Navigating Pregnancy with Diabetes: Expert Insights, with Dr. Sarit Polsky

Lessons Learned from Spontaneous Labor & Empowered Births, with Cali Young, T1D mom of 3

In this episode, I interview Callie Young, a mother of three and currently 20 weeks pregnant with her fourth (!) child, who has lived with Type 1 Diabetes since childhood. Callie shares her experiences navigating pregnancy with diabetes, discussing the evolution of her approach over the years, the challenges of insulin resistance, and the importance of self-advocacy in healthcare. Callie has had the rare experience for a high-risk pregnancy of having spontaneous labor with all 3 of her children. Our conversation highlights the important balance between managing diabetes and motherhood, advocating for yourself in medical settings and finding the right fit in a healthcare provider, and the importance of having strong support systems. Takeaways * Knowledge is power; the more you know, the more confident you become. * Self-advocacy is crucial in healthcare; don't hesitate to ask questions. * Maintaining a routine with meals helps manage blood sugar levels. * Insulin resistance is a real challenge during pregnancy; be prepared to adapt. * Having a support system is vital for managing diabetes and motherhood. * It's important to prioritize self-care; you can't pour from an empty cup. * Be proactive in your healthcare; don't wait for appointments to make changes. * Educate yourself about all birthing options, including spontaneous labor. * Postpartum care is just as important as pregnancy care; prioritize your health. * Every pregnancy is different; learn from each experience to improve future outcomes. 00:00 Introduction to Callie's Journey 10:37 Understanding Insulin Resistance 14:59 Managing Insulin During Pregnancy 23:45 Takeaways for Expecting Mothers 32:03 Navigating Labor and Delivery Choices 38:51 Tools for a Positive Birth Experience 45:21 Postpartum Management and Self-Care Mentioned: Register for Advanced Dosing Strategies [https://form.jotform.com/243176321762152], this Monday, November 25! ⁠⁠⁠⁠⁠ [http://diabetesstateofmind.com/]Check us out on Instagram at our NEW IG handle: ⁠⁠⁠⁠@sweetexpectations__⁠⁠⁠⁠ [http://instagram.com/sweetexpectations__] Want to learn all there is about Diabetes & Pregnancy: ⁠⁠⁠Your T1D Pregnancy Roadmap⁠⁠⁠ [https://greaterthancc.thinkific.com/courses/the-t1d-pregnancy-roadmap] will get your journey off to the right start. Need more support preparing for pregnancy or managing diabetes during pregnancy than your HCPs can give? Virtual diabetes pregnancy coaching is available with Allison, a Certified Diabetes Care & Education Specialist and T1D mom of 2: ⁠⁠⁠⁠Apply for 1-on-1 coaching here!⁠⁠ [https://forms.gle/xQBfbbyPV2py1mmZ8]

Navigating Pregnancy with Diabetes: Expert Insights, with Dr. Sarit Polsky

This week, Dr. Sarit Polsky discusses the complexities of managing diabetes during pregnancy, emphasizing the importance of preconception planning, the role of technology in diabetes management, and the emotional aspects of navigating unexpected pregnancies. We cover essential topics such as A1C management, the impact of menstrual cycles on diabetes, and the benefits of continuous glucose monitoring and automated insulin delivery systems. Dr. Polsky reassures us that with proper planning and support, a healthy pregnancy is achievable for you too! Takeaways * Planning ahead is crucial for a healthy pregnancy. * Discuss preconception counseling with your endocrinologist. * Continuous glucose monitoring is recommended for type 1 diabetes pregnancies. * Automated insulin delivery systems can help manage diabetes in pregnancy. * Insulin needs change dramatically during pregnancy. * Hypoglycemia is a major concern in early pregnancy. * It's never too late to improve your time in range. * Track your menstrual cycle for better diabetes management. * You are not alone in managing diabetes and pregnancy. * A supportive healthcare team is essential for a healthy pregnancy. 00:00 Introduction to Diabetes and Pregnancy Management 05:52 Preconception Planning for Women with Diabetes 08:53 The Role of Diabetes Technology in Pregnancy 11:50 Managing A1C Levels During Pregnancy 14:41 Understanding Blood Sugar Variability in Pregnancy 17:50 Automated Insulin Delivery Systems in Pregnancy 21:00 Insulin Resistance and Its Impact on Diabetes Management 23:46 Menstruation and Diabetes Management 25:58 Final Thoughts on Achieving a Healthy Pregnancy Mentioned: ⁠⁠⁠ [http://diabetesstateofmind.com/]Check us out on Instagram at our NEW IG handle: ⁠⁠⁠@sweetexpectations__⁠⁠⁠ [http://instagram.com/sweetexpectations__] Want to learn all there is about Diabetes & Pregnancy: ⁠⁠Your T1D Pregnancy Roadmap⁠⁠ [https://greaterthancc.thinkific.com/courses/the-t1d-pregnancy-roadmap] will get your journey off to the right start. Need more support preparing for pregnancy or managing diabetes during pregnancy than your HCPs can give? Virtual diabetes pregnancy coaching is available with Allison, a Certified Diabetes Care & Education Specialist and T1D mom of 2: ⁠⁠⁠Apply for 1-on-1 coaching here!⁠ [https://forms.gle/xQBfbbyPV2py1mmZ8]

A Mom Gets Pre-Eclampsia and Delivers at 30 Weeks, with Kirsten Duncan, RN, T1D Mom of 1

This week's guest is Kirsten Duncan, who has lived with T1D for 15 years. She works as a pediatric nurse and diabetes educator. Kirsten experienced high blood pressure and pre-eclampsia part way through her pregnancy, which led to a 72 day NICU stay for her son. We also talk about how she navigated her relationships with healthcare providers while also being a healthcare provider. And Kirsten shares her experience and top tips getting her A1C below 6% and managing insulin resistance. Takeaways * Kirsten Duncan has lived with type 1 diabetes since 2008. * She emphasizes the importance of preparing for pregnancy with a low A1C. * Managing blood sugar levels is crucial during pregnancy, especially with type 1 diabetes. * Kirsten faced challenges with nausea and insulin management in early pregnancy. * She highlights the significance of a supportive healthcare team during pregnancy. * Preeclampsia can occur even with well-managed diabetes, and awareness is key. * Kirsten spent 72 days in the NICU with her baby after an early delivery. * She encourages mothers to focus on their best efforts and not feel guilty about blood sugar fluctuations. * Adjusting to motherhood with diabetes requires patience and self-care. * Kirsten advises expecting mothers to enjoy the pregnancy journey despite challenges. Chapters 00:00 Introduction and Diabetes Journey 04:06 Preparing for Pregnancy with Type 1 Diabetes 10:25 Strategies for Managing Blood Sugars During Pregnancy 17:37 The Role of the Maternal Fetal Medicine Clinic and Diabetes Educator 26:12 Introduction and Diagnosis of High Blood Pressure 26:42 Admission to the Hospital and Diagnosis of IUGR 31:29 Emergency C-Section and NICU Stay 39:24 Managing Diabetes and Motherhood 45:48 Impact of Steroid Shots and Adjusting Insulin 47:29 Words of Wisdom and Enjoying the Journey Mentioned: ⁠ [http://diabetesstateofmind.com/]Check us out on Instagram at our NEW IG handle: ⁠⁠@sweetexpectations__⁠⁠ [http://instagram.com/sweetexpectations__] Want to learn all there is about Diabetes & Pregnancy: ⁠Your T1D Pregnancy Roadmap⁠ [https://greaterthancc.thinkific.com/courses/the-t1d-pregnancy-roadmap] will get your journey off to the right start. Need more support preparing for pregnancy or managing diabetes during pregnancy than your HCPs can give? Virtual diabetes pregnancy coaching is available with Allison, a Certified Diabetes Care & Education Specialist and T1D mom of 2: ⁠⁠Apply for 1-on-1 coaching here!⁠ [https://forms.gle/xQBfbbyPV2py1mmZ8]

Preparing for a Positive Pregnancy Experience with T1D, with Katherine LoPorto, T1D Mom of 1

This week's guest is Katherine LoPorto, who has lived with T1D for 30 years and is also the daughter of a T1D Dad. Katherine shares her journey from being diagnosed with type 1 diabetes at a young age to her decision to start a family. She talks about the importance of finding a supportive healthcare team and the challenges she faced with insulin resistance during pregnancy. Katherine also discusses the adjustments she made to her diabetes management and the use of multiple insulin delivery methods to manage the insulin resistance common in pregnancy. Managing diabetes during pregnancy can be challenging, but there are tools and strategies that can help! The cost of insulin and supplies can add up, but finding ways to conserve and use them effectively can ease the stress. We cover breastfeeding and the impact of postpartum hormones on pregnancy. We also discuss on the fears and worries of passing on diabetes to their children, which is a common experience for those with diabetes who are contemplating having children. Takeaways * Being diagnosed with type 1 diabetes at a young age can become a part of one's identity and make it easier to manage the condition. * Finding a supportive healthcare team, including an endocrinologist and OB, is crucial during pregnancy with type 1 diabetes. * Managing insulin resistance during pregnancy can be challenging, and adjustments to insulin intake and delivery methods may be necessary. * Using a combination of insulin pump and injections can help manage insulin requirements during pregnancy. * Reading through care guidelines and staying informed about the latest research can provide reassurance and helpful insights during pregnancy with type 1 diabetes. Managing diabetes during pregnancy can be made easier with the use of tools and strategies. * The cost of insulin and supplies can be a financial burden, but finding ways to conserve and use them effectively can help. * Pregnancy can be easier to manage than non-pregnancy because the changes in insulin resistance are more predictable. * Postpartum hormones can be unpredictable, but overall, the experience of pregnancy and childbirth can be rewarding and empowering for women with diabetes. * The fear of passing on diabetes to their children is a common concern, but many women feel that the joy of having a child outweighs the potential challenges of managing diabetes. Chapters 00:00 Introduction and Background 04:55 Diagnosis Story 07:33 Preparing for Pregnancy with T1D 09:57 Managing Blood Sugar Levels and Emotions 12:43 The Importance of Supportive Healthcare Providers 22:07 Insulin Dosing and Delivery During Pregnancy 23:55 Using Multiple Insulin Delivery Methods 27:19 Considerations for Insulin Resistance and Skin Irritation 33:19 The Financial Burden of Diabetes Supplies During Pregnancy 38:25 Predictable Changes in Insulin Resistance During Pregnancy 42:16 Overcoming the Fear of Passing on Diabetes to a Child Mentioned: With Diabetes in Mind [http://diabetesstateofmind.com/] - Katherine's blog Check us out on Instagram at our NEW IG handle: ⁠@sweetexpectations__⁠ [http://instagram.com/sweetexpectations__] Want to learn all there is about Diabetes & Pregnancy: Your T1D Pregnancy Roadmap [https://greaterthancc.thinkific.com/courses/the-t1d-pregnancy-roadmap] will get your journey off to the right start. Need more support preparing for pregnancy or managing diabetes during pregnancy than your HCPs can give? Virtual diabetes pregnancy coaching is available with Allison, a Certified Diabetes Care & Education Specialist and T1D mom of 2: ⁠Apply for 1-on-1 coaching here! [https://forms.gle/xQBfbbyPV2py1mmZ8]

Diabetes Technology & Medications During Pregnancy, with Dr. Diana Isaacs

This is a can't-miss episode! Dr. Diana Isaacs, Co-Director of Endocrine Disorders in Pregnancy at the Cleveland Clinic, comes on the show to discuss the various nuances of using automated insulin pumps in pregnancy. She highlights the challenges of using closed loop insulin pumps in pregnancy, as they were designed for use outside of pregnancy and have higher targets. We discuss the CAM APS system, which has a lower target and more customization, but is not available in the US. We also cover the use of sleep mode on the Tandem pump and the unique algorithm that allows for tighter control, Omnipod 5 and the challenges of customization, and research on Medtronic 780G system and its lower target. We also talk about the growing use of metformin in pregnancy and the controversy surrounding it. And we can't forget GLP-1 agonists! Learn what they might mean for aiding fertility. Finally, Diana shares her expertise on how to handle the ever-changing needs of pregnancy and how to approach high blood sugars. Takeaways * Closed loop insulin pumps are not designed for use in pregnancy and have higher targets than recommended for pregnancy. * The CAM APS system has a lower target and more customization, but is not available in the US. * Sleep mode on the Tandem pump allows for tighter control during the night. * Omnipod 5 has challenges with customization, but can still be used with adjustments to carb ratios and correction factors. * The Medtronic 780G system has a lower target and can be effective in pregnancy. * Metformin is commonly used in pregnancy, but there is controversy surrounding its use. * GLP-1 agonists are not recommended in pregnancy, but can be used before and after pregnancy with caution. * It is important to not stress over numbers and focus on the things that are in one's control during pregnancy. Mentioned: Diabetes Dialogues (Diana's Podcast) [https://open.spotify.com/show/29i5QTa1Us8hXLsj2TMnUl?si=91846ba8a35a4f50] Diana on Instagram: @dianamisaacs [https://www.instagram.com/dianamisaacs/] Check us out on Instagram at our NEW IG handle: @sweetexpectations__ [http://instagram.com/sweetexpectations__] Need more support preparing for pregnancy or managing diabetes during pregnancy than your HCPs can give? Virtual diabetes pregnancy coaching is available with Allison, a Certified Diabetes Care & Education Specialist and T1D mom of 2: Apply for 1-on-1 coaching here! [https://forms.gle/xQBfbbyPV2py1mmZ8]