The Diacast: A Podcast About Diabetes – Details, episodes & analysis

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 contact@diacast.com

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/

So many types of diabetes, so little time and so much confusion. This episode is those who have been confused by insulin resistance vs. insulin deficiency, what Type 3 diabetes actually is, and why Amy gets cranky when people claim you can have “double diabetes” (spoiler: it’s not a real thing). Join Amy and Liz as they provide a high-level rundown on the different types of diabetes, their causes, and treatments. Then save the episode to send to your friends and family who are confused.

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

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

Tweet us at @diacast

Email us at contact@diacast.com

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

Diagnosis and Classification of Diabetes https://diabetesjournals.org/care/article/26/suppl_1/s5/21693/Report-of-the-Expert-Committee-on-the-Diagnosis

Thyroid hormone T3 and attenuation of insulin resistance in mice https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3041250/

T3c Diabetes https://pancreaticcanceraction.org/help-and-support/living-with-pancreatic-cancer/type-3c-diabetes/

Diagnosis and Treatment of T3d in Patients with Chronic Pancreatitis https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3831209/

LADA https://www.ncbi.nlm.nih.gov/books/NBK557897/

Articles on T1b https://academic.oup.com/jcem/article/92/1/88/2598079 and https://pubmed.ncbi.nlm.nih.gov/33712367/

Covid-induced Diabetes https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9355745/ and

https://www.nature.com/articles/s41598-022-24185-7

Alzheimers as T3 Diabetes https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2769828/

Link between T2 diabetes and Alzheimers https://newsnetwork.mayoclinic.org/discussion/researchers-link-alzheimers-gene-to-type-iii-diabetes/ and full paper https://www.cell.com/neuron/fulltext/S0896-6273(17)30791-21

While Liz was away, Amy sat down with Dr. Irl Hirsch, an endocrinologist, researcher, and outspoken diabetes advocate (as well as an absolute legend). Join us for a discussion about the merits of A1C, access vs. cures, and the power of misinformation and well-placed ranting.

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

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

Tweet us at @diacast

Email us at contact@diacast.com

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

DCCT and EDIC studies on diabetes complications https://www.niddk.nih.gov/about-niddk/research-areas/diabetes/blood-glucose-control-studies-type-1-diabetes-dcct-edic

GWave glucose sensor article by James Hirsch https://diatribe.org/wave-future-new-glucose-technology-could-revolutionize-care

2022 Rant https://www.liebertpub.com/doi/abs/10.1089/dia.2022.0004

Seattle Times article (a little rant-y) https://www.seattletimes.com/opinion/high-insulin-prices-betray-spirit-in-which-the-lifesaver-was-created/

Diabetes in a hospital setting is an experience unto itself. Ever wonder why your blood glucose levels spike when you visit the doctor? Turns out there’s a name for that phenomenon. What about glycemic control leading up to and after a procedure? Did you know that CGM’s have limitations when under anesthesia, and insulin resistance does things that actually have a physiological reason. Join Amy and Liz as they delve into the wonderful world of diabetes management in and out of the hospital, pre- and post-op.

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

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

Tweet us at @diacast

Email us at contact@diacast.com

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

Stress hyperglycemia https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5975368/

Management of Diabetes in Surgical Patients https://diabetesjournals.org/spectrum/article/15/1/44/890/Management-of-Diabetes-Mellitus-in-Surgical

Clinical trial on CGM Monitoring during and after surgery https://clinicaltrials.gov/ct2/show/NCT02572856

managing diabetes under anesthesia https://www.sciencedirect.com/science/article/pii/S0104001417300623

Anesthesia for patients with diabetes https://www.uptodate.com/contents/anesthesia-for-patients-with-diabetes-mellitus

Insulin Pump Therapy in the Perioperative Period https://academic.oup.com/bja/article/116/1/18/2566071

CGM use in the operating room https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7896262/

Diabetes management has come a long way from being a wasting sickness/death sentence and tasting urine to measure blood glucose. This month, Liz, Amy, and Evan (an actual teacher) take a walk down history lane to talk about how diabetes management has evolved over the years. From the advent of home glucose monitoring, metformin, and insulin to CGMs and automated insulin delivery systems, things have changed a lot over the years.

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

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

Tweet us at @diacast

Email us at contact@diacast.com

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://www.medicalnewstoday.com/articles/317484

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4707300/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3749019/

History of Glucose Monitoring https://diabetesjournals.org/compendia/article/2018/1/1/144616/Introduction-History-of-Glucose-Monitoring

100 Years of Insulin https://www.fda.gov/about-fda/fda-history-exhibits/100-years-insulin

Brief History of Diabetes Meds https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4522877/

History of T2 Meds https://blog.profil.com/blog/medications-for-type-2-diabetes-a-short-historical-perspective

Dovc, K., & Battelino, T. (2020). Evolution of Diabetes Technology. Endocrinology and metabolism clinics of North America, 49 (1), 1–18. https://doi.org/10.1016/j.ecl.2019.10.009

'Mill Hill Infuser', the first portable insulin infusion pump, London, England, 1976 | Science Museum Group Collection

Pickup, J. C., Keen, H., Parsons, J. A., & Alberti, K. G. (1978). Continuous subcutaneous insulin infusion: an approach to achieving normoglycaemia. Br Med J, 1 (6107), 204-207.

Tadej Battelino et. al.; Clinical Targets for Continuous Glucose Monitoring Data Interpretation: Recommendations From the International Consensus on Time in Range. Diabetes Care  1 August 2019; 42 (8): 1593–1603. https://doi.org/10.2337/dci19-0028

It finally happened - Amy and DJ sat down to talk (in detail) about diabetes-related complications and comorbidities. For starters, what’s the difference between them (hint: they are not the same), how can you reduce your chances of getting them (you can’t always), and how do you manage/treat them. The good news is management and treatment options have improved dramatically over the past 30 years. Unfortunately, our pun game has not. So grab your glucose meter and hold on tight for an hour and a half of Amy being unable to pronounce words.

Tweet us at @diacast
Email us at contact@diacast.com

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 (many!)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2713155/
Incidence of complications for different types of diabetes
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3870323/
Calculating A1C
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4771657/
Limitations/Pitfalls of A1C https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3912281/
A1C and Mortality https://academic.oup.com/jcem/article/104/8/3345/5393288
A1C and cardiovascular outcomes https://cardiab.biomedcentral.com/articles/10.1186/s12933-021-01413-4
Epidemeology of neuropathy https://research.monash.edu/en/publications/the-epidemiology-of-diabetic-neuropathy
Vascular Complications and Neuropathy https://www.nejm.org/doi/full/10.1056/NEJMoa032782
T2 and Preventative Care https://acsjournals.onlinelibrary.wiley.com/doi/abs/10.1002/1097-0142(19930801)72:3+<1113::AID-CNCR2820721328>3.0.CO;2-A
Estimated Glomerular Filtration Rate (eGFR)
https://www.kidney.org/atoz/content/gfr
T1, Hashimotos, and Glycemic Control
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8314392/
Cardiovascular Complications in Diabetes https://jamanetwork.com/journals/jama/article-abstract/199831Trends in Cardiovascular Complications and Diabetes https://diabetesjournals.org/care/article/29/1/32/24455/Recent-Trends-in-Cardiovascular-Complications
Diabetes-Related Microvascular and Macrovascular Diseases in the Physical Therapy Setting https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2579903/
Behavioral Diabetes Institute https://behavioraldiabetes.org/

“Variations in comorbidity burden in people with type 2 diabetes over disease duration: A population-based analysis of real world evidence”, Jonathan Pearson-Stuttard, Sara Holloway, Rosie Polya, Rebecca Sloan, Linxuan Zhang, Edward W. Gregg, Katy Harrison, Jamie Elvidge, Pall Jonsson, and Thomas Porter

Boundaries around diabetes are tricky but necessary. Be it family, friends, medical providers, or complete strangers, establishing healthy, sustainable boundaries is hard. Liz and Amy are joined by clinical psychologist Dr Mike Fulop to talk about what makes self-efficacy so challenging and the components of healthy communication (nothing productive happens in the heat of the moment, avoid using absolute words like “never” and always”) for young, old, and every diabetic in-between. For parents of diabetic kids, we talk about the struggle between encouraging diabetes management and good control, and teaching self-management and empowerment. Facilitative Parenting is a powerful thing. Shaming and scaring techniques never work (regardless of who they’re coming from!), and interactions conveying love and acceptance without undermining a person’s sense of freedom and autonomy predicts good diabetes-management across the life span. This episode is for everyone who has a diabetic in their life.

Tweet us at @diacast

Email us at contact@diacast.com

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

https://patreon.com/diacast

Links

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/

Social Determinants of Health and Diabetes: A Scientific Review Felicia Hill-Briggs; Nancy E. Adler; Seth A. Berkowitz; Marshall H. Chin; Tiffany L. Gary-Webb; Ana Navas-Acien; Pamela L. Thornton; Debra Haire-Joshu  Diabetes Care 2021; 44(1) p258–279 https://doi.org/10.2337/dci20-0053

Fisher, Lawrence: Family Relationships and diabetes care during the adult years. 0071. Diabetes Spectrum Volume 19, Number 2, 2006

Learn to listen: The art of empathic understanding William R Miller, Ph.D [2018]

M de Wit, PM Trief, JW HUber, I Wiilaing: State of the art: understanding and integration of the social context in diabetes care:  DIABETICMedicine DOI: 10.1111/dme.14226  https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.14226 [2020]

Wiebe, D; Helgeson, V; Berg, C [2016] The social context of managing diabetes across the life span. American Psychologist. V71[7] p 526-538. http://dx.doi.org/10.1037/a0040355

Traveling with medical supplies, regardless of if they're for diabetes or not, can be a daunting prospect. We often find ourselves asking what extra steps we need to take to make sure our insulin doesn’t lose potency during road trips or long plane rides, how do you take supplies through airport security, and what the heck do you do if you run out of something? Amy and Liz talk about general tips for traveling with diabetes and then dig into extra tips for flying, driving, hiking, and generally existing on the move.

Tweet us at @diacast

Email us at contact@diacast.com

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

https://patreon.com/diacast

Links:

Insulin effectiveness after sun, heat, and cold exposure https://www.bmj.com/content/338/bmj.a2218.long and https://go.gale.com/ps/i.do?id=GALE|A235631421&sid=googleScholar&v=2.1&it=r&linkaccess=abs&issn=15209156&p=AONE&sw=w&userGroupName=anon~695c9ea3

Insulin storage study https://www.sciencedirect.com/science/article/abs/pii/S1544319118301924

ISPAD Clinical Practice Consensus Guidelines 2018 https://onlinelibrary.wiley.com/doi/10.1111/pedi.12718

GLP-1 storage and life-span https://www.researchgate.net/figure/Formulations-and-storage-conditions-for-GLP-1-RA-products_tbl1_326447155

TSA recommendations https://www.tsa.gov/blog/2020/11/13/travel-tip-traveling-diabetes and

Traveling with an insulin pump and cgm https://www.diabetesadvocacy.com/traveling-with-an-insulin-pump-and-cgm/

Airplane cabin pressure and unintentional insulin delivery https://medicalxpress.com/news/2012-11-airport-x-rays-diabetes-devices.html

General insulin pump screening recs https://medicalxpress.com/news/2012-11-airport-x-rays-diabetes-devices.html

T-Slim screening recs https://www.tandemdiabetes.com/docs/default-source/general-guides/ml-1000524_a_print_info_card_tsa.pdf?sfvrsn=2

Medtronic screening recs https://www.medtronicdiabetes.com/loop-blog/tsa-screenings-update-for-people-with-diabetes/

One day, in a fit of time-zones and sleep deprivation, Liz, Amy, and Cas sat down to talk about automated insulin delivery (AID), also known as looping. They talk about the commercially available systems and then dig in to the DIY looping systems and algorithms. It’s a throw-back to the original Diacast in celebration of the reboot’s 1 year anniversary.

https://beyondtype1.org/the-guide-to-diy-looping/

iLet bionic pancreas https://www.betabionics.com/our-technology/

DGLB1 Hybrid Closed Loop ****https://www.accu-chek.nl/insight-loop

DIY loop compatible pumps https://loopkit.github.io/loopdocs/build/step3/

Video about DynISF https://youtu.be/oL49FhOts3c

Tweet us at @diacast

Email us at contact@diacast.com

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