Latest / The Healthy Diabetic / #143: Redefining Pediatric Endocrinology & Diabetes Care: Dr. Jennifer Dyer

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#143: Redefining Pediatric Endocrinology & Diabetes Care: Dr. Jennifer Dyer · The Healthy Diabetic

• 0:19
  Speaker 2: Welcome back.
• 0:20
  Speaker 2: This is episode number 143 of the Healthy Diabetic Podcast.
• 0:24
  Speaker 2: I'm your host, coach Ken Kines.
• 0:26
  Speaker 2: Before we get started, please remember that nothing that you hear on this podcast should be considered medical advice or otherwise.
• 0:31
  Speaker 2: Please always consult your medical team before making any changes to diabetes management.
• 0:38
  Speaker 2: Okay, now here's my question for you.
• 0:40
  Speaker 2: Does that sound robotic?
• 0:42
  Speaker 2: I feel like every time I say that because I repeat it every single week.
• 0:46
  Speaker 2: You know it's not like other podcasts where they pre-record their intro and they pre-record their disclaimer.
• 0:54
  Speaker 2: I just I say it every single week because I want to leave you guys with whatever episode number that we're on.
• 1:01
  Speaker 2: I think that might be for your benefit, so you know what episode it is, and I think it's also for my benefit.
• 1:06
  Speaker 2: I like to hear that I'm continuing on with this podcast, but anyways, i feel like that's robotic and I'd be curious to know if you guys think that's robotic as well.
• 1:16
  Speaker 2: Hopefully it's not robotic, anyways.
• 1:18
  Speaker 2: So I was racking my brain on what I should talk about this week.
• 1:23
  Speaker 2: What should I convey, what message should I convey to everyone this week?
• 1:29
  Speaker 2: And I was actually inspired because I was looking at the feed for on my hosting site for just different episodes previous episodes that I've released, and I actually went so far down the feed as to see a very, very early episode of the Two Type Ones podcast.
• 1:53
  Speaker 2: My previous show that I was doing started in 2020 and ended last November, before I rebranded the show, and there was an episode that I came across that was very popular And I thought that would be a very pertinent thing to share, given a lot of the information and a lot of the things I've been talking about over the past month.
• 2:19
  Speaker 2: So that's what I wanted to do.
• 2:21
  Speaker 2: I'm repurposing this episode.
• 2:24
  Speaker 2: This was an incredible conversation that me and Graham.
• 2:27
  Speaker 2: You're going to hear Graham on the episode, so if you have been following the show all the way back from when the other episode was, congrats, you're going to hear Graham's voice again.
• 2:37
  Speaker 2: So we communicated and talked to a incredible, incredible enterconeologist.
• 2:43
  Speaker 2: She's a pediatrician enterconeologist here in Columbus, ohio, and she was giving her thoughts and her feelings about how she communicates and talks to her patients, especially newly diagnosed patients, because, as you know, i've been talking a lot recently about how, when we are first diagnosed, we are not met with empathy, kindness and getting the support that we need, and she relayed that.
• 3:14
  Speaker 2: She does this And this is why I love this individual so much, so I thought this was going to be a very, very purposeful episode for you guys to listen to.
• 3:24
  Speaker 2: If you're newly diagnosed and you're still looking for a pediatrician enterconeologist, she's going to be in Columbus Ohio.
• 3:31
  Speaker 2: She's going to be an amazing resource for you.
• 3:33
  Speaker 2: Without further ado, let's get with Dr Jennifer Dyer.
• 3:38
  Speaker 2: Yeah, we have three at the gym, three of your patients.
• 3:50
  Speaker 3: I know.
• 3:51
  Speaker 2: It's cool.
• 3:51
  Speaker 2: Every time I see all three of them.
• 3:54
  Speaker 2: I mean, jase, you just left for school.
• 3:55
  Speaker 2: But every time I see I always ask about you.
• 3:59
  Speaker 2: How's Dr Dyer doing?
• 4:00
  Speaker 2: She's good.
• 4:03
  Speaker 3: Well, I refer quite a few people over.
• 4:06
  Speaker 2: So thank you, thank you, that's awesome I appreciate that?
• 4:09
  Speaker 2: So how's that?
• 4:11
  Speaker 2: So how have you been doing?
• 4:12
  Speaker 2: I mean, we haven't seen you since what?
• 4:15
  Speaker 2: 2018?
• 4:16
  Speaker 2: We did that.
• 4:18
  Speaker 3: Has it been that long?
• 4:19
  Speaker 3: Oh my gosh.
• 4:20
  Speaker 2: What was it?
• 4:21
  Speaker 2: No, it was 2019.
• 4:22
  Speaker 3: I think, i think it was Yeah, I think it was two years.
• 4:25
  Speaker 2: Yeah, oh my gosh, time just flies, it's crazy.
• 4:30
  Speaker 3: Well, that was a good event, and speaking about exercise and tactics and tips and nutrition is so needed.
• 4:44
  Speaker 2: Yeah, right now.
• 4:45
  Speaker 2: Yeah, for sure, for sure.
• 4:46
  Speaker 2: Cool.
• 4:47
  Speaker 2: Well, let's just dive right into this.
• 4:50
  Speaker 2: I know Graham's got a bunch of questions.
• 4:53
  Speaker 2: I sent you some questions.
• 4:55
  Speaker 2: I think the first thing for us is going to be just kind of tell everybody who you are, what you do.
• 5:02
  Speaker 2: And then the first question that we would have for you, that we would love to know is like, what, like, what made you get into endocrinology?
• 5:10
  Speaker 2: What made you specialize in diabetes, that type of stuff?
• 5:14
  Speaker 3: Well, i'm Dr Jen Dyer and I am in private practice as a pediatric endocrinologist here in Columbus And it is the dream job, for sure.
• 5:28
  Speaker 3: And when I went to medical school I would say that I didn't know what I wanted to do exactly.
• 5:35
  Speaker 3: But I followed my heart and went into pediatrics because taking care of kids was just kind of an easy, an easy thing for me to figure out.
• 5:46
  Speaker 3: I just just was a lot more motivated and and it just was fun My patients are kids that are funny and I just always wanted to do the most that I could for them, and I still feel that way, and they always inspire me and they always make me laugh and they make me cry too, because I worry a lot But I just care a lot And that's the way that I wanted to be as a doctor.
• 6:17
  Speaker 3: I didn't want to be an apathetic doctor, i wanted to be one that cares a lot And and it was so.
• 6:25
  Speaker 3: I didn't know what field I wanted to do, but I felt like endocrinology, especially type one diabetes, was the happy ending field, and I feel like I still feel that way that you can be empowered with information and hashtag live your best life.
• 6:48
  Speaker 2: Yeah, I love that.
• 6:49
  Speaker 1: That's great.
• 6:50
  Speaker 1: Where did you study?
• 6:51
  Speaker 3: So I'm a Texan and I studied, did my training at UT Southwestern in Dallas, and then I went to medical school in San Antonio.
• 7:04
  Speaker 1: Cool.
• 7:04
  Speaker 1: So you did a residency at the UT?
• 7:06
  Speaker 1: Yes, yeah, nice, and.
• 7:10
  Speaker 3: I'm so fortunate I was trained so well.
• 7:14
  Speaker 3: It's a really really busy program And I have experience with Camp Sweeney Diabetes Camp.
• 7:23
  Speaker 3: I was a very frequent volunteer for Diabetes Camp And I feel like I really learned the most about diabetes at Diabetes Camp.
• 7:34
  Speaker 3: I feel the same way.
• 7:38
  Speaker 1: No, you're not.
• 7:38
  Speaker 1: Yours is in Ohio, is it?
• 7:42
  Speaker 3: No, this was in Texas, in Texas.
• 7:44
  Speaker 1: Yeah, on the same way.
• 7:45
  Speaker 1: I mean I am, I am diet, approaching it from a diabetic standpoint, but it changed everything Actually don't remember I always say this on the podcast I really don't remember like the idea of being diabetic ever sinking in, because I was so quick to go to diabetic camp and that changed everything, cause I met, i met.
• 8:04
  Speaker 1: I met like just dumb idiots like me that are just normal crazy people.
• 8:09
  Speaker 1: That's really the best way of saying it.
• 8:10
  Speaker 1: You know, we're just all just clowns that made fun of the diet.
• 8:13
  Speaker 3: Essentially, we had fun with it, so Yeah, i mean it's healing for sure And I mean it's the best place for a medical student to learn about diabetes And for any doctor to learn about diabetes.
• 8:29
  Speaker 3: If you don't have diabetes And you just all you have to do is spend pretty much one day, maybe two days, there and you have a different, a totally different viewpoint of living with diabetes, but not, and not completely, but because you just can't get away from it.
• 8:52
  Speaker 3: And that's why I don't think doctors realize what it feels like with diabetes that you just can't ever get away from it.
• 9:01
  Speaker 1: Yeah, i, that's what a funny thing to make that I took for granted the amount of professionals walking around the camp as a kid And you didn't realize.
• 9:10
  Speaker 1: It's kind of like what you're saying in their profession they're being pushed to go and have those experiences where they can be immersed in a lifestyle what you're and you're, which is now to make your circle all the way around, to be immersed in a lifestyle that is very unique.
• 9:24
  Speaker 1: How diabetes is you know, like you're saying, and never changes.
• 9:28
  Speaker 3: And it goes away and it's hard to understand.
• 9:29
  Speaker 3: And it's also a great place to where you can normalize saying I feel high, Yeah, And nobody be like, oh my gosh, you know.
• 9:39
  Speaker 2: Yeah, that's what they say.
• 9:39
  Speaker 2: What was that?
• 9:41
  Speaker 2: Yeah, that's fine.
• 9:42
  Speaker 2: What's kind of your philosophy when you take in new patients?
• 9:46
  Speaker 2: what is your kind of for your philosophy as an ecologist?
• 9:52
  Speaker 3: I would say that my philosophy as an endocrinologist is that information is power and that I always say you're going to be okay, but this is a whole new life now And we're going to approach it as such.
• 10:08
  Speaker 3: But I also want to make sure that everybody knows that they could.
• 10:14
  Speaker 3: There's nothing that they did that caused this and that there's.
• 10:18
  Speaker 3: I try to get rid of the blame that parents feel and diffuse that from the very beginning, because it's not a productive use of their energy And that usually makes the parents cry right away, just to give up that idea that they could have done something different And it's, and they don't want to have a nonproductive thought process.
• 10:49
  Speaker 3: So I think they feel permission to not think that anymore.
• 10:56
  Speaker 1: So are you doing hospital rounds with newly diagnosed patients and you're walking in and giving the whole No, we aren't hospitalizing patients with diabetes anymore.
• 11:07
  Speaker 3: In fact, insurance companies don't want to pay for it because they're not sick.
• 11:14
  Speaker 1: We talk so much about this.
• 11:16
  Speaker 1: Oh my gosh.
• 11:18
  Speaker 3: So really in our community here in Columbus that the pediatricians and the primary care doctors are so good that no one really gets really sick, i would say, and it's caught pretty quickly.
• 11:36
  Speaker 3: Most offices I won't say all offices, but most offices do a screening UA and check glucose and the urine, and so a lot of things get caught like that and also from the history, so the patients can come directly to our office and get started with education and be in their own bed when they are having their first night at home.
• 12:04
  Speaker 1: Even a six year old boy.
• 12:06
  Speaker 3: Yep.
• 12:06
  Speaker 1: That's crazy.
• 12:07
  Speaker 1: Yep, we had a three year old pretty recently.
• 12:12
  Speaker 1: Wow, see, i'm from Columbus and I was diagnosed at seven or eight years old and I spent four days in the hospital at Children's.
• 12:21
  Speaker 3: Well, it's definitely changed.
• 12:25
  Speaker 1: We know we keep hearing This conversation blows my mind every time it comes up with a guest or a different person, just because I mean what you're saying.
• 12:32
  Speaker 1: But one of the first things you said is the amount of information that's out there and why you love the art of call it the art of diabetes, so kind of.
• 12:43
  Speaker 1: Maybe it is a double-edged sword if you're willing to bypass the emotions.
• 12:49
  Speaker 1: There's a lot to sort through for sure, but you alluded to something and we could spend a whole episode on this Why a diagnosis causes the emotions that it does.
• 13:01
  Speaker 1: Why do people falter when they get something like that?
• 13:05
  Speaker 1: And I think the faster you can get past that.
• 13:07
  Speaker 1: diabetes is very, very manageable because it's a mindset disease.
• 13:10
  Speaker 3: It is, but you have to realize that people, when they get any diagnosis, are grieving their life before the diagnosis and then their life after the diagnosis, and so they have to kind of go through a grieving period.
• 13:28
  Speaker 3: So I try to push it along and not have you use your emotions and use your energy, which is going to get tired, on things that aren't useful for you.
• 13:45
  Speaker 2: Yeah, i'm curious too, these individuals that are coming in there into your office and you are in front of those different kids, adults, whoever is getting this diagnosis Cause I remember for myself, like I was three years in denial, like three years in denial, and I attributes a lot of that to not having the community aspect that I could like, ask questions and talk to.
• 14:14
  Speaker 2: Like I, my parents were very, very good and very and behind me and I've talked about this before but they, they didn't know the struggle, they didn't know, like, what that was.
• 14:24
  Speaker 2: So I'm curious to know, like you know you're talking a lot about being able to have those conversations with those individuals that are going through that Are you pushing them, like, really pushing them to the community as well?
• 14:37
  Speaker 2: And and talking about like?
• 14:43
  Speaker 3: so meeting other people with type one diabetes is really healing, especially a camp environment.
• 14:50
  Speaker 3: So I really encourage the kids as much as possible.
• 14:56
  Speaker 3: You know I don't want to push them out of their comfort zone, but I do recommend that they get involved with a national organization.
• 15:06
  Speaker 3: I recommend that they get involved with advocacy for problems with the price of insulin and, you know, and research and that, and I know that they're automatically gonna meet more people.
• 15:23
  Speaker 3: But one thing that we have the opportunity to do in our office when someone is being diagnosed with diabetes is that we can introduce some of our other patients to them at that are there for their appointments And a lot of times that's a really very important and impactful moment, especially for the parents to, as you mentioned, having their young son that's six years old being diagnosed with diabetes.
• 15:56
  Speaker 3: And then I introduce them to a senior in high school that's thriving playing football and that they can see that their child could be like that too And that the parents will come in and I'll ask the family, because the family that's being diagnosed they're gonna be at our office all day.
• 16:18
  Speaker 3: So I'm seeing patients in between, kind of coming in and out, and when I'm seeing one of our patient, other patients.
• 16:26
  Speaker 3: I ask them would you like to meet one of our new families?
• 16:32
  Speaker 3: that they're kind of struggling a little bit And I think it would really help them to just see you.
• 16:37
  Speaker 3: And they're usually ecstatic and beyond just graceful And they usually, you know, kind of keep in touch, offer a phone number or the family say I know that you're overwhelmed and but I just want you to see my son and what he's doing right now.
• 17:00
  Speaker 3: And usually the parents cry about that too.
• 17:04
  Speaker 3: Cause just getting to see another, a teenager that's thriving and you know living hashtag living their best life is really powerful for a parent At that point.
• 17:19
  Speaker 1: Yeah, dr Dyer, and the future and moving forward.
• 17:21
  Speaker 1: tell them to call us.
• 17:23
  Speaker 1: We'll make fun of them, we'll give them some things to laugh about diabetes.
• 17:29
  Speaker 3: I will, I will.
• 17:31
  Speaker 1: So I wanna ask this is a huge question for me And I've probably what I consider it's gonna be a loaded question but I'm curious what your answer is gonna be.
• 17:38
  Speaker 1: If you met 25 people and you knew that they were all diabetics, can you pick out the five that are type one diabetic, like without like, if without question, would it be easy for you to say like they were all, like they all were the same, they you know cause?
• 17:56
  Speaker 1: if you met with I'll just leave it at that You met with 25 people and they said five of those were type one, would you be able to identify those type ones?
• 18:03
  Speaker 3: Really No thanks, Why I?
• 18:06
  Speaker 1: was gonna say the opposite.
• 18:08
  Speaker 2: It just I mean yeah, i think it why what is that?
• 18:11
  Speaker 1: What do you think that is?
• 18:13
  Speaker 3: Well, i'm.
• 18:14
  Speaker 3: You can't judge a book by its cover, and I'm asking you to.
• 18:19
  Speaker 3: Of course I am.
• 18:21
  Speaker 3: I think there's a trick to this question.
• 18:24
  Speaker 1: Well, no, no, no, no, let's say let's, let's eliminate that, let's eliminate that.
• 18:26
  Speaker 1: What if they were all the same height, the same stature?
• 18:29
  Speaker 1: What if it was just about the conversation, the added like what about the attitude, the conversation you had with them, the knowledge, do you think?
• 18:35
  Speaker 3: Yeah, I think, yeah, I could.
• 18:39
  Speaker 1: But let's let's let's word it this way Just the conversation, just based off the conversation alone you had with 25 people, let's say there's a door between you, would you be able to identify the five that are type?
• 18:49
  Speaker 3: Yeah, i would, but that's because that's what I do for a living.
• 18:55
  Speaker 3: Yeah, you know, I'd be, pretty bad doctor if I couldn't do that.
• 18:59
  Speaker 1: So, if the answer is yes, what?
• 19:00
  Speaker 1: what is it?
• 19:01
  Speaker 1: What is it about it?
• 19:02
  Speaker 1: What I did, what?
• 19:03
  Speaker 1: what's?
• 19:03
  Speaker 1: what's like a unique, What is something unique to in your eyes, to a type?
• 19:07
  Speaker 3: Things that they pay attention to that are not subconscious.
• 19:12
  Speaker 3: You know that's, that's how I would know.
• 19:16
  Speaker 1: Yeah.
• 19:18
  Speaker 3: And I can just tell by certain you know, whenever you're eating or talking about food, i can pretty much tell.
• 19:25
  Speaker 2: Yeah, yeah, that is an interesting question, it's.
• 19:30
  Speaker 2: It's a.
• 19:31
  Speaker 2: We always talk about not hiding and being advocates for yourself And and I think that for me, if I was in a room with 25 people and I had to pick out five of the diabetics, it would be very difficult.
• 19:45
  Speaker 1: You think so?
• 19:45
  Speaker 1: Yeah, you know, i asked that question.
• 19:47
  Speaker 2: Unless you're seeing, like physically, you also obviously could pick them out if they were like wearing a CGM or a palm.
• 19:53
  Speaker 2: Yeah, true, you know on on the physical level, but you'd have to, i'd be interested.
• 19:58
  Speaker 2: Dr Diet, too, is like in in that scenario and like you have a wall in between you and you're having a conversation with this individual.
• 20:04
  Speaker 2: I'm sure you're very good at understanding and coming up with the questions that are going to make that breakthrough for you.
• 20:11
  Speaker 2: Oh yeah, this person's diabetic.
• 20:14
  Speaker 1: You know, I mean, I thought your answer is going to be like yeah, they are so like cocky about their diabetes.
• 20:20
  Speaker 1: They would tell me within the first to see, because that's how I am, like I own, like everybody, I know and like, even can we own it?
• 20:26
  Speaker 1: we talk about it, we put it in your face, Like you know, that's my identity, My friends identify me as you know.
• 20:31
  Speaker 1: Oh, you're diabetical.
• 20:33
  Speaker 1: I wouldn't know.
• 20:34
  Speaker 2: Yeah, but you wouldn't say things like that, the beginning of your diagnosis, what You wouldn't be like that.
• 20:39
  Speaker 1: I guess.
• 20:39
  Speaker 1: Well, we didn't say anything about the beginning of a diagnosis.
• 20:41
  Speaker 1: Let me, hey, let me on the on the heels of kind of maybe slightly switching the direction of that.
• 20:49
  Speaker 1: Why do you think, like within diabetes, why do you think type one diabetics or type one is so overlooked and misunderstood?
• 20:57
  Speaker 1: What is it about the disease where people like wait, which one is that?
• 21:02
  Speaker 1: Or is that the one where you can't eat?
• 21:04
  Speaker 1: Who?
• 21:04
  Speaker 3: are you?
• 21:05
  Speaker 3: I don't know Society.
• 21:08
  Speaker 2: People just, i think he's.
• 21:09
  Speaker 2: I think he's referring to thinking about misunderstanding.
• 21:12
  Speaker 2: I think he's referring to the thought process, like between type twos and type ones, the not understanding the difference of the disease, the two different diseases, and I think, i think that's what you're doing.
• 21:24
  Speaker 2: Sure, right, yeah.
• 21:27
  Speaker 3: Well, i mean, people just really don't know about diabetes And that's kind of the bottom line.
• 21:35
  Speaker 3: There are even doctors, or I won't say doctors, but there are even emergency rooms that don't know what a ketone is, and my patient that is there because they're dehydrated or sick, and this isn't a children's ER, but just you know, and I'm not going to name what it would be or was, but my patient is educated and knows that she needs IV fluids and that she has ketones and they're like what's a ketone?
• 22:10
  Speaker 1: Yeah.
• 22:12
  Speaker 3: And that's you know.
• 22:13
  Speaker 3: So if that's happening at an emergency room, then of course a lay person isn't going to really know about diabetes.
• 22:20
  Speaker 3: So I don't I don't have an expectation that everybody's going to know about it.
• 22:26
  Speaker 3: Yeah, and then if they do know something, then they're going to have a misconception.
• 22:32
  Speaker 3: But I always try to say it's an opportunity to teach.
• 22:37
  Speaker 2: Yes, exactly.
• 22:38
  Speaker 2: I think it's interesting because even when I was diagnosed, my primary care physician said you know, you have diabetes in my head because I wasn't educated and I had no idea.
• 22:49
  Speaker 2: I'm thinking I'm not overweight, I'm not unhealthy, Like I think that is like what a lot of people associate diabetes to is like the unhealthy or the overweight or like that type of thing.
• 23:02
  Speaker 1: That's what I was going to say.
• 23:03
  Speaker 1: It's like.
• 23:03
  Speaker 1: It's like when you bring up the topic of like is an alcohol, like is alcohol, is alcoholism a disease?
• 23:08
  Speaker 1: People were like well, diabetes isn't a disease.
• 23:11
  Speaker 1: because you have a choice.
• 23:12
  Speaker 1: You're like well let's like, let me explain that, And this is why my question comes from it.
• 23:17
  Speaker 1: Well, let me explain what the type of the diabetes that I have.
• 23:20
  Speaker 1: So go ahead, dr.
• 23:22
  Speaker 3: I think most people think that type one is the bad kind, that's what everybody says Like oh, that's the bad kind.
• 23:30
  Speaker 3: Like the you have to use insulin.
• 23:35
  Speaker 3: That's you know.
• 23:36
  Speaker 3: That's what they, that's what they always call it.
• 23:39
  Speaker 3: Oh, you have the bad kind.
• 23:41
  Speaker 2: Are they saying bad in like a negative term because you have to take insulin, or bad because it's like a serious disease?
• 23:46
  Speaker 2: Both Both.
• 23:47
  Speaker 2: Yeah, hmm, that's interesting.
• 23:50
  Speaker 1: Bad that we send and this is why we have diabetes.
• 23:53
  Speaker 1: Yeah, let me.
• 23:56
  Speaker 1: So what?
• 23:58
  Speaker 1: so?
• 23:58
  Speaker 1: you said in the beginning why you chose to do your profession.
• 24:02
  Speaker 1: What's a what's like a life lesson you can attribute to choosing, like, what's something you've learned about your life that you can attribute to the profession that you've chosen?
• 24:09
  Speaker 1: Because it was as you said in the beginning, it was so important for you the direction that you chose.
• 24:15
  Speaker 3: I would say that, well, i'm just really inspired by the, the people that deal with diabetes on a daily basis, and they I just it's.
• 24:31
  Speaker 3: it makes me strive to be more graceful about taking on challenges and and just never giving up.
• 24:43
  Speaker 2: Yeah, i like that, like that, when you're seeing a patient, i'm curious in terms of your measurement and how you're measuring success or measuring oh, we're not doing X, y and Z Like.
• 24:59
  Speaker 2: What are those measurements for you?
• 25:01
  Speaker 2: Is it like, are you solely going based off of someone's A1C, off of their glucose monitor, off their CGM numbers, like what?
• 25:08
  Speaker 2: what data are you typically looking at to see progress over time?
• 25:13
  Speaker 3: Well, i mean I, we, we have to define.
• 25:18
  Speaker 3: That's an important issue to define for any patient, i mean in my patients, when they're five years old, they can't really answer that question about what?
• 25:32
  Speaker 3: what is my goal for health?
• 25:34
  Speaker 3: So I answer it for them and their parents answer it for them, which is to have an A1C under 7.5, as defined by the ADA guidelines and criteria.
• 25:48
  Speaker 3: But I equally look at time and range on continuous glucose monitor.
• 25:54
  Speaker 3: But that's the standard of care And so I just make sure that we're following the standard of care.
• 26:02
  Speaker 3: But I also want a child to be a child and to be their best self and be learning the way that they're supposed to be learning.
• 26:13
  Speaker 3: But as they get older, then the goals change about.
• 26:19
  Speaker 3: You know, if they want to be able to run a marathon, then I want them to be able to.
• 26:26
  Speaker 3: If they want to watch Netflix with comfort, and then I want them to.
• 26:34
  Speaker 3: And we do kind of define what, what their goal is.
• 26:39
  Speaker 3: Or I want to be able to have children one day, or I want to.
• 26:43
  Speaker 3: You know what is hashtag live your best life for them And and so I like to know what that is And that's going to change over time, but that I also a goal that I want from all of my patients is to let diabetes be a small amount of real estate in their brain so that they have room for doing more fun things.
• 27:13
  Speaker 3: But it's always going to be there And I find that the more attention that you spend to your diabetes, the less real estate of worrying about it happens.
• 27:24
  Speaker 3: So a lot of my patients that are, you know, kind of ignoring their diabetes, so to say, they're worrying about it more than anybody else.
• 27:32
  Speaker 3: It takes up a lot of space in their brain of worrying, and whenever I try to tell them that I want to, i want you to do these things so that you don't think about it as much, then I think that they agree with that goal, that they don't want to think about it a lot, they don't want to worry about it a lot And I want them to worry about more fun things, like teenager things, you know.
• 28:01
  Speaker 3: But they have a lot of things that they have to worry about with their grades and you know what college am I going to go to?
• 28:08
  Speaker 3: And I just don't want them to have to think about all of these things.
• 28:15
  Speaker 3: But diabetes is going to demand that they do think of some things, and we're going to have to figure out how to make that happen.
• 28:27
  Speaker 1: You said something that I've been diabetic for 27 years and I've never thought of it, but it's very true And it's probably a battle that you have is diagnosing kids at such a young age.
• 28:36
  Speaker 1: You can't completely ingrain the long-term effects it's going to have on them.
• 28:42
  Speaker 1: The best thing you can do is the moment and the now and treat them, and I hadn't thought about that.
• 28:46
  Speaker 1: You're right, it's all about the now.
• 28:48
  Speaker 1: You don't learn about long-term effects until you get older and you have worries and you become more of an adult.
• 28:53
  Speaker 1: So that's a very interesting component about your job that I give you a lot of credit for taking on.
• 28:58
  Speaker 1: I wouldn't sleep.
• 28:59
  Speaker 1: I don't think I'd sleep well at night knowing that It's not just the worry of the five-year-old going low at night and hearing the CGM blast off, but it's like holy crap man.
• 29:09
  Speaker 3: Well, it's a big responsibility to make sure that when you're a parent, but also when you're a doctor of children, that they can't make decisions for the long-term, that you help make sense to them about why we're doing these things.
• 29:31
  Speaker 3: It has to make sense to some extent, but they also just need to be kids, So we have to work around what's important for them.
• 29:42
  Speaker 3: But yeah, kids live in the now.
• 29:46
  Speaker 3: They think that, oh, 25, that's old.
• 29:49
  Speaker 3: I mean I remember when I thought that too.
• 29:55
  Speaker 2: I love that, because we talk a lot about mindset and we talk a lot about thinking about the end in mind And when we think about kids, they don't have the maturity, they don't have the skill to think long term.
• 30:11
  Speaker 2: I mean, that's perfect.
• 30:13
  Speaker 3: I mean developmentally.
• 30:15
  Speaker 3: They're not able to.
• 30:16
  Speaker 2: Yeah.
• 30:18
  Speaker 3: And even teenagers.
• 30:19
  Speaker 3: they're just not able to think.
• 30:20
  Speaker 3: They think 30 is really old And I don't care if I'm in a nursing home when I'm 30.
• 30:27
  Speaker 3: I just care about now.
• 30:30
  Speaker 1: Yeah, i think the go ahead, sorry, go ahead.
• 30:34
  Speaker 3: I was going to say that.
• 30:36
  Speaker 3: You know that's true about, like, tanning salons and stuff like that too.
• 30:41
  Speaker 3: You know.
• 30:43
  Speaker 1: I was going to say.
• 30:43
  Speaker 1: I think the aha moment that diabetics will have that you can also attribute to success in your everyday life is planning ahead and thinking ahead, and when that happens, then you're successful, because it's like people are like how are you so organized, honestly, because I've been diabetic for so darn long that I have to think of the.
• 31:03
  Speaker 1: I have to always be thinking of 30 minutes, one hour, three hour tonight, tomorrow, right?
• 31:07
  Speaker 1: So you're shaking your head.
• 31:09
  Speaker 3: Yeah.
• 31:11
  Speaker 1: By the way, people she's shaking her head.
• 31:12
  Speaker 1: I'm not a total idiot.
• 31:14
  Speaker 3: I just had one of my patients that went to college and he came back for Labor Day weekend and and he brought all of his supplies but he forgot his insulin.
• 31:29
  Speaker 1: Yeah.
• 31:30
  Speaker 3: And then he forgot it at college and I guess they didn't have any extra because he brought all of it with him, but he brought every single thing except for that, And you know, I bet he will never forget that again.
• 31:47
  Speaker 1: And it's an amazing lesson for that reason, but you also, in my opinion, you better wake up the next day and not give yourself grief because you have so much to think about.
• 31:56
  Speaker 1: It happens.
• 31:56
  Speaker 1: It is what it is You?
• 31:58
  Speaker 1: know we've all been there.
• 31:59
  Speaker 1: So, just because we don't have a lot of time, i one of my questions for you that what was the best tool for success?
• 32:06
  Speaker 1: but I think you probably could say it's the.
• 32:08
  Speaker 1: You know what's happened with the CGMs recently, with?
• 32:12
  Speaker 3: for parents and kids.
• 32:13
  Speaker 1: I want to hear what I want to hear your opinion of.
• 32:16
  Speaker 3: So CGM has been the most transformative thing that has happened in my diabetes career.
• 32:25
  Speaker 1: It's amazing to hear.
• 32:27
  Speaker 3: And I would say that it is the.
• 32:29
  Speaker 3: It's not pumps or shots, or pumps versus shots.
• 32:34
  Speaker 3: It's CGM that you have to have And the real time information about it, about what's happening with your blood sugars plus the direction of your blood sugars gives you so much information that it's transformed life And it's also a saved parents from worrying so much and allowing their kids to actually live a little bit more with the share features and and be able to spend the night at their friends and be able to to thrive with diabetes.
• 33:16
  Speaker 3: Yeah.
• 33:18
  Speaker 2: It's yeah, we talk about CGMs.
• 33:20
  Speaker 2: It's, it's like our number one thing, Our number one thing like that.
• 33:23
  Speaker 2: you have to be able to understand and do So.
• 33:28
  Speaker 2: yeah, we.
• 33:29
  Speaker 3: For our patients we have.
• 33:32
  Speaker 3: I think it's 97% of our patients are on CGM.
• 33:38
  Speaker 3: That's crazy, That is crazy.
• 33:39
  Speaker 3: And the only reason there's the 3% haven't is because they've had bad experiences with other CGMs and and I have to still build- their trust back.
• 33:53
  Speaker 3: Yeah, i'm going to tell you a funny thing.
• 33:57
  Speaker 1: You've never you've maybe never heard this, but I've been diabetic long enough that I watched the wave happen.
• 34:01
  Speaker 1: There was a crossover point with the CGMs where it was too much information And that's why that she's again people, she's shaking her head.
• 34:10
  Speaker 1: That's why most and I did it to him like what do you mean?
• 34:12
  Speaker 1: You're going to put some on me for 48 hours and you're going to get my blood sugar every five minutes, like, don't invade my privacy?
• 34:20
  Speaker 1: And it was.
• 34:21
  Speaker 1: It was like this mental block.
• 34:22
  Speaker 1: And then that was probably Yeah, probably 10 years ago.
• 34:26
  Speaker 1: And then over the next The years that would follow, insurance would pick it up And you know, like you know, dexcom has gotten, you know, new versions of it and stuff, so it's become more commonplace.
• 34:36
  Speaker 1: But that's the the best part of it all is that it's so much information that it was scared of.
• 34:41
  Speaker 1: Well, i would also venture to say that it The inflection point.
• 34:48
  Speaker 3: When everything changed is when The accuracy of the CGM hit The same accuracy of the meter.
• 34:56
  Speaker 3: And that because I mean, if it's a bunch of junk information, then it's just annoying, yeah, and it's, it's not how it's done.
• 35:05
  Speaker 3: And it's not how it's done, it's just annoying, yeah, and it's it's not helpful.
• 35:12
  Speaker 3: And, and there used to be this glucose watch that, like That, burned your skin, you know, and I mean that's, it's a cool idea, but if it's not accurate, then I don't think anybody wants to spend any time with it.
• 35:29
  Speaker 3: So, and if you have to And the other inflection point is where you don't have to calibrate it- Yeah.
• 35:38
  Speaker 3: Cause, then That was a big helpful to you because you don't have to add more things To your life.
• 35:45
  Speaker 3: It actually improves.
• 35:48
  Speaker 3: It improves your life because you do have to do less.
• 35:52
  Speaker 3: Yeah.
• 35:54
  Speaker 1: My favorite nerd thing about a CGM and follow me here is You have dinner, you take insulin.
• 36:00
  Speaker 1: You know that.
• 36:00
  Speaker 1: You know that you don't expect that the human long to work.
• 36:02
  Speaker 1: Well, you know, good, like three hours.
• 36:05
  Speaker 1: But at two hours you check your CGM and you're 125.
• 36:08
  Speaker 1: Well, you're 125 and plummeting down.
• 36:11
  Speaker 1: If you were just doing manual you would just see 125.
• 36:15
  Speaker 1: I'm perfect.
• 36:16
  Speaker 1: But then, you know, you go in for a walk and then the next thing, you know, you're like shaky and you're like what the heck happened?
• 36:22
  Speaker 1: I was just 125.
• 36:23
  Speaker 1: That, to me, is the changing point.
• 36:25
  Speaker 3: Yes.
• 36:26
  Speaker 1: In the CGM is like that to me.
• 36:27
  Speaker 1: Is you never expected that to happen?
• 36:29
  Speaker 1: but talk about planning for the next couple hours.
• 36:32
  Speaker 1: You know so.
• 36:33
  Speaker 3: Yeah, and then you make better decisions that you know if you were going to walk the dog you might not walk the dog at that time and make sure that you're planning treating your low.
• 36:46
  Speaker 2: Yeah, yeah, it's a game changer.
• 36:48
  Speaker 2: I think the CGM is just.
• 36:50
  Speaker 2: It's a game changer.
• 36:51
  Speaker 2: It is.
• 36:52
  Speaker 2: It is one piece of technology, one piece of thing that we're going to keep harping about that with the, the arrows and like it's just.
• 37:00
  Speaker 2: It's such a game changer of being able to make decisions right now instead of having to wait an hour, two hours down the road.
• 37:06
  Speaker 3: Well, it is interesting, I'm on guest faculty with Stanford and Stanford did a study about a year ago actually, or not, during COVID, So two years ago, 2019.
• 37:23
  Speaker 3: And I did a study about giving a DEXCOM to families and patients that were just diagnosed with diabetes And and it it's actually changing the paradigm of worrying about lows to worrying about highs at the very beginning And that has a has a lasting effect that improves A1C, because then obviously the first thing a family is going to be concerned about is a low And with the, the technology of a CGM, you don't have to worry about the lows the way that you used to and then you start worrying about the highs, and that that really influences the very beginning A1Cs.
• 38:15
  Speaker 3: And they also have showed that the first year of your diabetes is the most influential time for developing your diabetes habits.
• 38:29
  Speaker 1: What's the theory behind the highs Cause?
• 38:31
  Speaker 1: I think I have one.
• 38:32
  Speaker 1: Do you think, do you, do you?
• 38:35
  Speaker 3: The theory behind.
• 38:36
  Speaker 3: Why has it been more of?
• 38:37
  Speaker 1: a worry about?
• 38:37
  Speaker 1: not, it's like what you just said, like the paradigm that happened, where it's more of a it's more of a concentration on the highs.
• 38:44
  Speaker 3: Because they don't feel as bad with with highs versus lows.
• 38:49
  Speaker 3: But what I'm noticing nowadays, with better control of of that patients have, is that they don't like feeling high anymore.
• 39:00
  Speaker 1: You know what I mean.
• 39:01
  Speaker 3: To be okay with it.
• 39:02
  Speaker 1: You know when I hear you say that, like my gut is, it's not.
• 39:05
  Speaker 1: it's not either of those, it's accountability, it's embarrassment.
• 39:08
  Speaker 1: You don't want to.
• 39:09
  Speaker 1: I do not want you to know that I was riding at 250 for six hours.
• 39:14
  Speaker 1: Seriously.
• 39:16
  Speaker 1: And I never thought about that as much as I do now with the CGM.
• 39:18
  Speaker 1: I'm like, oh my God, look, i'm going to be like they just kind of see me overnight at 203.
• 39:23
  Speaker 1: Seriously, and accountability, i think, is the difference in the CGM too.
• 39:26
  Speaker 1: That was the hesitant.
• 39:28
  Speaker 1: That was why I was hesitant.
• 39:30
  Speaker 2: Well, that's an interesting I.
• 39:30
  Speaker 2: that's very interesting that you're bringing this up, because I'm very honest.
• 39:34
  Speaker 2: You are honest, you are.
• 39:38
  Speaker 3: But, but you know what I have to add, though?
• 39:40
  Speaker 3: that I want to make sure that my patients don't Attach their self worth to to the number.
• 39:50
  Speaker 1: It's an awesome point.
• 39:51
  Speaker 3: Yes, great point, great And that this is a good number.
• 39:55
  Speaker 3: This is the bad.
• 39:55
  Speaker 1: Sure Sure.
• 39:56
  Speaker 3: You know and and I'm hearing that a little bit in what what you're saying?
• 40:01
  Speaker 1: No, no, no, I'm saying that because I'm being brutally honest and blunt with you.
• 40:03
  Speaker 1: Diabetes has never been like that with me.
• 40:06
  Speaker 1: I've always, as I said it or I make fun of diabetes, and the trick for me is making fun of it.
• 40:10
  Speaker 1: I laugh about it.
• 40:11
  Speaker 1: And no, no, no, i don't associate that.
• 40:13
  Speaker 1: I mean I'm nice, i've, i've, i've, i've shattered blood sugar monitors because I've been so pissed off.
• 40:18
  Speaker 1: But that's, that doesn't, that's, you know, that's in one ear and out the other.
• 40:21
  Speaker 1: That's what drives me.
• 40:22
  Speaker 1: It's my mortar, you know.
• 40:24
  Speaker 3: I think that we're human and we're going to always attach like a value to the numbers.
• 40:29
  Speaker 3: but, as interestingly enough, as you know the doctor, i'm not really thinking that way.
• 40:36
  Speaker 3: I'm thinking more about this disinformation.
• 40:39
  Speaker 3: and this information says that when you eat a little Debbie, it goes up this way And when you eat something else, it goes up a different way.
• 40:50
  Speaker 3: And I'm definitely not putting any value of of oh, that's good or that's bad, but you are right.
• 40:59
  Speaker 3: in the moment It's kind of competing with yourself, right About.
• 41:03
  Speaker 3: can I make this a really good day, or?
• 41:07
  Speaker 1: And I would say that, as a rebuttal to you is you can have all the confidence in the world if the person is doing it for themselves.
• 41:14
  Speaker 1: If it's, if it's an inner struggle and that 200 breaks you down, that 200 should also lift you back up, cause isn't that the essence of life?
• 41:21
  Speaker 1: You know, you learn from your failures And that's what I would say as a to don't.
• 41:25
  Speaker 1: I've never been competitive with other diabetics.
• 41:27
  Speaker 1: I couldn't give two craps with you know, i really I couldn't give two craps.
• 41:30
  Speaker 1: but you know everybody's, everybody's different.
• 41:32
  Speaker 1: So I see your, i see the point and I see your outlook.
• 41:37
  Speaker 1: You're really soft, soft way The opposite of me.
• 41:39
  Speaker 3: Yeah, You know a really great teacher said that it about diabetes is that if you've seen one person with diabetes, you've seen one person with diabetes, because everybody's diabetes is different.
• 41:55
  Speaker 1: Call it a snowflake disease.
• 41:57
  Speaker 1: I always have.
• 42:00
  Speaker 3: So it is kind of competing with yourself, yeah, totally.
• 42:04
  Speaker 2: I personally think that if you're struggling with the highs mentally, it's an identity thing with diabetes, like you don't have a good relationship with diabetes because you're not able to I think you alluded to it You know you can't associate that high to something positive.
• 42:21
  Speaker 2: That's going to tell you they're paying a picture for you.
• 42:23
  Speaker 2: That's going to tell your story.
• 42:24
  Speaker 2: Right, i eat this, i go to 200.
• 42:27
  Speaker 2: I eat this, i only go to 120.
• 42:30
  Speaker 2: Right, so I think that is a.
• 42:33
  Speaker 2: That is a big thing for me.
• 42:34
  Speaker 2: That has really helped me as I become more confident in my management.
• 42:41
  Speaker 2: That's something that's really helped me.
• 42:47
  Speaker 1: So, dr Dyer, what are your thoughts on the price of insulin and where do you project your patients, like what are some things they have to think about in the next 10 to 15 years and with the scope of things right now?
• 43:00
  Speaker 3: Well, i have a master's in public health, so I have a very strong background and understanding about health policy, and I'm also an optimist and I think that because we have, with type 1 diabetes, such a strong advocacy group and I can also tell you that because there's no force stronger than a parent that wants to get rid of diabetes for their child they'll do what they need to do to make this happen.
• 43:37
  Speaker 3: And I think it's not going to happen at the federal level, it's going to happen at the state level, and that each state is going to cap the costs of of insulin and and that's what I think they should do, and thankfully a lot of states are have already done that, like starting with Colorado and in Pennsylvania, you actually don't pay anything for life-saving insulin, which is awesome, so they pay a lot of taxes.
• 44:11
  Speaker 1: I love life-saving, i love that verb.
• 44:12
  Speaker 1: Well, that's it.
• 44:15
  Speaker 2: It's interesting that you're stating that I'm because I'm curious.
• 44:18
  Speaker 2: Why wouldn't that?
• 44:19
  Speaker 2: that seems that it seems like a very like big thing for this disease, and why that wouldn't come from the federal level and it would have to come from the state level.
• 44:32
  Speaker 2: Well, i mean, i just don't think they can get anything done.
• 44:40
  Speaker 3: So I think we have to be practical and get things done.
• 44:42
  Speaker 3: Yeah, and I just don't see it happening because I'm not optimistic about that.
• 44:51
  Speaker 2: Yeah, gotcha, and so I think that we'll get the best action from the state level At least for that, for a life-saving insulin.
• 45:00
  Speaker 3: that needs to not be a reason.
• 45:01
  Speaker 3: The price needs to not be a reason that somebody would succumb to diabetes.
• 45:12
  Speaker 3: Yeah, agreed, it's just.
• 45:15
  Speaker 2: it's such a crazy thing that it was meant to be free and now it's, like you know, 110 times the cost of what it is to make it.
• 45:30
  Speaker 2: It's just.
• 45:30
  Speaker 2: it's unbelievable, But it's just like happened recently too, I mean it's, it's.
• 45:36
  Speaker 1: It's a very recent thing.
• 45:39
  Speaker 3: And so.
• 45:40
  Speaker 3: But we as as advocates so I'm an advocate as well We as advocates are not going to let that happen.
• 45:46
  Speaker 3: So that's just the bottom line of it.
• 45:50
  Speaker 3: But what I've learned about type one diabetes, advocacy, advocacy groups and just people with type one diabetes for some reason it chooses the most awesome people to live in type one diabetes does and and the people that love them And the community just comes together when there are emergencies.
• 46:16
  Speaker 3: So I did my training in Texas and have a lot of friends that are doctors and in the and advocates in Texas and during Hurricane Harvey three years ago in Houston, the community group together and everybody kind of forwards insulin and supplies.
• 46:40
  Speaker 3: I mean I think it's just a natural thing that we do in this day and age For thinking about emergencies.
• 46:46
  Speaker 3: I mean 20 years ago, 9 11.
• 46:50
  Speaker 3: I think about 9 11 every day.
• 46:53
  Speaker 3: I was actually leaving New Orleans during Katrina And so I think about emergencies probably more than most.
• 47:03
  Speaker 3: But I think we all think about emergencies and kind of stockpile things And what ends up happening in a real emergency is that people use social media to ask for help about I don't have any insulin and I can't, and you're in Houston and you're there's, you know, six feet of water and you can't drive, and people come on a boat and give you insulin.
• 47:32
  Speaker 3: So crazy What happened.
• 47:33
  Speaker 3: So I imagine, in an apocalypse kind of situation, people with diabetes are very resourceful and have will collect their stockpiles and and help people out.
• 47:51
  Speaker 3: That's kind of what ends up happening And it's given me a optimistic viewpoint of what would actually happen in an emergency.
• 48:04
  Speaker 2: Yeah, i just yeah, it's.
• 48:05
  Speaker 2: I can't.
• 48:06
  Speaker 2: I still in baffled every single day when I get on social media I know you're a big social media person as well That the community and like how much people are just like helping each other.
• 48:18
  Speaker 3: I mean you can put a post on Facebook and one of these diabetes groups and get a response to your, to your query, in what two minutes It just yeah, actually one of my patients was in Austin and she put out a social media post about oh my gosh, i'm out of my T slim pumps, pump supplies, and somebody in Austin said I've got some.
• 48:46
  Speaker 1: Yeah.
• 48:48
  Speaker 2: And so crazy.
• 48:48
  Speaker 2: You talked a little bit I'm curious.
• 48:53
  Speaker 2: You talked a little bit earlier about nutrition.
• 48:56
  Speaker 2: How much nutrition, counseling or advice do you give to patients that need it?
• 49:04
  Speaker 3: So I'm a very amateur foodie, So I'm really interested in nutrition in general So I know a lot more than most doctors do.
• 49:18
  Speaker 3: But so I talk about it, I take pictures of my food and you know yeah, i always see, i always see probably also talk about it more than most people, but I do talk about it a lot And we have a consultant nutritionists dietician that we have our patients meet with via telemedicine and we do intensive discussions about which carbs and the type of carbs and total versus net carbs and and doing low carb and how to do it right And we go into in depth if you want to.
• 50:05
  Speaker 2: Yeah, is low carb kind of your thing that you guys kind of educate about, or is it just like what we're you?
• 50:14
  Speaker 3: or we really try to meet every family and patient where they are and what they want to do And I advise, if it's, you know what would be dangerous or not danger or healthy, how this would help them achieve their goals and what they need to watch out for.
• 50:37
  Speaker 2: Yeah.
• 50:38
  Speaker 3: I wouldn't say that I promote one diet more than the other, but I make sure that what each family and patient wants to do is going to help them achieve what they want to achieve.
• 50:53
  Speaker 2: Yeah, okay, nice, i don't know how you are on time.
• 51:00
  Speaker 1: I don't have much.
• 51:01
  Speaker 2: Yeah, i think one of our last questions that we that we really like to ask our guests is if there was three or four things that you could tell a newly diabetic, a diabetic at any age, what they should be thinking about or do to be successful, what would that?
• 51:22
  Speaker 3: be So number one, they have to have a CGM.
• 51:25
  Speaker 3: I mean there's just that's just number one.
• 51:31
  Speaker 3: And number two they need to be empowered with information about food.
• 51:41
  Speaker 3: And number three they need to make sure that diabetes does not overwhelm their thought process about life And we.
• 51:58
  Speaker 3: if it is overwhelming, then I will help you get, get it to where it's not.
• 52:05
  Speaker 2: Yeah, nice.
• 52:10
  Speaker 1: Have you ever seen a diabetic tattoo Really?
• 52:14
  Speaker 3: On the left wrist.
• 52:15
  Speaker 1: Just one.
• 52:17
  Speaker 3: No, a lot.
• 52:18
  Speaker 1: How many Like?
• 52:19
  Speaker 1: what do you think?
• 52:19
  Speaker 1: Like a dozen?
• 52:21
  Speaker 3: Like No, probably 200.
• 52:26
  Speaker 1: No way, wow.
• 52:27
  Speaker 1: Have you ever seen one?
• 52:30
  Speaker 3: on the butt, no, not on the butt Mine's on the butt, oh, okay.
• 52:36
  Speaker 3: Well, that's the first one for me.
• 52:38
  Speaker 1: Hey, i want to.
• 52:38
  Speaker 1: I have a closing question.
• 52:40
  Speaker 1: People always associate endocrinology with diabetes.
• 52:45
  Speaker 1: What's something that, what's something that, like, an endocrinologist does that on a regular basis, that, like everybody forgets about, or like something that you like about your profession, that doesn't involve diabetes?
• 52:57
  Speaker 3: Well, i, i'm the only medical person in my family.
• 53:02
  Speaker 3: So I tried to explain to them when I said I want to be an endocrinologist.
• 53:07
  Speaker 3: So what's that?
• 53:08
  Speaker 3: And I said, well, it's everything that's on TLC is like too tall, too too small, too big, too little, and yeah, am I a boy, am I a girl?
• 53:25
  Speaker 3: That that's what being an endocrinologist is.
• 53:29
  Speaker 3: So I think it's really interesting that, of course, i'm really biased, so that's awesome.
• 53:34
  Speaker 2: I love that.
• 53:36
  Speaker 3: Did they?
• 53:36
  Speaker 1: tell you that you're going to be doing all the feed exams too.
• 53:39
  Speaker 1: Was that a thing that was specified in college?
• 53:42
  Speaker 3: No, they never said that That was a surprise That came out of nowhere.
• 53:46
  Speaker 1: You have to touch a lot.
• 53:48
  Speaker 3: But yeah, I would say that I have, whenever I'm at a cocktail party with with friends, that they're like what do you do?
• 53:57
  Speaker 3: What's an endocrinologist and a pediatric endocrinologist?
• 54:02
  Speaker 3: And you know it's they're.
• 54:04
  Speaker 3: they find it pretty interesting too, And I had one funny guy at my high school reunion asked Have you ever seen anybody born with a tail?
• 54:14
  Speaker 3: And I've not.
• 54:19
  Speaker 1: Would that be in your profession?
• 54:20
  Speaker 1: That fall?
• 54:21
  Speaker 1: No, it wouldn't.
• 54:23
  Speaker 3: But he thought it would maybe like am I a boy, am I a girl, am I a dog?
• 54:29
  Speaker 2: Yeah, that's, that's the way it is.
• 54:31
  Speaker 2: One last closing question As diabetics, how can?
• 54:40
  Speaker 2: and we're coming into your office, whether it's newly diagnosed, you've already been working with us.
• 54:45
  Speaker 2: What is one thing that you could tell us that would make your life easier?
• 54:55
  Speaker 3: I mean, if all of your goals are really clear, well, i always need you to be honest with me.
• 55:02
  Speaker 3: I mean, i'd say that's probably the most important thing for me to be able to help you.
• 55:08
  Speaker 3: But if all of your goals are clear and we're meeting them, i feel like some lately.
• 55:19
  Speaker 3: But with CGM I don't even know if I'm even helping anybody anymore.
• 55:24
  Speaker 3: Or you know, what do you need me for?
• 55:28
  Speaker 3: Yeah, so it's a nice feeling, i would say.
• 55:33
  Speaker 3: But really you just need to be honest with me And even if you think that you're going to disappoint me, you're not.
• 55:43
  Speaker 3: You just need to be honest.
• 55:46
  Speaker 1: I like that.
• 55:46
  Speaker 1: I remember going.
• 55:47
  Speaker 1: I went through that as a teenager, like because I, you know, i met my doctor at seven, so by the time I was like 17,.
• 55:53
  Speaker 1: You know, i was a no at all and I would fake numbers and you know.
• 55:58
  Speaker 1: Back to the accountability thing.
• 56:00
  Speaker 3: A lot of the you know teenagers that grow into their twenties that I still see they're like.
• 56:06
  Speaker 3: I'm sorry I lied to you.
• 56:09
  Speaker 2: Yeah, yeah.
• 56:11
  Speaker 2: Well that's, yeah, it's, that's good.
• 56:13
  Speaker 3: But now, with all the technology and CGM, you can't lie.
• 56:18
  Speaker 2: Yeah, yeah, the data is right there in front of you.
• 56:20
  Speaker 2: Yeah, god, that's awesome.
• 56:23
  Speaker 1: Yeah.
• 56:23
  Speaker 2: That's awesome.
• 56:24
  Speaker 1: Thanks for your time, thanks for all you do.
• 56:25
  Speaker 1: Thank you so much.
• 56:26
  Speaker 1: Thank you, guys.
• 56:28
  Speaker 2: Yeah, thank you Where.
• 56:31
  Speaker 2: One last thing is I think that you have some really cool stuff on social media.
• 56:35
  Speaker 2: Where can people find you on social media if they want to follow you?
• 56:41
  Speaker 3: Well, i try to be pretty informational on my Twitter feed.
• 56:46
  Speaker 3: So I'm at Dr Jen Shine Dyer on Twitter and I'm also on the same handle for Instagram, dr Jen Shine Dyer, and that's more of what I'm doing.
• 57:04
  Speaker 3: If you care about what I'm doing and food, i'm all about food.
• 57:11
  Speaker 2: You are Fashion Yes, you are foodie and fashion Yes.
• 57:17
  Speaker 3: So I try to have my handle be like I'm a stylish pediatric endocrinologist.
• 57:22
  Speaker 3: I talk about Texas, because this is where I'm from, and I talk about food and that's what my handle is, because I started, Oh good.
• 57:35
  Speaker 1: So, when I started social media.
• 57:38
  Speaker 3: I didn't think that I would do social media if it wasn't even interesting to me.
• 57:45
  Speaker 3: So, things that are interesting to me are food and fashion, and Yeah, you're very active on there.
• 57:51
  Speaker 2: So, yeah, it's awesome.
• 57:52
  Speaker 2: That's awesome Well thank you so much.
• 57:56
  Speaker 2: Thank you so much, Dr Dyer.
• 57:57
  Speaker 3: Thank you guys.
• 57:58
  Speaker 2: This was amazing.
• 57:59
  Speaker 2: We'll have to get you on again.
• 58:01
  Speaker 3: Yes.
• 58:01
  Speaker 2: Just keep talking and having fun with these conversations, so we appreciate you coming on.
• 58:05
  Speaker 3: Well, thanks for all that you do and for connecting people with diabetes.
• 58:09
  Speaker 3: It's always healing for them and important work that you do.
• 58:14
  Speaker 2: Yeah, thank you, thank you.
• 58:17
  Speaker 3: We hope you tell people about the podcast.
• 58:18
  Speaker 3: I will, i will.
• 58:20
  Speaker 2: Yeah, thank you so much.
• 58:21
  Speaker 2: Bye, bye.
• 58:23
  Speaker 2: Thank you so much, everyone for listening.
• 58:28
  Speaker 2: I really hope that you got some value out of this episode.
• 58:31
  Speaker 2: It was when we recorded it.
• 58:34
  Speaker 2: It was such a fun episode to talk to her.
• 58:37
  Speaker 2: She really is emulates everything that I've really been trying to push and talk about with meeting newly diagnosed patients with kindness, empathy and giving them the support that they need, and she really does implement that.
• 58:52
  Speaker 2: So, again, if you're someone that is newly diagnosed or you're in transition from Interconologists, dr Dyer is going to be just an amazing resource for you, so please make sure you reach out to her.
• 59:06
  Speaker 2: If you're looking for a new Interconologist, she's an incredible endo.
• 59:10
  Speaker 2: All right, well, thank you so much for listening.
• 59:13
  Speaker 2: As a reminder, please remember to follow like the show, leave a five star review And I would really appreciate if you share the show with someone that you think really needs to hear a friendly voice, hear some really good conversations and learn something about diabetes.
• 59:31
  Speaker 2: And, lastly, if you're interested or looking for some more diabetes guidance, my 10 week coaching program is up and it's been so much fun taking people through that.
• 59:41
  Speaker 2: I'd love to share more information with you.
• 59:44
  Speaker 2: Make sure that you can click actually, you can click the link in the show notes to go and sign up for the program And it will prompt you just to schedule a free call with me before you even pay anything, so you don't have to worry about having to jump into something that you're still kind of maybe learning about.
• 1:00:04
  Speaker 2: So I'd love to chat with you and talk you talk through the program because it really has been a really fun and cool program to take people through.
• 1:00:13
  Speaker 2: Make sure you sign up for the newsletter that also is in the show notes, that link to the newsletter.
• 1:00:19
  Speaker 2: Thank you so much for listening and I will see everyone next week.