Stacey talks with Justin Thomas, the director of Camp Carolina Trails, an American Diabetes Association camp and Galen Horton, a staff member at the camp who works with Animas Corp. Both men were campers at the program  (Galen was Justin's counselor once upon a time) and have a lot to say about why the experience is so meaningful and why they keep coming back. This summer marked Galen's 30th! You'll also hear from a once-reluctant camper who turned her experience around. This will be Sara's 9th year at Camp Kudzu. Stacey shares her son's experiences at "regular" non-diabetes day camp and sleep away camp.

In 2014, Sierra Sandison won the Miss Idaho pageant with an insulin pump clipped to her bikini, prompting the #showmeyourpump social media movement. We talk about her new book and online projects as well as take a look back at her incredible experience at the Miss America Pageant. In Community Connections, you'll hear about a new diagnosis, a new school, and a fortuitous meeting for the family of a first grader.

Stacey talks to blogger, author and speaker Kerri Sparling, of Six Until Me. Kerri talks about the power of ordinary success with diabetes, how she decides what to keep private and the Spare a Rose charitable campaign. We'll also hear about a connection at theater camp and Stacey has some advice if you're looking to connect with other people with diabetes in real life.

Stacey talks to Jeffrey Brewer, former head of JDRF, now CEO of Bigfoot Biomedical. We’ll find out how he hopes to simplify diabetes management through technology and the story behind the Bigfoot name. Stacey also hears about a teenager’s first trip away from home and how a diabetes connection on the road made a big difference. Plus, what to do this summer to make school better for your child with diabetes this fall.

Episode Transcription:

Stacey Simms 0:00
Hi, this is Stacey. Just a reminder my podcast is not intended as medical advice. I am not a doctor. If you have medical questions, please talk to your healthcare provider.

Announcer 0:13
This is Diabetes Connections with Stacey Simms.

Stacey Simms 0:17
This week, I'll talk to Jeffrey Brewer, the former president and CEO of JDRF. Now he's part of a new venture, Bigfoot Biomedical that aims to simplify life for people with Type One Diabetes.

Jeffrey Brewer 0:30
I pick up my smartphone, and I can contact people that I haven't seen in 20 years through Facebook instantaneously, I can press a button and have a car show up and take me anywhere I want within three minutes. And yet, if I'm looking for advice or help on self-dosing this dangerous drug called insulin, I'm completely and totally disconnected from the rest of the world. And that just seems crazy.

Stacey Simms 0:55
Plus, a school competition means the first time away from home for a teenager: 12 hours away for a whole week, a surprise diabetes connection makes a big difference.

Jennifer 1:05
She texted me and you know, I could hear the excitement, even in the text. She's like, "Mommy, announcer has Type One." And I'm like, "Are you kidding me?" I said, "How do you know?" She says, "You know, kind of sitting near him and I saw him announcing and I spotted a pump." And she was like, "Oh my god, one of me!"

Stacey Simms 1:21
And the most important thing you can teach your child with diabetes now, to make school easier in the fall. It all starts now on Diabetes Connections. My guest today is breaking new ground, the CEO of JDRF. Formerly, he left that group in 2014 and founded a new venture later that year. It's a diabetes technology startup called Bigfoot Biomedical. We will talk about the story behind the name. And I'm excited to talk to Jeffrey Brewer. Jeffrey, welcome to Diabetes Connections.

Jeffrey Brewer 1:54
Thanks very much. Thanks for having me.

Stacey Simms 1:56
Oh, it's great to talk to you, you know, I was on the board of our local JDRF chapter from 2007 until about 2013, when I cycled off. And of course, you heard your name so much before and after that, it's so nice to chat with you. Um, do you mind telling us your family's story? Your son, of course, has Type One, when he was diagnosed and how he's doing now?

Jeffrey Brewer 2:18
My son was diagnosed in 2002, September 19. For people affected by this disease, especially with children, you remember exactly when and where. We had just moved to New York City and my son was a couple weeks into a new school. And he was at that point, seven years old. Sean is now 20 years old. And so, we have been living and he has been living with this disease for over 13 years. And my involvement in various efforts and initiatives, starting with my volunteer work at JDRF. And then my service on the international board of directors and and then leading to my executive service as the CEO of JDRF for the last four years, all motivated by my desire to see that he lives the best, healthiest, and safest life. And I think there is a big opportunity that we have on the way to a cure for this disease, to improve life, health, and safety through the use of technology. And I've been pursuing that pretty aggressively since the very beginning.

Stacey Simms 3:27
But let's talk about that. I mean, you know, when you're talking about moving forward and actually getting to a cure, and all of the advances that are happening and we want to happen as people affected by diabetes, let's let's talk about Bigfoot Biomedical. First, the name, you know, as you listen, you may be aware, there are a few people in the U.S. who are basically putting together their own artificial pancreas, using existing technology: pumps and CGMs and things like that working together. Some people are are better known and have put their name on their ventures, but others are not so well known, including one family that a reporter named "Bigfoot" because they were so hard to find. Do I have all that right?

Jeffrey Brewer 4:07
You do, you do. Bryan Mazlish, who is one of the founders of Bigfoot Biomedical, as long as two and a half years ago, had begun experimenting with a prototype system for the automation of insulin delivery. One which has been operating continuously for the last two years now on his wife, who has Type One Diabetes, and also his now nine year old son.

Stacey Simms 4:36
Wow. It's incredible for somebody like me who has a child with a CGM, a Continuous Glucose Monitor and a pump to think that there are people with basically the same equipment who just have figured out, and I may be getting this wrong, so feel free to correct me. It seems like they're just figuring out a software pattern or some way of making it more automated and it's working and it seems safe for them. It's just incredible.

Jeffrey Brewer 5:00
It is incredible. And it is using today's technologies, today's standard for insulin pumps and Continuous Glucose Monitors and providing a software solution that connects the two, but also using other important technologies that have become part of our daily lives, including a smartphone, which increasingly all of us carry around, even young children. And then using the connectivity that that smartphone offers to the cloud, and what you can do in terms of remote monitoring and remote diagnostics, and to essentially improve the way the system works over time, based on all that data, a lot of opportunities and so it's definitely time to wrap all these things up, we believe, into a complete package, which is going to give the benefit that currently Bryan's son and wife share to a great deal more people.

Stacey Simms 5:57
Wow, okay, and the other founding member is former Medtronic chief engineer Lane Desborough. What is the mission here? I am assuming it is beyond this closed loop automation. Tell us what Bigfoot Biomedical is all about, what you hope to do?

Jeffrey Brewer 6:13
Well, at the end of the day, we believe our mission is to improve the life and health and safety of people who are living with Type One Diabetes. And to do that in a way that's cost effective. There is a crisis in terms of the outcomes of people living with the disease. We don't have enough endocrinologists to treat people with Type One. In fact, most people were treated by primary care providers who have this disease in this country. There is a pushback by the payers on the health care returns for tools and technologies that we believe can help improve life, health, and safety. All this together really cries out for a new approach and one that we think of more as a service than as the selling of a hardware device or a gadget. We're a solutions provider that will provide in a way, glycemic management that will help administer insulin better than people are able to do themselves today, and certainly with a lot less trouble.

Stacey Simms 7:18
So does that mean you're working with existing hardware companies, I mean, I don't want to, I don't know if that's the right term to use. But I'm thinking about the technology that's out there right now. And as you said, it's not just about better gadgets.

Jeffrey Brewer 7:30
That's right, we're in fact, working with some existing hardware providers. We see ourselves not as a hardware company, however, as a, an ecosystem provider that's orchestrating a bunch of different components to connect them into a solution that's really holistically designed and which will be supported by Bigfoot Biomedical. So we have great partners across a range of activities. And since some of those are not yet publicly announced, I can't really disclose. But wherever there is a best of breed solution today, if you're talking about Continuous Glucose Monitoring, or insulin infusion sets, or Blood Glucose monitors, these are going to be partners of Bigfoot Biomedical. And then there's some things that we have to develop ourselves to, to create a comprehensive and integrated system. But essentially, we're providing the solution and the software and the connectivity and the outcome. We're going to sell people we believe, a better approach to managing this disease; one, which allows them to do better, to live better, and to do so more cost-effectively.

Stacey Simms 8:38
You know, one thing I find very interesting is you've been quoted many times talking about how living with Type 1 Diabetes is really hard, you know, that things are just I believe you said "not okay," was the quote that stuck out to me when it comes to current management for kids and adults with Type One. And I point this out, because a lot of parents, including myself, you know, we try to stay positive as an example for our kids. I'm curious to know, why is it important for you not to put on those rose colored glasses?

Jeffrey Brewer 9:06
Well, I just think there's a lot of opportunity to do better. And I think that fundamentally today with people with Type One and their caregivers have an unreasonable burden to carry around on a daily basis. If you step back from it for a second and just thinking apart from Type 1 Diabetes, which you and I know too well and, and and thinking apart from insulin, if you imagine a world where a person is diagnosed with a life-threatening disease, and then they're told, "Here's the drug which will keep you alive. You need to take it every day. But you need to take it in amounts that are going to be varying based on all these different factors you need to track in your life, measuring food, nutrition, measuring your exercise, your stress level, measuring all the different aspects of your environment which might influence the operation of your metabolism and by the way, don't take too much of it as you could kill yourself and render yourself in need of aid, at least in a hypoglycemic episode, or if you take too little over over time, you're going to have all sorts of nasty long-term complications with a macrovascular or microvascular variety. And by the way, you're going to do all this by seeing a doctor four times a year for maybe 45 minutes." That sounds like that sounds like a completely unreasonable request of your average person, or of any person, I would say. And yet it is what people with Type 1 Diabetes are asked to do every day, and it doesn't work well, it doesn't work well for them in terms of the quality of their lives, they have to turn over this massive amount of emotional and cognitive bandwidth to living with this disease. And even when they do, there are adverse outcomes all the time, people ending up in emergency rooms, and my own son spent a couple days in the ICU from an hypoglycemic episode that almost killed him. And so people work hard, they still are not doing well. And the system is not working to really alleviate this burden. So when I say it's not okay, that's what I mean. And I really think that we have to focus on the now and doing better today, on the way to the cure. It's not an either/or for me, it's and and both.

Stacey Simms 11:26
Speaking of that, and and both, you know, I am, as you were, very involved in JDRF. And I'm curious, just your take, having left that organization now, are you going to be working with them on this mission? Or do you think they have an important role to still play?

Jeffrey Brewer 11:43
Absolutely. JDRF is an indispensable organization, because they bring the perspective of the person with Type One Diabetes, and the people who love those people with Type One. In interactions with the government, for instance, critically important in terms of driving Type 1 Diabetes research dollars, critically important in terms of working with the Food and Drug Administration in order to make sure that there are very sound and justified policies for regulating, for instance, medical devices and artificial pancreas technologies, working with the government in terms of the government's component of healthcare spending, through Medicare and Medicaid, to make sure that the therapies which are going to really have an opportunity to change people's lives are reimbursed. And so JDRF is a key partner for any of the players in the community, whether they be in the academic world, doing research, whether they be an industry world like Bigfoot, developing solutions, which we intend to bring to market, working with the doctors themselves who are going to deliver these solutions. I see us as part of a broader community of which JDRF is sort of the orchestrator.

Stacey Simms 12:54
After all this time of being a parent of a child with Type One, and now an adult child with Type One, what drives you crazy, what's frustrating for you? I can give you some examples for me, but I'm just curious, is it the technology? Is it the lag time and things seeing things come to market? Is it just how many healthcare providers still don't seem to understand the basics?

Jeffrey Brewer 13:13
Well, I guess what drives me most crazy as somebody who comes out of the internet space, and is very heavy user of technology, you know, I pick up my smartphone, and I can contact people that I haven't seen in 20 years through Facebook, instantaneously; I can press a button and have a car show up and take me anywhere I want within three minutes, I can look up any information that I want about our business and our customers and our relationships. And yet, if I'm looking for advice, or help on self-dosing this dangerous drug called insulin, I'm completely and totally disconnected from the rest of the world. And that just seems crazy. We are using our smartphones as the entry point to a wide universe of services that will help improve our lives and convenience and keep us safe. And yet for the biggest challenge that the people with Type One have in their lives, this need to regulate the delivery of insulin in a safe and effective way and basically, keep safe and healthy. The phone is of no use. And that's just crazy.

Stacey Simms 14:26
How would you change that? Is that a question of being more connected with endocrinologists? Is it a question of better apps? Is it a question of better, you know, patient-provided information?

Jeffrey Brewer 14:34
Well, I think it's a question all of the above. The world's changing now to where, you know, it's not so much about the device. It's more about the connectivity that we have through these devices. I really think you have to take a very customer-focused point of view and say, you know, I have this great platform. I'm basically available to this person as a resource. I'm through their smartphone walking around with them all day long. And I have a connectivity to the broader world in the background and can do so much to help them with the decision making they make across the day, either through recommendations and support that can be provided today through that cell phone, and ultimately, through directly to the devices themselves that deliver that drug called insulin. Starting to change the perspective for how we build businesses to meet these needs, I think is the first step and really getting away from the devices and thinking more about the ecosystem and that connected world that we are now part of.

Stacey Simms 15:37
My guest today is the CEO of Bigfoot Biomedical and the former head of JDRF, Jeffrey Brewer. And I'm curious what the reaction has been from where you sit to Bigfoot Biomedical because I know a lot of people are excited, especially to hear who's involved with this in terms of, you know, Bigfoot himself, Ryan Mazlish. You don't call him that around the office, do you?

Jeffrey Brewer 16:01
Jokingly! He jokes and his wife jokes that they've become the Bigfoot family. But I suppose there are worse things you could be. I think we are qualitatively different in a very meaningful way. And that we are in our DNA, it is an understanding of Type 1 Diabetes that you don't have in most companies. So, we are eight people now, eight full time employees in this company. And not that we have an affirmative action policy for people affected by Type One, but four of us are parents of a child with Type One Diabetes, three others have Type One Diabetes themselves. And these are top quality people who share the passion for our mission, as well as being outstanding domain experts in the area where they're working. I think we're uniquely positioned to understand the community and what's important to the people who live with this disease and the challenges of living well with this disease in the current healthcare system. And I think that gives us a unique advantage and we plan to stay true to that.

Stacey Simms 17:15
What would you consider success in, you know, a year or two years from Bigfoot Biomedical?

Jeffrey Brewer 17:21
Well, we have a long term plan. A long term plan is that you're essentially going to have a portfolio of services that's going to help you live with this disease, down to the actual gadgets that you carried around with you that are going to be as automated as they can be in terms of protecting you from hypoglycemia, and hyperglycemia. And requiring as little from you as a person with Type One Diabetes to manage the disease on a daily basis, as is possible. So we basically went overtime outsource all the work worry and burden of living with Type One, we're going to do that in a staged way, some of the things we're going to do are going to be in the context of a smartphone app. That might be something we could offer in six months, some might have regulatory oversight, and therefore have some mature of interaction with the FDA and some clinical trials. And then some are going to actually be medical devices, like we talked about, that will actually deliver automated insulin delivery. And that's got the longest term time horizon because that needs to go through a development process, through clinical trials, and a regulatory review period that is appropriate for our system on which people's lives are going to depend.

Stacey Simms 18:35
Yeah.

Jeffrey Brewer 18:36
We're going to see a cascade of help that's going to be coming soon. And we're building a service company to deliver the service that have improved the quality of life with Type 1 Diabetes, and there are going to be a bunch of components to that over time without being too specific.

Stacey Simms 18:50
You and I have been living in our families with Type One for quite some time, you longer than me, it's been eight years for us. But what do you tell newly diagnosed families? I hope there are some listening now, you know, hang in there, it's all these horrible things. What do you tell newly diagnosed families?

Jeffrey Brewer 19:07
Well, I tell them that there are some amazing developments on the horizon, some of which are very close and are well within the range of industry and things like Bigfoot is doing in terms of using technology and automation and connectivity to support people in the administration of this dangerous drug, to try and automate that process of life with Type 1 Diabetes, that life's gonna look a whole lot different and a whole lot safer for people in the very near future. I think also on the longer time horizon, there are going to be opportunities to prevent this disease from happening and people who are highly at risk. I do expect that to see, expect to see, that development in the meaningful adult years in my son's life. And I do think that one day, we will cure this disease. But it's going to be a process. And it's going to be a series of accomplishments along the way that are going to decrease the burden of the disease up until the point it goes away. But it's not going to happen all at once. But the good news is that we're on that path and people are going to see a return on it very soon.

Stacey Simms 20:20
Well, thank you so much for joining me. It's been great to talk to you. Jeffrey Brewer, the CEO of the new Bigfoot Biomedical. Thanks for spending some time with me.

Jeffrey Brewer 20:29
Thank you. It was a pleasure.

Announcer 20:33
You're listening to Diabetes Connections with Stacey Simms.

Stacey Simms 20:38
I love hearing the everyday stories of Diabetes Connections. Because you know, they're not really an everyday occurrence. You kind of get that weird feeling when you see somebody with an insulin pump or checking blood sugar. Excited, like, "Hey, you know, one of us," but also you don't want to be that weirdo. You know, don't be creepy and overshare. Not that I have a personal experience with that. But my community connection this week is from Texas, where a family faced a daunting task, a homeschooled child, now a teen in public school, traveling for a robotics competition to a different state 12 hours away for a week.

Speaker 2 21:13
My name is Jennifer. And my daughter's name is Ashley. And she was diagnosed when she was nine years old. She's now 15 years old, we were prepared to deal with you know, a certain amount of hours at first, and then she ended up winning. So we didn't expect that, this was a big leap for us. No one was really trained at the school, they had the bare minimum down, as far as diabetes care, which really is all we asked for. And there wasn't a nurse going on this trip. It was all the responsibility was going to be on her. Which really meant it was on us to prepare her for the trip. So she could do her own diabetes care.

Stacey Simms 21:52
That's great. Now was she, it's got to be that dual emotion of "Yay, she won and she's going to Iowa!" to "Oh, she won. She's going to Iowa." How far is that from you?

Speaker 2 22:01
It was actually 12 hour trip.

Stacey Simms 22:04
Wow. And what was her attitude? Did she really want to go? Was she nervous though?

Speaker 2 22:10
She actually had to be convinced to go, she really really wanted to go, but she was kind of afraid because she had never been that far apart from us or anyone that was really trained in diabetes care, she knew that the responsibility, responsibility was all going to be on her. So that was new. And it was scary to her. But I've been talking to a group of diabetes parents online, and they really encouraged me to make it something that she could follow through with. So I was looking through all her care plans and all this other stuff. And I knew that she could do this. She takes care of herself when I'm on her. You know, when I tell her after you remember to do this. "I know Mom, I know." So I'm gonna put all those "I knows" to the test.

Stacey Simms 22:56
Fantastic. But what I love too was there was this connection in the middle of, really at the start of it, how did she figure out? Tell us what happened and how she figured it out.

Speaker 2 23:05
It was actually, yeah, it was actually on day two, which I was really glad about was on day two. She texted me and you know, I could hear the excitement even in the text. She's like, "Mommy, announcer has Type One. And I'm like, "Are you kidding me?" I said, "How do you know?" She says, "You know, I was kind of sitting near him and I saw him announcing and I spotted a pump." And she was like, "Oh my god, one of me!" So, after he was done announcing everything and she goes, "Hey!" with a cool demeanor, "Hey, are you diabetic?" And he was like, he didn't miss a beat. She said he just like "Yeah!" and he pulled out a pump right away. So I guess he assumed you know, she knew that she had seen the pump. And he was excited too. I expected him to be older and she showed me a picture because I'm like, "Oh my god, go take a picture with him!" You know, cuz I'm the mom and all, I need stuff like that to show off. And he was like, he was probably 17 or 18 years old. So that was kind of surprising. But, you know, she made that connection. I'm glad it was on day two, though, because on day one, she knew she was still on her own with her diabetes care and everything. And I think that if she had known that there was another diabetic there on day one, she would have felt like she had some kind of safety backup, if that makes sense.

Stacey Simms 24:25
Yeah.

Speaker 2 24:26
Yeah, I want her to still know that she did everything on her own and didn't have that person, oh, just in case I screw up.

Stacey Simms 24:33
What do you think, I know his parents, and I'll ask you this as a parent in a moment, but what do you think for your daughter when she met another person with diabetes with a pump? You know, they're at this big competition. What was that? Why was she so excited? What do you think she was thinking, if you can speak for her?

Speaker 2 24:49
Yes, funny cuz she's tried to describe it to other people. She can't even do that. It's just kind of camaraderie. I don't know. I mean, knowing that someone experiences the stuff she goes through, we can say, as parents, "I understand you feel that way, I understand diabetes," but we don't. I mean, we're on the outside of her body, she, they have the inner turmoil going on at certain times, when they have the high or low and they're having to think cognitively what to do. I mean, they do a great job and everything, but you know, that's gonna be a whole different kind of thinking process going on. So I don't know, maybe just having those inner feelings of knowing that their experience was going on in the inside.

Stacey Simms 25:28
Yeah, that's a great point.

Speaker 2 25:29
We can't relate to that.

Stacey Simms 25:30
And what did it mean to you when you got that text?

Speaker 2 25:34
I was excited for her. I mean, I really was just that she stopped that connection for something so personal for her so far away from home. I mean, I don't think she could have had that feeling replicated in any other way than meeting a fellow diabetic.

Stacey Simms 25:49
So how did it go? I mean, I know she didn't win or anything, but was a good experience overall?

Speaker 2 25:54
You know, Ashley is very passionate person and she's very emotional. I mean, plus she's a teen. And the team did not do well at all. They actually came in like 75th out of 84th. But you know, it was the first time they ever had a girls team in the school. And the girls team actually beat the boys team to make it to Nationals. So that was pretty cool. I thought for sure that she was gonna be heartbroken and just very negative when she came home. But between meeting the fellow diabetic and she had a really big sense of accomplishment, taking care of herself. She won't admit it all the way, she kind of says to me, "Well, Mom, I knew I could do it." I was kind of like, "Haha," but she felt the independence. For now she's looking forward to more for future without fear. She was actually looking at apartments in Austin the other day. "Like Ashley, you're 15. Calm down, slow down. You made it a week, okay?" o it was all that it was also a good segue into, you know, we're gonna have to talk actually, "You did fantastic. Taking care of yourself, your short term and everything. Let's kind of go over, you know, long term stuff. As far as you know, you were high for the week, which I totally, you know, I totally get I'm not upset at all, let's kind of look at how they, you know, go more into the diabetes care." So, and she was all for it, because now that she got to take the independence without having to pay bills. She's really wanting more of it. And I mean, that's, that's all I can ask for. I was, I think it was great experience for both of us. I had to let go of control. And that was very hard.

Announcer 27:35
You're listening to Diabetes Connections with Stacey Simms.

Stacey Simms 27:40
You know, this week, I was asked by somebody, what can we do to get our child with diabetes ready to go to school in the fall? Ready to go to kindergarten? Such a great question. You know, at that age, the parents are doing most of the readying, right? You're meeting with school, you're filling out all the paperwork, but they were asking, what can they do now? You know, what can they do in the weeks leading up to school to make sure it's a good experience? Well, Benny was diagnosed before he turned two, my son, and when he started kindergarten, so we were already almost four years into our diabetes management. So he knew a lot of the basics of care, he could do a lot of the care, but you know, you're not gonna let a five year old take on all of that responsibility. But certainly, he knew that low meant he needed sugar, high meant he needed insulin, and he knew how to check his blood sugar and use his pump, that sort of thing. So we were more concerned with how much the school knew, and what they were willing to do, or you know, prepared to do. And he at the time was the only child at the Type 1 Diabetes in the school. So yes, you're going to want to have your 504 plan. And by the way, 504 is a plan that is developed to meet the requirements of federal law, the law that prohibits discrimination against people with disabilities, it's actually section 504 of the Rehabilitation Act of 1973. And that's why we call it a section 504 or a 504. And it means that the school is going to take this action that you all agree on to make sure the child is medically safe, has the same access to education, is treated fairly. I have more information on 504 plans and examples at Diabetes-connections.com. So you can find out more there. But I do think the most important thing your child needs for school isn't exactly diabetes-related. You want to teach your child to speak up politely, respectfully, but to speak up when they need assistance. If your child doesn't feel well, you want to make sure that she understands it's okay, in the middle of reading or in the middle of gym or in the middle of lunch to raise her hand and say, I need, whether it's I need to check, I need to go to the bathroom, I need a drink of water, I'm not sure what I need, but to not be afraid or worried about that extra attention. Frankly, my kids didn't really need any extra instruction in this regard, we did work on the politely and respectfully. But I was never really worried about my son going to school because I knew that if he needed something, he would raise his hand and he would speak up. And he would, politely I hope, push for himself. But I do think that's important. There are some very shy kids who don't want anybody looking at them, they don't want the extra attention. They especially don't want diabetes to get any extra attention. So is there a way that you can maybe roleplay with your child this summer, maybe there's a way to talk to the teacher and the administration in the fall, and figure out a system where your very shy child can get that attention, and not feel like they're making a fuss, because really, that's all that's important, in my opinion, at this age with diabetes. If you're five years old, somebody should be watching you at all times, whether you have allergies, or asthma, whatever, everybody's got something. So as long as they care, and they're paying attention, your child will be okay if they are able to speak up. So to me, I think that's incredibly important. Now, of course, I also recommend that you have all the supplies that you need at the nurse's office and in the classroom, and maybe a little something extra gym. If your child's not changing classes, that's a little bit easier to work out. I also recommend that you go to school and read a story or talk about diabetes. Kids today are exposed to so many health issues that we didn't even think about. Allergies, ADHD, autism, my kids knew more about this stuff in second grade than I did as an adult. I wouldn't worry about making a fuss or extra tension, you know, you are educating and the teachers appreciate it. The younger the class, the simpler, read a story. Just talk a little bit, maybe show the insulin pen or the pump and explain what's going on. I actually send a letter home, well, I get an email home to parents, here's what your child learned today, they may come home and have questions. Here's what we discussed. And I can certainly post that, along with this podcast this week if you want to take a look at what I sent home. School is not going to be perfect. And that's okay. But taking these steps, I think makes it easier on you and on your child. My kids knew, as I said that if they spoke up, and they were polite, that I would have their back. They knew that I would back them up, diabetes or not. If they stood up for themselves, if they felt it was necessary, in a respectful way. So my advice is to work on that this summer, you might feel a little silly, but you know kids love to play school, especially kids going into kindergarten. So I would talk, if you can, talk to your school first and my school wouldn't let us contact or talk to the teacher until four days before school started in kindergarten. It was a little stressful, but it worked out just fine once I was able to actually sit and meet with her. It really did work out a lot better than I had anticipated. And boy was I nervous that summer. But if you can sit with your child and roleplay some of this stuff, it'll make it a lot easier when that first day of school comes around. Thanks for joining me for another week. This is Diabetes Connections. I'm Stacey Simms.

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