type One Diabetes would argue with you that a simple bolus reminder in the form of a parent does not make that much of a difference. Yeah. But I hear you, I   Sean Salmon  12:07 think it Yeah, I mean, the difference here is the bolus reminders, and just it's time to bolus what we can do. Knowing the history of how much insulin is on board. Get a quick estimation is the medium small, large amount of carbohydrates being consumed, we can tell you how much to bolus not just that you need the bolts, right? which we think is a helpful insight.   Stacey Simms  12:28 When you talk about Klue. It also makes me laugh as you listen. As I talked about Klue, we did an episode with them in the past if you'd like to learn more, and Sean , I laugh because every time I talk about Klue I do the gesture of eating food. I don't you can't see me but every time I mentioned it, I think that's because that's how it was explained to me when they first demonstrated it. It's a really interesting technology. But that'll be in not just pens, you're planning on using that in pumps as well.   Sean Salmon  12:53 Yeah, so you know, Klue actually runs on on a wearable. And then it talks to the algorithm that's either you know, on your phone for your pen, or can be the algorithm that's driving the automated insulin delivery system. So think of it like a sensor, and the sensor gives input so that the algorithm knows what's happening. And it lends itself to any means of insulin delivery.   Stacey Simms  13:15 One of the big concerns and you know this when a large company buys or acquires a small company or product the big concern is that you know, it'll be shelved or there will be big changes to make it more proprietary. The in pen is now used with Dexcom and the ever since implantable CGM. Can you reassure people who are using it right now that you're not going to change that I assume it'll be used with a with a Medtronic sensor, but will you continue with the sensors that it is integrated with right now?   All right, right back to Sean answering that question. But first diabetes Connections is brought to you by Gvoke hypo pen, and almost everyone who takes insulin has experienced a low blood sugar and that can be scary. A very low blood sugar is really scary. That's where Gvoke hypo pen comes in. It's the first auto injector to treat very low blood sugar Gvokek Hypo pen is pre mixed and ready to go with no visible needle. That means it's easy to use in usability studies 99% of people were able to give Gvoke correctly. I'm so glad to have something new. Find out more go to Diabetes connections.com and click on the G voke logo. gvoke should not be used in patients with pheochromocytoma or insulinoma visit gvoke glucagon comm slash risk. Now back to Sean , talking about Medtronic plans to continue in Pen with its current partners.   Sean Salmon  14:44 Yes, we have no plans to take away anybody's sensors from them. But we're not entirely in control of that. So if if sensionics and Dexcom plan to maintain that access and then we're game we want to make sure that people have the support they need   Stacey Simms  15:00 When you say you’re not in control of it, you’re talking about what Dexcom and Eversense would do,  you're not talking about something on your side.   Sean Salmon  15:07 No. So the way all this works is you have to have, depending on what platform of phone you're dealing with, you have to have a thing called an API, which is basically a hook of software into the algorithm. So somebody on Sony decides they don't want to have that access to the longer they can turn it off. But we're not going to turn it off. We don't have control over that. So our belief is that, you know, if we're meeting patients where they are, and they're on a Sensionics device, we should maintain that access for those patients. Of course, we want to open up access to our own CGM. So we have a lot coming in the pipeline for CGM, which is pretty exciting. But no, I understand the sentiment that when you a large company buy something that they want to shelf it This isn't like big oil buying biofuel. Right now we're, we think we're gonna bring a lot better experienced to patients by combining the best of what companion has developed an impact with what we're endeavoring to do with things like Klue and neutrino and a lot of other personalization algorithms that be used in the closed loop side.   Stacey Simms  16:08 So let's talk about sensors. Let's just pivot right to that first, though, before we let this whole thing go within any timeline and integration with the guide. assume it's with the Guardian, CGM.   Sean Salmon  16:17 Yes, so initially, we'll have Guardian, but there's no we have three or four, five actually different generations of sensors coming and it's going to be compatible with everything we develop going forward as well.   Stacey Simms  16:30 Let's talk about Guardian Connect. This is the standalone CGM doesn't need to be paired with an insulin pump. Tell me a little bit about the reception of that, what the plan is for it. And you know, Who is it for?   Sean Salmon  16:41 Yes, so I think a standalone Guardian has been sort of an on ramp to be able to use an integrated CGM with our pump. But frankly, I think the experience that we've provided with that needs a lot of improvement. That's what we're endeavoring to fix with the pipeline. And there's two parts to that one is finger sticks, you know, to, to calibrate or to confirm before dosing as required finger sticks, and that's something that we are trying to remove in the next generation. And the other one is on just the, the ease of putting it on. And it takes a lot of overtaken steps to insert, and generates a lot of trash in the process. So all of that's problematic. And we're, we're moving to an integrated platform where the sensor, and the transmitter all in one, easy to apply three step, just press it on your body kind of approach. And in the interim, reducing or eliminating the need for finger sticks. That's what the near term pipelines about and then longer term, we can take the size of that down even further, we're already taking about 50% of the volume down from one move to next, we can get a lot smaller than that we have some really interesting technology that uses something called a wafer fabrication, which just means you can make very small electronics in a very highly repeatable way. So you take a lot of variation out. And then of course, you know, making sure that we're continuously improving the reliability and the wear life of these devices. There's a lot of technologies we have aimed at to to ensure that that happens. And simple things like we spend a lot of time money and effort developing patches is going to stay there, you know, the adhesive that won't interfere with the skin, but will stay there through very difficult conditions. And it took a lot of engineering, we actually did a lot of work in the fields in South Florida, just you know, high humid, very hot heat to make sure that we would have this he's up just right. So there's a lot going on in the CGM side of things. That's pretty intriguing.   Stacey Simms  18:40 I'm curious, and this is a very specific question. These future generations, any plan to go straight from a CGM sensor to a watch, that's something that just seems to be very difficult, you know, no phone involved in between? Nothing like that.   Sean Salmon  18:55 Yeah, no, it is difficult. And it's difficult for a lot of reasons, including power management of how that that Bluetooth connection is different than one to a phone. So I think as as watches evolve, and maybe that technology changes and the ability to kind of talk a lot of this on the kind of wearable side of things. It's not entirely just what can you do with your CGM, your algorithm said some, it is more complicated than you'd think, you know, hopping from phone to watch that takes the processing power and the connectivity that's already there. But think of it like a highway, right? There's like so many lanes have a highway that you can drive a car on. And if the watch is already tethered to one, one connection by Bluetooth to your phone, you've got fewer lanes available, other connections. So that's really, you know, it's I don't get too technical about it. But that's really the the near term challenge. But you know, I think there's strong interest in this. And as the wearables progress, I think we'll have the opportunity to to do things like that. But right now, it's just complicated.   Stacey Simms  19:56 All right, let's talk 770 g This was approved by the FDA in August, and it's down to kids as young as two, my understanding was for the approval. Now I'm this is gonna pardon my take on this. And this is for all of the pump companies. I wish you guys would call your pumps, something that told us more about it. I don't know if it's a medical device thing, and I have this problem with Omnipod and Tandem and everybody else. But you know, it's all numbers. So tell us a little bit about what's different from the 770 g to the 670. And then to the 780. Like, right, what's different about this pump?   Sean Salmon  20:33 Yeah, so the the biggest difference other than age education, which does, you know, it's still indicated for people over the age. I think there was some confusion at first said it's just for kids, and it's not Oh, kids. Yeah, so I, you know, I think that the biggest difference is really the inclusion of Bluetooth connectivity with this with this device. And that does a number of things. So first and foremost, it allows a person or a parent or caregiver to see the CGM pump date on a film. So we we've been lagging in that competency. Now that's available. It also allows the carelink system which is our management system glucose to automatically update so that you can do things like telehealth visits, right. Or if somebody's going to the doctor's office, rather than that, that kind of interruption to the workflow where the pump has to be connected and then downloaded, that really slows down that visit for for the person that's, you know, at the visit, it slows down the workflow for the health care providers. So the ability to take that connection and automatically upload it at your convenience without having to do anything, is what that connectivity brings to us as well. And then finally, it goes all the way to we can when software becomes available, make upgrades. Or if you have to patch something knows you know how to get out of your phone, where they'll have a new version to patch up something, you can just push that over the air. So we have that capability to upgrade future algorithms without having to connect anywhere.   Stacey Simms  21:59 So just to be clear, this is like what we do with the Tandem X2, you plug it into the computer, you get the latest download, it changes the software in the pump, and then you're off and running. Same thing, plug it in,   Sean Salmon  22:09 that was what one big difference, we'll plug into the computer, it goes over the air, just like you can update your unit up to your phone over the air today. If you changing your operating system, it's the same idea. You can do this without having to have a computer or having to plug cable in,   Stacey Simms  22:24 do you need a doctor's prescription for changes? Or is that a change by change? I would assume there might be?   Sean Salmon  22:30 Yeah, it depends on the change. So if you're talking about, you know, a security patch, you don't need a prescription for that, if you're talking about moving to the next algorithm, like the difference from 770 to 780 is really an algorithm change. It's the same hardware platform that would require a prescription.   Stacey Simms  22:45 So let's talk about the 780 which is the I assume this is the next thing in the pipeline and following the numbers.   Sean Salmon  22:52 Yes, so we we have released the adult data for the 780G, which at is about the algorithm now at the American Diabetes Association began this year virtually. And really, there's a couple of differences here. What this device does now is it takes the Ability Beyond just basal insulin, but also to bolus where you can the situation where there's rising glucose, the algorithm can bolus every five minutes to control. Somebody maybe missed a meal bolus, so they miscalculated how many carbs they ate, for example, and blood sugar still rising, we can predict where it's going to go both correct it without stacking up insulin. So what all that means is we can drive better time and range when there's there's missed boluses or miss calculations on carb counting. That's one big difference. The other big difference is the target that you set these two, so you can set a target, as you may know, on the 670 G, the target you can set is 120, we can still set a 120 target on this algorithm. But we can also set that target of 100. And the clinical results that we showed, were clear that you could take the target lower without increasing the risk of hypoglycemia. In fact, it was so numerically lower rate of hypoglycemia. So this, this algorithm, I think really gives a lot more freedom. And that's, I think the biggest thing that we were looking for all these are great, you know, time and range, we've been leading that the industry and being able to provide the best time and range, but the user experience got a lot better. And a lot of it had to do with alerts and alarms and all the things that we did. And I think To put it simply, there was a belief as the first hybrid closer algorithm out there, that whenever something goes awry, that you should kick somebody out of what was called auto mode and have them go confirm something with like a finger stick. Because I think the belief at the time was that you know, you can't trust his algorithms take care of somebody, and a person is better off better able to manage their diabetes than a machine. And I think that was probably a fallacy. As it turns out the algorithm that what we change here is we just aren't kicking people out. We are waking people up in the middle of night do things the algorithm pretty good at smoothing things out without causing any new troubles prevention. So a lot of that, I think out of abundance of caution safety alerts, kicking people out asking for fingerstick calibrations was unnecessary. And we're seeing a big reduction in all of that and very high satisfaction among the people in a clinical trial. And we've launched it in a limited way in Europe so far, and feedback has been really tremendous. This is a very big improvement of what we had been offering a couple   Stacey Simms  25:25 of just questions for clarity, Sean , the you're talking about the algorithm in the 780? Right, the 770?   Sean Salmon  25:32 Yes, that? No, that's 770 is basically the 670 algorithm. The big difference is really that indication of age, as well as the the ability to upgrade   Stacey Simms  25:44 software. If you want a pump right now that you can then upgrade when the new 780 algorithm is available. It's got to be the 770 you can't upgrade. Yes,   Sean Salmon  25:54 yes, you're correct. Okay.   Stacey Simms  25:56 Um, to that end, just again, just to clarify, are there other ranges you can set? Is it totally customizable down to 100? Or is it 120, or 100.   Sean Salmon  26:06 So you can choose, you can choose either target, but you can adjust other settings like the part ratio like insulin sensitivity factor. So there's some customization that can get there. And we ran, I think, three clinical trials. And we're currently doing what we call a continued access study in the US where we're trying to optimize those settings, to make sure that we can get the very best experience for people with the pump. And I think what we've learned is there's a lot of these other settings that we can give more help to the endocrinologists to be able to set those but right now, those settings are, are the endocrinologist job to go fix, we can give them suggestions. But the user themselves can't make those adjustments as easily.   Stacey Simms  26:46 Wait, I'm confused. The endo can make some changes, but the users can't.   Sean Salmon  26:50 Yeah, so there's certain things again, it's about making sure that people are safe, where we could recommend changes, or the algorithms can change things along the way. But there are certain settings like these carb ratios and everything else that need to be dialed in. Yeah, but   Stacey Simms  27:03 the user can do that. Right. I don't have to bring the pump to my endocrinologist and say, I Well,   Sean Salmon  27:07 they can, but they should they should make sure that you're talking to   Stacey Simms  27:11 Got it, yes, no, no with it with the guidance of an endocrinologist, but you're not going to make me get a prescription to change my carb ratio.   Sean Salmon  27:17 No, no, no, I think it's just that we can really fine tune the system. But rather than experimenting on yourself, I think we can give some help to know what are the optimal settings for you. And that's know something we call personalized closed loop is, we could do that automatically in the background without anybody talking to anybody. That's one of our future pipeline projects, we can also tell you from the history of your glucose and insulin data, how you can get a little bit better precision for somebody. And I think that's what we're trying to do on the carelink side of things. Here's the ability to really dial this in the right way. I think that for some endocrinologist, that's not going to be helpful, right? They're very, very good at this to do it all the time. And then there's others who don't really have large type one populations. And they could use a little bit of light called the teachers edition of the textbook, to help them make sure that they're doing the best for patients.   Stacey Simms  28:08 I think that sounds wonderful. I just think, you know, this podcast audience is a little bit different, or I shouldn't, it's a lot different. This is an incredibly well educated audience that is going to get a pump like this, and mess around with it themselves at home and see how much they can change it. In fact, as you know, part of this audience is going to physically try to probably break into the pump and see what they can do with it. So I know you can comment on that you don't have to comment on it. But that's why my hackles went up when you said the endocrinologist can, but I get what you're saying for the vast majority of people with diabetes, the endocrinologist or even their general practitioner, which is different story altogether, is really going to be the guiding hand here. Just another question you mentioned with the 780. The change from, you know waking people up kicking out of auto mode, fewer calibrations, is that really in the works in terms of fewer or no calibrations or that's a hope for a future sensor?   Sean Salmon  28:58 No, that's absolutely in the works for the sensors. So we we have a product in that's complete as clinical trial and other ones very close to doing that. That eliminates or vastly reduces fingerstick calibrations? And then yeah, so it depends on the regulatory claims that we make on that specific device. And then we have two others in the pipeline that absolutely eliminate finger sticks altogether. Now, that doesn't mean that you know, if you get a reading, it doesn't make sense to you that you shouldn't go confirm it, the glucose, the blood glucose, then calibrate No, no perfect sensor. But yeah, our algorithm itself that goes into 770 cuts down by about half the number of requests for finger sticks with the same sensor. And then when we change the sensor, we can, we can largely eliminate that unless there's something that needs to be confirmed, because the reading doesn't make sense.   Stacey Simms  29:53 So is the hope that the 780G would launch with, I hate to compare it to Dexcom but let's just go ahead and do that. Cuz that's what we're all talking about here anyway, obviously, most people who use a Dexcom understand that it's not infallible, you do have to double check, sometimes, you know, you'll get a sensor error when it doesn't understand what the you know what it's getting the information that it's taking in, it'll stop working, that kind of thing. So is the hope to launch the 780G system with a sensor that's comparable to what I just described.   Sean Salmon  30:20 So it's gonna depend on where you are in the world. But the 780 is going to be compatible with past and future sensors. So you know that they may be on different timelines. And we really try to think about this like it's a system to so we've got the pump, we've got the algorithm, we've got that sensor. And the other thing we have is the tubing set and reservoir. And there's another innovation we're bringing that allows you to extend the use of that on label of that tubing set from the typical two to three days. At the seven days. We call that the extended wear infusion said that's also known as clinical trial. And the goal is to have that also compatible then 780G algorithm. So the algorithm that's on that pump, which can have all that connectivity Vantage can work with this current and future pipeline of sensors, and be upgradeable on the infusion set is all sort of in a suite of what we're trying to bring together.   Stacey Simms  31:14 Well, Boy, am I glad you brought that up. Because I have said for years, and my son has been using an insulin pump for I don't know, 13 years now that the inset is the weak link of pumping. And I know, you know, a couple years ago, we were all excited about the BD flow was supposed to be this the latest and greatest, it didn't work out so well. So that went away. Can you tell us a little bit about what you found? When I hear longer? Where insets? I think, Oh, my gosh, you know, we've all been warned about infection and scarring and don't use the same site for that long. What are you finding?   Sean Salmon  31:47 No, it's a really good question. And you know, what is it that's so magical about it? How do you get to extend it? And without getting too much detail to the simple answer is that things that are in insulin to keep it from going bad, the preservatives, if you will, are behind a lot of that sort of site reactions that you get. So we're able to take that stuff out and have just filtered insulin if you will deliver to the site. And that's really the magic behind getting extension of abuse. And you know, we did a study where we, we measured this and about 80% of the study participants were able to get seven days your body is going to react a little differently being who you are. You see that with CGM, right? Some people can wear those things for two weeks, and other people can't. Because their body's more aggressive at attacking that foreign body response, just by comparison, for three days, which was our control arm 70% of people got to three days, right? So we've got a higher proportion of people able to make it seven days, we think it's largely due to getting out those preservatives that are the insulin to keep it fresh.   Stacey Simms  32:50 That's fascinating. It's simple as a filter. I've always thought that yeah,   Sean Salmon  32:54 it's not it's no, it's also your insulin is a very sensitive molecule too sensitive to temperatures, you know, and it's also sensitive to you know, how it's contained in the reservoir. So our rigid reservoir system doesn't like mechanically damage the molecule either. So that's, you know, an advantage that we've always had with our reservoir design, then you add to this, the ability to filter out the preservatives, and you get this extension to where so you can preserve a lot of insulin, use a little more judiciously, and of course produced it. You know, the difficulty of having to change your set every day. Maybe it's a fusion set Sunday, you change it once a week, and maybe same time of changing your your sensor as well. Who knows?   Stacey Simms  33:34 Well, I think that would be pretty amazing to have a longer wear inset. That works. Because a lot of people have trouble as you said, getting to three days. Yes. One of the big questions that came up in with my listeners when I told them I was talking to you, and we've covered most of them. But one of the big questions came up was Medicare, in terms of this technology is great. Will it be covered? Can you speak to that at all?   Sean Salmon  33:53 Which which part of Medicare you asked about? Are you asking about the Well, let's talk Yeah, more of a?   Stacey Simms  33:59 Well, I think the real question is everything. But let's talk about the the system. As you mentioned, you talked about it as a system, the 780 will the system be covered? Or will it be piecemeal?   Sean Salmon  34:09 Yeah. So the rules of Medicare are really around the designation of the sensor, can you make a claim of what's called non adjunctive, meaning that you know, you don't you don't have to confirm the CGM ruling before you dose insulin. So when you're 64 years old, and your pre medic quick care and you're on like a 670 g system today, your commercial insurance pays for the sensors, the tubing sets, the reservoirs, of course, did initial investment in the pump. When you turn 65 and you move to Medicare, you no longer can get the Guardian sensor paid for because we don't have that designation. For Non exempt. They've even though it's clearly driving the pump all day long every day. So we have to get that labeled claim for the sensors for everything to be covered. And that's what we're trying to do right now with the Guardian sensors and of course, the future pipelines. themselves. But like I think it's a, there's a couple different efforts on that. But it is a little bit of an idiosyncratic thing that that exists in Medicare itself, just the way the payment law works. And we're trying to get that changed,   Stacey Simms  35:14 has COVID, delayed studies, submissions, things like that for you, while   Sean Salmon  35:19 at the branch of the Food and Drug Administration that regulates diabetes face is also involved in a lot of things COVID related, including like the in vitro diagnostic testing, and that sort of stuff. So yes, I'd say on the medical reviewer side, in particular, there's been just a difficulty for them to service all the kind of pre market or new devices that are coming through while doing this difficult work of making sure that all the COVID tests and things related to that are done. So yeah, there's been something that has been a little bit challenging. And of course, in the clinical trial environment, we actually had a couple of trials going on during COVID. And some of them have gone pretty well. Honestly, I think people are stuck at home and not willing to participate the trial. It's not been like that. In other parts of Medtronic, we've got a lot of the hospital based studies have been very difficult and highly impacted by understandably, people's fear of going to a hospital for for anything right now is pretty high. So I'd say it's been a mix. Like we've had really good collaborative conversations with FDA making sure that we streamline and make it as simple as possible as we submit new dossiers. But there is really a constraint at that medical reviewer level that's been, you know, difficult for the entire industry.   Stacey Simms  36:35 You've been so generous with your time. I really appreciate it. I just have one more question for you here. And that's about tide pool, about a year ago, maybe more now, Medtronic and tide pool announced that they'd be working together on a, you know, a future interoperable, closed loop. And it would be a separate system from the seven at any update on that.   Sean Salmon  36:55 Yeah, we're worth continuing to work with tidepool. There's a joint steering committee that we participate in. Our goal here is to create a Ace designated pump that runs the tide pool algorithm. But yeah, that collaboration is ongoing. We're working well with them. But I don't really have an update on that.   Stacey Simms  37:13 Well, Sean , I really appreciate it. There's so much going on. Do you know to talk about and thanks for keeping us straight with the numbers and everything else. I hope you come back on and you know, continue to explain all of these developments. But I really appreciate it. Sean , thank you so much for spending so much time with me for sure.   Unknown Speaker  37:28 Thank you, Stacey.   Announcer  37:35 You're listening to Diabetes Connections with Stacey Simms.   Stacey Simms  37:41 We talked about a lot of stuff there. There is a lot more information as always over at Diabetes connections.com. You can learn more on the episode homepage about everything that Sean talked about. I'll link up some stuff to Medtronic into some other studies. I said a couple of weeks ago, there's something about September, October. It's like all summer long. Yeah, we have the ADA and we have the different conferences. But then every year at this time, I feel like oh, it's kind of slow, nothing's happening. And then I get all the tech companies in the fall. So I'm excited to continue to bring you as much information as I can. I have more interviews coming up. We just talked to Dexcom. I'll also be talking to Abbott. I'd love to get Omni pod that folks from Insulet back on here. So we'll we'll see what we can do. But in the weeks to come. definitely let me know if there's particular technology you want to hear more about. I love talking to these companies. It's always fun to get a kind of a peek under the hood. And I like hearing the voices and the stories of the people who are in charge of this stuff. I appreciate them coming on not everybody does you know that but it's great when they can answer your questions. And I love doing that. So let me know if you want to hear from and let me know what you want to know. All right innovations in just a moment with that once a week basal insulin that's being tested. We'll we'll talk about that. But first diabetes Connections is brought to you by Dexcom. And when you have a toddler diagnosed with type one, you hear rumblings for a long time about the teen years when it hit us full force a little early. I was so glad we had Dexcom you know Benny's insulin needs. I've shared this. They started going way up around age 11. And when I say way up, I know some of you parents out there with little ones think maybe we increased by point two or something like that, because I remember those days Benny's first basal rate was 0.025. That's how much basically got an hour. But by the time between ages 10 and 12, his basal rates doubled. And between 12 and 13, they doubled again. So along with the hormone swings, I really can't imagine managing diabetes during this crazy time. Without the Dexcom continuous glucose monitoring system. We can react more quickly to highs and lows. see trends adjust insulin doses with advice from our endocrinologist. I know using the Dexcom g six has helped improve Benny's A1C and overall health. And by the way, he's almost 16 and those insulin needs have already started going down. This is wild. If your glucose alerts and readings from the G six do not match symptoms or expectations. Use a blood glucose meter To make diabetes treatment decisions to learn more, just go to Diabetes connections.com and click on the Dexcom logo.   Innovations this week, a once weekly, basal insulin. This is something that was announced earlier this summer. I don't know about you, but it's snuck by me It was announced at the ADA Scientific Sessions, Novo Nordisk announced that a once weekly insulin Icodec had performed as well as Lantus in a 26 week trial. Now, this particular study was done with people with type two diabetes. But before you dismiss it, there has already been a trial of people with type one diabetes, and novo expects to submit and get this and hopefully FDA approved for people with type one and type two diabetes, I couldn't find a lot of information about the previous trial with type one, there is another one that completed over the summer, hopefully, they'll release the information on that maybe some of you who are more savvy in the ways of clinical trials can dig it up the Can you imagine once a week basal insulin, I mean, obviously, the benefits of that would be incredible. And also thinking about it for people who like to go untethered using basal insulin from an injection along with an insulin pump, which is something we did for two years. And even with control iq and you know, more advanced hybrid closed loops. Just talking to Medtronic about there's, I know a few people who like to use untethered with it, who find that there's just something about getting that always constant, steady, basal insulin smooths everything out. And certainly when you get into the enormous elephant doses that Benny was taking for a while, it helped tremendously to take that load off of the pump. I mean, between his weight loss and you come in at a puberty and I know he loves when I talk about this stuff, his insulin needs have come down incredibly, and certainly to the point where we didn't need to stay on untethered, but I think it's fantastic, it's a great option to have and once a week, basal insulin makes that a lot better. So I will keep you posted if I find out more about the type one trial, but is called insulin Icadec. If you have something for innovations, please let me know this can be a hack that you thought up a tip or trick something with technology or new influence. You can always email me Stacey at Diabetes connections.com. I mentioned Benny's 504 Review earlier in the show. And that happens later this week. He's also got an endo appointment this week. lots going on. I don't think the endo appointments going to be too exciting, hopefully. But you know, we do check in every quarter. And I think to mix it up, my husband is going to take him this time. Slade rarely goes to the endo usually because he's working in busy and and it's been on me for the last couple of years, which I love to do. I really like catching up with our endocrinologist who's become a friend. But I think I'll let the boys go. And gosh, you know, another reason not to go. I'm looking at making sure my door is closed. So Benny can't hear me. You know, the kid has this permit, and he's gonna be getting his driver's license if he passes in January. And I know Slade will let him drive to Charlotte, which is like a 40 minute drive. So he can do that. I don't need that stress of sitting in the front seat and putting the mom's seat belt right throwing my arm out, which I cannot believe I do. But I've done it with both of my kids. Oh, I remember my mother doing that clear as day. I don't even know if they're doing driving tests here. They haven't been. I know plenty of kids who got their licenses this year, because of COVID. They're not actually giving them a driving test. They're just saying, oh, did you do your hours? Alright, here's your license. And it's a graduated system here in North Carolina. So they can't get their afternoons they can't drive at night until they take an actual driving test. I don't mind goodness. All right. So let's keep you posted and updated on next week. We'll see how much he lets me share. Thank you so much to my editor John Bukenas from audio editing solutions. Thank you so much for listening. Don't forget if you want the free audio book, email me Stacey at Diabetes connections.com subject line audio book, and the first two will get that promo code. Thanks so much for listening. I'll see you back here next week. Until then, be kind to yourself.   Benny  44:03 Diabetes Connections is a production of Stacey Simms Media. All rights reserved. All wrongs avenged

There's new help for doctors who want to treat the person with diabetes and not feel overwhelmed with data. The people at DreaMed Diabetes are behind the brains of the Medtronic 780G system, but they're hoping to help thousands of people who may never use an insulin pump by making diabetes data a lot easier for doctors to use. This week, CEO and Founder Eran Atlas explains their Advisor Pro system to Stacey. Study in Nature Medicine about DreaMed Diabetes  Join the Diabetes Connections Facebook Group! In TMSG a big award for a doctor you all may know better as an Amazing Racer and I learn the word Soccerista. Read about Emerson in her own words here  In Innovations – women and diabetes tech design. Read the DiabetesMine Article here Sign up for our newsletter here 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 new book: The World's Worst Diabetes Mom! ----- 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 (beta transcription - computer only) Stacey Simms  0:00 Diabetes Connections is brought to you by One Drop created for people with diabetes by people who have diabetes by Gvoke. hypopen, the first premix autoinjector for very low blood sugar, and by Dexcom take control of your diabetes and live life to the fullest with Dexcom.   Announcer  0:23 This is Diabetes Connections with Stacey Simms.   Stacey Simms  0:28 This week, there is so much data when it comes to diabetes that even your doctor would like an easier way to interpret numbers and make dosing recommendations. A new first of its kind technology called DreaMed may help   Eran Atlas  0:43 with the use of your system. I can stop being a technician I can learn to being a mathematical or an engineer, I learned how to be a physician and I wanted to continue to go and practice medicine. I don't want to go and practice engineering.   Stacey Simms  0:55 That's DreaMed co founder and CEO Eran Atlas, talking about the reaction he's getting from people who use their system will explain what it's all about and how it could help in Tell me something good. A big award for a doctor you all may know better as an amazing racer, and I learned the word soccerista. innovations. Let's talk about women and diabetes tech design. 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 Diabetes Connections. I'm so glad to have you along. I'm your host, Stacey Simms, we aim to educate and inspire about type 1 diabetes by sharing stories of connection, as well as stories of technology. And that's what I'm talking about this week. And I went into this episode, I gotta tell you sort of thinking it would be one thing, because I know many of you are very familiar with the technology and these companies. DreaMed is behind the algorithm that's inside the Medtronic 780 G, which was just approved in the US. And we actually are talking to Medtronic and our very next episode about that many other things. But the agreement with Medtronic and DreaMed was it was done several years ago. And DreaMed while I'm sure very proud of that algorithm, they've moved forward, they moved on they want to talk about something else. It was very interesting for me to go through this interview, and I hope you enjoy it as well, for more of the mundane, less technology and more basic, how much more basic can you get with diabetes and insulin? I'll give a quick update at the very end of the show. I had mentioned in a previous show, we had some insurance changes, a bunch of you wants to know how that was going. Hey, yay, insurance changes are always fun. So I will talk more in detail about that at the end of the show. But in terms of insulin, yeah, we're switching types. Don't you love that? We had been on novolog for many years. And then when Benny was I want to say about eight or nine. We switched insurance and they switched us to human log and we have been on that ever since he's 15 and I guess it's time to go back to no vlog. So I'll talk more about that at the end of the show. Luckily, we don't have any issues or haven't had so far I know a lot of people do. Fingers crossed. So yeah, insurance update and more at the end of the show. All right. Interview with the CEO of DreaMed in just a moment. But first diabetes Connections is brought to you by One Drop. One Drop is diabetes management for the 21st century. One Drop was designed by people with diabetes for people with diabetes. One Drops glucose meter looks nothing like a medical device you've seen this. It is sleek, compact, seamlessly integrates with the award winning One Drop mobile app, sync all your other health apps to One Drop to keep track of the big picture and easily see health trends. And with a One Drop subscription, you get unlimited test strips and lancets delivered right to your door. Every One Drop plan also includes access to your own certified diabetes coach have questions but don't feel like waiting for your next doctor visit your personal coach is always there to help go to Diabetes connections.com and click on the One Drop logo to learn more. My guest this week is the co founder and CEO of DreaMed and is really company with the slogan we treat the data you treat the person Eran Atlas talked to me about everything from their partnership with Medtronic. As I said they develop the algorithm that's inside the newly approved 780 G to their newer technology. And this is all about helping doctors better interpret the data they're getting from CGM and pumps. He mentioned a brand new study on this, comparing their algorithm very favorably to outcomes from Yale and Barbara Davis diabetes centers. And I will link that up in the show notes at Diabetes connections.com. I learned a lot from this conversation. I really hope you enjoy it as well. Here's my talk with Eran Atlas of DreaMed. Eran, thank you so much for joining me. I'm excited to learn more about this. Thanks for coming on.   Eran Atlas  4:49 Thank you very much for having me.   Stacey Simms  4:50 All right. Tell me just generally, what is DreaMed What does this mean for the diabetes community?   Eran Atlas  4:56 Well, you know, for a certain amount of years A lot of effort has been invested on, let's get more accurate glucose measurements, let's get more continuous glucose measurements, let's get those glucose measurements and insulin measurements being connected. And everybody told us that if we will have more data, more accurate data, more accessible data, all the problems about managing people with diabetes will be solved, right, because the patient will be more knowledgeable, the providers will be more knowledgeable, will have the tools to get into a better decision. Now DreaMed started as a technology team within one of the biggest Institute's that treat people with diabetes, Type One Diabetes here in Israel. And what we saw there is that data is not all and and sometimes in order to make this analogy, these logic thinking between data and decisions, there is a lot of gap that you need to jump in order to make that move. You need to be experience, you need to know what is important, what's not important, and you need to be able to make the right decision in the right time for the right patient. So what dreamed is taking on is we would like to take the responsibility of allowing providers and patients to make better decisions about insulin dosing. When we started in 2007, the Holy Grail was okay, let's try to develop these automated insulin delivery algorithm that will make these decisions in real time. And we managed to do a prototype and we published these results as were the first publication in New England Journal of Medicine. And finally, after didn't several clinical trials send people home, we were the first group in the world that sent people home with automated insulin delivery, we licensed that to Medtronic diabetes. But the cohort of people that are going to be using are currently being using automated insulin deliveries pretty small depend on the amount of people with diabetes type one type two that needs to make decisions about insulin. So what dreamed is now focusing is on developing those and commercializing those algorithms that will be able to take all the vast amount of data that's out there, and it can be accessible from cloud to cloud, mobile and everything. And how do we get into the most accurate, personalized decision about how much insulin a specific person with diabetes need to infuse? Not just in terms of real time, but more about looking on the treatment plan? How to optimize carb ratios? How to optimize basal treatment, how to optimize insulin sensitivity factor? What is the difference between a patient on an insulin pump to a patient that is using multiple daily injections based on only different kinds of types of injection regimen? That's what DreaMed right now to do. So we would like to make sure that we will treat the data. So a person with diabetes can continue to live in a provider can start dealing with the person that is in front of them and not just looking into the computer, making himself a technician with numbers and decide what to do.   Stacey Simms  8:04 you have heard the podcast. So you know, I'm easily overwhelmed by data and information. I listened to everything you said. And here and I'm trying and here's what I heard. We want to make life easier for you. There's too much information that comes your way even with accurate CGM. Even with automated insulin delivery, there's so much data and information that unless you are a numbers person, you know, you may not be able to crunch it yourself. And I know you, you mentioned already a lot more down the road. But if I could focus on that the automated insulin for just a moment and come back to some of the other things. Can you just tell me as I'm listening and please correct me if I'm wrong, Vinnie, my son is using control IQ with the algorithm that's inside the Tandem pump using partnering with Dexcom. Is this sort of that? Is that the first step that you're talking about when you talked about automated insulin? Is it the algorithm that controls the pump in the CGM together?   Eran Atlas  8:56 Correct. We started in 2007. Building such an algorithm at the time we called him the medical doctor, the MD logic artificial pancreas. And the idea of what is different between the algorithm that we developed back then and the one that you have right now in control IQ, is how do you make these real time decision about how much insulin to infuse and, and while control IQ, as you may know, is using MPC technique, a Model Predictive Control, and you have that model of Medtronic that uses a different kind of type of control. It's coming from the engineering world, we were strong in understanding how physician analyze data and what we did is we took a technology called fuzzy logic, and I thought you know what fuzzy logic is but I'm sure you have it in your washing machine, and you have it in trains in China and everything. And the idea behind fuzzy logic is that you know why the world is not one and zero black and why there has to be a mathematical way to make decisions based on gray areas. And it's pretty much the way that we're thinking as a person. So, we took his the way that physicians analyze data, make a decision and automated using dispatches fuzzy logic. And we develop these automated insulin delivery algorithm. And we tested it and when he got the the ability to communicate with Medtronic pumps, and now, we have our some part of our algorithm is going is inside the Medtronic 780G that they announced that they got to see mark for that in June DC or in there, I'm sure that they're going after that the FDA, the main difference between what we did and what happened in control IQ and Medtronic 670 G, is the fact that we were the first that play with the changing automatically both the basal and bolus. And we have the ability to predict glucose into the future and dose insulin based on the predicted glucose. Some of the elements that we have, you have also in control IQ. And I noticed Ctrl Q is working pretty well. But one of the things that we had in that time is the understanding that there's a lot of sensitivities off the patient that these AI D algorithm will need to use. So for example, when you are using your control IQ, you still need to go through your meals, right? So you need to optimize your carb ratios. And some of the safety limits are still dependent upon the insulin sensitivity factor off the pump or the open loop basal rate of the pump. So the algorithm is like riding on that basal rate. So we had a similar methodology. And we developed these what we call today, the DreaMed Advisor. It's that algorithm that optimize the sensitivity factors. So I back into the time we have two pieces of our technology. We only licensed one of it to Medtronic. And we continue to develop the other one because we believe that the other one will have a much more larger number of people with diabetes.   Stacey Simms  12:01 So tell me about that other one, where will it be used? Or you're talking about people with type two or people who use insulin, any type?   Eran Atlas  12:08 So that's an interesting question. So we just we started with an algorithm that basically optimize open loop pump therapy, and we took data from CGM at the beginning. And history of pump delivery basically did an automated way what any physician is doing in the clinic right now. And we developed that technology we got we won a grant from Helmsley Charitable Trust back then in 2015. I out of 70 applicant applicants got $3.5 million to evaluate the performance of this algorithm versus doctors from Joslin Diabetes Center, the School of Medicine yell, Barbara Davis in Colorado University of Florida, within three sites in Europe, with the intention to show that if you are a physician, any kind of type of physician that uses all algorithm, you'll get into the same clinical outcome as if that patient data was analyzed by doctors from these leading academic diabetes centers. And yesterday, the results of the study were published in Nature medicine, showing that we are doing the same outcome. As expert Doc's. If you can think about it, 60% of the cohort, we type 1 diabetes, the adults one are being treated by primary cares where we can do to the to the glucose control of these patients, if we will equip those primary cares with a technology that helps them analyze data and get the same performance as special endocrinologist, what we can do to the touchpoint of changing the insulin treatment of a patient, if instead of the patient will need to wait 3, 4, 6, 8 months to see his endo will have some sort of virtual place that he can send the data and share the data with the algorithm the algorithm will make all the calculation and recommend how to change the insulin dosage or the insulin treatment plan of that patient. So that was the what we did so far. And when we approach FDA, we that FDA didn't know how to regulate such a device. Yeah, because there was no predicate to what we offer to FDA to do. So what we managed to do with a very strong partnership with the FDA team is to decide and we will regulate this device as a new product. So in 2018, we got FDA clearance based on 510 k de novo. So we are the first in the US system that regulated a product that an algorithm can take continuous glucose sensor data and make recommendations to our healthcare providers how to optimize insulin treatment for our patients.   Stacey Simms  14:44 So I'm trying to break it down because that does sound like such a useful tool. I'm an adult with type one, I'm seeing a general practitioner who may not know the nuances of treatment, they take my CGM data, they take my dosing data either I'm assuming either from a pump or from me They send it to your service, the care provider, the doctor then gets the data back and can give the patient advice based on your technology using the expertise and you know, from the algorithm. And that new study said that advice is comparable to Yale and Barbara Davis and all the places that you indicated. Did I get that right?   Unknown Speaker  15:21 Exactly.   Stacey Simms  15:28 Right back to Eran in just a moment. And he's going to be explaining their agreements with other diabetes groups like Glooko, like Tidepool, but first diabetes Connections is brought to you by Dexcom. And do you know about Dexcom clarity, it's their diabetes management software. And for a long time, I just thought it was something our endo used, you can use it on both a desktop or as an app on your phone. It's an easy way to keep track of the big picture. I try to check it about once a week, it really helps Benny and me dial back and see longer term trends, and help us not to overreact to what happened for just one day or even just one hour. The overlay reports help add context to Benny's glucose levels and patterns. You can even share the reports with your care team, which makes appointments a lot more productive. managing diabetes is not easy, but I feel like we have one of the very best CGM systems working for us Find out more at Diabetes connections.com and click on the Dexcom logo. Now back to my interview with Eran Atlas   Eran Atlas  16:27 And the way that it has been flowing in so we sign a data partnership with gluco. With Dexcom, we take all we have our own platform, so the patient can download the data at home, he doesn't have to get physically to see the provider, which is super important, especially now when it COVID-19 is and then the data is coming to our system, all the provider needs to do is just push a button request the recommendation here we'll get that recommendation and nothing's going to get you know, blurred the things you know, please consider looking on. He will get exact numbers that the algorithm will tell them listen at 6am change the call ratio, that specific patient from one to 15 to one to 10 exact numbers.   Stacey Simms  17:11 All right, I have two questions. From a very practical point of view. I'm curious if you've run into a provider who says I can do this better? I don't need this. Sure. I don't know the difference between Lantus and Tresiba. I'm a general practitioner. But why do I need something like this? Have you run into resistance from providers? Or are they I could see the flip side, thank goodness for taking this off my hands because I don't have the time to learn all of this.   Eran Atlas  17:37 So there are two types of providers. So first of all, that the approval that we have right now the clearance that we have with FDA is just for type one people on insulin pump, we are pursuing the advance of the indication for use for the injection cohort and with the intention to submit it by the end of the year. But in the study that we did, and right now we are we already deployed the system in several clinics around the US. You know, we are in Stanford University, University of Florida, New York University, Texas Children's so that we are already people who have already more than 1000 people that use the technology. And so when we heard for them, these couple of things. So number one, it became they curious, they want to check, we want to make sure that we didn't make any false recommendations. And they're not agreeing 100% with anything that we are recommending. So we always allow them to edit. If there's anything that they would like to edit, they can edit it before they share it with a patient. But as time goes on, and they building their confidence with a system, they are relying on the system, and they're really feeling how they've helped them. So for example, Dr. Greg Forlenza from Barbara Davis said, you know, what would you use of your system, I can stop being a technician, I can learn to be a mathematical or an engineer, I learned how to be a physician. And I wanted to continue to go and practice medicine, I don't want to go and practice engineering. So this is one of the feedbacks. And I think that when we'll code to the mass numbers of providers, there will be different kind of providers, some of them will be resistance, but I think that one thing we'll see the clinical benefit and the response of their patients, I think that it will endorse that and it will build our confidence with it.   Stacey Simms  19:17 I love that that he doesn't want to be an engineer, he wants to be a physician. We should all be so lucky to have a doctor who wants to do that. My other question on this and I'm apologizing just throw things at you to mess up the system. But the first thing I thought of was somebody like my son who's a not an unbiased person, but he's a great kid. He is not a perfect diabetes person. Perfect example that I think would mess up your algorithm. This morning. He had I don't even know coffee, hot chocolate glass of juice. I don't know what he had. But he had something as he's going to virtual school to. He's he's right down the hall for me so I could go ask him, but I can see that his blood sugar has already gone up to 140 it'll drift back down thanks to control IQ. I don't know if he bolus for that drink. If or If people just after, what is the algorithm do when people aren't, quote, perfect diabetics, because you can adjust the carb ratio and the basal rate all you want, but most people with type one aren't automatons who are going to fit an algorithm?   Eran Atlas  20:14 Oh, that's an excellent question. I think that at the end, if you are creating something for the use of people, you have to understand that nobody's perfect. And you have to make sure that the recommendation that you are providing will be a right on the spot, because otherwise it will cause safety issues. So what we are doing, when we're taking the data, number one that we are doing, we are trying to split that data into events, and understand, okay, that's a meal event, that's a bonus event, that is events that usually debatable could make an influence because there's no BOCES a meal. Before afterwards, we also apply different kinds of techniques to automatically detect places where the patient ate, and the bowls for that, or didn't report the name use these calculator in order to calculate the amount of light and and then for each one of the events, we are trying to ask the algorithm is asking himself Okay, is it a issue of dosing problem? Or is it an issue of behavioral problem? Do we see the high glucose posted meal because the carb ratio is wrong, or because the patient just deliveries, bolus 1520 minutes after the meal, and there's no way that the glucose could be down? So we are from our experience, because we are so much integrated with doctors that understand data. And because you know, I'm here, ces 2007 is closing my 14th. year on February, we know so much about people with diabetes, how they behave. So we programmed the algorithm in that way. So the recommendation that we are delivering is on the spot. If we're saying that we don't have enough events that imply on changing and dozing will not issue that we can personalize even the behavioral messages and calculate what is the most important behavioral that will improve the timing range. And we're not issuing 20 types of behavioral messages. Learn to be have a message note, we're issuing no more than three. And we're very specific. So if we're seeing something that happened specifically on the breakfast of Benny world, tell him listen, Benny, please pay attention on breakfast, deliver the insulin, 10 minutes before the meal, because that's what's set what makes your entire day being hot. Or if we're seeing that when he has an iPhone, you just eat whatever he finds in the refrigerator. And we see it from from the dynamics, we're trying to teach him how to compensate for a high pole in a better way.   Stacey Simms  22:46 It's absolutely fascinating. I think that's tremendous that you're building in the behavior as well. And you can really account for it back to the automated systems. And forgive me, Eran, you used a term open loop rather than closed loop and pardon my ignorance, you explain what that is?   Eran Atlas  23:02 Sure. So open loop is what we call using pump therapy with CGM or with self management blood glucose meters without any ID system. So though some people call it sensor augmented pump therapy, some people say just a regular insulin pump therapy. Some people say it's open loop, there is no algorithm that closed the loop in real time and command in real time how much insulin to infuse on an insulin pump based on CGM data.   Stacey Simms  23:33 Okay, if we go back to the algorithm that is more closed loop and kind of looking ahead for what you're planning on that we've already talked about mealtime, boluses, and how challenging they are for people, whether it's estimating correctly or remembering to do them or doing them late. What's your plan for that? I know there were a few AI systems that are looking to try to do away with a manual mealtime bolus is that in the cards here.   Eran Atlas  23:56 So for us is not on the cards at a moment. I think that what we are trying to look is is beyond the AIP system. It is how to help those with type two on insulin, how to have those on injections because think about it a couple of years ago, nobody knew what's going on with people that still doing injections, right? None of them knew CGM you didn't know what's going on with injections because they didn't record that or they just cheating and when they sat in, in the reception area of the clinic, they to complete the paper and and try to make lottery on when they did at those doors. They're instantly now these days been available thanks to the hard work that Dexcom you know avid Medtronic is doing on the CGM space and companies like companion medical and others they're doing you're connected to and and we know other efforts of other companies. You know, no voice is doing that Louie's doing that. So all of a sudden the same problem that we had a couple of years ago when people on CGM and pumps for the type one persons and depression And the amount of data, we're not going to have it in a much, much broader population, you have about 12 million people that dose insulin in the US, but only 1 million of them are on pumps with type one. So the question is, what are you going to do with these 11 million people? And that's where our focus on that's number one, another focus that we are looking at is going into contextual data? And how can we know and combine the fact that we can know where you are from your personal life in terms of you know, if you are driving or you are walking, or you are going into a restaurant? And how to combine that information with the glucose data? And what predictive real time notification we can give you in order to improve that, and the glucose control?   Stacey Simms  25:49 Alright, wait, wait, you're gonna know where I'm driving? I'm walking to a restaurant. Wait a minute back up? Are you in my this is something in my phone? Are you using cell data?   Eran Atlas  25:58 That's easy. You know, when you're driving? Do you have a Bluetooth in the car? Yes. So the phone knows that you are connected to the Bluetooth of the car, right? Yes. So for example, if you will give the permission, our application will be have the knowledge that you are driving? Are you using navigation software?   Stacey Simms  26:17 Yes. Do you have to lift or no, I don't mean to interrupt your train of thought here. But for some reason, I just thought of the Pokemon Go app from a couple of years ago, because it knew when my kids were in the car and not walking, right. I mean, I know I sent you're probably laughing because I sound so ignorant with this stuff. But yeah, with our cell phones, I'm sure that everybody knows where we are at all times. It's   Eran Atlas  26:37 amazing. That's right. But I think again, so I'm not talking about you know, poking your privacy and everything. And it's have to be on a certain things that that the user will need to authorize, or the benefit of the user, but but potentially, many will learn driving, like they will go into any driving license, I'm sure that nobody wants a person with diabetes, that these glucose is going down or predicted to be down in next 30 minutes to start driving.   Stacey Simms  27:05 So would it give in your system, would it then give a reminder, um, you know, I'm walking into a restaurant time to bolus Is that what you're envisioning.   Eran Atlas  27:13 So again, your glucose is dropping in the next 30 minutes it please take something before you start to drive. Or we're seeing that you're going into a restaurant and you're using glucose is sky high, or going high and the high trend, please correct your glucose now before start eating, because then it will be much more difficult to correct your glucose. These are the types of things that you know are examples of how you take context and combine it together with glucose and insulin data.   Stacey Simms  27:41 It's so interesting to me, because I think, especially with the type two community who use insulin, it's a very different world than the type one community where most people well, I'm biased, because my podcast audience is so well educated. But people are thinking about it so much more often. I have lots of friends with type two, who dose insulin who don't really think about it, who don't really know, just because they're, as you said, they're seeing a general practitioner, they're not as educated. It's not a it's not a personality flaw. And I could see where this would be so helpful. Just these reminders with people with type two, have you already learned any nuances of how they want to use this kind of system? Is it different than people with type one?   Eran Atlas  28:22 So I think that within the type two population is very much dependent when there are on multiple daily injection therapy, or they're just doing basic only. So that's one big difference between type two and type one another big difference is Yeah, like you said, they're thinking about the condition differently. They are denying the fact they have a condition. I think that's much stronger than people with type one, especially teenagers with type one that you know, try to break the system and try to see what's going on. But it's still you need to find other ways to do that. And we're still studying eighth, what is the best way to deliver that to people that have type two diabetes. And that's why initially we're focusing on their providers, and try to better understand what people that are treating people with type one diabetes would like to see how we can help the providers provide a better treatment for them. That will be our first step, then when we will get these endorsement and understanding about the actual users will be much more comfortable to offer something that will go directly to the user because as you said it truly it's a different population. I remember   Stacey Simms  29:31 years ago, there was a big push and I know you were you were around. If you started in the mid 2000s, there was this big push to almost gamify type 1 diabetes, right with apps that kind of gave you rewards for checking or here's a game that would help kids learn or even adults. And it turns out that most people didn't want to think that much about it. They just wanted the system to take care of it like stop reminding me to log stop reminding me to dose handle it. Talk to me about how DreaMed will do that. Even though You are talking about reminders,   Eran Atlas  30:02 because I think that the difference between the reminders that are in the market, they used to be in the market. And what I'm trying to talk about is that those reminders were based on general timeframe. So for example, you know, you're logging into the app that you need to take your basal insulin between seven and 9am. And and now it doesn't matter if you are going just to go into deliver that it will be some sort of mechanism to just ping that, that reminder to you and will drive your crazy, right? I think that what dreamin is trying to do is a couple of things. Number one, we're not just giving them regular reminders, we're giving actionable reminders, so it will tell you to do something, because this is the right time for you to do these actions. And number two, we are trying to take off the burden of treating diabetes, you know, taking the burden off thinking about your glucose and thinking about what you need to do right now, for people that use a ID system. This is exactly what he gave them, you know, you know that there is something that looks on your glucose on a regular basis every five minutes, analyze the situation and provide your the actual dozy, but on people with with multiple daily injections are not using pumps. So there is the only way to make the insulin injected is to make some sort of a partnership with a user. So that's what we're trying to do. We're trying to create all the mechanisms that will bring this partnership between the person with diabetes on injections and the algorithms, we're trying to make sure that wherever we are issuing some sort of reminder, it will be an actionable one. And and hopefully it will be within a certain timeframe that the user is willing to accept such a reminder, because for example, if you're driving and then the system is shouting out, give insulin right now there's no way that you're going to give that insulin right because right now you're driving. But if we're able to capture the exact moment that you're open to get that reminder, and this international reminder, it's not a general one, I hope that people with diabetes will find it useful. And I think that's the thing that we are trying to learn together with the community. And to be are we personally diabetes at work for us, because at the end, it's a partnership between the person, the provider and the industry. And that's what we're trying to create. It's important for people to know that there are companies that are not in the US and might be a little bit small, but they are trying to make a difference for you. And I hope that together with what we're trying to do and what the community is trying to do, when we are partnership, we really, really be able to make that difference. Because the culture of dream ed is coming from a clinic. It's a company that the importance of making lives better is on our culture. Another thing in our countries, make sure that whatever we're issuing has a clinical benefit. We're just not not just want to have a cool product and just get more money. And I really, really optimistic about the impact that we can do on people with diabetes. And we're committed to do that   Stacey Simms  33:14 around before I let you go. Do you mind if I ask about the population with type one in Israel? Sure. I'm trying to think I know in Scandinavian countries, it's very high.   Eran Atlas  33:23 it's debatable, but it's between 30 to 50 k people in type 1 diabetes in Israel, this is it. But we don't have a lot of people with type 1 diabetes. If you're looking on the pieds all the peas are being treated by you know, academic centers, big hospital clinics, the clinic that I'm coming from, is pretty much treating a very large portion of this of the kids and adults are usually go in the same way either to a specialist, but the most of them are going into two primary cares. Where were very techie we were had a lot of a lot of people on CGM and insulin pump. We currently don't have control IQ and ease rail. It's not approved so and 670 G is not reimbursed so the majority of the cohort here in Israel are on regular pump and CGM.   Stacey Simms  34:11 This is well as I said, before we started taping, my son is planning a long trip to Israel next summer. So maybe knocking at your door if you're just some hand holding.   Eran Atlas  34:22 I will be happy to I will be happy. Don't worry. Yeah, I think I can vouch for that.   Stacey Simms  34:29 Everyone, thank you so much for joining me in explaining all this. I really appreciate it. I hope we can talk again soon.   Announcer  34:39 You're listening to Diabetes Connections with Stacey Simms.   Stacey Simms  34:45 More information in the show notes Just go to Diabetes connections.com. And every show has show notes we call them I call it an episode homepage as well because not every podcast player supports the amount of stuff I put There, every episode this year has a transcript. Every episode ever has links. And so sometimes if you go to Apple podcasts or if you listen on, you know, Stitcher or Pandora, or wherever you listen, and we are everywhere, right now, they don't support the links. So if you're ever curious, or you can't get to something, just go to the homepage and find the episode, there's a very robust search, because we're up to 325 episodes. So I wanted to make it easy for you to find what you were looking for. But when you do that, you can find more information about DreaMed, and I linked up the study as well that he mentioned, comparing their algorithm to doctors at Yale, that sort of thing. You know, I'm curious, as you listen, what you think about something like this, I feel like this podcast audience is so involved in their numbers in a way that most people in diabetes land are not. I mean, let's face it, there's very few people who are interested in DIY stuff like this audiences. I mean, I know you guys, you're very technical, you're very involved, even if you're listening, saying, hey, that's not me, the very fact that you're listening to a podcast about diabetes puts you in a different educational plane, then, you know, 90 95%, let's say, of all people with all types of diabetes, which is not a knock on them, it's just the reality of diabetes and education. So I'm really curious to see how this can help. Because as he's saying, you have a general practitioner, who's treating people who's dosing insulin, right, they're given the prescriptions out. And an algorithm like this can make it so much more precise and safe for the people who are getting those recommendations from these doctors who, you know, might really want to do good, but do not have the experience of the education in at a chronology. So that's my stance on it. We'll see what happens I'd love to know what you think. All right, innovations coming up in just a moment. And I want to share this article I found about women in diabetes a device design, but first diabetes Connections is brought to you by a new sponsor this week. I am so excited to welcome g Volk hypo pen. You know, 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 evoke hypo pen comes in Jeeva is the first auto injector to treat very low blood sugar. evoke hypo pen is pre mixed 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 five seconds. That's it, find out more go to Diabetes connections.com and click on the G Vogue logo. g Vogue shouldn't be used in patients with pheochromocytoma or insulinoma, visit Jeeva glucagon.com slash risk.   saw a great article that I wanted to pass along to you from the wonderful folks at diabetes mine. And the headline on this is where are the women in diabetes device design? And I'm not going to read the whole thing to you I will link it up. But the question here was all about our the shortcomings of diabetes technology a result of just the the functional design requirements the way it has to be made? Or could it be related to the fact that there aren't enough women in the medical technology design field, they did a whole survey about you know wearing this stuff, and you know where to attach it, how to put it, you know, dresses, things like that, which you know, at first, listen may sound kind of silly. But when you think about it, wearing the device, the comfort of wearing the device, the mental stress about wearing the device, these are so incredibly important, because people with diabetes men and women, as you know where this stuff 24 seven, I mean, you think about the difference between something that is clunky, that looks outdated, that, you know, just doesn't feel right in your hand. I mean, these things make a big difference in terms of how I hate to use the word compliant, right, but you know, how well we use them how much we use them how comfortable we are with them, in addition to focusing on the pump companies, and in particular Omni pod, very, very interesting take on women who work at Omnipod there, they also focus on women designed accessories for diabetes tech, because when you think about it, and they list all of these companies, you know, we've talked about a bunch of them in the past myabetic and funky pumpers spy belt tally gear pump peels, one of my book to clinic sponsors, thank you very much pump peels, these are all founded by women, because they saw the need and wanted to make life easier and better. So I'll link that up. I really thought it was a great look at a topic that we hadn't thought a lot about before. We focus a lot on what patients need to be involved people with diabetes who actually wear the gear need to be involved. But what about people who wear the gear differently and have different expectations and that by that I mean women. My daughter when she was in high school, wrote a whole paper on pocket equality and did hard research into why women's clothing doesn't have pockets and rarely has pockets that are big enough. I mean, my son puts his phone and his palm I don't know, you know, a lunchbox in his pocket, and he can fit everything in there. He doesn't think twice about it. But sometimes I think about where the heck would I put a pump, if I was wearing what I'm wearing today, right, I have any pockets. Really interesting discussion and hats off to diabetes mine for focusing on that innovations is also your chance to share hacks and tips and tricks that work for you, you know, just little things that make life better with diabetes. So you can post in the Facebook group, or you can email me, Stacey at Diabetes connections.com.   Didn't tell me something good this week, a big award for a familiar face around here. Most of you remember Dr. Nat Strand from The Amazing Race. She was the in the team of Nat and cat. And that was The Amazing Race 17, which I can't believe was 10 years ago. We talked to Dr. strand, earlier this year about working as a physician. And during this time of COVID. And how she was treating her patients. She treats patients with chronic pain and that sort of thing. And we're talking about her on tell me something good, because she is the inaugural winner of the Lisa Stern's legacy Diversity Award from the American Society of pain and neuroscience. So congratulations, Dr. strand. Of course, the ceremony was virtual, but you could follow her on Twitter and see the pictures and see what nice things people are saying about her and I will link up her Twitter account if you don't follow her already. Also, in Tell me something good. Something that popped up in my local group. Brian shared a post about his daughter Emerson about diabetes and soccer. And he said I could share it. And it's actually a story about her. It's a story by her. It is Emerson's sucker rista story playing with diabetes. And this is a column that Emerson wrote that is published on the girls soccer network, I would really urge you to read it especially if you have a child who is a high performing or wants to be a high performing or elite athlete. She talks about no days off. And how well you know I'm sure your mind went to diabetes. That was her mantra in terms of sports. And it has really helped her she says deal with soccer. And with diabetes. I'm not going to read her words here. I just think it's a great column I would urge you to read it I'll link it up on the episode homepage and I'm going to put it in the Diabetes Connections Facebook group as well. Well done Emerson really great to see the incredible hard work that it looks like you've been putting in and what a wonderful column as well. So thank you so much Brian for sharing that and for letting me talk about it a little bit here. If you have a Tell me something good story could be a birthday a diverse serie, you know, your child has published in a national print publication, you know, anything you want to focus on, that is good news in the diabetes community, please reach out and let me know, just tell me something good.   Tell me something annoying, could be the name of this segment, I just want to talk a little bit about our insurance changes, mostly to commiserate with with many who have gone through this. So as I said at the top of the show, our biggest change is now that they're going to switch insulin on us. You know, I talked to Benny about this, we are so fortunate to have a frankly, have a pretty good stockpile of insulin that we've built up. If you follow the show for a long time, you know that I've discussed his insulin needs went way up. And they have gone back down to almost pre puberty levels. But we never changed the prescription. So you know, I have unfortunately or fortunately, I don't know I have shared insulin in the Charlotte area with adults in need. We have some great local groups. And it is ridiculous that we need to do this, but we do share with each other. And I've been happy to help out on that. But we are basically out of pins. And I like to use pins as a backup. And Benny likes to have them for flexibility. You know, he'll take them sometimes. And if something's wonky with his pump, he knows he can get himself a shot, that sort of thing. But I hate the idea of changing insulins right everything's cookin right now everything's chugging along really well. I don't want to rock the boat. But I also don't want to pay $300 for a pen. So I'm going to be talking to our endocrinologist, Vinny has an appointment in two weeks, as I'm taping probably more like a week and a half as you listen. And we know we'll talk about it, then maybe have some samples, but most likely we will be switching and we did not have an issue when we switched in the past. So I have fingers crossed that it will be fine. It'll be fine. But that is annoying. And I know I don't feel like appealing and fighting if we don't need to. It's possible that novolog will work just as well for him. So let's at least find out and we'll go from there. The other issue was, of course, that we are now dealing with edgepark. And I will spare you all of the details. But I tried to do a workaround. And I'm laughing because I should know better by now. I tried to get the Dexcom prescription to stay at our pharmacy because man we've been filling it at the pharmacy for the last couple of years. And if you have already been able to do that, you know, it's like a dream. At least it is for us. It may take an extra day to get it but it's a day. It's not like they're mailing it out for you and it takes three weeks. It's been wonderful. And I just had on auto refill. And it's been great. But edgepark told me, we don't filter your pharmacy, you only can do it mail order. Well, I didn't want to wait. I didn't want to be cut short. So I let edgepark go ahead and fill the order. But then I did some detective work. And I kept calling and talking to people, because what else do I have to do, but be on the phone with these people? And I finally got someone at my insurance company to admit they would fill it at the pharmacy. But here's what she said. She said, Well, we don't like you to go to the pharmacy, because they don't often have it in stock. And I said, Come on, you know, that's not true. They can fill it in a day. They've been filling it for four years. And she said, Okay, well, you can you do a pharmacy benefit and, you know, blah, blah, blah. So I hung up the phone, and I will fill it at the pharmacy next time. I already have the order from edgepark through the mail. And I thought you know, that's just because my insurance company has a deal with edgepark. That's all that is. She's trying to discourage me from going to the pharmacy because that's their business. I get it. But how stupid is that? How outrageous is that? Oh, now you know why I saved it to the end of the show. I will keep you posted on our many adventures as this moves forward. Because Up next, I have to fill Benny's tandem pump supplies. And we've never been able to do that at the pharmacy. So I'm sure it'll be more adventures with edgepark my new pals. Ah, goodness gracious. All right. Thank you to my editor john Kenneth for audio editing solutions. Thank you. If you are still here, listening to me rant. I love you. Thank you so much for listening. I'm Stacey Simms. I'll see you back here next week. Until then, be kind to yourself.   Benny  46:35 Diabetes Connections is a production of Stacey Simms Media. All rights reserved. All rounds avenged   Transcribed by https://otter.ai

Jeanne Martin was diagnosed with type 1 diabetes at age ten, in the 1950s. Technology was very different back then, of course, but so was the medical community's reaction. Jeanne was told she would never have children and if she did, she wouldn't live to see her children grow up. Today, Jeanne not only has a daughter, she's also a grandmother. She shares what she’s learned along the way. We also talk to Jeanne's daughter Jessica, who talks about growing up with a parent who has type 1. In Innovations, find out why when it comes to keeping track of long and short acting insulin, a CDE says invest in rubber bands. This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. ---- Other episodes with amazing people living long and happy lives with T1D: Richard Vaughn was diagnosed in 1945 Judith Ball was diagnosed in 1941 ---- Check out Stacey's new 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 One Drop created for people with diabetes by people who have diabetes. By Real Good Foods real food you feel good about eating and by Dexcom take control of your diabetes and live life to the fullest with Dexcom.   Announcer  0:24 This is Diabetes Connections with Stacey Simms.   Stacey Simms  0:30 This week, Jeanne Martin was diagnosed with type one at age 10. Back in 1955. She's had to fight a lot of doctors along the way, including one who told her she would not live to see her child grow up.   Jeanne Martin  0:45 And my reaction was I told my husband that guy can go walk up the street and get hit by a bus tomorrow. I'm not going to go along with that. That's was my reaction. I got mad. I didn't buy into it. I didn't get depressed because I Just thought he was full of baloney.   Stacey Simms  1:00 Jeanne was right. She's now a grandmother. And she shares what she's learned along the way that made her question and stand up to doctors like that. We're also joined by her daughter, Jessica, who shares with like growing up with a parent who has type one in innovations this week why a diabetes educator says invest in rubber bands. 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 Diabetes Connections. I am so glad to have you here I am your host, Stacey Simms, and we aim to educate and inspire about type one diabetes by sharing stories of connection. My son was diagnosed with type one right before he turned two that was back in 2006. My husband lives with type two diabetes. I don't have diabetes. I have a background in broadcasting and that is how you get this show. I spent 20 plus years and local television and radio news. I've been doing this show for more than five years now and I don't remember Ever putting the topic of the show to a vote, but I did that for this week, I put up a poll in our Facebook group, it's Diabetes Connections, the group, I have a couple of interviews. I'm usually a few weeks ahead with interviews in the can. And I asked the group to vote on which interview they wanted to hear next, and everybody chose Jeanne, I cannot say blame you. I am always amazed at the strength of these people, the stories of people who are living well with diabetes for 50 60 70 years. I mean, you think about it, before blood glucose meters were a thing. I mean, they weren't available to the 1980s. And this was a time that we're talking about with Jeanne before some doctors would even know about different types of diabetes. I was shocked to learn that that for a very long time, it was just diabetes and you treated it with a one shot a day, or then they would say juvenile diabetes. And you couldn't possibly have that if you were an adult and you're just on and on. And if you're new to the show, I've done several interviews with people who were diagnosed in the 50s in the 40s. And they've lived with type one for 70 years. And I will link those up with this episode. You can also search with a very good search engine at Diabetes connections.com. We're up to more than 320 episodes. So if you want to Google keywords like living long or 60 years with diabetes, that sort of thing. You can find that on the website. Before I get to the interview. I want to read something that was sent to me it's actually a review on Apple podcasts. I'm really bad at asking for reviews and keeping up with reviews. If you want to leave one up man, I would love it. Whatever podcast app you listen on, there is a way to leave a rating or review. This one came in from Shelley. Now her name is not on this but I know who this is because we featured her. We featured her son in a recent show. So Shelley wrote I love this podcast so much. I learned so much from listening especially enjoyed the tech episodes with Dexcom and Tandem etc. As the mom of a newly diagnosed four year old. I have found much needed encouragement and tips for helping and thrive with diabetes. Also, cannon was excited to hear you mention him swimming in the lake. Surely thank you for writing that. Yeah, we talked about cannon she had sent a picture into the Facebook group about him burning off the glucose. She said swimming in the lake pan swimming is one of those ways where Benny used to just those little kids just swim with every part of their body. They used to go low all the time in the pool. It's a little bit different. Now you know, a 15 year old does not swim like a four year old. But surely thanks for sending that review in. It's always nice to get reviews like that. And if you like the show, truly the best thing to do is to tell somebody about it tell somebody in the diabetes community. That's the best way to get the word out. All right, Jeanne and her story in just a moment but first diabetes Connections is brought to you by One Drop, getting diabetes supplies is a pain. Not only the ordering and the picking up but also the arguing with insurance over what they say you need and what you really need. Make it easy with One Drop. They offer personalized tester plans plus you get a Bluetooth a glucose meter test strips lancets and your certified diabetes coach, subscribe today to get the test strips for less than $20 a month delivered right to your door. No prescriptions or co pays required. One less thing to worry about. not that surprising when you learn that the founder of One Drop lives with type one, they get it One Drop gorgeous gear supplies delivered to your door 24 seven access to your certified diabetes coach, learn more, go to Diabetes connections.com and click on the One Drop logo.   I feel like I've known Jeanne Martin for as long as my son's had diabetes. That's almost 14 years. And that's because while I have never met Jeanne in person, I have been friends with her daughter Jessica Graham for even longer than those 14 years. We met when Jessica was in public relations here in Charlotte, and I was working as a health reporter for a local TV station. And later we were on the board of our local JDRF chapter together. I cannot believe it has taken me this long to share Jeannes story. She is just incredible. I was able to talk to Jeanne and Jessica, about living well with type one for 66 years. Jeanne and Jessica, thank you so much for joining me. I've known Jessica for so long, but I don't know so much of this story. I'm so excited to talk to you both. Thanks for coming on.   Jeanne & Jessica  6:17 Thank you for having us. You're very welcome.   Stacey Simms  6:20 Jeanne, I got to start with you. Because you have lived with type 1 diabetes now for more than 65 years. Let me just start out by saying How are you? How are you doing?   Jeanne Martin  6:30 I'm doing great. I think I'm doing just fine.   Stacey Simms  6:35 What do you mind if I ask what technology you use how you manage anything you'd like to share?   Jeanne Martin  6:40 Well, I checked my blood sugar with little contrast test strips. And I shoot nice. Well, I take shots   Stacey Simms  6:49 you can say brands, we’re all friends here.   Jeanne Martin  6:51 Yeah, I say I shoot myself   four times a day. I see my doctor every six months. Well, that's about it.   Jessica Graham  7:01 She does not use a pump or   Stacey Simms  7:04 any of that. No, if you don't mind, let's go back. Do you remember what it was like when you were diagnosed? You were 10 years old. Do you remember anything about that time?   Jeanne Martin  7:13 Oh, yes, I do very much. We lived in a very small town, not far from the Mayo Clinic. We just lived there a couple years. My friend's mother mentioned to my mother that I was drinking a lot of water and going in the bathroom a lot and she thought maybe my mother should have me checked out. So we did in the small town with the with the doctor there said, Well, she's either got diabetes or TB. Well, I didn't know what diabetes was. And I knew what TB was. So I thought, Oh, please don't i don't want TB. I'll have the other and so so the little basically country doctor didn't know what to do. So anyway, so they sent me to St. Mary's, which is public Have the Mayo Clinic. And they tested me and for sure that's what I had. So I had to stay there. I think it was five years. I didn't do all this stuff with the diets. And they wouldn't let me leave until I could get myself a shot. But I was active. And I don't really remember too much about it. The doctor were very nice, and everybody was very helpful. And back then you had glass syringes and needles and you couldn't check your blood sugar. You had to pee on the stick, and they sent me home and my mother had to weigh everything, and I had to watch what I ate. But other than that, that's about it. Then I just basically went on with my life. Did you   Stacey Simms  8:46 really? Were you able to jump back in go to school, do all the things you wanted to do with that time?   Jeanne Martin  8:51 Yeah, I did.   Stacey Simms  8:52 Mm hmm. It seems like such a different time, right. I'm just trying to think,   Jeanne Martin  8:55 Oh, yeah, it was a very different time and when I first got married, Remember, I had to boil my syringe once a week, we had to do that. And I was still peeing on a stick. And I only had one shot a day back then all through, you know, school. And of course, I didn't want to tell my friends when I was in high school. That's what I had. But of course, my mother told my best friend's mother. So everybody knew it, but I didn't know they knew it. Oh, wow.   Stacey Simms  9:25 Anyway, moms are sneaky that way. But yeah. The you know, the regimen was so different. You had one shot a day, right? And then you had to kind of eat around that shot. Did you have problems as a teenager? Did you do remember, you know, any issues or were you able to buy I would assume by routine and by figuring out what to eat, you know, how did it work out for you?   Jeanne Martin  9:47 Well, I didn't run into any problems when I was a teenager. And I do remember I don't know how I would go not very often, my friends and I and I would have hot fudge sundaes. Believe it But other than being bad like that, I lived at home and my mother, kind of watch what I ate. And I didn't need a lot of sweets. You know, it was my mother's management, not mine. And I came home for lunch all during school. And I didn't start taking more shots until about, oh, I don't know, maybe 45 40 years ago.   Stacey Simms  10:23 Yeah. It's so different to think about because we're talking about I mean, if doing my math correctly, you were diagnosed right? In the early 50s 1950s.   Jeanne Martin  10:30 Right? And 1955   Stacey Simms  10:33 Yes, so the routine was completely different. I mean, as you're listening, you got to understand not only one shot a day, but no blood sugar home meters, right. You're still checking. How often did you check done by check? We mean, pee on the stick.   Jeanne Martin  10:50 I probably did it maybe once a day. I honestly don't remember that. Not a lot. It's very different now. And somehow, I think my pancreas has always worked a little bit because I don't take much insulin. And I'm very, I don't want to say touchy with it, but I don't have to take a lot. And when I was diagnosed at the Mayo Clinic, they said that yes, my pancreas was working a little bit. That's what they thought. And I still think that's the case because I just don't need much insulin. And and I watch what I eat. I do, but you know, I'm not 100% I mean, I do have cookies,   Stacey Simms  11:30 but you're told us you were eating hot fudge sundae. So the cat is out of the bag…   Jeanne Martin  11:35 That was in my youth. You know, I do take care of myself. Now. I check myself four times a day, shoot up four times a day and I watch myself better now because I know better. I'm more wiser.   Stacey Simms  11:48 I'm curious to growing up. Did you know anybody with Type One Diabetes and if not, when did you meet somebody with no,   Jeanne Martin  11:55 I never knew anybody. I didn't know anybody with any kind of diabetes. It wasn't in my family, so none of my relatives had it. No, during high school I did not know, as an adult. I have met very few type one diabetics, I know they're out there, but very few. And it's kind of fun when I do just to kind of say, Well, you know, compare notes, so to speak. Sure.   Stacey Simms  12:21 Just let me ask you a couple of questions. Because the perspective of a kid, you know, we're all adults now. But a child growing up with type one in the house and the type one is in the parent is not something that I've talked a lot about on the podcast. What's your earliest memory of your mom and diabetes?   Jessica Graham  12:38 Well, I don't ever remember it not being there. And that was more because I worried about her than it was her. There was never literally and I'm, I mean, this literally, there was never a day when my mom said, Oh, I don't feel well or Oh me, you know. My sugar is off, or I just don't feel good today, never. And so it was nothing that she did. I just knew that if mom started acting funny, I needed to get the orange juice. So I remember that I never had a problem with shots. And I think that's because I always saw you give yourself a shot. So it was just, it was always there. The other thing that I remember is that I was always told that it skipped generations. And so I do remember I don't even know if you remember this. But I remember at one point when I was little, I told mom that I didn't want to have kids until there was a cure, because I didn't want my kid to have type one. And I she got really mad. My mom never got mad. But she got upset at that and told me that was absolutely you know, the wrong attitude to have and that she had a great life and it didn't have any impact. And so that was the end of that but it was just always there. So just always a part of life. Jeanne, I'd love to hear your perspective. On when Jessica who now has a I want to say a tween a teenage Yeah, yeah. just turned 13 Yeah. Wow.   Stacey Simms  14:07 I want to hear your reaction Jeanne to when she said that! Right back to Jeanne answering that question but first Diabetes Connections is brought to you by Real Good Foods. True story from my house. Benny came downstairs the other night, open the freezer door, looked in it close the door and said who ate the mint chocolate chip ice cream. And I had to say it was the I finished it off. Sorry, Benny. But they're Real Good Foods. Ice cream is really good. We had a vanilla chocolate and mint chip this last time I promised him I would buy more and I have to get the peanut butter kind as well. We haven't found the ice cream yet in our grocery store freezer so I get that online but our grocery store carries a lot of the meals and they are so good and super easy and basically just heat them up. If you have an air fryer. It's even better They have everything from pizza to breakfast sandwiches to bowls, these new bowl meals that are really nice entrees. Find out more, check out that mint chocolate chip ice cream for yourself. It stays frozen. They they package it up the right way. I was worried about that, but no need to worry should have known. Just go to Diabetes connections.com and click on the Real Good Foods logo. Now back to Jeanne answering my question about her reaction. When Jessica told her she was really concerned about having children.   Jeanne Martin  15:33 Well, I didn't want her to dwell on it. And I didn't want her not to have kids. You know, it's so much more advanced nowadays. And there's so much more that they can do. And I always do hope for here. I mean, I've been hanging on that for a long time, but you never know, one of these days. No matter what your problem is. You just have to get along and do the best you can and get along with your life and not dwell on it. And I've never dwelled on it.   Stacey Simms  16:02 Well, I'm curious too, because now we know and I've heard that too. it skips generations. We know it absolutely does not. But I'm curious Jeanne, you know, when you decided that you wanted to have children? Did anybody try to talk you out of it? This was a very different time for diabetes.   Jeanne Martin  16:14 Well, I was told that I would have a hard time having a child. And so we put up for adoption. And we were waiting to hear and I went to the doctor and thought I had a tumor but the tumor was Jessica. So I thought, okay, so we said, you know, we were going to have a baby so we don't need to adopt and they said, Well, why don't you wait to see if everything is okay. And I said, okay, because the doctors told me that Jessica only had a 40% chance of being born alive. So we waited and she was screaming and kickin, so she was Fine. So we stopped the adoption because we didn't need two babies at one time. And I didn't see her for I think it was like two or three days. She was in an incubator because her blood sugar was low when she was born, but then after that, she was fine. And I was fine. And that's it.   Stacey Simms  17:19 I'm sorry. I'm still on the tumor.   Jessica Graham  17:24 Well, and I'll add to that, because, you know, she won't tell you this part, but because she was diabetic, she couldn't have any medicine or or painkillers. When I was born, and you were in labor, what, 24 hours? No, no,   Jeanne Martin  17:39 it was, I don't remember 13 hours. So it was a   Jessica Graham  17:42 ridiculously long and I was stuck behind a piece of cartilage. And so I wasn't coming out. So she went through hell delivering me. But it all worked out. Yeah.   Stacey Simms  17:54 Oh, worked out. things really have changed. I mean,   Jeanne Martin  17:58 Oh, yes. And I also was I would not live to see my child grow up. Now I've got a 13 year old grandson.   Stacey Simms  18:07 But let's talk about that, because I've heard that from so many people diagnosed not only in the 50s, but even as late as like the 70s and 80s. This Doomsday of you're not going to live past 30. And I know that for many people, that unfortunately was the case, there was not the care. There was not, you know, whatever they needed, but it seemed as though in some ways, the doctors, I don't know, I don't want to editorialize here, but they seem to have this Doomsday approach. And when you were told that Jeanne, what was your reaction? I mean, I think a lot of people would have said, well, what's the point? Oh,   Jeanne Martin  18:37 I'm kind of stubborn.   And my reaction was, I told my husband, that guy can go walk out in the street and get hit by a bus tomorrow, and I just, I'm not going to go along with that. That's was my reaction. I got mad and he did die. A younger The age that I am now is a matter of fact, the guy that told me that I didn't buy into it. I didn't get depressed because I just thought it was full of baloney. I love it.   Stacey Simms  19:10 All right, this is getting interesting now. I do love it. Jessica. I know your mom is sitting right there. But you're doing great Jeanne, obviously with with your shots and with your checking, but the technology has advanced. I'm going to assume, Jessica, that you guys have had a lot of discussions about this. And your mom has said no. And you're respecting that don't put words in your mouth. But I'm curious how have those conversations happened?   Jessica Graham  19:36 Oh, yes. And I don't mind saying it with her sitting right here. So I don't mind that she doesn't do the pump because I understand. I mean, she's had incredible control for 60 some years and so i don't i don't blame her that but I want her to have a blood sugar monitor because she tends to go away Low, and she goes low at night. And it's been a problem as I call it a problem. Whenever she goes low it to me it's a problem. And so while she keeps great control, and I mean, it's her life, right, and it's her decision to make, I wish that she would get some of that electronic help with the monitoring of it. So yeah, we have that conversation a lot. But I lose.   Stacey Simms  20:26 That's a difficult situation. You know, we, as parents of children with type one have these conversations, especially once there were certain age, and I'm going to say, as young as four or five years old, where it really has to be up to the person to buy into it and say, Yes, I want this technology. And I would imagine and I'm just imagining having this conversation with my mother, who I think you have a lot in common with with Jeanne. And I think it would go that well. Yeah, well stubborn, but also you're doing very well.   Jessica Graham  20:52 Yeah, and Exactly. That's why I mean at the end of the day, what am I going to do right now I can only put in my two cents but that that is is the one thing that I wish you would do. And my dad to his credit. I mean, he's kind of grown up with this too, right? And so he's a great monitor strangely, he knows when it's the middle of the night and she's having a hard time. But I don't like to rely on that.   Unknown Speaker  21:17 But again, I lose   Jeanne Martin  21:19 stubborn. Well, let me cut in here. But the doctor prescribed a new kind of insulin that I've been taking. I don't know six months now and I have not had any trouble at night. Oh, good.   Stacey Simms  21:32 We don't have to use it in the show. Are you taking Tresiba?   Jeanne Martin  21:34 It's Tresiba. Yeah. And I have not had any trouble at night. Since I've been on that. Yeah, that's a good thing.   Stacey Simms  21:41 But my son uses an insulin pump. But long story short, we had him on Tresiba with the pump for a while because teenagers use the most ungodly amount of insulin that you could imagine. He's coming out of it. So we did away with the trusty bow, but boy, it's like the best long acting we've ever used. I'm curious too, and the bridge kind of skipping around chronologically. Hear but I mentioned earlier that there were not blood sugar meters for home use when you were diagnosed. Do you remember when you started using one of those maybe the 80s   Jeanne Martin  22:09 Well, I thought it was great because then I really knew what was going on. I mean it just it was very helpful because and that's why I checked myself a lot because you can't guess how much it's I mean, you can guess kind of how much insulin but you really can't without knowing what your blood sugar is to my mind. I mean, I think that's what's helped me keep control in Yeah, I don't like to stick my fingers but I mean, I'm so used to it now just comes second hand to me, so it made a big difference. What really made a big difference to is having plastic syringes that don't have to boil. Tell me   Stacey Simms  22:49 more about that. When did that switch? Not Not Not necessarily like what year but tell me more about that. What do you remember kind of the transition? Did you just one day throw all the glass ones out? What happened? Right   Jeanne Martin  23:00 Yeah, I did. I guess the doctor told me that these were available. And so I bought them and and use them. And then you know, he used it, throw it out. And it just, it made a big difference. It's just like, oh, gosh, you know, this is getting easier. Well, and you know, it was a lot easier. I mean, it sounds like a small thing, but it was a no to boil, you know, syringes once a week and needles once a week. And so this was great.   Jessica Graham  23:28 When did you I don't remember you ever boiling? Was that in the 60s or   Jeanne Martin  23:32 70s? No. Well, I must know. I don't think when you were born. Other times, I must have used the plastic ones. Yeah. Because I don't remember doing that either. When you were born.   Stacey Simms  23:43 You know, Jeanne, it's interesting. You said it seems like a little thing. I think for someone who has my perspective. My son was diagnosed in 2006. When we basically have I think we have all of the technology. At least it was on the drawing board if not available at the time. It wasn't as good as it is now. Just 1314 years later, but it was there. And so to think about transitioning from peeing on a stick to a blood sugar, meter glass syringes, to plastic syringes, these are monumental changes. I don't think it was a little thing. I can't imagine how much of a difference that made. I mean, the needles had to even feel different. They were more comfortable, I assume.   Jeanne Martin  24:20 Oh, well, it was it was like one size needle with the glass syringes, and they weren't that small. And now, you know, you can get all different kinds of sizes. Jessica, do you remember growing up?   Stacey Simms  24:32 It sounds like your mom's diabetes was not front and center, as I'm sure she would not have wanted it. But are there any things that stand out? You know, when you were a teenager? I'm trying to think his parents are just super embarrassing to begin with?   Jessica Graham  24:44 Honestly, no, because it just my mom wouldn't let it be the center. I mean, you're absolutely right about that. She she would never have wanted that. And I don't remember there being anything that happened when I was a teenager. That was odd. She She had one episode. I guess I was a teenager when you broke your ankle. She was we discovered that she couldn't drink champagne. She had a glass of champagne. I mean, literally a glass and the next morning passed out and broke her ankle because it messed up her blood sugar so badly that I don't remember anything ever. Embarrassing or weird or no, not not at all again, I I remember when I was a younger teenager, like if you started acting strangely, I needed to get you orange juice like I vaguely remember that but and that went for anybody. Like I think if anybody started acting strangely, I would have ended them. Shoes. But   Stacey Simms  25:43 Jeanne, did you have a career did you work? Did you work at home? Tell me a little bit about what you you know what you did?   Jeanne Martin  25:49 You know, I work during high school, I worked at clothing stores and I worked at a bakery. And then after school, I worked at a real The state office. And I guess that was it because it was the board of realtors, because I had to quit them when I got pregnant with Jessica. So that was it. And then when my husband started his company, I worked for him. I did the payroll and things like that.   Stacey Simms  26:19 Jessica, what led you to JDRF? I mean, we had met Previous to that, but we connected again at the Charlotte chapter.   Jessica Graham  26:25 I led community outreach for Harris Teeter, but didn't formally get involved. They were supportive of JDRF, but didn't formally get involved in a board capacity until I got to Time Warner Cable, and they were also involved with JDRF. And so I joined the board at that point, and was on the board for, I don't know, six or seven years, I think, and shared it in there. But I think I knew about JDRF through mom, like I think you just always supported them. Yeah, um, if I'm not mistaken, the world. organization was born the year I was born. Just another thing that has always been a part of my life. And I was really excited to get involved with the chapter because yeah, as you sort of already mentioned, the parents of type one diabetics are really involved. But there really aren't many children of type ones out there. There weren't at the time. It meant a lot to me to be involved and to be part of it.   Stacey Simms  27:24 I'm just curious, your mom, Jeanne, you just seem so laid back. And I've talked to several people who have lived with diabetes for this long who are I want to say relax, because obviously you're not, but who are more of the, hey, I'm taking care of it. We don't need to talk about it. You know, I'm not surrounded by people with type one. And then there are people who are younger, or we've been diagnosed more recently, who are really a big, big, big part of that community and want and need to kind of breathe that air. And I was curious, Jessica, was it surprising for you to kind of be involved in JDRF and be around people who were more like well, I am talking about every day and I am going to tell you more about it.   Jessica Graham  27:58 Yeah, I mean, it was it was definitely Different, because that's just not how it was in my house. I mean, it wasn't a big secret or anything. But Mom definitely didn't advertise it. And it certainly wasn't part of her identity. It was very, very different. And I really loved to one be involved that I really loved getting my mom in that community, like I would take her to the gala and that kind of thing. And she really is such an inspiration to a lot of people, especially those who are newly diagnosed because they can see somebody who really, I mean, has had a full, long, wonderful life with it. And so it's not this Doomsday message. And so she's really, I think, a real inspiration for that. And I think too, she's a great inspiration for how important attitude is an outlook is because she's never let it define her and she's never really Let it limit her. And I think she's really inspirational. So yes, it was very different to be around different people with it. But also it was really exciting to just to be able to share her with that community.   Stacey Simms  29:12 Jeanne, what's your reaction to have your daughter sitting next to you and saying, what an inspiration she thinks you are?   Jeanne Martin  29:17 Well, I think that's very nice. It's very complimentary. I never thought of myself that way. But I'm glad she sees me that way.   Stacey Simms  29:26 I know my listeners are going to want to know, a few more little details. Jeanne, do you exercise a lot? Have you always been active? Are you more kind of laid back about that too? You know, that's one of the things that people always ask me about.   Jeanne Martin  29:37 No, I say I'm pretty active. Well, since we've lived here almost the whole time. I would go to the why three days a week. I don't do that now because I suppose and when I was younger, I played golf, and did a little bit of tennis. I've always gardened Well, not always but for a long time I went out in the They are dug in the dirt and that type of thing. And I try to walk about a mile a day. I mean, I walk more, but I go for a mile walk, or more. I tried to do it every day, unless it rains. I do it early when it's hot, because the heat affects my blood sugar. I run into trouble easier. And I don't know if that's the same with other people. But anyway, that's what it is. Yeah, I think I'm pretty active.   Stacey Simms  30:27 Yeah, you're very active. Jessica, I'm curious, have you. You mentioned that you were worried about your son having type one and he's 13. Now, do you still think about that? It's in the back of your mind. Is it something that you've ever had checked out? Anything like that?   Jessica Graham  30:41 Um, yes. So I worry about it every day. But I don't   I try not to think about it. And I certainly have never mentioned it and   Unknown Speaker  30:49 we had   Jessica Graham  30:50 it chat once and I forget why you've charged it. Yeah, maybe. Maybe you were the one anyway. I feel like I had it checked once and I don't remember why maybe he was thirsty that day. But I do worry about it a lot. And I mean, literally every time he says I'm thirsty, because I'm just a little neurotic that way, but I don't talk about it at all. Like he would have no   Unknown Speaker  31:14 idea. I don't   Jessica Graham  31:16 think anybody would know that. But yeah, I worry about it a lot. But then again, I think, well, if he ever were to develop it, oh, my gosh, he has the world's greatest teacher to help him navigate it. So that puts my mind at ease. When he was very, very small. I found a test that he could have done. It might have even been when he was born. I mean, it was he was really, really young. And I think it was down in Florida, talking about TrialNet Yes, that must be what it was. And we just decided   Stacey Simms  31:49 not to do that. And I think I talked to you about it and talked to my mom about it. And she, I think suggested that we not do it and I decided not to so Well, Jeanne, let me then ask you about that because you would, as Jessica said, you know, he would have such a great role model and teacher, God forbid something would happen like that. So let me just ask you, what would your advice be for a newly diagnosed adult or a newly diagnosed family facing something like this now in in 20?   Jeanne Martin  32:19 Well, it depends the age of the kid. I think when you're a teenager, I think it is be harder on the kid because, you know, you don't want to be and maybe it's because I'm a girl and maybe it's back then you don't want to be different. I mean, you know, you want to blend in as a teenager, you don't really have enough self confidence to just say, Okay, I've got this and I'm gonna deal with it. I mean, I'm not saying that kids don't but I would think that's a harder age. But I guess I would just be very positive and all the things that can help. At the same time, it was would be your his responsibility to see He does try to do what he should do with diet and exercise and taking this medicine. I have a niece who came down with it when she was 10. And she never did well with it. She didn't do what she was supposed to do. And over the years, she's had all kinds of complications. And she just got very depressed with it. And you have to be positive. But you the kid himself, has to take responsibility for himself to do what he should do. And I strongly believe in that.   Stacey Simms  33:36 Thank you both so much for joining me today. It was amazing to learn about your story, Jeanne, and I'm so glad, Jessica that we were able to do this. Thank you for being on the podcast.   Jeanne Martin  33:45 Thank you for having us. Yes, thank you. It was nice meeting you via the computer.   Announcer  33:55 You're listening to Diabetes Connections with Stacey Simms.   Stacey Simms  34:01 I shared some photos in the Facebook group that Jeanne and Jessica sent me, I was so happy to finally get a chance to talk to her. And you know what, after that interview, she sent me an email with some advice for Benny, which I thought was really, really nice. Now he is, as you've heard him here on the show, he maybe he's a little too confident, but he's very independent and very confident. But Jeanne has some really nice words just about you know, not letting diabetes stop you and keeping a good attitude that has served her well. And I really appreciate that she took the time to do that this community is just great. All right, innovations is up next. And we have a very low tech solution to a very scary problem. It has to do with rubber bands. All right. I'll explain that in just a moment. Diabetes Connections is brought to you by Dexcom. And we started with Dexcom back in the olden days before share. So trust me when I say using share and follow apps make a big difference. I made a lot of people who don't realize that when Dexcom launched you could not see numbers not only on your phone, but you could not share than with anybody else. But now it's such a great system. And Benny and I set parameters about when I'm going to text him or you know how long to wait all that it helps us talk and worry about diabetes less when he is at asleep over or goes on a trip. It gives me peace of mind. It also helps if I need to troubleshoot with him, because I can see what's happening over the last 24 hours and not just one moment. The alerts and alarms that we set help us from keeping the highs from getting too high and help us jump on lows before they're a big issue. Internet connectivity is required to access separate Dexcom follow app. To learn more, go to Diabetes connections.com and click on the Dexcom logo.   As you know I am the queen of diabetes mistakes I wrote a whole book about why I think mistakes are great. It's the world's worst diabetes mom real life stories of raising a child with type one. But I will say that making mistakes is also incredibly scary at times. And the one mistake that I think almost everybody with time wonder who's a caregiver for someone with type one has made is mixing up the long acting and the short acting when you're on MDI, whether it's the beginning or you've been doing this for a while, I've been enough Facebook groups where I see this happening. It's once in a blue moon for the individual. But it seems like almost every week somebody is coming in and saying, Oh, my gosh, I did this. I'm so scared. What do I do? Right? Well, one of the best tips I ever heard on is so simple. And I heard it from a CDE. And I'm so embarrassed that I don't know their name. And I'm so sorry, if this was you, email me Stacey at Diabetes connections.com. And I will give you credit, but what you do is this, whenever you have a new vial or a new pen, have long acting and do this on the long acting only take a rubber band and wrap it around the pen or the vial. Just wrap it around a couple times. You know, make sure it's not loose, it's not sliding around. And then every time you pick up your long acting, you will know that it feels different. It's got those rubber band bumps on it and If you do this often enough, really doesn't take that long, maybe two weeks, your fingers will start to associate that feel with the long acting. So if you make a mistake if you accidentally grab the wrong pen, your hand and your brain will instinctively know that something is wrong. Now, this is not proven. I haven't seen any studies on it. But this is advice that was given to me that I've heard other people use. And it really does make sense. It is incredible that after all this time was different kinds of insulin, that the pens are pretty much exactly the same. The Lantus vial, I remember might be a little skinnier, right? It looks a little bit different. But when you're moving quickly and automated, like a lot of us are, I mean, I could do that Tandem cartridge in my sleep, whereas when we first got it, I thought, oh my god, this is so complicated. I've got to lay everything out on the table. We did the Animas pump for 10 years, I could definitely feel that thing blindfolded. You just get used to your routine and how things are Feel so if you just wrap the rubber band around the long acting, you will get used to the feel of it. Let me know what you think. Does that make sense to you? Has anybody tried that? And if you've got an innovation like that This segment is for everything big and small. That makes living with type one just a little bit easier. Let me know I would love to hear from you.   Just a little personal update before I let you go, this has to do with insurance. We've had some employment situation changes around my house, which means I have already spent far too much time on the phone. I decided to start taking advice from one of our previous guests from Melissa Lee, who said when you have insurance issues, you should start with the diabetes companies and work backward. So I called Dexcom and Tandem and I said hello, I have changed insurance. What do I need to do? And they were very helpful. The bad news is my new insurance means we have to order from a third party supplier and it's Edgepark. Edgepark. If you're listening, please, please handle this. Well, we were with Edgepark years ago and I hate to disparage anybody. But let's just say let's turn this into a positive. I felt that it was such a gift for the last five and a half years to order directly from Tandem and directly from Dexcom. I am sad to see those days in my rear view mirror. So I will keep you posted on how it goes. I'm currently as I'm recording in the limbo of an Edgepark representative, we'll get back to you. We have plenty of supplies. I have a great support system if I need anything, so I'm not worried about Benny. But man, although I'm a liar, because I did say to him, you know, before you rip anything off your body, so bad before you take off that sensor or that inset, come talk to me, and make sure that it's okay to do so. Isn't that terrible? I mean, I'm laughing because we really are fine. But it just makes me crazy how expensive this stuff is, and how difficult the process is to order what you need. So I will keep you posted on that. Hopefully, it'll all go smoothly. But this is not my first rodeo. So I'm anticipating navigating a not so smooth road. I'll let you know. Thank you so much to my editor, John Bukenas from audio editing solutions. Thank you all so much as you listen, I'm Stacey Simms. I'll see you back here. Next Until then be kind to yourself.   Benny  41:07 Diabetes Connections is a production of Stacey Simms Media. All rights reserved. All Wrongs avenged

When Shaina Hatchell's little brother was diagnosed with type 1 at age nine, she knew her life - and her life's goals - had changed forever. She decided she would teach everyone about diabetes when she grew up. Now a registered nurse and certified diabetes educator, Shaina has written "Shia Learns," a children's book to teach families about diabetes. In this episode she shares her story and answers listeners questions about teaching kids with T1D all about acceptance. Watch Shaina's JDRF FB Live here Check out Stacey's new book: The World's Worst Diabetes Mom! In Tell Me Something Good, cheerleaders and a lot to cheer about and.. our newest segment.. Innovations.. new studies and approval for the latest hybrid closed loop pump systems. .. More information here about Semglee insulin This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. 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 transcript: Stacey Simms  0:00 Diabetes Connections is brought to you by One Drop created for people with diabetes by people who have diabetes. By Real Good Foods real food you feel good about eating and by Dexcom take control of your diabetes and live life to the fullest with Dexcom.   Announcer  0:21 This is Diabetes Connections with Stacey Simms.   Stacey Simms  0:26 This week when her little brother was diagnosed then 12 year old Shaina Hatchell knew her life and her life's goals had changed thanks to their diabetes educator.   Shaina Hatchell  0:38 It was in that moment of her teaching my entire family teaching me allowing me to trial everything that I realized like this is what I want to do with my life. So at 12 I already was telling my mom, I'm going to be a diabetes educator one day because I loved it so much. I love learning.   Stacey Simms  0:54 Shaina is now a registered nurse and a certified diabetes educator. She's also the author of a new children's book about type one. And she's answering your questions about kids and T1D In  tell me something good cheerleaders and a lot to cheer about, and in our newest segment, innovations, new studies and approval for the latest hybrid closed loop pump systems. 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 Diabetes Connections. I am so glad to have you along. If you are new Welcome. My name is Stacey Simms. I'm your host and we aim to educate and inspire about type one diabetes by sharing stories of connection. My son was diagnosed with type one right before he turned two. He is now 15. He's a sophomore in high school. So we've been doing this for a while. My husband lives with type two. I don't have diabetes. I have a background in broadcasting and that is how you get the podcast and I'm laughing a little bit because as I was recording that, I don't know what I said, but I activated the Siri I just said it again on my phone, don't say anything, okay, didn't activate it. And he started talking. So if you heard that I apologize. But it's funny sometimes. And I promise I'll get to the guest to the diabetes stuff in just a minute. But I was talking about my radio days recently, I worked a long time in radio, and I'm taking part in a podcast festival, a virtual podcast Festival, which is all about learning and sessions and panels and stuff, kind of like diabetes festival, or I guess, more like a diabetes conference. But it's all about information and podcasting, and we were talking about my time in radio. And it's amazing to me to think about how many people worked on that show that I was on. I did a four hour morning news show with a co host and a sports guy and you know, reporters and lots of moving parts and running around this little studio. But we had sound engineers and we had producers and you know, we had interns that we had so many people working on that show. And so to do a podcast, of course is usually I mean unless you're NPR or You have a lot of corporate power behind you is usually a one person or maybe a two person show. I do have an editor who helps me out after the fact. But it's when little things happen like my phone going off that I remember those days. Not that I'm really itching to go back to spending five hours because we did also have an hour show prep in the studio, which was the size of the room that I'm in right now about the size of a, let's call it a standard bedroom with four or five, six people every day, starting at four o'clock in the morning. So I can't say I recommend that. Oh, my goodness, sorry to get off on such a tangent, but I am taking part in the Charlotte podcast festival. If you're at all interested in podcasting, I will link it up. I'm sure you could attend. It's free. And then later on in the show, I'll get back to diabetes conferences and tell you what's on tap because there's some interesting changes happening. Of course, everything's still going virtual, but some new announcements and I will get to that a little bit later on in the show. Okay, Diabetes Connections is brought to you by One Drop, and I'm really impressed at how much they just get diabetes. It makes sense their CEO Jeff was diagnosed with type one as an adult. One Drop is for people with diabetes by people with diabetes. The people at One Drop work relentlessly to remove all barriers between you and the care you need. Get 24 seven coaching support in your app and unlimited supplies delivered. No prescriptions or insurance required. Their beautiful sleek meter fits in perfectly with the rest of your life. They'll also send you test strips with a strip plan that actually makes sense for how much you actually check One Drop diabetes care delivered. learn more, go to Diabetes connections.com and click on the One Drop logo. My guest this week is the author of what is meant to be a series of books for children and families about type one. The first book released is called Shia Learns, author Shaina Hatchell is a registered nurse and CDE and her brother was diagnosed when he was nine. The book is adorable the illustrations are really top notch. It's gorgeous. But the substance, of course, is what this is all about. Shaina talks about her family's story. And she answered some listener questions that you sent in about kids and type one. And she gets these kinds of questions every day in her practice. She meets a lot of new onset families. She talks about that and a lot more. Here is my interview with author Shaina Hatchell. Shaina, thank you so much for jumping on. I know, it's been a really busy time for you with the pre sales, but the book is out now. Thanks for spending some time with me.   Shaina Hatchell  5:32 Thank you for having me. I'm so excited and it's been busy, but I couldn't miss this interview.   Stacey Simms  5:37 Oh, thank you. All right, let's just jump right in. But we'll talk about your background and your brother and everything. Let's start by just talking about the book itself. What is Shi'a learns, tell me the story of the book.   Shaina Hatchell  5:50 Oh, right. So I have been wanting to write a book that does some sort of diabetes education for many years, even before I became a diabetes educator, there have been a lot of experiences that I've had in my home with my brother and my parents that I felt like when we were going through certain situations, it would have been great to have a book that would have kind of given us a little bit more guidance, because we only see the doctor every three months. So now that I had the time and I felt like you know, I had enough knowledge to really create what I wanted to create. From the beginning I decided to go ahead and start writing some books. And in the beginning, Cheyenne learns wasn't the title was just me writing honestly, more so like poetry style books about diabetes education, because I love poetry, and then it kind of just dawned on me like okay, this is turning into a series and this should be about a child and let me just go ahead and title it Shai learn. Shi'a is the name of a child that I lost during gardening. decided that, you know, this was another way for her to be bored. And then just having her be the title of the book she learns, which is actually perfect for me. So the reason why I wanted to make her a young African American Girl is because I wanted to help with the disparities and care that some African American face. And I do that by increasing education with the book in the topics that will come in not only this first book, but the books to come, as well as increasing representation. So that is the reason why we're starting with preDominantly African American characters, but that is going to grow, because I want everyone to feel represented in these books,   Stacey Simms  7:39 a lot to unpack there. But let's start with the book itself. That first, as you said, it's a series what's the story of the first book? Is it her diagnosis? Your take me through it?   Shaina Hatchell  7:49 Yes. So in the first book, it's actually going to be explaining in following Shia and her parents in their journey for a new one set in the hospital. So basically in the first one Shia is going to start to have some films that the parents notice are not normal. And so they take her to a hospital. And mom explained to the providers, what she's been noticing about Shia. And then they do a couple of tests and they diagnosed her with type 1 diabetes. Then in comes the diabetes educator Dom who will start to explain to the family, you know what type one diabetes is how insulin works in the body, and give them everything they need for discharge. So it's literally just that first story that anyone who has a loved one with type one or if they're the type one themselves, have experienced, you know, that first new onset experience.   Stacey Simms  8:45 I gotta say, the illustrations are just beautiful, but one that caught my eye. Oh, yeah, one that really caught my eye is the depiction of insulin as a key, right where we're explained a lot. Can you take us through what that illustration is showing, and I know As you're listening, I'll put some things out on social media and in the show notes, you can see these photos. It's an adorable depiction of what insulin does.   Shaina Hatchell  9:08 Yes. So anytime I educate because as a diabetes educator, I do preDominantly new onset education. So this first book is literally what I teach almost every single day. And when I'm explaining to families, what insulin does in the body, I always draw the picture on the board. And so I sent this to my illustrator and she did an excellent job. Thank you, Candace Bradley, you did an amazing job in actually bringing this to life. But what I always say is that when we eat carbohydrates, we eat food that has sugar. So your carbohydrates are even if we had like a regular juice or soda, which is sugar in the simplest form, you know, the carbs broken down in the stomach turn into sugar and then the sugar that pure sugar goes to the bloodstream. And when there's more sugar into the bloodstream, the body sends a message to our pancreas that sends a message to our body. To sell to release the insulin, and insulin is the only key that can unlock ourselves so that sugar can go inside and be used for energy.   Stacey Simms  10:09 Our endo use the exact same analogy with the key and I I wish I had a book like this to show my two year old. I don't think he even has that analogy in his head to this day. Tell me a little bit more about your story. Your brother was diagnosed when you both were kids that has to have influenced you. What do you remember about his diagnosis? He was nine.   Shaina Hatchell  10:28 Yes, he was nine and I was 12 years old. I remember when he started to lose weight. And I remember when he started to drink a lot of water and go to the bathroom a lot. And that was probably for like, I want to say two weeks before we my mom, I say we but I was too young to be a part of that before my parents decided that they needed to take him to a doctor's appointment, but I remember just seeing him like the weight and then at nighttime, he started to put sheets from off of It started with sheep into his pants into his pajamas. So that if he went to bed while he was sleeping at night, it would like be on the sheets and not all over the bed. And I remember like, of course, as an older sibling in older sibling fashion, like making fun of him about it. And I think that's when my mom was alarmed because my brother was upset with me. And I told her why he was upset. And you know, I made a joke. And then I went to school. And when I got out of school, I got in the car with my mom. And usually my brother was first to be picked up. So I was expecting him to be in the car with us. But he wasn't and my mom was sitting and says, We're on our way to the hospital, your brother is in the hospital. When I got there. I just remember being really confused and feeling really bad about the joke I made and learning that he has type one diabetes. My family had never heard of a kid being able to get diabetes. And we had no idea that this was even possible for our family because we didn't have a family history of it. So we were kind of confused and then we of the day, the next day was a diabetes educator who explained everything. And it was in that moment of her teaching my entire family, teaching me allowing me to trial, everything that I realized, like, this is what I want to do with my life. So at 12, I already was telling my mom, I'm going to be a diabetes educator one day, because I loved it so much. I love learning.   Stacey Simms  12:22 But today, kind of pat you on the head and say, Sure, sweetie, are they Yes, we understand. And this is   Shaina Hatchell  12:27 something you're gonna do. My mom is like, amazing. She actually is like, Yeah, well, you know what? We need you. So yeah, you do this when you get and it was like it. From that point forward. It was kind of like a thing like Shay is going to become a nurse and she's going to be a diabetes educator. And I went to vocational high school and got my LPN at 17. And it was like, we're gonna make sure you get there. So they were actually super supportive from the beginning. It's fantastic.   Stacey Simms  12:56 And your brother is in the book, right? Am I he's one of the characters   Shaina Hatchell  13:00 He is he is a diabetes educator. So Dom is his actual name. And Dom is the name of the diabetes educator in the book. And he is the educator, because he taught me way more about diabetes management in the home and you know about diabetes in general, and how it affects the person then, than anything I've learned in any textbook or any other experience. I got that firsthand knowledge directly from him. So it was only right that he'd be the educator in the book.   Stacey Simms  13:31 You know, you you talked about how you want more representation for the African American community. We want to see more black characters in these books, and curious, there's so much misunderstanding, even in the middle community about diabetes and I hear stories of people who are Latino who are black, who have been told you can't have type one, you have type two, or you know, you don't understand what's going on. It just seems like there's a lot of medical disparities. Do you recall the Did you and your brother face that When he was being diagnosed   I know right back to our chat but first Diabetes Connections is brought to you by Real Good Foods. Real Good Foods is all about making delicious foods you feel good about eating high in protein, low in carbs and always made from simple real ingredients you feel good about eating. their newest products include these bowls they have these great meal bowls, Mongolian beef, lemon Chicken, Chicken lasagna, all low carb and in a handy little bowl. You can get all of their items delivered or find out where to buy. They're in our local Harris Teeter I know they're in the Walmart here as well. And you can find that in their store locator right on the website. While you were there. I highly recommend you get some ice cream. They do a great job of shipping the ice cream I was a little nervous about that. But it comes fully frozen. They do a terrific job and it is so good. My whole family loved the peanut butter I am always partial to chocolate and I thought the mint chocolate chip ice cream was top notch. Find out more go to Diabetes connections.com and click on the Real Good Foods logo. Now back to Shaina answering my question about whether there were any questions of the doctors minds that her brother had type one.   Shaina Hatchell  15:22 So when my brother was diagnosed we didn't face that. Personally, I think that his signs were pretty clear that this was type one. There was never a question for type two. But this is something that people of color do experience and I do have a friend of mine that she started to have the increase in, you know, thirst and urination and all of the crystal clear signs. She is an athlete, very thin and always healthy. And she went to the doctor's when she was experiencing these things and she was older and they automatically put her on That format and told her this was a type two diabetes, they didn't even try to test to test her for like any sort of type one. They didn't do any antibodies, any labs. It was just this was a type two diabetes because you are an older teenager, and you're African American, like that's what this is. And of course it ended up being type one. And so seeing her experience that and the frustration of thing I'm taking this Metformin on eating healthy, I'm exercising like you asked me to, and I still don't feel good. And not being heard initially was it was very difficult for me to see that because you know, me, I'm like, No, I know my brother is like, no, it's not it's got to be. And so to know that, that is an experience that many people of color with diabetes have is heartbreaking for me. And so just for like, if there are books that are available, that people of color that do not have diabetes at all can read, that will give them more of an understanding of what is happening in the body of someone with T1D, that if they see someone experiencing it their cousin, family member friend, that they'll be like, Oh my goodness, this is what I read in this book when I was a kid. And so you should ask them to check you for type one diabetes, or you know if they're experiencing it themselves, but they'll think you know, what I remember, these were the things that were talked about in that children's book. And so I should definitely be pushing more toward them. Checking for type one specifically, I   Stacey Simms  17:28 can't tell you how many listeners I have who diagnose themselves because of the baby sitters club books. So you know, it does work. Right. Exactly. It really does. So my listeners had some questions for you, if that's okay, if I could jump in and ask some advice questions, because you do work with families. Thank you so much for letting us do that. So I like this one a lot. Um, Valentina asks, how to handle remarks about what it is that you eat. She gets asked, What is that on your arm? Why do you get to keep that Your phone and nobody else can use she feels overwhelmed by the questions her friends are asking any ideas to help kids deal with that?   Shaina Hatchell  18:07 Yeah, you know, that can be it can be overwhelming to constantly get these kinds of questions. And so a part of why I created the book is that this will be something that children again, not living with diabetes can read, and start to understand a little bit better what's happening to their friends. And so being able to give them a book that is entertaining, that has these, you know, great illustrations and allowing them to read this content will help to decrease the questions, right, because there'll be able to get some of those answers in the book. But the other thing really starts in the home with the parents and the child. I find that the same way that we prepare for job interviews, adults, prepare for job interviews, we look over the questions if we can, you know, we have them and we think about the best ways to answer them so that when we are in that interview, with Parents, and we feel less stress and less anxiety because we prep for these questions is the same way that family should look at how they can prep for questions that may be x, you know, of their child or you know, is a child of yourself. So I think that it's really important for parents to sit with the child and say, Okay, let's talk about the kinds of questions that you might get asked, let's talk about what you would say if someone actually why you get to have your phone, or let's talk about the kind of answer to the question of why you're eating certain things or what's that when your body? How would you like to answer that, that way the parent can hear the child's response, and maybe there is some uncertainty and help really guide how that answer will be. A lot of times children are diagnosed and I know this because I do it. Sometimes, you know, you try to involve the child but depending on the age, maybe the child isn't as involved. And so as they get older and they start to understand a little bit more what's happening in their body. Sometimes the parents have those better answers and have never thought about having that discussion, you know, because the child's had diabetes now for, let's say, five years. So we think, you know, they understand but the reality is that the real understanding is with the parents who was really alert and and listening to what was happening from the beginning. So I think that that's really important.   Stacey Simms  20:17 That's a great point. I'll reach back to my son. When my son was diagnosed, he was only two. So he learns nothing, right. We learned to ride a bike. He used to say, when he had something your question, I don't know, his friends asked him a question, or they just pointed out or pulled at it or whatever. And he would say, that's my diabetes, you know, leave my diabetes alone. got older, we would teach him and he had different words for it. Now he's 15. And he has actually told people you know, hey, that's Skynet. I'm robot controlled. It's a tracking device. I mean, 15 year olds are a little bit more snarky. I would not recommend that. That's what you teach your children to say they will come to that themselves, but that's good advice you do you kind of roleplay and talk them through it. And it's okay to say it's a medical device. Leave me alone. In a polite way,   Shaina Hatchell  21:00 of course, of course, in a polite way, and just being able to be prepared for those kinds of things, and from some people are not ready to talk about it. And that's okay, too. I think that it is also important to understand that it's okay to just have healthy boundaries and say, you know, I just, I don't want to talk about that. Please do not touch it. And when you're ready to have that conversation, that's all right to   Stacey Simms  21:24 another question was, and it kind of goes hand in hand. There are children. And as you said, there, there are children who don't want to talk about it. My son is very open. We're so lucky that way. But there are kids who don't want to, and they get embarrassed by it. How do you help children get over that feeling of I don't want to call it shame. That's a bit of exaggeration, but they're more private. They're a little bit more embarrassed by diabetes.   Shaina Hatchell  21:45 It's actually funny that that's a question. So I like the liaison of my family and my brother, Matt, very fond of being open and talking about diabetes. Honestly, growing up A lot of his friends did not even know that he had diabetes, it's just not his thing. And he will even say it to me now, like, you know, this is not just not my thing. Like, you know, it's not my family like talking about it, I'm like, okay, you know, I think that it's just, again, I feel like everything starts in the home, if you make them feel comfortable and confident in it being okay that they that want to share all of the information that does help you know, them establish again, really healthy boundaries at school, building healthy boundaries with with friends, but I also feel like the war that we normalize conversations about diabetes, the more that we normalize, discussing, it's kind of like a kid with asthma. I'll give this example because I grew up with asthma. And I remember as a kid, my inhaler, having my inhaler, having to give my inhaler to my teacher at the beginning of class, and I remember you know, all the kids, we had our inhalers and baggies or names and we would just hand them over and no kid thought twice about it because there was a normalized conversation about being a child with asthma. So, kids Oh, that's your inhaler, because you have asthma, okay? My friend has it or I saw something about that, or my mom talked to me about that. And it became just so normalized that there was, I didn't feel ashamed, you know, I kind of felt a sense of pride in like handing over that inhaler like, yeah, I'm one of the special ones. What I have. And so I think that if we have increased in the type of content that talked about type one diabetes, I think we'll see that kids will feel a little less shy about it, because it's going to be normal conversation to have so with me creating these books, I'm doing a lot of marketing to people that are not living with Type One Diabetes, I'm trying to market it to children in general so that it becomes more normal to know someone that has type one diabetes, I tell people all the time, you probably have met someone or you know someone or your your waiter or waitress, or somebody that you've encountered is either living with type 1 diabetes, or someone really close to them is, and so it's closer to home than we think. And if we start to have this be something that we just talked about, as usual, it really does decrease that feeling.   Stacey Simms  24:16 Yeah. When my son was in elementary school, especially for the younger kids, they used to always ask, you know, for your kid's birthday, maybe don't send in cupcakes send in a book. I mean, this was not because of diabetes. This was just because we had great teachers. I loved that. And so we would always send in a book about diabetes, like, um, you know, one of the Lilly diabetes books, or one of the books that we enjoyed is when Benny was little, and it was always a really popular book for other kids in the classroom. You know, they keep it a little classroom library and the other kids would bring it home and I would get emails from parents, like, Do you know my child brought home Is this okay? It's like, yes, it's for them to read. It's not like it's book like they didn't take it from him. Oh, my goodness. Okay. So let me ask you another diabetes educator type question that I get all the time. The tech analogy is wonderful, but it can be overwhelming. Especially I think when a family is first diagnosed and just trying to learn the basics, how do you kind of coach your families and educate them through, you know, they're gonna go home and get on Facebook and everybody's gonna say, you've been diagnosed for three days, get it on Dexcom get control, like, you know, get this one. So how do you get you deal with that?   Shaina Hatchell  25:21 That's a really good question. So one thing that we used to do so before working our children's national I worked at Children's Hospital of Los Angeles as a diabetes educator. So I have been on both the West Coast and East Coast with diabetes education and one thing that is the same as that, you know, for someone who is newly diagnosed if they want to start to look into technology, they have had to have been living with Type One Diabetes for a minimum of three to six months, give or take. And so that was kind of like a thing at Children's National but we've been actually just made a change where, of course what for insulin pumps is still three Next month, because you really need to know the basics before you can hop on to that kind of technology because it's man made. And if an insulin pump fail, you have to know how to jump right back into your manual mode. And so for that one, we still make it the same. And we tell the mat at New onset, like, Hey, you know, I know you might read some things about insulin pumps, but this is definitely something that we would discuss further with you, after your first follow up appointment with your endocrinologist. And then even then, you know, you have to have a conversation with them. And they may not think it's time yet, because honestly, influent pumps is a lot more work when you think about it and making sure that you understand again, how that pump works. And also remember, you know how to do things in manual mode, just in case things don't work with the pump, but as far as continuous glucose monitors, what we've started to do is really introduce it at New onset. If the family is really interested in it, or they know someone that has a CGM and they've already heard about it. Then we will introduce it It'll tell them that it was linked to them things. And the family then is calling every single day. So we might start the process of them getting a CGM at new one set. But of course that took time insurance has to approve it. There's so many different steps. And then after it's finally approved, and it's sent to the home, we have been talking to them every day on the phone. So if they had more questions about it, they have plenty of opportunities to discuss it with a nurse practitioner who was also looking at how their blood sugar's have been. And then once they receive it, they have to go through an entire class, either myself or another CDE. We will do a class with the family before they put it on, and really teach them everything about the CGM. So I just think that those technologies take a lot more education a lot more understanding in the very first day is always sounds great for families, but then once they start realizing how much more work is entailed with it, how much more they need to know about it. They either decide to go ahead, let's continue move forward. Or they might say you know, nevermind. The other thing is like the kids usually don't Feel that great and it sounds good while they're in the hospital because it sounds like something that'll take away them having to do finger sticks. But when the child is actually feeling a lot better realizes that this is a device that's going to be on their body for days, sometimes, not all of them. But sometimes the kid decides that that's not something that they're ready to do yet. And that's okay to sort of make sure I always tell families like, this is not like if you decide to start the process of getting a CGM. That doesn't mean that you have to wear it, it doesn't mean that it becomes the only way that you can do things, you know, the manual way we've taught you if you have your meter if he or she decides that they don't want to have that on their body, even if they've had it on for three months, and they just say, you know what, I just really don't like it. Take it off. It's no love loss. It's totally okay. And they can always come back and visit it later. If they like.   Stacey Simms  28:50 Going back to your book. I know that you've been in pre sales for a while and you've got some reaction to it. It's about to kind of go as we're speaking it's about to go live. What has that The reaction been hasn't been what you hoped.   Shaina Hatchell  29:02 It has been beyond my hopes and dreams. When I created Cheyenne learned, and I thought about combining my love for poetry with my love for diabetes education, I thought it would be more of like a local thing. I thought that people that knew me were kind of spread the word around the DMV area, maybe you know, Delaware, which is where my family is that Philadelphia, which is where I'm from, I thought those areas would take a liking to it and it would kind of just be there but it there are people that I have never met. There are people all over the world that are buying this look at pre sale and sending mixed messages and are so excited and that just makes me feel great and not for the sales or anything like that. But truly because I know that Cheyenne learns about insulin is going to be a book that really reaches people and really accomplishes my goal far better than I do. Did it to do so. I'm grateful. I'm really grateful and excited.   Stacey Simms  30:04 So let me ask you and you mentioned right at the beginning of our interview, that Shia is the name that you were planning for your baby and you had a miscarriage. We don't talk about miscarriage at all. Right. And I was not going to ask I feel like I'm prying but I also you named the character after her. So I hope you'll forgive me for being nosy or prying. But was it hard to make that decision to use that name that means so much to you? Tell me just a little bit more about that if you don't mind?   Shaina Hatchell  30:34 Oh, I don't mind at all. I am so open about having this conversation. And even in the acknowledgments, I mentioned that she's you know, shy is now my rainbow baby. She's born she's here. So for me naming the book shy learned was like this is it I have talked about since I was young that like, Oh, I'm gonna name I could show you because my name is Shaina. And it just felt right back. About his name Shia for years for years and so when I found out that no I was with child I was pregnant. I was like, Oh goodness Shia and it for me, it didn't matter if it was boy or girl like the meeting was shy like this is it. And so once I miscarried, I was actually in the middle again of writing the books in like poetry form and so it just kind of like dawned on me like, Okay, this is it. This is how Shai is supposed to be born. This is how my baby is supposed to be put into this world, I kind of felt like it was destiny, that shy of the birth a different way, you know, and so now, Shia lives forever. And I think that that is so awesome for me. And I'm just I'm excited about having another way of bringing forth this name that I've held on to for so long.   Stacey Simms  31:51 This is not a show about pregnancy or miscarriage, but at the same time, I can't pass on the opportunity. You have found a way To deal with something again, we never talked about it. And I know that women listening are relating to you. So I have to ask, do you have any advice for somebody who has gone through this and hasn't hasn't said anything or doesn't know what to do with all this emotion?   Shaina Hatchell  32:13 I think that it's all about, you know, making sure that you talk about it. But you know, think of healthy ways to get those emotions out. It's, it's different. It's definitely a feeling that I never thought I would have, you know, feeling sad, and then you're like, can be a little frustrated. There's still grieving process that you go through, you know, regardless of what how far along you are in the pregnancy doesn't matter when you know that you were going to be bringing life into the world and then you know, it doesn't happen. It can be an entire grieving process. So give yourself time, be kind to yourself, love yourself. Let your family love you know, those are all things that made the difference for me and allow for my coping to be one that turns in to something so beautiful. And so for me, it was just like, you know what, being kind to myself and letting my family and friends be a part of my journey of healing through this. And it's been great for me, I just say, you know, tap into yourself tap into your loved one, and you will make it through. This is not the end, you know, you can absolutely a lot of people feel like once they miscarry that they will never have children. And that's not true. You know, our bodies can do amazing work, and it will happen for you. Don't give up. Just be kind to yourself.   Stacey Simms  33:33 Be kind to yourself, indeed. Hey, you have already mentioned I always ask people what's next? You have already mentioned that this is a series of books. Yeah. What is the plan here? So when it you know, is there another one in the works? Is it already planned out?   Shaina Hatchell  33:47 Yes. So you this is exclusive right here, this is elusive. So there are actually two more books that I already have in the works. I'm going to of course release them one at a time. So the next book is going to be Shai learns about home management, and Shia is going to meet her very first friend. And her friend's name is Trevor Garcia. And Trevor is going to have type 1 diabetes as well, Trevor will have been diagnosed earlier than her. So he'll have diabetes since he was three years old. And they're going to meet at her first clinic visit, the first follow up in the waiting room. And the families of course, are going to connect, and they're going to talk about some of the things that they've been doing in the home. So the very first book again, I'm just going over the journey through being diagnosed, I don't yet start talking about the treatment, right, the whole management, that aspect of it, so I'm gonna give that in the second book. And then the third book, I'm like, super excited about the third book. I'm excited about the second one, but the third book, I'm going to be introducing type two diabetes into the series, and it's going to be Cheyenne learns about type two diabetes and it's going to be shy and meeting her bye babysitter so the family is going to need a babysitter. And they're not going to be wanting to trust just anybody right because Ryan needs a lot of care and so they end up getting a young lady as a teenager by the name of Kenny and Kimmy is going to have type two diabetes is going to have had been on you know, for favorable influence therapy but has been doing really well with eating healthy and exercise, lifestyle modifications that she's going to be on just like basal insulin and Metformin, and she's going to teach Shai about the difference between her type one diabetes and you know the type two diabetes that she has. So I'm really excited about introducing Kimmy into this Shire learns world and starting to kind of merge type one and type two diabetes so that we have an understanding of each other. I've heard a lot of mean things being said about type two diabetes, like you know, they don't have as much work or things like that and i i Don't like that that is kind of like the conversations that are had or that they're even compared in that way. I think it's time that all types of diabetes, you know, what the the main two types of diabetes really start to understand each other a little bit better. So I'm really excited about that one.   Stacey Simms  36:14 Oh, that sounds fabulous. I'm with you. I think we're all stronger together and a lot of misunderstanding. Shaina, thank you so much for spending time with me. I am so excited about this project. I know how important these books are to families. And I'm thrilled that you've done this and it looks beautiful. So again, you mentioned the illustrator at the beginning, kudos to her as well. But thank you so much for joining me.   Shaina Hatchell  36:35 Thank you so much for having me. I really enjoyed having this conversation with you today. And I am super excited for everyone to continue to see what Shailene has in store.   Announcer  36:51 You're listening to Diabetes Connections with Stacey Simms.   Stacey Simms  36:57 More information about Shia learns and their whole story. I'm gonna link this up in the show notes. The episode homepage is always at Diabetes connections.com. There's also a video that she did with jdrf. I'll link that up as well, really nice explainer. She did a live on Facebook a couple of weeks ago. So if you want more information, we will put all of that there as well. And right now her book is not on Amazon is my understanding, but still shipping from her website. Again, Diabetes connections.com. For all of the details. tell me something good in just a moment. But first, diabetes Connections is brought to you by Dexcom. It's hard to think of something that's changed our diabetes management as much as the Dexcom, share and follow apps. The amazing thing to me is how it's helped us talk less about diabetes. That's the wonderful thing about share and follow as a caregiver, a parent, a spouse or whatever, you can help the person with diabetes managing the way that works for their individual situation. Vinny and I have had multiple conversations over the years about how to use share and follow what you know what works best for us when he was nine. It's a lot different. When he is 15 and these conversations really help us have fewer conversations if that makes sense. You think Dexcom internet connectivity is required to access Dexcom follow separate follow app required. learn more, go to Diabetes connections.com and click on the Dexcom logo.   All right, we have some terrific Tell me something good stories. If you've got one, you can always send it to me through social media or Stacey at Diabetes connections.com and Mandy writes in hi Stacey, I have something good to share. My type one daughter Maddie entered high school this year and she made the JV cheer team. She is beyond thrilled and excited. me I have to say I'm a bit nervous considering our current pandemic situation and in type one and managing the ups and downs of physical exertion on her blood sugar, but I'm also excited for her to have this experience safely. Have a great day. Mandy, thank you so much. And I hear ya you know, no easy decisions, the stays, but she sent me a picture of Maddie. I asked for cheerleading picture and it hadn't started at the time. So hopefully Mandy, you can send me another one and we'll do a follow up in the Facebook group because I'd love to see that. I do have a true confession sort of thing about cheerleading. And this is kind of embarrassing, but I'll tell you anyway, when I was in high school, I tried out for the JV cheer squad. I was a freshman or sophomore year. I don't remember that. But I was in high school. I can't do and I couldn't do at the time split, a cartwheel, and anything that required cheerleading skill. It might have just been my school, but I think it was also the time. It truly wasn't the incredible sport that it is today. Did I make the squad? Absolutely. Was I captain of the JV team? You bet. Why? I don't know. Looking back. I think it was just force of personality. Because it certainly wasn't my skill. I had fun but I was also on the swim team all throughout high school and it was just a little too much for me to do so children was one and done but it was a really fun experience. Another Tell me something good comes from bond Who says here's my new meow Miss Charlotte and posted a picture of her cat. She said I needed a companion doesn't alert like my dog Sammy could but it is love funny that cat is beautiful. So welcome Miss Charlotte and if you want to see these pictures, you can go to Diabetes Connections, the group in Facebook, if you have a Tell me something good just send it to me You can post there or send it to me as I said at Stacey at Diabetes connections.com in innovations this week, last week, we talked a little bit about listener made hacks. But this week is all about the pros. I want to tell you about FDA approval and some new studies about hybrid closed loops.   big announcement for Medtronic recently FDA approved the mini med 770 g for people with type one diabetes down to age two and it lets caregivers See real time CGM and pump data this is on the smartphone. Interestingly, I didn't think this made a big splash when it was announced last week, I would have thought that a share and follow system from Medtronic would have made a bigger punch through of the news that we've been hearing lately. Maybe I am missing something. The whole system is the pump, The Guardian sensor, three, the mini med mobile app, and it is compatible iPhone and Android and the Accu check guide link meter with Bluetooth and that if you talk about the mini med 770 g system, that's what you're talking about. So I will link up more information about this. They are taking orders already for this system. So if you're a Medtronic person or want to learn more, I've got information in the show notes. Another system already approved, but more information about was in the news recently as well and that is the Tandem control IQ for younger children. So this study was for kids ages six to 13. In this study, they spent about three tene hours in range, which is an average gain of about two and a half hours after four months of the study, which was supported by the National Institutes of Health and published in the New England Journal of Medicine, there were also no severe cases of low blood sugar and there were no cases of decay. The city basically confirms what came before because the FDA has already approved a control IQ for kids as young as six years old. And again, more of this study in the show notes as well. Doesn't really matter how high tech the pumps are if we cannot afford the insulin to put in them. So I'm always on the lookout for insulin pricing stories. This one is not about fast acting, which would go in the pump. This is about a lower priced insulin that is basically a knockoff of Lantus. I never know how to pronounce these new insulins. I think this one is pronounced Semglee. It was launched here in the US at the end of August, and it will cost nearly three times less than the list price of Lantus. DiabetesMine points out and I'll link There article that this is the first time in a decade in more than a decade that the United States has any insulin with a list price lower than $100. I should note that is for a box of five pens, so it's $100. For five pens, it's not $100. For one, I really want to make that clear. At the same time, little editorial. I mean, how much does it cost to make So while we're celebrating a lower price, and a lot more work still needs to be done and there's a it still remains to be seen. If the pricing changes, right? Will the other long acting insulin prices come down? Or will simply price go up? I know I sound cynical if you're a newer listener, I apologize. But it's been a long time since we've had any actual good news in this so I will wait to be seen. I would like to be impressed. So let me know if you buy Semglee if you're if your insurance covers it, if you have experience with it. I would love to know how it works, how it compares to Lantus. I'm sure we'll hear more about that it gets out into the real world and what the price actually turns out to be when you go get it at the pharmacy. So let me know, if you have something for innovations. It can be something as complicated as these large studies and approvals. Something as simple as a hack that you do something that you have created to make your life easier with diabetes, definitely let me know you can email me or you can drop into the group or just ping me anywhere on social media.   Before I let you go, I mentioned at the beginning of the show, couple of diabetes events coming up that you'll want to make note of TCOYD is having a big virtual conference in October, take control of your diabetes is a terrific conference. It was mostly geared for adults with type one, I went to one of their in person conferences A while back, but they have added more for parents of children with type one. So something to look into. If you fall in either group, I highly recommend TCI D it's also for people with type two, and I think we just could use more events that crossover and really help the entire diabetes community so kudos to them Plus, they have so much humor that they Using their presentations, really great people and friends for life, which usually has a conference in the fall in Falls Church, Virginia, they have moved that is this virtual Of course, it will be in December, I will link up more information about both conferences at Diabetes connections.com on the episode homepage for this particular episode, but definitely check out friends for life, they did a terrific job of their large their big, big July conference making that virtual, this more regional conference, although this year, it's probably worldwide because anybody can join in virtually, but it is a smaller scope. It's not gonna have as many days, it probably won't have as many speakers, but I'm still learning more about it. And I hope to take part in that as well as a speaker or a presenter, but I'll definitely go as an attendee. So check that out as well. All right, thank you to my editor, John Bukenas from audio editing solutions. Thank you so much as you listen, I really appreciate you being here. I'm Stacey Simms and I will see you back here next week. Until then, be kind to yourself.   Benny  46:04 Diabetes Connections is a production of Stacey Simms Media. All rights reserved. All rounds avenged   Transcribed by https://otter.ai

If you enjoy this episode today and it inspires you in some way please take a second to rate this podcast by scrolling down on this episode and tapping the 5-stars. All you have to do is click here. When you take the time to rate and review this podcast it helps expand the reach of this podcast and makes it possible for other people to find this show and benefit from hearing this content, too. Thank you so much for your support of this show!   Almost 4 months ago my insulin pump broke and I had to switch back to using multiple daily injections (MDI). In the past 3 months I’ve used 3 different types of Basal insulin: Triceba, Lantus and Toujeo. I’ve experimented and continue to experiment with dosing and in this episode you’ll learn the comparison of each and what has worked and what hasn’t and how I’ve been able to manage my blood sugars with a 93% in range average being back on MDI.     In This Episode You’ll Learn: Which basal has worked best for me What’s worked and what hasn’t  How much insulin I’m currently injecting Tips for better blood sugars using MDI Dosing tips using basal insulin / MDI How to curb morning high blood sugars What basal Insulin is my personal favorite     Want to add your own insight to this episode? Scroll down on this episode and click to leave a review and share your own tips! All you have to do is click here.   Questions Answered During This Episode: Q1: “Heard of Lantus…the 24 hr 1? Others? & What successes or failures have you had?" Q2: “Advice to get the best results of Lantus" Q3: “Toujeo seems to work pretty good when you find your sweet spot? Start small and increase" Q4: “Toujeo gave me golf ball size lumps in my stomach. Does that mean I’m allergic??"   Links Mentioned On This Episode: Click Here to join Shredded Body for Type 1’s program Click Here to connect with me on Instagram for more inspiration and information   Have you subscribed to this podcast yet? If not, please subscribe here so you don't miss out on weekly episodes and bonus content.   THANK YOU SO MUCH FOR TUNING IN! XOXO

Chris Wilson helps run some of the largest diabetes technology groups on Facebook. He's also always on the lookout for the latest news from these companies and very involved in clinical trials. Chris also shares his diagnosis story, inside scoop on Facebook groups and even talks about bowling in sandals. Yikes. Check out Stacey's new book: The World's Worst Diabetes Mom! In Tell Me Something Good, a middle school 3D printing class helps out a 9 year old with type 1 and a running event goes virtual & big Join the Diabetes Connections Facebook Group! This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. Sign up for our newsletter here Check out Aaron Kowalski's virtual run Twitter thread here  3-D printing club news story ----- 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 Transcript  Stacey Simms  0:00 Diabetes Connections is brought to you by One Drop created for people with diabetes by people who have diabetes. By real good foods real food you feel good about eating, and by Dexcom take control of your diabetes and live life to the fullest with Dexcom.   Announcer  0:21 This is Diabetes Connections with Stacey Simms.   Stacey Simms  0:27 This week, Chris Wilson helps run some of the largest diabetes tech groups on Facebook. It turns out he's also very involved in clinical trials. This one for a new emergency glucagon,   Chris Wilson  0:39 kind of an interesting experience. They hook you up to IV and so on and push your blood sugar down, I want to say under 50 and then turn off the IV and give you the injection and watch what happens.   Stacey Simms  0:52 Chris tells us more about participating in trials. Staying on top of diabetes news and bowling in San Jose. Tell me something good. A Middle School 3d printing class helps out a nine year old with type one. And a running event goes virtual and big. 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 so glad to have you along. I'm your host, Stacey Simms. And you know, we aim to educate and inspire about type one diabetes by sharing stories of connection here. How are we doing these days? I gotta tell you, I'm having good days and some rough days. I think like everybody out there. I don't know. I feel like I'm not doing enough. Right? I have this weird feeling some days where it's not like I'm not doing enough in my house, which I am not because we moved to a new house at the beginning of March. I know great timing. And so when I tell people that they're like, Well, you've had so much time to set things up and get organized. I kind of Yeah, I guess We haven't really jumped right in and set everything up the way I think we might normally do. We certainly have the time. And many rooms look very nice. Many rooms still have stuff in boxes. Because I don't know, there's there's some days where I have a lot of urgency. And I feel very efficient. There are some days when I lie on the couch and watch YouTube all day. So I'm trying to be kind to myself, like I always advise everybody else to be, you know, I don't think this is very unusual. There are some people doing amazing things out there. I mean, I don't so, you know, I'm trying to figure out what I can do. I'm trying to serve the diabetes community, certainly, but you know, I think we'll find ways to help as we move forward here, certainly in my local community as well. But I was talking to my kids about school. My daughter was concerned about the number of credits she was able to register for, I mean, long story short, like a lot of colleges out there. They're making some changes they're adjusting. No decisions have been made yet, but the way that people registered for classes changed a little bit. And so she was really concerned about Getting the number that she wanted as an incoming sophomore. And I said to her, you know, why? What's the big deal? Because this school year may look totally normal. Everybody may go back to college, everything's fine. You know, who knows? It may look extremely different. Nobody goes back to college, they continue online learning or they get there and things change. I mean, who knows what's going to happen this fall? So all we can really do is act like it's going to be, quote, normal, register for the classes that you can, but expect the unexpected and realize that, you know, maybe you'll take some summer classes. Maybe you won't graduate in exactly four years, which horrified her you she's a very good student. And I was able to say to her look, did you have big plans for 2023? Yes, she's not on a set schedule, which kind of made her laugh, but also made me realize I've got to be more kind to myself, too. I mean, the podcast is not getting out on Tuesdays, like clockwork, as it has been, and I very much pride myself on that schedule. I think it's Hey, to let these things go, right. I mean, we want to come out of all of this with our mental health as best as it can be. And if that means tonight, I need to watch the what's up with that skit from Saturday Night Live on repeat, because and if you haven't seen this, I'm not really into Saturday Night Live lately, but I saw the one from home. I laughed so hard at the what's up with that, and I couldn't believe it was an ongoing sketch. It's so stupid and so funny. And it was just remarkable. And the one with Zach Galifianakis where he's playing the flute, I'll link it up in the show notes. That's how much I left and it's so dumb anyway. But if that's what I need to do that night, I'm going to let myself do that. So a long way of saying, I hope you're hanging in there, I hope you're not being too hard on yourself. For You know, when we went into this, we all thought I'm gonna organize my house and I'm gonna work out every day and you know, there are people doing wonderful things, but it's okay to do ordinary things and be there for each other and just come out the other side of This was a feeling that we made it through. I keep reminding myself we're doing something important by staying home. Right. That's how we're helping. One thing that really has helped me a lot through this is doing some of these live events and chat events and just the zoom calls. I've been doing a bunch lately, had a lot of fun last week doing the world's worst diabetes parent meetup. That was amazing. Thank you Project Blue November for letting me do that on your page. We got a great group chat with some parents told our mistake stories and gave away some books gave away some amazon gift cards. I'm doing stuff this week with the college diabetes network. And of course, I will be doing the 300th episode taping. As you listen, that will be Wednesday. So I believe this episode is going to be coming out either late Tuesday night or Wednesday morning. So Wednesday, April 29. I will be live on Facebook answering your questions and talking about the diabetes community in June of 2015, which is when I launched the podcast holy cow So that's the episode 300 taping. Okay, all right, getting to Chris in just a moment. Diabetes Connections is brought to you by real good foods. And last night Ben he came downstairs and said, Hey, do we have any ice cream? And we're at the point of this where we have quite a lot of ice cream we have, but we didn't have what he wanted. We had like regular I think my daughter had some Ben and Jerry's. We had some mini ice cream sandwiches, but he wanted the real good foods ice cream that I've talked to you about. And I said, I think maybe there's some in the garage freezer and he went and looked and there wasn't any love, so I have to order some more. And as I'm looking right now there is a sale 20% off on their ice cream, so I forgot to get Benny's order today. He really liked the peanut butter. They have the super premium peanut butter chocolate chip ice cream is so delicious. I happen to be a big fan of just the chocolate and my husband likes the mint chocolate chip. We didn't try the salted caramel list. I'll have to put an order in for that. This ice cream is so tasty. It's not like that. A lot of lower carb ice creams, you know that chalky kind of chunky weirdness that you can get sometimes, but this is, as they say, a real ice cream experience with real ingredients, low sugar, 200 calories per serving, they list all the ingredients online so you can read everything that goes in it. And of course, when they ship it to you, they ship it in a cooler with dry ice when we got our first shipment of ice cream. It had we're in North Carolina, we're in Charlotte where it's already warm. I know it may have just snowed where you live, but it's been beautiful here and when we got our first shipment, the ice cream is frozen solid. They do such a great job free shipping on orders over $50 just go to diabetes, connections calm and click on the real good foods logo.   My guest this week is well known to a lot of you who are on Facebook, or maybe his profile picture is you may not actually know too much about him and that's why I'm talking to him today. Chris Wilson is one of the admins for two very large closed Facebook groups. We're talking thousands of people in these groups all about tandem and Dexcom. Well, if you're not familiar, and I know some people still aren't on Facebook or have left, you know, an admin is somebody who may have created the groups, but is always there to make sure things run smoothly. They can add or remove people or kick you out for bad behavior, that sort of thing. I run two groups on Facebook, and it's a lot of fun, but it can be a lot of work. And Chris always seems like he knows an awful lot of behind the scenes stuff. He doesn't work at tandem or at Dexcom. He gets asked that a lot. And we also talked about his clinical trial experience. I didn't realize like he had so much to say about that was very interesting. So here is my interview with Chris Wilson. Chris, welcome to the show. Thank you so much for jumping on to talk to me. I really appreciate it. Well, thanks for the invite Stacey. You know, it's one of those situations where I feel like I know you because we talk on Facebook all the time and I see your posts and you know, I read the valuable information you provide And then   Chris Wilson  9:00 I realized as we were recording as I, as I hit record, I don't really know that much about you at all. I'm not sure I've been less prepared for an interview in a long time. So I appreciate you writing this out with me. Well, I mean, that's kind of the the nature of the the online community is we interact with people, you know, we get to know them, at least in one aspect of their lives, but somebody that you've never met in person, you never had a chance to sit down and have a drink with or whatever. So,   Stacey Simms  9:29 well, I'm gonna start with a very hard hitting question. I did my research and I looked you up on Facebook. And it was very difficult because we're already Facebook friends, but it does say the last time I wore shoes was January 2015. Is that true? And if so, what's with the not wearing shoes?   Chris Wilson  9:47 That is true? It just sort of I mean, I wear sandals.   outside the house, it just sort of happened by accident. My job's done. don't require me to, you know, wear close toed shoes or anything I live in Southern California on a really cold night in the winter it might get down into the 40s there's you know, no real need to wear close toed shoes and insulate one's feet.   Stacey Simms  10:18 All right, okay, so I have a much better mental picture of your day to day life. No close toed shoes do formal wear. You're not going to the office with a briefcase.   Chris Wilson  10:28 Right? I even actually have a pair of custom made bowling sandals that I use for bowling.   Stacey Simms  10:33 You do not you? I do. Can you post a picture of that when we do the when we hear this? Because that just sounds like you never got hurt wearing them   Unknown Speaker  10:42 now. Oh, man. That's funny.   Chris Wilson  10:47 Well, when I had the idea to do it, because bowling was at that point, the only time I was wearing shoes, and I sort of had the idea of Hey, I could you know, take the soul off of these a tournament a bowl of cheese, replace it with a bowling soul and be Half of my friends said, Oh, that's awesome. And about the other half said, That's the dumbest idea I've ever heard in my life.   Stacey Simms  11:07 Well, now that I know you're not getting hurt, I'll refrain from commenting, but I'm what my initial reaction was. Okay, so we're going to talk bowling, we're going to talk all sorts of stuff. But let's start with diabetes, which is really kind of how we know we found each other. Certainly, Tell me your story. When were you diagnosed?   Chris Wilson  11:26 I was diagnosed my freshman year of college. Oh, wow. I had and I was probably starting to really get the beginnings of symptomatic as I was leaving for college. But you know, you go away in August and I went to school 3000 miles away from my parents on the other side of the country, and so no interaction with them. You know, they didn't see me for anything like that. And I started losing weight in the classic symptoms thirsty all the time having to go to the bathroom all the time, but you never crossed my mind that something that could be diabetes. This lasted all the way until Thanksgiving. I went to go see my grandparents for Thanksgiving. And my grandmother took one look at me and said there's something not right with you. My grandfather was type two. So he had a meter and two mornings in a row, they prick my finger and got readings in the three hundreds. And I went to calling the advice nurse for my health insurance and said, you know, hey, what should I do? I'm from California. I'm in DC going to school. Right now I'm in Pennsylvania, my grandparents house and they said, stop whatever you're doing, do not pass go do not collect $200 get yourself to the nearest emergency room. When I got there. Actually, the meter wouldn't even read. They had to send my blood to the lab to get a blood sugar reading and it came back at almost 1000 milligrams per deciliter. And I was well into DK And the doctors looked at me and they said, We can't explain how you're alive, let alone conscious. Oh my gosh. And so I got to spend a couple of days they actually sent me to the pediatric ward even though I was an adult, because that's where all the people that knew type one were right. So I spent a couple of days in the hospital there my my mom flew out to come and collect me and they taught me how to give myself shots and prick my finger and everything else. And then after that, I went back to school when finished out the semester.   Stacey Simms  13:32 Okay, I have a couple of quick questions for you. Do you remember what it felt like when you got your first dose of insulin? I've heard that that's just an amazing feeling after you've been feeling lousy like that for so long.   Chris Wilson  13:43 Oh, it is it's you can almost like feel the the ketones leaving your blood is sort of the the way that I think about it. almost feel like pins and needles inside as things get really bad. And if it's happening slowly and building up, you don't necessarily feel it acutely. You just sort of build up a tolerance to it when they started me on the insulin and everything else it was just like this weight was lifted and I didn't even realize how bad I had been feeling until I felt better. Yeah, that's amazing. I   Stacey Simms  14:14 you know, obviously not living with diabetes myself I don't have I can't I can't relate to that at all. But I can only imagine how much better you must have felt. But then to go back to college, what was that transition? Like? Because I assume your mother did not move into your dorm   Chris Wilson  14:27 always wanted to? She did not. She made me tell my roommate and all the other people on my floor. What was going on? Some of them or were actually like oh, wow, cool. You know, you get syringes and stuff. It's almost like we're living with a druggie. Lots of joking about it, but at least the first couple years actually, it was almost like an extent I had a really long honeymoon phase. And so I didn't even really need it. You know, I gave myself the insulin and I ate when I was starting to feel hungry. You're low and didn't really even think about you know, managing intensely or correctly or the way that we do now. It was just okay this happened. We'll we'll deal with it. And   Stacey Simms  15:15 and when when was this What year was this? If you don't mind me asking? This was 1997 Okay, so before certainly before CGM, and well before a lot of people even had an insulin pump,   Chris Wilson  15:25 right he will log was I believe brand new at the time.   Stacey Simms  15:29 It is wild to think about that stuff. I mean, Lantus had just been approved pediatric Lee when Benny was diagnosed, we thought Wow, this is so cool. We get to use this new insulin that just got approved. You know, it was really it's amazing when you look back on it. When did you start getting interested in technology and I say it like this because I assume you are pretty interested since you run these these groups now on Facebook.   Chris Wilson  15:50 I didn't pay too much attention to it because for the longest time, I was surviving uninsured haha and the over The counter Rnm I actually couldn't get to a Walmart. There wasn't a local Walmart. I was getting it from CVS in the basement of the Watergate hotel, if you believe that. That was the the local CVS. Wow. And that was just, you know, kind of what I knew. I mean, even at that point, anything newer than that, the more modern analogs and stuff like that was just prohibitively expensive without insurance. So I figured that out, I figured out you know, which meter had the cheapest test strips that I could could get and I didn't test nearly enough wound up in it DK and hospitalized briefly, once during that time, although not entirely due to the insulin regimen. My parents had come to visit me and I, being a impetuous college student got mad at them and decided I was going to take a road trip so I hopped in my car and drove to Florida from DC without any insulin. By the time I got back, I was feeling pretty awful and went and checked myself into the yard.   Stacey Simms  17:00 I feel like I want to say something. It's funny, Chris, as a parent, I'm, you know, I hold my breath when I hear stories like that, but as someone who's talked to people with diabetes for a long time now, so many people have done things like that it's just life, you know, and if you as you're listening you're I could never imagine, you know, things happen, right? It's nobody's perfect. So I'm glad you were okay. That is kind of scary.   Chris Wilson  17:24 Well, I wouldn't do that now. Oh, of course. I know. I know a lot better. Now.   Stacey Simms  17:28 Of course, when were you able to get insurance and then to get you know, a pump or CGM and everything that you have now. Right back to Chris in just a moment, but first Diabetes Connections is brought to you by One Drop and getting diabetes supplies is a pain. Not only the ordering and the picking up but also the arguing with insurance over what they say you need and what you really need. Make it easy with One Drop. 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Now back to Chris talking about when he was able to get coverage for what he really needed.   Chris Wilson  18:39 It was with the ACA when in fact, I had actually looked at insurance options briefly and the one insurer in because I've moved back to California by this time, the one insurer in the state that would even offer me a policy quoted me a premium that exceeded my gross income once the ACA went into effect and they couldn't raise the premium Just because I had type one diabetes, all of a sudden it became an option and you know, we went through the the standard of Okay, we're not going to do the the regular the mph anymore, we're going to get you on lattice and get you on human log. And after trying that and tweaking things here and there and figuring out what worked and what didn't, and they decided that really, my basal needs fluctuated so much throughout the day that I needed to, to be on a pump. Then after I was going through, I don't know 1015 test trips a day cuz I was testing about once an hour, trying to catch the spikes and dips and figuring out where things were. And I was regularly having my blood sugar dip into the 50s and 40s without feeling it. At that point, my endocrinologist looked at me and said, You know what, we should probably put a CGM on you. Hmm.   I said, Okay, yeah, let's let's do that.   Stacey Simms  19:58 What did you think? When you got on Dexcom,   Chris Wilson  20:01 my first thought was, oh my god, this is amazing. I can actually, you know, see, maybe not quite in real time but basically close enough what's going on and where I need to make adjustments to things that are crucial say, you know, make knowledge your superpower. And then a lot of ways it really is. And that kind of actually dovetails in with my job because as an IT consultant, I do a lot of working with data and data analysis and stuff like that, and actually having enough data to be able to analyze it and then make changes based on it. Yeah, was almost a perfect fit.   Stacey Simms  20:40 So how do you get from being you know, a regular guy, work for yourself and you're on a pump and you're on a CGM, taking care of yourself. You're doing well to suddenly having thousands of people in these Facebook groups where you big Facebook guy from the beginning?   Chris Wilson  20:54 Well, I've actually been on Facebook. Basically since there was a Facebook. I was in college. We were, I want to say the fourth or fifth school to get Facebook. That was number one was obviously Harvard, that Stanford was second. And then they started expanding to two other schools. And where did you go to   Unknown Speaker  21:15 college? I don't know that you said it   Chris Wilson  21:16 was it was George Washington University. I see.   Stacey Simms  21:19 That's funny. I mean, I went on, I got on in 2008, which I thought was really early. If you go, there's no record of that. Because long story short, I messed up my Facebook when I left my old job at the radio station, and went from like a friend to a pub, whatever I did, I messed it all up. But I was on in 22,008. And I thought that was early. But oh my gosh, you've been there really? Since the beginning?   Chris Wilson  21:40 Yeah, I want to say it was like 2001 or two, when it was the Facebook when it was the Facebook. My endocrinologist actually had encouraged me to when I was even just starting to research pumps, and then CGM and the other things. I was encouraged to go online, find user groups, do some research. So I joined initially the the tandem t slim pump group. And as I got better at using it and more familiar with it and figuring out how things worked, and at least the best way to do things for me, I started answering more and more questions. After a few months of that, I think one of the, the original admins of the group asked me if I would be willing to help out with admitting and you know, making sure people didn't do things that violated the rules and answering questions and stepping in when incorrect information was given out, and that sort of thing. So that happened, and not too long after that happened. Then, when the G five came out, one of the admins of that tandem group started the G five CGM users group. She sort of tapped me to come in and help out with that. So that's sort of how I wound up there. I mean, both of the groups have have grown significantly since then. It used to be that we, you know, let anybody post whatever they wanted pretty much. It that's, you know, had to be clamped down on somewhat just to keep things orderly.   Stacey Simms  23:12 What's the what are some things that people should know about Facebook groups? Like, is there anything that's kind of behind the scenes stuff that would help us either post better or use them better? Or they just drive admins crazy.   Chris Wilson  23:24 One of the big things that that gets me at least is Facebook is not Twitter. There's no character limit. You don't have to cram whatever question it is that you're asking her describe the situation in 140 or 280 characters or less, you know, by all means, use lots of words be as descriptive as possible, because sometimes in there, there's a little curl that have a little nugget that gives away what the actual source of the problem that person is having is the other   Stacey Simms  23:56 thing that was really interesting. We saw this so much with control IQ When it first came out was people don't search the group to see if their question has already been answered. I mean, I run to smaller groups, and they're usually really great. But that's kind of drives me crazy.   Chris Wilson  24:12 It used to be, it drives me crazy less, because I've just kind of learned to shrug it off. In large part, it's a function of just the way that Facebook's algorithms and ranking in the way that it orders the posts that people see works. Facebook's always trying to get the most recent stuff up at the top, or the stuff that it thinks you might be most interested in based on stuff that you've interacted with in the past. And there's, I'm sure tons and tons of algorithms and things that go into deciding what you see and when. And it's not even intuitive, especially looking at it on a phone or on tablet versus on the desktop website. There's even really a search to group option in a lot of cases. And there are Tons and tons of people that do search that that's one thing. But the people that do search, almost never actually post a question because they get their answers by searching the group. So those are the people that that we frequently interact with. It's you know, and you, you wind up seeing somebody posts a lot, because they've never realized that there's a search function. Good point.   Stacey Simms  25:24 So when control IQ came out, and this is particular to the tantum group, like hundreds of people, thousands of people, it seems like came into that group. Was it that many or is it just, you know, I'm sitting on the outside wasn't really that many people,   Chris Wilson  25:37 I want to say, because the group's kind of, you know, had a long steady growth. But I want to say for especially that few months when it was approved and not yet released, and then right after it was starting to roll out, there was definitely a spike in interest. We were seeing the group grow at almost three times the rate that it had been before that Wow.   Stacey Simms  26:00 So if you don't mind, let me ask you about your experience with control IQ because there's still you know, certainly a lot of people who haven't who have tanto haven't tried it yet. And there's a lot of people who've listened who haven't switched over to it, you post a lot of, you know, very publicly posted about your experience. How's it going now?   Chris Wilson  26:16 It's so going along, okay, I've actually backed off because, of course, when it was new, I'm paying attention to it all the time, right? I'm looking at it, I want to see what it's doing. I want to see why, you know, see if I can figure out why it's deciding to do what it's doing right now. Now, I've gotten to the point where I trusted enough that I frequently just let it go. And sometimes that means that I don't catch or foresee something that I would have otherwise. So my time range has dropped back down a little bit from where it was I'm not running, you know, 9597 90% time and range. It's closer to being in the low 90s still, but a slacker in all honesty The low 90s is fine. And my average blood sugar has come down significantly. And the biggest thing that I was anticipating getting help with from it, I'm still getting out which was gone phenomenon. I'm still seeing that improvement. I'm not as a general rule waking up at 180 or 200. Even though my basal rate doubles before I wake up, Wow, it's so definitely helping. And I've kind of decided I'm gonna let it go and try to be a normal user, not a someone who's focused on it all the time, and sort of see how that rides out.   Stacey Simms  27:38 I think that almost in a way, it's better. I think that and I have because I have a 15 year old son, who is very responsible. I mean, I don't want to put him it's gonna sound like I'm putting him down. I'm not he's very responsible. But truly being a person who really would prefer to never touch this pump again, has helped him so much because I know people who overreact everything and they're not doing as well with control like you He bonuses for food and then leaves it alone. And you know, four or five hours later, he'll be like, Oh, yeah, it's good. You know, he doesn't, you know, and I'm not I'm not checking him as much as I used to because he's a teenager. But it's amazing. When you would let it do its thing if your settings are right, which is a whole other story. It really works out great. So, you know, we'll see how it goes for you. But I think that you know, anything you can do to think less about diabetes is also very nice.   Chris Wilson  28:23 That's right, it gives you you know, more time to think about the other things in your life.   Stacey Simms  28:27 So let's talk about other things in your life. You're okay, so you bowl, you're an IT guy work for yourself. There's some surfing stuff in your bio, do you surf or is that a company that you work with?   Chris Wilson  28:37 It's primarily my biggest client is a nonprofit organization that focuses on ocean waves of beaches that includes access for recreation. So there's a lot of surfing related stuff there. I can surf I have served. I'll be honest wearing a pump and CGM is is not necessarily conducive to being out in the water recreating, I would need to figure out some sort of untethered regimen or something if I wanted to do it regularly, I can at least paddle out and catch a wave or two and not get tossed around too much. But actually, the the big surfing thing is comes from my dad. My dad who's now in his 70s, you know, started surfing when he was 15 or 16. And still goes out and in surfs, usually two or three times a week at least when he can when we're not all under house arrest.   Stacey Simms  29:38 Yeah. Oh, that's great, though. That's really cool. Do they live nearby?   Chris Wilson  29:43 They do. They live about a mile mile and a half for me. Oh, that's great. So how   Stacey Simms  29:47 is everybody doing? I you know, I I don't know exactly when this will air but I assume it was it will not be at a time when we're all running around outside yet. So how are you holding up?   Chris Wilson  29:57 We're all doing okay. The nature of my job is such That I can largely work from home. Most of the time anyway, that hasn't been a huge impact for me. My parents have figured out Netflix and zoom, and doordash. And so they're adjusting to their new restrictions, although they still do get out and walk around and make sure they get their exercise in as well. So   Stacey Simms  30:25 well, who knows what it's gonna look like on the other side of this. So we'll just do what we can. But one of the questions that you I've seen you answer in the groups and I want to talk about is, you know, people sometimes think you work for them, or you work for Dexcom and you don't, but you get a lot of really good information. Can you talk to us about what you do? You know, how can lay people stay up on information from these companies, because it's all public, I assume the things that you're looking into.   Chris Wilson  30:55 It is, none of it's a secret. It's just a lot of it isn't well publicized. I pay attention to every press release that the companies put out. You know, I have one of the stock tracking apps and I have it set up to notify me whenever any of the companies on my list put out a press release, and it's not just Dexcom in tandem, it's insolate for the Omni pod. Medtronic psionics. Basically, almost anybody in the diabetes space, I try to at least keep up with what they're doing. I listened to the conference calls that they have for investors.   Stacey Simms  31:33 I salute you, because I have been on some of those conference calls. And they are so boring, but they are they have great information, but they are a slog, sometimes   Chris Wilson  31:42 they can be most definitely and if it doesn't work out schedule wise that I'm able to listen to the call. Honestly, sometimes I prefer to go back through and read the transcript after it's done. There's that I follow the diabetes media. You know, I read everything that gets Put just about everything that gets posted on diabetes mind or diatribe, or any of the other publications that sort of track what's going on in the diabetes world. And well, I do have some friends that do work for those companies living in San Diego or near San Diego, where they're headquartered is kind of inevitable, but they don't share any inside info with me or anything else. It's just a matter of really paying attention. I'm curious why you   Stacey Simms  32:31 do that. What is it that makes you so interested? Obviously, you have diabetes, you were the technology, but most people don't   Chris Wilson  32:38 follow it that closely. I think part of it's just sort of the way that I brought was brought up, I have sort of the the engineering bent to and that goes again, with with the job, but, you know, I like looking at things and taking them apart and figuring out how they work and how they're put together. And that's not necessarily always a option with diabetes technology. Although obviously the, the we're not waiting, the CGM, the crowd group has has done a lot with reverse engineering, what goes into these devices and how they're communicating with the radio signals and figuring out ways to sort of hijacks some of that to use for their own purposes, in ways that the tech wasn't necessarily originally designed to be used. But I've got some of that same sort of inquisitiveness about how things work. I mean, I remember when I was eight years old, I took apart my mother's computer that she had at home to install an expansion card so that I could attach a joystick to it to play games. And I remember being told that man, if you put that to get back together, if it doesn't work, you're not getting your allowance for the next four years.   And you were eight and it worked. And I was about eight and it worked. was safe there.   Stacey Simms  34:01 It's funny. But that says a lot. Right about being curious about, you know, having a knack for things. And for having the I don't know, there's something different about people who take a look at technology and say, I can do that. It's like you said that like the night scout people in the DIY crowd to be able to look at something and have the confidence or just even the curiosity to say we can make this better. I think that's really admirable. I don't have that. There's no doubt I'm, I'm scared of it.   Chris Wilson  34:28 Well, a lot of it just comes down to looking at it looking at what is the data is going into it, looking at what the actions are, that are coming out of it and figuring out what must be happening in between those because you don't necessarily have any insight as to exactly what the system is doing. But if you input a two and it gives you a four, and then you input a four, and it gives you an eight, and you input an eight and it gives you a 16. It's probably just taking whatever the input is and multiplying it by two and giving you the answer.   Stacey Simms  34:57 When you look at the technology and I No that, you know, who knows exactly what timelines are going to look like after this situation that we're all in right now? What's coming that excites you down the road for diabetes technology, because there's a lot that's on the horizon.   Chris Wilson  35:13 I think the biggest thing that I see and it's actually sort of already here is the option to be able to infuse multiple hormones both insulin and glucagon. Now that we actually do have a shelf stable liquid glucagon on the market, that being the G voke. from Paris, I would assume that Zealand's product isn't too far behind that since that's what's being used for the for the island with beta bionics. So we should have two options before too much longer. Hopefully, just having the ability to not just take your foot off the gas, so to speak, but actually be able to apply the brakes is I think, going to be a major thing and then going along with that and something that I haven't really seen talked about too much is Lily's faster humalog which I mean, that's one of the big challenges is always that food is fast and then slow, the slow. And so anything that that can be done to speed up the insulin action to get it closer to what you would actually seen that happen naturally when your pancreas dumps that insulin straight into your veins, I think gonna be a big improvement.   Unknown Speaker  36:26 You mentioned g Volk. Did I read you were in one of the trials. Did you talk about that at some point? I did. I've discussed it.   Chris Wilson  36:33 From time to time I do various clinical trials as they as they pop up. A lot of the research gets done here in San Diego, and if nothing else is an option to get paid for having diabetes, which is nice to have happen. Once in a while. I did participate in the phase three clinical trial for for the G Volk, where they actually compared it to the standard glucagon kit to prove that it was of equivalent efficacy. That was Kind of an interesting experience, they hook you up to IV insulin and push your blood sugar down, I want to say under 50 and then turn off the IV and give you the injection and watch what happens. And the sort of the cool thing was that they actually didn't make me take off my CGM when I was doing it. So I saved and screenshotted the data from the days that I did both the traditional glucagon kit and then the, the product that they were testing the G voke to be able to look at and sort of compare the two, but doing that kind of stuff. And I also did the G six clinical trial, proving that it was good for 10 days if you wore it and also that it would block at least up to a certain dose of Tylenol.   Stacey Simms  37:43 Oh, that's interesting. I didn't realize you're in that trial too. Did they give you a bunch of Tylenol?   Chris Wilson  37:47 It was thousand milligram pill of kill of acetaminophen. They had as a saw, I want to say it was you know, 15 ish people and all basically crammed into a clinic room. IVs in so they could do blood draws every five or 15 minutes depending on what stage we were in of the of the testing. And they were running them through the lab grade glucose meters right there in front of us and comparing the readings from the CGM because we were all wearing both the G five and Digi six so they could compare the two. That's wild. And it was it was basically controlled chaos for about six hours.   Stacey Simms  38:28 Yeah, I've signed up any for a few you know, to get into some clinical trials. But here in Charlotte, North Carolina, we really don't have the access. We could drive to Virginia sometimes sometimes there's some stuff in the Raleigh area, you know, the Research Triangle, but and the pediatric ones are hard anyway, but we'd love to do one that's really interesting. I'm going to tell them about that thousand milligrams of Tylenol in one pill   Chris Wilson  38:51 which actually isn't too much more than the extra strength the normal extra rectangle   Stacey Simms  38:56 so Oh, wow. I used I thought it was like 200 milligrams in one And then so it would be five. But I didn't think that the extra strength oh my goodness,   Chris Wilson  39:04 well, if nothing else, I mean the the clinical trials also give you a chance to have testing done that nobody would ever pay for as a normal patient. They're looking at all kinds of stuff I've done at various stages of research trials for other things where they're looking at measuring your resting metabolic rate. And they've actually got a giant plastic hood that they put over your head to measure how much oxygen is going in and co2 is coming out. And based on that they can calculate how fast your normal metabolism is running. And they'll do it under various conditions where they're running extra insulin into you and extra sugar to counteract that insulin in an IV. Under normal circumstances, I would never do think it was 100 gram of carbohydrate challenge to see what would happen but I do Did a trial where they did it before and then after giving the medication that they were experimenting with to see what the difference was how high did your blood sugar peak? How fast did it come down? And nobody would ever do that. They're laying in the bed and they're practically doing blood draws and you've got your CGM on and you can see exactly how your body responds to various things. And it was actually kind of cool because if I had not done that trial, I would not believe that in score lasted five hours in my body. Oh, yeah. But because I did that, I've now actually got documented proof that I can show that no, like, here's where I had the hundred grams of carbs and gave myself the the bolus of insulin. And I could then watch as the blood sugar's slowly comes down and tails off. And that was six hours of measurements. Well, I   Transcribed by https://otter.ai

Using a shot of long-acting insulin along with an insulin pump sounds like a weird idea. But Stacey found when her son's insulin needs went way up around age 11, that it worked incredibly well for them. She explains the method of untethered, which is also sometimes called POLI (Pumping On Long-Acting Insulin), what led them to believe it would work, and why you don't always need to use a ton of insulin to benefit from it. More info on untethered here More info on Tresiba here  ------ Check out Stacey's new 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 (rough transcript, please excuse any grammar, spelling, punctuation errors)   Stacey Simms 0:00 This episode of Diabetes Connections is brought to you by the World's Worst Diabetes Mom, Real life stories of parenting a child with Type One Diabetes available as a paperback eBook and audio book. Learn more at diabetes connections.com Announcer 0:21 this is diabetes connections with Stacey Simms.   Stacey Simms 0:27 Welcome to an episode of diabetes connections. I'm your host, Stacey Simms, and this is one of the new episodes I've added for this year. Where in addition to the weekly interview shows that are longer. I have started doing these shorter mini episodes where it's just me talking about one topic, hope you're enjoying them. It's been really fun to get the reactions and hear what people want to hear more about. So if you're brand new, just real quick. My son was diagnosed right before he turned two back in 2006 he is now 15 and a freshman in high school taller than me, and recently got his permit to drive like North Carolina. And our young, young permitted drivers are graduated licensing. But that's not what we're talking about today. Just to give you context on how old he is, and you know where we've been, he was diagnosed 13 years ago.   couple of episodes back. I mentioned Tresiba. I was actually talking about a Tell me something good segment on the show, which we do every week. Um, a family was sharing their last night of Lantus because their daughter was going out of pump, and Lantus really burns. So I was talking about Tresiba, which is another newer, long acting insulin as an alternative. And I had a couple of people asked me about that, one through email and a couple online. Don't you use Tresiba, they said, as an untethered method for Benny, and I thought this would be a really good chance to answer that question and talk a little bit more about what's called untethered or POLI. They both kind of mean the same thing. They're a little bit different, but we'll go through them. I will start out by saying, once again, I am not a medical professional. All of the information I'm giving you here is through my personal experience as a parent of a child with Type One Diabetes. I am not a healthcare provider, please call your endo or your care team to follow up and ask them any questions especially about a topic like this one. But this is the kind of topic I love sharing about because the only reason we tried untethered, which changed my son's life and has just been amazing. Over the last. It's been more than a year now. We started in September of 2018. So the only reason we started it is because another diabetes mom reached out and said, Hey, have you thought about trying this? So Cheryl, thank you very much. I'm just trying to pass along the information here. So what are we talking about? Well untethered means making use of an insulin pump. pump and taking long acting insulin at the same time, a lot of people use untethered to mean that they only use the pump for boluses. So in other words, all of the basal would be coming from the long acting shot. That's why another term has cropped up which is POLI pumping while on long acting insulin. And that is supposed to mean where you do something a little bit more flexible 50% of Basal from the pump 50% from the long acting, and all of the boluses from the insulin pump, and that's actually what we do, but I still call it untethered. So for the purposes of this podcast untethered is going to refer to any use of an insulin pump with long acting insulin, whether you're doing 20%, long acting 100%, long acting Basal, that sort of thing, just for conversational purposes. I think untethered is an easier way to go. I have been criticized online For calling it untethered, because I guess technically it's not correct, but you know me that has never stopped me before. Alright, so why would you use it? Right? What this is my question, why would you go through all of the bother that is an insulin pump, right? inserting the inset every three days wearing the pump itself, you know if you've got little kids wearing it in the pouch, or if you've got the Omnipod schlepping the PDM around, you know, why would you do all that and then add a shot of long acting? Well, in my case, I couldn't imagine it until Benny became a teenager because what happened was his insulin needs went up so quickly and went up to numbers I never thought we would see. I didn't know people could take that much insulin and be ok. And in our case, and this is a layperson opinion, but I stand by it. I think the insets get overloaded. You know when your basal rate is 40 50, 60 or more units a day. Those insets just They don't seem to be able to keep up. We had so many leaks. We had so many issues. And we tried everything. We rotated sites. We tried a longer needle. We tried every two days every one and a half days. But you know, I turned around the insulin would be like leaking down this kid's stomach. And we knew that it just wasn't working. Something wasn't going right. Plus, he has the Tandem tslim X2 which holds 300 units, we had switched from Animas which held 200. I mean, no pump holds exactly about that. It says it was always a little bit less because you have to prime it and blah, blah, blah, if you use a pump, you understand. But with that 300 units, he was still changing out his cartridge so much more often than before. And I knew that something had to give. And then Cheryl reached out online and said, Hey, I really think you might want to try this. It really might help. So we talked to our endo about it. He recommended Tresiba which was also what Cheryl had recommended which is a newer long acting. And I always laugh because when I talk about Tresiba, I feel like I'm talking about whiskey Right, it's smooth. There's no burn. It's steady. It just doesn't sound like you're talking about insulin. But all those things are true. And it just lasts longer in the body than Lantus or Levimr. And that works really well. For some people, it doesn't work as well. For others. Of course, your diabetes may vary as always. But what's nice about Tresiba is once you hit the steady state, once you've been taking it for three to five days, there's a little bit more flexibility in when you have to take it. In other words, if you take Lantus every day at seven o'clock at night, you really have to take it at seven o'clock at night. There's there's not a lot of wiggle room with it. But of course, it's always better to take it at the same time. But with Tresiba you can miss that dose. We have missed the dose by several hours. And it really has been okay. It just works a little differently in the body and I'll link up more information as to why it's a different makeup. It really does work differently in the body and it's been amazing for us. So we worked with our endo and CDE to figure out the dosing, because we had to change it gradually over time to get to I believe we started out with 30% basal from Tresiba 70% from the pump, and we gradually moved it up. And now he's 50-50. It really took about three months to find the right dosing because we were hitting moving target, right, we went from 30 to 40 to 50%. And we were changing things all the time. But we saw changes right away. I mean, it was incredible. Once those basal rates in the pump came down, it seemed to work so much more efficiently. I really do believe it was the insets, but even if your insetts are working great, and your basal rate is like 20 a day, you know, if it's different and you're not a teenager, why would you want to try this? Well, interestingly, the first people I ever heard of doing untethered, were adults. And the reason that they shared with me was, they just had a little bit of trouble, especially at first trusting the insulin pump. You know, think about it. If you've taking shots, your whole life with diabetes. And suddenly you're on an insulin pump. But you know, it's been 10 years or 20 years, it may be difficult to trust it, not just the technology, but you don't see the insulin going in, like you do with shots. So both adults said that they started with untethered, because it was kind of an emotional thing. They wanted to make sure that everything was working, they wanted to kind of ease into the pump. And then one person did that for a couple of months and one person stayed on it. And I have another friend who has really bad anxiety and she found herself worrying. Are my insets working? Do I have a bad cannula, is something's gonna go wrong while I'm sleeping. And her endocrinologist prescribed, untethered to help her with that anxiety and to help her feel better and to know that the insulin is indeed going in. And that's made a huge difference for her too. So there are a lot of reasons why you consider something like this. But I think the most important thing is to know what's out there to know that this is something that you can do. You don't have to do it forever. You don't have to do it at all. But if you want to try it out, you talk to your endo. And you can do it for a couple of weeks, couple of months. Keep it or not, if it doesn't work for you, nothing ventured, nothing gained. And if it works, it could work amazingly well. Benny hit puberty and oh my gosh, I'm sorry, I don't wanna get too personal on him. But I do want to share this. He hit it like a rocket ship. I mean, it just happened so quickly. It was and he was younger than most kids. And his insulin needs went way up, his numbers went way up, because we really didn't understand what was going on. You know, we were doing everything we felt we were supposed to be doing. I was helping him at the time. So I know it wasn't a question of not bolusing. But whatever we did, you know, once you get high, it's so hard to come back down and that was happening all the time. And in my head I'm thinking, you know, is he eating when I don't know about it, is he not taking insulin, you know what's going on, and it was the basal rates, they just needed to be increased. And once we added Tresiba, and took the load off those insets, his A1C, all his numbers, his time in range, everything went back to pre puberty, even though his insulin needs have gone up, and his teenage hormones are obviously still there. So he's 15. We just had an endo visit and things are finally beginning it looks like to come back down in terms of insulin use. So I don't know how long will stay on untethered and control IQ coming out is, you know, possibly going to change things for us. But he has said he wants to stay on untethered for at least a month into control IQ, and our endo and our CDE supports that and of course, I do too, so we shall see what happens. But if you're a parent of a teenager, and you're freaking out, because their numbers have started to get really high, and you think, oh, they sneaking food, are they not bolusing, but you know, that doesn't feel right. You just don't think that's really the case of what's happening with your kid and I don't want to talk about sneaking food that's those two words should not be used together. So let's just say eating food without bolusing. That's a different topic for another time for sure. But you You're not sure what's going on with your kid. Do not assume the worst is all I'm saying, do some basal testing, talk to your endo about basal needs. Because if like me, your kid was diagnosed at two. And the first basal rates you ever saw on a pump were 0.025 when they suddenly shoot above needing three full units every hour, it's easy to think this can't be happening. This isn't possible. But it is. And this is just one way to kind of help ease the pressure off the pump. If that's not working the way you and your endo think it should be. It's an alternative to think about that really, really helped us. It is no fun to take a shot every day. I give Benny so much credit. Although now he rolls his eyes at me. I can't even say like, I'm so proud of you. And he's like, Mom, you're so lame. But you know what I mean, right? It's not me taking the shot. It's not you if you're a parent. So we really have to get our kids on board with this. I'm not above incentives. Try this for a month. You know, here's 25 bucks for Amazon, or whatever works in your family. But I think it's important to at least ask these questions rather than live day in and day out wondering, what are we doing wrong? Feeling like a failure. teen years are tough enough. And I know, you know, using Tresiba isn't gonna solve everything. But I talked to so many parents who just don't realize how high the insulin needs can get. I mean, look, a basal rate of four units an hour. sounds crazy, but it's not that uncommon, using 80 to 100 units a day of basal insulin. It sounds bananas. But for some people, that's what they need. And people who don't have diabetes, their pancreas is are just pushing this insulin out as teens. You have no idea how much insulin your kids’ friends without diabetes is making them his body. They need what they need. So talk to your care team about it. Talk to your kid about it. And if nobody thinks it's a good idea, just remember, I am the world's worst diabetes mom. Oh, I will would be remiss before I go to not say, while I have sung the praises of Tresiba, like everything else in diabetes land, you're often at the mercy of your insurance company. We were very lucky to find that this was covered. But it is not always it is a much newer, long acting, so you may have to fight for it. definitely make sure your endo is willing to go to bat and help you appeal if need be. If this is something that you really feel strongly about, and they do, too. You don't have to use Tresiba as the long acting to go untethered, it's just what has worked for us, but unfortunately, it is so new that a lot of insurance companies do not cover it yet. Alright, we are doing these minisodes every Thursday, and every Tuesday, we have our regular length interview shows where I talked to newsmakers, athletes, artists, celebrities, authors, speakers, and everyday people just living with Type One Diabetes. Learn more at diabetes connections.com. You'll also find the episode homepage and links to a lot of what I spoke about here, including studies about untethered and a lot more information so head on over to the website, please be sure to join the Facebook group diabetes connections group. I'm Stacey Simms, and I'll see you back here next week. Until then, be kind to yourself.   Benny 14:19 Diabetes Connections is a production of Stacey Simms media. All rights reserved. All wrongs avenged   Transcribed by https://otter.ai

Aerospace engineer April Blackwell works at NASA’s Mission Control. She dreamed of being an astronaut but her type 1 diabetes diagnosis at age 11 changed everything. Since that day, though, she has found ways to break down barriers and pursue her love of space. Check out Stacey's new book: The World's Worst Diabetes Mom! April calls herself a "rule-questioner" and shares where asking those questions got her. She and Stacey talk about everything from family – she has two young children – to what it’s like to work as part of history in the space program. Join the Diabetes Connections Facebook Group! In Tell Me Something Good, a milestone for a tween with T1D – and her whole family gets in on the celebration. Sign up for our newsletter here This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. 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 (Note: this is a rough transcription of the show. Please excuse spelling/grammar/punctuation errors) Stacey Simms 0:01 Diabetes Connections is brought to you by One Drop created for people with diabetes by people who have diabetes. By Real Good Foods real food you feel good about eating, and by Dexcom take control of your diabetes and live life to the fullest with Dexcom. This week, aerospace engineer April Blackwell works at NASA's mission control. She always wanted to be an astronaut, but she was diagnosed with type one at age 11. And that changed everything. But since that day, she's found ways to break down barriers and pursue her love of space. April shares where asking those questions got her and we talked about everything from family - she has two young children - to what it's like to work as a part of history in the space program in Tell me something good a milestone for a tween with type one, and the whole family gets in on the celebration. This podcast is not intended as medical advice. If you have those kinds of questions, please contact your healthcare provider. Stacey Simms 1:32 Welcome to our first full show of 2020 Happy New Year everybody. Hope your year is off to a great start if you're new to diabetes connections, welcome. I'm your host Stacey Simms. We aim to educate and inspire about type one diabetes by sharing stories of connection. My son was diagnosed 13 years ago, just before he turned two. He's now a freshman in high school. He's 15 years old. My husband has type two diabetes I don't have diabetes, but I have a background in broadcasting and local radio and TV news. And that is how you get the podcast. As you have heard, if you are a longtime listener, some new things this year, we have some new sponsors. I dropped a minisode, a short episode last week. We're going to be doing those every week. So you get the full episode, which is something like this where it's an interview and we have some segments and then you'll have that minisode and planning for every week right now. We'll see how it goes. Which is a much shorter episode just me on one topic. And please follow along on social media because we're doing more new stuff this year. On the Tell me something good segment which has become really popular in the show. We're putting that out on social media every week, making sure you're following on Instagram. I am Stacey Simms on Instagram, there's only the one account on Facebook, Diabetes Connections the Group, although I do post everything on our page, but you know how Facebook is sometimes they are just obnoxious and don't show you everything you want to see. Something else I'm trying in the new year is transcription. I am putting in the show transcription of every episode. On the episode homepage. You can go to diabetes dash connections dot come, and you scroll down. Make sure you look at the current episode, click on that. And in the show notes will be the transcription of the interview and hopefully the whole episode as well. as well. Something new we're trying we'll see how people like it will see how you respond if it's popular and people use it will keep doing it. I have had a lot of requests for the transcripts over the four and a half years of the show and as Technology is better and better. It's been a lot easier to get that done. Done. Maybe I'll do it behind the scenes minisode One of these days and tell you about all the changes that we've gone through and some of the technology as podcasting really grows, how things have changed, but I know you're here to talk about April and NASA and how she got involved in the space program. It's such a great story. My talk with April Blackwell in just a moment, but first Diabetes Connections is brought to you by One Drop. One Drop is diabetes management for the 21st century. One Drop was designed by people with diabetes. For people with diabetes. One Drops glucose meter looks nothing like a medical device. It is sleek, compact, is sleek, compact and seamlessly integrates with the award winning One Drop mobile app, sync all your other health apps to One Drop to keep track of the big picture and easily see health trends and with a One Drops of script You get unlimited test strips and lancets delivered right to your door. Every One Drop plan also includes access to your own certified diabetes coach. If you have questions you don't feel like waiting for your next doctor visit. Your personal coach is always there to help. I am so excited to have One Drop on board. Their program is amazing. Check them out, go to diabetes dash connections calm and click on the One Drop logo to learn more. My guest this week is not someone who takes the answer No, and accepts it and goes away quietly. April Blackwell grew up dreaming of the space program. As you'll hear, she watched out for NASA news. Like most of us watched Saturday morning cartoons when we were kids. But a diagnosis of T1D in sixth grade grounded her astronaut dreams. But how did you decide to carry on anyway? You know what did you have to do? To get where she is at mission control. her blog name and her Skype handle are nerdy April, and you'll hear me ask about that. But I gotta tell you, when you talk to someone on Skype, which is how I do a lot of these interviews, the the avatar, the logo, whatever you want to call it, of their name, or their face is on the screen. So the whole time I was talking to her, it said nerdy April on the screen, which really made me smile, all right here, which really made me smile on the screen, which really just made me smile, and I did have to ask her about it. Her story, though, is it's a story of grit, of asking questions and refusing to give up. Here's my conversation with mission controls. April Blackwell. Stacey Simms 0:03 April, thanks for joining me. I'm sure you're really busy. And I appreciate you taking the time to talk to us. How are you? April Blackwell I'm doing wonderful. How are you? Stacey Simms I'm great. And I'm excited to be talking to you. I have lots and lots of questions. But I have to start with, with your name online and on Skype as we're talking nerdy April. Did you reclaim that nerdy title? April Blackwell 0:27 Oh, I am a I'm a proud nerd. I think all nerds who are truly nerds are proud of it. So it actually started though, because the my blog title started as Nerdy April's Space Adventures. And if you take that as an acronym, like, you know, everything NASA related, it spells out NASA so it kind of was a little bit of a play on words and acronyms there, but it kind of turned into just Nerdy April and that's how I've been rolling lately. Stacey Simms 0:59 Okay, So I want to ask you at the blog, I want to ask you about NASA, but let's start at the beginning. You knew that you wanted to be involved in science and in space from a very early age, right? April Blackwell 1:13 Yeah, I was only about five or six years old. I was in a kindergarten and my dad actually, he is an aircraft mechanic. And so there's a little connection there. But he also is just a deep lover of the space program. And he grew up in the Apollo days, sort of that romanticized moon landings and everything and he was just an amateur but it and his love for the space program just really captured me. And so that's kind of where that all was inspired from. Stacey Simms 1:45 What were you doing, though, at age five? I mean, when you were with your dad, looking at stars were you watching launches? April Blackwell 1:52 We weren't watching launches. I grew up in Arizona, so it's pretty far away. Florida, where most of the launches happened. Well, Stacey Simms 1:58 (laughs) I was thinking about on TV. April Blackwell 2:00 Yeah, yeah, I definitely watch some on TV we did have a very rudimentary telescope. So we would go out and mostly look at the moon since that was it a big target we could watch. It didn't have a tracker or anything on it. So it was all manual. And it required some fine tuning by dad before I could look through it. We built model rockets together and launched those later on. I went to sort of local science camp during the summer, and started getting excited about computers and everything that had to do with science. So robots and engineering type problem solving. And so it just stayed with me my whole life. Stacey Simms 2:45 Wow. So when you were diagnosed, not too many years later, you were 11. What happened? were you hoping to actually be an astronaut at that time? April Blackwell 2:55 Yeah, so I i think that was always the pointy end of the spear for was to be an astronaut. And, you know, that's when you watch TV and everything those, those are the people that you see. And so that was always kind of my final goal. When I was diagnosed at 11, it took a little bit of time for me to realize that, you know, astronaut was going to be more difficult now that I had type one diabetes. And some of that sort of came into focus later in my life. But at 11 it was kind of just heartbreaking. You know, I was watching launches and getting excited about space, but then knowing that that probably would never be a reality for me. Stacey Simms 3:41 So at age 11, you know, I guess you have many choices, but you can say to yourself, well, that's that I've got to find something else and be devastated or too bad. Or I'm going to move forward and do this some way somehow. Did that decision happened for you? immediately. Did it take some time for you to continue to love science the way you did? April Blackwell 4:01 It definitely took some time. And I guess I'll just touch on the fact that I think being diagnosed with diabetes at 11. Well, in the first place, there's no great time to be diagnosed with diabetes. But I think being diagnosed at 11, it sort of puts you on this really fast trajectory towards adulthood. Because you want to maintain your independence as much as you can. My parents implemented it, such that I had to be able to give myself shots and test my own blood sugar before I could spend the night at a friend's house, for instance. And so that was a big motivator for me. And I think, you know, maybe I always had a little bit of an inclination towards being a little older than what my physical age was. You can ask my mom I used to wake up early on Saturday mornings, to watch the news, not cartoons, just in the hopes that I might see you know, some information about NASA. But I think, you know, sort of that catalysts of putting me on a trajectory towards adulthood helped steer sort of my ideas about what I wanted to be in the future. And while I knew I could never be, or probably could never be an astronaut, space was so exciting to me and talking about rockets talking about, you know, low Earth orbit and traveling 17,500 miles an hour, five miles per second, thinking about these huge engines that need to take astronauts and supplies up to space, I just couldn't get it out of my blood out of my brain. And so I decided that even if I couldn't be an astronaut, I would love to work in the space program in some capacity. And that sort of led me to looking at an aerospace engineering degree. Stacey Simms 5:54 All right, let's go back for a second about your parents in the transition at age 11. What was your diagnosis story like, were you very sick for very long? I mean, I know we kind of sometimes we talk about it like and then you you didn't have diabetes and then you did and then life went on. Can you kind of fill us in on on how you found out? April Blackwell 6:13 Yeah. So it was, I guess nothing extremely remarkable about it, but maybe that's why I should tell it is because, you know, there is this sort of the normal warning signs that everyone comes up or comes up against. And so it was kind of in the Christmas time frame, December timeframe. I just got a cold. And then, you know, my grandparents were in town for the holidays, and we usually would stay up late playing cards, and you know, eating Christmas candy, and I just, I couldn't I just physically couldn't I was extremely fatigued. And then when I started getting up multiple times during the night to go to the bathroom, you know, my mom bless her heart, thought that I was probably suffering from a urinary tract infection. And her old wives tales, of course, told her that we needed to treat this with the cranberries. Unknown Speaker 7:14 Of course, April Blackwell 7:15 yeah, so. So we hit up the cranberry juice pretty hard for a little while, and it just wasn't getting better. And so we started going to the pediatricians office. And it took almost a week of daily pediatrician visits. I, I joke to that I could just pee on command, because every time I would show up there, they would tell me to, you know, get a urine sample. So it sort of became this joke. And then I was finally diagnosed on December 30. And they told us that we needed to head over to the children's hospital right away straight from the pediatrician’s office. We had no idea what diabetes was about at all. I absolutely had zero idea. I don't think my parents really understood it at all. They were just scared. And so we had we went over to the Children's Hospital, but unfortunately it was a sort of a skeleton crew because it was the holidays and New Year's and stuff. So they told us to just go home. And it turned out that my old pediatrician, he actually lived next door to us. And so he came over for a couple days to help give me some insulin shots and test my blood sugar. While we still had no idea what you know, was to come more shots every single day and blood sugar tests every single day. So it was definitely a steep learning curve as I think most diagnosis stories are. Stacey Simms 8:41 Yeah, it can just take so much time to get the diagnosis. I get so frustrated by that. But you know, at least they got it before it was even more devastating. Fast forward a few more years, you have kept your interest in space as you said, What did you wind up studying in college or did you go you know what, where did your path lead you to continue after high school. Right back to April answering that question in just a moment, but first, diabetes connections. is brought to you by real good foods. Have you tried them yet? high protein, low carb, grain free, gluten free. They have so many delicious products from breakfast sandwiches to pizza. The stuffed chicken is delicious, the little poppers that they make are just excellent. You know, it's really nice to have something convenient when you're not in the mood to cook or if you're a 15 year old boy, you know you're starving and you need something to get you between the half an hour before dinner. So Ben evil just get a little personal pizzas and heated up. We're really big fans of really good foods. I'm thrilled to have them back on the podcast for the new year. The new year and I'm excited to try some of the new products they have out right now. And I'm excited to try some of the new products they have out right now. We will be bringing you some taste tests as we go forward. But find out more and go to their store but find out more, go to diabetes dash connections dot com and click on the real good foods logo. now back to April talking about what happened after high school. Let's go now back to April and I'm asking her about what happened after high school How did she get to where she is now April Blackwell 9:01 Yeah, so I was very fortunate to get a full ride scholarship in state in Arizona, and because of my grades, so I went to Arizona State University and studied aerospace engineering. And then once I got out, I kind of hit a little bit of a roadblock because there was a period of time in the aerospace industry that the space shuttle was looking at being retired. And so the the future of NASA was a little bit unclear as to what was going to happen. So a lot of companies and related industry sort of put put a hold on hiring right around that time. Which was unfortunate but it turned out to be a blessing in disguise because I ended up getting a job working with the army of all things in Huntsville, Alabama. So I moved across the country. Free to work in a triple wide trailer we like to call it in Huntsville, Alabama, which just sounds so glamorous. Unknown Speaker 10:10 Oh yeah, the stars all end up there. April Blackwell 10:14 But it turned out to be a really great experience. So Stacey Simms 10:17 did I also see somewhere where you were testing helicopters? April Blackwell 10:22 Yeah. So that's what I was doing for the army. And it was really awesome. It wasn't it wasn't quite space. But it was a really great way to get my feet wet on just what it means to be an engineer and what kind of engineering I personally like because there's so many different avenues you can go with that degree. So I got to fly on experimental helicopters and boss test pilots around which was really fun. The group I was in actually was really tight knit and it I'd say even more so than my group at NASA Now. And part of that, I think is because, you know, you had to fill out paperwork that said, who in your group would go tell your spouse or your significant other that there had been an accident. And so we really counted on each other to to watch out for each other. And all of them absolutely supported me with my diabetes. You know, my flight suit had specific pockets with snacks and blood testers and stuff. And so we always kind of joked, like, oh, if you need a snack, April always has one in her left lower leg pocket or whatever. Stacey Simms 11:42 Let me just jump in and ask. So when I said you were flying helicopters, I was gonna ask you how the heck did you get clearance to do that as a person with diabetes, but it was as a passenger? April Blackwell 11:53 Correct. Yeah. So I flew on them not actually physically flying them, but it did still require FAA medical clearance which took about six, six months to get all of the paperwork in and get clearance to finally fly on the helicopter. Stacey Simms 12:10 so that's what I wanted to ask you about. Can you talk a little bit about doing this because it's it sounds so exciting and I know so many young people who want to serve in the military or want to fly and Yep, we've just got, you know, the, in the United States, FAA says now you can be a commercial pilot with type one. So progress there. But right, what do you need to do, you know, as we're going to talk about your path going forward, to kind of accomplish what you've done. You've mentioned medical screenings, things like that. You there's just a lot is there a lot of paperwork and exams? I April Blackwell 12:44 Yes, I will tell you it's a little bit of a black box. Even now with the FAA ‘s new guidance. That type ones can apply for these waivers for class two and class one medicals. It's not clear to me how many type ones they've actually accepted into those medical clearance buckets. That data is never published. And, in fact, the process to get a medical for me, like I said, took about six months. And it was really me going to an FAA Doctor who said, Hey, I can't clear you because you have type one diabetes, I can check you for all the other stuff, but that's going to require some special paperwork. So he sent in his recommendation, of course, I had to get letters and agency readings from my endocrinologist. Initially, the paperwork I started with about a year's worth of data. I sent that in and it took about three back and forth between me and basically a blackbox doctor in Washington DC at the FAA to finally get the amount of paperwork they wanted. And to be honest, I just got frustrated with The process and so I called my mom and dad back in Arizona, and I said, Hey, can you just run down to the Children's Hospital and literally make copies of every single piece of paperwork that they have, since my diagnosis? Back then it was all paper, not, you know, digital, it was literally copies of these pieces of paper, you know, probably a three inch thick, you know, stack of papers, and I literally sent that into the FAA and I said, this is all the data that I have from my diagnosis, you know, X number of years ago, and I have nothing else to give you, basically, and they finally said, Okay, okay, that's that's enough. And they granted me clearance for one year. But it was it was a frustrating process and I haven't tried to get another one. You know, since moving to Houston because I do all of my medical clearance now through the NASA doctor so I can talk with them directly. There's an actual face to face, but the FAA doctors are a little bit of an enigma I guess. Stacey Simms 15:06 So I guess the lesson there if a parent is listening or if an adult with type one is listening is be persistent. April Blackwell 15:13 Yes. If it's something that you really want, you know, you're going to find a way to overcome it and do it. And I just, I just always say, never give up and be a rule questioner because there are a lot of rules that are based on old data and old diabetes technology and management techniques. So it's worth asking the question, because a lot of these doctors especially, you know, if you think military doctors and FAA doctors, they deal with really, almost perfect human specimens, if you will. And so they're just, they just don't have the knowledge of you know, what is going on in the diabetes sphere these days? Stacey Simms 15:54 What an interesting thought, Yeah, why would they know because everybody is like GI Joe walking in. Unknown Speaker 16:00 Yeah, exactly. Stacey Simms 16:02 That's a really interesting thought. Okay, so you're, you're, you're in these experimental helicopters, you're following your career. You're in a triple wide in Huntsville. How’d you get to Mission Control? April Blackwell 16:16 Yeah, it's a great question. Um, I will say just before I leave the helicopters for a minute there in Huntsville, you know, I had this opportunity to sort of push a lot of barriers that type one diabetics came up with against because the military doesn't allow type ones, you know, that were previously diagnosed at least right now. And so I got to go through the altitude chamber, the helicopter dunker trainer, which is basically two days of being drowned alive. And I went through the parachute course. And all of these required talking with doctors and just explaining the situation to them because they literally don't deal with type 1 diabetic patients, because that's a disqualification right off the bat. And all of them were super receptive, super open to it. My military friends supported me going and talking to them and coming up with plans. So you know, we would come up with a plan, like we're going to leave your pump on till we get to this pressure, and then we're going to take it off and leave it outside of the altitude chamber, you know, and that's going to be 15 minutes. So make sure your blood sugar is at least 130 at that time, or whatever it is, you know, but it was a really great way to sort of break down those barriers. And I even included a two week course at the Naval Test Pilot School, in Pax river, Maryland. So that was a really kind of culmination of all these, you know, sort of barriers that I had overcome and a way to, you know, sort of solidify that I was on the right path. Stacey Simms 17:54 That's fantastic. Wow. And that's great to have that support from the people around you. I love to hear that. April Blackwell 18:00 Yeah, they were really great. Stacey Simms 18:02 You get, you get dunked, that sounds so enjoyable. I mean, I know you and I, it sounds like we have very similar personalities and enjoy a lot of the same activities (laughs) April Blackwell 18:11 Bananas. Unknown Speaker 18:14 Tell me about what led you then to your position at NASA? April Blackwell 18:17 Yeah. So from my my helicopter job, I was doing a lot of traveling around two weeks every month I was gone. And for a newly married person, it was just a little bit hard on the family so started looking for, you know, some other opportunities and found these jobs pop up in Mission Control. And I had absolutely no inkling that I would even get called to interview for them. But it turned into, you know, this flight test experience that I had, working on the helicopter as well. Well, it sounds completely different, actually was a lot of the same skill set that they look for in flight control. rollers. And so that sort of, you know, allowed that door to be open to get an interview at NASA. And of course, I ended up falling in love with it. I mean, it was job working at the home of manned spaceflight and now crude spaceflight with women, you know, joining in and getting to work in such a historic building like Mission Control. And you know, I'm even going there tonight I'm working this evening, that evening surf to fly the International Space Station. So it's, it's just really a dream come true. YOUAREHERE Stacey Simms 19:33 Okay. I have chills as you're talking about controlling the International Space Station. The the setup, I just want to take a moment because I think we all do know what Mission Control and flight control you know, what it looks like and what you do, but and correct me if I'm wrong here, but what we're talking about is what we see in all those movies. Right. When you know when they say Houston, we have a problem your Houston I mean, you were that big room, right? Yes. The diagram was all the guys in the white short sleeve t shirts and the glasses from the movies that we've seen all these years. That's Mission Control. April Blackwell 20:07 Exactly a skinny tie and a pocket protector. We don't smoke anymore and missing control. Yeah, but if you get in the elevator it's in, it's in the same building so that the room for instance, if you've seen the movie, Apollo 13, the room that that movie was based on is actually just one floor up from our current International Space Station control room. And so when you get in the elevators, I always joke it's sort of this aroma of like 1960s cigarettes and coffee mixed together. But that's just the way missing control smells and it's, it's hard to describe. Stacey Simms 20:47 Alright, so when you're going to work tonight, and you know, controlling the International Space Station, tell us what that really means. I mean, do you mind breaking it down a little bit? What are you going to be doing? I mean, in Yeah, I understand. April Blackwell 21:00 Absolutely. It's not that hard. So basically, you know, we sit at a big console that has several computers, we monitor a lot of telemetry data coming down from the space station all the time. And it uses a satellite constellation to make sure that we can get our data even when they're on the other side of the world. So we look at that data, we make decisions based on that data. If we see any anomalies, we may send commands up to the vehicle. And then on certain days or nights, you know, there may be a big event like a docking or undocking, maybe a spacewalk. And on those days, you know, it's our job is even a little bit more critical because we'll be sending lots of commands and making sure that the space station is performing. Its absolute best to make sure we don't have any anomalies where maybe there's another vehicle really close by, so Stacey Simms 22:00 Have you ever had an experience that was kind of frightening is the right word, but you know, where, where someone or or a mission was in jeopardy. April Blackwell 22:13 Um, I've had a few kind of small anomalies happen. I haven't been on console for anything very major. But that doesn't mean that major things haven't happened. This was, you know, hasn't lined up with my console shifts. But it's interesting because even when when stuff happens when you aren't on console, you sort of have this adrenaline because you know what that person sitting in the seat is feeling, you know, the whole lead up to being a flight controller. It's not like you're hired and the next day here on console, we call it almost a second master's degree. So you have about two years of training. About a year, a little over a year of that is sort of bookwork so you're learning a lot of information about that. The system we control, and you're taking oral examinations. And then the next piece of it is simulation. So we actually simulate, you know, really bad days, days that are worse than any any days, we've actually seen real time. And this is all to prepare you for that prioritization skill of being a flight controller and being able to work through stress. stressful situation. So we always joke that, you know, one small anomaly in the real room feels like 5050 anomalies, you know, in the simulation room, and that's just how we have to train ourselves to be able to cope with that stress. Wow. Stacey Simms 23:44 What is the best part of it for you? Is it walking into that building? Is it knowing that you know that elevator is there and you're part of all that history? Is it just you know, logging in for the day I'm curious what you know what gets you still very excited about this? Because obviously You are? April Blackwell 24:02 Yeah, so I'd say there's kind of two pieces of it, there's sort of a physical, almost just, you know, like chemical response, when you cross the threshold into Mission Control, you know, you have to swipe your badge like five times, you know, to get in the building, and then get in the room and all this stuff. So when you cross that threshold, it really is like, you're just leaving all your other problems and everything else that you've thought about that day, outside, because you need to focus. And you need to bring your best self, you know, in here, because there are literally at least six humans on board that are counting on you to take care of them and take care of their spaceship. And then as you sit down, we have what we call big boards and the friends so they're like these big projection screens and we're always getting video down from the space station, usually in about six channels. And we call it the windowless room with the best view because the view is just incredible. I mean We now have these HD cameras on board. And as you're flying my favorite place to fly over the sort of the Mediterranean Sea, and just the colors juxtapose there with like the desert sand and Africa, it's, it's just incredible. And without actually being an astronaut, I feel like it's close to being the next best thing. And then the second part is sort of what you were talking about the history, you know, in this in that very building just one floor up is where the controller sat when we landed on the moon. And they worked through problems real time, you know, to tell the astronauts what to do. And these were people that had computers with much less computing power than our iPhones today. And they were very young. If you look at any of the documentaries and everything, these were like 20 something kids fresh out of college, you know, space, there wasn't as much history then. So it's hard to you know, lead your whole life thinking you're going to be working in space. It's like something you just thrust upon you basically. And they were able to overcome all of that and be able to land man on the moon. It just, it still blows my mind today, even when I walk in that building. Wow, Stacey Simms 26:17 that's amazing. So does Type One Diabetes on your job? Do you mind telling us a little bit about your routine? Because there's some very long shifts, lots of pressure, you know, you can't exactly take a lot of breaks, I would assume. Can you talk a little bit about how you manage it? April Blackwell 26:32 Yeah. Um, so I mentioned before that we're constantly monitoring telemetry from the space station. And as type one diabetics, we're kind of used to that already. Actually, we constantly monitor telemetry coming from our own bodies. I use a CGM. So I set that in a prominent place. And it is just become part of my scan pattern. I scan all of the data that I'm looking at Looking for anomalies. And then I also glanced over at my CGM, and just make sure that I'm trending the way I want to be trending. And generally on console, I'll keep my blood sugar a little bit higher. So try to avoid going below about 120 or so just because I know if at any moment something could hit, basically. And so, you know, I don't want to have that rush of adrenaline drop me really low. So I try to keep it a little bit higher. I always have snacks in the control room, we're allowed to eat, you know, as you mentioned, they are long Fest, so you usually have a meal that you eat while you're there. And then all of the flight directors also know that I have type one, that's not a requirement or anything, but I think as a member of their team, it's important that they know that's something that I'm also monitoring and so it may require that I you know, step out for a quick two minutes to go grab a snack or, you know, do a little Check or change the site even I've had to do that at work. And so I think just being really candid and open and and, you know, open to answering any questions that they have is really important in sort of these high stress jobs like this. Stacey Simms 28:19 And a while back, I interviewed Ernie Prato, who also works at NASA and also lives with type one. And I know you know each other. Unknown Speaker 28:27 I don't, this is gonna sound so weird. So I just kind of a mom question. So I'm sorry for asking it. But like, do you guys see each other at work? Do you check in with each other? I mean, I know not everybody with type one. Diabetes has to be friends. But the mom and me is kind of hoping that you support each other. April Blackwell 28:44 Yeah, so it's funny that you mentioned Ernie because we sort of have this unofficial Johnson Space Center Type One Diabetes club and Ernie actually sits in Completely different building off site. He sits over at the airport now. So I don't see him daily, but we have sort of instant messaging capability and so will frequently talk on there. And we have another friend who actually works in the search and rescue area. So he's doing a lot of cool things with the military in order to get our astronauts safely home after they land. And so it's really fun we all meet and you know, you think we would like talk about space and stuff because that's what we do. But we always end up just talking about our diabetes and what devices were using which ones are you know, giving us trouble which ones were low on supplies for, if anyone's tried to like, you know, come up with engineer way to make something work better or whatever. So it's really fun to sort of have that outlet and especially at work with kind of like minded people. Unknown Speaker 30:01 I'm glad I asked Stacey Simms 30:05 what do you think would be next for you? Do you have other goals within what you're doing now? I mean, what you're doing now is so exciting. And I would assume you would want to do this forever. But are there other things that you would like to accomplish that you're working on? April Blackwell 30:18 Oh, that's a loaded question. There's so many things. Right now, I think my focus is just to you know, be the best engineer I can at work. And then I also have two little kids. So I Unknown Speaker 30:33 yes, I want April Blackwell 30:35 a three and a half and a one and a half year old. So they are taking a lot of my energy right now. And I think that's totally fine. That's, that's the season I'm in and so I want to be able to enjoy that. And so I think as far as my career goes, and everything, I definitely still have that astronaut dream out there. And I think there are opening up some new ways To be able to make that happen, and if not for me, then definitely the next generation of diabetics or maybe, you know, if we come up with a cure, then the non diabetics. But I'm really excited to see where that goes. And then I, I think, also just kind of spreading this message that you know, even if you perceive that there's a something that could hold you back as a type one diabetic, make sure that you are asking questions because it may not always be a hard know, and you sort of need to figure out what it is that is really keeping you from doing those things. Stacey Simms 31:36 I don't want to get too personal, but I know a lot of listeners will be interested. You know, when you have type one. There are a lot of concerns about having children. I mean, less so today, but you have to do so much work, it seems to me, you know, was it? Gosh, you seem like such a disciplined person anyway. And again, I don't want to pry but healthy pregnancies you did okay. You said you had a CGM. Do you mind sharing a little bit about that? Yeah, April Blackwell 32:01 um, so I actually don't get this question very often, I think because everyone's so focused on the NASA and space scope, but I'm really happy to share it because I think it is important. It's not something that a lot of women talk about. So, yes, I had two kids, three and a half and a one and a half, one and a half year old now. The first was a girl and everything went really, really well. I was induced, and that was sort of just my ob was being a little cautious with having diabetes and making sure I didn't go too long. And so I was induced, which turned into like a 40 plus hour labor, which was unfortunate. But everything turned out just fine. And she has a lot of attitude now. So something worked there. My son, so he's just about 18 months now, a little bit different flavor of pregnancy. As weird as that sounds. He had a lot of fluid around him while I was pregnant. So I gained a lot more weight. And I was just generally uncomfortable because I felt like my stomach was literally just gonna like burst open, it was so, so stretched out. And he ended up being a C section baby and he was over nine pounds. And that was again early induced about 38 weeks, so to completely different pregnancies. I had good control through both and you know, all of the non stress tested all of that when we're going well, and it just turned into a little bit of a different labor situation with my son so but I have two awesome Healthy Kids now and they do take a lot of my energy It's interesting because you know, my daughter being three and a half, she understands I have these sort of extra devices hooked to me. Console, she, she knows the word diabetes, she knows the word pump, she knows that sometimes I eat her applesauce pouch when I'm low and we're at the playground. Because that has happened before. Sure. And my son is still you know, he's just, he isn't quite to the point of communicating those feelings yet. So he'll touch my site, and I'll tell him No, you know, but it's just interesting seeing how they react to it. And I think in a way it will hopefully make them more empathetic to you know, friends or people in the future that they come across and this is just a normal part of life. And you know, everyone has something they're dealing with, I think, you know, Type One Diabetes happens to be mine, but everyone has something and so keeping an open mind and judging people based on devices or things that they see right off the bat I think is really important. Stacey Simms 35:07 Do you mind if I ask what devices you use? But pumping CGM? April Blackwell 35:11 Sure I use the tandem. x to polymer and sex sex. com g sex ctm. So I get that data right on the pump, which was really nice. Yeah, I like both of them's though. I'm a big fan. Before Stacey Simms 35:30 I let you go, you know, this is kind of a tough question for you to answer. But your mom and dad, you were 11 when you were diagnosed, you shared this love of space and science with your father. Your you have an incredible career. You have two children, they must have been worried during the pregnancy. You know, have you had a conversation with them about Wow, did you ever think after that diagnosis where I would be today? April Blackwell 35:55 Oh man, we've had a lot of conversation about this. Yeah, it's it's very cyclical. I think for us, you know, when I was growing up, I would definitely have months where I was not literally diabetes high, but just high on life and really excited and full of energy. And then I definitely had points where I was really low and upset that I had diabetes. You know, the one person that I knew that really wanted to be an astronaut, and literally couldn't because of this disease, you know, somehow I was chosen to have this disease, of course. So I went through all those emotions and those feelings and my parents were always there. They always supported my dream. And they really stressed to me the importance of working hard. And I will tell you, engineering is hard work. And it is hard to get through engineering school, even if you're really passionate about it. And so that support was priceless. I know my mom, you know, see Susan emotional person. And I think she was sometimes afraid that I wouldn't be able to sort of realize some of these dreams. And it's so great. Now, you know, I'm in my early 30s and I have my dream job. And I send her picture hers, you know, for Mission Control probably every week, just because I think it's really cool. And, you know, seeing her and the being able to decipher that, hey, like, we made it together. It's not it's not just me. I mean, they did so much to help me and my poor Mom, you know, she's, she's not the most most into space, but she like dragged herself to those space museums that me and my dad wanted to go to Oh, man. Sometimes she would be doing her crocheting over in the corner. So bless her heart. She was such a trooper. through all of that, but I think it's really important now to, for her to see, you know, these moments in my life. And now she gets to share those with other people that she meets that, you know, maybe they've just had a diagnosis like this, or they know someone going through an issue that's, you know, putting up some barriers and she can say like, hey, look like we got through it. It's totally doable. I think that's the key, it's doable, and it's going to be tough. But if you want something, you need to just go for it, and it'll absolutely work out. So we've just sort of on and off had those conversations, you know, let's see, I've had diabetes for 20 years now. So the last 20 years, I would say there's been conversations like that throughout the whole time. Wow. Stacey Simms 38:48 Well, that that's great. I'm so glad that you've had this conversation with your parents, you know, as a as a mom have a son who is figuring out what he wants to do, you know, and we don't want diabetes to hold him back. Don't mind saying I find your story incredibly inspirational. So April, thank you so much for joining me. And, you know, I'll be following you on Instagram and elsewhere and looking for those pictures of Mission Control and everything. Thanks for joining me April Blackwell 39:13 absolutely anytime. Stacey Simms so much more about April at diabetes dash connections come and I'm going to talk about her had a really emotional reaction to something. I'll share that in just a moment but first… Diabetes Connections is brought to you by Dexcom. And you know when you have a toddler diagnosed with type one like we did, you hear rumblings for a long time about the team years, but when it hit us at full force a little early, I was so glad we had Dexcom early. I was so glad we had Dexcom Benny's insulin needs started going way up around age 11. And frankly, they continue to go up and told, I think they started topping out about age 14 really just late last year. And you know, those hormones, swings, everything we had to do all the adjustments we've made. I cannot imagine managing diabetes during this crazy time. Without the Dexcom continuous glucose monitoring system. We can react more quickly to highs and lows, see trends adjust insulin doses with advice from our endo. I know using the Dexcom g six has really helped improve Benny's A1C and overall health. If your glucose alerts and readings from the G6 do not match symptoms or expectations, use a blood glucose meter to make diabetes treatment decisions. To learn more just go to diabetes dash connections calm and click on the Dexcom logo before I move on from April Blackwell, in her terrific story, I just want to share one more thing. So when I, when I talked to all the guests, I always grab pictures of them, right? You see that on social media, when we put the episodes out or at the episode homepage, there's usually a picture of a product or the person or you know, the crux of what we're talking about. And often they email me photos, but sometimes I scroll through just to kind of see which one I'd want. Then I can say, Hey, can I grab that one picture or whatever. So I was doing that with April. And I came across, and I'll see if I can get her permission to share this in the Facebook group. She has a picture of herself dressed as an astronaut. And that picture is from about and that picture is from, you know, she was diagnosed, she was diagnosed at the end of December. So it's Halloween. I mean, it's just really a couple of weeks before she was diagnosed and seeing her as a little girl, knowing what she wanted to do, and knowing where she is now. And just I guess I could have been sad about it because I got very emotional. And I guess the reaction could have been, oh, it's too bad that you didn't get to be that astronaut but my reaction Was this? I mean, I really got emotional, it's kind of embarrassing. Was this, this swell of admiration, I'm not sure I'd be that strong, whether I was 11 years old or, you know, an adult, to be able to turn that situation into what she has been able to do with it. You know, and as she mentioned with Ernie Prado, who also works at NASA, and you don't have to be a you know, an aerospace engineer, to just kind of overcome what type one throws at you. And I think that's what happened when I saw that photo. I just thought, gosh, you're all of you.. All of you just have to be strong. You know, even if you don't feel strong, you kind of have to be you kind of have to be and yes, parents too, but it's a different kind of strong for us, right. That's a that's a different story altogether. So I'll see if April will let me post the photo and I wonder if you'll have the same reaction that I did. Foot boy What a great story and I can't wait to follow along with her. It's nerdy April I'll link it up in the show notes on her Instagram account on her Instagram account all right time for Tell me something good brought to you by our friends at real good foods. And this one is real good foods. And I know it's a podcast and I shouldn't be saying things like you got to see the picture. But you got to see the picture. And I will post it in the Facebook group. I will be posting it later this week on Instagram as we start posting the Tell me something good stuff. But Amanda lovely. posted a photo of her kids celebrating what they call their last Lantus party. And she says the reason they were having a party, Annika, who is her daughter with type one is 10. It burns right Lantus burns a lot of people if you're not familiar, this is a long acting insulin. This is a commonly used long acting insulin. And Amanda said that Anika isn't a fan. This was a big moment. The picture shows as they're having their last Lantus party, Anika with two of her siblings in party hats. party hats, so it's Nina and chi and they are hugging her and everybody looks like they're having a It looks like a birthday party. I mean, it's really cute. And apparently Malin, who is five but not in the photo was also wearing a party hat. party hat and the dog was as well but not pictured Amanda, you got to send us a picture of the dog. But they were really excited and supporting their sister, which is why this is the Tell me something good. Not so much about the pump start although I'm sure she appreciated that and that's fun too. But, too, but it's always just so nice to see a family kind of get behind each other, right? I mean, gotta have that kind of support. And I will say that if Lantus burns, you or your child know that there are long acting alternatives, not just switching to an insulin pump. And by the way, Amanda make sure you save some of that long acting just in case you have pump issues, right? You know, you never want to have no long acting on hand, just in case talk to your endo. But if you're having an issue with Lantus, ask about switching, there are other long acting's out there that don't burn as much and that work differently, but that's definitely an endo level decision. Do you have a Tell me something good story. It can be anything from a diversity a milestone of a last Lantus party. We have lots of fun stuff to share. And I love telling your good stories. You can always email me Stacey at diabetes dash connections. com or post in the Facebook group message me, you know, send a carrier pigeon, whatever works for you. We will be sharing these pretty far and wide this year. And I'd love to hear your story. With the time shifting nature of podcasting, as I've mentioned before, you know, sometimes and recording before things are happening that I want to talk about, and then they'll the show airs afterwards. And all of that to say, a lot of you've been following along with Benny, who has been on crutches for six weeks. And as I am taping this, he is hopefully getting the word in the next couple of days that he can be off crutches, and maybe start some physical therapy. So next week, I hope to tell you a little bit more about that. And we're also going to the endo, which is a really good time for me to interview Benny because we're alone in the car and we're in the same space for once because that kid is so busy, I don't even see him half the time. But I'm going to try to talk to him about control IQ in the last year and lots of things changes he's made. Control IQ and things that have gone on since we've last talked we've made some other changes. And you know, he's just a different kid than he was even a year ago which is kind of breaking my heart and kind of fantastic but Boy, it's been it's been a big year for him. I don't know about you. But when my kids went from middle school to high school, it wasn't it wasn't just a different school. It was like a different life. High School is very different. The schedule is different. The work is different. And I remember with my daughter, who is now a freshman in college, and as you're listening is going back to school next week to do her second semester there. It just flies by it goes by so quickly. So I'm trying to hang on for dear life. And hopefully Benny will will talk to me talk to you, and we'll get him on the show as well. Tons of events coming up. I'm not even going to run down the list. I will ask you though, to go to the community page at diabetes dash connections calm. You can see where we've been where we're going. I've got a kind of a de facto book tour, because I am the world's worst diabetes mom, which is taking me on the road right now but two events a month. You can see them on the community page and see if I'm coming to your town. And if not, and you'd like me to come speak or tape a podcast or whatever. Just let me know. Just let me know. Next week, just let me know. Alright, later this week we have our second minisode. This one's going to be all about sleep overs. What worked for us, I had some questions about that. And I'm answering them. So we're gonna be talking about sleep overs. That episode will air on Thursday, January 9, and then our next regular interview episode will be next Tuesday. Thank you, Tuesday. It's gonna take me a little time to fall into the rhythm of this, but I think it's gonna be a lot of fun. Let me know what you think. As always, the show is here for you. Thanks, as always, to my editor, John Bukenas from audio editing solutions, and thank you so much for listening. I'm Stacey Simms, and I'll see you back here on Thursday. Transcribed by otter.ai

Episode 290 is the 24th installment of the PED Q&A with Mike Arnold! In this episode we talked about different ways people talk about using Lantus, the chemical signaling aspect of "cruising", PED classes and gut interaction, injectable VS oral AAS, dosing Tb500, a listener case study, AND MORE! As always support Mike at the links down in the description box below!    •••SUPPORT OUR SPONSORS•••   (COACHING) Alex - www.theprepcoach.com   (FREE OPEN FORUM w/ EXCLUSIVE VIDEOS) http://www.theprepcoachforum.com   (SUPPLEMENTS) www.projectad.me___use discount code “BFR25” to save off your order!   (RESEARCH CHEMS) www.maresearchchems.net___use discount code “alex15” to save off your order!   (SPECIALTY SUPPS) www.masupps.com___use discount code “alex20” to save off your order!   (INJECTABLE L-CARNITINE) www.synthetek.com___use discount code “alexkikel” to save off your order!   (BULK SUPPLEMENTS) www.truenutrition.com___use discount code “AXK5” to save off your order!       •••FIND THE EPISODES•••   ITUNES:https://itunes.apple.com/us/podcast/beastfitness-radios-podcast/id1065532968   LIBSYN:http://beastfitnessradio.libsyn.com   VIMEO: www.vimeo.com/theprepcoach        •••PREP COACH APPAREL•••   https://teespring.com/stores/the-prep-coach-apparel    

Pop quiz: Do pharmaceutical companies spend more on research or advertising? The answer may surprise you as the price of prescription medicine goes ever higher. These price increases cause many patients to forgo medication, putting millions of lives at risk. For example, insulin, which is needed by Type 1 diabetics for survival, has nearly quadrupled in price. The price of Lantus, a brand-name insulin that's a mainstay of treatment as a long-acting drug that helps diabetics stay under good control, saw a 54 percent price increase in 2014 even though it's been on the market for decades. The simple question is why? Houston Healthcare Inititiative CO-OP founder and respected neurologist, Dr. Steven Goldstein takes the quiz and teaches the rest of us that a lot of what we thought about drug companies and the prices set by them are just wrong. Learn more at www.houstonhealthcareinitiative.org.

Episode Outline: Insulin Prices & What To Do About It Sky rocking cost of insulin - ADA and Health Care Cost Institute – prices 2x between 2012 and 2016, 3x in decade before 2012 - 100 year history – R&D is over – price changes are PhRMA increases - Sanofi - Novo Nordisk - Eli Lilly Insulins - Old – Humulin, Novolin - New Analog insulins – Lantus, Levemir, Novolog, Humalog – less hypoglycemia Harvard Study - Type 2 diabetes - JAMA recent study - Anthem patients witched from new to old insulins - Outcomes: Patients less likely to reach Med D donut hole (80% vs. 53% after the switch), no increased risk of dangerously high/low BS, no increase in ED or hospital stays House and Senate targeting cost of insulin - House Energy & Commerce Committee - Senate Finance Committee Options: - PhRMA regulations - Legalize Canadian imports – patients, wholesalers, pharmacists - PhRMA self-regulation - Competition from human insulins _______ Make sure to subscribe to get the latest episode. Contact Us: Email: info@propharmaconsultants.com Website: http://www.propharmaconsultants.com/ Facebook: https://www.facebook.com/propharmainc Twitter: https://twitter.com/ProPharma Instagram: https://www.instagram.com/propharmainc/ LinkedIn: https://www.linkedin.com/company/pro-pharma-pharmaceutical-consultants-inc/ Podcast: https://anchor.fm/pro-pharma-talks YouTube: https://www.youtube.com/user/ProPharmaEducation

It's Stacey's family's 12 year diaversary. Benny was diagnosed the first week of December in 2006 just before he turned two. This week, Stacey takes a look back and gives an update on how they're managing now. There are significant changes to share; Benny started an untethered routine about two months ago. Learn more about untethered here. Also known as POLI (Pumping On Long Acting Insulin) untethered means you take long acting insulin like Tresiba or Lantus once a day but also use the pump. Stacey explains more.  Also this week, one of the biggest changes in the past 12 years has been the rise of smart devices. Stacey talks about Klue, a new app that can sense when you’re eating and help you with boluses! Check it out and sign up to Beta here.  This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider.    Join the Diabetes Connections Facebook Group!  ----- 1:30 Stacey welcome & reads reviews 6:40 Stacey reflects on life in 2006 when Benny was diagnosed 9:40 Diagnosis story 17:00 Big recent changes we've made: switch from Animas to Tslim last year. Got Basal IQ in late August. Started Untethered management in October. Listen back to our Ten Year episode featuring Stacey's whole family 35:15 Interview with Klue's Katelijn Vleugels 46:20 Some programming notes, two more shows left in 2018 - no show the week of Christmas. Book Stacey for events for 2019 (the calendar is already starting to fill up!) email stacey@diabetes-connections.com  Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners!  ----- Sign up for our newsletter here Get the App and listen to Diabetes Connections wherever you go! Click here for iPhone      Click here for Android 

Dr Jimmy is back in the Humerus Hacks studio again to sweeten up our day and teach us about diabetes! Join us on this delicious journey to learn about the difference of type 1 and type 2, and let your heart go giddy up as we love mnemonics lots!   

Why split basal insulin?! WHY!? This is my first day using one of the longest acting insulins in the market recommended by the one and only Doctor Bernstein. This Vlog contains A LOT of information, that being said I wanna give a brief disclaimer; I am still learning the concept of basal splitting and get my information from Doctor Richard K. Bernstein, drop questions below!Why Doctor Bernstein?https://www.youtube.com/watch?v=WFNGdKSXx64Doctor Bernstein's protocol on basal insulin!https://www.youtube.com/watch?v=6lrbxITXAVA&t=59sMy first time doing Doctor Bernstein's Diabetes Solutionhttps://www.youtube.com/watch?v=dxX_Lh1E6pYMy name is Ali ABDUL-Kareem, I am 21 years old, I do daily vlogs on my journey towards achieving great health with diabetes. I've had type 1 diabetes for about 3 years now. Comment and say hi! I wanna get to know YOU and how you live with this disease. Be sure to SUBCRIBE to stay updated on DAILY vlogs! SUBSCRIBE HERE! https://www.youtube.com/channel/UCOgPM9FFVTOX5gN_qnVHRNA?------------------------------------------------------------------------Catch me hanging here with my Diabuddies!Instagram: https://www.instagram.com/ali.abdlkareem/Snapchat: https://www.snapchat.com/add/alawey96------------------------------------------------------------------------The Diabetes Hustle Podcast!https://itunes.apple.com/us/podcast/diabetes-hustle-podcast/id1313087483?mt=2Soundcloud: https://soundcloud.com/alawey-abdulkareemSpreaker: https://www.spreaker.com/show/diabetes-daily-hustle---------------------------------The Diabetes Daily Hustle Facebook Support Group!https://www.facebook.com/groups/153556628691697/Music: J Dilla-1nce Again instrumentalhttps://www.youtube.com/watch?v=7gYcuRLjQa4**Disclaimer: While we share our experiences with diabetes, nothing we discuss should be taken as medical advice. Please consult your doctor or medical professional for your health and diabetes management!!**

Why split basal insulin?! WHY!? This is my first day using one of the longest acting insulins in the market recommended by the one and only Doctor Bernstein. This Vlog contains A LOT of information, that being said I wanna give a brief disclaimer; I am still learning the concept of basal splitting and get my information from Doctor Richard K. Bernstein, drop questions below!Why Doctor Bernstein?https://www.youtube.com/watch?v=WFNGdKSXx64Doctor Bernstein's protocol on basal insulin!https://www.youtube.com/watch?v=6lrbxITXAVA&t=59sMy first time doing Doctor Bernstein's Diabetes Solutionhttps://www.youtube.com/watch?v=dxX_Lh1E6pYMy name is Ali ABDUL-Kareem, I am 21 years old, I do daily vlogs on my journey towards achieving great health with diabetes. I've had type 1 diabetes for about 3 years now. Comment and say hi! I wanna get to know YOU and how you live with this disease. Be sure to SUBCRIBE to stay updated on DAILY vlogs! SUBSCRIBE HERE! https://www.youtube.com/channel/UCOgPM9FFVTOX5gN_qnVHRNA?------------------------------------------------------------------------Catch me hanging here with my Diabuddies!Instagram: https://www.instagram.com/ali.abdlkareem/Snapchat: https://www.snapchat.com/add/alawey96------------------------------------------------------------------------The Diabetes Hustle Podcast!https://itunes.apple.com/us/podcast/diabetes-hustle-podcast/id1313087483?mt=2Soundcloud: https://soundcloud.com/alawey-abdulkareemSpreaker: https://www.spreaker.com/show/diabetes-daily-hustle---------------------------------The Diabetes Daily Hustle Facebook Support Group!https://www.facebook.com/groups/153556628691697/Music: J Dilla-1nce Again instrumentalhttps://www.youtube.com/watch?v=7gYcuRLjQa4**Disclaimer: While we share our experiences with diabetes, nothing we discuss should be taken as medical advice. Please consult your doctor or medical professional for your health and diabetes management!!**

You'll see more top-selling drugs go generic in 2016. But don't expect drastic price drops initially...the first generic usually has 180-day exclusivity before other generics come out. Prepare patients for these switches. Explain these are best-guess release dates...they can change due to legal maneuverings, etc. OxyContin (oxycodone ER)...available now. But advise patients generics are only out for the 10, 20, 40, and 80 mg tabs so far. Gleevec (imatinib)...February. This could be a game changer for certain leukemias...since the brand costs about $10,000/month. Crestor (rosuvastatin)...May. This is big...it's the only high-intensity statin besides atorvastatin. Consider rosuvastatin if interactions or muscle problems are an issue with atorvastatin. Nuvigil (armodafinil)...June. Explain armodafinil may last longer than modafinil...but there's no proof it's better or safer. Suggest either option for shift workers if nondrug treatments (sleep hygiene, etc) and caffeine aren't enough. Benicar (olmesartan)...October. It will join a handful of other generic ARBs. Pick one based on payer preference. ProAir HFA (albuterol)...December. Explain this generic will NOT be equivalent to Ventolin HFA, Proventil HFA, or ProAir RespiClick. Encourage prescribers to write "albuterol HFA" to give you flexibility. Zetia (ezetimibe)...December or early 2017. Suggest saving ezetimibe as an add-on for high-risk patients who can't tolerate a high-intensity statin. For patients on Vytorin, consider suggesting generic ezetimibe plus a generic statin instead...at least until Vytorin goes generic. Also look for Basaglar in late 2016. It's a new BRAND of insulin glargine that will be similar to Lantus...NOT a generic or biosimilar.

Today in FirstWord:

Today in FirstWord:

In der aktuellen Ausgabe der Zeitschrift Diabetologia wurden vier Studien über den Einfluss des Insulin Analogons Glargin (Lantus) auf das Krebsrisiko veröffentlicht. Dabei zeigte sich in drei der vier Studien ein erhöhtes, dosisabhängiges Risiko an einem Karzinom zu erkranken. Billrothhaus-News bat den Präsidenten der Österreichischen Diabetes Gesellschaft Univ. Prof. Dr. Bernhard Ludvik um ein Statement. Prof. Ludvik weist darauf hin, dass aufgrund teilweise widersprechender Ergebnisse und methodologischer Probleme, die Unterbrechung einer laufenden Therapie mit Glargin nicht zu empfehlen sei. Nationale und internationale Gesellschaften haben ähnliche Empfehlungen abgegeben. Trotzdem seien die vorliegenden Ergebnisse ernst zu nehmen und weitere Untersuchungen notwendig. Beunruhigten Patienten sollten seiner Meinung nach alternative Therapien angeboten werden.