Type 1 Diabetes and Pregnancy: Labor, Delivery, and the Postpartum Journey

Think Like a Pancreas Chapter 2--Why are we doing this? (what's MEANINGFUL to be gained by managing one's diabetes)

Chapter two of Think Like a Pancreas examines the motivation behind good glucose control. In this special episode, Dr. Paula Diab talks to author Gary Scheiner about the value of good glucose management now. Listen to learn why short-term benefits like better mood, energy, and focus are much more motivating than the fear of complications 20 years away, and why perfectionism has no place in diabetes management. MEET YOUR HOST AND HER GUEST: Dr Paula Diab MBChB, MFamMed, PhD, CDCES is the Director of Weight Management at Integrated Diabetes Services. She is a Family Physician and Diabetologist who runs a multi-disciplinary practice specializing in the management of chronic diseases, particularly diabetes and obesity in South Africa. Her approach is to walk the journey with her patients and to allow them to manage their disease rather than allow the disease to define who they are. Gary Scheiner, MS, CDCES is the owner and Clinical Director of Integrated Diabetes Services. He is an award-winning Certified Diabetes Educator, Masters-level Exercise Physiologist and person with type-1 diabetes since 1985.  Gary is also actively involved with many diabetes related organizations as a volunteer and clinical advisor. KEY TAKEAWAYS AND HIGHLIGHTS: ✔️ The threat of complications that may occur in 20 years does not motivate improved glucose control. ✔️ Glucose control that is too tight can take a toll on your physical and emotional health. ✔️ About half of complication risk relates to blood sugar; the rest relates to genetics, lifestyle, environment, and unknown factors. Glucose management is the one piece within your control. CHAPTERS: 00:00 Introduction and Welcome 02:23 The Positive Aspects of Diabetes Management 06:59 Why Short-Term Benefits Motivate More than Long-Term Complication Fears 12:49 The Impact of Poor Glucose Management 15:40 The Benefit of Proper Glucose Management 16:59 Learning from the Data 19:15 Closing Thoughts RESOURCES: Fear of Low Blood Sugars. Breaking it Down with Bill Polonsky [https://youtu.be/s3TtvAB409Y?si=oW15UoLwRHS9Vx6r]   https://youtu.be/s3TtvAB409Y?si=oW15UoLwRHS9Vx6r [https://youtu.be/s3TtvAB409Y?si=oW15UoLwRHS9Vx6r] Think Like A Pancreas - 4th edition [https://integrateddiabetes.com/store/think-like-a-pancreas-4th-edition]   https://integrateddiabetes.com/store/think-like-a-pancreas-4th-edition [https://integrateddiabetes.com/store/think-like-a-pancreas-4th-edition]   CONNECT WITH US: 🔵Website: integrateddiabetes.com 🔵 Follow on Social Media: @integrated_diabetes_services and @ integrateddiabetesservices on Facebook 🔵To work with the Integrated Diabetes Services Team , visit https://integrateddiabetes.com/appointments/ [https://integrateddiabetes.com/appointments/]   or email info@integrateddiabetes.com [info@integrateddiabetes.com] SUBSCRIBE AND REVIEW: If the podcast has helped you to live better with diabetes, please tell someone else how to find it! If you have a question, take a moment and ask! We reply to everyone. And then be sure to subscribe on Apple Podcasts, Spotify, or your favorite podcast platform to ensure that you never miss an episode!   Disclaimer The information contained in this program is based on the experience and opinions of the Integrated Diabetes Services clinical team. Please discuss any changes to your treatment plan with your personal healthcare provider before implementing.

Think Like a Pancreas: Everyone Has a Diabetes Diagnosis Story

Welcome to the 100th episode of Think Like a Pancreas—The Podcast! To mark this momentous occasion, we are launching a special series inspired by the book that started it all. Join us twice a week for the next five weeks, as we share insights from each chapter of this incredible book. In this episode, Katlyn Agosta, MSN, APRN, FNP-C, CDCES, sits down with author Gary Scheiner, MS, CDCES, FADCES, to talk about his diagnosis story, how it shaped his life, and how it changed his career path. During their conversation, Gary reflects on his 1985 type 1 diagnosis and how management has evolved from "guillotine" finger-poke devices, exchange diets, and NPH insulin. Katlyn also shares her diagnosis story as well, and together they highlight the progress in diabetes care and discuss irreplaceable value of human insight in diabetes management.   MEET YOUR HOST AND HER GUEST: Katlyn Agosta, MSN, APRN, FNP-C, CDCES is a Certified Diabetes Care & Education Specialist and nurse practitioner who has lived with Type 1 Diabetes since 2002. She is currently rocking an automated insulin delivery system, but has years of personal and professional experience with a variety of diabetes management approaches. After earning her bachelor’s in nursing from George Mason University in 2010, Katlyn became a board-certified nurse practitioner in 2020 and provides primary care services locally for patients in Florida. Gary Scheiner, MS, CDCES is the owner and Clinical Director of Integrated Diabetes Services. He is an award-winning Certified Diabetes Educator, Masters-level Exercise Physiologist and person with type-1 diabetes since 1985.  Gary is also actively involved with many diabetes related organizations as a volunteer and clinical advisor. KEY TAKEAWAYS AND HIGHLIGHTS: ✔️ Every insulin user has a backstory worth hearing. Gary shares his story for readers to better understand that he truly does understand what he is talking about.   ✔️ Both Gary and Katlyn emphasize that despite advances in technology (including AI), diabetes management remains deeply personal, and one-on-one care is central to how IDS works with patients. CHAPTERS: 00:00 Introduction and Welcome 01:19 Meet Gary Scheiner 03:47 Registered Nurse vs Nurse Practitioner. What is the Difference? 06:39 Gary’s Diagnosis and Care Changes Over Time 11:18 The Exchange Diet vs Carb Counting 14:52 “Fast” Acting Insulin 16:18 Discovering Diabetes Self-Management 18:27 The Value of a Clinician Over AI 20:06  Katlyn’s Diagnosis Story 23:33 Closing Thoughts RESOURCES: Fear of Low Blood Sugars. Breaking it Down with Bill Polonsky [https://youtu.be/s3TtvAB409Y?si=oW15UoLwRHS9Vx6r]   https://youtu.be/s3TtvAB409Y?si=oW15UoLwRHS9Vx6r [https://youtu.be/s3TtvAB409Y?si=oW15UoLwRHS9Vx6r] Think Like A Pancreas - 4th edition [https://integrateddiabetes.com/store/think-like-a-pancreas-4th-edition]   https://integrateddiabetes.com/store/think-like-a-pancreas-4th-edition [https://integrateddiabetes.com/store/think-like-a-pancreas-4th-edition] CONNECT WITH US: 🔵Website: integrateddiabetes.com 🔵 Follow on Social Media: @integrated_diabetes_services and @ integrateddiabetesservices on Facebook 🔵To work with the Integrated Diabetes Services Team , visit https://integrateddiabetes.com/appointments/ [https://integrateddiabetes.com/appointments/]   or email info@integrateddiabetes.com [info@integrateddiabetes.com] SUBSCRIBE AND REVIEW: If the podcast has helped you to live better with diabetes, please tell someone else how to find it! If you have a question, take a moment and ask! We reply to everyone. And then be sure to subscribe on Apple Podcasts, Spotify, or your favorite podcast platform to ensure that you never miss an episode! Disclaimer The information contained in this program is based on the experience and opinions of the Integrated Diabetes Services clinical team. Please discuss any changes to your treatment plan with your personal healthcare provider before implementing.

Type 1 Diabetes and Pregnancy: Labor, Delivery, and the Postpartum Journey

This is the final episode in the series, Type 1 Diabetes and Pregnancy: A Complete Guide for Women — Preconception to Postpartum. In part three, Jennifer Smith and Tavia Vital talk about Labor, Delivery, and the Postpartum Journey for women with type 1 diabetes. They cover building a written labor and delivery plan to share with your care team, deciding whether to self-manage insulin during delivery or hand it over to the hospital protocol, and preparing a partner as a backup safety net. They break down how IV insulin differs from pump or injection insulin, and how induction, spontaneous labor, and C-sections each affect blood sugar differently. The conversation moves into newborn blood sugar basics, the importance of switching to a new postpartum insulin plan within about an hour of delivering the placenta, and how breastfeeding — especially in the first two weeks — can cause significant glucose drops. Jenny and Tavia also highlight two often-overlooked postpartum risks--thyroid dysfunction (which affects roughly 1 in 4 women with type 1 diabetes) and the difference between normal "baby blues" and postpartum depression, encouraging women not to navigate any of it alone. MEET YOUR HOSTS: Jennifer Smith, RD, LD, CDCES is the Director of Lifestyle and Nutrition for Integrated Diabetes Services. She is renowned for her expertise in nutrition, diabetes education, and athletic performance. Having lived with type 1 diabetes since childhood, Jennifer offers unique insight into day-to-day diabetes management, pregnancy, sports nutrition, and technology integration. Tavia Vital BSN, BA, RN, CDCES is the Director of Intensive Diabetes Management for Integrated Diabetes Services. Tavia is a Registered Nurse, Certified Diabetes Care and Education Specialist, and Certified Trainer on most makes/models of insulin pumps and continuous glucose monitoring systems. Having lived with type one diabetes for over 40 years, she understands that each person’s experiences and needs are unique. KEY TAKEAWAYS AND HIGHLIGHTS: ✔️ It is important to have a plan created for labour and delivery that includes the role of your birthing partner. It is equally important to remember that you can change that plan once you are experiencing labour. ✔️ Cutting carbs in the final 2–4 weeks of pregnancy can help "train" baby's pancreas not to overproduce insulin, reducing the risk of newborn hypoglycemia after delivery. ✔️ About 1 in 4 women with type 1 diabetes develop postpartum hyperthyroidism, sometimes with no prior thyroid history — watch for hair loss, jitteriness, elevated resting heart rate, and frequent bowel movements.   CHAPTERS: 00:00 Introduction and Welcome 02:41 Building Your Labor and Delivery Plan with Your Care Team 09:05 Sharing Your Glucose During Delivery 10:33 Planning Your Insulin Protocol for Delivery 14:41 Educating Your Birthing Partner on Your Diabetes Management 20:17 Understanding IV Insulin vs Infused/Injected Insulin 23:27 Planning for Spontaneous Birth vs Induction vs C-Section 26:37 Post Delivery Insulin Needs for Baby 32:24 Post-Partum Insulin Plan 36:21 Curveballs: Preeclampsia and Steroids During Delivery 38:17 Glucose Needs While Breastfeeding 45:08 The Return of the Menstrual Cycle 46:36 Increased Risk of Thyroid Problems Post-Partum 52:51 Post-Partum Depression vs Baby Blues 57:31 Carrying Your Learning Forward   RESOURCES: Type 1 Diabetes and Pregnancy: Preconception Planning  for a Healthy Pregnancy [https://Integrateddiabetesservices.podbean.com/e/preconception-planning-for-a-healthy-pregnancy-with-t1d/]   https://youtu.be/o9LM3veYmiY [https://youtu.be/o9LM3veYmiY] Type 1 Diabetes and Pregnancy: Changes through the Trimesters [https://integrateddiabetesservices.podbean.com/e/t1d-and-pregnancy-changes-through-the-trimesters/]   https://youtu.be/_5sWX-lJ8s4 [https://youtu.be/_5sWX-lJ8s4] Pregnancy with Type 1 Diabetes: Your Month-to-Month Guide to Blood Sugar Management [https://www.amazon.ca/Pregnancy-Type-Diabetes-Month-Month] Pregnancy with Type 1 Diabetes--The Book and The Authors [https://Integrateddiabetesservices.podbean.com/e/pregnancy-and-type-1-diabetes/]   https://youtu.be/g2arb-bHSPg?si=Rk6gUmMdW5aOxDvl [https://youtu.be/g2arb-bHSPg?si=Rk6gUmMdW5aOxDvl]   CONNECT WITH US: 🔵Website: integrateddiabetes.com 🔵 Follow on Social Media: @integrated_diabetes_services and @ integrateddiabetesservices on Facebook 🔵To work with the Integrated Diabetes Services Team , visit https://integrateddiabetes.com/appointments/ [https://integrateddiabetes.com/appointments/]   or email info@integrateddiabetes.com [info@integrateddiabetes.com] SUBSCRIBE AND REVIEW: If the podcast has helped you to live better with diabetes, please tell someone else how to find it! If you have a question, take a moment and ask! We reply to everyone. And then be sure to subscribe on Apple Podcasts, Spotify, or your favorite podcast platform to ensure that you never miss an episode! Disclaimer The information contained in this program is based on the experience and opinions of the Integrated Diabetes Services clinical team. Please discuss any changes to your treatment plan with your personal healthcare provider before implementing.

Type 1 Diabetes and Pregnancy: Changes through the Trimesters

In part two of our three-part series, Type 1 Diabetes and Pregnancy: Changes Through the Trimesters, Jennifer Smith and Tavia Vital share what to expect after conception. They debunk common misconceptions and offer an honest look at what to expect now that you are expecting. From the value of continuous glucose monitor (CGM) data to changing insulin needs, nausea, hypoglycemia, and DKA, Jenny and Tavia share their clinical and personal experiences with the adjustments needed for diabetes management throughout pregnancy. MEET YOUR HOSTS: Jennifer Smith, RD, LD, CDCES is the Director of Lifestyle and Nutrition for Integrated Diabetes Services. She is renowned for her expertise in nutrition, diabetes education, and athletic performance. Having lived with type 1 diabetes since childhood, Jennifer offers unique insight into day-to-day diabetes management, pregnancy, sports nutrition, and technology integration. Tavia Vital BSN, BA, RN, CDCES is the Director of Intensive Diabetes Management for Integrated Diabetes Services. Tavia is a Registered Nurse, Certified Diabetes Care and Education Specialist, and Certified Trainer on most makes/models of insulin pumps and continuous glucose monitoring systems. Having lived with type one diabetes for over 40 years, she understands that each person’s experiences and needs are unique. KEY TAKEAWAYS AND HIGHLIGHTS: ✔️ Early pregnancy often brings a temporary insulin resistance spike, followed by a drop to as low as 1/3 of pre-pregnancy doses by roughly week 6–8. ✔️Hypoglycemia unawareness becomes more common in pregnancy — glucagon (including micro-dosing) and ketone strips should be on hand, not just "somewhere in a drawer." ✔️By third trimester, insulin needs can triple compared to pre-pregnancy doses. ✔️Ketone testing is advised any time insulin has been suspended for a while, after a suspected site/pump failure, or when glucose won't come down as expected — DKA can occur at lower glucose levels than the traditional teaching suggests.   CHAPTERS: 00:00 The Role of Technology in Diabetes Management 08:07 Finding the Right Tech Fit 14:44 Navigating the First Trimester 22:32 Dealing with Nausea 24:50 Hypoglycemia Unawareness 29:02 18-21Week Insulin Adjustments…Again. 31:47 The role of Protein in Pregnancy 35:01 The Third Trimester 39:12 Adjunct Pregnancy Therapies 40:38 DKA Risk During Pregnancy 44:11 The Conversations to Have With Your Healthcare Team During Your Pregnancy RESOURCES: Type 1 Diabetes and Pregnancy: Preconception Planning  for a Healthy Pregnancy [https://integrateddiabetesservices.podbean.com/e/preconception-planning-for-a-healthy-pregnancy-with-t1d/]   https://youtu.be/o9LM3veYmiY [https://youtu.be/o9LM3veYmiY] Pregnancy with Type 1 Diabetes: Your Month-to-Month Guide to Blood Sugar Management [https://www.amazon.ca/Pregnancy-Type-Diabetes-Month-Month] Pregnancy with Type 1 Diabetes--The Book and The Authors [https://Integrateddiabetesservices.podbean.com/e/pregnancy-and-type-1-diabetes/]   https://youtu.be/g2arb-bHSPg?si=Rk6gUmMdW5aOxDvl [https://youtu.be/g2arb-bHSPg?si=Rk6gUmMdW5aOxDvl] https://www.youtube.com/watch?v=p7eimb20zcI [https://www.youtube.com/watch?v=p7eimb20zcI] https://www.youtube.com/watch?v=fDPHdTAaT4o [https://www.youtube.com/watch?v=fDPHdTAaT4o] CONNECT WITH US: 🔵Website: integrateddiabetes.com 🔵 Follow on Social Media: @integrated_diabetes_services and @ integrateddiabetesservices on Facebook 🔵To work with the Integrated Diabetes Services Team , visit https://integrateddiabetes.com/appointments/ [https://integrateddiabetes.com/appointments/]   or email info@integrateddiabetes.com [info@integrateddiabetes.com] SUBSCRIBE AND REVIEW: If the podcast has helped you to live better with diabetes, please tell someone else how to find it! If you have a question, take a moment and ask! We reply to everyone. And then be sure to subscribe on Apple Podcasts, Spotify, or your favorite podcast platform to ensure that you never miss an episode! Disclaimer The information contained in this program is based on the experience and opinions of the Integrated Diabetes Services clinical team. Please discuss any changes to your treatment plan with your personal healthcare provider before implementing.

Type 1 Diabetes and Pregnancy: Preconception Planning for a Healthy Pregnancy

In part one of the three-part series, Type 1 Diabetes and Pregnancy: A Complete Guide for Women — Preconception to Postpartum, Jennifer Smith and Tavia Vital focus on preconception. They consider this to be the "missing trimester" that most women aren't coached through. They cover building a care team, adjusting meds/supplements, tightening glucose targets safely, nutrition, screenings, as well as some of the biggest fears that women bring to this conversation. MEET YOUR HOSTS: Jennifer Smith, RD, LD, CDCES is the Director of Lifestyle and Nutrition for Integrated Diabetes Services. She is renowned for her expertise in nutrition, diabetes education, and athletic performance. Having lived with type 1 diabetes since childhood, Jennifer offers unique insight into day-to-day diabetes management, pregnancy, sports nutrition, and technology integration.   Tavia Vital BSN, BA, RN, CDCES is the Director of Intensive Diabetes Management for Integrated Diabetes Services. Tavia is a Registered Nurse, Certified Diabetes Care and Education Specialist, and Certified Trainer on most makes/models of insulin pumps and continuous glucose monitoring systems. Having lived with type one diabetes for over 40 years, she understands that each person’s experiences and needs are unique. KEY TAKEAWAYS AND HIGHLIGHTS: ✔️ Recommended timeline: start preconception conversations with your care team at least 6 months before trying to conceive. ✔️ Glucose target tightening should be gradual and stepwise, not a sudden jump to pregnancy-range targets. ✔️Folic acid: pregnancy with diabetes often calls for double the folic acid found in a standard prenatal. Please confirm with your healthcare provider. ✔️Having type 1 diabetes does not automatically mean a big baby or an induced/C-section delivery. CHAPTERS: 00:00 Welcome and Introduction to Part 1 of Type 1 Diabetes and Pregnancy 03:45 Setting the Stage for a Healthy Pregnancy 05:34 Tavia’s Preconception Experience 07:18 Planning for Pregnancy Months in Advance 12:50 Gradually Shifting Glucose Targets Before Pregnancy 17:32 Shifting Gears for an Unplanned Pregnancy 22:35 What to Know About Nutrition Before and After Conception 33:52 Pre-conception Screenings 38:37  De-Bunking Common Myths and Misconceptions 42:53 Recommended Resources 46:15 Coming up in Part 2 of the Type 1 Diabetes and Pregnancy Series RESOURCES: Pregnancy with Type 1 Diabetes: Your Month-to-Month Guide to Blood Sugar Management [https://www.amazon.ca/Pregnancy-Type-Diabetes-Month-Month] The 100 Healthiest Foods to Eat During Pregnancy [https://www.amazon.ca/100-Healthiest-Foods-During-Pregnancy-ebook] Pregnancy with Type 1 Diabetes--The Book and The Authors [https://integrateddiabetesservices.podbean.com/e/pregnancy-and-type-1-diabetes/]   https://youtu.be/g2arb-bHSPg?si=Rk6gUmMdW5aOxDvl [https://youtu.be/g2arb-bHSPg?si=Rk6gUmMdW5aOxDvl] What to expect with IVF. Why Standard Diabetes Care Isn't Enough for Fertility [https://integrateddiabetesservices.podbean.com/e/what-to-expect-with-ivf/]    https://youtu.be/gfceQ_1Q70Y [https://youtu.be/gfceQ_1Q70Y]   CONNECT WITH US: 🔵Website: integrateddiabetes.com 🔵 Follow on Social Media: @integrated_diabetes_services and @ integrateddiabetesservices on Facebook 🔵To work with the Integrated Diabetes Services Team , visit https://integrateddiabetes.com/appointments/ [https://integrateddiabetes.com/appointments/]   or email info@integrateddiabetes.com [info@integrateddiabetes.com] SUBSCRIBE AND REVIEW: If the podcast has helped you to live better with diabetes, please tell someone else how to find it! If you have a question, take a moment and ask! We reply to everyone. And then be sure to subscribe on Apple Podcasts, Spotify, or your favorite podcast platform to ensure that you never miss an episode! Disclaimer The information contained in this program is based on the experience and opinions of the Integrated Diabetes Services clinical team. Please discuss any changes to your treatment plan with your personal healthcare provider before implementing.