Diabetics Doing Medical School with Hannah Hamlin

[00:00:00] Rob Howe: Welcome to the Diabetics Doing Things podcast, where we explore the amazing stories of type 1 diabetics around the world. I'm your host, Rob Howe, Diabetics Doing Things founder and 11-year type 1 diabetic. Help raise awareness for diabetics doing things by sharing this with your diabetic friends. We're also on Facebook and Instagram. Tag a type 1 friend today. Alright, we are here, episode 8 of Diabetics Doing Things. And our special guest today is Hannah Hamlin, who we actually got connected a couple weeks ago right when we were starting Diabetics Doing Things via email. So welcome. So excited to have you on the show.

[00:00:41] Hannah Hamlin: Thanks. I'm excited to be here.

[00:00:43] Rob Howe: So tell us a little bit about yourself. First of all, I think the thing I'm interested in right off the bat the most is how did you find Diabetics Doing Things? Walk us through sort of how we made that connection.

[00:00:57] Hannah Hamlin: Um, well, I think I might've found you on Instagram. Um, and then you have a blog. So I linked to that and I was just reading about it. I have a blog too. So I'm always interested to see what other people with diabetes are writing about. Um, and then you had mentioned a podcast and I thought that was a really cool idea. I just moved States last summer and I just don't know anybody with type 1 here. And so sometimes I feel like, uh, that connection is really helpful. So listening to your podcast so far this semester has been really great. Just, you know, to feel less lonely and have somebody who kind of gets what you're going through and just to have that grounding.

[00:01:34] Rob Howe: That's been something that's been interesting for me, too, really over the last year. I've never really had a bunch of type 1 friends who are around all the time. Just because, I don't know, by happenstance, maybe that they just weren't around. but really the last year or so I do improv at the Dallas Comedy House and there are at least three type 1 diabetics and two who I see very frequently and who have both been on diabetics doing things but just having them around and like having some people that you know you can like share that you know the struggle with sometimes it's like oh man I'm really not feeling it today I've had low blood sugar all day or like I can't my blood sugar's just been weird today I'm not feeling it That's such a huge piece of, you know, finding that community. So I'm really glad you found it through us because that's why we're doing it.

[00:02:23] Hannah Hamlin: Yeah, well, I'm really glad, too. I think it's definitely made a difference in my semester just having that therapeutic almost, you know?

[00:02:30] Rob Howe: Yeah, absolutely. And our episode today is Diabetics Doing Medical School. So first of all, before we kind of get into that, let's talk a little bit about your diagnosis and how long you've had type 1. And then we'll kind of go, because I know you've already, you know, spoiler alert, but you already mentioned you're studying to become an endocrinologist. So that's super cool.

[00:02:52] Hannah Hamlin: Yeah, I'm excited about that. Well, let's see. I was, my 10-year anniversary was about six or maybe seven days ago in the beginning of February. So that was a big deal for me. I spent some time reflecting on having diabetes for that long and just kind of what it had taught me and where I was because of it. And I think that was more emotional than I expected it to be. But so diagnosed, I was 13 years old and I was living in Houston, Texas at the time and just not feeling good, kind of going to the restroom a lot, craving orange juice for whatever reason. And my parents are really brilliant and they knew something was up. I wasn't acting like myself. So my mom took me to our family physician's office. She thought maybe I had a UTI or something like that, or just something was off. And so they ran some tests and did the blood sugar and a urine test and different things. And my family physician said, well, I think you really need to go see an endocrinologist. And so I, my mom was like, okay, we can call and make an appointment later this week. And they're like, no, no, no, you need to go. You probably need to go right now. We already called and made an appointment. They're waiting for you. So we get in the car and we were driving to the endo and, um, just kind of confused as to why our doctor didn't tell us a lot about what was going on and why we had to go there immediately, you know, cause I didn't think anything was crazy, um, crazy wrong. I was just feeling a little off. And so we get there and, uh, sit down in the office and there was a nurse there and she had all this stuff laid out, the shots and the blood sugar meter. And so she starts telling me about how I'm going to take shots every day when I eat and test my blood sugar this many times. And I remember looking at her like, I don't understand why, what's wrong with me? And so they had not told me I had diabetes. They forgot that step in the process, which was kind of a bummer. So finally, she's like, oh yes, you have type 1 diabetes. And of course, I didn't know what that was at 13. I kind of knew what type 2 was. I thought maybe it was something that older people got. I didn't understand. But my mom started crying. And so I was crying. And you know, that big emotional thing. And then finally kind of figuring out what it was. And I remember asking, okay, well, how long do I need to do this? And oh, you're the rest of your life and crying more. And then I remember the nurse looking at me and asking me why I was crying. And for me, that was really, I guess that was the first time I really felt alone with diabetes. I know sometimes it can just be something where you feel like people don't understand you. And that was the first time that I felt like that. And so my blood sugar, I think was only about five 50 or a little bit above that. It wasn't hugely high. So I took my first shot in the office and they sent me home with just a list of supplies. Uh, at the time we got to the office, it was about four 30. So they were about to close at five and I kind of got the feeling they were rushing me out, which was a little sad, you know? So anyway, um, it was a rough experience, but get home, do my first shot with dinner at home and it took me about 45 minutes. I remember my dad sitting with me in the dining room trying to talk me through it and, you know, the resistance and being scared and just the idea of having to do that for the rest of your life was really overwhelming. And then the next morning I got up and went to school and my mom brought me lunch and just kind of moved on with my life. And that was it. There wasn't a big moment like, or a big, you know, time off where I really had time to think about it. I just kept pushing forward and now I'm here,

[00:06:18] Rob Howe: I guess. So you didn't even, you didn't spend any time in the hospital. I've never been to the hospital for type 1 diabetes. No like extended training. You got there at 4.30. They were like, all right, well, got to go. It's 5.30. Time to got to beat traffic and get back home. Good luck.

[00:06:35] Hannah Hamlin: Yeah. And I think one of the best parts, well, now I laugh at it at the time. It wasn't funny, but they sent us with this CD-ROM kind of, or a DVD to tell us, you know, how to do the shots and the carb counting and stuff. And we get home and we put it in, and they accidentally gave us a Spanish version. So it wasn't even in English. It was all Spanish. And, I mean, we don't look like we speak Spanish. My family, my mom, she minored in Spanish, so she was able to kind of interpret some of it. But it was like a really loose interpretation of what we were supposed to do.

[00:07:03] Rob Howe: So your full diabetes education was translated secondhand from a Spanish DVD.

[00:07:09] Hannah Hamlin: Well, I mean, we did go back to the endo and, you know, do different classes. But that was the intro to it was Spanish.

[00:07:17] Rob Howe: So that is fantastic. That is truly unique. And I think the reason I start off these interviews when we talk about diagnosis is, first of all, everyone's experience is so different. I had a very similar one to you. I went to the urgent care and then straight from the urgent care to the hospital. But they told me that I had diabetes at the urgent care. They're like, yeah, you have type 1 diabetes. So I had this entire like 25 minute car ride from South Dallas where I lived to Children's Hospital. And I was just like boohooing, crying the whole time. I had no idea. So and then, you know, I've managed to like compose myself a little bit going inside. But it's interesting, like the differences in bedside manner and just like the way that you find out make a huge difference on how you approach things. So I want to focus on something, too. You had mentioned that the nurse asked you why you were crying. Did she explain, was it, is that part of an explanation of, well, you can live your life normally with diabetes or she was just confused?

[00:08:21] Hannah Hamlin: I don't know. I mean, it was 10 years ago, so I don't exactly remember. I just remember that sentence and her looking at me and me thinking, why, I mean, why wouldn't I be crying? Like, this is a huge diagnosis that'll affect me for the rest of my life. Like, I just, I thought that that was so crazy that she wasn't able to, you know, put herself in my shoes and understand that at 13, that's a really scary thing to hear. And maybe that's part of what motivates me to want to become a physician. And I think bedside manner is huge.

[00:08:48] Rob Howe: So yeah, absolutely. You've been a diabetic for 10 years. You're making the decision now. You're like outside of your undergrad. And at what point did you know you wanted to be an endocrinologist?

[00:09:03] Hannah Hamlin: That's a good question. It definitely didn't start that way. I remember in high school thinking that I never wanted to have a job that had anything to do with diabetes because I didn't want to have that as a bigger part of my life than it already was. But I went to undergrad, and I actually had a lot of health issues in undergrad. And I was diagnosed with mono and put on steroids at the school health center and then just lost a lot of weight and a lot of my insulin sensitivity. So I really struggled with health. My immune system kind of crashed, and I had a lot of repercussions from that. And so I really had to do a lot of research kind of on my own to figure out what was going on. I felt like my family physician knew a lot about, you know, the mom, but didn't know a lot about diabetes and then vice versa for my endocrinologist. So I feel like I started to really do a lot of research. And the stuff that I learned was able to help my health so much. I thought, wow, this is really cool. I kind of wish that, you know, maybe this would be something I'd like to do for other people. And at the time, I was at Texas A&M studying nutrition. So I kind of fell in love with the way that the food that we eat affects our blood sugar and learning about that for the first time, really, because at diagnosis, I wasn't told to change my diet at all, just to count the carbs and almost eat more processed foods because they have the nutrition labels on the back. So I think that I just really fell in love with the science and being able to help people. And then the really big moment for me that made me decide I wanted to become a doctor was one summer in undergrad, I was working at a camp for kids with type 1 diabetes. And I was there as a medical staff, and we would help the little 8-year-old girls do their shots for the first time and help them go swimming and take their pump off and change their pump sites and all that kind of stuff. And I just really felt like I was making a positive difference in the world, and so that was kind of my big motivator. and so I ended up applying my senior year at A&M and I got in and so I'm just completing my first year of medical school so I'm just starting it's a long road ahead. Sure that's that's so awesome

[00:11:09] Rob Howe: though that and I really want to focus on the the diabetes camp piece too because that's not something I did I didn't go I had an opportunity I think you know early on but I got I got diabetes when I was 16. So I was like, you know, I was, I was so cool. Um, you know, I didn't want to go to diabetes camp. So, um, and, and so I think, you know, when I talk to people now, they, they talk about what like a huge formative experience it was for them to spend that time around other people with type 1 diabetes. So, uh, what was that like spending, especially with, you know, young kids, um, who, you know, were five years younger than you were when you got diagnosed. What was that

[00:11:50] Hannah Hamlin: like working with them? Yeah, well, I actually, the camp that I was a medical staff at, I was, went to as a kid. And that first summer after I was diagnosed, my parents made me go. And the one I went to was in Texas Lions Camp. It's in Kerrville, Texas, so not too far from you, Rob. But it, I went as a kid and that first semester, I wasn't able to find the courage to tell any of my friends that I had type 1. It was kind of like a little secret that I had. I remember getting really emotional when my mom had to tell my teachers, you know, in school. And I went that summer and just hanging out with other kids that had type 1 and, you know, seeing them test their blood sugar and be okay with it. And, you know, they were still happy, healthy kids and, you know, living their childhood. And that made a huge difference for me. And I think just talking to them and, you know, the empathy that you can have with somebody that really changed things. And I left camp wearing a shirt that said something with type 1 diabetes. And I remember I wore it to a restaurant on the way home. And my mom was so emotional because I was letting other people know I had type 1. And that was a big step. So for me, that was huge. And then as a med staff, I think helping or being there for kids that were so much younger, it made me really thankful that I had my childhood kind of without it. And then I was able to adjust at a little bit of an older age. But it also made me realize that people with type 1 diabetes mature so quickly. I think it's just a huge weight to hang on your shoulders. And those little kids are just amazing with the way that they can take care of themselves. I mean, they can explain to you eight-year-olds explaining what ketones are. I mean, my med student friends are still learning that. So it was just really

[00:13:34] Rob Howe: cool, I think, and very humbling. Isn't that funny? On a previous episode, I was talking to another guest and uh they were talking about how it sort of forced diabetes forces you to grow up um and you you know i was 16 so it was a little bit of a shorter gap to close maybe uh some other people were in you know 13 or 15 like yourself um but when you're five six seven years old and even younger than that um that's such a huge uh like you said burden but also just like cognitively like it's something else that you have to think about um and so that's interesting you said, you know, that you're glad that you had your childhood. I was glad that I had my, you know, really most of my teen years to just kind of be a normal regular kid and then continue to be a normal regular kid just with this extra thing to think about and to plan ahead for.

[00:14:29] Hannah Hamlin: Yeah. Yeah. I think you can definitely be a regular kid or teenager or grown up. You just have to do a little extra prep work, you know, and be cognizant of what's going on. Yeah. And I think I think you're right it's that the kids uh that are diagnosed younger they just seem to have a greater sense of autonomy and they make decisions you know and have to stand up for themselves in certain situations you know like no I need to leave class right now to go test my blood sugar and treat this low you know and stand up against teachers or you know whatever it is

[00:14:55] Rob Howe: just being aware of what's going on what changed for you I think uh once you sort of got either got home from camp or started to become more comfortable with your life as a type 1 diabetic How did your demeanor change when you were talking to people about it? Were you more confident making those decisions, stepping out of class or stepping out of, I don't know, if you played sports or anything like that? You know, taking a seat for a second, testing your blood sugar, giving yourself a shot or grabbing some orange juice, whatever it might be.

[00:15:23] Hannah Hamlin: Yeah, I think it changed in that I was okay with it myself. I had kind of come to terms that this was something I had and I was going to have for the rest of my life and it was going to be okay and I could deal with it, you know, and my life wasn't going to suffer for it. You know, it was going to be okay. And I think once I accepted it myself, I was able to talk about it with other people easily and explain it. And sometimes people think it's cool and sometimes they think it's weird, you know, and you just have to kind of give them the facts and, like, this is me and this is what I do. And it's different, sure, but it works for me. And, you know, I think really just accepting it for myself was the key there.

[00:16:02] Rob Howe: Yeah. And that's huge. I mean, just like anything else, but I think especially when you're talking about something that you're going to be dealing with for the rest of your life, you know, when you start to make it a part of yourself publicly and like just accepting it and, you know, treating yourself with kindness sort of and not, you know, blaming yourself for it, I think, or, you know, feeling sorry for yourself sometimes, you know, it's easy to slip into those habits. So it's kind of really cool when you talk about that process and think about, you know, the way you used to feel and those things. Um, so let's talk about some stories. Let's, let's just swap, swap diabetes stories. Any, what's your most maybe memorable, uh, living with diabetes story, whether that's low blood sugars or, uh, high blood sugars or whatever that might be, you know, supplies, scenarios, traveling,

[00:16:51] Hannah Hamlin: whatever. What do you got? Oh, let's see. There's so many to choose from. It's hard to pick a good one. Um, well, I know you often ask about funny or low blood sugar stories. So I was trying to think of one before this and one that came to mind was, um, I was, it was a couple months after I was diagnosed and still kind of learning how to do things. My mom would come and wake me up in the middle of the night to test my blood sugar, which was really great that she did that. But one night she woke me up and I thought it was time, I guess I was dreaming and I thought it was time to wake up. And so we tested my blood sugar and I think it was low. Um, so my mom was going to grab some juice or something and she comes back and I guess I thought I was getting ready and I was using the the lancet to like put on makeup. So I have the lancet up here by my eye. And my mom freaked out because of course it's like cocked and she thinks I'm going to like poke my eyes out or something. So that's when we laugh about a lot. I think that was pretty funny. Um, and then high blood sugar stores. I don't have a ton. I think when I, my blood sugar's high, I just kind of, I'm a little recluse and maybe not as chipper as normal. So I don't have any good ones for that, But low blood sugar, I mean, some of them are, I don't know.

[00:18:02] Rob Howe: Yeah, it's interesting. You were saying when you were diagnosed that you crave orange juice when you were high, or that was kind of like what your body was craving. Because when my blood sugar is low, point me in the direction of some OJ, because that's like, I feel like Super Mario after I drink it. I just like power up right after that.

[00:18:22] Hannah Hamlin: Yeah, definitely feeling that when I was low. I think I was just craving orange juice when I was high. before I was diagnosed because I didn't have any insulin. So I had a bunch of sugar, but I wasn't able to use it, right? So my body was saying, we need more sugar, all my cells. But yeah, definitely when you're low, it's like your body releases all of these hunger hormones as a method of survival, and you just feel like you want to eat everything. And sometimes, I mean, sometimes I give in to that and eat way more sugar than I should for a low. But it's hard. You know, you only have so much, I think, self-control when your body's in that fight-or-flight response. So you just kind of got to do what you got to do.

[00:18:54] Rob Howe: I remember a few times in college where I'd have like a pretty low hypo and I'd like take a beat and I'd be like, hey, this is just I feel I'm OK. I'm safe. This is an opportunity for me to get creative with this junk food. And so I remember, you know, just like organizing this plate of like the weird of, you know, peanut butter and jelly and orange juice and cookies and all this stuff is like. So, yeah, sometimes those are those guilty pleasure moments where you're like, OK, my blood sugar is low. I'm going to treat it, but I'm going to treat this low in style. And then I'm going to have to take insulin after. Obviously you have to overcorrect, right? Um, what's the, what's something that you've learned, you know, in your, maybe in your studies, um, that maybe has, that you didn't know before, uh, about type 1 or diabetes in general, or just, you know, some sort of scientific, um, I don't know, methodology to something that you already knew. Huh? I realize

[00:19:52] Hannah Hamlin: That's a great question. That's a good one. Well, I think definitely an undergrad studying nutritional sciences, just learning how much food impacts our blood sugar was huge for me. I was able to tweak some things in my diet that really had a positive impact on my health. That was cool. I think just the general lifestyle things that I learned from that. Now in medical school, we're learning a lot. We just did a section on acid-base disorders. We We were learning how to treat different things that cause acidosis like DKA or diabetic ketoacidosis. So learning not just giving insulin with those people but also giving potassium and why that is and the different mechanisms. I think stuff like that for me is so interesting, especially when I have a place to kind of apply it to. So stuff like that's been really interesting. But what I've also learned through my education is being around other people who are into medicine and science and their view of type 1 diabetes and what they think it is or what causes it or how it comes about has been really interesting. I think everybody, there's a lot of misconceptions out there, as I'm sure you know, because you probably hear them all the time. But a lot of people think that we're born with type 1 diabetes or it's something that we got because we ate too much sugar when we were little. That one kind of hurts, I think, because it's definitely not something we did to ourselves. And just different ideas. A lot of people think that people who get DKA and go into the ER, it's because of uncompliance. I think that's definitely not the case. I don't think they realize that it only takes about eight hours without insulin before you start seeing high levels of ketones with high blood glucose. That could be just you rolling over at night and your insulin pump's falling out and you're not catching it until you wake up, and then that's it. I think what other people think about diabetes is almost as interesting as what I'm actually learning.

[00:21:39] Rob Howe: And I think, too, at that level, you're talking to future practitioners and future doctors. So to hear their perspective on it and having it be sort of across the board, just like everyone else's, I'm sure has been interesting. Any of them stand out in particular of misconceptions about type 1?

[00:22:06] Hannah Hamlin: That's a good one. And I think that being born with type 1 diabetes was a big one. In undergrad, my biochemistry professor taught that to a class of 300 students. I just remember sitting there being so upset. I'm like, this isn't true. Where are you getting this science and why are you teaching it to us? I was so upset. So I ended up talking to him after about it, and he was very understanding and then corrected himself. But that was just something that I was like, wow, really? At this level, we're still here? So that's a big one in my eyes.

[00:22:37] Rob Howe: Isn't that crazy how, I mean, I think about really the last 11 years or so and like how the technology and research has evolved and like the, and all the new studies that have come out. And then I think back, like one of the type ones who's around the comedy club with me has had diabetes for 47 years. so the she has seen like the full spectrum of like insulin from cows to like where she is today with like a with an Omnipod pump so um like it's so crazy to think how quickly like some of the research you know gets progressed but imagine like you know if you if you hadn't been in that class uh you know those 300 students might not have uh had the latest most up-to-date uh you know diabetics, you know, information on diabetes. So, so props to you. So you're out there, you're out there doing things and, and helping, you know, to dispel some of those misconceptions.

[00:23:36] Hannah Hamlin: Yeah. It's something I've actually had to be really conscious of, I think in my medical school class, because I know that most, I mean, my class is a hundred students. So most of them know that I have type 1 diabetes and what I do is going to be what their conception of diabetes is. You know what they think when they have that first patient with type 1 that comes into their office, whatever they're practicing. And so I've had to be really careful because I eat a very kind of like low carb diet because that's what works for me. But I, that does not work for everybody. And I totally realized that. So I've had to be really careful when sometimes my friends will be like, oh, would you like a piece of cake? Oh, wait, I forgot you have diabetes. You can't eat that. And I have to say, hey, actually, I choose not to eat that because it doesn't make me feel good. But people with diabetes can totally eat cake. They just have to, you know, count the carbs. And I just have to be very careful with making sure that, you know, I'm not the only picture of diabetes that they see in them, knowing that there's a whole spectrum of ways to take care of yourself with this disease and just making sure that that's something they recognize. And that so they don't reprimand, you know, patients when they come in, if they're, you know, eating different things or whatnot. Not that physicians ask about diet maybe as much as they should.

[00:24:44] Rob Howe: Well, and I think you really hit the nail on the head, right? We're all so different. This disease is, by and large, different every single day. I'm eating a very strict diet right now, eating really healthy, really high-quality ingredients. And still I have days where my blood sugar just spikes in the middle of the day. And I can't point that back to anything other than, well, that's how my body decided to react today. Yeah. And so, yeah, I think that's really interesting. It's like, yeah, there were days where I would get that same question. we celebrate at my job birthdays every month with like cupcakes or s'mores or like just regular cake. And almost, you know, for the first 10 or 12 celebrations while I was there, somebody would ask me like, hey, is this like, can you have that? Is that okay? It's like, yeah, I just have to count it. And some days I don't, some days I do eat it, some days I don't. And it, you know, it really just depends on how I feel.

[00:25:41] Hannah Hamlin: Yeah, definitely. Well, can I ask you how you've been doing with the, you said you're doing the Whole30, and eating healthy. How has that been going for your blood sugars? What adjustments have you had

[00:25:49] Rob Howe: to make and stuff like that? Oh my gosh. Uh, it's been amazing. So I actually did a podcast, um, on Thursday, recorded an interview with the founder of whole 30. Um, and so that'll be coming out this week. Uh, diabetics doing whole 30, kind of like a switched format where she really interviewed me. Um, but long story short, um, obviously like very, very low carb, um, very, you know, no sugar, no, um, and so like your spikes are like almost eliminated. So like you're, it's a very low like curve and you're keeping very close to, um, you know, your nice, your, your good, strong base levels and, um, really like, and almost totally eliminated all of my boluses for that 30 days. And my basal reduced like 60% as well. So I virtually, uh, cut down like 70% of my insulin consumption and kept my, kept my levels still really low. So I love it. Uh, and I feel amazing. So, um, I'm taking a couple of days off and just having some, um, I really wanted some noodles. I have this great noodles, uh, shack, like right by my apartment that I really wanted. Um, and then I'm going to jump right back into another one because it just, I just feel so good, uh, really great energy. And, um, you know, it's, it just makes so much sense for my diabetes. And plus, you know, insulin is a depressant, you know? So, and I think a lot of people overlook that, like, you know, in some days, even when your blood sugar is fine, you just kind of feel down because you're, you know, your body's, you know, you're introducing that outside steroid that's bringing, you know, that's helping you get balanced, but brings you down sometimes. So, you know, the less dependent I can get on it, the better I, you know, I feel and whether that's, you know, if there's any science to that, or it's just like mental um you know because you know what what i thought there's science to that yeah there's there's science to that great at least i have that backed up now but also um from a from a nerd perspective i gotta think you know i gotta look out zombie apocalypses around the corner guys you know we gotta keep an eye out for it um which is a joke that i tell but also like what you know what if there's some sort of tragedy and you and you have to and you know your insulin production is down. And you know what I mean? So you have to have ways to know how to take care of yourself with, you know, what if insulin isn't an option somehow? What if there's a shortage, you know, whatever that is. And I, and I like those challenges of, Hey, I have this disease, but also, um, I've, I've kept myself in such good condition and shape that, um, I can eating the right things, um, and really knowing your body and listening to your body. Um, you know, you can get through a lot. So all that to say, it's a long roundabout way to say, I love doing whole 30. The one thing is that you do have some lows that kind of sweep in because you're eating really low carb. So I always keep 100% all natural unpasteurized orange juice around just to perk me back up if

[00:28:43] Hannah Hamlin: I get a little bit low. Awesome. Yeah, well, I eat similar to that. And I definitely have had the same experience that my insulin needs have dropped a lot. And I just feel so much better. It's a huge game changer. And not having those big swings in blood sugar. I mean, for me, studying all the time and having tons of tests, that's a, that's a big thing I worry about, you know, just from an academic standpoint. So it's absolutely just made a huge difference in my life. And I love that you said, um, zombie apocalypse, because that's a joke in my family too. Uh, my mom won't let me throw away my expired insulin. There was one point where we had mail order, um, insulin and they just sent us too much. And she absolutely doesn't, she doesn't want me to throw it away because she's like, if something happens, like the zombie apocalypse joke, that we can at least use it because it's not fully denatured. It's going to help a little bit. And that came true when I was living in Houston and we had a hurricane where some trees were knocked down in our neighborhood and we were kind of stuck there for a couple of days and we didn't know how long that that would be. But I think in a case like that, I mean, that's huge. It could be something like that. And then as well, there are certain diseases that also have life-saving drugs that are enzymes. And often the pharmaceutical company that makes them, it's a small group of people. So there's only one company. And if something happens to that company, then those people are in big trouble. So it's absolutely a real thing. We joke, but it's true. It's true. Well, and like you said,

[00:30:11] Rob Howe: sort of in your hurricane example, you're eight hours without insulin until you're in DKA, even if you're super compliant and regulate your blood sugars really well. I mean, that's just reality. So, uh, yeah, that's, that's really great. Uh, you know, and I, I'm kind of the same way, you know, a lot of people are like, Oh, well, you've had that for a long end than a month. You should probably throw it out. And it's like, Oh, well, what if I need it? You know, then at least I have something and I've never had any issues with insulin going bad or anything like that. Knock on wood. So, um, that's, that's good. So let's talk, let's talk about this. Uh, since we're on this, we're on this vein, uh, what's your plan? What's your zombie apocalypse plan? Because I've got one. And it's intricate. So what do you what do you got? What are you going to do? Zombie apocalypse happens today? What's your next move? Well, maybe I haven't put as much

[00:30:59] Hannah Hamlin: thought into it as you so I might need to take notes. But I think just definitely cutting back carbs even further than I have, you know, trying to exercise a lot to upregulate those receptors that bring glucose into your muscles and in your fat storage. So you don't need as much insulin. I would probably just kind of like biohack my way through it, trying to decrease my insulin needs. And definitely maybe raid a CVS depending on, you know, what it got down to. So what about you?

[00:31:28] Rob Howe: Yeah, I want to, don't let me forget to talk a little bit about exercise because I want to talk, since you have the science background, I want to table that until we finish this zombie discussion because this is important, obviously. It's very important. Zombie apocalypse happens tomorrow. my first step is to hole up because the first 48 hours are going to be complete mayhem everybody's going crazy so yeah, just hole up and then during that time kind of tactically map out where the Walgreens are in the area and then just raid them one by one systematically because I think once you have all that insulin in one place that sort of dictates how long you have left I suppose before you really have to go find some more so I think that's my wait 48 hours, wait for it all to blow over and everybody to get kind of settled down or find their places and then go to those Walgreens and find that insulin. Because I feel like if people are looting a Walgreens or a CVS, they're going for the narcotics and they're going to leave the drugs in the fridge probably alone. That's at least my belief.

[00:32:32] Hannah Hamlin: Right. Yeah, I think so too. And if we got really smart about it, we could probably find insulin synthetically made now so you could find a lab where they make it and man, we'd be golden.

[00:32:40] Rob Howe: Yeah, then you're done. I mean, that's the lottery of the apocalypse, I think. Pretty much, yeah. So all jokes aside, you were talking about the impact on your receptors from exercise. I was an athlete in college and a little bit afterwards playing professionally, and I always had, you know, whenever I was in a period of extreme training or in really good shape, my blood sugar levels were always better without fail. Even that continued after just, you know, when I was working out more, you know, just going to the gym. So can you talk a little bit about the science behind that?

[00:33:15] Hannah Hamlin: Yeah, absolutely. This is the stuff I love. So we have these receptors on our muscles and in some of our fat cells called GLUT4 receptors. And when we exercise, we upregulate them so they become more active. And those receptors pretty much they help you store the glucose from your blood into your muscle cells or into your fat cells as fat. So anyway, so those receptors are upregulated when we work out. And if you've heard kind of in bodybuilding, they talk about that 30-minute anabolic window post-workout. And that's when they try to carb load and get a lot of protein in because they know their body can use that food more efficiently to store in their muscles. So when we are working out, especially strength training, but it could be anything, cardio. I mean, a lot of us know the ways that our blood sugar swings when we work out. We're able to become more insulin sensitive, meaning that we need less insulin then. And we also have that natural GLUT4 receptor upregulation, which helps us store glucose. And I think when we work out, so that's kind of the receptor side of things. But as well, just from a bigger standpoint, when we work out regularly, we're kind of burning through the glycogen stores in our muscles. and so our body is able to store the glycogen back more efficiently. When we top off those glycogen stores, then our body kind of has to start converting that glucose to fat and storing it as fat, and that takes a little bit more insulin. We'll notice maybe we'll get a little bit less insulin sensitive when our glycogen stores are full in our muscles. So just kind of keeping that glycogen stores, always working it off a little bit and storing it back, that can definitely help with blood glucose control as well.

[00:35:01] Rob Howe: That's fantastic. I need to make sure that we plug your blog on this towards the end, because I'm sure you have some insights on there as well, like being a med student and a type 1 diabetic. So we want to make sure that we link you up there when we post this as well, because that's really interesting. And that's something where my expertise as a diabetic is just from experience. But I always love to have not only another diabetics recommendation and sort of sign but also somebody who really knows what they're talking about. So I'm sure that we'll be reaching out to you in the future just to give us some science behind some of our tips and tricks for being a type 1. Cool. I totally love that. So as we sort of like wind down, I try to ask, and sometimes I forget, but if we opened up your diabetes kit, what do we find? What are you carrying with you either every day or say you're going on like a trip? you know, either to Europe or wherever you were going for a trip for a few days, what's in your

[00:36:03] Hannah Hamlin: kit? Let's see. Well, my daily, my daily kit right now is actually pretty crazy. I go to school all day and then I end up usually going to the gym after class and then maybe to the library or to a friend's to study or back to school to study. So I try to bring a lot of meals with me. That's something that I usually eat breakfast here in the morning at my apartment. And then I'll bring lunch and probably dinner just in case I get caught out studying somewhere or in a study group. So I'm always prepared just to have food on hand. Um, so that's the food aspect. I always, always have something, um, to eat when I'm low, I'll have some juices. Um, but I've been doing, they have these little, um, 10 grams of carbs boxes of raisins, organic raisins that are awesome. And I love those, um, cause I wear a CGM so I can usually tell when I have a low coming on. So even though the raisins have a little bit more fiber, they'll digest in time to kind of fix that low. Usually when I catch it, if I'm really low below like 50 or so, then I'll definitely hit a juice. But, um, so I have that. And then I always have, I wear an insulin pump. So I'll have my insulin pump clearly. And then my continuous glucose monitor, and then a finger test meter just to calibrate it. If I feel like something's wrong or, you know, if something happens. And recently I had a bad experience with some sites falling out, um, during finals week last semester. So I've been carrying around some extra insets with me, uh, just in my backpack, since I have so much stuff already. Uh, it's easy to throw them in there, but that's been important. Uh, I got caught at the library during finals week, uh, last semester and my pump got, my pump site got stuck on the chair and I turned around and it ripped out and then I had to drive home and I was like, Oh, I missed two hours of studying. I really needed that, you know? So stuff like that. I think time management is important. So I just, I tend to be over-prepared, uh, kind of with my lifestyle right now.

[00:37:46] Rob Howe: I always talk about being in diabetics, like being a boy scout, you just always have to be prepared. So go ahead.

[00:37:51] Hannah Hamlin: Yeah. Yeah. There was a time last week where I had a technical error in my pump. So I just brought my insulin vial, the new cartridge, everything to class. And during class, I'm just setting it up. I'm like, we've got to do what I've got to do. I have to be here. We have an attendance policy. And then traveling, let's see, the last time I traveled abroad was I went to Costa Rica two summers ago. and I just packed, I wasn't on the pump at the time, which was kind of nice, I guess, just because there's a little bit less you have to bring. So I just brought enough insulin to last me maybe two weeks or three weeks. I always pack more just because you never know what's going to happen. And then plenty of needles and test strips and then lots of snacks for traveling, you know, on the airplane back and forth or, you know, just being in Costa Rica, you don't really know what kind of foods they're going to have or the availability of it. especially with a different currency, that's always a worry. You can't just go out and buy something if you just got there and you have to go and exchange money and stuff. So I always bring kind of a lot of food too.

[00:38:53] Rob Howe: Yeah, I think especially when you're traveling to countries, like I spent two weeks in Colombia earlier this year. I was like, you know, some countries I'm pretty confident that I'd be able to figure out a solution if something happened or like my insulin got stolen or my bag got lost or something. but there are countries where it's like I don't speak Spanish I don't know how this health care system works so it's like always over prepare and like keep as much stuff on your person as as possible but that's that's really cool and yeah you're right like you know when you're on pens or you're just doing regular injections sometimes there's less stuff to bring than with a pump but obviously then you don't get the pump convenience yeah yeah I've kind of gone back back

[00:39:33] Hannah Hamlin: and forth through my life, uh, pump and then back to shots. And surprisingly, my, uh, blood glucose control doesn't change a whole lot. You know, it's just kind of preference for whatever's going on

[00:39:42] Rob Howe: in my life at that time. So, yeah, I'm kind of the same way. Um, I, I, I fought the pump for a long time. I didn't think it was cool. Um, and, uh, but you know, once I got it, I was like, oh yeah, this is, this is way better. I really like this, but my control stayed about the same state really, you know I I'm proud of my control I've got nice uh you know good a1c's so um that's that's great

[00:40:04] Hannah Hamlin: I think um as diabetics we're often so proud of that number you know if it's something we're working hard for I know like for me my a1c is a way bigger deal than my gpa and it always has been

[00:40:14] Rob Howe: like that's just how it is so as it should be you know like one affects your life literally affects your life I mean obviously gpa is important I was a big nerd as well so don't feel bad about that. But yeah, A1C is super important. Um, and it should be, and it should be a point to, to brag, you know, when you have a, you know, you look at that chart and it's like, it has that big normal range, you know, it's like, Oh, if you don't have diabetes and has like elevated under control or whatever. And it's like, when you're in that range, it's like, Hey, yeah, I have diabetes, but, um, I'm right here in control of it. And, um, you know, these people down here didn't earn those numbers, you know, they just got, they got lucky. That's true. Yeah. It takes

[00:40:51] Hannah Hamlin: a lot of work to get there. It really does. Um, yeah. And I think as a, as someone who's in school to be a physician, I really have to remind myself daily that I can't sacrifice my health for, you know, uh, studying more or my GPA or my board scores, because I think, especially wanting to be an endocrinologist that being able to take care of diabetes is my end goal anyway for my patients. So I better know how to do it myself for sure. You know, and I think that that's going to beat out grades or anything else. Um, and I, a lot of people in med school, you know, it's kind of losing sleep, you know, not exercising. It's a lot of, it's a really stressful environment to be honest. And so, um, it's, it's a constant reminder, you know, I have to kind of do, do differently than my peers and, um, and go to the gym and not study as much, you know, and, and take time to cook my meals and stuff. So. All right. So any, anything, um, anything,

[00:41:45] Rob Howe: Any kind of last thoughts before anything that you want to plug? Where do we find you on either social or tell us a little bit about your blog and how to get in touch?

[00:41:55] Hannah Hamlin: Sure. So my blog is called The Keto Life, and it's on WordPress, so I'll definitely give you the link to post. And I don't have a ton of information on there. I kind of post maybe monthly, lately. But I recently just released an article about 10 things I learned from a decade with diabetes, and it just kind of is very more emotional than anything, but just kind of talking about the different things that diabetes has taught me over the years. And I'm working on a blog for meal prepping. I do meal prep every week, and it's something that just saves me so much time and energy throughout the week, and it's really nice. And a lot of my friends have asked me about it, whether they have type 1 or not. So I'm going to work on an article about that, and hopefully I'll just keep kind of keeping up to date. So you can see me there. And then the other social media site I'm most active on is probably Instagram. I like to post pictures of my food. Hey, so you can follow me there too. And I'll give you links, but that's about it.

[00:42:51] Rob Howe: Fantastic. Well, thanks so much for coming on today. It was great to meet you. I'm really glad that we got to do this interview. Thanks for listening to Diabetics Doing Things. Subscribe to our newsletter for weekly emails and behind-the-scenes content. And if you or someone you know has an amazing story to share, send an email to rob at diabeticsdoingthings.com.