Juicebox Podcast: Type 1 Diabetes

Episode #1739: Smooth Operator - Part 2
Host: Scott Benner
Guest: Claire
Date: January 16, 2026

Episode Overview

In this episode, Scott Benner interviews Claire, who has lived with type 1 diabetes for ten years and recently navigated pregnancy and early motherhood. The conversation covers her carefully strategized approach to diabetes management during pregnancy, labor, and postpartum; the pivotal role of advanced diabetes technology; and her ongoing journey towards optimal control using new automated insulin delivery (AID) systems. Claire’s candid experiences, setbacks, and triumphs provide practical insight and reassurance for listeners managing T1D in similar life stages.

Key Discussion Points & Insights

Navigating Diabetes Through Pregnancy

• Early Awareness & Proactive Adjustment

  • Claire sensed she was pregnant before taking a test due to mild insulin resistance detected on her continuous glucose monitor (CGM).
  • She preemptively increased her basal insulin and collaborated closely with her endocrinologist (endo) ([02:23]).
  • Tightly managed A1C and blood glucose goals throughout pregnancy, emphasizing the need for individualized care.

• Medical Team Coordination

  • Her care team included an OB, a high-risk doctor, and an endo, with her endocrinologist leading diabetes-related adjustments ([04:13]).
  • Used a patient portal for frequent communication and regular data review. Adjustments were made every two weeks, or sooner if patterns changed ([05:08]).

• Insulin Resistance Changes

  • Gradual increase in insulin needs during the second trimester, consistent with the "roller coaster" others have described.
  • At 36 weeks, she unexpectedly experienced recurring hypoglycemia, which her endo identified as a normal late-pregnancy plateau or dip in insulin needs ([06:06]).
  • Changes attributed to:
    • Maturation/aging placenta lowering hormone-induced resistance
    • Increased fetal glucose uptake
    • However, an abrupt drop can signal placental insufficiency and should always be reported ([06:49]–[08:04]).

• Quote:

  "At 36 weeks, your insulin kind of plateaus or even dips... A modest reduction in insulin around 36 weeks is common. Normal physiological change. And a dramatic drop should always be reported to the care team." — Scott (07:00)

Labor & Delivery Decisions

• Control Handover: Who Should Manage Your Blood Glucose?

  • Claire planned to turn blood sugar control over to the clinical team during active labor, believing IV insulin’s tighter control would reduce her stress ([11:33]).
  • Her OB empowered her to continue self-managing since she was doing well, but assured her the option to switch to IV was always available ([12:58]).
  • Maintained tight control (BG 70–100), and ultimately opted to manage her own needs through labor.

• Quote:

  "[My OB] empowered me. She's like, 'Look, you've been doing a great job so far. Why don't you just keep doing it yourself?'" — Claire (12:58)

• Unexpected C-section & Real-Time Problem-Solving

  • Labor stalled, requiring a C-section; Claire prepped her husband to switch her insulin pump settings per their plan after placental delivery.
  • Unexpected error with the Omnipod PDM during an active temp basal led to Claire, nauseated and lying on the OR table, taking control herself, switching her insulin settings one-handed ([18:00]–[21:20]).
  • The story illustrates the importance of preparation, adaptability, and firsthand familiarity with diabetes tech.

• Memorable Moment:

  "I just grab my PDM from him with my left hand... and change my insulin pump settings on the OR table." — Claire (19:31)

Postpartum Experience & Returning to Routine

• Transitioning Technology & Expectations

  • Postpartum, Claire found it took about six months to return to a rhythm and more predictable blood sugars ([22:05]).
  • Began using Omnipod 5, enjoyed some automation but craved more granular control as she sought to replicate her pregnancy-level management with less mental load ([25:31]).
  • Worked with diabetes educator Jenny Smith for Omnipod 5 “hacks” and advice; ultimately switched to using Loop (AID algorithm with Omnipod Dash), through a third-party company that built it for her, offering more flexibility and features ([27:00]).

• Quote:

  "Now I'm on the Loop algorithm using Omnipod Dash and... definitely feel like I'm putting in less effort and getting better control, which is just such a hard balance to strike." — Claire (28:08)

• Reflections on Technology Choices

  • Values tubeless options, minimal long-term hardware commitments, and the user flexibility that comes with pods rather than traditional pumps ([29:09]).

Unique Insight: Early Pregnancy Scare & CGM as Reassurance

• Around 11 weeks, Claire experienced bleeding—potential sign of miscarriage—and endured a weekend of uncertainty ([31:22]).

• Through the ordeal, her CGM data and insulin needs remained consistent with early pregnancy, offering hope even before clinical confirmation ([32:45]–[35:15]).

• Diagnosis: subchorionic bleed, which resolved on its own.

• Quote:

  "Because I had type one, I was wearing a cgm, ... my CGM was showing me like, you're still pregnant, baby's okay. And that was just like very cool to look back on." — Claire (31:10–31:15)

• Notes the lack of open discussion around such scares, and the additional layer of reassurance diabetes tech can provide.

Guidance for Others with T1D Considering Pregnancy

• Planning

  • "It's hard to go from 0 to 60. I'm really glad I took a year to ramp it in, do some research, listen to other people's experiences. But it is totally doable." — Claire (38:54)
  • Emphasizes incremental improvements, education, and leveraging the community.

• Advantages of T1D

  • Continuous monitoring makes one more attuned to bodily changes, which can be an asset in recognizing and addressing complications early ([39:55]).

• CGM as an 'Extra Vital Sign'

  • The technology gave both medical data and emotional comfort during uncertainty ([40:02]).

Personality & Connection

• Often lighthearted banter with Scott about technology, family, and football provides relatability and warmth.
• Memorable anecdote: Claire’s husband proposed on the 50-yard line of her college football field—with stadium employees as accomplices ([41:32]–[43:47]).

Notable Quotes & Timestamps

• "A modest reduction in insulin around 36 weeks is common. Normal physiological change. And a dramatic drop should always be reported to the care team."
  – Scott (07:00)

• "She empowered me. She's like, 'Look, you've been doing a great job so far. Like, why don't you just keep doing it yourself?'"
  – Claire (12:58)

• "I just grab my PDM from him with my left hand... and change my insulin pump settings on the OR table."
  – Claire (19:31)

• "Now I'm on the Loop algorithm using Omnipod Dash and... definitely feel like I'm putting in less effort and getting better control, which is just such a hard balance to strike."
  – Claire (28:08)

• "Because I had type one, I was wearing a cgm, ... my CGM was showing me like, you're still pregnant, baby's okay. And that was just like very cool to look back on."
  – Claire (31:10–31:15)

Timestamps of Key Segments

• 02:23 – Early pregnancy detection & initial management adjustments
• 04:13 – Coordinating with her care team & making insulin changes
• 06:06–08:04 – Late pregnancy drop in insulin resistance explained
• 11:33–13:45 – Labor, delivery, and who manages BG during labor
• 18:00–21:20 – C-section curveball: hands-on tech problem-solving
• 22:05–28:19 – Postpartum transitions, AID systems, and technology upgrades
• 31:22–36:45 – Early pregnancy scare, subchorionic bleed, & CGM as reassurance
• 38:54–40:02 – Advice for others with T1D considering pregnancy
• 41:32–43:47 – Football proposal story
• 46:07–End – Reflections on podcast impact, community, and staying driven

Takeaways

Claire’s story delivers both practical and emotional guidance for people with diabetes embarking on pregnancy, labor, and parenthood. She shows that

• Tight management is possible with planning, teamwork, and technology,
• Diabetes tech (CGM, pumps/AID systems) provide not just medical safety but also peace of mind,
• Life with T1D may be challenging but can empower individuals to be more in tune with their bodies,
• Flexibility and self-advocacy matter, from the delivery room to choosing the right insulin delivery system.

Her journey is both an instructional roadmap and an encouraging affirmation for others facing similar paths.