Hello Diacast fans! As I’m sure you’ve noticed, Amy and Liz have been missing for a few months and there have been no new episodes. Our lives have become quite complicated over the summer, and we have not been able to put the time, energy, and heart into creating content for y’all. Unfortunately it looks like this is going to be our new normal, at least for a little while, so we have made the difficult decision to break our promise of monthly episodes and go on hiatus for a while to recharge our batteries and hopefully find new time and motivation to bring you more great episodes. We do have a couple projects in the works, and as those are finished we will be releasing them here to our wonderful subscribers.

For our patrons, thank you from the bottom of our hearts for your support. We will be disabling continued donations for the time being as we are not delivering new content. Liz has been working her way through the backlog of episodes to re-cut and deliver bloopers and behind-the-scenes audio, and when those are finished we will still make them available on our Patreon.

Once again, thank you all for all of your support, and hopefully talk to you soon!

This episode is basically a family therapy session about growing up with diabetes (all parties consented to the recording). Clinical psychologist Dr. Mike Fulop returns to lead a discussion with Amy and her parents about overcoming some of the challenges of raising a child with diabetes and what they did to pull it off. Hear about some of the challenges with (lack) of local support networks and diabetes care providers, as well as steps taken to facilitate an adventurous life.

Instagram @diacastpodcast (https://www.instagram.com/diacastpodcast/)

Facebook Diacast (https://www.facebook.com/diacastpodcast)

Email us at [email protected]

Please feel free to join the wonderful diabetes communities on Reddit and Discord.

r/diabetes subreddit:

https://www.reddit.com/r/diabetes/

r/Diabetes discord:

discord.gg/diabetes

Patreon (help us stop losing money - plus early access, bloopers, and more!)

https://patreon.com/diacast

Reference Links

Behavioral Diabetes institute Institute https://behavioraldiabetes.org/

With insulin and other diabetes med shortages on the rise, Liz, Amy, and Evan dive in to some of stated (and hypothetical) reasons for the shortages. While official explanations for insulin shortages are sparse, changes in the supply chain and manufacturing demands (and probably some good old fashioned corporate greed) are all at play. There’s no clear answer, but there are steps we can take to plan ahead and mitigate how insulin shortages impact us.

Instagram @diacastpodcast (https://www.instagram.com/diacastpodcast/)
Facebook Diacast (https://www.facebook.com/diacastpodcast)
Email us at [email protected]

Please feel free to join the wonderful diabetes communities on Reddit and Discord.

r/diabetes subreddit:
https://www.reddit.com/r/diabetes/
r/Diabetes discord:
discord.gg/diabetes
Patreon (help us stop losing money - plus early access, bloopers, and more!)
https://patreon.com/diacast

Reference Links
Insulin assistance programs (through manufacturers)
https://diabetes.org/tools-resources/affordable-insulin

Press releases:
https://www.jdrf.org/press-releases/jdrf-statement-and-update-on-insulin-shortage/
https://www.lilly.com/our-medicines/humalog-and-lispro

Articles on Insulin and Med Shortages
https://www.aljazeera.com/economy/2024/5/2/what-is-behind-the-insulin-shortage-in-the-us
https://www.cnn.com/2024/03/22/health/insulin-shortage-eli-lilly/index.html
https://nabp.pharmacy/news/blog/diabetes-drug-shortages-and-fake-ozempic/

Liz and Amy dive into the basics and talk about treating hypos and their favorite low snacks. Not all treatments are created equal. And remember, the best low snack is the one you have on you - so stash them and carry them!

Instagram @diacastpodcast (https://www.instagram.com/diacastpodcast/)

Facebook Diacast (https://www.facebook.com/diacastpodcast)

Email us at [email protected]

Please feel free to join the wonderful diabetes communities on Reddit and Discord.

r/diabetes subreddit:

https://www.reddit.com/r/diabetes/

r/Diabetes discord:

discord.gg/diabetes

Patreon (help us stop losing money - plus early access, bloopers, and more!)

https://patreon.com/diacast

Diabetes management is all about finding what works for you - and then implementing it. This month we dig into self-management and self-advocacy. Join Liz, Amy, and Kelly to discuss choosing the management methods that work best for you, benefits of MDI vs insulin pumps, use of medications for T2 management, and tips for getting what you want from your care team.

Instagram @diacastpodcast (https://www.instagram.com/diacastpodcast/)

Facebook Diacast (https://www.facebook.com/diacastpodcast)

Email us at [email protected]

Please feel free to join the wonderful diabetes communities on Reddit and Discord.

r/diabetes subreddit:

https://www.reddit.com/r/diabetes/

r/Diabetes discord:

discord.gg/diabetes

Patreon (help us stop losing money - plus early access, bloopers, and more!)

https://patreon.com/diacast

Reference Links

T2 Diabetes and CGM Usage https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7957379/

Flexible vs Rigid Dieting https://europepmc.org/article/MED/10349584

Flexible vs Rigid Dieting and Disordered Behavior https://pubmed.ncbi.nlm.nih.gov/10336790/

https://pubmed.ncbi.nlm.nih.gov/11883916/

Diabetes Etiquette Card https://behavioraldiabetes.org/product/diabetes-etiquette-card-for-people-who-dont-have-diabetes/

Diabetes Etiquette Card for Parents of Teens https://behavioraldiabetes.org/product/teen-etiquette-card-diabetes-etiquette-for-parents-of-teens/

Behavioral Diabetes Institute https://behavioraldiabetes.org/

Season 3 kicks off with a back-to-the-basics look at carbs. This being the Diacast, the basics include a discussion of different types of carbs, how they absorb, and why they’re important. Also a discussion on the link between low carb diets and increased insulin resistance. 

Instagram @diacastpodcast (https://www.instagram.com/diacastpodcast/)

Facebook Diacast (https://www.facebook.com/diacastpodcast)

Email us at [email protected]

Please feel free to join the wonderful diabetes communities on Reddit and Discord.

r/diabetes subreddit: https://www.reddit.com/r/diabetes/

r/Diabetes discord: [discord.gg/diabetes](https://discord.gg/diabetes)

Patreon (help us stop losing money - plus early access, bloopers, and more!)

[https://patreon.com/diacast](https://patreon.com/diacast?utm_medium=clipboard_copy&utm_source=copyLink&utm_campaign=creatorshare_fan)

**Reference Links**

American Heart Association - Carbohydrates https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/nutrition-basics/carbohydrates

American Diabetes Association - Types of Carbs https://diabetes.org/food-nutrition/understanding-carbs/types-carbohydrates

Mayo Clinic - Carbs and Nutrition https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/carbohydrates/art-20045705

Cleveland Clinic - Carbohydrates https://my.clevelandclinic.org/health/articles/15416-carbohydrates

Study on low-carb diets and insulin resistance https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10061153/

Dietary Carb Intake and Mortality https://pubmed.ncbi.nlm.nih.gov/30122560/

Harvard Health - Carbs and GI https://www.hsph.harvard.edu/nutritionsource/carbohydrates/carbohydrates-and-blood-sugar/

Ever wondered how accurate your CGM and meter really are? Join Amy, Liz, DJ, and Paul as they discuss how accuracy is determined for blood glucose measurements, how CGM placement impacts readings, and how to restart different sensors. Plus what meters are the most accurate and other nifty tips.

Instagram @diacastpodcast (https://www.instagram.com/diacastpodcast/)

Facebook Diacast (https://www.facebook.com/diacastpodcast)

Email us at [email protected]

Please feel free to join the wonderful diabetes communities on Reddit and Discord.

r/diabetes subreddit:

https://www.reddit.com/r/diabetes/

r/Diabetes discord:

discord.gg/diabetes

Patreon (help us stop losing money - plus early access, bloopers, and more!)

https://patreon.com/diacast

Reference Links

FDA reporting form: https://www.safetyreporting.hhs.gov/SRP2/en/Home.aspx?sid=9c514b5e-a059-4c6c-b3fd-2b3c4957e2d1

Flash Glucose Sensor Alternative Placement https://diabetesonthenet.com/diabetes-digest/accuracy-and-tolerability-of-alternative-sites-for-flash-placement/

Libre Placement on Alternate Sites https://www.researchgate.net/publication/357225781_Where_can_you_wear_your_libre_Using_the_FreeStyle_Libre_Continuous_Glucose_Monitor_on_Alternative_Sites

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5444490/#:~:text=In 1987%2C the ADA suggested,30 and 400 mg%2FdL.&text=Today's CGMs allow frequent glucose,between 3 and 14 days

Measures of CGM and Glucose Meter Accuracy https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6501529/

Discussion of International Organization for Standardization revised quality standards for blood glucose meters https://jdrf.org.uk/information-support/treatments-technologies/continuous-glucose-monitors/how-accurate-is-my-blood-glucose-monitor/

Investigation of Accuracy of 18 blood glucose monitors  https://www.diabetestechnology.org/surveillance.shtml

Use of diabetes medications in non-approved (aka off-label) ways is increasingly common. This month, Amy and Liz dig into common off-label usage of Type 2 medications in insulin-deficient diabetes. Meds like GLP-1s, SLGT2’s, and metformin have an established history as a treatment for improving insulin sensitivity in T1’s. Ever wonder how that works and what the potential down sides are? While they’re on the topic of medications used for non-FDA-approved purposes, stay for the second half of the episode where they delve into use of supplements (cinnamon and turmeric) for diabetes management and if/how it works (the answer may surprise you) (or not).

Instagram @diacastpodcast (https://www.instagram.com/diacastpodcast/)

Facebook Diacast (https://www.facebook.com/diacastpodcast)

Email us at [email protected]

Please feel free to join the wonderful diabetes communities on Reddit and Discord.

r/diabetes subreddit:

https://www.reddit.com/r/diabetes/

r/Diabetes discord:

discord.gg/diabetes

Patreon (help us stop losing money - plus early access, bloopers, and more!)

https://patreon.com/diacast

Reference Links

https://diatribe.org/how-people-diabetes-are-getting-during-ozempic-shortage

Off-Label Medication in T1D https://www.utsouthwestern.edu/newsroom/articles/year-2023/february-type-1-diabetes.html

GLP-1s in T1D https://www.endocrinologyadvisor.com/home/topics/diabetes/type-1-diabetes/type-1-diabetes-adjunct-insulin-therapy-glucagon-like-peptide-1-receptor-agonists-glp-1-ra/

Current and Therapeutic Use of Metformin https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7915435/

Metformin in T1D [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5771191/#:~:text=Metformin reduces hepatic glucose production,20%2C 21%2C 26]](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5771191/#:~:text=Metformin reduces hepatic glucose production,20%2C 21%2C 26])

https://www.sciencedirect.com/science/article/pii/S2589936821000049

Metformin as an anti-cancer med https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6497052/#:~:text=Based on recent analyses and,prostate%2C colon%2C pancreas%2C and

TZDs in Diabetic Children and Beta Cell Preservation https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3890222/

TZDs Info https://dtc.ucsf.edu/types-of-diabetes/type2/treatment-of-type-2-diabetes/medications-and-therapies/type-2-non-insulin-therapies/insulin-sensitizers/

TZDs in T2 Treatment

Liz and Amy are joined by friends-of-the-Diacast DJ and Evan to discuss the day-to-day decisions that go into living with diabetes. From the small habits and snack-stashing to timing of meds and decision fatigue, they talk about some of the multitude of things that they do every day. Just because diabetes is an invisible disability doesn’t mean it doesn’t significantly impact every aspect of our lives. Bonus content: an in-depth (and on-topic) conversation about warm butt skittles (totally safe for work).

Instagram @diacastpodcast (https://www.instagram.com/diacastpodcast/)

Facebook Diacast (https://www.facebook.com/diacastpodcast)

Email us at [email protected]

Please feel free to join the wonderful diabetes communities on Reddit and Discord.

r/diabetes subreddit:

https://www.reddit.com/r/diabetes/

r/Diabetes discord:

discord.gg/diabetes

Patreon (help us stop losing money - plus early access, bloopers, and more!)

https://patreon.com/diacast

Links:

What is Decision Fatigue https://www.ama-assn.org/delivering-care/public-health/what-doctors-wish-patients-knew-about-decision-fatigue

Behavioral Diabetes Institute resources for those experience decision fatigue and diabetes distress: https://behavioraldiabetes.org/resources/

It’s officially summer and that means time for Liz and Amy to sit down and talk about diabetes management during those fun summer parties, BBQ’s, and events. While they’re at it, they discuss how dehydration can increase your blood glucose levels (but maybe not the way you think it does) and how diabetes impacts our body’s ability to handle thermal stresses. Grab your sunscreen and drink with an umbrella and enjoy!

Instagram @diacastpodcast (https://www.instagram.com/diacastpodcast/)

Facebook Diacast (https://www.facebook.com/diacastpodcast)

Email us at [email protected]

Please feel free to join the wonderful diabetes communities on Reddit and Discord.

r/diabetes subreddit:

https://www.reddit.com/r/diabetes/

r/Diabetes discord:

discord.gg/diabetes

Patreon (help us stop losing money - plus early access, bloopers, and more!)

https://patreon.com/diacast

Reference Links

Dehydration effects on blood glucose https://beyondtype1.org/dehydration-blood-sugar/?gclid=CjwKCAjwo7iiBhAEEiwAsIxQEU7aaXtKP2rO5uZ0F4UluPlgwpch0p_Sjx-kE4ny0jUIf9g4ClR1nBoCAOYQAvD_BwE

Body Temperature Regulation in Diabetes https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4861190/