Top 5 Things I Learned at ADA 2024

[00:00:00] Rob Howe: Alright, what's up? Welcome back to another episode of Diabetics Doing Things. It's Rob Solo in the studio today. I am going to attempt to do this all by myself, all in one take, for this episode. And the title is Top 5 Things I Learned from ADA 2024. It's also going to include some Diabetics Doing Things updates, but first I'm going to do as I normally do and start my solo pod with a fresh cracked Coke Zero. All right, maybe this little burst of dopamine and caffeine will power my episode today. So let me just get my notes in order here and let's roll. So starting off right now, the middle of the summer is the busy diabetes event season. There's primarily in the US like three big ones every year. And I've been fortunate enough to go to all three now, which is pretty exciting. My infinity stones of diabetes events. I've pretty much all crossed off my list. There are a few international ones that I still haven't yet been able to attend, but I'm sure that those will happen in subsequent years. And I hope that they do. But for the most part, the U.S. Diabetes Event Season Breakdown is three big events. That's American Diabetes Association Scientific Sessions, ADA 2024. So I'm going to break down my top five things I learned at ADA 2024. The second one is Friends for Life, which is happening as I speak. I think people are starting to arrive to Friends for Life, the Children with Diabetes Main Conference. They have a lot of satellite conferences throughout the country and even internationally now. But the main one's in Orlando on the Disney campus at Coronado Springs. I'm sure people are going to have a really great time there this week. So sending good vibes to everyone. We went for the first time last year, had a really great time, treated it as a diabetic, doing things offsite. But this year, with as busy as June was for me, and ADA was a big part of that, I wanted to just take a little bit of a break and do fewer things. And you'll see why that's important because we have a ton of stuff happening, not just in July, but ongoing at Diabetics Doing Things. So the final one is ADCES, which I'm also going to this year is in New Orleans. And that's the Association of Diabetes Care and Education Specialists. And that conference is sort of wrapping up the U.S. summer season. And it's probably my favorite of the three conferences because everybody is just like very tired and chilled out a little bit. and it's easier to talk to people on the event floor and easier to just kind of cut through whatever people have been pitching. All the energy is sort of dying out and it's a nice like finishing capstone for the event season. So looking forward to seeing all the CDCES friends in New Orleans in August. Okay, Diabetics Doing Things updates. On June 15th, we had our first Diabetes Legends basketball clinic in Dallas. It was amazing. It was so different from Denver and yet the energy and excitement was very much the same. We had WNBA number three draft pick in 2021 and Dallas native Lauren Cox at the event. And I think it was really special for me to see the journey. I first met Lauren when she was like 16 and it was my first panel at a JDRF Type 1 Nation event. JDRF now breakthrough T1D. And it was really cool to track that journey from that first panel where I met Lauren and her family to now Lauren coming to our clinic and really building an amazing day for our campers. And congrats to Lauren. She just signed a new deal in Australia for the upcoming season. So congrats to her and wishing her all the luck as her career continues. We had about 25 kids at the Dallas Clinic, and it was just an amazing Saturday. It was hectic. It was fast-paced, but we had some ballers come through. some of the young women who were our campers really can play and I think it was just a really cool opportunity to see young people with diabetes get to interact with someone who is currently living out their life dream and their life goal and I know for me a really important part of my early days with diabetes was seeing someone with diabetes doing the thing that I wanted to do and that was Adam Morrison playing college and professional basketball at the highest level and saying, okay, well, it's not going to be diabetes that keeps me from my dreams. And so I think that same thing can happen. Like you're in the camp and you see this person who is doing something that you want to do, or you're listening to someone on this podcast, it expands your mind to the idea of what's possible. And that's really important for me to continue to show through these camps and continue to give our campers a chance to interact with real life diabetes legends, make friends with diabetes and get all the good vibes of diabetes camp. So shout out to all our volunteers. My mom came to this camp, which was really special for me. And shout out to our amazing med staff from Children's Medical Center in Dallas. You guys are awesome. And I honestly, we had a little bit of a one camper came in with a low, but during the camp, almost no campers pulled themselves out. So our med staff were there and super supportive, but ultimately we had some good sugars at our Diabetes Legends Basketball Clinic in Dallas. So really, really loved that. A couple of things coming up to mark your calendars for, if you want to hear me speak, there's two of them in particular. The first one is a virtual event, is July 25th with the International Diabetes Federation. And the title of it is called The Power of Movement to Tackle Diabetes. And that is a virtual event. We'll include a link in the show notes. Would love to invite you there. I'm going to be part of a panel with other athletes who are living with diabetes. And I'm going to share my story. And I've been talking about a little bit more openly recently, but my peak days as an athlete were some of my worst A1Cs of my diabetes life. And they weren't bad by any stretch. They certainly were below the national average. My A1Cs have never been very high. I've been very fortunate that diabetes management has always sort of clicked with me and worked really well for me. But for people who are stressed out or parents or caregivers or athletes who are stressed out by the ups and downs of their sugars during intense exercise and during intense competition, I want to just normalize that blood sugars can be really volatile. And I actually, the number one thing, so this is teasing out the end of today's episode, the number one thing, the top thing I learned from ADA 2024 is related to that topic. So stay tuned. So join me at the Power of Movement to Tackle Diabetes event with the International Diabetes Federation on July 25th. The next thing is the Breakthrough T1D Summit, which is here in Dallas, Fort Worth on August the 3rd and is in, it's at the Omni Hotel, I believe in Frisco. So join us there with Breakthrough T1D Dallas chapter on August 3rd. I'm speaking and my speech is a little bit different. I'm writing a new presentation on how to use social media to, as part of your diabetes therapy and how to find community, how to find creators, how to find other people like you, and really summing up almost 10 years now of life in the diabetes online community and more than 10 years working in content and social media and as a content creator, what can I learn to help you find people who can help you? And I think the biggest thing for me is that, you know, through this podcast is something that I've really been focused on since day one is that if you can get connected with someone who is living your dream with diabetes or is doing something that you want to do, is doing the thing that you want to do with diabetes, you should be able to find them and we should be able to connect you there. So that is going to be what I really showcase is that now more than ever, there's someone out there doing what you want to do with diabetes and social media can be the gateway to you finding them. I can speak from my own personal experience, you know, with my relationship now with Gary Forbes, who has become not only a collaborator and a supporter of diabetics doing things, but a personal friend of mine was my literal hero during my college basketball years, being able to see someone with diabetes, talking about their diabetes, playing in the NBA, and to now be able to have a real friendship with that person wouldn't be possible without social media. So that's what I'm going to try to bring to the Breakthrough T1D Summit in the North Texas, Oklahoma Breakthrough T1D chapter on August 3rd. So join us there. I'll include that link in the show notes as well. I mentioned this a little earlier. I'm going to be at ADCES. I'll be there with Medtronic Diabetes. So I won't have a ton of time. I'm going to be there on a quick in and out trip. It's New Orleans in August. I don't want to be there very long. It's going to be super hot. But while I'm there, if you want to connect or you want to talk about something from the podcast, I will be there to briefly cover what I can from the conference. So hopefully if you're listening to this and you want to connect, please reach out and we'll get it on the calendar. Also, we're returning to Denver, September 14th. Diabetes Legends Denver. The link is live on Eventbrite, you can register your camper today. We're going to send out emails to last year's participants. I think a big part of Diabetes Legends and just diabetes camp in general is consistency. So we've got a new t-shirt design that we're going to release here soon. We've got exciting, Gary Forbes is going to come back. We're going to have a new camp program. We're going to add a adults meetup following the basketball camp. So we'll have the clinic in the morning, the live podcast with Gary and the live Q&A, followed by an adult meetup at the basketball social house. We're going to play some games, have some apps and some food and hang out with the Denver diabetes community. So more information coming on that. The Eventbrite is in the show notes. Be sure to check it out. I've been talking a lot about what's going on in diabetics doing things. And as I was writing it out in this agenda, it's honestly a little bit overwhelming to me on like how many things that we have going right now. This next one is one of some of the work I'm most proud of though and it's our doing well with diabetes series with Centerwell and Centerwell is a primary care chain for seniors with diabetes and or just seniors in general rather primary care chain for seniors and they want some diabetes programming for their community. And you guys have heard us talk about on this podcast, when Erica and I went to ATTD, the conference in Florence earlier this year, there was a slide during one of the presentations, which shows the likelihood for diabetes diagnosis of any kind, type 1 or type 2, increases almost 10 fold after age 70. So for seniors, the risks and the signs of diabetes are extremely high. So we need to create awareness on that. So we've got some programming, We're going to have lunches catered at our events for seniors here in Dallas. We're working with CenterWell, which has 15 locations here in Dallas-Fort Worth. And we're really just digging into our local communities and trying to help people with diabetes. And we got this introduction through our relationship and partnership with the North Texas Food Bank. And we'll have some more updates on what we're continuing to do here in Dallas for our food insecure folks with diabetes. And there's actually some stuff in my ADA recaps for food insecure populations and some really interesting digital tools that are affecting them. So continue on. Stay tuned. Don't just tune out because these are Rob's updates. So continuing to deepen that partnership with NTFB. Our Doing Well with Diabetes series is also sponsored by TheracosBio. You guys remember we had Brian, the CEO of TheracosBio, on earlier this year to talk about Brenzavvy, which is the low-cost drug for people with type 2 diabetes that has about a $40 out-of-pocket cost without insurance on a monthly basis. So a very accessible drug. And Theracose is a really cool company and a supporter of diabetics doing things. So really excited to debut that for our senior population. And this is a pilot program doing well with diabetes. We are continuing our goal to expand into other food banks across the U.S. and where this has led us is also to more primary care locations throughout Texas. So this is the pilot program in Dallas. We're going to go to two locations, one in July, one in August, and then hopefully we're able to generate enough buzz and enough interest to scale that to the rest of Dallas, but also to Austin, Houston, and South Texas. So we are continued to plow forward here. We're a small team, but we're making the most of the time and the opportunities that we're getting. Okay, really exciting news coming up. And this for me, I think as I have like been reflecting on where we are with diabetics doing things and how it's grown and how it's evolved over the years, this is one I'm particularly proud of. We have been asked by the International Diabetes Federation, which is the international governing body for diabetes worldwide. They've asked us to host a series and for Eritrea and I to be the hosts of their D podcast, D Talks. So we are going to host four episodes for them with athletes with diabetes. And it's a big opportunity for us because of the notoriety, but also because of the consistency that we've had here at Diabetics Doing Things. And to be asked to do this was really awesome. And And some of the guests that we've got worked out for that series, I'm extremely excited about. So that'll be hosted on their feed, but we'll actually get the uncut long form interviews here on Diabetics Doing Things as well. So that'll be coming out later this year. We're working on it now. But again, just to be asked by the global leaders, the people who are helping influence policy decisions worldwide with a truly global audience and global impact is just really special to me. and we're still just a small, oftentimes one to three person operation in our spare time, in our free time. And to be recognized like that and be asked to do this at such a high level is important to me. I can't wait to show you who the people are and the work that we've got planned. It's gonna be a little bit of a different format than Diabetics Doing Things, which I'm also excited about. I get to power our creativity a bit and support some of our partners. And we are donating our time there to support the mission of the International Diabetes Federation. So thanks to Bruno and the team at the IDF for their support and for believing in us and championing us to be the hosts of that. We've also got in global news, we've got the Olympics coming up. You guys know I started my career in the Olympics and working on the London Games. And so the Olympics obviously is an extremely fun time to celebrate athletes from all over the world, supporting and pushing their country to the highest level. And what I really want to do in order to drum up some extra excitement is to highlight some of the Olympic team members and national team members who we've already had on the podcast. So over the next couple of weeks, we're going to be re-releasing some episodes. One with Mary Markworth, who's on Team Novo Nordist on the cycling side. She posted a really great story on her Instagram page earlier. So check that out, Mary Markworth on Instagram. She's not going to be at the Olympic Games because every Olympic sport has a different qualification process. And cycling in particular is totally based on like your team's performance and you get number of points in international competition. And unfortunately, she's not going to be able to be at the Paris Games. But you can read a little bit more of that. So I thought it'd be really important for us to highlight her story. She was on the podcast, I believe, in 2019. So it'd be cool to revisit that. We're also going to be resurfacing and re-airing Charlotte Drury's story from our Diabetics Doing Things zine interviews in 2022. And we'll also include Lauren Cox's interview from our 2023 interview with her here in Dallas, because she played on the 3x3 Team USA national team in the World Championships a few years ago. So we'll be re-airing some of those. and as we can we'll be able to continue to ask athletes who have been on national teams or Olympic teams to come on the podcast so stay tuned for that as well I'm just going to lean into the Olympics theme here during the summer and I think that's a good transition for me to talk about the summer podcast schedule we have been posting weekly for nearly two and a half years at this point, which I'm particularly proud of. And I think just given all of the ups and downs in the world and all of our extra responsibilities, that consistency is one of the most proud things I can speak about over the past five years, really, for me. That's a huge moment and a huge testament to our hard work and our consistency. However, I'm trying to maintain a little bit of of seasonality in my life. And I would like to ask for a little bit of grace over the next few weeks. You've already heard about all the things that we have going on just up until September at this point and all the extra sort of side missions that we've taken on. So if we don't post every week for the next few weeks, or if we post some older episodes, or if we recap a few things, just give me a little break on that. We're continuing to do the podcast. I have some amazing guests that we're still reaching out to. And, you know, I say all this now, we may still get an episode up every week, but if we miss a week here or there, or if we're not as consistent, or if we're posting older episodes, just know that we're working on things really hard behind the scenes. And we're just allowing ourself a little bit of breathing room to step back some from the podcast in order to focus on the main things. We're working on some amazing stuff behind the scenes. And when it releases, I think you're really going to be proud of the work that we've done. I'm obsessing over quality. We've got to build quality. We've got to stop doing too many things. Diabetics doing things can sometimes mean too many things. And I want to make sure that we're really focused on quality and we're dialed into the important things and really bringing you guys the amazing stories of people with diabetes from all over the world. So give me a little bit of grace, but here we go. Let's transition to the top five things that I learned from ADA 2024. This was my fourth ADA scientific sessions. And the first ADA that I went to, which was in 2018, I learned that the most interesting part for me, especially given the short amount of time and the short amount of sessions that I'm able to attend, the best way for me to use my time at ADA is to go to the poster hall. And if you don't know what the poster hall is, it's almost exactly as I describe it, it's almost like a science fair. So everybody has a poster and they're able to showcase research. And there are sessions in the poster hall where the researchers and the people who've done the studies can actually present their study to an audience. I wasn't able to attend any of those sessions, but the top five things I learned from ADA are all from the poster sessions. I'm going to attempt now to take you through these poster sessions that I was able to go through during my time at ADA. So number five, how emerging adults with T1B seek self-care info. So this is the background of this study. It's emerging adults, people who are 18 to 24 or 18, 25 years old with type 1 diabetes and are independent in self-care. These individuals may struggle to determine where to seek accurate information. So this is something that related to me because when I was that age and I was in my mid-20s, that's how I found the diabetes online social communities. I was looking for information about diabetes, looking for community. That's how I ended up here. So this was really interesting to me to look at. And the results were there were two themes and then they kind of had some categories underneath them. So theme one is emerging adults with type 1 diabetes seek self-care information from people who have lived experience from T1D. So two of the stories that they highlighted was one was a type 1 diabetic Reddit thread, and then the other was someone who had a best friend who had diabetes for a long time. So they call or they text that person. So seeking out people with lived experience of T1D, and then underneath them, we're looking for agreement across multiple sources. So if you kind of try to aggregate, so in the case of the Reddit guy, maybe aggregating experiences and looking for as many opinions as possible. But then also they differentiate between universal and individualized aspects. So the examples that they gave, if someone ate pizza and took 20 units for it, posted about it, and they're like, oh, this worked for me, I know it's probably not going to work for me because it is an individual experience. So that's one of the individual experiences is bolusing for pizza, which we all know is a little bit different for all of us. And another respondent said that they usually look for answers based on people who know them and know their diabetes. So people who have more experience. So people who not only are their friends or they have contact with, but also know and have some experience with the way their diabetes works. So I say it a lot. A friend with diabetes is a friend indeed. And this study shows that emerging adults with type 1 diabetes seek out self-care information from their friends, but also just from people that have a similar lived experience with diabetes than them. And then the second theme in the results were they identify people with formal education or training about diabetes management. So the interesting thing here is that one of the respondents said they don't really like to Google things because they have really accessible endocrinologists or diabetes educators. So that's a really, I think, unique experience. but if you have an endocrinologist or a nurse practitioner or a diabetes educator who is accessible and is able to either text or email you on a regular basis, that's a way that emerging adults seek that information. And then on the other side, you know, kind of the counterpoint to theme one is this person said they tend not to trust answers through forums because they know it's different for everyone. It's hard to take advice from someone else who's not really an expert in the field. So it was really interesting to see how in the online community, especially like there are different categories. There are people who are just friends and there are people who are, you know, maybe creators or community builders. And then there are also people who are creators, but have a clinical background or coaches or are endocrinologists or nurse practitioners. So I thought it's really interesting. There are a lot of ways that emerging adults are seeking that self-care information. But remember, a friend with diabetes is a friend indeed, and I think there's real power in the online community. So that's number five. The number four thing is adults with diabetes have a significantly higher observed prevalence of taking psychotherapeutic drugs compared to adults without diabetes. This to me made a lot of sense because I think we talk about like adults with diabetes are three times as likely to suffer from anxiety or depression. and this to me is just a confirmation of of that data point and you basically it shows the results like overall there's a 50 percent higher observed prevalence of psychotherapeutic medication use among participants with diabetes compared to those without diabetes so you know to me there's a couple of interesting data points there the study has it reached 57 000 adults so quite a good sample size So you say, all right, well, people with diabetes are three times as likely to suffer from anxiety or depression. Does that automatically equal them taking psychotherapeutic medications? No, not necessarily. But something that I've thought of in the past is because of my reliance on insulin and my reliance on pharmaceuticals, I may be more likely to accept an additional prescription or an additional pharmacology solution to a problem that I'm having. So then someone who doesn't already have that relationship with pharmaceuticals. So, you know, I see insulin as a lifesaving drug and a lifesaving thing that I have to have on an ongoing basis. So if there's another similar type of interaction, maybe I will be more likely to take that. So that was really interesting. And it kind of goes into and I'll link all of these studies. You can't actually access them publicly. So I'll have to figure out a way to share these in a compliant manner because I was pressed at this event and I need to make sure that I do my part to not break any embargoes or whatever the case may be. But anyway, adults with diabetes have a significantly higher observed prevalence of taking psychotherapeutic medications compared to adults without diabetes and with prediabetes. Okay, number three, the association of environmental mastery and diabetes distress among young adults with T1D. All right. If I have a new favorite term, it is environmental mastery. And I'm going to tell you what environmental mastery is. And it's my favorite thing now. Environmental mastery measures one's perception of ability to effectively manage and control complex environments through one's mental and physical actions. Man, that is amazing. I think I have prided myself. You might call it street smarts. To me, environmental mastery is like one of the most important things for people around me. It's one of the things that I hold in high regard for people. So the association of environmental mastery and diabetes distress was something that really piqued my interest. I did not know what the name of environmental mastery was, but now I do and I really love it. So the key findings in this study, they sampled 416 young adults and they evaluated their higher levels of environmental mastery were associated with lower prevalence of diabetes distress. So the higher and greater your environmental mastery, the lower your diabetes distress. And remember, environmental mastery is effectively managing and controlling complex environments through one's mental and physical actions. And if there is something that's more correlative to positive diabetes experience, to me, it is environmental mastery. So this included controlling levels of A1C and the use of CGMs or insulin pumps. So the graded inverse association between environmental mastery levels and the prevalence of high diabetes distress was present across the levels of A1C, including those in the optimal range, which is below 7.5%. So overall in this study, greater environmental mastery was associated with lower diabetes distress and may protect young adults with T1D from developing diabetes distress. Interventions to reduce diabetes distress in young adults may benefit from a broader focus at competency in other areas of life beyond blood sugar management. Such empowerment efforts may be a valuable complement to current disease-centered practices. So what does this mean? This means your ability to problem solve in other situations in your life indirectly helps your diabetes. So sometimes it's not just obsessing over the blood sugars. Sometimes it's not just looking at the data or fixing the settings. Sometimes it's just understanding the relationship between your diabetes and the rest of the world around you. And that's been something that over the last few years, we've been talking a lot about. All the scientists have spent all the money and all the research on the things to live longer, things to increase your health. And it turns out it's walking outside in the sunshine, it's regular exercise and quality sleep and drinking water. To me, those are what help make life better all around. And they're very simple. Environmental mastery to me is, you know, just your ability to problem solve. That could be something as simple as like defensive driving, being more proactive, being more organized. All of those things will help you. And, you know, developing a stoicism or a meditation practice, any of those things, I think will dramatically help reduce your diabetes distress. And that comes back to my sort of view on work-life balance. I think early in my career, younger employees were coming to me and asking like, Rob, you seem to have this like well-rounded life. How do you find work-life balance and and I find that for me you know you have to work basically eight hours a day most full-time jobs are like eight hours a day what are you doing with the rest of the eight hours that you're awake because if you're just going home and sitting down and watching Netflix or YouTube or whatever that time will quickly pass and then you'll think oh well all I really do is work so what I did in that time in my life was fill that time with appointments and things that yeah I had to muster the energy for but they filled my cup on the life side. So I had a heavy workload and I combated that with a heavy life load. And I think, you know, that really contributed to my level of environmental mastery. So I thought that was really cool. So that was number three for me. Number two is the impact of digital health coaching on food insecure individuals with type 2 diabetes in rural areas. So this was a six month digital health coaching program with individuals with type 2 diabetes who were experiencing food insecurity in rural areas. So these are people who we are directly serving through our work with North Texas Food Bank. So it really sparked my interest because we think of health coaching, we think of digital platforms. We often don't think about the people who need them most. We recently had Frank Westerman from 9AM Health on the program, and he was talking about the accessibility aspect for people with type 2 diabetes. And I brought up people in rural areas who often have to drive a long way to go see their endocrinologist because they don't have one nearby. And a digital solution could really help with that. So the conclusion of this study were as follows. So at six months, almost 1,100 participants were enrolled in the study. 31% lived in a rural area. And after the six-month health coaching, there were significant improvements in the mental health score and physical health score of the participants. While previous studies have focused on the impact of health coaching or food delivery few have accessed the impact of a combined intervention and most studies had a small percentage of rural participants participants who completed the six-month intervention had significant improvements among food insecurity and diabetes related quality of life metrics a combined intervention may lead to improved mental and physical health outcomes among rural populations with type 2 diabetes and food insecurity so again access is such a huge thing and it can be digital it can be scalable access to food so people who are living in food deserts, we really need to address those food insecurity issues. And we also need to address the access issue, which starts with diabetes information. If you can't get diabetes information because you live 100 miles away from an endocrinologist and you can't take time off of work or you don't have transportation, you're not going to be able to get information. Health equity starts with information. In this study, I really want to be able to see if we can get the folks who were on this, who put this together to come on the podcast. I really found it super. Okay. And the number one thing, the top thing I learned from ADA 2024 in the poster session are data shows that moderate intensity exercise demonstrated significant improvements in glucose levels compared to high intensity exercise. And I called this earlier, called this out earlier in the episode. I've talked about this a lot. I talk to athletes all the time, especially ones who compete in a sport like basketball or track and field high intensity outputs powerlifting is another one that i think we've had on the podcast or crossfit when you are doing high intensity exercise your glucose response can be highly variable so in this study they basically just took this was a literature search was conducted on the pubmed database using the keyword cgm type 1 diabetes in exercise. They took all the data from that and they matched five CGM studies that matched their criteria. When they subdivided that data based on exercise intensity, moderate intensity exercise demonstrated significant decrease in glucose levels, whereas high intensity exercise tended to demonstrate an increase in glucose levels. But the change was not statistically significant. So the conclusion was in the meta-analysis of CGM exercise studies in people with type 1 diabetes demonstrated that the glucose response to exercise is highly variable, in part because moderate intensity aerobic exercise lowers glucose levels, while high intensity aerobic exercise tends to increase glucose levels. So I wanted to focus on this really simple part right here. Glucose response to exercise is highly variable. Anybody who does any sort of cross training knows this. If you go and run a slow paced mile or two miles or a long walk, your blood sugars, you're going to become more insulin absorbent. Your insulin resistance is going to go down. And you might drop low. You might need to have a snack on you. You might need to have some glucose gels on you. When I ran the marathon around about mile five, I had to start consuming my gels because my body was becoming much more, it was taking in all the insulin that I had in my system. Compared to high intensity exercise where you're putting these outputs through, you're getting your cortisol, you're getting your adrenaline, you become more insulin resistant for a short time. And, you know, oftentimes your sugars go up. I've talked about in my college basketball career, I could go from a fasting blood sugar of 80 to nearly 400 by the time the game started because I was so amped and adrenalized and just adrenaline dumping and my glucose was going up in response. So that to me was the most impactful thing, the top thing I learned from ADA 2024. And remember, I talked about this earlier, there's no way to see all the sessions. I'm still combing through the sessions and the transcripts through the online database from the American Diabetes Association. But those were the top five things I learned from the poster sessions at ADA 2024. Okay, keep it locked on the podcast. Exciting things coming up. If you want to subscribe, please visit us online, diabeticsdoingthings.com, and subscribe to the drip, new drip coming out in July. See you next time.