#729 Dr. Harbison
Scott Benner
Rocio Harbison, MD is an endocrinologist in a mostly Spansih speaking practice. The Dexcom G6 app in now available in Spanish.
You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Spotify - Amazon Music - Google Play/Android - iHeart Radio - Radio Public, Amazon Alexa or wherever they get audio.
+ Click for EPISODE TRANSCRIPT
DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.
Scott Benner 0:00
Hello friends and welcome to episode 729 of the Juicebox Podcast.
On today's podcast I'll be speaking with Dr. Harbison. She's here to tell us a little bit about what it's like to be an endocrinologist who mostly Hispanic population. And she's going to talk a little bit about the Dexcom G six app, and how it now has Spanish language capabilities. While you're listening, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan. We're becoming bold with insulin. If you have type one diabetes, or the caregiver of someone with type one, please go to T one D exchange.org. Ford slash juicebox. Join the registry. complete the survey. When you complete that survey, you'll be helping people with type one diabetes, helping yourself and supporting the Juicebox Podcast T one D exchange.org. Forward slash juicebox.
Dr. Harbison 1:11
And continue the glue Casa Dexcom hair says is Dallas probably our aura in espanol en la aplikace Yan Dexcom hair says in tanto en el iPhone como el Android, for forwarders, Kerrigan, mo e communes with Yama, I Spanien.
Scott Benner 1:32
This episode of The Juicebox Podcast is sponsored by touched by type one, go to touched by type one.org and find them on Facebook and Instagram. They're a wonderful organization, doing great things for people with type one diabetes. And they have an event coming up in August in Orlando, that I'm going to be speaking at. You can also learn more about that at touched by type one.org. The podcast is also sponsored by in pen from Medtronic diabetes. If you're looking for an insulin pen that will give you some of the functionality that an insulin pump does go to in pen today.com
Dr. Harbison 2:08
Hi, Scott. My name is Rocio Harbison, I am an endocrinologist in Houston, Texas. I've been practicing endocrinology for the past 12 years. And I have a large Hispanic population. Given that Texas is a diverse and large population of Hispanics, and I speak Spanish, I tend to have a large population of Hispanics in my in my practice,
Scott Benner 2:32
what what drew you to the profession?
Dr. Harbison 2:36
So it's very interesting. When they asked me this question, I go back and forth into deciding what made me decided to endocrinology. And really I am an endocrine patient. I do not have diabetes. But I was diagnosed with an endocrine illogical condition when I was a child. And I'm sure that that play a big role in my decision.
Scott Benner 2:59
Sure. Did you have good doctors is the kid or did you just feel comfortable with them? Or
Dr. Harbison 3:03
I did, I had really good pediatric endocrinology. And then I follow with primary care for some time. Knowing my own condition is very easy. So I don't tend to follow us often once a year is pretty good, because I've been stable for many, many years. But it's a different perspective, when you have been a patient yourself, and treating your own patients with similar conditions, you're able to identify with them to give them recommendations. And if you're able to disclose as a physician, some of the conditions that you have, it almost seems like you have a better rapport with your patients, they feel like you're truly understanding their medical conditions.
Scott Benner 3:48
And so let me just ask you, truthfully, does it just feel like that? Or is it actually true? Do you do that? I mean,
Dr. Harbison 3:57
I really think that is true when they're speaking to me. And they're telling me their symptoms. I'm like, Yes, been there, done that, I totally get it. And so it just makes that communication with our patients in a way a little bit easier. I don't think that we necessarily, obviously need to experience a medical condition to be able to treat our patients, but in a way, particularly when the symptoms tend to be pretty vague. In general, it is kind of good for our patients sometimes to hear them that we truly get what they're saying.
Scott Benner 4:31
So how much of your practice do you think is diabetes?
Dr. Harbison 4:34
It's probably a good 60%. Okay.
Scott Benner 4:37
Mostly type one.
Dr. Harbison 4:39
Most mostly type twos,
Scott Benner 4:41
mostly type twos. Okay. How do you find? How do you find? What's the question I want to ask? So, I, I know you don't know me, but I've had over 1000 conversations with people who use insulin and that have been recorded and many more like privately and And I always kind of contend that type two diabetes does not feel immediately emergent. As as the way type one does. Do you think that's one of the reasons why type ones are quicker? I guess generally speaking to focus in on what they need to do, and or do you not find that? Am I just making things up?
Dr. Harbison 5:23
No, you're absolutely correct. are patients with type two diabetes, they have a different disease process, basically a different pathophysiology. So that many of them are still producing enough insulin, to not feel all the symptoms and it tends to be this silent disease. Particularly when you have not gone to the doctor for many years, you have not been screen. So who knows? When you get checked and have a new diagnosis of diabetes, how long you have truly had the diabetes. That's why we always encourage our patients to at least get that yearly checkup with their primary care physicians. So yes, diabetes, type two tends to be silent and type one, you do require insulin for that reason, symptoms will happen early on,
Scott Benner 6:12
which sort of forces you to embrace is the wrong word. But I'm, I'm a little it's Friday morning, doctor. I'm a little lost for the for the word. But But I think it makes them jump in maybe more dreamy more. I don't know what it is, I want to say exactly. I'm trying to figure out why type twos end up not seeming as engaged with their, with the disease as type ones do. I guess that's what I'm trying to figure out? And how to help them with that.
Dr. Harbison 6:45
Sure. And thank you for asking that question. Because hopefully, we use your platform to educate a lot of your listeners, what they could do, many of them might be parents of a kid with type one, maybe we many, many have family members with type one diabetes, both of them themselves may have a high risk for developing type two diabetes. And like I said, it is silent. It is very important to know our family history, I have a very strong family history of type two diabetes being Hispanic. And I get my regular agency checks at least once a year to make sure that my glucoses are within range. And understood understanding that diabetes, type two usually is asymptomatic, meaning that they will not have symptoms of higher low blood sugars, because they're still producing some insulin. But that doesn't mean that the sugars are within range. I think one of the fears that many people have when they have type two diabetes is how much it will impact their life and the quality of life, their daily activities, the food that they like to eat. In a way it can be put very easily in the backburner. Nobody wants to be diagnosed with a medical condition. And there is fear of how many medications they will need. There's also a fear of the potential side effects of those medications. There is a fear that sometimes you make like you could develop a complication that you have seen in a family member. So it could be quite emotional to be diagnosed with type two diabetes.
Scott Benner 8:23
No, I would imagine. I also think that possibly because of the slow onset, it's just, it's hard to see it happening, right? And then before you know it, you're sort of buried underneath of it, like those tired feelings or I'm always tired after I eat or something like that. It just, I don't know, you just think it's normal after a while or culturally, a lot of times what I've seen is that people just expect to get it and so they almost don't, they almost don't bother guarding against it because they think it's like it's the family curse or something like that. You know what I mean by that?
Dr. Harbison 8:57
Absolutely. And there might be the patients where they feel like their family members have been okay they have not developed any complications. And so they go out their lives thinking that those complications will not happen to them but remember that we all have different genetics you have the genetics from mom and genetics from that and if a family member did not develop thankfully any complications that doesn't mean that you as diabetic patient with type living with diabetes will not
Scott Benner 9:25
well I appreciate you talking about that with him. I'm always very interested in it. So let me get to type ones when you when you see do you see mostly adults or children?
Dr. Harbison 9:35
Adults I do see a few adolescents there are transitioning to adult endocrinology. But my most of my patients are adults.
Scott Benner 9:44
What do you think the what do you think the biggest hurdle is when you're transitioning from from endota? Endo, especially from being a child to being an adult?
I'm going to make this quick go to touch by type one.org. Click on the program's tab, scroll down to annual conference. And there you'll have everything you need to know about touched by type ones annual conference that I'll be speaking at. It's on Saturday, August 27. At the Loews Portofino Bay Hotel at Universal Orlando, from 9am to 4pm. Registration for the conference is open right now at touched by type on.org. Just go to the program's tab, click on annual conference, and then the purple button that says register now. And the conference is for everyone who has type one diabetes, or love someone who does. So go over now. Get yourself a ticket, they're free. That's right registration is free, touched by type one.org. The ink pen is a reusable smart insulin pen that uses Bluetooth technology to send dose information to a mobile app. Offering dose calculations. And tracking in pen helps take some of the mental math out of your diabetes management. The link you want is in Penn today.com. Learn all about the embed and the app at this link. Actually, you can also get started with the impenetrable link. Schedule an online healthcare provider visit. Learn about how the app works from the dosing calculator to the digital log book and everything in between. You'll see insights from real customers and learn about the support that impact offers like 24 hour technical support, hands on product training, and online educational resources. Maybe the most exciting thing you're going to find it in pen today.com Is it is completely possible that you may pay as little as $35 for the pen offers available to people and commercial insurance terms and conditions apply. But as little as $35. This is worth you finding out about this is an insulin pen that talks to an app on your phone. And that app is going to give you access to your current glucose meal history dose history activity log dose calculator, active insulin remaining glucose history and reports in Penn today.com in Penn requires a prescription and settings from your healthcare provider, you must use proper settings and follow the instructions as directed. Or you could experience higher low glucose levels. For more safety information. Visit you guessed that in pen today.com links to in pen touch by type one and all the sponsors are in the shownotes of the audio app that you're using right now. Or you can always find them at juicebox podcast.com. When you click directly on my links, you're supporting the podcast.
Dr. Harbison 12:47
That is a very interesting question. I think in adult endocrinology, one of the first steps that I like to take with my patients is making sure that they're taking ownership of their conditions that they are in charge of filling their prescriptions. And I like to have those visits one to one without mom or dad being in the room, sometimes mom or dad will come into the room initially, just to give me the brief background story making sure that my patient is able to communicate all that information, the medications that they're on where they feel that prescriptions etc. But after that, I really kind of push them to be in charge and control many of my patients will be going to college, and oftentimes will be doing tele visits if they are within the state going to a college in the state of Texas. So taking that responsibility, making sure that they are they know exactly when to contact us when they need a prescription refill not only for their insulin, or their supplies, if they are on that list technology, but also for all of the other things that they might need, like glucagon, for example. What to do in that transition period, like I said, many of our patients come in and they're already on the way to college. So I don't have much time to get to know them and educate them as well and what could happen when they're transitioning also to college life. So that that makes it a little bit of a challenge. I kind of love it because it's pushing them to take control of their diabetes on their own and moving them from the dependency. Sometimes I'm mom and dad. And as you know, having a child with diabetes, you want to make sure that your kid is okay. And I'm a mother of five. I want to make sure that my kids are okay. They will do everything that they're supposed to. So we always kind of want to look over their shoulders. And we want to make sure that they're doing what they're supposed to. But I tried to transition that quickly.
Scott Benner 14:55
So there's this void. So I ended up interviewing a lot of mid 20s Pete All who've had diabetes as children, and then head off to college, like you said, or just sort of go off on their own. And for, in my opinion, for far too many of them, there ends up being this void in the middle where I don't think they realized how much their parents were doing. Or maybe, or maybe sometimes how much they didn't understand about what was happening. And then they spend these years in college with just, you know, not great results for their blood sugars. And then they emerge from college and have time to focus on all the sudden. And I haven't had one of them on here yet, who hasn't expressed some sort of regret for not for not understanding it better as they were going, I think part of it is the age. Right? There's that what do they say? Like people's brains? Brains aren't formed right in their early 20s. Still, like, right, you're still developing. But I think it's amazing to have somebody there who understands that. And I love the idea of you sort of separating the parent from the child in the room once the child is an adult, because I guess you really do get to assess like, how much did they really know about this? And how much have they just been a passenger on the journey so far? Right?
Dr. Harbison 16:07
Yes, and it's always good to have them review with CDE, or dietitian, we are blessed to have one on staff in the office where a very small office, only two physicians, and we do have a dietician on staff. But sometimes you might feel like you know, everything about carbohydrates, it's always good to give them a little bit of a different perspective, because as you have probably heard, every year there's a new medication to treat diabetes, particularly type two. And then we also have newer and newer technologies is, is a great opportunity to review with our patients their knowledge. And I will say the one of the most difficult things when you're transitioning for peds to adult and the crane is mean able to create that rapport with the doctor. Some of our patients were diagnosed when they were four or five, six years old, and coming into adulthood, will they have seen the same endocrinologist for the past 15 years? I assume? And I can imagine that it's a little bit of a shock? And will I trust this doctor that has given me all of this new information? And it's pushing me to do all these things on my own? And it is part of our job as physicians really to gain that trust from our patients?
Scott Benner 17:32
No, it's it seems like, it seems like difficult work. Honestly, there's a lot going on there that's on set. And and it's very important to get accomplished. So that my last question before we move on is about seeing an adult who was diagnosed, I can't, I'm trying to imagine. I'm a very simple person, I lived my whole life. Like with numbers in front of me, I thought when I was 16, I'll be able to drive when I'm 18, I'll be able to vote, I'm 21, I'll be able to do this, like you know, and then you start thinking about it more as you get older in terms of health, like, well, if I can make it through my 20s, without this happening, I'll probably be okay if I can make it through my 30s Without this happening. So when people are diagnosed with something that is, you know, generally for the last 20 years been referred to as juvenile diabetes, it has to be incredibly shocking to them, and then they don't get the benefit. If it is the benefit, they don't get the benefit of being younger and a little more, a little more, I guess, flexible in their thinking. When they're diagnosed sick, you're already set in your life and at many ages, you could think I'm okay, like I'm gonna make it to the end. You know, I'm wondering what that's like in the in the in the very early moments and how you get them to a point of acceptance.
Dr. Harbison 18:50
I am so glad that you brought this up because type one diabetes, don't use often that juvenile diabetes, I tend to like to mention the type one diabetes can happen at any age, including people having type two and then transitioning to type one because they do develop antibodies and an autoimmune condition that is causing this attack on the pancreas. That can happen in any age. And sometimes, as clinicians, we might miss that type one diabetes diagnosis, particularly if our patients are overweight or obese, you immediately think about type two diabetes or if they have a strong family history. But the truth is that we tend to diagnose quite a bit of type one in adulthood. My oldest patient diagnosed with type one new onset is a 79 year old male and so it is important to keep in our minds that anyone can develop type one diabetes, I believe that with good education and really kind of diagnose them, giving them the right diagnosis. It helps with At transition, I will say many of my adult patients newly diagnosed with type one, well, it might be sort of a shock, because you will expect as a new diagnosis of diabetes, that you may start with oral medications and not injections, that is probably the biggest shock to them. It, they do tend to embrace the diagnosis if you weren't giving them that right education or providing that support, not only in terms of treating them and educating them about diabetes, per se, but that emotional support and holding their hand throughout the process.
Scott Benner 20:35
How quickly do you go to a C peptide test for an adult whose looks like a type two, but isn't acting like one,
Dr. Harbison 20:44
it pretty much immediately, they seem to not be responding to oral hypoglycemic agents, they've been referred, they have a significantly elevated a one C, we have previously one see, for example, that will be a great guidance. Just to give you an example, there was a patient that I recently saw in in March, he was he was completely normal. And four months later, it was 11. Well, that's type one until proven otherwise. So we're getting some of that background. History is very helpful also on their symptoms, and how fast they progress, particularly if they have had regular yearly checkups.
Scott Benner 21:21
So now my next question is in kind of getting onto our topic, when someone's diagnosed, and English isn't their first language, but the world is built. I mean, the country is built around English, right? And a lot of the world is actually what what does that I mean, I can, I'm trying to imagine the extra level of difficulty that's built on top of it. And, and the reason I jumped so quickly to have you on the show, when I when when I found out you were available, is because I'll give you a tiny bit of background, this podcast has 700, and I don't know, seven or 30 episodes, it's been going for eight years. And one of the things that I hear about very frequently from listeners is, you know, we have certain content about like pro tips for diabetes and defining terms and things like that, can you please put those into Spanish and the truth is that I can't afford to do that I would need voice actors. And it would be and then the biggest problem becomes for me, even if I had that say magically, you were like, oh, Scott, here I have a pile of money, you take it now and hire to voice actress. I don't speak Spanish. So I can't QC anything that's being said. And so it almost feels like it's impossible to create that content for that audience. I mean, gratefully, what what Dexcom has done has happened. But I'm just I'm trying to find I'm trying to decide how much of this that I don't see what what ends up happening to people when, when language is also a barrier.
Dr. Harbison 22:54
So what ends up happening is that many people number one are not offer technology, they might not be offered the education. And while we do have educational material, in Spanish, many companies do provide the Spanish educational material. Not all clinicians or educators are aware that that is available, and it takes extra time. In my case, because Spanish is my native language, I can communicate with my patients very easily. I do believe that having a clinician that speaks the patient's language makes that barrier in that communication a lot easier for the patients and their education is probably in a way better than if they use a translator. Partly, I've heard people translate before. And there is always a little bit of message that is lost. Because you're listening to someone speaking to you in English, and then someone else in Spanish and your brain is going from one end to the other. When you're having the communication in your own language is always going to be easier. So that's a big barrier for sure.
Scott Benner 24:10
Every time I've had serious conversations with people about about taking content and turning it into Spanish content, they always say look, there's going to be words or phrases that just don't translate and then it's going to be on me to to explain it. Or, or that there are and I'm going to use the wrong word here, but many different versions of the same language sometimes. So if you're from one, right, is that right? Like GI Joe? Yeah, there could be differences.
Dr. Harbison 24:40
If you think about, I have learned I'm Puerto Rican. I have to learn to speak in a way we say it kind of in a jokey kind of way, you know, Mexican, Ecuadorian Colombian, because there's different slangs and there's different terminals. ologies that are being used for the same Spanish word, we are speaking the same language. But I need to understand who the person is in front of me what the terms that they use, because just very easy to give you a good example, an easy example that we find is, for me breakfast is this idea of, but for a lot of patients, that will be more so which for me means lunch. And so I had to learn that terminology when I moved to the States, in being able to communicate with my patients, otherwise, you're gonna be confused about the instructions that I'm providing,
Scott Benner 25:34
right? So do you? Do you end up limiting information or simply oversimplifying it? How do you? Or? Or is there a way to get the explanation out fully, because when people come to me, either privately or as listeners to the podcast very frequently, sometimes it doesn't matter if they've been newly diagnosed, or if they've had diabetes for 20 years, they lack some of the most basic ideas about how to use insulin. And it's it's baffling that they've seen a doctor three times a year for 20 years. And then I say, Hey, you should really Pre-Bolus Your meals. And they act like they act like I don't know, like somebody brought them tablets. You know, what I mean with was Moses that came to them with this amazing information. I'm like, this is pretty basic stuff here. It's it's bizarre that you've never heard this before. So I don't know what I don't know what happens. Like I'm always trying to imagine like what happens in that office, that somebody could live 20 years with insulin and not understand that it doesn't begin to work right away.
Dr. Harbison 26:40
And so funny that you mentioned that I've seen it happen many times. One, I think it's someone has had diabetes for many years, and they come to see me as a new patient, they've already been using insulin. I guess we tend to assume even though in medicine, we always say do not assume anything. That's like a rule for physicians. But we might tend to assume that they already know how to inject. And we might not review that. I like to review a lot of those things, because I have seen it happen. But it you know, it puts us into it's almost like a given why why even review this that I know they're already doing. But we always should. That's the truth. And when you're in a conversation with a patient, it's like going to school, if you're in an hour topic, or a 45 minute topic, I probably only get 15% of what they're saying. And then I have to take notes for everything else so that I can review at home if I am even taking notes. So I'm sure that during the visit, there is some information that we have discussed, but that they will not remember.
Scott Benner 27:52
So is the answer here? Well, first of all, it's I ended up doing this a lot better. I'm so sorry. We're 25 minutes into it. Why don't we tell people why you came on the podcast first, and then I'll keep asking my questions.
Dr. Harbison 28:04
You'd have a really good question.
Scott Benner 28:07
Still, though, you know, the title of the episode is going to be Dexcom Gs 25 minutes into it. I'm like, why doesn't this happen? And Why couldn't this happened like this? So what do you what are you here to share with us?
Dr. Harbison 28:22
So yes, as of July 27, Dexcom, G six is now available. Thankfully, for our Spanish speaking patients, the patients is very easy. Pretty much they can download the Dexcom G six app, the newest version, and they can go into their language, the preferred language and switch that to Spanish, if it's already not already set to Spanish. And they will immediately turn it up into Spanish. If you have not had the opportunity to use it Dexcom has done a really nice job in changing all of those alerts that were familiar with with the Dexcom GS six dispatch. And so it makes it really easy for them. And it's a great opportunity to start breaking that barrier in terms of health equities, because many of our Hispanic populations and minorities in general, do not tend to have access to diabetes technology. And partly, I will say, if we as clinicians know that there's nothing available that will assist our patients in a way that they can understand it, are we going to even offer it to our patients. So now we really have no excuse for those patients that speak Spanish. And we can offer technology that will be very helpful to them in terms of managing their diabetes, for us to help them educate their diabetes management as well.
Scott Benner 29:46
So two questions so there's been times for you as a doctor you thought I'd like to give this person a Dexcom but they don't know enough English to make sense of it. Correct. Okay,
Dr. Harbison 29:59
that happens and We do have occasionally biases, not that we intentionally do it, right. But we might be biased. If we see a patient. For example, to give you a great example, I have learned over time that many of my Hispanic patients, the family member is always waiting in the waiting area. And they keep the family member keeps the phone. So in a way, I kind of assume that my patient might not have a phone. So I've learned now to always ask, and to use the right terminology. For example, what you call a smartphone, that's not a familiar phrase for many. If you call it a cell phone, believe it or not, that might not be a familiar phrase. And I'm talking about saying it in Spanish to the patient, but if you say just plain phone that works. So from now on, I always ask if you have a phone with you. And so those who like little tips and tricks that you learn with clinical practice, okay, but it's important to always,
Scott Benner 31:05
yeah, so doctor, so simply speaking, the Dexcom G six app that the user uses the person with diabetes, the app that's on their phone, there's just an update to the app that now gives you the ability to switch the language. There's not like a separate Spanish app, is that correct?
Dr. Harbison 31:23
That is correct. There's no separate Spanish app that makes it easier also, for the clinicians, whenever we're asking our patients to download the app into their phone. Because we don't have to direct patients to different apps.
Scott Benner 31:36
Oh, that's amazing. Hey, did you want to while you were here, ask all the other device manufacturers to do the same thing? Yes, please. What's the breakdown in the United States? I mean, how many Hispanic people? Are there? versus me people who just look at me, I don't know how to talk about this people who probably don't speak English as their first language, like, what's the percentage?
Dr. Harbison 32:03
I actually don't know that exact percentage, what I can tell you is that there's close to 12%. Hispanics, to have diabetes. And that's a pretty large number. Not only that, is that US Hispanics, we have a 50% chance of developing diabetes in the future. That's a huge percentage. And so it is very important that we educate that we not only try to educate ourselves, but that, in general, our communities provide education for patients. Health literacy is a big barrier to diabetes Care, diabetes, technology, literacy is a big barrier. Oftentimes, our patients believe that a continuous glucose monitor might be a device that is delivering medication, rather than reading glucoses. So we need to be able to discuss and answer all those questions, and be able to bring up that conversation and explain to our patients, what technologies are available to them. And what it means because I assure you, I've mentioned it many times to our patients about continuous glucose monitor and what it means and they still at the end of that conversation, believe that the device will give them some sort of medication is reinforcing the concept and educating our patients.
Scott Benner 33:21
So it's interesting, my daughter was at a party recently, and her Omni pod was visible. And a woman came up to her she didn't know her. And she kind of looks at my daughter, my daughter's 18. And she looks at her very seriously. And she says, Do you have a nicotine addiction? And my, and my daughter was like, what? And she points to the pod and my daughter goes, No, I don't have a nicotine addiction. And then the woman gets very sullen and says, Oh, I'm so sorry. Are you going through cancer treatment. And my daughter's only knows about that, because my mom has recently won a battle with cancer. And after her chemo, they would give her this medication that actually is contained and they don't call it an omni pod. But it's literally the same exact thing. And it's used in different medical and my my daughter's like, no, and Elise, she knew about that. She's like, I'm a type one diabetic. There's insulin in this, that turns out the woman she was speaking to was a nurse. And her and her first two guesses had nothing to do with diabetes. So now you're just talking about regular people who don't have any interactions with this and you expect them to know what these things do. I'll tell you that. I think a large part of my job sometimes is just explaining, like, I have a um, I have about a 47, maybe 50 episode series that I just called the finding diabetes, and we just take every word that people run into with their diabetes, and explain them very simply, because I was I was getting notes from people that would say, Hey, I didn't realize that I was doing MDI. I had been like injecting insulin for five years. I didn't know anybody called it MDI. And so then when you hear people talking about it, even if you're an English speaker and you're listening to the the erection in English. As soon as you get to a term you don't know, it's sort of like a, it's a blank spot in the conversation for you, and you can't fill it in. And then the stuff that comes next doesn't make as much sense, etc. So I think this is all really wonderful. I really do, I hope the other people listening, think the same, because I have been, I've tried so hard over the years to get somebody to take this seriously, but I'm just not the right person, apparently, to get them to take it seriously. But there are a lot of people out there that could benefit from good information. And you just need to deliver it to them in a way they can understand. So this is wonderful, thank you
Dr. Harbison 35:35
simple is always better. And sometimes reinforcing. If there's mispronouncing, for example, a one C always kind of correcting them and what it means. i One of the things that I will like to say, because many patients, they don't like to put their fingers, right. And the continuous glucose monitor provides that opportunity where they don't need to prick their finger when they're on the G six. But the the part of the story of someone that has diabetes that helps the clinicians adjust your medication is really those glucose readings. And that glucose, Trent, one finger stick a day, as you know, is not enough information. And it's just one second of the day, versus when you have a whole day of information. But one thing that I like to say is oftentimes we look at agencies and agencies are not perfect test, they want to see can give us an average of what the sugar has been in the past three months. But it doesn't speak to what happens when you exercise or what happens when it's too hot outside or when you're under stress. Or when you eat the same meal and you have different results. What happened that particular day? And how could I adjust my medications based on that. And sometimes the agency might look really pretty, but when you look at the sugars, they're all significantly elevated. And so from not not everybody that a wants to see is the right tool to monitor. So, I would like to mention that, because there is an importance on glucose readings,
Scott Benner 37:22
ya know, and getting people to understand standard deviation, time and range, those things are such a big deal. And you're I mean, obviously you're right, like you know, a lot of low blood sugars, and a lot of high blood sugars could average out and look like a reasonable a one C and with and without this information. It's just it's difficult to it's difficult to put your finger on what's happening sometimes. So is there anything else that I have? Is there anything I haven't asked you about that I should have?
Dr. Harbison 37:52
Not I just think that, in general, I'll take the opportunity for everyone out there to help us change the barriers in terms of diabetes access to our minority friends, if you know that you have heard this podcast, and you have a family member if you have a friend that they have a type one or type two diabetes on insulin, and they do not have technology available to them. Let's educate those people so that they could bring it up to their clinicians. And perhaps they might get on a medication at the end of the day. We want to achieve good diabetes control to prevent complications. And we want that to be equal throughout all of the ethnic groups.
Scott Benner 38:45
Yeah, I agree. And I'll tell you about while we're doing this, anyone who wants to sponsor the translation of some of my episodes to help people, amen. As long as you're not doing something really crazy about like some really strange company I met for I really, I really hope someone sees the value in that and steps forward one day. So I really appreciate you doing this. Hey, can I ask you something silly? And if it's weird, you'll tell me but for social media for social media, so I can get Spanish speaking people to the the episode. Can you in Spanish give me that the G six is available now. Like whatever your explanation would be. I don't I'm not I don't want to direct you to what to say. But could you give me a soundbite
Dr. Harbison 39:27
for sure. And maybe we'll come to that the glue Casa Dexcom hair says is Dallas probably our aura in espanol en la pika Seon. Dexcom hair says in tanto en el iPhone como and Yolanda with a perfect word is Kerrigan mo e commence with Yama is find your
Scott Benner 39:50
doctor do you know I took three years of French in high school and all I know is North means nine so I feel Like I heard iPhone and Android and glucose, which I've heard a number of times, and I was like, I don't know what you're saying. So tell me what you said just for for edification.
Dr. Harbison 40:09
Sure, I said D Dexcom. D six is a continuous glucose monitor that is now available in Spanish to please, for those that habit of Dexcom to six, to download the app, either on iPhone or Android or in Spanish, and change the language to Spanish so that, you know, basically that they can use it.
Scott Benner 40:29
Thank you so much. I really do appreciate this. I appreciate this so very much. I hope you have a terrific day. And I appreciate you taking the time
Dr. Harbison 40:37
saying to you, Scott, thank you for having me. Thank you.
Scott Benner 40:53
Well, I want to thank Dr. Harbison for coming on and remind you that if you're a Spanish speaking person, it would probably be easier to see your Dexcom G six in Spanish. All you need is the latest version of the Dexcom G six app, and then change the settings to Spanish. Thanks also to the in pen from Medtronic diabetes for sponsoring this episode of the podcast. And don't forget to go to N pen today.com to learn more. Want to see me speak in Orlando, Florida or just want to find out more about a great organization touched by type one.org. Don't forget about the T one D exchange survey T one D exchange.org forward slash juice box takes fewer than 10 minutes
Please support the sponsors
The Juicebox Podcast is a free show, but if you'd like to support the podcast directly, you can make a gift here. Recent donations were used to pay for podcast hosting fees. Thank you to all who have sent 5, 10 and 20 dollars!