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If you’ve ever eaten a carb-heavy lunch and watched your glucose climb for the rest of the afternoon, this episode is for you. Rob sits down with Lauren Turner, a PhD candidate in Dr. Michael Riddell’s lab at York University in Toronto. She has lived with type 1 diabetes for seven years and has her name on 36 research publications on T1D and exercise. Her research on post-prandial walking started with a simple habit: 20-minute walks around the block after dinner with her dad and their dog. Lauren explains the science of why moving your body brings glucose down, even without extra insulin. She covers muscle acting as a “glucose sink,” why just three minutes of movement every 30 minutes can improve time in range by 14%, and why walking after a meal can cut post-meal spikes without causing lows. She also explains why that afternoon walk can still affect your numbers 24 to 48 hours later. Rob and Lauren also question some older advice. They talk about the outdated rule against exercising above 250 mg/dL and why the insulin on board shown on your pump is only an estimate. They share their personal thresholds for when to start moving, and a study finding that 10 to 30 minutes of activity gives an 83% chance of getting back in range in under an hour. Whether you’re a hybrid athlete or someone who finds 150 minutes a week overwhelming, you’ll come away with practical options: exercise snacks, stair climbing, the talk test for intensity, and a reminder that any movement counts. Resources: Lauren Turner’s thesis, The Timing of Walking and Post-Meal Blood Sugar Levels in Adults with Type 1 Diabetes (YorkSpace): https://yorkspace.library.yorku.ca/items/45a24ad2-b616-4d16-a1f8-c8cc7bbf79f3

Rachael Stickles started The Chronically Illest because, as Rob puts it, diabetes had absolutely no swag. People with diabetes get beige meter cases and T-shirts that don’t inspire daily wear. Rachael wanted to change that. So she and her partner turned their studio apartment into a workshop and taught themselves how to make stickers, screen printing, and web design, all while working full-time jobs. Her partner asked "So what have you done on the business this week?" every single Sunday until it became a reality. Now, this year it's Rachael's full-time work. Getting there wasn't the glossy quit-your-job story. Diagnosed with type 1 at twelve, Rachael spent her teens and college years sneaking food, skipping doses, and taking just enough insulin to get by. She thought she was the only one, until she posted about it and hundreds of people replied: me too. As an adult she always held at least one job just for the insurance, and in this episode she's honest about what finally let her leave her corporate role. Rob and Rachael also push back on the "you can do anything with diabetes" message. You can, Rachael says, but often with extra steps, and being honest about those steps matters. They get into finding community when you don't see yourself in the room. Rachael started posting online because she wanted to find people that looked like her and had similar experiences. Rachael is half-asian, half-white, and queer. She wanted to find the other T1D’s that were bolusing for rice! In this episode, we are redefining success away from A1Cs and follower counts, and explaining why a meetup with two people is still a meetup. If you've ever felt like the diabetes community was a room you couldn't quite fit into, this one's for you. Chapters 00:00 Rob introduces Rachael and The Chronically Illest 02:01 Twenty years with T1D, diagnosed at twelve 04:35 Skipped doses, DKA, and a secret shame 07:12 Why the teenage years hit hardest 09:40 Finding community online before the DOC existed 12:55 Why one connection is worth it 17:25 The Chronically Illest starts with zero swag 19:44 A studio apartment becomes a sticker workshop 21:44 Learning to say no as an entrepreneur 22:28 The myth of "diabetes can't stop you" 23:31 Insurance, partnership, and quitting the nine-to-five 31:34 How to keep your heart open in hell 34:46 Redefining success: A1C, followers, and money 39:15 Giving back through copay giveaways and picnics 42:08 Advice for anyone who doesn't fit the mold Resources: The Chronically Illest shop Instagram: @thechronicallyillest Instagram: @thechronicallyrachael

Peter Simpson has been at Dexcom for over 24 years, back when it was a small startup, and he says he's more excited about the technology now than at any point in that run. In this bonus tech episode, Dexcom's CTO walks us through the upcoming G8 sensor: about 50% smaller, plus a new in-use calibration system that checks itself every five minutes to account for the fact that every body is a little different. The goal isn't just a better average accuracy number. It's fewer of those nights where your sensor and your fingerstick seem to be describing two different people. We also dig into the landmark CONNECT study, just published in The New England Journal of Medicine, which found CGM use lowered A1C by 0.9% more than routine care for people with type 2 diabetes not on insulin. Peter shares a surprising finding about people already on GLP-1s, and what Dexcom's new State of Type 2 report says is really standing between people and better care: awareness, education, and access. Near the end, I ask Peter about the recent G7 app terms and conditions update that briefly kept some users from seeing their glucose data. He shares how future updates will roll out and answers questions about metadata and AI. There's more I wish I'd had time to ask, and if I get another conversation with Dexcom, you'll hear it here first. Chapters 01:22 Meet Dexcom CTO Peter Simpson 02:01 Why innovation is speeding up after 24 years 03:21 G8 preview: 50% smaller, more accurate 04:15 How factory calibration actually works 05:05 Real-time calibration that adapts to your body 06:03 MARD explained: fewer bad sensor outliers 07:15 Type 2 barriers: health and tech literacy 07:48 Inside Dexcom's State of Type 2 report 09:08 CONNECT study: CGM results without insulin 10:25 GLP-1s plus CGM: the biggest impact 11:38 Addressing the G7 terms and conditions 12:12 "We made an error": what changes now 13:15 Metadata, pump partners, and AI explained* 15:07 What's next for type 1 and type 2 Resources: The CONNECT Study published in The New England Journal of Medicine Dexcom

A lot of people think the $35 copay cap fixed insulin. For most of us, it didn't. In 2024, 36% of people responding to T1 International's out-of-pocket survey said they were rationing insulin, twice the rate in 2016. With midterms weeks away and the Insulin Act up in both the House and Senate, we brought in two people who have been in the room for this fight for years. Shaina Kasper, Executive Director of T1 International, returns to the show alongside first-time guest Kristen Whitney Daniels, who co-leads T1I's federal working group with Shaina. Both live with type 1, and both have rationed insulin themselves. Kristen walks through the Insulin Act in plain language: the difference between a copay cap and a true price cap, why the IRA only covered part of the Medicare market, and how the House and Senate versions differ. One of the biggest differences is only the Senate bill includes a pilot program for people without insurance, which is why T1 International endorsed the bill for the first time. From there, Kristen and Shaina explain exactly what to say when you call or email your representatives They explain why your personal story matters more than any statistic, and why 2026 is T1I's Year of Public Pharma: California's CalRx glargine at $55 for five pens, Connecticut's ArrayRx discount card, and a tribal nation studying generic manufacturing. We close on patent reform, maybe the least flashy but It's what gives public manufacturers and biosimilar makers the legal room to compete and bring prices down for the long haul. Diabetes is political, which means your story matters. Email your representatives about the Insulin Act, because your story could be the one that moves the right person. Chapters 00:00 Why the Insulin Act matters before midterms 04:20 How T1 International became a global movement 08:15 Copay cap vs. price cap, explained simply 11:47 Why people think insulin is already fixed 13:13 Who the Insulin Act helps and misses 14:33 Insulin rationing has doubled since 2016 16:12 Senate vs. House: the uninsured pilot program 18:29 Insurance gaps and the 2027 coverage squeeze 22:38 What lawmakers don't know about diabetes 25:53 Storytelling lessons from Magic Johnson 27:47 How to call or email Congress 31:54 Why 2026 is the Year of Public Pharma 34:08 Discount cards, GoodRx, and pharmacy closures 36:34 ArrayRx and a tribal-nation manufacturing study 39:07 Patent reform and the December 11 deadline Resources: T1 International: Take Action: Email your House rep and both senators about the Insulin Act 2025 Impact Report Start a Fundraiser CalRx Biosimilar Insulin Initiative ArrayRx discount card Donate to T1 International T1 International Access Survey: over 30% of people rationed insulin due to cost in 2024 ADA 2026 National Access and Affordability Survey: 41% rationed due to cost last year, and 2 in 3 reported higher out-of-pocket insulin costs in 2026 than in 2025 Health Affairs research: a quarter of adults with type 1 have experienced a lapse in insurance coverage KFF: Key Facts About the Uninsured Population

Leah Orleans shoots a bow and arrow with her toes, juggles fire, puts knives on her face, and performs around 300 shows a year as Tiny Girl Big Show. In her late twenties, in the middle of a tour, she landed in the ER with an A1C of 14. A few months later, a well-meaning doctor asked what other skills she had, and suggested she start looking for a desk job. She didn't. Instead, she got loud about it. Leah started writing comedy about diabetes (it turns out it's a genuinely funny word), performed a song called "Diabuddies" using a giant cardboard pancreas, and now when she asks "Who's diabetic?" from the stage, hands go up all over the crowd. We talk about the $2,000-a-month reality of living with type 1, how the logistics skills of a touring performer turned out to be life-saving, and why she has convinced food vendors near her stages to keep an insulin pen in their fridge for her. (They've never said no.) We also get into the Big Nonprofit Insulin Party happening in Brooklyn on Friday, October 23, benefiting Project Insulin, the nonprofit working to sell insulin at cost. And we land on a question I keep coming back to: what are you optimizing for? If you've ever been told to trade the life you want for the one that feels safe, this conversation is for you. Chapters 00:00 Welcome and meet Tiny Girl Big Show 03:01 From touring acrobat to an A1C of 14 05:26 Following your passion versus healthcare security 06:13 Turning a $2,000 monthly bill into logistics 07:31 Diabetics are everywhere, even at Ren Faires 08:57 Why "diabetes" is a hilarious word 10:25 Diabuddies and a giant cardboard pancreas 11:22 Health content doesn't have to be sterile 13:13 The Big Nonprofit Insulin Party in Brooklyn 14:24 Why Project Insulin's mission hits home 17:02 The doctor who said find a desk job 20:10 Advice: pick the problems you want to solve 22:43 Systems, habits, and insulin in strangers' fridges 24:12 What are you optimizing for? 28:25 Where to find Leah and her diabetes content Resources: Tiny Girl Big Show Website & Schedule Tiny Girl Big Show Instagram The Big (Non-Profit) Insulin Party Tickets Youtube Channel

When Aurelian Briner's wife was diagnosed with type 1 diabetes about twelve years ago, the hardest questions kept coming back to the plate: how many carbs are in this or how big is this portion? Aurelian, a product manager with a business background and an entrepreneurial itch, decided that was a problem worth solving. In 2017 he co-founded Snaq, and today the app has more than 300,000 registered users and around 20,000 monthly active users around the world. In this episode, Rob and Aurelian trace Snaq's evolution from a photo-based carb counter, to a platform that connects meals with CGM, pump and activity data, to the AI Nutritionist, a 24/7 companion built to help people reach their nutrition goals. They also dig into what it takes to bring AI into healthcare responsibly: fast product iteration on one side, slow and careful clinical validation on the other, and why both matter. Rob makes his case: he doesn't want your vibe-coded diabetes app. Not because building your own tools isn't exciting (it is), but because there's a huge gap between a weekend prototype and a product that's used, trusted and clinically backed. Aurelian breaks down Snaq's moat (users, data and clinical validation), shares an MIT finding that app releases roughly tripled while engagement stayed flat, and explains why building got easier for everyone while marketing got harder. Snaq's published RCT showing a 6.6% time-in-range improvement on top of AID systems, upcoming research on the AI Nutritionist versus standard of care, a US study on T1D pregnancy (one Aurelian's family lived firsthand), the shift from reactive apps to proactive AI agents, and the founder lesson Aurelian would give his younger self: it always takes longer than you think, so make sure you care enough to stay. Chapters: 00:00 Meet Aurelian Briner, CEO of Snaq 01:10 Why AI health tech changed in 2026 02:20 A wife's T1D diagnosis sparks Snaq 03:42 From carb counter to AI companion 05:10 Late-night questions and clinically safe AI 06:20 Build fast, iterate, then prove it clinically 08:09 Why insulin pumps lagged behind iPhones 09:26 Rob's case against vibe-coded diabetes apps 11:40 Snaq's moat: users, data, clinical validation 14:05 Triple the apps, flat engagement: MIT study 17:13 What users say about the AI Nutritionist 19:49 New research: 6.6% more time in range 21:05 Studying T1D pregnancy while living it 22:14 From reactive tools to proactive companions 24:50 Ten years in: lessons for founders Resources: Snaq.ai

At 15, Liz Van Voorhis landed in the ER on spring break with a blood sugar of 1,200. She weighed 78 pounds. She had two questions for the doctor. First, when could she get back to cheer conditioning? Second, did this mean she couldn't finish her Halloween candy? It was April. That mix of grit and humor is Liz Van Voorhis. Liz is an executive coach and founder of The Fit Collective. She has built wellness programs for brands like Equinox, Peloton, and Lululemon. She tells Rob about the 15-year corporate career she walked away from after losing her mom to brain cancer. She also talks about her "brain sabbatical" year teaching 15 spin classes a week, where her class quietly became a safe space for people with Type 1 all over New York. She explains the values exercise from 2004 that she still revisits every New Year's Eve (her birthday) to decide what gets her commitment. They also go back to the January 2025 LA fires. Liz used her retail-operations background to help organize more than 400 volunteers and get diabetes supplies to around 50 displaced families, which earned her the self-appointed title "diabetes drug dealer of Southern California." Along the way, Rob and Liz dig into several other topics: * Rob's thesis that diabetes doesn't get easier, but you get better at it * A million-dollar business loss * A prayer for financial abundance that was answered by a stolen car * Why "we are meaning-making beings" beats "everything happens for a reason" * Why Liz put off switching to Omnipod for years for purely vain reasons, and how much she regrets it If you've ever wondered whether you can build a big, beautiful life with or without type 1, this one's for you. Chapters: 00:00 Meet Liz and the Thailand retreat 01:38 How the 2015 diabetes Instagram connected us 03:13 Diagnosed at 15 with a 1,200 blood sugar 08:11 From church-basement aerobics to corporate career 11:41 Losing her mom and blowing up her life 13:00 Teaching spin and finding her T1D community 14:13 Alignment and the courage to walk away 15:45 The values exercise that changed everything 18:51 Organizing diabetes supplies during the LA fires 26:04 It doesn't get easier, you get better 30:09 Breakthroughs, a $1M loss, and a stolen car 35:19 Meaning-making vs. "everything happens for a reason" 36:44 Identity, basketball camps, and embracing who you are 38:42 Tuning out the noise and never drinking 43:29 Omnipod, Dexcom, and getting over vanity Resources: 1. The Fit Collective 2. Liz Van Voorhis Instagram

Rob sits down with a rare three-person interview: Danica Doble (@type1deeabetes) and her partner Lucas, who both live with type 1 diabetes. Their story starts with a genuinely wild diagnosis arc. Lucas was told he had type 2 diabetes, put on metformin, and left to figure it out on his own for over a year. It wasn't a doctor who caught the mistake. It was Danica, watching his Dexcom numbers from the outside and refusing to let it go until he got a GAD antibody test. She was right. The conversation moves from that misdiagnosis story into what it's actually like to build a life and a relationship around two people managing the same disease. They talk about pre-bolusing habits rubbing off on each other, supply emergencies solved by sharing pods, and the strange comfort of dating someone who doesn't need diabetes explained to them. Danica also opens up about a year of debilitating fear around low blood sugar that came out of nowhere in 2022, how it shaped what she couldn't do, and how she worked her way back out of it. There's also a real look at Danica's path as a creator from a fitness account that hit 300K on TikTok to launching as its own page, growing to 60,000 Instagram followers in under a year, and running a six-week fitness challenge built specifically for the T1D community. She talks candidly about online hate, why she doesn't shy away from clapping back, and how she's learned to hold onto the good instead of fixating on the one negative comment. It's a funny, honest episode complete with the story of a PowerPoint presentation Danica made to teach Lucas about type 1 diabetes, a jiu jitsu sensor casualty count, and a love story that started at a casino. Press play for the full conversation. Chapters: 00:00 Cold open and guest introduction 01:20 Welcome and introductions from Danica and Lucas 02:18 Lucas's symptoms begin and the misdiagnosis story starts 04:36 ER visit ends with a type 2 diabetes diagnosis 06:37 Danica suspects type 1 and pushes for testing 08:47 GAD antibody test confirms type 1 diabetes 10:00 Onboarding to insulin and Danica's PowerPoint presentation 12:52 Danica's content creation origin story begins 16:48 Danica's year-long fear of low blood sugar 20:04 How diabetes shows up in their relationship 23:05 Inside Danica's six-week fitness challenge 25:31 Handling online hate and diabetes stigma 28:23 How they actually met: the casino night origin story 33:03 Closing reflections and advice for listeners 34:53 Jiu jitsu, sensor casualties, and daily management tips Resources: 1. Danica Doble Instagram 2. Danica Doble TikTok

Dave Holmes spent the late '90s and early 2000s as one of the faces of MTV, and these days he's a sharp, funny voice at Esquire — but before any of that, he spent six years being told he had type 2 diabetes when he actually had type 1. This week, Rob sits down with Dave to talk about that misdiagnosis, the strange cluster of friends who were diagnosed around the same time, and a diabetes-age chart Rob saw at a conference that will change how you think about who gets T1D. From there, the conversation turns into a real, unpolished look at what it takes to live a creative life. Dave and Rob are both working through Julia Cameron's The Artist's Way right now — morning pages, artist dates, and all — and they get honest about guilt, perfectionism, and the fear of putting out work that isn't ready. Dave, a professional writer with a book and a byline at one of the biggest magazines in the country, admits he still feels like a fraud turning in a rough draft. It's a good reminder that "getting easier" was never really the goal — getting better at the hard parts is. Along the way, Dave and Rob swap stories about the universe nudging you toward where you're supposed to be — a DJ gig that came out of nowhere, a stranger at a DVD store, a maintenance worker who turned out to also be living with diabetes. It's the kind of episode that starts as a diabetes story, turns into a conversation about creativity, and ends up being about paying attention to your life. And because no DDT episode is complete without some fun, Dave and Rob close it out with a segment they're calling the Bad Advice Song Draft — three rounds each of picking the most beloved songs with the absolute worst advice buried in the lyrics. Stalking anthems, teenage recklessness, and one song so ethically questionable that Kidz Bop wouldn't touch it. Tune in for all of it. Chapters: 00:00 Meet Dave Holmes: MTV VJ turned Esquire writer 02:52 Dave's six-year road to the right diagnosis 05:54 The surprising truth about T1D and age 07:13 How The Artist's Way found them both 08:37 Why Dave restarted the 12-week program now 12:48 Comparing morning page routines and habits 15:39 Getting unstuck: movement, walks, dumb writing 17:30 An artist date leads to an unplanned DJ gig 20:10 Beginner's mind and the fear of being filmed 21:09 Dave on perfectionism and feeling like a fraud 25:18 Resilience: "it doesn't get easier, you get better" 27:36 A screenwriter's ultimatum sparks Dave's fiction project 30:41 Meditation, synchronicity, and a DVD store coincidence 33:28 The ball-spinning experiment: "you can just do stuff" 38:05 Signs from Rob's dad, and a Disney parking-lot miracle 42:19 The Bad Advice Song Draft begins Resources: 1. The Artist's Way by Julia Cameron 2. Dave Holmes on Instagram 3. Dave Holmes at Esquire — his latest writing and pop culture commentary.

It's episode 450 of Diabetics Doing Things — a milestone Rob almost forgets to mention until he's three topics deep. Fresh off Friends for Life in Orlando, he lays out what he calls the diabetes conference pyramid: the industry side (ADA, ADCES, ATTD, EASD) built for HCPs and brand messaging, and the community side, where Friends for Life stands alone as the one event he'd choose if he could only pick one. He also previews the upcoming Diabetes Legends Dallas clinic and makes his now-recurring case for why kids with diabetes belong on a team. Then Rob shifts from the conference circuit to something he's been quietly building: a searchable AI archive of every Diabetics Doing Things episode — all 450 of them — that surfaces clips, timestamps, and quotes on demand. He walks through a live demo, asking it about diabetes and mental health and watching it pull exactly the right moments from years of the show's back catalog. It's his first real answer to a question he's been sitting with: what do you actually build for people with diabetes when you have this much lived experience and the tools to use it. The back half gets more personal. Rob is wrapping a 90-day clinical trial on an unreleased insulin pump algorithm — a strange experience in handing over control of his own management — and talks candidly about what "locking in" has looked like lately: earlier mornings, journaling, lower-carb meals without the guilt spiral, and a real 30-day discipline streak. He closes with an unguarded account of the Diabetes Sangha meditation retreat he attended this spring, why the "woo-woo" label doesn't scare him off, and a new mental health resource from Omnipod and Calm worth knowing about. If you're weighing whether diabetes conferences are worth your time, curious what an AI trained entirely on this show can actually do, or just want to hear someone talk honestly about discipline and burnout without the performance — this one's worth the full listen. Chapters 00:00 Episode 450 and fresh Friends for Life recap 02:22 Mapping the diabetes conference pyramid: industry side 05:41 Why Friends for Life beats every other conference 08:20 TCOID, Connected in Motion, and Camp Diabetes 11:07 Diabetes Legends Dallas and youth sports advocacy 14:41 Insulin Sensitivity Playbook recap and fan-favorite guests 17:02 Unveiling the DDT AI archive (live demo) 22:00 Personal update: the 90-day clinical trial 25:51 Locking in: mornings, journaling, and low-carb peace 28:21 Inside the Diabetes Sangha meditation retreat 30:52 Omnipod x Calm partnership and mental health resources 32:46 What's coming next and how to find Rob

Melissa Slemp has lived with type 1 diabetes for 44 years — since she was diagnosed in 1982, before glucometers, before CGMs, back when insulin came from vials and syringes and "boiling your needles" was still a recent memory for a lot of people. In this episode, she and Rob trace that whole arc: what early management actually looked like, the high-risk pregnancy she navigated in the 90s, and the moment — after more than four decades on injections — she finally switched to a pump. If you've ever wondered what it's like to hand over that much control after that much time, this is the conversation. But the real heart of this episode is the part almost nobody is talking about: what happens to blood sugar when a woman with type 1 diabetes hits perimenopause. Melissa walks through her own experience of watching her basal insulin needs climb for no obvious reason, the years she spent without an explanation, and what she eventually learned about estrogen, progesterone, and insulin resistance — knowledge she says she had to dig up herself, because most endocrinologists and OBGYNs simply aren't trained in the overlap. That research became the reason she wrote Highs, Lows, and Hormones, a survival guide for women navigating diabetes from their monthly cycle through menopause. Along the way, Rob and Melissa get into hormone replacement therapy, why so many women blame themselves before they ever think to blame their hormones, and the bigger pattern underneath it all: how much of diabetes research and care has historically centered men, and what it costs women when it does. There's also a genuinely great story about how Melissa met her husband, who also lives with type 1 — on the side of the road, of all places. This one's for anyone managing type 1 diabetes as a woman, anyone who loves someone who is, or anyone who's ever felt like their body changed the rules without telling them why. Chapters * 00:00 — Cold open and introducing Melissa Slemp * 01:21 — Welcome, and 44 years living with type 1 diabetes * 02:24 — Diagnosed in 1982, before glucometers existed * 04:03 — Reframing: the best and hardest time to have diabetes * 04:59 — Growing up rural with limited access to healthcare * 07:09 — Early management: injections, mixed insulin, urine strips * 07:46 — A high-risk pregnancy in the 90s * 08:13 — Switching to a pump after 40+ years on injections * 10:24 — How Melissa met her husband, also living with T1D * 13:06 — Introducing the hormone and diabetes connection * 20:14 — Rising basal needs and insulin resistance in perimenopause * 25:25 — Community stories and menopause's hidden career toll * 29:44 — The gender gap in diabetes research * 33:04 — Hormones, GLP-1s, and insulin as hormone therapy * 36:03 — Advocating for yourself with doctors and specialists

Rob was at ADA 2026 in spirit — armed with press access and a list of questions unrelated to the usual conference talking points. His first guest from that coverage is Jake Leach, Dexcom's new CEO, who took over the role on January 1st after 22 years at the company. This is Jake's first time on Diabetics Doing Things as CEO. It sounds like two people having a real conversation about what it means to lead a company that millions of people with diabetes depend on every single day. They get into the research that came out of this year's scientific sessions — specifically, the CONNECT trial, a global randomized controlled study that examined what happens when people with type 2 diabetes who aren't using insulin start using the Dexcom G7. The numbers are striking: an average 1.6% reduction in HbA1C, 5 additional hours per day in range, and 97% sensor utilization over 6 months. That last number might be the most telling — it answers the question the diabetes world has been asking for years about whether people without hypoglycemia risk would actually wear a CGM consistently. Turns out, they will. Rob also pushes the conversation into territory that most executive interviews don't touch. When Dexcom products intended for destruction were stolen and resold to patients, Jake had to go from leading conference sessions to serving as something closer to a chief detective. His candid answer about feeling genuinely betrayed — and how the newly launched Customer Advisory Council became an unexpected asset in getting the word out — is one of the more honest moments you'll hear from a medical device CEO. The council itself, publicly announced and facilitated externally to get truly unfiltered feedback, is something Jake stood up as one of his first acts as CEO. They close on the bigger picture: G8 on the horizon (half the size of G7, with adaptive sensor technology that auto-corrects signal drift), the Nutrisense acquisition adding nutrition coaching to the platform, and where Jake sees Dexcom going as it scales toward serving hundreds of millions of people globally. If you've ever wondered what the person at the top of your CGM company is actually thinking about, this episode gives you a pretty clear answer. Chapters: 00:00 Rob sets up ADA 2026 remote coverage 01:46 Welcoming Dexcom CEO Jake Leach back 02:30 First 90 days: Jake's three CEO priorities 04:39 The Customer Advisory Council goes public 06:47 What the council revealed about communication gaps 08:44 Stolen sensors: Jake's personal reaction 10:39 How the council helped contain the crisis 11:20 CONNECT trial: CGM for non-insulin type 2 users 15:16 97% adherence and five more hours in range daily 16:16 G8 preview: smaller, smarter, adaptive sensing 16:44 Acquiring Nutrisense and redesigning the app experience 19:52 Optimizing beyond insulin: smart bolus and GLP-1s 21:13 Why CGM and GLP-1s are surprisingly powerful together 22:27 Jake's long-term vision for Dexcom's global impact 24:14 Transparency as the foundation of high-performance culture Resources: * Dexcom — dexcom.com | Follow Jake and the team for updates on G8, Stello, and the Customer Advisory Council findings * CONNECT Trial — The full study results from ADA 2026 Scientific Sessions.

When mutual friends in the diabetes community kept telling Rob he had a doppelganger in LA, he figured they were exaggerating. Then he met Dylan Leonard — creative director, documentary filmmaker, college basketball player, type one diabetic, philosophy reader, world traveler — and yeah, the comparisons held up pretty well. Dylan was diagnosed at 15, having dropped 45 pounds before anyone realized something was wrong. He went from a hospital bed thinking he'd never eat sugar again to playing college basketball while managing T1D without a CGM, without a pump, and without knowing a single other person with diabetes for his first decade. What carried him through was activity — six hours of workouts a day during basketball season — and a mindset he's been intentionally building ever since through reading, travel, and genuinely hard conversations with himself. This episode goes wide. Rob and Dylan dig into Dylan's upcoming documentary Breaking Limits: Life on the Edge, which follows elite athletes with type one diabetes across seven different sports — from Olympic competitors to IndyCar drivers to American Ninja Warriors. Dylan invested his own money and thousands of hours into this project, not to make a cent, but to hand a 15-year-old sitting in a hospital bed the resource he never had. They also get into the philosophy of travel as the cheapest education on earth, why our brains literally haven't caught up to the abundance of modern life, the difference between manifesting and obsessing, and what a five-hour train conversation with a Norwegian stranger taught Dylan about human connection. Oh, and they're making plans to run a hoop session next time Rob's in LA. Cameras included. Chapters: 00:00 Rob's T1D doppelganger, meet Dylan 01:49 Dylan introduces himself: creative, hooper, T1D 02:39 Dylan's diagnosis story: 45 lbs lost at 15 04:36 First pickup game post-diagnosis, flying blind 06:26 How activity literally saved his diabetes management 07:28 Life after college ball: blood sugars out of whack 09:12 Morning routine: walk, no phone, delayed caffeine 10:34 Civilized to Death and the myth of progress 14:48 Our brains weren't built for this level of abundance 17:21 Phones, phones everywhere — even for T1D management 19:45 Abundance mindset, FOMO, and the creative career trap 21:01 Why athletes list it: delayed gratification is a superpower 24:20 Self-help books, repetition, and finding what actually works2 7:48 Manifestation is obsession with action behind it 29:15 Compounding growth: who were we six years ago? 33:14 Breaking Limits documentary: T1D athletes across seven sports 38:59 Nine months of travel: Vietnam, Norway, Australia, Mexico 40:00 "The cheapest education on earth is a one-way flight" 44:44 Japan and what loneliness taught him about human connection Resources: * Dylan Leonard on Instagram * Civilized to Death by Christopher Ryan — the book Dylan cites on the myth of perpetual progress and why foraging societies may have been happier than ours * The Game of Life and How to Play It by Florence Scovel Shinn — Dylan's twice-a-year read, ~95 pages, written 100 years ago, still hitting * Risley Health / Rising Above T1D — where Dylan has previously appeared on podcast and debuted early cuts of Breaking Limits (link to Riseley Health podcast)

Tyler Cook is a professional GT3 racing driver who has competed in some of the most grueling endurance races on the planet, the 24 Hours of Spa, the 24 Hours of Nürburgring, IMSA, and GT World Challenge Europe. He's also been living with type 1 diabetes since he was 11 years old. This episode gets into what it actually looks like to manage blood sugar in a fire suit, in a 130-degree cockpit, at 150 miles per hour, sometimes at 3 a.m. Tyler takes us back to his diagnosis in 2006 — an ICU stay, four IVs, and a very specific grief over the chocolate mousse at Epcot's France pavilion. From there, he walks us through the journey from go-karts in his dad's garage to GT3 race cars with 650 horsepower. Along the way, there was bullying in middle school over his diet, sneaking to the bathroom to give injections on dates, and a decision somewhere along the line to stop hiding his diabetes and start owning it. We get into the technical side, too: how OmniPod changed his race management strategy, why adrenaline sends his blood sugar climbing instead of crashing, what a 24-hour-race insulin plan actually looks like, and what it means to have a Gatorade button wired into your cockpit as an emergency low-blood-sugar protocol. Tyler also talks about the physical training side of racing — heart rate zone work, neck day (yes, neck day), and why a GT3 driver can be pressing 1,200 pounds of brake force per pedal. The episode wraps with something that's been sitting with both Rob and Tyler: the idea of trusting the process. For Tyler, the lesson comes through racing — you can't skip steps from spec Miata to GT3. For people with T1D, it's the same. Wherever you are in your management journey, that's where you are — and it's going to get better if you just keep going. Chapters: 00:00 Climbing out of a race car at 2 a.m. 00:51 Introducing Tyler Cook, GT3 driver with T1D 01:52 Diagnosis at 11: ICU, four IVs, and Epcot chocolate mousse 04:16 Go-karts at three, racing in the family DNA 06:20 Racing pre-CGM: going off vibes and feeling lows 07:29 Bullied for his diet in middle school 09:53 Dating with diabetes and deciding to stop hiding it 12:29 Going public: from fear of losing opportunities to advocacy 13:35 A potential cure and why staying healthy now matters 17:19 What GT3 racing actually is — and why you should go watch it 23:02 The Gatorade button: CGM and cockpit glucose management 24:28 130-degree cockpits, adrenaline spikes, and pre-race hydration 25:39 WHOOP strain scores: practice vs. race stint 28:37 Training for the car: heart rate zones, neck day, 1,200-lb brakes 36:45 What Tyler would tell 11-year-old himself: trust the process Resources: * Tyler Cooke Instagram * Breakthrough T1D * Conor Daly (T1D IndyCar driver Tyler mentioned)

Steven Cannady was diagnosed with Type 1 diabetes on December 21, 2004, during Christmas break, in eighth grade, after eating a family-size box of Fruit Loops and spending hours on the kitchen floor before his mom got home from work. Rob was diagnosed one week later on New Year's Day 2005. Neither of them knew this until they were halfway through this conversation. Twenty-one years later, they're both living actively with T1D and talking openly about it, and it shows. Steven has run six marathons in roughly two years, starting with the New York City Marathon in 2024 as part of the Beyond Type 1 team. He just earned a spot on Team Abbott for the Sydney Marathon, a seriously competitive field. But the race that meant the most wasn't the fastest one — it was the Raleigh-Durham marathon earlier this year, where he ran slowly through the streets of the city that raised him, stopped to talk to friends at mile markers, and decided that running doesn't always have to be about the clock. This episode gets into the nuts and bolts of marathon prep with T1D — carb loading with Maurten, skipping insulin entirely on race day, why Steven would rather run high than risk going low at mile 20, and how 77% time-in-range can be genuinely excellent management. He also gets into how a doctor scared him straight during his second DKA in 11th grade, why he doesn't drink Diet Coke and won't pretend otherwise, and how a single conversation shifted how he thinks about living with diabetes versus managing around it. Steven is MDI — no pump — and runs with fruit snacks in his pocket. He's not interested in letting diabetes set the terms of his life. This one's worth a full listen. Chapters: 00:00 Introduction — who is Steven Cannady? 01:17 Duke fan crashes Carolina basketball camp 02:14 Eighth grade, Christmas break, DKA diagnosis 04:05 First weeks with T1D — family holds him down 05:42 Rob and Steven were diagnosed one week apart 06:35 Going back to school and the Seattle trip prank 08:58 Going public with diabetes — why Steven started sharing 10:45 Six marathons in two years — how it started 11:42 Running as therapy and running through Durham 15:08 Running is more mental than physical 16:56 Race prep breakdown: 3 miles vs. 10 miles vs. marathon 19:12 Carb loading, Maurten, MDI, and skipping insulin on race day 22:32 Diabetes in the background — not the only conversation 24:23 Diet Coke, cookies, and the food police 25:40 Learning to run while high — reframing the numbers 28:59 Duke Camp, honeymoon phase, and bringing diabetes along for the ride 31:33 Wrapping up — Diabetes Legends camps and Team Abbott Resources: Steven Cannady Instagram Maurten Gel Packs