SPEAKER_00 0:00

All right. I am so excited to talk about this topic. Today we've got Coach Lindsay coming in, who is a registered dietitian, someone living with type 1 diabetes and a CDCES, which is a certified diabetes care and education specialist, to talk about GLP1s. Lindsay, thank you so much for taking some time to come on today.

SPEAKER_02 0:19

Sure. Thank you so much for having me.

SPEAKER_00 0:21

I this conversation's been a long time coming. I feel like there's so many questions around like GLP1s, type 1 diabetes specifically. Obviously, the mass population has a lot of questions as well. It's kind of a hot topic right now, but um maybe start with just a little bit of your background. Um, how long have you had type 1 diabetes? How long have you been practicing with uh you know registered dietitian, C D C E S, but background on you?

SPEAKER_02 0:45

Yeah, yeah. So I have had type one for about 30 years now. I was diagnosed when I was nine. Um, and ever since then, like when I was diagnosed and met with a dietitian, I decided that was my career path. That's like what I had to do, what I wanted to do. So um went to college to become a dietitian, and then after that became a CDC ES. So I've been doing this for gosh, I think it's been almost 20 years now. Um and I love it.

SPEAKER_00 1:12

That is so cool. And I love this that because you get to bring the experience side of living with type 1 diabetes to the education side, uh, being able to train on it, right? Uh, and for those who don't know, so Lindsay's actually a coach in our program as well. And so that's why I get the unique pleasure of saying, hey, we should make an episode about this, uh, because she's in our ecosystem. And I gotta say, our clients sing your praises. Uh so Lindsay helps a lot of our clients with their insulin adjustments and like making recommendations. She is a rock star if you have not met her. So uh really excited to have this chat too, though, because they've been asking about it. So, GLP1, for those who don't know, and again, I'm gonna just kind of play dumb throughout this interview. I think it's helpful for me to ask what might seem like silly questions because I know some people have the silly questions. Uh, so what is a GLP1?

SPEAKER_02 2:00

Yeah, so a GLP1 is a natural hormone that our gut releases and it helps with basically managing blood sugars after meals. It slows digestion, it signals fullness to the brain. Um, they're peptides that our bodies naturally make, but in some of us, we just don't have enough of it. So it can help to take these GLP1 medications to give us more of those GLP1s in our body.

SPEAKER_00 2:25

And what does it stand for again?

SPEAKER_02 2:27

Glucagon-like peptide is a GLP, and then these are the receptor agonists. So GLP1 is a glucagon-like peptide receptor agonist. So a lot of words for, you know, basically a hormone that our body makes.

SPEAKER_00 2:40

It's no wonder they call it GLP. Yeah, that's way easier to say.

SPEAKER_02 2:44

Okay.

SPEAKER_00 2:45

And is this like a combination of things? It does a lot of different effects, or is it one specific peptide?

SPEAKER_02 2:52

So there's a few different types of these medications. The first ones that came out were just one hormone, and they kind of targeted one pathway. And that would be something like Victosa or even Ozempic, if you're familiar with that name, um or Wigovi. And now there's some newer ones that are two hormones that they're still called GLP1s, but there's actually two hormones in them. And that would be like Manjaro, Zethbound. So those work a little bit differently. Some people find them a little bit more effective because they're actually targeting two pathways rather than just one.

SPEAKER_00 3:24

Interesting. And let's talk about effective. So, what is it that they do? What is it that people want them to do? We'll say that. What's the big target audience? Yeah.

SPEAKER_02 3:34

So I think the big thing that everyone's talking about is weight loss. But they actually do a lot more than that. They can really help with blood sugars, they can help with insulin sensitivity, they can help a lot with just food noise in general. So, you know, of course, that can help lead to weight loss, but just that like constant thinking about food. And for those of us with type 1 diabetes, like you and I, we're actually lacking five other hormones that help us regulate our appetite. So that's where these jumpy ones can come in really handy for people like us, um, with just regulating appetite, less food noise, they can help with inflammation. Um, there's some newer research showing that they're actually beneficial for heart and for kidneys. So there's a lot of things besides just weight loss that they can be helpful for.

SPEAKER_00 4:20

I love that you brought this up with type one. So, type ones, it's not just insulin that's missing, right? Like the whole system was kind of there's a ripple effect. So, and I actually heard this too. They were like, Oh, yeah, type ones might not always feel like they're full. And I was like, Yes, I do. And then I realized it just hit me like a train. Um, I don't feel full. I felt physically full, like I could not eat more food. And that was my feeling of fullness. My wife was like, Why do you eat like a thousand calories in a meal back in the day? Not anymore. Yeah, but I was like, 'cause I love feeling full. And then yes, I realized I didn't feel full, I was at capacity. And they think that's a different thing. So can you talk just a tiny bit about what type one specifically are lacking and what what's different that we might not know?

SPEAKER_02 5:03

Yeah. So the big one that most people have heard of is amylen. That's a hormone that we don't produce sufficient amounts of with type one. And that's like the hormone that tells your body that you're full. It's like one of those hunger hormones that can really help with fullness. So that's something that we, you know, are not making adequate amounts of in our bodies. And these GLP ones, they don't replace amylene, but they can kind of help mimic that and help us feel full.

SPEAKER_00 5:29

That's very interesting. Um, do you have anyone that you've worked with that takes amylen?

SPEAKER_02 5:36

You know, not recently. Um it's not really prescribed a lot anymore, especially because these GLP ones are more effective and have less side effects. So I don't know of anybody currently that's on amylen.

SPEAKER_00 5:51

Okay. Uh, and correct me if I'm wrong, but I believe we have amylen, we have leptin and ghrelin. Uh, you mentioned five. What am I missing?

SPEAKER_02 6:00

Yeah, yeah, I'd have to look them up. There's some I don't even think leptin and ghrelin are in the five that we are impacted by. I know amylin is, but there's uh I'd have to look up the names of them because there are some pretty like you know, scientific names. But there's there's some articles out there that I can like send to you to post in the notes if you'd like about the five different hormones.

SPEAKER_00 6:23

Gotcha. Well, and obviously insulin is the most critical one. Without that, we die. So that's a pretty important one. Um, but let's talk about the interaction for type ones who might get on a GLP one. So right now, uh, I believe widely it's not something you can get prescribed, uh, like under a generic. You have to have like an in, right? Like I think you have to know someone who knows someone to get you one. Is that right?

SPEAKER_02 6:47

Kind of. So they're right now off label. They're not FDA approved for type one diabetes. They are FDA approved for type two diabetes and for obesity for weight loss. So there are some roundabout ways that people with type one are getting them approved, um, in some cases with some insurance companies. So it's one of those things that's kind of hit or miss right now. And you have to find a provider who's on board with it and you know is willing to write that prescription and kind of even go through some prior authorizations and things like that to explain why you might need it.

SPEAKER_00 7:21

And is that something you can talk about? Or are you like potentially outing someone that's gonna lose their prescription if we talk about who has it?

SPEAKER_02 7:28

No, I can tell I personally have a prescription for a GLP1 and I take like a small microdose of it. So I take like two-thirds of the smallest dose. So not even the smallest dose, but it has helped me a ton, which I can I can get into that, but it's helped me a lot, not even really for weight loss. That wasn't my goal, but for all these other benefits that we've talked about.

SPEAKER_00 7:49

Well, and that's what I'd love to hear about too. So your experience and anybody else who has type one that you know or have worked with or coached, what does it look like for a type one starting a GLP one? I've followed a few other influencers and friends of mine who've done that, and they're like, insulin needs are just shifting like crazy. Uh, some people got really sick, they felt uh very nauseous, other people felt totally fine. So, what does that experience look like?

SPEAKER_02 8:13

Yeah. So it really depends on you know how you tolerate it. But I will say when I first started it, I took like that full starting dose, the smallest dose that you can take. Um, and I felt terrible. I was so nauseous.

SPEAKER_01 8:26

I couldn't eat.

SPEAKER_02 8:27

I was like, I can't take this anymore. I'm not doing this. And then I gave it a few weeks and I was like, maybe I'll try cutting it back to half of that because you can I'm ready to be heard again. Yeah, I'm like, maybe half of it will be better though. That's what I had been hearing. So you can on the Azembic pen, you can click, you know, to a smaller dose. And so that's what I did. I clicked to like half of the dose and um took that and I felt great. And actually noticed my blood sugars were much better, um, wasn't nauseous at all. You do have to really be careful of your blood sugars because it does make you more insulin sensitive and it makes you want to eat less. So that is something that you do need to, you know, right away pay attention to and likely reduce your insulin to carb ratios and correction factors, basal rates, and all of that.

SPEAKER_00 9:14

Very true. Interesting. Um, it's what a challenging experience of more insulin sensitive. So you're more likely to go low, but not wanting to treat the low because you're not hungry, right? Yeah. Oh man. Um, actually, on that topic, does it block hunger signals from a low? So, like when I get low and when most people go low as type one, we are starving because it's like survival mode, right? Does it block that?

SPEAKER_02 9:38

I would say it probably does a little bit. It may depend on the person because different people, you know, have different effects from it. And it probably depends on the dose that you're on too. Like if you're on a really high dose or a dose that's too high for you, I would think it would block those signals. Like you'd probably have other symptoms like shaky and sweaty and you know, whatever else you normally have from a low, but um, the hunger may not be there.

SPEAKER_00 10:02

That's wild to think about. Okay, so we've got uh, you know, hunger cues impacted with type ones. You said insulin needs can shift. Um, I'd like to open up a discussion of potential dangers. So obviously, one of them is increased insulin sensitivity can yield uh lows or bad situations there. But we hear a couple experiences of people who have gone on giardians, let's say, and developed euglycemic DKA. How does that happen?

SPEAKER_02 10:29

So that can happen if you're not taking enough insulin. Basically, if your insulin needs all of a sudden are, you know, so low that you're, you know, that is a risk. You can go into DKA. I think that's more of a risk with Jardians and some of those other medications than it is with these GLP1 medications, but it is something, especially at first, that was a big concern. And I think that is one of the reasons why it has not been approved for type 1 diabetes yet. Um, but you know, as long as you are eating, you are taking insulin, you're staying well hydrated, the risk of that is pretty low.

SPEAKER_00 11:02

Okay, that's helpful to know. And yeah, obviously I can see where there's some hesitancy around that if there is a real risk factor, even if it's just from negligence, you know, people who weren't paying attention and oops, I took too much and took too little can be a bit scary. So um around the risk factors, we have kind of back to the insulin sensitivity question. Is that an immediate threat and then it's gone? Like the first week is sketchy, or is it um like a tapering where you're most impacted for the first 30 days and then less for the 60 following that? What does that look like?

SPEAKER_02 11:35

Yeah. So, you know, it really depends on if you are losing weight, how quickly you're losing weight, because your insulin sensitivity will increase. But if you're losing weight on these medications, as you lose weight, you'll also need less insulin. So it's kind of something that you have to continue to keep an eye on. And a lot of people increase their dose over time as well. So anytime that dose increases, you really need to be extra aware of potentially needing to reduce your insulin needs as well. So, you know, I would say like if you're on the same dose, um, you haven't changed it recently, you're not losing weight very quickly, then that risk kind of levels out once you get your settings right. But if you are losing weight and you are, you know, increasing your dose, then that is something to watch out for.

SPEAKER_00 12:20

Well, and let's talk about that, like what mechanism leads to the increase of insulin sensitivity. So one of them obviously is if anybody loses weight, you're gonna see reduced insulin resistance, which reduces your insulin need. And the studies that I've seen most commonly point to belly fat specifically as holding insulin resistance. Um, is this just a matter of it causes weight loss and weight loss causes insulin sensitivity? Or is that the drug itself causes insulin sensitivity and weight loss reduces insulin resistance, therefore insulin sensitive?

SPEAKER_02 12:50

I think it's a little bit of both, honestly. I think even independent of weight loss, these drugs still help with insulin sensitivity. So it's not just the weight loss, but you know, it's kind of a double whammy if you're losing weight and you're taking these medications that are just naturally improving insulin sensitivity.

SPEAKER_00 13:05

Yeah. And then if you're extra motivated and like working out more on top of that, uh-oh. Oh my goodness. Well, in in that realm too, if somebody doesn't want to lose weight, but they like the idea of the other benefits from it, is this something they should consider? Or is it like only if weight loss is part of your your goal?

SPEAKER_02 13:25

I think it's up to up to that person, really. I mean, some people may not want to be on any more medications, and that's totally fair because this is something that I think of as a medication that you'll probably be on for life, like insulin, if you want to continue to have the benefits of it. So, you know, I think some people might really like the other benefits of it. Like I personally like the idea that it is protective for my heart, for my kidneys. Um, it really helps with my blood sugars because it helps with the food noise. So, whereas before I started taking this, I would always get like hungry and snacky at night before bed. And then, you know, overnight blood sugars are impacted by that. So, with this, I, you know, I eat dinner and I'm full and I'm good, and my blood sugars overnight are perfect. So it helps a lot with things like that, that really has nothing to do with weight loss.

SPEAKER_00 14:14

And I guess my question was more so targeted, that's still helpful to know though, um, is does it always yield weight loss? Like if somebody who is 10% body fat and they're like, I don't want to lose any weight, you know, like is it still gonna have that effect on them?

SPEAKER_02 14:31

So you would have to be a little bit more careful. If you're really not wanting to lose any weight, you're like, I'm good where I'm at. You would have to make sure that you're eating enough, essentially, you know, really track your calories, track your macros, make sure you're getting enough protein. Um, but you could still have other benefits and maintain your weight. You would probably need to stick with a lower dose. You wouldn't want to keep climbing and increasing the dose because then you would just not be hungry and not want to eat. But if you were on a lower dose of it, you could still see some benefits of it without the weight loss for sure.

SPEAKER_00 14:59

Interesting. Well, and a thought that comes to my mind, and I know a lot of people who are more um athletic are concerned with muscle loss. So, what did that look like within GLP1s?

SPEAKER_02 15:10

So the muscle loss is really due to the rapid weight loss. So a lot of people start taking these and they're just not eating enough protein, they're not eating enough calories, they're losing weight super quickly. And obviously, you know, if you're losing weight that quickly, you're losing muscle too. So if you're keeping an eye on that, you're eating protein, you're, you know, staying active, you're doing resistance training, um, the risk of muscle loss is very low.

SPEAKER_00 15:34

Okay. And as far as protein goals, does that change from standard protein goals in terms of how much protein per day one should consume? Is it more than what's normal, or is it about the same? Just don't forget to eat protein.

SPEAKER_02 15:45

Yeah, I usually recommend, you know, it's about the same. It's just make sure that you are taking in that protein and maybe being extra diligent with tracking to make sure you're getting enough. But you really don't need more protein just because you're on these medications.

SPEAKER_00 15:58

Got it. And what is the the mechanism for weight loss with the GLP1? Is it as simple as it makes you less hungry, therefore there's less calories, therefore you lose weight? Or is there something else going on like urinating out extra glucose that's not being filtered, or something else like that?

SPEAKER_02 16:17

Yes, you're not urinating out extra glucose like some of the other medications. It's a combination of, you know, you're just less hungry, less food noise, um, decreased inflammation, you know, that overall can help with weight loss. And for some people too, like decreased insulin needs for like for us with type one, you you know, not necessarily insulin doesn't cause weight gain, but if you're taking less insulin, it could be a little easier to lose weight. So it's a whole nother can of worms that we don't have to get into. But I think there's there's different, um, it's not just because it makes you less hungry.

SPEAKER_00 16:53

Got it. Yeah, and in the respective time, we won't open up Pandora's box of insulin and weight gain, but uh I will give one analogy that I think is helpful for people just to see. Because we a lot of us hear it, a lot of us experienced it. Oh, I got diagnosed, I started taking insulin, and I gained 30 pounds. So insulin, it's like, no, no, no, you're you're finally accepting the nutrients that you consume, you know. Uh, but the example that I find most helpful is everyone on planet Earth needs insulin to survive. And because there are people who are very, very fit in existence, that disproves that insulin makes you fat because they have insulin and they're not fat, right?

SPEAKER_01 17:30

Very true.

SPEAKER_00 17:31

But it's very easy to fall down that trap of like, I take insulin and then I gained weight when we're first diagnosed, and I think it just kind of poisons our our perspective. But um so these medications then, uh, you mentioned the lifelong piece. I agree. Some people just don't want to stack medications, even if it means less benefits. But you touched on something interesting, which is uh, I would say secondary benefits. You said heart health, kidney health. Tell me a bit about that.

SPEAKER_02 17:57

Yeah, so that's being studied right now, and it hasn't been studied in people with type 1 diabetes yet that I'm aware of. It's really been more people with type 2 diabetes that they've been studying this in. Um, and I think more research will come out on that. I think we'll see more. I don't know if it's directly related to weight loss improving those metrics, or if there's more to it. I think there's there's other, you know, other things I probably have to do with, you know, decreasing inflammation and things like that as well that are really helping with heart health and kidney health.

SPEAKER_00 18:27

Well, and that right there, it's the causation versus correlation, right? Like, is my heart healthier because I lost weight or because the drug? You know, it's like which one was it? Um, yeah, always a fantastic question to ask. So we know that there are benefits that could be studied, hopefully, for type ones to confirm that with contraindications. Are there any contraindications that exist, like somebody who has gastroparesis and digestive issues should stay away from this or kidney function is altered, should they stay away? I wonder if anything like that that you can shed light on.

SPEAKER_02 18:57

Yeah, there's a specific type of um thyroid cancer. If you have a family history of that, it's something that you should not be taking for sure. Um, gastroparesis is kind of hit or miss. That's something that I would, you know, really talk to your provider about if it's if you have gastroparesis and you're interested in these medications, because it does slow gastric emptying, so it can make you feel fuller, and gastroparesis is already doing that. So it's something that's not necessarily contraindicated, but I would have a conversation with your provider about that if it's something that you're interested in. Um as far as I know though, the there's really no other contraindications besides the specific type of thyroid cancer.

SPEAKER_00 19:39

Wow. That's actually encouraging. Uh, is this something that you see in the future being part of every type one's arsenal toolbox kind of thing, where it's like we recommend GLP1s alongside insulin. You can choose not to take it, but you probably should, kind of a thing? Or is it more of a personalized choice?

SPEAKER_02 19:58

I think it's gonna be a personalized choice still. You know, I think it's something that some people really will benefit from and it really helps them while other people will really have no interest in it. And I think that, you know, I think it will be kind of more common than it is now down the road, but I don't think it's something that's like a blanket, like every type one needs this. I think it's still, you know, there's pros and cons, like anything. And it's something to have a conversation with your doctor, your diabetes educator, um, and really weigh those pros and cons.

SPEAKER_00 20:29

Totally. Well, and I like to to zoom out and like look at the macro level of things. So for me, one of my initial thoughts is why would I add another medication that could potentially create new problems, right? Like I don't want to have to deal with changing insulin needs or um what was the other thing we talked about? Oh, like the muscle mass loss, right? Like, oh, I don't want to add issues. And I think about it, it's like, well, if you take too much, it could create problems. If I take too much insulin, I also create problems, but I need insulin to survive, and it's a good thing. So I think that there is a kind of a conversation we had around finding the balancing point for each person, like you said, personalized if they don't need it, if they wouldn't benefit from it as much. There are those in the population who are overweight who might benefit more from this, versus some people have just a little benefit, and maybe it's not worth the risk to them, right? Because the cost-benefit analysis. So I think it's it's worth opening this discussion, which I'm glad we are. One other thought that comes to mind for me, for somebody who is very active, does having a GLP1 as part of your medication routine, does that impact how you exercise or cautions that you should be aware of?

SPEAKER_02 21:37

I think the big thing is just keeping an eye on low blood sugars, you know, because if you are more insulin sensitive and maybe you haven't really tracked down like what your insulin doses need to be on the dose of the GLP1 that you're on, you could be more likely to have a low blood sugar. But that would be the biggest thing that I'd be cautious about is just, you know, keeping extra. Things on hand in case you do drop.

SPEAKER_00 22:02

Totally. Yeah. Be prepared. As always. Maybe not as prepared as I was. For those who know my story, when I first started exercising with type one and got nervous, I would carry 400 carbs in a backpack with me, just in case. You might might not need that many, but uh it gave me the confidence I needed to get out there. I was like, no matter what, I'm safe. There's no way this isn't enough. Um but that is very interesting. So big picture. It sounds like there really aren't that many downsides, right? Like it's mostly a positive thing. And for some people, it's only a positive thing when they get their dosing right and they have a great time. Um what gets in the way of this becoming a widespread thing for type ones? Is it just approval by the FDA that could get in the way, or are there other things that we should be aware of or fight for with Congress? You know, what's what's getting in the way of us?

SPEAKER_02 22:55

I think the big thing is the FDA approval because they they have done a few studies on it now with type ones, but they haven't done a ton of studies because it's expensive to do research. And, you know, there's a lot more type twos in the world than type ones. And so I think it just hasn't been a huge priority for these companies to research type ones and GLP ones, but there have been a few recent studies showing a lot of promise in the type one community. So I think that's the big roadblock, is if you don't have coverage, you know, they're very expensive. And because they're not FDA approved, many doctors are just not even willing to have the conversation with their patients. Like my endo that I had a couple of years ago was not even open to the conversation. He just said that's not for type ones. No. Um, so I think those are kind of the roadblocks right now.

SPEAKER_00 23:43

Gotcha. Well, and on that road, um, you don't have to tell us your uh your supplier, you know. But I am very curious, what does the process look like? Obviously, the first step is asking your endo or your pharmacy, like seeing what that could look like. But um, what are some paths that people have found success uh if they got the no initially? Or is it just a matter of firing the endo and finding a new one?

SPEAKER_02 24:06

Yeah, I mean, that's essentially what I did was I found a new provider who was on board with it and was willing to write the prescription and then trying to see if I could get coverage for it with my insurance. Um, so I think you know that's the big thing. Even if you find a doctor who's on board with it, you can get these for like if you have a prescription, you can go to websites like Lily Direct or Novo Nordis website, and you can buy them through those websites just without insurance, basically. So they are quite a bit more expensive. Uh so that there still are ways to get them if your insurance doesn't cover it, but you do have to have a prescription for it. So I don't always recommend like the compounded routes where you can get them from random websites and med spas and things like that, because you don't exactly know what you're getting. So I think the first step is just finding a provider who is willing to kind of work with you on that and help you out with getting a prescription.

SPEAKER_00 24:59

Well, I think that opens up the discussion to a much larger arena, which is just peptides in general and how a lot of people, it's a hot topic right now. A lot of people are exploring how to get them, it's changing their lives. I'm always hesitant to cause, uh well, not cause necessary, but uh trigger anything irreversible. So if I'm injecting something into my body, it could trigger something. If it's unproven, I'm hesitant, you know. Um, and so when we talk about peptides, you mentioned sourcing. And, you know, if you're just going to some random wellness website, you're not a hundred percent sure what's in there, you know, and that can be detrimental to your health. So um I agree. Go on the right path, ask your endo, go through your pharmacy, don't just go to some back alley, I found it. You know, that's that's it's spelled different than I thought it was. That's interesting. You know, it's like, oh no, it's a knockoff. Um, so be cautious with that, obviously. But if somebody did want to go the correct route, right, and get a prescription for it, what are some questions they can ask their endo? How do they kickstart that conversation?

SPEAKER_02 26:00

Yeah, I usually recommend just starting by asking, like, do you have other patients with type 1 diabetes that are on these medications? And that will tell you right away if they're even open to it or not. And then just kind of asking about their experiences and asking, like, is this something that you think might benefit me? And, you know, even like bringing up some of the research that you've heard and why it could be beneficial for you and why you might be interested in it, but really just starting out that conversation by, you know, I think a good icebreaker is just you have other type one patients like me that are on this medication.

SPEAKER_00 26:34

100%. Yeah, I would say uh if there is any advice I can give from somebody who has not had that conversation specifically, but has had other conversations with my endo and my primary care, it's that I want, as silly as this sounds, I want to protect their ego while I introduce curiosity. So I'm not gonna tell them I found this thing that you should put me on because I know better, because that's not gonna get you anywhere, right? Uh, but saying, hey, I'm sure you've heard about this. I would love to know more information about this thing. I did some research, so I'm informed, but I would love to have your expertise. You know, and what would you recommend? And it's not that you're gonna listen to whatever they recommend no matter what, it's that you're seeing how they respond. Because if they're curious and open, fantastic, you got a good one. Do not let that endo go or the primary care. Even if they end up saying no, if they're curious, it's a great start. If they open a conversation, I think that when there's this authoritative veto, that's where you're like, you didn't even Google it. You know, you didn't even give me a chance. What's going on? And that's the same story for me, what ended up uh leading to me firing my primary care a couple of years ago and getting the new one because I was like, hey, uh I'm concerned about my heart health. I would like to get these labs. And he was like, You're not showing any symptoms, you don't need labs. Go home. I was like, I don't want symptoms, I don't want a heart attack. You know, like let's fix this before it's a thing. And went to another doctor. He signed off on the labs. I am healthy, which is great, but I wanted to know, you know. So I think that um those those are helpful ways I've found to start conversations and just see where they're at. Because it sounds like you had a similar experience getting vetoed. And it's like, whoa, we didn't even have a conversation. Right.

SPEAKER_02 28:10

If they're not even open-minded to the conversation, it's just, you know, what else are they not going to be open-minded about down the road?

SPEAKER_00 28:16

So 100%. And it's like, at the very least, ask why I'm inquiring about it. Because if you're like, let's just say, because you didn't go on a GLP1 to lose weight, but let's just say it was that. Your endo didn't even ask, well, why are you interested in this? Right. And then maybe you would have said, so I could lose weight. And then she could have said, Have we explored fine-tuning your insulin dosing, exercise routines, dietary? Like she could have still supported you, he or she. I don't know. Um, I assume she, because my last three endos have been female, but it was he, actually. Okay. But I think that that's the base of any good medical professional is curiosity and openness to conversation because they're there for you, right? And and that's what it needs to be about. Um, love this. So GLP ones as a whole, beneficial for a lot of people. It's worth expressing some caution and expressing it, engaging in some caution if you are starting something new, as with any medication, right? Um, starting small, sounds like is the recommendation. Don't just jump to the full fullest dose you can because you want to see results tomorrow. Um, and of course, working with your primary care, your endo, whoever's on your medical team closely, because as a type one, if most of our viewers are type ones, um, there's likely going to be some insulin changes, insulin sensitivity, maybe your dosing timing, maybe nausea, which can make it hard to treat a low blood sugar if you don't want to eat, right? Um, is there anything that we've missed in the discussion about GLP1s that's been a hot topic or a common question you've seen?

SPEAKER_02 29:49

Yeah, I mean, the insulin timing that you just brought up, that's a common question that I've heard lately is like, what if I don't know how much I'm planning on eating at my meal? Like if I take my insulin, you know, I pre-bolus my insulin and then I end up eating a third of my meal and I've already taken my insulin because I'm just too full. Um, so that is a common thing to think about too, and like figure out how and when to dose for meals, like you mentioned, especially at first when you just don't know how your appetite will be impacted. Um, so that I think is another big consideration.

SPEAKER_00 30:19

100%. Well, I love that. Now, this is, I mean, honestly, this was eye-opening for me. I knew a chunk about GLP1s, but I've learned new things as well from this conversation. And uh I I'm more of the mind that I would rather avoid adding additional medication, supplements, whatever I can, if I don't need need them, just because I want to keep it simple. But if there's something to benefit my health, especially you mentioned potentially protective for heart health, kidney health, anything like that, I think it's worth exploring. So I really appreciate the conversation today, Lindsay. Thank you.

SPEAKER_02 30:51

Yeah, thanks so much for having me.

SPEAKER_00 30:53

Yeah, if for anybody else who's curious and likes the idea of curiosity, getting new information, I'll put some links in the description of this episode for you guys. Uh, but one of the biggest things I can recommend right now is that we have an upcoming event where we are going to be leaning into the curiosity aspect of type 1 diabetes specifically. So, GLP1, that is Lindsay's thing. You should get in our coaching program and ask your questions about that specifically, because I am not your guy for that. But if you like the idea of getting blood sugars controlled and understanding how to make diabetes feel easier, we have an in-person event. I'll put a link in the description, or you can go to t1dmasterylive.com. So, Lindsay, you're amazing, fantastic. Our clients are lucky to have you as a coach, and I appreciate you coming on, spending some time educating us on the GLP ones and open up a new conversation. So thank you.

SPEAKER_02 31:39

Anytime, no problem.

SPEAKER_00 31:41

Everybody else, thanks for hanging out. Check the links in the description. We'll see you in the next one. Keep up the fight.