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Welcome back to the Bad Diabetic Club. In case we haven't met, I'm Maddie Schieber. And in the last episode, we covered two things. Why none of this is your fault and why blood sugar does what it does. The glucose, the insulin momentum, the dawn phenomenon, why the 2 a.m. spike is almost never random. And today I wanna show you two more things. First, why the system works the way it does and why the advice you've been getting isn't actually designed to help you.
And second, what becomes possible when you finally get the education you actually deserve and you understand your blood sugar? So I'm gonna start with a story. One that kind of made me furious at the time and now I'm genuinely grateful for, but it's the reason I am doing everything I do because it was a lot. So early in my T-windy journey, I had a provider who told me to adjust my
home settings every few weeks. So maybe I'll back up before then. I was newly a college student and I went to my endocrinologist there. That endo was the only one within an hour and a half radius. So was like, okay, I gotta go. So that's who I went to. At least the only one covered by my insurance. And the first year was fine. And then it was like January, I think of my, either my freshman or sophomore year.
He was like, hey, every two weeks I want you to set an alarm in your report. You need to be fine tuning some things. So set an alarm in your phone and then download your reports and then make some adjustments and then we'll see how that goes. And that's all he told me. He didn't teach me how to do it. He didn't teach me the why, the what, the whatever. So I was like, okay, I'll figure it out. And of course, me being me, I did.
Over the next year, I taught myself every other week I was reading. I mean, more than every other week, but in between the weeks I was reading everything I could find, learning nutrition, experimenting, adjusting, and I was trying to figure out settings. I was trying to figure out systems. And truthfully, over that year, my time and range improved and my average got better and my standard deviation was lower. And I was making real progress for the first time in a long time since...
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Basically like my first progress was getting diagnosed, getting that in control. Second progress was from manual injections to insula, or actually CGM, introducing the CGM. And then a year later introducing the pump. And then at that point I was kind of hanging out like high sevens, low eights when my doctor was like, figure it out, change your settings. And so I did. So every two weeks, three year, I changed my settings in my insulin pump. was on a Tannam T-Slim X2 at the time. was before.
Control IQ existed. So it was still like manual, but it was me figuring it out. So like I said, all my numbers got better. And in fact, my A1C was better than ever. I had to get my A1C done before going in. So I knew that it was better before I went to that next appointment. So I went to that appointment and I had these visions of like, this man was gonna praise me for how awesome I was. Like I said, I was stuck like high sevens and then now I was all of a sudden low sixes.
and without having a bunch of lows. And so, when I went to the office, was like, he's gonna tell me how awesome I am, what a great job I've done, da da. So I'm sitting in his office and he's looking through my palm, but he's kinda quiet. He's like looking through things, kinda more in-depth than usual. And he was like, I see like a lot of shifts happening, what's happening? And I was like, every two weeks, I'd have an alarm on my phone, I go in, I analyze, I check my systems, da da da da da da. Like I explain, you know, I was like.
Good, he excited. And I walked him through it and I showed him and he looked at me and he said, I need you to stop.
That right there, I put my hands up immediately. I'm not that confrontational, let's be real, like in person, I'm not that confrontational ever, but I said, I'm gonna stop you right there. You told me that you wanted me a year ago to do this, to change my settings every two weeks and analyze my reports, so if you wanna take back what you said, you can.
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Otherwise, my blood sugar A1C in control is so much better, no thanks to you." And I was pointing in his face. I feel a little bad about that. And he just kind of was shocked, because this like 19 year old girl was, you know, talking at him. And he was like...
Okay, well fine, then carry on. And I basically was like, hey, I don't want a personal relationship past this. have to see you because you're my provider. Don't ask me about my life. I don't want to know about yours. I was really upset. I was so upset. And looking back, I wish we could have laughed about it together and grown a good relationship, but it never happened. So I want to be clear about what did happen in that appointment. My A1C was better than it had ever been. My approach was working.
and my medical professional told me to stop doing things that were actually working with Zero Alternative Offered. And maybe it's because I stopped, you know, I called them out right there and I was like, if you want me to stop, fine, but my numbers are better than ever. No thanks to you. And I left that appointment, I remember leaving furious. And I decided if no one is gonna teach me and if I'm gonna get in trouble for doing it myself, I will teach myself. And then I will make sure no one else has to do this alone. And that decision...
is why I do what I do today specifically in diabetes. I was already on track to become a dietician, but that is why I do diabetes education for T1D. That's why this podcast exists. That's why the Bad Diabetic Academy exists. The link is in the show notes. It came directly from that moment. And here's what I need you to understand. Unfortunately, that provider wasn't a one-off. That's not the only time that that's happened. That 15-minute appointment was not unique.
The eat less carbs advice isn't a one off. That's not one bad doctor. This is a structural problem, a systemic problem. you deserve, sorry words are hard, you deserve to understand why that happens, why that exists. And you deserve to have great blood sugar and not be blamed for it. That was ridiculous. I should not have been given those words. But thankfully I stood up for myself.
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And want to be clear here, endocrinologists are not the enemy. Most of them went to medicine because they genuinely want to help people. So the problem is structural. It's not personal. I think that provider is probably a great human being. It's been many years since. But a T1D patient gets on average like three or four 15-minute appointments per year. It's roughly an hour of FaceTime to cover your A1C, your medications, your labs, your pump, your CGM settings, your complications, your concerns.
the 50 million different things that impact blood sugar and whatever else has happened in your life since the last time they saw you. And in that collective hour or so, there is simply not enough time to explain why you spike after breakfast specifically or how to actually test your carb ratio instead of guessing or why insulin timing is what it is, does what it does, and what it means for real meals when you eat with your real life. It's not a complaint.
about an individual provider, although I did feel very personally attacked for years. It's just math, it's numbers. It's a system designed around acute care and prescriptions, not around sustained personalized ongoing education growth and support that managing T1D actually requires. And most diabetes education in this country is still built primarily around T2D. It's generics of insulin.
Oftentimes if you're diagnosed as an adult as well, you might've been misdiagnosed with type two. It's not designed for us. We are the niche population. So you've been trying to use a tool that wasn't built for your specific situation and then you're getting blamed for the gaps and that's not fair and that's not okay. Real education is understanding the why, not just the what. Take your insulin before you eat, but...
why that timing matters and what happens in your body when it's off and how to adjust it if it's not working. Not eat less carbs, but what carbohydrates actually do in your bloodstream and your digestive system and how different meals interact with insulin differently. Real education teaches you how to look at your own data and understand what you are seeing, not just being handed a report at an appointment, actually understanding what the patterns mean and what to do about them. Being able to sit with your CGM and say, okay,
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I know why that happened and here's what I'm gonna do different. Real education gives you the tools to troubleshoot and to know what to do next. Because your body changes, your life changes, your day to day is gonna be different, your insulin needs change. Real education gives you the understanding to adapt instead of just waiting for your next appointment, now hoping someone notices something in the numbers. And this is genuinely my goal with every single person I work with. Eventually,
I don't want you to have to name me for anything other than a second opinion if you want it or to be diabetes, but you become your own expert. You understand your body. The endo is honestly just there for prescriptions at a certain point. Everything else, you are so competent, capable, and educated that you've got it and you know you've got it. And I want to show you what this looks like in real life because I think the thing that most people don't make changes or the reason why it isn't...
because they don't want to, it's because they don't believe it's actually possible for them or they have the end of it's like, you're not allowed to make any changes every time you make your appointments and then, you know, they get blamed. So one of my clients for confidentiality, I'll call her A. A came to me with an A1C of 10 and a half. She had been living with T1B for years, doing everything she'd been told to do, of course, and she was scared of her own insulin. So that's why she was running high.
She'd been burned so many times by going low that she would run herself high on purpose because high felt predictable, high felt safe in a way that lows didn't. Now though, because of our work together, her A1C is a 6.1. And when I tell you her endo's jaw dropped, or at least that's what I heard, she was so excited and she told me, and I think about this all the time, she said that she finally...
trusted herself to manage it. Not the number, the trust, the confidence. That was the transformation. And I think about another client, he's a shift worker, eating at 4 a.m. sometimes, cereal at 11 p.m. He's not living a textbook diabetes lifestyle or like a typical nine to five, and I don't know if he'll ever be, but that's his real life.
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But now he knows the map, he knows his body and what it does with certain foods and he actually eats on a schedule and even though the schedule varies every day, his time and range has hit over 70 % for the first time in years, higher than he ever expected to see in his own words. And there's so much more shared language with his significant other around diabetes management for the first time ever. And this is not a story about restriction.
We have a lot of fun with the foods we're eating there and those conversations let me tell ya, it's not about restriction, it's about strategy. And then I had a client who ate donuts at a hotel breakfast during a work trip and still managed 88 % time and range that day. And if you've been living under the advice that certain foods are simply off limit, I need you to hear that again. Donuts, 88 % time and range, not magic, strategy, insulin strategy.
Nutrition strategy and to be honest, I eat pizza all the time I had pizza last week and still had wonderful blood sugar and I don't say that to flex I say it because I spent years convinced that pizza was not something I was allowed to eat and if you listen to my last episode you know that and I need you to know that that doesn't have to be your truth in case you feel like pizzas off limits to I eat it and I can keep my blood sugar between 100 to 200 for the next eight hours that to me
is worth it. So the numbers matter. But I want to talk about what changes emotionally when blood sugar finally makes sense because I think this is the part that we don't get to talk about enough. So one of my clients came to me with like the overwhelm of data, tracking overwhelm. She wanted to quit. In one session, she genuinely went from screw it, I hate diabetes to okay, maybe I feel better and can manage things.
All it took was one session, one conversation. We figured it out together. I have another client whose whole family has been living with CGM alarm anxiety for years. It's mom, it's dad, it's daughter, it's all together, it's stressed all the time, it's ruining sleep, it's stressful after school, there's work involved, there's so many things, but when they finally understood how to read their reports and make sense of the data.
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Mom said, it just made me grateful for our time with you. And that's paraphrasing, but they know how to read their reports now and the alarms are quieter. Why? Because they happen less. It's not because the numbers magically changed. They don't magically change overnight, but because the fear of the unknown got smaller and our education and knowledge and capabilities got bigger. That is what it looks like when we actually do the work. It's not about perfect lecture.
It's not about being afraid anymore. And again, what is why I built the Bad Diabetic Academy? Because I have never seen a resource that actually does all of this for T1 adults. Not a textbook, not a class, not a Facebook group, not a meal plan. The Academy is a complete foundation for managing T1D the way it deserves to be managed, the way we deserve to be treated, the why behind blood sugar, insulin timing, how to understand your CGM data.
how to think about food and strategy instead of restriction, how to handle highs without rage-bolusing, how to treat lows without rebounding, exercise stress, 42 million factors, all of it taught by someone who has clinical credentials and has been living with T1D since middle school and uses these strategies every single day. That's me. And I want you to know the doors are opening literally this week to the Bad Diabetic Academy. The wait list is live right now.
The link is in the show notes. And if you join the wait list, you will be the first to know when enrollment opens. So I want you to find me online. I'll send you details directly if the link below for some reason isn't working for you. But I wanna close with something that keeps coming back to me across, both of these episodes. If you missed the last one, you should listen to it too. But you are not a bad diabetic. You've never been a bad diabetic. That's why I named this podcast and named my program.
diabetic club and academy. Because we're not, we're breaking that stigma. You've been a person with a complex, demanding, lifelong chronic disease trying to navigate it without real help, real support, the map that you need. But that map exists. The education exists, the strategy exists. You don't have to access it alone. You don't have to figure it out alone. That's what I'm here to change. And I want to see you inside the academy. So with that.
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Thank you for listening and I'll see you all next time.
