Advocate Rob Howe on Living Out Loud with Diabetes

Rob Howe is close to hitting his 20-year di-anniversary, and despite the challenges type 1 diabetes (T1D) brings, he’s living his best life. He runs a successful advertising agency, podcast and patient-led media company that raises awareness and connects T1Ds by allowing them to share stories about their lives. 

About Rob Howe

Rob Howe grew up in Dallas, Texas, with his parents and two siblings. At age 16, Howe experienced the classic T1D symptoms, increased thirst, polyuria, and weight loss. Howe shed 20 pounds in two weeks, and at an overnight lock-in at the mall, he counted using the restroom – 27 times. When he woke up nauseous, his mother took him to the urgent care. From there, Howe was rushed to the Children’s Medical Center of Dallas and put on an insulin drip, where he immediately felt better.

Luckily, Howe’s mother had 15 years of health experience, which was instrumental in his post-hospital recovery. Also, he received incredible support from an endocrinology staff at the hospital who taught him the essentials.

As a high school athlete, Howe’s main concern was continuing to play basketball, which was his life’s dream. Fortunately, his healthcare provider told him he could keep playing and achieve anything he wanted to do in life if he controlled his diabetes. “That kind of framed diabetes management as a gateway to what I wanted,” said Howe.

“I’ve seen now that the rhetoric and the information you get when you’re diagnosed is very critical no matter what age you are. It sets up your life with diabetes for the next few years from that experience. So yeah, I was very fortunate to have the attention of the care team at Children’s in Dallas. They spent time with me and my family to set us up for success.”  

Medtronic Ambassador

Howe did multiple daily injections for about two years and initially resisted going on an insulin pump. After that, a nurse practitioner educated him on the benefits, and he’s been pumping ever since. He’s currently on the Medtronic MiniMed 780G system and Guardian 4 continuous glucose monitor (CGM). “I’m keeping an eye out for the new Simplera link sensor, so hopefully, in the next year or so, I’ll make the switch,” said Howe.

The Medtronic Simplera is an all-in-one CGM designed to replace fingersticks. Now FDA-approved, it’s intended to be used with Medtronic’s InPen smart insulin pen and the MiniMed 780G. As a Medtronic ambassador, Howe helped launch its Blue Balloon Challenge. 

College and Beyond

Howe said he was pretty independent during his high school years, and his parents encouraged him to learn everything he needed to know about diabetes.

As class valedictorian and athlete, Howe received a scholarship to play basketball at the University of Colorado, Colorado Springs. His family made the decision to be very upfront with the coaching staff about Rob’s diabetes. “We wanted them to be aware and to know what was going on and for me to feel comfortable,” said Howe. 

“My coach was supportive. I think the main thing he wanted was for me to communicate when I needed to treat a low or high; we got into a rhythm,” said Howe. “I had no hospitalizations, although one time I had the team pull over at a convenience store because my pump battery died.”

Howe graduated with a Bachelor of Science in Business and then played professional basketball for the Washington Generals against the world-famous Harlem Globetrotters on their 2012-2013 world tour.

Playing with the Pros

“I had a chance to get an agent and play professionally,” said Howe. “It was a really short amount of time where I could chase that dream, and having the opportunity play all over the world was incredible.”

Howe said that while he was upfront about his diabetes in college, it was the opposite in the pros. “There were plenty of reasons not to get hired, so I wasn’t going to let diabetes, either from an insurance standpoint or the perception standpoint, keep me from getting a job.”

Later in life, Howe began searching for his next career direction, knowing he wanted to give back somehow. He was in Columbia at the time and said that his insulin pump literally fell out of his pocket, which he took as a sign.

“It occurred to me I might be able to help someone with diabetes, and that had never really been something I thought about. The first half of my life with diabetes, I wasn’t focused on the diabetes community or living out loud with diabetes, and now the second half of my time with it is the opposite.”

The Diabetics Doing Things Podcast

In 2015, Howe contemplated blogging or doing a podcast. He was listening to the Apple podcast, “Serial,” at the time and settled on podcasting. “The joke I tell is that starting a blog would be a great way to write zero blogs, so I decided to do ten podcast episodes. If somebody says I want more of this, I’ll continue to do it, and thankfully, after 10 episodes, people really started getting behind it. The people who came on were really generous with their time.”

Howe heard, 90% of all podcasts only have three episodes or less, so if you have a podcast and have more than 10 episodes, you’re in the top 10%. “Consistency is really a powerful thing that I believe in.”

“Sharing my story and connecting with others has brought me so much that I wouldn’t have had otherwise,” said Howe. “I’ve learned a lot about diabetes management, and my numbers clinically are better, and I’ve been able to use my voice to hopefully impact others.”

A T1D Triumph

Diabetics Doing Things recently published episode 305. “With over two million downloads now, it’s really cool to think about the amount of time people have spent listening; it’s now 750 thousand hours, which is over 100 years—talking about diabetes,” said Howe.

“I take it really seriously, and I’m grateful for the position that we’re in. I’m going to continue, for as long as I can, to tell these amazing stories. I think the cool part to me is that there are so many unique, diverse, exciting people living their lives with diabetes, and as long as there are people doing that, I’ll have something to talk about.”

Diabetes Legends

After the smashing success of the Diabetics Doing Things podcast and his online content, Howe explored ways he could help kids with diabetes. He created the Diabetes Legends basketball clinic for T1D children and teens.

“It’s been awesome; we’ve done three of them now (two in Denver and one in Dallas), and we are going to do one again next year,” said Howe. “Over 100 kids have attended.”

The youth events host guest speakers and coaches, including Gary Forbes and Lauren Cox, two of the first T1Ds to play in the NBA and WNBA. “I think you can see in kids’ faces when you see someone with diabetes who is at the highest level of their craft, whatever that may be, it opens up your mind to what’s possible,” said Howe.

Howe said an article in the Denver Post about T1D Gary Forbes, who played for the Denver Nuggets then, inspired him to keep playing basketball. “I read it when I was in Colorado Springs, and it helped me deal with what I was going through,” said Howe. “I’m a big proponent of sharing your story because I have benefited from other people sharing theirs.”

Future Events for Diabetics Doing Things

At the beginning of 2022, Howe saw an opportunity for DDT to hold in-person meet-ups in the Dallas area, from coffee meet-and-greets to a Pickle Ball Classic. “They’re new and exciting, and I love doing them.”

He also hopes to expand Diabetes Legends to other areas around the country. “Getting to interact with kids with diabetes through the game of basketball—that has brought me so much in my life is rewarding.”

Rob’s profile as a diabetes influencer has grown to over 19k followers and has been featured in all major diabetes publications. You can follow him on Instagram and watch replays of all his podcasts on YouTube.

T1D Advocacy

Today, Howe serves on many T1D committees and boards. He was the Chair for BeyondType1’s Leadership Council Ambassador Committee, served on Breakthrough T1D’s (formerly JDRF) North Texas board, and was a board member for Life for a Child USA. Also, Diabetics Doing Things has many community partners, including T1D International. Howe continues to advocate for affordable insulin, coverage for preexisting conditions and health equity for all.

“Being able to support diabetes creators is sort of our updated mission,” said Howe. “So we’ve been able to find people who are making an impact and connect them with people in the community who could benefit from it, and I think that has been a point of pride for us.”

Mental Health & Diabetes Burnout

Howe said one of the things that he’s learned is how difficult diabetes can be from a mental health perspective. “I’ve heard we’re three times as likely to suffer from anxiety and depression. We think twice the amount of thoughts that people without diabetes think every day.”

“The way I think of it, my mental health is tied to my physical health, so if I’m sleeping well, exercising, getting outside, if I’m drinking my water, that does a lot to help me balance my mental health,” said Howe. “I’m also a huge believer in talk therapy; I’ve been seeing a therapist for a number of years. It helps me process, and it helps me grow.”

Diabetics Doing Things features a Mental Health resource on the website. Also, you can follow Howe’s Email Series – 13 Simple Lessons. The lessons are what Howe wished he had learned upon his own diagnosis at 16. “Until you’re speaking to someone who lives it—You don’t really know what it’s like; you can guess, you can read about it, but you just can’t relate.”

“A few years ago, we did a couple of scholarships for people with diabetes to speak with a family therapist,” said Howe.

The Pareto Principle

In addition to running a successful for-profit media company, Howe also co-founded the advertising agency Recreation Dallas, working with local and global brands like American Airlines, Medtronic, 7-11, and the MannKind Corporation.

Howe manages the 80/20 rule, also known as the Pareto principle, where 80% of outcomes come from 20% of causes. “80% is spent on the agency, and the other 20% is Diabetics Doing Things. I’ve created a life for myself where I wanted to do both. I wanted to be an entrepreneur and create brands, and I wanted to have the space to continue and grow our impact and help people with diabetes.”

Long Term Success

One bit of advice Howe suggests to recently diagnosed T1Ds is to make a friend with diabetes. “I didn’t realize and resisted this early on, but clinical studies show how helpful it is for people to get involved with the diabetes community.”

“It takes some courage, but what you get in return is so disproportionate to the effort that it takes. You’ll gain so much knowledge from people so willing to help.”

As Howe’s healthcare team set him up for long-term success, he is paying it forward through Diabetics Doing Things, which now has more than 20 million users in over 80 countries. Most people’s stories go untold; however, Diabetics Doing Things honors everyday heroes who champion living with T1D because it’s a daily battle, and everyone’s story deserves to be heard.