Special Episode - 2017 in Review

[00:00:07] Rob Howe: Welcome to the Diabetics Doing Things podcast. We've been telling the amazing stories of type 1 diabetics all across the world since 2015, and we have over a thousand years of living with T1D on the podcast. The interviews range from incredible feats to everyday victories, and we celebrate them all just the same. Thanks for listening, and if you want to get involved even further, just send me an email at rob at diabeticsdoingthings.com. Hello everyone, welcome to the Diabetics Doing Things podcast. Rob Howe here on the mic. It's just going to be me today. No guest, but I'm going to try to keep it as entertaining as possible and try out a couple new things here to close out 2017. It's a little bit different, so definitely let me know what you think about this format. I'm testing out a few new formats that we're going to explore next year to try to deliver more value for you and then challenge me a little bit on the podcast production side of things. So your feedback always is super important, so be sure to let me know. So just to start, I wanted to cover a few things to recap the last year. If you've been listening since the beginning, well, one, you know how far we've come, but you know that I launched this podcast in January of 2016. We did 11 episodes through May 2016. I didn't do any more podcasts after that, mostly because I was unsuccessful in managing my own time. But in January of this year, 2017, I decided I was going to start back up again and then challenge myself to recommit and step my game up and get new guests and really build out the podcast. So we started this year. We published our first episode with Emily Emblem of Pump Peelz. That's episode 12 on February 13th. And then since then, we published 59 interviews, and this will be the 60th podcast published in 11 months. So, wow. I'm tired. No, but it's been really great. I'm actually so grateful to all my guests for their time, willingness to share their stories with the community and overcome sometimes really significant scheduling difficulties or rescheduling for one reason or another. You guys are all rock stars, and I'm super, super happy that I know you. And, you know, really taking a chance on me, especially early on when, you know, this was really just an idea. You guys have turned it into a real thing, and I'm super grateful for that. On top of that, I've also recorded about 25 other interviews that I've yet to publish with some big names as well. So I'm really excited to release those next year. I'm going to do a little bit of a creative refresher on some of the elements of diabetics doing things, bring on some sponsors, again, all in an effort to deliver you guys the most value that we can. So, you know, we're really taking a step forward. We've done a lot so far. We want to continue to do more. And, you know, you guys sharing and listening to the podcast has been a huge driver for us in terms of saying, hey, do we want to keep doing this? Is this still something that can bring value? And yeah, so I'm happy to say that it is. Something that struck me about halfway through this year was the dramatic amount of years with type 1, years living with type 1 diabetes that we had on the podcast. Wow, I'm just everywhere today. So the amount of experience, valuable lessons, funny stories, and then honest, vulnerable sharing was really great. But I'm pleased to announce now that we have over 1,000 years of living with type 1 diabetes on this podcast. Altogether, whether you've had diabetes for one year, three years, or 57 years, as one of our guests has, you contribute to that amount. And obviously, that's going to continue to increase every year. But we've all worked really hard for those 1,000 years. And I'm really grateful to have shared a short time of those with you guys. So I can't promise that we'll get to 10,000, but we definitely have 1,000. We're going to keep going forward with that. So really proud of that number. We're fast approaching my 13th anniversary of my own diagnosis, or my diiversary as it's called. So to commemorate that, wow, it's not even a remotely believable transition. Honestly, don't know if this has anything to do with my diiversary, but I'm going to do my best to make it stick. in honor of my diversity i'm going to answer some of your most popular questions that i get on social media or email so if you're ever wondering ah gosh does rob actually uh you know get these questions am i the only one that asked this uh is he ever going to write me back or respond to my comment yes i will um and then i'm gonna try to do that sort of a general uh addressing of some of those questions today so uh with that let's just dive right into it i think the most popular question that I get revolves around type 1 diabetes and exercise. Since I was an athlete, both recreationally and then professionally on the basketball side of things, there's so many things that can get in the way of exercise when you have type 1. Really, even if you don't have type 1, I think that's the biggest thing. There's so many excuses that you can use to not go to the gym to not go for a run, especially when you've been doing it for a while and you're sore or you're tired or whatever the case may be. But if you're type 1, you throw a low blood sugar or a high blood sugar in there either before, during or after a workout. And you're going to get a little bit of that mental fatigue. So the biggest thing that I try to do is to note and record in like a journal how your body responds to different types of exercise. I'm a huge believer in listen to your body because if you get really plugged into it, it's going to help you whether that's diabetes related or fitness related or whatever the case may be. But you're going to know how your body responds to different exercises. So for example, my body, when I do 30 minutes of yoga, even if it's an intense sort of flow, my body responds differently than when I go play 30 minutes of basketball or I go for a run or I do a high intensity training or a heavy weightlifting session. Those are typically the types of exercise that I do. They span from heavy weight lifting, high intensity training, like HIIT workouts, yoga, and the occasional run, and then basketball. So if I know how I'm going to respond to each of those, I have a starting blood sugar and I always test before I go to the gym, just really for knowledge. I just want to know where I stand or when I'm wearing a CGM, I just have it right there on my phone. So that really makes it a lot easier. But I think the main thing is to always be prepared. So if you are going to the gym and you know you're going to do a workout that causes your blood sugar to dip or go lower, I would always have a snack or a Gatorade or have access to some type of sugar that you can get in your system. On the other side of things, if you're doing a high-stress, high intensity type workout, you might have to treat a little bit of bolus insulin before that workout just to make sure that you don't spike up too high when those cortisol levels in your body starts producing glucose because of the stress or whatever the case may be. I know when I do a high intensity style workout with a lot of plyometrics or a lot of really quick stuff or a basketball workout where I'm just going to get really mad and run up and down the court for an hour and a half, I give myself a little bit of insulin ahead of time just so that I can settle in and know and have confidence that I'm not going to spike up really high because the unintended consequences of spiking high when I'm playing basketball is that I just am no good. I can't hit a shot for it to save my life. So I really try to keep my blood sugar right in that 130 to 160 range when I'm playing ball. That way I don't drop too low. Okay, so that's my T1D and exercise. Always, here's your checklist. Always test before you go. Make sure that you know how your body's going to respond to whatever type of exercise you're doing. And if you need treatment beforehand, know what you're getting into and have a backup in your bag. And then, you know, always record the results. We can't learn anything unless we track it and you are what you measure. So be sure to keep a little journal or just make a mental note or whatever the case may be. Semi-related to exercise, another question that I get is, do I still play recreational basketball? Yes, I do. I'm actually in a league right now. I came off my ankle surgery at the end of 2016, rehabbed a lot in 2017, and much to my chagrin took a lot longer than I had anticipated to get back to where I wanted to be. but now I'm feeling almost back 100%. So starting this spring will be my second basketball league since my surgery. So I'm still playing, still having a blast, plan on doing that for at least another 10 years, hopefully. So knock on wood that I can make sure to keep myself in good enough shape to make that happen. But that's where I'm at with basketball. The next question is a hole 30 related. I've done about eight hole 30s in the last few years. It's probably my favorite, I hesitate to say diet, but just way of looking at food and nutrition. It's very strict and I just frankly lack the discipline to do it all the time, more than on like a 30-day, sometimes a little bit 45-day increments, two or three times a year. But I pretty much 80-20 my life Whole30 versus anything else. And a question I get around Whole30 is, how do I treat my lows on a Whole30? This is a tough one because there aren't that many options when you're on a Whole30 for a quick, if you're on the go, grab a juice or a Gatorade or something like that. Those all have sugar added, so you're not able to do that. But there are some Whole30-approved juices. Trader Joe's has a great orange juice that's 100% juice, doesn't have any sugar added. There's an apple juice that's at most supermarkets that's in this big glass tub, and it doesn't have any sugar added, and those are great for treating those hypos on a Whole30 without having to break it. The only other option I usually use is maybe a Larabar or a couple of Granny Smith apples, depending on how low and how much you need to spike back up. But yeah, compliant juice, that's the best way. And if you have any other Whole30 questions, episode seven of the podcast is with Whole30 founder, co-founder Melissa Hartwig, who is, that's actually our most popular podcast episode ever. And she has been a super big supporter of diabetics doing things. And she answers a lot of Whole30 and type 1 diabetes questions on that episode. So be sure to check that out. The next one, how do I treat my diabetes? What technology do I use? so when I was diagnosed I was on pens for my first few years and then in 2009 I made the switch to a pump so I guess I'm in just finishing up year eight with my pumps so I have a Medtronic Minimed Revel and I use Humalog by Lilly Insulin in that in that pump I love my pump I fought it for a long time because it wasn't sexy and I didn't want something that was going to be plugged into me or I thought I didn't. But my doctor was like, no, no, this is great. You can snack. You can treat highs really easily. And I couldn't agree more. My life with diabetes changed significantly for the better when I got a pump. I realized it's not for everyone. And my pump technology now as it stands is a few years out of date, but I'm really excited to get a new pump, the Medtronic 670G Hybrid Closed Loop System, complete with the continuous glucose monitor and auto mode. I should have that sometime in Q1 2018, knock on wood for me again. Really excited to get that. I also use a OneDrop glucometer, so my test kit is by OneDrop. I really love their tester. It's super modern looking and cool. Whenever I have lunch with other diabetics, they see it and they're like, oh, wow, that's very neat. I've never seen that before. It's got a cool case. And they're just a great company. They are a prescription-free service for test strips. So they will actually send you your test strips every month for a small fee with no copays, no pharmacies, no nothing like that, and as many as you need. So if you need 300 test strips in a month, if you're that type of tester, they have a plan for you. So you can check them out at onedrop.today. In terms of CGMs, I did try a CGM for the first time in 2017. I guess technically for the second time, but we won't count my 2010 journey with a Guardian sensor way back. but I use a Dexcom G5 sensor. I love it. It gave me a new turnover, a new leaf for me really with looking at my numbers. I didn't know what I didn't know and I was super excited to find that it was so easy to use and integrate with my phone and my Apple Watch. I played basketball with it on for the first time and got to see my numbers throughout a basketball game which made me super happy and it was just very cool and I'm very excited to get the new Guardian sensor with my new Medtronic pump but yeah Dexcom could not recommend it enough if you're looking to take the jump into that the continuous glucose monitor world I know there are other CGMs that are out there right now Freestyle Libre I believe is one as well I've never used it but I see great things and I think it has a free trial program as well So if you're curious about CGM, there are a lot of options out there for you, and I couldn't recommend at least trying it. There's really nothing to lose. Okay, do I have any other chronic diseases besides type 1? I actually do. That is a question I don't get too often, but I've been getting it a little bit more lately in some other discussions that I'm having online. But I have hypothyroidism, and I was diagnosed with that in 2009. I was like all tired all the time and I felt like I was in really good shape, but for some reason just like was always tired. And so I take basically a once a day oral medication for that. And that kind of keeps me keeps me good with my hypothyroidism. But yes, my endo told me at the time, not sure if this is true, but she said that a lot of T1Ds are susceptible to thyroid disorders, whether hypo or hyper, and that they often run side by side. So that was pretty common. um outside of that other medication that i take for um for my hypothyroidism what vitamins and supplements do i take on a regular basis okay good question um i want to i want to preface this with it changes kind of all the time i'm a little bit of an experimenter with um with things that are available i like to read um you know who who are all these scientists that are out here looking at the cutting edge of supplements trying to maximize human performance and life extension has been something that I've discovered here in 2017 that I've been really interested in. So a lot of these are based on recommendations from researchers and doctors who are looking to improve human performance or extend the lifespan of humans and the things that they take and recommend are based on that. So, uh, yeah, Trader Joe's fish oil. I take that just for like skin and hair health. Um, they're giant fish oil, uh, tabs and they're relatively cheap. So I like those, um, chelated magnesium threonate. So I'll say that again, chelated magnesium threonate. Uh, I take that at night for brain function and muscle recovery. Um, it does both, I guess. Uh, I can really tell the difference, especially when I'm working out heavily, that I can sort of recover faster and bounce back faster if I'm taking that chelated magnesium threonate. There's a lot of different kinds of magnesium. So be sure you know which one you're taking. And obviously, like if you're going to get any of these supplements and you're worried about it, be sure to consult with your doctor. I'm not a doctor. So just make sure that you are being safe with these. None of these have seen significant increases in performance or side effects from any of them, but that doesn't mean that you shouldn't talk to your doctor. I am vitamin D deficient, so I take vitamin D, 5,000 international units per day. And then later in the year, about the beginning of Q4, I was reading about a couple different things in terms of insulin absorption. And there are a lot of doctors who attribute better insulin absorption over your life to fighting off other chronic illnesses like heart disease, cancer, brain degeneration diseases like Alzheimer's and stroke. So I was like, wow, well, you know, insulin absorption will help me from a T1D perspective, you know, always trying to maximize, you know, our ability to absorb that insulin. So I take berberine, B-E-R-B-E-R-I-N-E for insulin absorption. And I also take alpha lipoic acid for insulin absorption. Those two, I can actually see like relatively quickly. Once I take it for two or three days, I could see that I was absorbing insulin faster in some cases. And then my body kind of got used to it after a little while, but I definitely take those. If you're looking for recommendations on some of these supplements or like, you know, where does Rob get all this information? Dr. Peter Attia, A-T-T-I-A, is a great resource for that. He has some great recommendations and research for other life extension style supplements. And again, what I find interesting is that a lot of these researchers are finding insulin absorption is a key attribute in fighting off chronic illness, especially as you age. And I think there's something to be said about, you know, being conscious of how much insulin you're taking, how much you're putting in your body, making sure that you maximize that and use it efficiently. There's a great interview with Dr. Attia on Tim Ferriss' podcast. So just search Tim Ferriss, Peter Attia, so A-T-T-I-A, Tim Ferriss, two R's, two S's. Big fan of Tim Ferriss' podcast, and it's a great interview with Dr. Peter Attia. okay another uh another question that i've been getting intermittently uh throughout this sort of podcast journey is uh thoughts of the use of the word diabetic in diabetics doing things i find this question to be a little strange uh mostly because it hadn't occurred to me until someone mentioned it early on um but now it's come up a few times that someone would feel negatively about the term diabetic or consider it derogatory. I think that all comes in terms of your interpretation of it and your relationship with the word. I think any decision or labeling of a term out of fear is a mistake. Really, any decision made out of fear is a mistake in my mind. I think if we are motivated by fear, we're going to get ourselves in trouble. I've always viewed the term diabetic as more of a fact less of a label so people with diabetes have diabetes and are thus diabetics in certain uses of the context do I like the terms T1D or people with diabetes? sure and I often use them but I don't rank them in terms of better or worse and I don't think there's a reason to manage by exception and acquiesce to those who would maybe like the word to not be used And I honestly really do think if you're caught up on the labels, you're probably missing the point. So, yeah, I mean, there's no reason to make those decisions out of fear. You know, a lot of what we do here on the podcast and diabetics doing things, even the hoodies, we're pushing out empowerment and confidence. And I think, you know, getting hung up on the word diabetic, positive or negative, you know, I think it's a trap. So again, don't get caught up on the labels. We are diabetics. We are people with diabetes. We are T1Ds. And we're in it together. And I think we need to be more confident, not less confident about who we are going forward. another thing people have been asking me a little bit more lately is uh what's next for diabetics doing things and what kind of things are we working on so for 2018 i'm working to have more face-to-face interactions with the t1d community you guys have heard my voice a lot you guys seen some photos on instagram but i rarely get to touch the different groups of you guys uh throughout the country so i'm going to be speaking at a few type 1 nation events with jdrf uh throughout the country throughout 2018, starting with the JDRF Dallas Type 1 Nation Summit on January 28th here in Dallas. So if you are in Dallas and listening to this, I would love to see you there. I'm also going to have a few of the notable podcast guests, Laura Pavlakovich, Lauren Bongiorno, Libby Russell, Gretchen Otte, and Kira Richards will also all be there at the summit. So I'm really excited to A, meet them in person and then get to interact with everyone at the Type 1 Nation Summit. So January 28th, Type 1 Nation Summit here in Dallas. That's going to be the kickoff of all the face-to-face interactions with the T1D community for the year. I'm also working on a mini documentary. Documentary is a loose term there that will document some of the different insulin and treatment options that are out there and my results using them. And this was based on a conversation that I had with Medtronic where they told me that their number one customer complaint is how expensive diabetes management is. And that sort of runs the gamut, whether you're a Medtronic or a Dexcom or you're an Omnipod or whatever it is, type 1 diabetes is expensive. I quit my job, my old job at the beginning of 2017 And I stepped out into the Brave Unknown With no plan really for insurance Until I was making enough money to afford it So for a long time I let that decision of Hey, I have all this unknown out here insurance wise Keep me from starting my businesses so uh you know and i didn't know what was available to me over the counter so in some discussions with a few friends and a few industry people um i've i want to try and i want to i want to create awareness about the treatment options that are available over the counter uh without insurance uh and so you can live uh live a life with t1d on a budget uh so if people have lost a job, lost insurance, or starting new companies and concerned about healthcare costs. I'm going to do 30 days on the over-the-counter treatment options and document my results and track that with a CGM as well. So hopefully be able to give you a little bit of insight of what it's like and what's available to you because I didn't know and I think it'd be really interesting. I'm also going to do a counterpoint on that documentary when I get the Medtronic 670G to talk about the latest and greatest technology and its impact on day-to-day life. So I basically go from one end of the spectrum to the other and get to talk about the pros and cons of both. I'm also working on my first book for diabetics doing things. And then once we get all our nonprofit paperwork in order, which, you know, just taking a little bit of time, we're going to start fundraising so that we can provide scholarships for diabetics who want to do things. And I think that's something that I really have a strong passion for. I know there are tons of type ones out there who want to accomplish their dreams and their goals, but they just maybe need some financial support or some confidence or some assistance in the right direction and some encouragement. And I want Diabetics Doing Things to be able to provide that for them in the future. So if you're thinking, hey, where is Diabetics Doing Things going? That's what I want it to be. I want it to be a resource for type ones who want to do things. Okay, so that's a pretty short and sweet version of this podcast. I'm going to try some of these periodically in 2018 just to give you a look behind the scenes and to give your questions a bigger platform. I think that there's plenty of room for discussion on your most pressing issues or just your musings and thoughts. So please keep sending me those. I'm looking forward to a kick-ass 2018 with all of you and I can't wait to hear all the things that you do so this is me this is Rob Howe signing off see you all in 2018