#1739 Smooth Operator - Part 2

Summary

Juicebox Podcast: Type 1 Diabetes

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

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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.

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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.

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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]).

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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]).

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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)

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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

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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.

Transcript

[A]

Foreign. I'm Claire and I've had type 1 diabetes for 10 years. I'm really excited to talk today.

[B]

Friends. We're all back together for the next episode of the Juice Box Podcast. Welcome. Please don't forget that nothing you hear on the Juice Box Podcast should be considered advice, medical or otherwise. Always consult a physician before making any changes to your healthcare plan or becoming bold with insulin. All right, let's get down to it. You want the management stuff from the podcast. You don't care about all this chitting and chatting with other people. Juiceboxpodcast.com lists they are downloadable and easy to read. Every series, every episode, they're all numbered. Makes it super simple for you to go right into that search feature in your audio app. Type Juice Box 1795 to find episode 1795. JuiceBox podcast.com lists. Foreign. I'm having an On Body Vibe alert. This episode of the Juice Box Podcast is sponsored by Eversense 365. The only one year wear CGM. That's one insertion and one CGM a year. One CGM one year, not every 10 or 14 days. Eversensecgm.com Juicebox this episode of the Juicebox podcast is sponsored by usmed.med juicebox or call 888-721-1514. Get your supplies the same way we do from usmed. Today's episode is sponsored by the Tandem MOBI system with Control IQ technology. If you are looking for the only system with auto bolus, multiple wear options and full control from your personal iPhone, you're looking for Tandem's newest pump and algorithm. Use my link to support the podcast. Tandem diabetes.com/juicebox check it out.

[A]

I'd say the first trimester. First trimester. I kind of knew I was pregnant before I took the test just based on my cgm. I was like little insulin resistant today. So that was kind of cool. So I immediately had changed my settings and just kind of increased my basal a little bit to compensate for that reach out to my endo. And I was seeing her the next week anyway, so it's perfect. So went in, made some adjustments and she basically just kind of cranked everything up a little bit.

[B]

Yeah.

[A]

To help with the resist the little bit of increase the resistance I was having and to make sure I'm hitting those tighter goals. And then we were keeping it a secret at first which everybody, everybody can. Everybody's probably going to do it a little differently. We kept it a little secret at first. We wanted to get all that blood work back, we wanted to try and tell our family in person. It was still very, you know, much Covid times. So we were able to tell our family on mother's Day. And I think I was about 10 weeks pregnant at that time. And then I just was trying to be very cautious with what I was eating, count my carbs, know what I was eating, all that stuff, using all the tips and tricks I had, you know, previously read about and researched and experimented with. Yeah. But the first trimester wasn't too crazy. But then in that second trimester was probably around, like 18 weeks, give or take. It just. It was like Jenny says, you know, that roller coaster, cranking up, cranking up, cranking up. But I had a great team at my ob, My high risk doctor and my endo. And the three of them are familiar with each other because they all work in the area. My high risk doctor and my OB actually went to med school together.

[B]

Okay.

[A]

And then my endo kind of led all the blood sugar, insulin stuff, because I've heard a couple episodes where one person's driving, one of those three doctors is driving, you know, the. The changes, the insulin needs and, you know, all the changes. But for me, it was my endo. So every two weeks, we would connect through the messenger app. She would review my log, or she would review my cgm, all my pump data, everything, and then send me a message back with adjustments. And then once a month, I would meet with her. So I was making adjustments at least every two weeks. And then anytime I would see a pattern change for two days instead of three or more, I would make adjustments accordingly. Okay, so it just kept going up, up, up, up, up. How were you about.

[B]

I'm sorry, how were you guys? How are you guys connecting? Was it texting? Were you doing a portal? How does the phone message?

[A]

Yeah, messaging through the portal. And then once a month, I think at first I was going in person, and then we were doing virtual appointments where she would again review my data and we would talk in person.

[B]

Okay.

[A]

So I was just in very close contact with her, and as soon as anything went funky, I would just reach out and immediately get a response. I remember I went into work. I was 36. I was, I think, right at 36 weeks, went into work, and my blood sugar just kept crashing. And I was like, I don't think this is a good thing. Now Jenny's book, she talks about it. Must have missed that part. But at 36 weeks, your insulin is kind of plateau or even dip. So I reached out to my endocrinologist. And they called me right back. And she was like, yep, this is typical. Just. I think I decreased my basal 10%. Everything leveled out. It was fine. So I was like, man, I didn't take Jenny's book to work today.

[B]

Why, why does that happen? Why does that happen at 36 weeks? Do you know?

[A]

I think it's. I mean, Jenny would know, but it's something about, like, everything kind of just settles out. Like, I don't think it's. And it all kind of goes back to the placenta. I think a lot of that insulin resistance is from the placenta, but I think everything just kind of like starts to settle out, level out, and your needs sometimes almost dip. I don't know. But at first I was, like, worried that something was wrong. Like, why, why is this dropping? But once I found out that it was typical, expected, and the change was made and everything leveled out, then I was. That was okay. And my baby was moving fine too. So I was monitoring that too.

[B]

Well, ironically, because eventually AI will stop us from needing to make babies. But it seems to know about this. So let's check into it for a second. Why insulin needs drop around 36 weeks. A shift can occur where insulin requirements plateau or even drop. The main reasons would be one. Placental changes. As the placenta begins to age or mature towards the end of pregnancy, production of those insulin resisting, driving hormones may decline. Less placental hormone equals less insulin resistance, equals lower insulin needs. Fetal glucose use. The baby is growing rapidly and using more glucose directly from the mother's circulation. That extra uptake by the fetus can reduce maternal blood sugar levels, again lowering insulin demands. And this one's listed as a clinical concern. Early placental insufficiency. In some cases, a sudden and sharp drop in insulin needs can signal placental insufficiency, which is the placenta not functioning well. That's why obstruction obstetrics teams usually monitor closely. If insulin requirements fall rapidly, it can be an early red flag. Practical takeaways are 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. There you go.

[A]

There we go.

[B]

Nice. And. Yeah. And then one day, like you'll. We'll grow babies in labs and I'll take care of all for us. And none of this will be important when it takes over and then turns us into the machines that run the world.

[A]

But who's going to name the babies?

[B]

Well, if I can gain control, they'll all be named Scott?

[A]

Yeah.

[B]

If my culture. Here's the plan. I start a cult based around people taking care of their diabetes. Well, then eventually I get some coders in there, we develop our own AI and one day we're. Can you imagine, by the way? If any of you are worried about AI, I understand. And if any of you are excited about it, I understand too. I'm very much hopeful that we fall somewhere in the middle where we're not slaves to computers, but yet it's helping us in different ways.

[A]

Yeah.

[B]

I was listening to somebody talk about medical research the other day, and they said in their lab where they're researching, you know, a thing that most of the people in that lab prior to AI would be people who were compel, you know, compiling data and, you know, just making models so they could try to hopefully figure something out. Then they'd end up calling, you know, somebody else that they knew and said, hey, have you ever seen this? Like, it was a very, like, like that kind of process. And now those people. Well, here's the downside of it. Those people don't have a job in the lab anymore, but. But the AI is. Is doing the compilation. And then how did he put it? He said, and then it considers things that would take me years of sitting there banging my head against the desk to see the. The. The connections between. It sees the connections in, like, a couple of hours and. And made it sound very hopeful. And so I was like, awesome. So hopefully that's the way I hope it goes. Nevertheless.

[A]

Yeah.

[B]

Yeah. Although in my mind, I just see that the, The. The robot smashing the. The skulls. The beginning of the Terminator movie.

[A]

So I'm thinking of Spider Man. With great power comes great responsibility. If you can use it for good or for evil.

[B]

Yeah. And someone's gonna do one and someone's gonna do the other for sure. Like, for every person who's out there, like, I wonder if it could help us compile data faster so that we. Medical advances. There's someone else who's thinking, I wonder how I could get it to steal someone's money for me Or House. Yeah, something like that.

[A]

Well, yeah.

[B]

People. What are you gonna do, Claire? That little kid you're raising over there, he could go either way. We don't even know yet.

[A]

No.

[B]

You ever think about that? You ever think about that? Like, you could be raising a bank robber or, you know, somebody who's out helping people.

[A]

I think he'll be a helper.

[B]

Yeah, I hope so. It's nice. I wonder if the people know, like, I'd like to get the people whose kids ended up being bank or bank is bank robber a real thing. I'm saying something like, it's 1965, but I wonder if somebody whose kid, like, grew up to do something like that. I wonder if you could get an honest answer from them and say, hey, when they were five, did you think this kid's going to grow up to be a criminal? Like, did you know? You know what I mean? I'd love to know that.

[A]

Yeah.

[B]

All right, Claire, we've lost the thread.

[A]

There are probably some small signs, but.

[B]

Small signs. I'm like. She's like, do not bum me out about my 3 year old. He's awesome. Stop it, Claire, right now. She's like, oh, my God, he's going to use heroin and rob banks. That's not what I know. Okay, so you get that. You get that drop 36 weeks, you make your adjustment, and then how does it proceed from there?

[A]

So listening to the podcast episodes, I was like, okay, do I want to manage my own blood sugar during labor and delivery or not? So the plan was to induce it 39 weeks, which is their recommendation. Anyone who's well controlled, we're going to induce you at 39 weeks. They didn't want to let it go on too long and risk placental failure. That was their concern about letting me go longer than 39 weeks. So I was like, okay, let's go with the plan. And when I hit active labor, I was like, you know what? I'm gonna. I'll turn over the blood sugar control to you guys. Because in my mind I was like, IV insulin is gonna work faster than subcutaneous and I don't wanna be high. So I was like, okay, I'll turn it over to you guys and one less thing for me to worry about. That was my plan once we get there. I was managing my blood sugars during the early phases of labor all on my own. I was wearing a Dexcom. I was in manual mode. This was before the Omnipod 5 algorithm existed. I still was on my 10% decreased basal. I think once I hit active labor, I actually had to drop it more because just all that energy expenditure of labor was bringing me low anyway. So I'm monitoring, managing, doing everything fine, and my OB walks in and she's like, are you sure you want to pass control over to us?

[B]

Your OB's like, you're doing a great job here.

[A]

She did. She actually, 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? And you know, you can always change your mind. You have IV access. We can switch you over. No big. And I was like, really? Like, you think I can do it? Well, yeah, you're right. Like, I, I've been doing all this myself here and it's going really well. I mean, my blood sugars are great, between like 70 and 100. And I was like, well, what's my blood sugar now? 70. I was like, well, what's your, what would you do now? Like, what's your protocol? And they're like, well, your blood sugar's only 70, so we wouldn't give you any insulin. I was like, wait a second, you're not going to give me any insulin? I'm not going to stay at 70. I was like, yep, Okay, I got it, I got it. You guys, you do your job, I'll do mine.

[B]

We're cool.

[A]

Got it.

[B]

Nice and worked out well.

[A]

It worked out really well. There was only one minor problem, but this is a great story. So what happened?

[B]

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[A]

Eventually, my labor stalled and my doctor was like, okay, I'm going to give you an hour, but if I come back in an hour and things are not ready to go, we're. I would highly recommend a C section because I think if we just keep delaying it, we're delaying the inevitable. I was like, okay, got an hour. So in that hour, trying to, like, relax, keep it together, look at my husband, I'm like, okay, you are going to have to change my insulin pump settings for me when the time comes because I had my, you know, all my pre pregnancy settings, like, ready to go on my omnipod, my pdm. I was like, all right, so take this in to the OR in your pocket. And, you know, once the baby comes, we're all excited, we're all happy once the placenta is out. So we're gonna assume that happens. Like, oh, pretty.

[B]

Oh, where'd you go?

[A]

Sorry.

[B]

No, it's okay.

[A]

Speaking of, speaking of, what is it? AI? There it goes. My Amazon Alexa. Okay, so. So my doctor says that, you know, I'm going to come back in an hour. Probably gonna need a C section if we keep delaying it, you know, an hour at a time, keep checking it every hour. She's like, I think we're just delaying the inevitable.

[B]

So you should have had your husband pinch your nose and blow into your mouth.

[A]

I was trying anything. Mentally, I was like, try and relax. Like, baby move. Like, let's go. But to me, C section wasn't the end of the world. My. My labor and delivery plan was I want the epidural and I don't want my kid to get stuck on the way out. So as long as we accomplish those goals, we're good. So I had that all on board, you know, kind of mentally preparing. Okay, this might end in a C section, but I Had all my pre pregnancy settings and everything, like, ready to go in my omnipod. I just knew I had to switch it and I knew how to switch it once the, the placenta was out, since that was like the main driver of all the insulin resistance. So. So I turned to my husband like, okay, here's my pdm. Let me talk you through how to change it. Okay, you ready? You're good? All right, we're all good. So I go in the OR first and then he comes in right after me. I'm like, you got the pdm? He's like, yep, cool. I actually feel terrible by this point. Like, it's just been a long time, a lot of drugs, I'm exhausted, and I'm laying on the OR table and I'm like, oh, my gosh, I'm gonna, I'm gonna throw up. I'm laying on my back. I can't throw up right now. This is the best moment in my life, but I feel like I'm gonna throw up. So I was a. I was a mess. But my husband's there, he had the pdm, so we're good to go. And then, you know, they're like, he's coming, he's coming. Baby comes out, he's crying, he looks great. I can see him. My husband goes over to him and then I'm like, hubby, you got to change that. You got to change the settings. And I can barely talk because I feel like if I open my mouth, I'm just going to throw up everything. And he gets. If Anybody's familiar with Omnipod 5 in manual mode, I had a temp basil running. And when you have a temp basil running, you get an error message when you try and change your profile settings. So here's my husband getting this error message. He's never seen it before. I haven't seen it in a long time. And when we practiced him switching it over, he didn't actually hit go. So neither of us anticipated this error message coming up. And I can't talk because I'm going to throw up if I open my mouth. So I just grab my PDM from him with my left hand. I'm right handed, so with my non dominant hand, I change my insulin pump settings on the OR table.

[B]

I would love to clip out this like five minutes and make like 18 to 23 year old girls. Listen to it. To hear you go, it was the best moment of my life. Because they're probably like, oh my God, what is. They'd be like, what is happening to this woman?

[A]

Yeah.

[B]

How is she describing this as the best moment of her life? Oh, my God. Did he think you were mad at him?

[A]

No, no. He was just like. He had this panic look, like, I don't know what to do. And I literally was afraid if I opened my mouth to say anything, vomit was coming with.

[B]

Yeah.

[A]

Yeah. And I'm like, I probably shouldn't throw up when I'm flat on my back. And I probably shouldn't move because I'm on an OR table.

[B]

Also, I don't want to dirty the. The memory. You know what I mean?

[A]

But anyway, so that was probably the second coolest moment of my entire life. I was like, that was pretty badass. Like, I just grabbed it, swiped it, and did it. No, I just think he was just like. He was like, oh, my gosh, I had one job. I don't know what I'm doing. Like, what is this error message? Just, like, moment of panic.

[B]

And from you, if. And I can lend some perspective as a person who's been married longer than you. Never mention it. It'll just. It'll loom large for him. And then one day, when you see his confidence come back and you realize he's forgotten about it, that's when you bring it up. Yeah. Yeah. You have plenty of time to use this as a psychological manipulation, is what I'm saying. If that's what your goal is. No, look how nice you are. People are like, God, this guy's wife must be terrible. She's not. She's just Catholic. And, you know.

[A]

It was just so. It was just so funny because in that moment, it was like we had just, you know, our son's born, he's happy, he's healthy. Well, he was healthy. Yeah.

[B]

You don't know if he was happy or not.

[A]

Yeah, we don't know. He was probably like, what the heck? It's cold out here. Pull me back.

[B]

Yeah. No code.

[A]

But it was just like, this moment of, like, sheer panic on his part. What's going on? Slash. I was like, I don't know what else to do. Let me do it myself. And I was like, wait, I just changed my insulin pump settings while I'm lying on an OR table. I was like, that was pretty cool.

[B]

Yeah, that's really awesome. It felt empowering, huh?

[A]

Oh, yeah. I can do anything.

[B]

I can do anything. But then how long was it until you're like, I don't want to do anything. I'm going to stop. Because there's a moment where you're Like, I'm exhausted. There's a lot going on here. Where does your A1C and your goals change to? How long do they stay there before you say to yourself, you know what? Screw this. I can be that healthy, like, forever if I want to be.

[A]

Yeah, probably. Gosh, there's just so much going on and so many changes occurring, like, day to day, week to week. There was probably once I got back, more in, like, a rhythm and a routine. Probably, like, back to work and not, like, right back to work, because that was. That was a rough re entry. But maybe when my son was about, like, six months old, I was like, okay, I feel like we've got a little bit of rhythm, a little bit of routine. My blood sugars are a little bit more understandable. They're not quite so crazy that I was like, okay, like, I can. I think I can do this. And then Omnipod 5 had come out, and I. I liked the idea of having that kind of like that assistant to your blood sugar. Right. You've got, you know, so a lot of adjustments going around in the background that you don't have to, like, mentally think about. So I was like, that sounds great. Like, if I could get better control with a little more automation. That sounds perfect.

[B]

Hey, I want to let people know you. I think you did misspeak at one point telling the labor story where you said Omnipod, but you were not using Omnipod 5 during the delivery. Right. I have always disliked ordering diabetes supplies. I'm guessing you have as well. It hasn't been a problem for us for the last few years, though, because we began using U.S. med. You can to us med.com juicebox or call 888-721-1514 to get your free benefits. Check. U.S. med has served over 1 million people living with diabetes since 1996. They carry everything you need, from CGMs to insulin pumps and DIA testing supplies and more. I'm talking about all the good ones, all your favorites, Libre 3, Dexcom, G7, and pumps like Omnipod 5, Omnipod Dash Tandem, and most recently the eyelet pump from Beta Bionics. The stuff you're looking for, they have it at us med, 888-721-1514 or go to usmed.com juicebox to get started. Now use my link to support the podcast. That's usmed.com juicebox or call 888-721-1514.

[A]

Correct.

[B]

Right.

[A]

I might have misspelled.

[B]

Yeah, that's all I Just want to make sure so it doesn't confuse people, that's all.

[A]

Yeah, I was on Omnipod, but in.

[B]

The plain old regular using a dash and manual.

[A]

Yeah, manual.

[B]

Okay.

[A]

So then I did that for a little while and I still wasn't quite getting the results that I wanted. My A1C has been really good and fine. I've been in the sixes ever since my son was born. But I think it's like, it's this very interesting place I'm in now where like I kind of come up for air. My son's a little older. Come up for air. I'm like, kind of like, okay, I think I can handle a little bit more control. I can handle a change. I can handle like a little bit more interaction with my diabetes because I want better control. And Even though my A1C is coming out good, fine, passing on, you know, medical standards, I still see these big fluctuations or stubborn highs. And I'm like getting really frustrated with that because I'm like, I know I can do better, I know I feel better. You know, I felt so good when I was pregnant, but I also put in so much effort. Like, can I kind of find something in between here?

[B]

Yeah.

[A]

So all the aid systems are coming out and you know, everybody's upgrading and leveling up and this and that. So I was like, okay, like, let me try. I had Omnipod and I really didn't want a tube because I'd never had a tube. So I was like, all right, I'm sticking with Omnipod or maybe looping, but just the idea of looping was just so overwhelming. I was like, oh my gosh, I can't, I can't, can't build anything. I can like barely get my Apple products to work. So, so actually I met with Jenny through ids. I did a one time consultation and met with Jenny and I was like, kind of, you know, this Omnipod 5 algorithm isn't giving me what I want. You know, I don't have enough options in there. You know, it's doing so many things automatically, which is great, but it's like not quite enough. Like, what else can I do? So she gave me some like, hacks for the Omnipod 5, just some suggestions and she was like, or you could try another algorithm. So she told me and you know, she mentioned that Omnipod and loop, you know, when you loop you can use the Omnipod so you're still tubeless. But I was like, jenny, I, I, I can't, I Can't build Loop. Like, I know. So she told me there's a company that will build it for you, and you pay them a monthly fee. And I think you actually interviewed one of the guys who's working there now.

[B]

Yeah, I'm sure. I think there's a couple, but, yeah, there's. There's a couple. So you got somebody to set it up for you. That's awesome. Yeah, that's great.

[A]

Now I'm on the Loop algorithm using Omnipod Dash and the Loop algorithm that was built for me. And it's definitely giving me more options, which now I can. My brain can function using more options and features. Whereas some days I was like, no, you just do it all for me. Algorithm. You do it all for me. I can't mentally deal with this right now, but. But now I'm in a headspace where I'm like, okay, I can mentally deal with it. I want more options. I want more control to see the results and to feel. To feel better, but without so much of the effort that I was putting in back in the day. So I really like the algorithm. I think it's helping me more. I think I could definitely do more with it if I sat down. I probably need to go back through the Pro Tip series. Probably need to learn more about the Lookout Loop algorithm. Excuse me. And I can definitely do more with it, but that's where I'm at now. And I definitely feel like I'm putting in less effort and getting better control, which is just such a hard balance to strike. And then I think in the future, I'll be able to customize it more, learn about it more, customize it more, and have it serve me even better.

[B]

Yeah. And you went with Loop, not with Trio.

[A]

I did. I think that just came out because I switched to Loop about a year ago.

[B]

I see. So just as you were doing it, it felt a little newer. Arden's really, I think, having a lot of success with Trio, by the way. Yeah. Now that you're a. You're a professional, you could just jump back and forth.

[A]

I know. Try them all.

[B]

You know, plenty of people have both of those algorithms on their phone.

[A]

Wow.

[B]

Yeah. And they'll just, like, start a pod on one or start a pod on the other one. You think you'd be that kind of person?

[A]

I don't know.

[B]

I just like it. You just went, ah, that was great.

[A]

But I. I do love the. The Omnipods Tubeless. And the other appeal, when I was, like, hesitant to switch from MDI to to pumping. Just, you know, change is hard. Right. And I was like, I don't know. But the appeal was instead of purchasing the pump, you know, and having to wait four years for insurance to pay for another one or whatever gives you more flexibility. There's a way with the, with the pods that you can really kind of do it month to month, I think, because instead of being dme, it's considered a pharmacy something or other. Anyway, so I was like, that's appealing too. You're not like locked in, committed for four years to a pump. I definitely didn't want to do that.

[B]

Awesome. Have you shared everything with me that you were hoping to share today?

[A]

I think so.

[B]

Don't over in your head. Take your time.

[A]

I think so. I think the only other tidbits I know you have interviewed ton of other people with type 1 with interesting stories of diagnosis or crazy things that happened or. And obviously pregnancy. The only other thing I can offer as just something a little different is when I was pregnant, I was about 11 weeks pregnant and we had a little bit of a scare where we thought we were. We thought we were having a miscarriage. We thought we were losing our son. So that was very, very rough couple of days. But what was interesting was looking at that cgm. My cgm, my blood sugar numbers, my insulin needs were all behaving like I was still pregnant. So I was oscillating back and forth between being absolutely devastated and still hopeful because those CGM numbers and then looking back on it once we found out that, you know, every. I went to the doctor, got checked out, everything's okay. But it was just so cool to look back on it and realize that because I had type one, I was wearing a cgm. And because I was looking at my 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 because it's again, like a very unique experience.

[B]

Yeah. What was happening that made you think that the pregnancy was not viable?

[A]

Yeah, I started bleeding. It was like 10 or 11 weeks. I went to the bathroom and I was like, oh, I'm bleeding.

[B]

And then what do they say to you? Like, what. What's the steps to take after that? Rest and see if it stops.

[A]

Yep, yep. So. And it was a. It was a Friday.

[B]

It's always been Friday, Claire.

[A]

Friday, Friday it was 6pm and I was like, do I go to the emergency department? What do I do? Well, I called the OB on call, who was great. He was like, you know, he's like, okay, it might be something or it might be nothing. It's nothing you did. You didn't do anything wrong. It's nothing you did. It's nothing you ate. It wasn't the green jello. He was just like, you know, trying to, like, calm me down, but I still remember that day. It wasn't the green jello. I was like, okay, I didn't eat green jello, but just, you know, just trying to like, relax me, calm me down. He's like, look, what you're gonna do is just rest this weekend. See us first thing Monday morning and we'll check and we'll see what's, what's happening. And so I was like, okay, don't go to the emergency department. Also, whatever they told me, you know, that's not their area of expertise. So I'm like, I could just go to the emergency department. But also I was like, all right, trust my ob. If they say, just wait, we'll wait. Which was not a fun wait.

[B]

Yeah, geez, I bet. Would you just sit in the house, like, staring at each other?

[A]

No, we. We thought about. Yeah. Canceling all plans and like, just holing up in the house, but I was like, okay, we're going to lose our minds. We were going to go to an outdoor concert and we still went. I just sat the whole time instead of standing.

[B]

Yeah. It wasn't in Australia, was it?

[A]

Oh, gosh, no. It was only like a two hour drive away, but it was like out in the country outside, you know, big field music. And I was like, okay, well, we'll just bring like camping chairs to sit on. Because I was told, like, don't you. Don't run. Try and sit, rest. Don't lift anything heavy. You know, this stuff like that.

[B]

Yeah, don't bounce the kid around it.

[A]

Yeah, yeah, don't make it any worse.

[B]

Stop jostling the baby.

[A]

Like, what did you do? But yeah, sometimes it just happens. And so I went to the doctor Monday and they're like, oh, yeah, sometimes this just happens. But you know, they're like, baby's fine, baby's fine. Sometimes this stuff happens. Just, you know, relatively rest. And then eventually everything was fine.

[B]

It was just okay. And. And there's no answer after that. There's no, like, great pronouncement about what happened or didn't happen. Just like, oh, that's over. Cool.

[A]

Oh, it's actually, hopefully I'm pronouncing right. It's called a subchorionic bleed and it's Just blood fills somewhere in the uterus. I forget. I think it's between the uterus or placenta or something. But it's just this little pocket of blood. And usually, depending on the size and the severity and symptoms, sometimes bad things can happen. It puts you at increased risk for other things. But in my case, it was small and it resolved on its own. It was fine, but that's what I was seeing. And then, as I think any woman would assume, you're pregnant, there's blood, that's it, it's over. Yeah, but I didn't know that this existed and actually happened to a friend of mine who was pregnant at the same time. It happened to her a couple weeks later. And we kind of circled back on it later, comparing notes, like, oh, my gosh, that happened to you too? So I was like, why doesn't anybody talk about this? Probably because they don't want you to assume one thing or another. They don't want you to assume that everything's okay or assume everything's the end of the world. Terrible.

[B]

Yeah.

[A]

But it was just very interesting, like later on to compare our experiences. And I think she probably didn't wait a whole weekend like I did to get checked out by the doctor. But that weekend I had that CGM information and my insulin needs were the same. And I was like, huh? I was like, I think I'm still pregnant.

[B]

That's something.

[A]

So it was just interesting to have that. It was kind of a comfort, but I didn't know. It was just different.

[B]

Two questions. If that would have been a Wednesday and not a Friday, do you think they would have had you write in, you would have been examined? Do you think that that exam would have alleviated all your concern right then and there or not necessarily.

[A]

Yeah, maybe. It probably would have given me answers sooner, but it probably would have been the same result. Like, hey, hang out, wait, relax. Yeah, I don't know.

[B]

What was the bleed called again?

[A]

I think it's called a sub chorionic bleed. You can probably look it up on AI, find out how to spell it and pronounce it, but it was just a. It was. It was just interesting to go through that as a type 1 with the CGM information while I was waiting to find out if everything was okay or not. Because all of my technology, my insulin needs, my blood sugar needs were all showing that I was still pregnant. So I was, like, pretty hopeful that I was still pregnant, but I didn't know.

[B]

Yeah, but did you cling to that a little bit?

[A]

Yeah, I Was like, holding out hope. So I was definitely oscillating between, like, oh, my gosh, we're losing this kid. We already know it's a boy, and all, all of that. But I kept clinging on to that little bit of hope because I had that cgm and.

[B]

And you could see your blood sugar was still being screwed with by. By a pregnancy. And you thought, oh, yeah, a kid must be okay in there. Look at my insulin resistance.

[A]

Yeah, yeah, yeah. Not just the cgm, but yeah, my insulin needs were the same as the day before when I knew I was pregnant.

[B]

Right.

[A]

My blood sugar wasn't crashing. I wasn't going sky high. I was like, oh, okay. I was like, I think I'm still pregnant. I acted like I was still pregnant.

[B]

Well, I have here that a pelvic, let's see, like a cervical dilation, whether the cervix is soft or thin, but it doesn't tell them how the baby's doing. Fetal heart rate monitoring, Doppler in the office, continuous monitors in the hospital. The main tool to assess distress in the baby. Patterns in the baby's heart rate show how well oxygenated they are. Non stress tests measure how the baby's heart rate. Did you end up doing all this when the week finally came around?

[A]

I think they just did a quick ultrasound.

[B]

I was like, that's the next thing. Ultrasound. NST to check movement, breathing motions, muscle tone and amniotic fluid. Contraction stress test. Ultrasound. Okay. All right.

[A]

I was pretty early. It was 11 weeks. I went into the doctor's office and they were like, okay, let's just. They're like, okay, let's just take a look. Yeah, ultrasound, take a look. And she was like, oh, that's what it is. I see the bleed there. And spent a minute, like, we listen to his heart rate. She's like, oh, baby's fine.

[B]

All good. Yeah. Now, does that experience early on in the pregnancy? Are you able to give it away or does it stick to you the entire time the baby's in there? Like, do you think about.

[A]

Did for a while. And then because I was getting so many ultrasounds and that was on my record, they looked, they checked like, oh, it's gone. It's resolved. It's a non issue now, I think, you know, I didn't know as much about that. I already knew everything was high risk for everything being type one and, you know, mid-30s. And so I was more worried about that. Yeah, I was like, oh, just another thing. But I was just more worried about all the other risks. More being associated with type 1 and not being 25. Awesome.

[B]

So you would tell people who have type 1 and are thinking of getting pregnant. It's very doable, I assume.

[A]

Yeah. I used to think it was impossible. There is absolutely no way. These goals are insane. There's no way I can do that. But I did it. So I'm like, okay, if I can do it, anybody can do it. I would do some research, some planning first. And it's hard to go from 0 to 60. So I'm really glad I took, like, a year to kind of hone it in, ramp it in, take the information in, do some research, listen to other people's experiences. But it is totally doable. And I think we have a little bit of an advantage because we're all in better touch with all of the things. Sleep, exercise, nutrition. We're so, so much in better touch with our bodies and the way we feel in the world. More in tune. Yeah. Than somebody without type 1 or a chronic health condition that needs constant monitoring. So I think we're already at a bit of an advantage there. So, like, if anything funky does happen, I feel like we kind of know. Know our bodies best, can trust our gut, really.

[B]

Well.

[A]

We've got this. I feel like that needs. And CGM's, like, an extra vital sign when they're doing all this monitoring and testing. So.

[B]

Yeah. That's really awesome. I'm. I'm very happy that you. You took the time to share this with me. Thank you very much. I want you to know that when you earlier said, like, you sounded, like, embarrassed about how much you like college football, made me find you on Facebook and. Yeah, yeah, yeah. You might have a problem.

[A]

I just want to say, I might have a problem. I may or may not be wearing football attire right now. Like, my second favorite day of the year. It's, you know, big kickoff tomorrow is beginning the college football season, so.

[B]

But you don't care about pro football.

[A]

I follow the football players I like in college. I follow them to the pros, but then they change teams, like, 20 times, and I get very confused.

[B]

Yeah, I like it when you're just forced to play for this one team. It's better. It's awesome.

[A]

You just stay in one place so that I can buy the jersey and it's still valid a few years from now.

[B]

Now, is this. Is there an irony here where, like, you know, we finally find a girl who loves football, but the guy you married doesn't care about it? Or do you guys have that in common?

[A]

He Knows what he married into, but.

[B]

He doesn't love it like you do.

[A]

He will get into it for me. He enjoys it, but he doesn't seek it out. In the same way he doesn't have.

[B]

An illness like you.

[A]

Exactly. I will seek it out. I will turn it on. I'm ready to go. And he's like, wait, what time is it? What channel is it on? Okay, it's on. Yeah, let's watch.

[B]

That's fine.

[A]

But funny story about us is he actually proposed to me in on the 50 yard line of my college football field, which is not easy to get on.

[B]

Did you do it legally?

[A]

Yes. Yeah.

[B]

Very nice.

[A]

Yeah, we had an employee escort us out there.

[B]

What does he tell you you're doing? Because do you know you're being proposed to?

[A]

No, I didn't know. It was definitely a little odd. He was like, you've never, you've never taken a tour of the stadium? I was like, no. I was like, I have been on the field one time, right? But I was, no, I wouldn't take a tour. Never been on a tour. I been to many games there. Why do I need a tour? He's like, oh, well, I'm going to take you on a tour. I was like, okay. We pull up and this employee, he shows up and he's like, oh, are you guys here for the tour? So that the employee was totally in on it.

[B]

The tour. At what point were you like, I am not having sex with you on this football field, you creep. Is that where this is leading to?

[A]

No. My husband and I pulled up and there are these two employees and they're like, are you guys here for the tour? And we were like, I guess so. And my husband's like, oh, yeah, yeah, we're here for the tour. And then. And at first it seemed like a legit tour. Like, you know, here's the locker rooms, here's that, here's this, and then we get to the field and here I am being like the nerd that I am. Like, how often do you have to paint the field before a game? Well, we paint it like twice a week. But crazy lady, like, stop asking me questions.

[B]

I'm like, it's not really a tour. And I don't. I don't know. I don't know a lot about this stadium.

[A]

I mean, I think they, they did. So they were kind of trying to answer my question, but also facilitate getting me to center, like, yeah, to the 50 yard line, like the center of the field. And they're like, why don't you go just, you know, walk out there, see what it looks like from the center. And that's where my husband proposed. And the employees got photos of the whole thing. It was great. And afterwards, I was like, okay, that was amazing. But I was like, you didn't have to go to. I would have said yes anywhere. You didn't have to do that. He was like, no, but it was cool, right? I was like, oh, that was very cool. Pictures are great.

[B]

Set the bar too high. He's gonna be. He's gonna be chasing that dragon the rest of his life now.

[A]

I know, I know. And then, like, all. Any. Any mutual friends were just like, oh, dude, come on. Like, yeah, you did that. What am I going to have to do?

[B]

I looked at my wife in the bedroom we were living in, and I said, you know, this would probably be easier if we got married. And she's like, what? I'm like, well, you know, we could afford the car insurance, and my wife and I got married for car insurance. Like, I'm not kidding. We were dating for a while, living together because of a bad circumstance in her family, and she got a great job, but we couldn't afford to. Like, you couldn't afford anything. So we figured out a way to lease her a car because it was very inexpensive back then to get started. Right. And. But we couldn't figure out how to. Like, she couldn't afford the insurance, but if we were married, the insurance would have been much cheaper. So we got. We planned a wedding and got married in a number of weeks, use the money that people gave us as gifts, which, if I'm remembering correctly, did not equal more than about $750 to put a down payment on a leased car. And then we could afford the insurance because she was now on my insurance policy.

[A]

Wow.

[B]

Not as sexy as your story, but, like, that's. Now, keep in mind that seems like a terrible way to start a. A marriage and a life, and we've almost been married for 30 years.

[A]

Yeah.

[B]

Yeah. Who knows how it works and how it does?

[A]

Thank you. Car insurance.

[B]

Thank you. Hey, yeah.

[A]

Insurance premium.

[B]

Exactly.

[A]

Yeah, I've heard of. I've heard about health insurance, but not car insurance.

[B]

So she had to get. It was a great job. Like, we couldn't. She couldn't not take the job. But it was too far away. There was no other way to get there. She needed a car. It needed to be dedicated to her. We didn't have anybody that could help us with that. And so those are the steps we took. So if you're. If you're sometimes wondering, like, how did Scott figure out diabetes without having any knowledge about it? That's how Scott figured out to get car insurance when he was broke and, you know, like, 20 some years old.

[A]

Yeah. There's a will, there's a way.

[B]

I'm just a practical person, that's all. All right, Claire, you were great. I'm going to take a little breaky, and then I'm actually interview. I'm actually recording with your friend Jenny in 30 minutes. I'm going to go rest my voice and then come back and do it again.

[A]

Yeah, good.

[B]

You were terrific. Really. I really genuinely appreciate it.

[A]

This is really fun. It was really fun to be a part of something that I've been listening to for so long. It's influenced me positively for so long. So it's. It's really cool. I've been telling a lot of people. I'm like, oh, my gosh, guess what? I'm doing. So excited. And it's really cool to talk to you in person, too. And I just want to thank you for all this, all of this hard work. So many episodes. I'll tell people, like, this is, you know, the number one diabetes podcast. It's this many episodes, and they're just floored. They're like, oh, my gosh. I know.

[B]

I appreciate that.

[A]

So much time, energy, and effort.

[B]

And I would certainly not. I am not complaining, and I certainly would not complain, but if you were here and watched me every day, you would be like, I think maybe Scott should go outside a little more often. Or. I'm worried that he's not living a life just making this podcast. But I just see it as. I mean, it's a moment in time. It's not going to be here forever. And the more conversations, the more ideas, you know, the more people get stretched a little bit and come up with new ideas and come back on and have time to share. I think it's just important, you know, and. And I think it's. I think it's a time in my life where I'm dedicating more time to a job than I probably should be for me personally. But I think that hopefully, you know, big picture, it's going to be something like when I leave it, when I put it down at the end and I go, here it is. You guys can do whatever you want with it. I think it might keep helping people. So that's my goal, certainly. And I appreciate you speaking so nicely about it. Thank you.

[A]

Yeah. And it'll Keep helping people, even if you were to stop tomorrow, because it's all out there just sitting and waiting on the Internet.

[B]

I can't stop now, though. I keep seeing connections to other things. I interviewed a guy the other day, and at the end of talking about, you know, this really amazing conversation about how the podcast helped him get his daughter on her feet in just a few years before she was on her way to college. And then she had this experience, like, right away at college, and she handled it really well. And he related that all back to the podcast. And we're kind of done talking, you know, 45 minutes, an hour later, and he just sort of pops up, and he's like, oh, also, I listened to your weight loss series and changed my life. And I was like, oh. And he's like, I've lost 36 pounds in the last six months. And talked about all the good things that had happened for him personally. And I was like, my gosh, like, there are days, Claire, like, I just record this stuff. I just assume, like, no one's listening to it. Like, you really. Like, you'd have to be a maniac to just think I'd be insane if I actually believed that the number of people listening to this were the number of people listening to it. Like, I know functionally that's how many people are listening, but when you sit down and talk, you can't think, I'm about to speak, and X number of people are going to hear the words. Like, it's just not a way to think about it. So when he comes around and he's like, this helped me. I spent like a half an hour after done recording thinking, like, wow, like, I decided to do a thing and listen to what happened for him. Listen to what happened for his daughter. Listen, you know, like, that's. It's awesome. Like, I want to do more of that. And then you start seeing connections with it, and you're like, you know, we got to keep talking about this. I'll tell you right now, I was out ahead of Talking about injectable GLPs for type ones, and when I started talking about it, I took a lot of from people about it. And I've been out ahead on a couple of things, but I think I'm only there because you guys are all coming and, like, having these conversations, and I'm seeing, like. Like, through lines, and I'm like, no, that really does feel like something that's. That's positive right here. Something we should pay more attention to. We have to keep talking about that so it can grow. I think that one of the saddest things about content in general is that it's fleeting. Like most content creators that you listen to, they burn out pretty quickly or the algorithm gets tired of them or whatever happens, and before they can really build a compendium, they're here and gone. And because there's no financial incentive to keep going, they just stop. And so I think that's part of why the podcast grows and becomes more and more valuable is because we're able to put this much effort into it for such a long time. That's a lot of, like, high minded talking about me making a podcast, but that's sort of how I think about it.

[A]

Yeah.

[B]

Yeah. So anyway, I really appreciate you saying that. It's very kind of you.

[A]

Yeah.

[B]

Awesome. Yeah, awesome. All right, hold on one second for me. Okay. Head now to tandemdiabetes.com juice box and check out today's sponsor, Tandem Diabetes Care. I think you're going to find exactly what you're looking for at that link, including a way to sign up and get started with the Tandem MOBI system. Arden has been getting her diabetes supplies from US MED for three years. You can as well usmed.com juicebox or call 888-721-1514. My thanks to USMED for sponsoring this episode episode and for being longtime sponsors of the Juice Box Podcast. There are links in the show notes and [e-mail] to us Med and all the sponsors. Today's episode of the Juice Box Podcast is sponsored by the Eversense365. You can experience the Eversense365CGM system for as low as $199 for a full year. Visit Eversensecgm.com juicebox for more details and eligibility. My Diabetes Pro Tip series is about cutting through the clutter of diabetes management to give you the straightforward, practical insights that truly make a difference. This series is all about mastering the fundamentals, whether it's the basics of insulin dosing, adjustments or everyday management strategies that will empower you to take control. I'm joined by Jenny Smith, who is a diabetes educator with over 35 years of personal experience. And we break down complex concepts and into simple, actionable tips. The Diabetes Pro Tip series runs between episode 1000 and 1025 in your podcast player, or you can listen to [e-mail] by going up into the menu. If you're looking for community around type 1 diabetes, check out the Juice Box podcast Private Facebook group Juice box podcast type 1 diabetes but everybody is welcome. Type 1, type 2 gestational loved ones it doesn't matter to me. If you're impacted by diabetes and you're looking for support, comfort or community, check out Juice box podcast type 1 diabetes on Facebook. Hey, thanks for listening all the way to the end. I really appreciate your loyalty and listenership. Thank you so much for listening. I'll be back very soon with another episode of the Juice Box Podcast.