August 5, 2025 • 43 mins
This is an extra special edition of Think Like a Pancreas--The Podcast as fangirl, and fellow Integrated Diabetes Services clinician, Alicia Downs talks to Gary Scheiner, author of Think Like a Pancreas after the release of the book's FOURTH EDITION!
A staple read for anyone who lives with diabetes and uses insulin, Alicia shares how these books changed her life and gets Gary to reveal how the original book came to be.
Meet Your Host and Her GuestAlicia Downs, RN, MSN, CDCES, BC-ADM experienced years of mis-diagnoses and ineffective treatments that gave her the incentive to take the lead in her own health care and educate those around her. Areas of clinical specialty for Alicia include working with patients through cancer treatment, Type 3C diabetes, Diabetes management along with complex medical challenges, diabetes management in combination with behavioral and mental health challenges, as well as Tandem diabetes device optimization. Alicia is also passionate about providing educated compassionate informed and equitable care to all people. Her specialized experience in gender diverse care, LGBTQ care areas, as well as experience in diverse ethnic and faith backgrounds is Alicia’s greatest pride in her professional career.
Gary Scheiner, MS, CDCES, is the award-winning author of Think Like a Pancreas as well as numerous other books that act as guides for people living with diabetes. A Certified Diabetes Care & Education, Masters-level Exercise Physiologist, and person living with type 1 diabetes since 1985, Gary was named 2014 Diabetes Educator of the Year by the American Association of Diabetes Educators. He trained at the Joslin Diabetes Center and has dedicated his career to helping others live well with diabetes through education, advocacy, and innovation.
What you’ll learn:
✔️ What is new in Think Like a Pancreas 4th Edition.
✔️Why Think Like a Pancreas needs to be updated.
✔️When knowledge and care come together in a book, you get one like “Think Like a Pancreas”.
✔️A good diabetes educator knows how to communicate.
✔️ The impact of technology and new medications on diabetes management.
✔️ The value of old school methods in modern diabetes management.
✔️Reflections on what a cure for diabetes will look like.
Chapters:
00:13 Welcome and Disclaimer
01:30 How the Think Like a Pancreas book impacted Alicia Down's life
03:13 The Evolution of Think Like a Pancreas
04:17 When is it time to update the book?
05:27 Who should read Think Like a Pancreas 4th Edition?
06:15 Now available in an audio version.
08:59 What to expect from Think Like a Pancreas Edition 5?
11:59 The Unique Approach of 'Think Like a Pancreas'
17:18 Writing "Think Like a Pancreas"
20:50 Advice for aspiring health writers
24:25 How to get the most out of "Think Like a Pancreas Edition 4"
31:29 Music plays a key role
38:13 Other diabetes resources
39:25 The future of diabetes management
Resources Mentioned:
Think Like a Pancreas (Fourth Edition)
Sugar Surfing by Stephen Ponder
Bright Spots and Landmines by Adam Brown
Pumping Insulin by John Walsh
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Gary Scheiner (00:06):
Welcome
to Think Like a Pancreas--ThePodcastwhere our goal is to keep you
informed, inspired, and a littleentertained on all things diabetes.
The information contained in thisprogram is based on the experience
and opinions of the IntegratedDiabetes Services clinical team.
(00:30):
Please discuss any changes to yourtreatment plan with your personal
healthcare provider before implementing.
Alicia Downs (00:35):
Hey, thanks so much for joining us on the
Think Like a Pancreas podcast.
I'm Alicia Downs rn, MSN,CDCES, BC, ADM,here live in office from a hot 30 feet
away from, yeah, from author of the ThinkLike a Pancreas book, Gary Scheiner.
(00:57):
We're gonna sit down today anddig into Think Like a Pancreas.
So thanks so much, Gary forjoining us on your podcast.
Gary Scheiner (01:06):
I, I actually proposed to Barb, our podcast
manager, that I interview myself.
I could kind of go, so, Gary,what'd you think of this?
And I go, you know what?
And that she wasn'treal high on that idea.
So I'm glad you stepped in so Iwouldn't have to talk to myself.
Alicia Downs (01:22):
Well, I wanted to make it different from,
you know, days in the office.
I actually wanted to start... I wasactually kind of keen on hosting, hosting
this episode because I got my job hereat IDS because of Think Like a Pancreas.
I mean, I'm alive because of Think Likea Pancreas, but I, I got my job due to
(01:44):
unabashed fangirling from, from the book.
I always tell my patients, uh, thefact that they have made the call, gone
online, however, they connected with ushere at IDS, they're already one step
smarter than me because I never did that.
I lived an hour and change down theinterstate in Maryland, but I never
(02:05):
was a patient of Integrated Diabetes.
I just read Think Like a Pancreasover and over and over, probably 14
times, and I don't think I ever turnedit over and "located in Wynwood,
Pennsylvania call for an appointment."
It never even occurred to me.
I just kept reading.
So anyone who's listeningto this, don't be me.
(02:29):
If this is helpful call.
We're here to help.
Don't just read the book 14times, but do read the book.
And so I actually got my CDE andbrought up a, a LinkedIn job opening
and it had a picture of a guy andmy husband walked behind me and he
happened to look over and go, isn'tthat the guy on the back of your book?
(02:53):
And it was so a staple in my worldthat it was just "your book".
It was just always on, on the table.
And I went, yes it is.
And I, I don't know if I'm qualifiedfor the job, but I'm gonna go and say
just thank you for writing the book.
Gary Scheiner (03:06):
I...with every edition...
Alicia Downs (03:08):
So eight years down the road.
Thank you for writing that book, Gary.
Gary Scheiner (03:10):
Every edition, I look at the photo on the back
and I have less hair on my head.
My beard is grayer.
I've got a few more wrinkles.
It's not like Dorian Gray.
I am truly aging with every edition.
Alicia Downs (03:23):
Well, having, uh, been here through a couple of edition
updates, now I understand why, uh, it'snot nearly as easy as one might think.
And with that said, what is your process?
What does it look like toupdate Think Like a Pancreas.
We've got Edition Four?
Gary Scheiner (03:43):
It's out.
It's in
Alicia Downs (03:45):
Nice!.
Gary Scheiner (03:45):
It's in our store.
It's in bookstores.
It's on Amazon.
It's Google.
It's, yeah.
Alicia Downs (03:50):
I lost track of the release date.
It flew by me.
So four is out.
Three is on sale.
I did see that.
Gary Scheiner (03:58):
Sold out.
Alicia Downs (03:59):
Sold out already?
Sorry guys.
If you miss three, you're gonnahave to get it on eBay or something.
It's a collector's item now.
Good luck.
So I have one and two.
I didn't get three.
I guess I have to get four now.
I'm gonna have to go find three.
So what does it look likewhen it's time to update?
How do you know it's time to update?
(04:19):
And how?
What does that process look like?
Gary Scheiner (04:21):
Well, let's put it this way.
Yesterday I learned some things thatmake me think, oh my God, I need
to update the fourth edition now.
This is the diabetes world,and things change so quickly.
It seems like every day, every weekwe've got new medications coming
out, we have new processes that welearn, new devices that come out, the
(04:42):
experience we gain from research andjust empirically in day-to-day management
and practice, we learn new things.
So it's a necessity to update this thing.
And it is accelerating.
They were eight years fromedition one to two, and then
seven years from two to three.
And now from three to four, Ithink it was only five years.
(05:03):
So we're having to update morefrequently and honestly, it, it could
be updated annually with all the newthings that that are taking place.
And you know, the last four or fiveyears there's been such an influx in
technology, in diabetes management.
Um, you know, particularly forpeople on intensive insulin therapy.
Now the book is intended for everybodywith type one diabetes, but also
(05:27):
anybody with type two who usesinsulin, whether it's just basal
insulin or basal and mealtime insulin.
And it's not just for people on, youknow, pumps and automated systems.
It's also for people on injections.
I don't, it's not exclusiveto people on the tech stuff,
and it's a matter of choice.
Everyone chooses what's in theirbest interest or what's accessible
(05:50):
to them wherever they happen to be.
Right now it's only in English, but thethird edition was translated into seven?
I think seven different languages.
Different parts of the world,Europe, Asia, et cetera.
So this one probably will too.
But another thing that'sspecial and new with the fourth
edition, it's the first audio.
(06:11):
We have an audio version.
Alicia Downs (06:12):
Which was a little rougher to make than you anticipated.
Gary Scheiner (06:15):
I had no idea.
They actually put out auditions for peopleto read my book for the audio version.
I applied and I won.
I mean, it's a blindedprocess, but they felt that my
voiceover was a very good one.
So they, they went with meas the recording or the, the
sound expert, the audio expert.
(06:35):
So I had to spend six days in a basementstudio in downtown Philadelphia, literally
sealed in a soundproof room, just me, achair, a microphone, and my book reading.
And they had a, you know, a soundtechnician and they also had an editor
listening to every word I said, andif, if I stumbled on a word or if my
(06:58):
pitch on that word wasn't just right?
Let's stop there and rerecord from thispoint for six straight days, I did that.
It was exhausting.
So that's something I, I don't knowif I'll do that myself again, but it
was an interesting, an interestingprocess to at least go through one time.
But the audio book, I thinkit was, it was a great idea.
The publishers came up with peoplenowadays, they're busy, they wanna
(07:21):
listen in the car, they wanna listenwhen they're doing other things, not
have to be reading out of a book.
So.
I think it'll do well.
So it's, you know, it's, you goto Google Play, you can, you can
access the audiobook now, and theebook is also available for people
who don't want a paper version.
I'm still a guy.
I get the daily paper, I get thePhiladelphia Inquirer every morning
(07:43):
and spread that out on my kitchentable while I'm eating my, my cereal.
And, and a cereal is not the best thingfor type ones, but if you know how
to manage your insulin properly, youcan still manage your glucose well.
So I, I still like the paper part.
Being able to circle things and highlightand make notes and, wipe my finger,
stick blood spots on the pages and thingsso you can get 'em really gunked up.
Alicia Downs (08:06):
Well, and you can't get your ebook signs, so you come
to an event where you're speaking,
you can't have Gary sign it.
Gary Scheiner (08:12):
In fact, anybody who orders any edition, you know, the
fourth edition included from our office.
Uh, we'll send a, a signed copy.
Alicia Downs (08:19):
I don't have any of my copies signed.
Gary Scheiner (08:22):
I'll sign 'em for you.
Alicia Downs (08:25):
I've been saying that for eight years.
Gary Scheiner (08:26):
Just bring food, and I'll do whatever you want.
I'll sign whatever you got.
Alicia Downs (08:29):
I, I think I've got a couple things laying around with your
signature on it somewhere, so I think I'mcovered, but so that's updating to four.
What do you... and that's it cracksme, you just said five years between
three and four, because I reallyfeel like we were just proofreading
three, going over kind of like, doesit feel like everything's in there?
Does it... I feel like thatwas just a couple of years ago.
(08:49):
What do you feel?
What do you think is gonna be in five?
Gary Scheiner (08:53):
Five?
I think there'll be even moretechnology available to us.
The, I use, use this term AID I'mreferring to automated insulin delivery,
and the systems that we had six monthsago when I was writing the manuscript, um,
have been, they've been upgraded already.
There's more automation taking place.
There's more use of other medications.
(09:16):
The medications take a takea big part in this edition.
There is more and more people on intensiveinsulin therapy, including type ones,
are making use of other diabetes meds.
The GLP-1 medications.
The SGLT-2 medications.
These are playing a bigger role inmanagement and we're figuring out creative
(09:36):
ways of getting them covered by insurance.
For people with type one diabetes,you know, they're not technically
approved for that population, butthey are approved for people with
obesity or with insulin resistance.
So we can often find creative solutionsand ways to get access to them.
The SGLT-2 meds are another story.
(09:57):
They're not approved by the FDA for typeone because there's an increased risk
of, uh, ketoacidosis with their use.
But we have excellent strategies in placefor eliminating that risk pretty much.
And now again, new technology.
And I was at the ADA scientificsessions and I saw Abbott's new
sensor that they're developing thatmeasures ketones as well as glucose.
(10:20):
So we can detect ketones in the earlieststages and prevent DKA almost entirely.
So once that comes to fruition, theFDA has no reason to deny access to
drugs like SGLT-2s for type ones.
So, yeah, the, the technology'schanging, the meds are changing.
Other things, even theinsulins are changing.
(10:40):
The third edition, we didn'thave... we might have just started
seeing the ultra rapid insulins.
And you can only see this if you'rewatching the video part, but I
always use a little quotation markswhen I say ultra rapid because, you
know, or just make a nasty face.
Rapid acting insulin is only a littlemore rapid than regular, that's all.
(11:00):
It's not really rapid and ultra rapid isjust a little more rapid than ultra rapid.
So you know when the pancreas makesinsulin, that stuff's ultra rapid.
It works in seconds.
This stuff we injector deliver with a pump?
We gotta wait hours for that stuff topeak and clear so it's not really, but
it is get... the insulins are gettingfaster, so we have to accommodate
(11:22):
for that and take that into account.
The hormone glucagon is becoming moreof a, an upfront product now because
it's so much easier to administer withthe new, you know, things like, uh,
Zegalogue and we have, uh, Gvoke andwe have the inhaled version as well.
You know, these, these make glucagonmuch more accessible, easier for
(11:44):
anybody to use, including loved ones.
We've even dabbled a bit with microdosingof glucagon in different situations.
It can work nicely.
We try everything here at the office.
All of our clinicians, as you know,we, we all live with type one.
We're all living the dream.
If something new comes out orwe have a notion of a way to use
things differently, what do we do?
(12:05):
We try it, and if I'm afraid to tryit, I'll say, here, Alicia, you do it.
Alicia Downs (12:11):
You're crazy, and your basal settings make no sense.
Yeah.
Gary Scheiner (12:15):
You try this.
You know, if you survive.
Yeah, I'll try it too.
No, we, we all, we're all prettybrave when it comes to these things.
We try just about everything that comesout, devices, meds, we'll try these out
first and see how they work in real life.
Not just from a glucosemanagement standpoint, but a
quality of life standpoint.
And so we can offer ourpatients unique insight.
(12:36):
And, and I try to dothat throughout the book.
I try to keep in mind.
These are not test subjects,they're not patients.
These are people and quality oflife is a very important element
of anything we're gonna do.
Probably the most important element.
You know, I try to consider thatthroughout the book and in my writing.
Alicia Downs (12:54):
I think the most powerful thing about Think Like
a Pancreas and what made it standout for me when I was diagnosed?
Um, I always say my, itwas part of my doctor.
I had a great doctor.
Her husband had type one.
The doctor who diagnosed me, andshe sat me down on day one and she
said, you're not gonna learn whatyou need to know from doctors.
You're gonna need to learn it yourself.
(13:16):
And she said, you're gonna wantthese books-- and Think Like
a Pancreas was one of them.
And what made Think Like a Pancreasdifferent was the other books were
telling me what to do to manage my bloodsugar, and that was very difficult to
just memorize a lot of things to do.
Think Like a Pancreas wastelling me how to think, which
helped me know how to live.
(13:36):
And that really revolutionizedeverything about my management and
helped me help other people nowbecause I can't, I can't give everybody
a big list of everything to do.
'cause that's gonna be differentfor everybody, but I can help
people think through things.
Gary Scheiner (13:50):
That's a great testimonial.
I wanna put that on the next edition.
Exactly what you said.
Alicia Downs (13:57):
Yes!
I got my name on edition five.
Gary Scheiner (14:00):
Teaching people how to think.
And it is kind of a,it's a kamikaze approach.
You do whatever it takes tomanage those glucose levels.
See, I still remember back, 40 years agowhen I was diagnosed and you know, we
were told, this is your insulin program.
Now your life needs to conform to it.
And that's not the way we do things now.
Now you live your life.
(14:21):
You do what you choose to do.
Now here's how we can manage theglucose with your life as you choose it.
So we do what it takes, and we haveto, we have to get creative sometimes
using insulins in creative ways, usingcombinations of insulins, using it
advanced technologies and features thatdon't get a lot of play in most places.
We're, we're big on using those.
(14:42):
So, you know, for people who arejust happy with, I can manage
my blood sugar reasonably welland that's good enough for me.
Eh, this might not bethe best book for them.
This is for people who wanna, take itto the next level and manage as well
as, as they as possible, as reasonable.
Alicia Downs (15:00):
Well and I even find, I even find patient... sometimes it's
not even the blood sugar management.
Sometimes people go, you know, I've gota, I've got an A1C of 6.8 and that's
good enough for me, but sometimesit's, I've got an A1C of 6.8, but
it's taking me 80% of my availablebrain power and bandwidth to do that.
Give a read through the book, you mightpull out two or three tips that are
(15:25):
real shifters in how you manage that.
Take it from 80% to 60% and nowyou've got extra bandwidth, extra
energy to do something else.
That means more in your lifethan blood sugar management.
I, I'm a person with diabetes.
Diabetes is my profession, but diabetes isnot the most important thing in my life.
(15:46):
Shocker.
So if I can just free upsome, some hard drive space.
Reallocate that to something else.
Often that is what makes it worth it.
Even if my numbers don't change a bit,that is the big game changer for me.
So if you're out there and you're like,I don't want, I don't want more tech
and I don't wanna be like the cuttingedge, and I don't need to have super
(16:07):
tight control, and aaah, that's me.
I don't need all that stuff.
What I do need is a little bit more time.
A little bit more chill and a wholelot more focus somewhere else.
Gary Scheiner (16:16):
Like on a little boy who likes to destroy things.
Alicia Downs (16:19):
Oh, I don't think there's enough focus in the world.
I think we're gonna need a cure andI'm gonna need to win the lottery.
Gary Scheiner (16:25):
Yeah, I mean, I'd rather use my brain space thinking about fantasy
sports statistics than glucose levels.
But you know, just getting a systemin place that works well, that doesn't
require you to invest a lot of your time,energy, and money for that matter, and run
with that so you can free up that brainspace and that energy for other things.
(16:46):
Quality of life, things thatare more meaningful to you.
Alicia Downs (16:48):
So, speaking of 40 years ago when you were diagnosed, what did
life look like for you when you thought.
I'm gonna write a book about this thing?
What did life look like when the,when the seed of Think Like a
Pancreas started to germinate?
Gary Scheiner (17:03):
Yeah.
That was back in 98 andsomeone reached out, out to me.
He, uh, he owned a smallpublishing house in New York City.
His name was Matthew Lore.
And, uh, he had read articlesthat I had written for a number of
magazines and journals and said,Hey, you're a pretty good writer.
You know, if you're ever thinking aboutwriting a book, you know we should talk.
(17:24):
And that's how think like the original,Think Like a Pancreas came into being.
His company was absorbed by another,which was absorbed by another.
Is this is what happensin the publishing space.
And now there's only a handful left, butthey're pretty big, dominant players and
you know, the book has, it's done well.
I, I think, I know there'sover a, over a hundred thousand
(17:45):
I think have sold overall.
It's still a fraction of the populationthat could benefit from it, but it's
pretty good for a niche population likepeople on intensive insulin therapy.
But yeah, you were right.
You know, the, the updates are necessary.
'cause if you go back to earlier editions,so the first edition, you know, we
were talking a lot about NPH insulinand regular insulin even, you know,
(18:08):
Humalog, NovoLog, Novo Rapid, thoseinsulins that were just coming out then.
So, you know, now we're dealing with,you know, much higher level things,
tech meds, management approaches.
You know, back then, uh, proteinand fat weren't even part of the
discussion when we looked at howblood sugars changed from meals.
And now, you know, we've spent a,a fair amount of time in, in this
(18:29):
book and the previous one about.
The effects of fat in protein, especiallypeople who go on, you know, the lower
carb diets that have become popular.
When you eliminate a lot of carbsfrom your diet, then protein starts
contributing to rises in glucose levels.
So we do need to accommodate forthose, and we've learned that
fat will not just slow down.
(18:49):
At the rate of digestion, but it'll alsocontribute to some insulin resistance,
which can raise glucose levels.
So that all has to be taken into account.
There's, there have been listspublished of the factors that
raise in lower blood sugar.
I think we have a morecomprehensive one in this book.
One chapter covers just all of theweird, odd things that can raise in
lower glucose levels, so people wholook through that chapter might suddenly
(19:14):
discover, that's why that happens.
You know, when I drink a RedBull that doesn't have carbs in
it, but my glucose shoots up.
Wow.
The caffeine can do that.
Or a comp... competitive sports.
What?
My sugar goes up.
Oh, that's why that happens.
And then we address howyou know how to manage it.
What do you do in those situations?
You don't have to stop enjoying the thingsyou enjoy, you just, you adapt to it.
(19:39):
I always felt when the goinggets tough, the tough adapt.
You know, we learn how to makeadjustments and deal with it.
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(20:21):
And now back to our program.
Alicia Downs (20:23):
So what would your advice be for someone who's, "I feel
like I have something to share inthe health space specifically", and
they want to put together a book.
'Cause the space is big now.
We've got self-publishing, we'vegot online writing, and what
(20:45):
direction would you point someone in?
Gary Scheiner (20:47):
Blogging is a very effective way of
sharing what you wanna share.
You can reach a lot of peoplethat way, and it costs nothing
more usually than your own timein putting the materials together.
And, uh, you can say pretty muchwhat you wanna say in your own blog.
Book publishing?
I mean, there's no moneyto be made in book publish.
(21:09):
I don't make money on this book.
Trust me.
This is.
This is my own way of spreadingthe love to the diabetes community
and helping people out there.
Um, you know, it helps thatpeople know about us as a result.
Our practice is alwaysaccepting new patients.
We're constantly expanding.
But the book is sort of, I you know,it's my, my testimony of, let people know
(21:30):
there, there are better ways to do things,better ways to live with and manage
diabetes and wanna get that word out.
But I, I don't usually recommendpeople go out and try to publish a
book on a healthcare specific topicunless there's something very, very
unique about what you're offering.
There's a huge demand upfront for it.
(21:51):
That's what the online community is for.
You can blog, you can post things and, youknow, get your, your message out that way,
and that's how you can share your passion.
Alicia Downs (22:00):
Yeah, that's, I try to explain to people like,
they're like, but there's so muchmoney to be made in writing books.
Look at Stephen King.
I'm like, yeah, but Stephen Kingwrites fiction that is timeless.
So everyone on the planet from nowtill the end of time can buy that book
and read it, and it applies to theirlife, and they're gonna enjoy it.
Like a book on type onediabetes management is extremely
(22:24):
niche and extremely timely.
You're not gonna be a NewYork Times bestseller on that.
It's just not a thing.
Gary Scheiner (22:30):
For every Stephen King, there are a million Gary Scheiners.
Alicia Downs (22:34):
And a billion people self-publishing on Amazon who just have
a like car trunk full of their own booksthat they give away at every holiday.
It's tough.
Gary Scheiner (22:44):
Yeah.
My dad,
Alicia Downs (22:45):
and it's tough out there.
Gary Scheiner (22:46):
My dad, God bless him, my dad, he's in his eighties and he, he even
self-published a book after he retired.
It was about how to save for retirementand I think it was just his way of
telling me and my sisters what weshould be doing to save for retirement.
But he did it in the form of a book.
Yeah.
He didn't sell any, you know, he, he justwrote this book and self-published it.
Alicia Downs (23:08):
I love it.
I love it.
I will, one thing I always admire though,is the knowledge set to, to have that
discipline and the knowledge set to pulltogether what you know in one place is
amazing, but also then to have the care.
When the care meets confidence,because there are a lot of people who
(23:29):
care, but they don't have confidencein themselves to step out and
really share it in a powerful way.
There are a lot of people in the worldthat have confidence in themselves.
So they'll go out there and share it, butthey don't have the care for the community
to do it in a way that is really usefuland valuable when those two come together.
(23:51):
I think that's the other reason thatThink Like a Pancreas has been so powerful
and continues to be so powerful and willcontinue to be so powerful because it's
really evident that both are present.
Gary Scheiner (24:03):
Yeah.
I mean, it's one thing to know stuff.
It's another to be able tocommunicate it effectively.
That's why I'm, I'm proud tobe, you know, we still call
ourselves diabetes educators.
Although our title has gotten longerand longer and longer, a teacher, a
good teacher knows how to communicate.
You can't just throw data out there andthrow numbers and instructions out there.
(24:26):
And like you were saying,that's what a lot of books do.
They're, this is like aninstruction manual or a textbook.
This is not like that.
It has, the, the information is there.
The insight is there, but it'slaid out in a way that's fun and
it's understandable and it's, uh,you can absorb it and apply it.
Alicia Downs (24:45):
Because a lot of books have this other, this thing
of like, this is the right way.
Like this, this is thebook that you have to read.
This is the way and theother books are wrong.
And there's none of thatin Think Like a Pancreas.
It's, it's take every tool you canget your hands on and, and duct tape
it together and make it work for you.
(25:07):
Because if there's a right way, that meansif I try that way and fail, I'm wrong.
There's the wayand I am the problem.
Gary Scheiner (25:14):
There's a section, I mean, I devoted an entire chapter to
resources and it includes organizations.
It includes onlinecommunities, books, journals.
So I think it's, we gotta share thisstuff and as you as... there's resources
to all of the manufacturer devicemanufacturers and pharma companies
and financial resources that areout there for people with diabetes.
(25:38):
And one big news section I put in the bookhas to do with the tech and the automated
insulin delivery because they're growingin popularity by leaps and bounds, but,
uh, we have a, a guide on how to selectthe best system for you based on what
your personal goals and interests are.
'cause different systems requiredifferent amounts of user engagement,
(25:59):
but they also produce differentlevels of quality outcomes.
And, you know, work in equals work out.
I mean, you can get a system thatrequires almost no energy on your part.
You're not gonna get glucose managementthat's as, as tight as you might like.
That might be okay for somepeople, others who want, you
know, really tight management?
And we will direct 'em tothe system that'll work.
(26:20):
And I try to drop in like littletip, like little pointers throughout.
We call them like special secrettips throughout for AID system
users about how things have changed.
You know, for example, everyedition we've talked about how
to best treat hypoglycemia.
But it's changed now.
People who use AID systems.
It's all different.
We have to, you know,pair back on the carbs.
(26:42):
Um, we have, when we, depending on wherewe catch it, how early in the, in the
stage and with an AID system that cutsout basal insulin for quite a while.
We just don't need asmuch carb as we used to.
You know, we go into those kind of things.
Those are just examples.
There is probably about 40 or 50tips like that throughout the book
specifically for AID system users.
You're an AID system useryourself, so you've, you've
(27:05):
experienced a lot of these too.
Just changes.
Alicia Downs (27:07):
Yeah.
My, when I look back, um.
I kind of pinch myself every nowand again because of how much my
diabetes management life has changed.
It's been kind of strange because mydiabetes diagnosis came at a time of
change, and it always seems like everybig change in my management comes in
(27:30):
a time when my life is also changing.
So sometimes it gets masked.
It's like, well, yeah, everything'sdifferent, so of course my
diabetes management is different.
But then I'll go, I'll go old school.
I'll go manual pumpingfor a good three weeks.
I had a complete insurance snafuand couldn't get my Dexcoms.
So I went CGM free for three weeks, muchto the utter horror of my coworkers.
(27:55):
Everyone was trying to slap a Libresample or a Dexcom sample on me, and
I was like, guys, I survived pre CGM.
I'm just gonna roll old school for alittle while, but realizing how very,
very different my life was in the 10finger sticks, didn't know what my blood
(28:16):
sugar was doing while I was driving.
Treat hypoglycemia with a fistfull of jelly beans days versus
the, always knowing what'sgoing on one Jelly Bean day, so.
Gary Scheiner (28:29):
Some of our brightest patients are using old school approaches.
Alicia Downs (28:32):
Yeah.
Gary Scheiner (28:33):
I, i'm proud of them.
I, I love the job they're doing.
Alicia Downs (28:36):
Yeah.
Gary Scheiner (28:37):
They're managing exceptionally well.
So I wanted to make sure that in the bookI address that and some of the tips and
tricks that can be applied to people whoare on traditional injection therapy or
using inhaled Afrezza as their insulin.
There are combinations ofinsulin that can be used.
You know, for example, if you'regoing into a meal that you know
(29:00):
is gonna digest lightning quick,Afrezza is a great insulin for that
because of how quickly it works.
You know, if that meal is, youknow, kind of an average meal, then
a traditional rapid insulin, inquotes, rapid insulin will work.
A real slow digesting meal keeps someold fashioned regular insulin on hand.
It works really well for those meals.
(29:20):
So it is even within the area of,of old school injection therapy,
there's some creativity thatwe can apply to manage better.
Alicia Downs (29:29):
Oh yeah, I, that's actually one of my favorite places
to work with patients is the patientsthat are like, I really like MDI,
but I want to get as close to pumplevel maneuverability as I can.
Either they really want the freedomof their exercise and their activity
routine or their diet routine, andI have patients, some of my patients
(29:52):
with their, the best outcomesclinically, with the best quality of
life and just joy and ease with theirmanagement are on injection therapy.
And they are also the ones thatare kind of the most savvy that go
in and they educate their, theirprescribers 'cause they go, okay,
oh yeah, here's what I'm gonna do.
(30:13):
I'm gonna use Basaglar andNPH and regular and Afrezza.
And their, their prescribersgoing, what are you doing?
What kind of witches brew ofinsulin are you, you're gonna?
We see that they teach their insulin...
Gary Scheiner (30:27):
we work with, there's so many people on open source, you know,
the quote unquote DIY type systems.
Um, and we've all usedthem ourselves as well.
So there's a, the book covers quite a bit.
So it doesn't just stick toFDA approved type things.
We're also getting into the opensource technologies and who they are,
who they can benefit, what's involvedin using them, and how to get the
(30:49):
most out of them because we have alot of both professional and personal
experience using these systems.
I also like to start each chapterwith a, a song quote as I try to
add some musical touch to this.
And so you'll have to look at thestart of every chapter, there's a
song quote that applies to the topic.
That was the most fun Ihad in doing the book.
In every book I try to, I gotta findnew song quotes for each chapter,
Alicia Downs (31:12):
and don't miss 'em guys, because being in this office?
Gary's brain is like a musical lexicon.
The radio is just on whatever,like Spotify, Pandora channel Nancy
happens to pick, and whenever Garywalks through, he just announces
the artist who is singing songs.
Sometimes if it's a different writer.
(31:33):
Sometimes the year comes out.
I'm like, where in everythingthat lives in your head, does
this information also get to?
Gary Scheiner (31:40):
That's what I get for not thinking about
my blood sugars all the time.
I have room in my brain forall this musical trivia.
Alicia Downs (31:47):
That's what Gary is allotting his extra 10% of hard
drive to is the greatest, the totalcatalog of the Doobie Brothers.
Gary Scheiner (31:56):
Well, that was on this morning.
That's why she mentioned that.
So for people on the visual part,there's the new book, A new Color.
You know, it's a new color,it's gotta be good, right?
So people can order this from our office.
They can call.
It's 877-735-3648 to order it.
Outside the US?
(32:16):
Well, we will have all this inthe show notes, but they can go
online to our, our online storeat Integrated Diabetes Services.
Alicia Downs (32:22):
On video, i'm sure it's, it's down there somewhere.
Gary Scheiner (32:24):
Yes, Barb will take care of that.
It's all, that's, if you wanna geta signed copy and I signed a bunch
yesterday 'cause we had a bunchof orders, so my hand's a little
crampy, but I'm happy to sign them.
But anyone who wants to order it justfrom anyplace else, you can go to Amazon.
You can go to Google.
Uh, Google Play has the audio version.
If you could stand listening to my voicefor that many hours, God bless you.
(32:46):
Because I had to do it.
I was not ha, I hated the soundof my voice by the end of that.
Alicia Downs (32:51):
Which brings me to a tip for people who are reading and listening,
especially on your first time through.
This isn't a novel.
If you try to read this sucker fromcover to cover, if you just sit
down and you're like, okay, I'mgoing to the beach this weekend.
I am reading, Think Like a Pancreas.
(33:12):
It's, it's a little, it's a littlemuch because it's not meant to
really all just absorb at one time.
It's really meant to kind of take in.
And absorb and like apply and thentake in and, and apply and kind
of make it part of your world.
Not just read it and thenmove on to the next thing.
Gary Scheiner (33:34):
Every chapter, chapter builds on the previous information.
So it's a cumulative, it builds up tothis denouement., In the, the chapter
on bolusing for meals-- that's a bigchapter 'cause there's a lot involved,
but we kind of, we start out with, wellfirst how do you dose for your food?
Then how do you adjust for theglucose that's not on target?
(33:56):
And how do you adjustfor physical activity?
And then how do you adjust for thedirection your glucose is headed?
And then we finish it up withthe, the timing of that insulin.
Now that's the ult, I callit the ultimate bolus.
It's the right amount at the right time.
That's, you see, that's a thing of beauty.
I get all misty and teary-eyedthinking, not really.
(34:16):
So, you know, thingsbuild upon each other.
It's not like, you know, you, you'renot gonna understand things going in.
'cause we start with the basicsand, and build up from there.
There's an outline at the beginning.
It's not just that list of chapters.
I made them include an outline.
So if there's something specific youwanna look for, like sports management
or managing your post meals, et cetera,you can go right to that section and
(34:38):
it's indexed in the back so you canfind specific things right on that page.
So try to organize as well as I could.
Alicia Downs (34:45):
So if you, if you dive in and you feel like, this must not
be the book for me because I feelcompletely overwhelmed, you're probably
just trying to eat the book when whatyou're meant to do is savor the book.
So make your bite smaller.
Just take a little bit and I, I thinkI would probably read a couple of
pages at a time and then go, okay.
(35:06):
I've got a thing there.
And then I would just kind of sit, Iwould, I would apply that, that piece
that I got until it worked with mylife and it was just kind of a rhythm.
It was just kind of habit.
It was natural.
And then I would moveon to the next thing.
It probably took me-- that bookwas beat by the time I got to the
end because it was just going backand over and beat back and over.
(35:29):
My first copy of Think Like aPancreas, looks like it went through
a war with me and it kind of did.
Gary Scheiner (35:34):
Session log book.
Alicia Downs (35:36):
Yeah, it was, it was rough and there were
a lot of notes and scribbles.
Yeah, taking it to the doctorand showing her things.
Gary Scheiner (35:44):
It's not a lot, it's not all text.
There's a lot of graphs, especially CGMgraphs to illustrate different things.
There's, there's tables and images, so it,it's, you know, it's a, it's a light read.
It's not, yeah.
Heavy reading.
I don't like heavy.
Alicia Downs (35:58):
It's not heavy.
It's meant to be lived with.
It's meant to be.
It's meant to be done, notjust... yeah, it's not a novel.
It's not to be meant to be just likeread and then stuck on the shelf.
It's meant to sit on the table withyou and kind of do life with you.
But that's, I wanted an audiobook and Itried to take the ebook and like make Siri
read it and I was like, I thought my brainwas gonna come outta my ear because it was
(36:19):
just like word vomiting, diabetes at me.
And I was like, ah, it's too much.
So I'm glad you're reading it.
That will make it much more palatable.
I can't wait.
I can't wait to dive in.
I'm actually on myvacation this, this summer.
I can't believe I'm saying this on myvacation i'm listening to my boss's audio.
I don't think listening to it throughPhiladelphia traffic is the good idea.
Gary Scheiner (36:43):
That's what it's meant for, that's what it's meant for.
For raging through Philly traffic is...
Alicia Downs (36:49):
yeah.
Yeah.
They got a lot of funny stories spreadthroughout, so it'll keep you entertained.
It does and I...
Gary Scheiner (36:54):
you're sitting on the Sooco expressway and things aren't moving.
Alicia Downs (36:57):
I love the humor.
It's got your particularsort of viewpoint.
It's got a little bit of snark, it's gotthe right amount of diabetes inside jokes.
Which I love 'cause we are a community.
We're a culture.
We've got kinda our own insidejokes that are in there.
Do you or did you have yourgo-to diabetes management book?
Gary Scheiner (37:19):
No, I really didn't.
Alicia Downs (37:21):
Like the AccuCheck log book that was, I mean...
Gary Scheiner (37:25):
I don't remember the first book I got, I just went to, it
was called Walden Books back then.
It was an old, oldbookstore and I think I just
Alicia Downs (37:33):
You don't have to say old twice.
Gary Scheiner (37:35):
I picked up a, I think it was a Joslin diabetes guide of some kind.
It, it was just, it was like a textbook,you know, it was just information.
Here's information.
And, you know, that's not how I liketo write or read for that matter.
So I guess I've fanned a way.
But yeah, there's books that havecome out that I've, I've really liked.
The Sugar Surfing book.
I enjoyed Adam's book.
(37:56):
The name slips my mind,
Alicia Downs (37:57):
Bright Spots and Landmines
Gary Scheiner (37:59):
Bright Spots and Landmines, I enjoyed.
John Walsh's books havealways intrigued me.
Also, you know, his Pumping Insulinbook, his Using Insulin book.
Those I found incredibly great resources.
They weren't as readable as I,
Alicia Downs (38:13):
yeah,
Gary Scheiner (38:13):
I generally like, but the information,
Alicia Downs (38:15):
they're more clinical.
Yeah.
Gary Scheiner (38:17):
Yeah.
Alicia Downs (38:17):
Kind of a read.
Yeah.
Gary Scheiner (38:19):
Although, you know, my book's really popular among clinicians.
When I, I go to conferences, uh, youknow, the diabetes educators, the
endocrinology conferences, this book isa pretty popular one for clinicians to
understand insulin management better.
I'm doing,
Alicia Downs (38:34):
I just wonder how much that is because their patients have
come in and gone, please read this.
Gary Scheiner (38:40):
That is probably very likely.
So everyone out there, yougotta do the same thing.
Get the book.
Read it.
Love it, and then tellyour doctor to read it too.
Alicia Downs (38:47):
Hand-- buy two copies, hand one to your doc next time you go in.
So before we head out, Iwanna ask one last question.
We know what's coming in,we know what's in four.
We got a glimpse of what's coming in five.
What do you think is comingin Think Like a Pancreas.
10?
Gary Scheiner (39:02):
Well, let's hope there is not a Think Like a Pancreas 10.
There's, we've gottahave this thing solved.
Have this, this riddlesolved long before then.
I mean, I hope there's not even a five.
There probably will be, butyou know, we're getting closer.
The research is, it's honing inand yes, it's been a long journey,
but every day we're closer.
(39:22):
We're one day closer.
So you know, the cure, I don'tthink it's gonna be just magically
someone snaps their fingers.
We have a cure.
It's gonna be progressive improvementsand improvements that take less work out
of living with diabetes and ensure thatdiabetes glucoses are managed effectively.
It'll probably be somewhat technological,somewhat biological in a sense, but
(39:45):
yeah, I, I do not wanna see multiplemore editions of this book come out.
Alicia Downs (39:49):
No, we don't have to have Gary Shiner's head in a jar picture.
Gary Scheiner (39:53):
Monty Burns on the Simpsons in the future.
That's, that's a scary thing.
Yeah.
I gotta, I, I'd have tofind a new line of work.
I think I'd be a very good, either atraffic engineer because I love like
efficiency, or I'd be a laziness cop.
The Government can hire me towrite people tickets who are being
lazy and just wasting their time.
Not doing what they should be.
Alicia Downs (40:14):
I always tell people, they say, oh my gosh, Alicia, your whole,
like, your whole career is, is diabetes.
What would you do if itwas, if it was cured?
I'd be the happiest person on theunemployment line, but I'm a nurse.
There's no such thingas an unemployed nurse.
Like as Scarlet O'Harasaid, her go hungry?
Gary Scheiner (40:36):
Tomorrow is another day.
Alicia Downs (40:37):
I'll think about that tomorrow.
Thanks Gary.
It has been fantastic fangirlingabout Think Like a Pancreas,
and I cannot wait to read four.
I can't believe I don't already have it.
Gotta catch up on my calendar andI look forward to not reading six.
Hold on.
He is time traveling, travelingthrough space and time.
My copy of Think Like aPancreas 4 just arrived!
(41:01):
Amazon same day has nothing onGary Scheiner, 30 feet away.
So thanks Gary.
Look at that.
He promises you're shipping willnot be quite that fast unless
you live in the Wynwood Metro.
Gary Scheiner (41:15):
Faster than the postal service, that's for sure.
Alicia Downs (41:18):
You're not, you're not beating that delivery time guys!
That is service.
It's a lot faster than our insulin.
So thanks for joining us.
Thanks for sticking aroundwith the Think Like a Pancreas
podcast and catch us next time.
This Alicia Downs and Gary Scheiner.
Gary Scheiner (41:32):
Thanks for tuning in to Think Like a Pancreas podcast.
If you enjoyed today's episode,don't forget to like, follow, or
subscribe on your favorite podcast app.
Think Like a Pancreas podcast is broughtto you by Integrated Diabetes Services.
Where experience meets expertise,passion meets compassion and diabetes
(41:53):
care is personal because we live it too.
Our team of clinicians, allliving with type one diabetes,
understands the challenges firsthand.
We're here to help no matterwhere you are in the world.
From glucose management, to self-carestrategies, to the latest tech,
sports and exercise, weight loss,type one pregnancy, and emotional
(42:14):
wellbeing, we've got you covered.
We offer consultations inEnglish and Spanish via phone,
video, chat, email and text.
Wanna learn more?
Visit integrateddiabetes.com oremail info@integrateddiabetes.com
to schedule a consultation.
On behalf of Think Likea Pancreas, the podcast.
(42:34):
I'm Gary Shiner, wishingyou a fantastic week ahead.
And don't forget to Think Like a Pancreas.
Welcome
to Think Like a Pancreas--ThePodcastwhere our goal is to keep you
informed, inspired, and a littleentertained on all things diabetes.
The information contained in thisprogram is based on the experience
and opinions of the IntegratedDiabetes Services clinical team.
(00:30):
Please discuss any changes to yourtreatment plan with your personal
healthcare provider before implementing.
Alicia Downs (00:35):
Hey, thanks so much for joining us on the
Think Like a Pancreas podcast.
I'm Alicia Downs rn, MSN,CDCES, BC, ADM,here live in office from a hot 30 feet
away from, yeah, from author of the ThinkLike a Pancreas book, Gary Scheiner.
(00:57):
We're gonna sit down today anddig into Think Like a Pancreas.
So thanks so much, Gary forjoining us on your podcast.
Gary Scheiner (01:06):
I, I actually proposed to Barb, our podcast
manager, that I interview myself.
I could kind of go, so, Gary,what'd you think of this?
And I go, you know what?
And that she wasn'treal high on that idea.
So I'm glad you stepped in so Iwouldn't have to talk to myself.
Alicia Downs (01:22):
Well, I wanted to make it different from,
you know, days in the office.
I actually wanted to start... I wasactually kind of keen on hosting, hosting
this episode because I got my job hereat IDS because of Think Like a Pancreas.
I mean, I'm alive because of Think Likea Pancreas, but I, I got my job due to
(01:44):
unabashed fangirling from, from the book.
I always tell my patients, uh, thefact that they have made the call, gone
online, however, they connected with ushere at IDS, they're already one step
smarter than me because I never did that.
I lived an hour and change down theinterstate in Maryland, but I never
(02:05):
was a patient of Integrated Diabetes.
I just read Think Like a Pancreasover and over and over, probably 14
times, and I don't think I ever turnedit over and "located in Wynwood,
Pennsylvania call for an appointment."
It never even occurred to me.
I just kept reading.
So anyone who's listeningto this, don't be me.
(02:29):
If this is helpful call.
We're here to help.
Don't just read the book 14times, but do read the book.
And so I actually got my CDE andbrought up a, a LinkedIn job opening
and it had a picture of a guy andmy husband walked behind me and he
happened to look over and go, isn'tthat the guy on the back of your book?
(02:53):
And it was so a staple in my worldthat it was just "your book".
It was just always on, on the table.
And I went, yes it is.
And I, I don't know if I'm qualifiedfor the job, but I'm gonna go and say
just thank you for writing the book.
Gary Scheiner (03:06):
I...with every edition...
Alicia Downs (03:08):
So eight years down the road.
Thank you for writing that book, Gary.
Gary Scheiner (03:10):
Every edition, I look at the photo on the back
and I have less hair on my head.
My beard is grayer.
I've got a few more wrinkles.
It's not like Dorian Gray.
I am truly aging with every edition.
Alicia Downs (03:23):
Well, having, uh, been here through a couple of edition
updates, now I understand why, uh, it'snot nearly as easy as one might think.
And with that said, what is your process?
What does it look like toupdate Think Like a Pancreas.
We've got Edition Four?
Gary Scheiner (03:43):
It's out.
It's in
Alicia Downs (03:45):
Nice!.
Gary Scheiner (03:45):
It's in our store.
It's in bookstores.
It's on Amazon.
It's Google.
It's, yeah.
Alicia Downs (03:50):
I lost track of the release date.
It flew by me.
So four is out.
Three is on sale.
I did see that.
Gary Scheiner (03:58):
Sold out.
Alicia Downs (03:59):
Sold out already?
Sorry guys.
If you miss three, you're gonnahave to get it on eBay or something.
It's a collector's item now.
Good luck.
So I have one and two.
I didn't get three.
I guess I have to get four now.
I'm gonna have to go find three.
So what does it look likewhen it's time to update?
How do you know it's time to update?
(04:19):
And how?
What does that process look like?
Gary Scheiner (04:21):
Well, let's put it this way.
Yesterday I learned some things thatmake me think, oh my God, I need
to update the fourth edition now.
This is the diabetes world,and things change so quickly.
It seems like every day, every weekwe've got new medications coming
out, we have new processes that welearn, new devices that come out, the
(04:42):
experience we gain from research andjust empirically in day-to-day management
and practice, we learn new things.
So it's a necessity to update this thing.
And it is accelerating.
They were eight years fromedition one to two, and then
seven years from two to three.
And now from three to four, Ithink it was only five years.
(05:03):
So we're having to update morefrequently and honestly, it, it could
be updated annually with all the newthings that that are taking place.
And you know, the last four or fiveyears there's been such an influx in
technology, in diabetes management.
Um, you know, particularly forpeople on intensive insulin therapy.
Now the book is intended for everybodywith type one diabetes, but also
(05:27):
anybody with type two who usesinsulin, whether it's just basal
insulin or basal and mealtime insulin.
And it's not just for people on, youknow, pumps and automated systems.
It's also for people on injections.
I don't, it's not exclusiveto people on the tech stuff,
and it's a matter of choice.
Everyone chooses what's in theirbest interest or what's accessible
(05:50):
to them wherever they happen to be.
Right now it's only in English, but thethird edition was translated into seven?
I think seven different languages.
Different parts of the world,Europe, Asia, et cetera.
So this one probably will too.
But another thing that'sspecial and new with the fourth
edition, it's the first audio.
(06:11):
We have an audio version.
Alicia Downs (06:12):
Which was a little rougher to make than you anticipated.
Gary Scheiner (06:15):
I had no idea.
They actually put out auditions for peopleto read my book for the audio version.
I applied and I won.
I mean, it's a blindedprocess, but they felt that my
voiceover was a very good one.
So they, they went with meas the recording or the, the
sound expert, the audio expert.
(06:35):
So I had to spend six days in a basementstudio in downtown Philadelphia, literally
sealed in a soundproof room, just me, achair, a microphone, and my book reading.
And they had a, you know, a soundtechnician and they also had an editor
listening to every word I said, andif, if I stumbled on a word or if my
(06:58):
pitch on that word wasn't just right?
Let's stop there and rerecord from thispoint for six straight days, I did that.
It was exhausting.
So that's something I, I don't knowif I'll do that myself again, but it
was an interesting, an interestingprocess to at least go through one time.
But the audio book, I thinkit was, it was a great idea.
The publishers came up with peoplenowadays, they're busy, they wanna
(07:21):
listen in the car, they wanna listenwhen they're doing other things, not
have to be reading out of a book.
So.
I think it'll do well.
So it's, you know, it's, you goto Google Play, you can, you can
access the audiobook now, and theebook is also available for people
who don't want a paper version.
I'm still a guy.
I get the daily paper, I get thePhiladelphia Inquirer every morning
(07:43):
and spread that out on my kitchentable while I'm eating my, my cereal.
And, and a cereal is not the best thingfor type ones, but if you know how
to manage your insulin properly, youcan still manage your glucose well.
So I, I still like the paper part.
Being able to circle things and highlightand make notes and, wipe my finger,
stick blood spots on the pages and thingsso you can get 'em really gunked up.
Alicia Downs (08:06):
Well, and you can't get your ebook signs, so you come
to an event where you're speaking,
you can't have Gary sign it.
Gary Scheiner (08:12):
In fact, anybody who orders any edition, you know, the
fourth edition included from our office.
Uh, we'll send a, a signed copy.
Alicia Downs (08:19):
I don't have any of my copies signed.
Gary Scheiner (08:22):
I'll sign 'em for you.
Alicia Downs (08:25):
I've been saying that for eight years.
Gary Scheiner (08:26):
Just bring food, and I'll do whatever you want.
I'll sign whatever you got.
Alicia Downs (08:29):
I, I think I've got a couple things laying around with your
signature on it somewhere, so I think I'mcovered, but so that's updating to four.
What do you... and that's it cracksme, you just said five years between
three and four, because I reallyfeel like we were just proofreading
three, going over kind of like, doesit feel like everything's in there?
Does it... I feel like thatwas just a couple of years ago.
(08:49):
What do you feel?
What do you think is gonna be in five?
Gary Scheiner (08:53):
Five?
I think there'll be even moretechnology available to us.
The, I use, use this term AID I'mreferring to automated insulin delivery,
and the systems that we had six monthsago when I was writing the manuscript, um,
have been, they've been upgraded already.
There's more automation taking place.
There's more use of other medications.
(09:16):
The medications take a takea big part in this edition.
There is more and more people on intensiveinsulin therapy, including type ones,
are making use of other diabetes meds.
The GLP-1 medications.
The SGLT-2 medications.
These are playing a bigger role inmanagement and we're figuring out creative
(09:36):
ways of getting them covered by insurance.
For people with type one diabetes,you know, they're not technically
approved for that population, butthey are approved for people with
obesity or with insulin resistance.
So we can often find creative solutionsand ways to get access to them.
The SGLT-2 meds are another story.
(09:57):
They're not approved by the FDA for typeone because there's an increased risk
of, uh, ketoacidosis with their use.
But we have excellent strategies in placefor eliminating that risk pretty much.
And now again, new technology.
And I was at the ADA scientificsessions and I saw Abbott's new
sensor that they're developing thatmeasures ketones as well as glucose.
(10:20):
So we can detect ketones in the earlieststages and prevent DKA almost entirely.
So once that comes to fruition, theFDA has no reason to deny access to
drugs like SGLT-2s for type ones.
So, yeah, the, the technology'schanging, the meds are changing.
Other things, even theinsulins are changing.
(10:40):
The third edition, we didn'thave... we might have just started
seeing the ultra rapid insulins.
And you can only see this if you'rewatching the video part, but I
always use a little quotation markswhen I say ultra rapid because, you
know, or just make a nasty face.
Rapid acting insulin is only a littlemore rapid than regular, that's all.
(11:00):
It's not really rapid and ultra rapid isjust a little more rapid than ultra rapid.
So you know when the pancreas makesinsulin, that stuff's ultra rapid.
It works in seconds.
This stuff we injector deliver with a pump?
We gotta wait hours for that stuff topeak and clear so it's not really, but
it is get... the insulins are gettingfaster, so we have to accommodate
(11:22):
for that and take that into account.
The hormone glucagon is becoming moreof a, an upfront product now because
it's so much easier to administer withthe new, you know, things like, uh,
Zegalogue and we have, uh, Gvoke andwe have the inhaled version as well.
You know, these, these make glucagonmuch more accessible, easier for
(11:44):
anybody to use, including loved ones.
We've even dabbled a bit with microdosingof glucagon in different situations.
It can work nicely.
We try everything here at the office.
All of our clinicians, as you know,we, we all live with type one.
We're all living the dream.
If something new comes out orwe have a notion of a way to use
things differently, what do we do?
(12:05):
We try it, and if I'm afraid to tryit, I'll say, here, Alicia, you do it.
Alicia Downs (12:11):
You're crazy, and your basal settings make no sense.
Yeah.
Gary Scheiner (12:15):
You try this.
You know, if you survive.
Yeah, I'll try it too.
No, we, we all, we're all prettybrave when it comes to these things.
We try just about everything that comesout, devices, meds, we'll try these out
first and see how they work in real life.
Not just from a glucosemanagement standpoint, but a
quality of life standpoint.
And so we can offer ourpatients unique insight.
(12:36):
And, and I try to dothat throughout the book.
I try to keep in mind.
These are not test subjects,they're not patients.
These are people and quality oflife is a very important element
of anything we're gonna do.
Probably the most important element.
You know, I try to consider thatthroughout the book and in my writing.
Alicia Downs (12:54):
I think the most powerful thing about Think Like
a Pancreas and what made it standout for me when I was diagnosed?
Um, I always say my, itwas part of my doctor.
I had a great doctor.
Her husband had type one.
The doctor who diagnosed me, andshe sat me down on day one and she
said, you're not gonna learn whatyou need to know from doctors.
You're gonna need to learn it yourself.
(13:16):
And she said, you're gonna wantthese books-- and Think Like
a Pancreas was one of them.
And what made Think Like a Pancreasdifferent was the other books were
telling me what to do to manage my bloodsugar, and that was very difficult to
just memorize a lot of things to do.
Think Like a Pancreas wastelling me how to think, which
helped me know how to live.
(13:36):
And that really revolutionizedeverything about my management and
helped me help other people nowbecause I can't, I can't give everybody
a big list of everything to do.
'cause that's gonna be differentfor everybody, but I can help
people think through things.
Gary Scheiner (13:50):
That's a great testimonial.
I wanna put that on the next edition.
Exactly what you said.
Alicia Downs (13:57):
Yes!
I got my name on edition five.
Gary Scheiner (14:00):
Teaching people how to think.
And it is kind of a,it's a kamikaze approach.
You do whatever it takes tomanage those glucose levels.
See, I still remember back, 40 years agowhen I was diagnosed and you know, we
were told, this is your insulin program.
Now your life needs to conform to it.
And that's not the way we do things now.
Now you live your life.
(14:21):
You do what you choose to do.
Now here's how we can manage theglucose with your life as you choose it.
So we do what it takes, and we haveto, we have to get creative sometimes
using insulins in creative ways, usingcombinations of insulins, using it
advanced technologies and features thatdon't get a lot of play in most places.
We're, we're big on using those.
(14:42):
So, you know, for people who arejust happy with, I can manage
my blood sugar reasonably welland that's good enough for me.
Eh, this might not bethe best book for them.
This is for people who wanna, take itto the next level and manage as well
as, as they as possible, as reasonable.
Alicia Downs (15:00):
Well and I even find, I even find patient... sometimes it's
not even the blood sugar management.
Sometimes people go, you know, I've gota, I've got an A1C of 6.8 and that's
good enough for me, but sometimesit's, I've got an A1C of 6.8, but
it's taking me 80% of my availablebrain power and bandwidth to do that.
Give a read through the book, you mightpull out two or three tips that are
(15:25):
real shifters in how you manage that.
Take it from 80% to 60% and nowyou've got extra bandwidth, extra
energy to do something else.
That means more in your lifethan blood sugar management.
I, I'm a person with diabetes.
Diabetes is my profession, but diabetes isnot the most important thing in my life.
(15:46):
Shocker.
So if I can just free upsome, some hard drive space.
Reallocate that to something else.
Often that is what makes it worth it.
Even if my numbers don't change a bit,that is the big game changer for me.
So if you're out there and you're like,I don't want, I don't want more tech
and I don't wanna be like the cuttingedge, and I don't need to have super
(16:07):
tight control, and aaah, that's me.
I don't need all that stuff.
What I do need is a little bit more time.
A little bit more chill and a wholelot more focus somewhere else.
Gary Scheiner (16:16):
Like on a little boy who likes to destroy things.
Alicia Downs (16:19):
Oh, I don't think there's enough focus in the world.
I think we're gonna need a cure andI'm gonna need to win the lottery.
Gary Scheiner (16:25):
Yeah, I mean, I'd rather use my brain space thinking about fantasy
sports statistics than glucose levels.
But you know, just getting a systemin place that works well, that doesn't
require you to invest a lot of your time,energy, and money for that matter, and run
with that so you can free up that brainspace and that energy for other things.
(16:46):
Quality of life, things thatare more meaningful to you.
Alicia Downs (16:48):
So, speaking of 40 years ago when you were diagnosed, what did
life look like for you when you thought.
I'm gonna write a book about this thing?
What did life look like when the,when the seed of Think Like a
Pancreas started to germinate?
Gary Scheiner (17:03):
Yeah.
That was back in 98 andsomeone reached out, out to me.
He, uh, he owned a smallpublishing house in New York City.
His name was Matthew Lore.
And, uh, he had read articlesthat I had written for a number of
magazines and journals and said,Hey, you're a pretty good writer.
You know, if you're ever thinking aboutwriting a book, you know we should talk.
(17:24):
And that's how think like the original,Think Like a Pancreas came into being.
His company was absorbed by another,which was absorbed by another.
Is this is what happensin the publishing space.
And now there's only a handful left, butthey're pretty big, dominant players and
you know, the book has, it's done well.
I, I think, I know there'sover a, over a hundred thousand
(17:45):
I think have sold overall.
It's still a fraction of the populationthat could benefit from it, but it's
pretty good for a niche population likepeople on intensive insulin therapy.
But yeah, you were right.
You know, the, the updates are necessary.
'cause if you go back to earlier editions,so the first edition, you know, we
were talking a lot about NPH insulinand regular insulin even, you know,
(18:08):
Humalog, NovoLog, Novo Rapid, thoseinsulins that were just coming out then.
So, you know, now we're dealing with,you know, much higher level things,
tech meds, management approaches.
You know, back then, uh, proteinand fat weren't even part of the
discussion when we looked at howblood sugars changed from meals.
And now, you know, we've spent a,a fair amount of time in, in this
(18:29):
book and the previous one about.
The effects of fat in protein, especiallypeople who go on, you know, the lower
carb diets that have become popular.
When you eliminate a lot of carbsfrom your diet, then protein starts
contributing to rises in glucose levels.
So we do need to accommodate forthose, and we've learned that
fat will not just slow down.
(18:49):
At the rate of digestion, but it'll alsocontribute to some insulin resistance,
which can raise glucose levels.
So that all has to be taken into account.
There's, there have been listspublished of the factors that
raise in lower blood sugar.
I think we have a morecomprehensive one in this book.
One chapter covers just all of theweird, odd things that can raise in
lower glucose levels, so people wholook through that chapter might suddenly
(19:14):
discover, that's why that happens.
You know, when I drink a RedBull that doesn't have carbs in
it, but my glucose shoots up.
Wow.
The caffeine can do that.
Or a comp... competitive sports.
What?
My sugar goes up.
Oh, that's why that happens.
And then we address howyou know how to manage it.
What do you do in those situations?
You don't have to stop enjoying the thingsyou enjoy, you just, you adapt to it.
(19:39):
I always felt when the goinggets tough, the tough adapt.
You know, we learn how to makeadjustments and deal with it.
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(20:21):
And now back to our program.
Alicia Downs (20:23):
So what would your advice be for someone who's, "I feel
like I have something to share inthe health space specifically", and
they want to put together a book.
'Cause the space is big now.
We've got self-publishing, we'vegot online writing, and what
(20:45):
direction would you point someone in?
Gary Scheiner (20:47):
Blogging is a very effective way of
sharing what you wanna share.
You can reach a lot of peoplethat way, and it costs nothing
more usually than your own timein putting the materials together.
And, uh, you can say pretty muchwhat you wanna say in your own blog.
Book publishing?
I mean, there's no moneyto be made in book publish.
(21:09):
I don't make money on this book.
Trust me.
This is.
This is my own way of spreadingthe love to the diabetes community
and helping people out there.
Um, you know, it helps thatpeople know about us as a result.
Our practice is alwaysaccepting new patients.
We're constantly expanding.
But the book is sort of, I you know,it's my, my testimony of, let people know
(21:30):
there, there are better ways to do things,better ways to live with and manage
diabetes and wanna get that word out.
But I, I don't usually recommendpeople go out and try to publish a
book on a healthcare specific topicunless there's something very, very
unique about what you're offering.
There's a huge demand upfront for it.
(21:51):
That's what the online community is for.
You can blog, you can post things and, youknow, get your, your message out that way,
and that's how you can share your passion.
Alicia Downs (22:00):
Yeah, that's, I try to explain to people like,
they're like, but there's so muchmoney to be made in writing books.
Look at Stephen King.
I'm like, yeah, but Stephen Kingwrites fiction that is timeless.
So everyone on the planet from nowtill the end of time can buy that book
and read it, and it applies to theirlife, and they're gonna enjoy it.
Like a book on type onediabetes management is extremely
(22:24):
niche and extremely timely.
You're not gonna be a NewYork Times bestseller on that.
It's just not a thing.
Gary Scheiner (22:30):
For every Stephen King, there are a million Gary Scheiners.
Alicia Downs (22:34):
And a billion people self-publishing on Amazon who just have
a like car trunk full of their own booksthat they give away at every holiday.
It's tough.
Gary Scheiner (22:44):
Yeah.
My dad,
Alicia Downs (22:45):
and it's tough out there.
Gary Scheiner (22:46):
My dad, God bless him, my dad, he's in his eighties and he, he even
self-published a book after he retired.
It was about how to save for retirementand I think it was just his way of
telling me and my sisters what weshould be doing to save for retirement.
But he did it in the form of a book.
Yeah.
He didn't sell any, you know, he, he justwrote this book and self-published it.
Alicia Downs (23:08):
I love it.
I love it.
I will, one thing I always admire though,is the knowledge set to, to have that
discipline and the knowledge set to pulltogether what you know in one place is
amazing, but also then to have the care.
When the care meets confidence,because there are a lot of people who
(23:29):
care, but they don't have confidencein themselves to step out and
really share it in a powerful way.
There are a lot of people in the worldthat have confidence in themselves.
So they'll go out there and share it, butthey don't have the care for the community
to do it in a way that is really usefuland valuable when those two come together.
(23:51):
I think that's the other reason thatThink Like a Pancreas has been so powerful
and continues to be so powerful and willcontinue to be so powerful because it's
really evident that both are present.
Gary Scheiner (24:03):
Yeah.
I mean, it's one thing to know stuff.
It's another to be able tocommunicate it effectively.
That's why I'm, I'm proud tobe, you know, we still call
ourselves diabetes educators.
Although our title has gotten longerand longer and longer, a teacher, a
good teacher knows how to communicate.
You can't just throw data out there andthrow numbers and instructions out there.
(24:26):
And like you were saying,that's what a lot of books do.
They're, this is like aninstruction manual or a textbook.
This is not like that.
It has, the, the information is there.
The insight is there, but it'slaid out in a way that's fun and
it's understandable and it's, uh,you can absorb it and apply it.
Alicia Downs (24:45):
Because a lot of books have this other, this thing
of like, this is the right way.
Like this, this is thebook that you have to read.
This is the way and theother books are wrong.
And there's none of thatin Think Like a Pancreas.
It's, it's take every tool you canget your hands on and, and duct tape
it together and make it work for you.
(25:07):
Because if there's a right way, that meansif I try that way and fail, I'm wrong.
There's the wayand I am the problem.
Gary Scheiner (25:14):
There's a section, I mean, I devoted an entire chapter to
resources and it includes organizations.
It includes onlinecommunities, books, journals.
So I think it's, we gotta share thisstuff and as you as... there's resources
to all of the manufacturer devicemanufacturers and pharma companies
and financial resources that areout there for people with diabetes.
(25:38):
And one big news section I put in the bookhas to do with the tech and the automated
insulin delivery because they're growingin popularity by leaps and bounds, but,
uh, we have a, a guide on how to selectthe best system for you based on what
your personal goals and interests are.
'cause different systems requiredifferent amounts of user engagement,
(25:59):
but they also produce differentlevels of quality outcomes.
And, you know, work in equals work out.
I mean, you can get a system thatrequires almost no energy on your part.
You're not gonna get glucose managementthat's as, as tight as you might like.
That might be okay for somepeople, others who want, you
know, really tight management?
And we will direct 'em tothe system that'll work.
(26:20):
And I try to drop in like littletip, like little pointers throughout.
We call them like special secrettips throughout for AID system
users about how things have changed.
You know, for example, everyedition we've talked about how
to best treat hypoglycemia.
But it's changed now.
People who use AID systems.
It's all different.
We have to, you know,pair back on the carbs.
(26:42):
Um, we have, when we, depending on wherewe catch it, how early in the, in the
stage and with an AID system that cutsout basal insulin for quite a while.
We just don't need asmuch carb as we used to.
You know, we go into those kind of things.
Those are just examples.
There is probably about 40 or 50tips like that throughout the book
specifically for AID system users.
You're an AID system useryourself, so you've, you've
(27:05):
experienced a lot of these too.
Just changes.
Alicia Downs (27:07):
Yeah.
My, when I look back, um.
I kind of pinch myself every nowand again because of how much my
diabetes management life has changed.
It's been kind of strange because mydiabetes diagnosis came at a time of
change, and it always seems like everybig change in my management comes in
(27:30):
a time when my life is also changing.
So sometimes it gets masked.
It's like, well, yeah, everything'sdifferent, so of course my
diabetes management is different.
But then I'll go, I'll go old school.
I'll go manual pumpingfor a good three weeks.
I had a complete insurance snafuand couldn't get my Dexcoms.
So I went CGM free for three weeks, muchto the utter horror of my coworkers.
(27:55):
Everyone was trying to slap a Libresample or a Dexcom sample on me, and
I was like, guys, I survived pre CGM.
I'm just gonna roll old school for alittle while, but realizing how very,
very different my life was in the 10finger sticks, didn't know what my blood
(28:16):
sugar was doing while I was driving.
Treat hypoglycemia with a fistfull of jelly beans days versus
the, always knowing what'sgoing on one Jelly Bean day, so.
Gary Scheiner (28:29):
Some of our brightest patients are using old school approaches.
Alicia Downs (28:32):
Yeah.
Gary Scheiner (28:33):
I, i'm proud of them.
I, I love the job they're doing.
Alicia Downs (28:36):
Yeah.
Gary Scheiner (28:37):
They're managing exceptionally well.
So I wanted to make sure that in the bookI address that and some of the tips and
tricks that can be applied to people whoare on traditional injection therapy or
using inhaled Afrezza as their insulin.
There are combinations ofinsulin that can be used.
You know, for example, if you'regoing into a meal that you know
(29:00):
is gonna digest lightning quick,Afrezza is a great insulin for that
because of how quickly it works.
You know, if that meal is, youknow, kind of an average meal, then
a traditional rapid insulin, inquotes, rapid insulin will work.
A real slow digesting meal keeps someold fashioned regular insulin on hand.
It works really well for those meals.
(29:20):
So it is even within the area of,of old school injection therapy,
there's some creativity thatwe can apply to manage better.
Alicia Downs (29:29):
Oh yeah, I, that's actually one of my favorite places
to work with patients is the patientsthat are like, I really like MDI,
but I want to get as close to pumplevel maneuverability as I can.
Either they really want the freedomof their exercise and their activity
routine or their diet routine, andI have patients, some of my patients
(29:52):
with their, the best outcomesclinically, with the best quality of
life and just joy and ease with theirmanagement are on injection therapy.
And they are also the ones thatare kind of the most savvy that go
in and they educate their, theirprescribers 'cause they go, okay,
oh yeah, here's what I'm gonna do.
(30:13):
I'm gonna use Basaglar andNPH and regular and Afrezza.
And their, their prescribersgoing, what are you doing?
What kind of witches brew ofinsulin are you, you're gonna?
We see that they teach their insulin...
Gary Scheiner (30:27):
we work with, there's so many people on open source, you know,
the quote unquote DIY type systems.
Um, and we've all usedthem ourselves as well.
So there's a, the book covers quite a bit.
So it doesn't just stick toFDA approved type things.
We're also getting into the opensource technologies and who they are,
who they can benefit, what's involvedin using them, and how to get the
(30:49):
most out of them because we have alot of both professional and personal
experience using these systems.
I also like to start each chapterwith a, a song quote as I try to
add some musical touch to this.
And so you'll have to look at thestart of every chapter, there's a
song quote that applies to the topic.
That was the most fun Ihad in doing the book.
In every book I try to, I gotta findnew song quotes for each chapter,
Alicia Downs (31:12):
and don't miss 'em guys, because being in this office?
Gary's brain is like a musical lexicon.
The radio is just on whatever,like Spotify, Pandora channel Nancy
happens to pick, and whenever Garywalks through, he just announces
the artist who is singing songs.
Sometimes if it's a different writer.
(31:33):
Sometimes the year comes out.
I'm like, where in everythingthat lives in your head, does
this information also get to?
Gary Scheiner (31:40):
That's what I get for not thinking about
my blood sugars all the time.
I have room in my brain forall this musical trivia.
Alicia Downs (31:47):
That's what Gary is allotting his extra 10% of hard
drive to is the greatest, the totalcatalog of the Doobie Brothers.
Gary Scheiner (31:56):
Well, that was on this morning.
That's why she mentioned that.
So for people on the visual part,there's the new book, A new Color.
You know, it's a new color,it's gotta be good, right?
So people can order this from our office.
They can call.
It's 877-735-3648 to order it.
Outside the US?
(32:16):
Well, we will have all this inthe show notes, but they can go
online to our, our online storeat Integrated Diabetes Services.
Alicia Downs (32:22):
On video, i'm sure it's, it's down there somewhere.
Gary Scheiner (32:24):
Yes, Barb will take care of that.
It's all, that's, if you wanna geta signed copy and I signed a bunch
yesterday 'cause we had a bunchof orders, so my hand's a little
crampy, but I'm happy to sign them.
But anyone who wants to order it justfrom anyplace else, you can go to Amazon.
You can go to Google.
Uh, Google Play has the audio version.
If you could stand listening to my voicefor that many hours, God bless you.
(32:46):
Because I had to do it.
I was not ha, I hated the soundof my voice by the end of that.
Alicia Downs (32:51):
Which brings me to a tip for people who are reading and listening,
especially on your first time through.
This isn't a novel.
If you try to read this sucker fromcover to cover, if you just sit
down and you're like, okay, I'mgoing to the beach this weekend.
I am reading, Think Like a Pancreas.
(33:12):
It's, it's a little, it's a littlemuch because it's not meant to
really all just absorb at one time.
It's really meant to kind of take in.
And absorb and like apply and thentake in and, and apply and kind
of make it part of your world.
Not just read it and thenmove on to the next thing.
Gary Scheiner (33:34):
Every chapter, chapter builds on the previous information.
So it's a cumulative, it builds up tothis denouement., In the, the chapter
on bolusing for meals-- that's a bigchapter 'cause there's a lot involved,
but we kind of, we start out with, wellfirst how do you dose for your food?
Then how do you adjust for theglucose that's not on target?
(33:56):
And how do you adjustfor physical activity?
And then how do you adjust for thedirection your glucose is headed?
And then we finish it up withthe, the timing of that insulin.
Now that's the ult, I callit the ultimate bolus.
It's the right amount at the right time.
That's, you see, that's a thing of beauty.
I get all misty and teary-eyedthinking, not really.
(34:16):
So, you know, thingsbuild upon each other.
It's not like, you know, you, you'renot gonna understand things going in.
'cause we start with the basicsand, and build up from there.
There's an outline at the beginning.
It's not just that list of chapters.
I made them include an outline.
So if there's something specific youwanna look for, like sports management
or managing your post meals, et cetera,you can go right to that section and
(34:38):
it's indexed in the back so you canfind specific things right on that page.
So try to organize as well as I could.
Alicia Downs (34:45):
So if you, if you dive in and you feel like, this must not
be the book for me because I feelcompletely overwhelmed, you're probably
just trying to eat the book when whatyou're meant to do is savor the book.
So make your bite smaller.
Just take a little bit and I, I thinkI would probably read a couple of
pages at a time and then go, okay.
(35:06):
I've got a thing there.
And then I would just kind of sit, Iwould, I would apply that, that piece
that I got until it worked with mylife and it was just kind of a rhythm.
It was just kind of habit.
It was natural.
And then I would moveon to the next thing.
It probably took me-- that bookwas beat by the time I got to the
end because it was just going backand over and beat back and over.
(35:29):
My first copy of Think Like aPancreas, looks like it went through
a war with me and it kind of did.
Gary Scheiner (35:34):
Session log book.
Alicia Downs (35:36):
Yeah, it was, it was rough and there were
a lot of notes and scribbles.
Yeah, taking it to the doctorand showing her things.
Gary Scheiner (35:44):
It's not a lot, it's not all text.
There's a lot of graphs, especially CGMgraphs to illustrate different things.
There's, there's tables and images, so it,it's, you know, it's a, it's a light read.
It's not, yeah.
Heavy reading.
I don't like heavy.
Alicia Downs (35:58):
It's not heavy.
It's meant to be lived with.
It's meant to be.
It's meant to be done, notjust... yeah, it's not a novel.
It's not to be meant to be just likeread and then stuck on the shelf.
It's meant to sit on the table withyou and kind of do life with you.
But that's, I wanted an audiobook and Itried to take the ebook and like make Siri
read it and I was like, I thought my brainwas gonna come outta my ear because it was
(36:19):
just like word vomiting, diabetes at me.
And I was like, ah, it's too much.
So I'm glad you're reading it.
That will make it much more palatable.
I can't wait.
I can't wait to dive in.
I'm actually on myvacation this, this summer.
I can't believe I'm saying this on myvacation i'm listening to my boss's audio.
I don't think listening to it throughPhiladelphia traffic is the good idea.
Gary Scheiner (36:43):
That's what it's meant for, that's what it's meant for.
For raging through Philly traffic is...
Alicia Downs (36:49):
yeah.
Yeah.
They got a lot of funny stories spreadthroughout, so it'll keep you entertained.
It does and I...
Gary Scheiner (36:54):
you're sitting on the Sooco expressway and things aren't moving.
Alicia Downs (36:57):
I love the humor.
It's got your particularsort of viewpoint.
It's got a little bit of snark, it's gotthe right amount of diabetes inside jokes.
Which I love 'cause we are a community.
We're a culture.
We've got kinda our own insidejokes that are in there.
Do you or did you have yourgo-to diabetes management book?
Gary Scheiner (37:19):
No, I really didn't.
Alicia Downs (37:21):
Like the AccuCheck log book that was, I mean...
Gary Scheiner (37:25):
I don't remember the first book I got, I just went to, it
was called Walden Books back then.
It was an old, oldbookstore and I think I just
Alicia Downs (37:33):
You don't have to say old twice.
Gary Scheiner (37:35):
I picked up a, I think it was a Joslin diabetes guide of some kind.
It, it was just, it was like a textbook,you know, it was just information.
Here's information.
And, you know, that's not how I liketo write or read for that matter.
So I guess I've fanned a way.
But yeah, there's books that havecome out that I've, I've really liked.
The Sugar Surfing book.
I enjoyed Adam's book.
(37:56):
The name slips my mind,
Alicia Downs (37:57):
Bright Spots and Landmines
Gary Scheiner (37:59):
Bright Spots and Landmines, I enjoyed.
John Walsh's books havealways intrigued me.
Also, you know, his Pumping Insulinbook, his Using Insulin book.
Those I found incredibly great resources.
They weren't as readable as I,
Alicia Downs (38:13):
yeah,
Gary Scheiner (38:13):
I generally like, but the information,
Alicia Downs (38:15):
they're more clinical.
Yeah.
Gary Scheiner (38:17):
Yeah.
Alicia Downs (38:17):
Kind of a read.
Yeah.
Gary Scheiner (38:19):
Although, you know, my book's really popular among clinicians.
When I, I go to conferences, uh, youknow, the diabetes educators, the
endocrinology conferences, this book isa pretty popular one for clinicians to
understand insulin management better.
I'm doing,
Alicia Downs (38:34):
I just wonder how much that is because their patients have
come in and gone, please read this.
Gary Scheiner (38:40):
That is probably very likely.
So everyone out there, yougotta do the same thing.
Get the book.
Read it.
Love it, and then tellyour doctor to read it too.
Alicia Downs (38:47):
Hand-- buy two copies, hand one to your doc next time you go in.
So before we head out, Iwanna ask one last question.
We know what's coming in,we know what's in four.
We got a glimpse of what's coming in five.
What do you think is comingin Think Like a Pancreas.
10?
Gary Scheiner (39:02):
Well, let's hope there is not a Think Like a Pancreas 10.
There's, we've gottahave this thing solved.
Have this, this riddlesolved long before then.
I mean, I hope there's not even a five.
There probably will be, butyou know, we're getting closer.
The research is, it's honing inand yes, it's been a long journey,
but every day we're closer.
(39:22):
We're one day closer.
So you know, the cure, I don'tthink it's gonna be just magically
someone snaps their fingers.
We have a cure.
It's gonna be progressive improvementsand improvements that take less work out
of living with diabetes and ensure thatdiabetes glucoses are managed effectively.
It'll probably be somewhat technological,somewhat biological in a sense, but
(39:45):
yeah, I, I do not wanna see multiplemore editions of this book come out.
Alicia Downs (39:49):
No, we don't have to have Gary Shiner's head in a jar picture.
Gary Scheiner (39:53):
Monty Burns on the Simpsons in the future.
That's, that's a scary thing.
Yeah.
I gotta, I, I'd have tofind a new line of work.
I think I'd be a very good, either atraffic engineer because I love like
efficiency, or I'd be a laziness cop.
The Government can hire me towrite people tickets who are being
lazy and just wasting their time.
Not doing what they should be.
Alicia Downs (40:14):
I always tell people, they say, oh my gosh, Alicia, your whole,
like, your whole career is, is diabetes.
What would you do if itwas, if it was cured?
I'd be the happiest person on theunemployment line, but I'm a nurse.
There's no such thingas an unemployed nurse.
Like as Scarlet O'Harasaid, her go hungry?
Gary Scheiner (40:36):
Tomorrow is another day.
Alicia Downs (40:37):
I'll think about that tomorrow.
Thanks Gary.
It has been fantastic fangirlingabout Think Like a Pancreas,
and I cannot wait to read four.
I can't believe I don't already have it.
Gotta catch up on my calendar andI look forward to not reading six.
Hold on.
He is time traveling, travelingthrough space and time.
My copy of Think Like aPancreas 4 just arrived!
(41:01):
Amazon same day has nothing onGary Scheiner, 30 feet away.
So thanks Gary.
Look at that.
He promises you're shipping willnot be quite that fast unless
you live in the Wynwood Metro.
Gary Scheiner (41:15):
Faster than the postal service, that's for sure.
Alicia Downs (41:18):
You're not, you're not beating that delivery time guys!
That is service.
It's a lot faster than our insulin.
So thanks for joining us.
Thanks for sticking aroundwith the Think Like a Pancreas
podcast and catch us next time.
This Alicia Downs and Gary Scheiner.
Gary Scheiner (41:32):
Thanks for tuning in to Think Like a Pancreas podcast.
If you enjoyed today's episode,don't forget to like, follow, or
subscribe on your favorite podcast app.
Think Like a Pancreas podcast is broughtto you by Integrated Diabetes Services.
Where experience meets expertise,passion meets compassion and diabetes
(41:53):
care is personal because we live it too.
Our team of clinicians, allliving with type one diabetes,
understands the challenges firsthand.
We're here to help no matterwhere you are in the world.
From glucose management, to self-carestrategies, to the latest tech,
sports and exercise, weight loss,type one pregnancy, and emotional
(42:14):
wellbeing, we've got you covered.
We offer consultations inEnglish and Spanish via phone,
video, chat, email and text.
Wanna learn more?
Visit integrateddiabetes.com oremail info@integrateddiabetes.com
to schedule a consultation.
On behalf of Think Likea Pancreas, the podcast.
(42:34):
I'm Gary Shiner, wishingyou a fantastic week ahead.
And don't forget to Think Like a Pancreas.
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