Sweet Expectations

Allison Nimlos

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HEALTH & FITNESS
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Navigating the highs and lows of a pregnancy with pre-existing diabetes.

21/11/2024

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, this Monday, November 25! ⁠⁠⁠⁠⁠Check us out on Instagram at our NEW IG handle: ⁠⁠⁠⁠@sweetexpectations__⁠⁠⁠⁠ Want to learn all there is about Diabetes & Pregnancy: ⁠⁠⁠Your 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!⁠⁠

54 min
30/10/2024

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: ⁠⁠⁠Check us out on Instagram at our NEW IG handle: ⁠⁠⁠@sweetexpectations__⁠⁠⁠ Want to learn all there is about Diabetes & Pregnancy: ⁠⁠Your 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!⁠

50 min
18/09/2024

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: ⁠Check us out on Instagram at our NEW IG handle: ⁠⁠@sweetexpectations__⁠⁠ Want to learn all there is about Diabetes & Pregnancy: ⁠Your 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!⁠

49 min
11/09/2024

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 - Katherine's blog Check us out on Instagram at our NEW IG handle: ⁠@sweetexpectations__⁠ Want to learn all there is about Diabetes & Pregnancy: Your 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!

48 min
30/07/2024

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) Diana on Instagram: @dianamisaacs Check us out on Instagram at our NEW IG handle: @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!

40 min
16/07/2024

Managing Type 2 Diabetes During Pregnancy: A Personal Journey, with Jacquean Kosh, T2D, mom of 2

In this episode, Jacquean Kosh, a licensed therapist and type 2 diabetes advocate, shares her journey of managing type 2 diabetes during pregnancy. She was diagnosed at the age of 26 and has two children. She discusses her experience with diabetes management, including going on insulin to finally get her blood sugars where they needed to be for pregnancy, and the challenges of controlling blood sugar levels. Jacquean's second pregnancy was unplanned and happened during a very stressful tim ein her life. Her A1C was over 13%, and she discusses what she did to bring it down safely. She emphasizes the importance of finding a supportive healthcare team and asking for help when needed. Takeaways Managing type 2 diabetes during pregnancy requires careful diabetes management and support from a healthcare team. Insulin may be necessary for blood sugar control during pregnancy, even for individuals with type 2 diabetes. Asking for help and building a support system is important during pregnancy and postpartum. Focusing on what can be controlled and finding the silver lining in difficult situations can help maintain a positive mindset. Chapters 00:00 Introduction and Diabetes Journey 04:45 Finding a Supportive Endocrinologist 07:56 Going on Insulin, Managing A1C Levels and Preparing for Pregnancy 10:13 Challenges with Hypertension 26:08 Jacquean's Birth Experiences 28:57 Managing Diabetes During Labor 31:59 Postpartum Differences 35:59 The Importance of Support 37:40 Advice for Pregnant Individuals with Diabetes Find Jacquean Kosh on Instagram

43 min
02/07/2024

On the Cusp of 3 with T1D, with Maggie Youngblood

In this episode, I talk with Maggie Youngblood, who is in the final weeks of her 3rd pregnancy with type 1 diabetes. She shares her journey and experiences with her 3 pregnancies, including diabetes management and labor & delivery (including 3 inductions), tandem breastfeeding, and maintaining good blood sugars between pregnancies. We also talk about the impact of mental health on managing diabetes during pregnancy. Maggie emphasizes the importance of listening to her body, asking for help, and managing her emotions around blood sugar control. Takeaways Managing diabetes during pregnancy requires close collaboration with healthcare professionals and making adjustments to treatment methods. Listening to your body and making smart food choices can help optimize blood sugar control during pregnancy. Having a strong support system, including healthcare professionals, family, and friends, is crucial during pregnancy and postpartum. Managing emotions around blood sugar control and seeking therapy can be helpful in navigating the challenges of pregnancy with diabetes. Chapters 00:00 Maggie's Story 04:49 Preparing for Pregnancy and Managing Diabetes 10:18 Managing Diabetes in Postpartum 17:28 Comparing and Contrasting Pregnancy Experiences 32:43 Preparing for the Third Delivery 36:29 Emotional Aspects of Blood Sugar Management Resources Follow Maggie on Instagram ⁠@maggieryoungblood Follow us on Instagram page, ⁠⁠⁠@yourdiabeticpregnancy⁠⁠⁠ To learn more about a T1D Pregnancy, enroll in the self-paced course, ⁠⁠⁠Your T1D Pregnancy Journey⁠⁠⁠. Need more personalized assistance? ⁠⁠⁠Apply for diabetes coaching⁠⁠⁠ with Allison, a certified diabetes educator and T1D mom.

43 min
19/06/2024

Pregnancy with MODY Diabetes, with Kylie Kulwicki

Although we are most familiar with type 1 and type 2 diabetes as being the dominant pre-existing diabetes in pregnancy, there is also MODY, Maturity Onset Diabetes of the Young (MODY), a rare form of diabetes caused by a gene mutation. In this episode, we chat with Kylie Kulwicki, who shares her experience living with MODY and how she managed her type of diabetes during pregnancy. MODY is caused by a gene mutation, and there is a 50% chance that her children will also have MODY. She discusses how she and her husband approached this risk in the episode. She also discusses the challenges of insulin resistance, the importance of pre-bolusing, and the anxiety of managing blood sugar levels. Takeaways Maturity Onset Diabetes of the Young (MODY) is a rare form of diabetes caused by a gene mutation. Having a child with a 50% chance of inheriting MODY can be a source of anxiety, but being prepared and having knowledge about diabetes can help manage the situation. Managing blood sugar levels during pregnancy with MODY requires careful monitoring and adjustments to insulin doses. Pre-bolusing and setting lower blood sugar ranges can help manage blood sugar levels during pregnancy. Induction of labor is often recommended for people with diabetes to reduce the risk of stillbirth. Breastfeeding can affect insulin needs, and it's important to be prepared for potential lows and adjust insulin doses accordingly. 00:00 Diagnosis with MODY 04:50 Managing Blood Sugar Levels During Pregnancy 13:02 Insulin and the Pregnancy Experience 16:01 Coping with Anxiety and High Blood Sugar 29:11 Managing Diabetes Postpartum 33:13 Breastfeeding and Future Children Resources Follow Kylie on Instagram @mylifewithmody Follow us on Instagram page, ⁠⁠@yourdiabeticpregnancy⁠⁠ To learn more about a T1D Pregnancy, enroll in the self-paced course, ⁠⁠Your T1D Pregnancy Journey⁠⁠. Need more personalized assistance? ⁠⁠Apply for diabetes coaching⁠⁠ with Allison, a certified diabetes educator and T1D mom. Disclaimer: Nothing you hear on the Sweet Expectations podcast should be a substitute for personalized professional medical or mental health advice. Please always consult your physician or other medical professional before making any changes to your diet, insulin dosages, or healthcare plan.

35 min
12/06/2024

Tips for Lowering Your A1C, with Ginger Vieira, T1D mom of 2

Ginger Vieira, author of 'Pregnancy with Type 1 Diabetes', mom of 2 and 25-year veteran of T1D, shares her experience and advice on managing diabetes during pregnancy. She emphasizes the importance of being intentional with insulin doses and being mindful about overtreating low blood sugars. She encourages women to focus on what they can control and not strive for perfection. Ginger is the co-author of Pregnancy with Type 1 Diabetes, and a new book, How to Stop Overtreating Low Blood Sugars. Takeaways Be intentional with insulin doses and make careful choices around food Focus on what you can control and prioritize getting the right amount of insulin Adjust basal insulin and be consistent with blood sugar management Insulin needs will increase during pregnancy, and that's normal and necessary for a healthy pregnancy 00:00 Introduction and Background 05:04 The Importance of Diabetes and Pregnancy Resources 09:42 Preconception Planning and Blood Sugar Targets 14:27 Changing the Definition of 'High' Blood Sugar 23:08 The Differences Between Injections vs. Pumping 28:42 Treating Lows Effectively 31:01 Don't Be Afraid to Increase Insulin 35:50 Encouragement for Women Considering Pregnancy

40 min
04/06/2024

Optimizing Management Strategies for Pregnancy, with Jenny Smith, RD, CDCES

In this episode of Sweet Expectations, I interview Jenny Smith, a registered dietitian, Certified Diabetes Care & Education Specialist and a mom with type 1 diabetes. We discuss the importance of preconception planning, including optimizing glucose management by becoming more skilled in using the tools and strategies available. We discuss the benefits of continuous glucose monitors (CGMs) and automated insulin delivery (AID) systems in managing blood sugar levels during pregnancy, as well as utilizing multiple daily injections. Insulin resistance is a common challenge for women with diabetes during pregnancy due to hormones have a significant impact on glucose and insulin levels. Insulin resistance can start in the early days of pregnancy and gradually increases throughout the second and third trimesters. We discuss ways to manage insulin resistance, including adjusting insulin doses, pre-bolusing, using alternative insulins like U-200 and considering medications like metformin. Takeaways Preconception planning is crucial for managing diabetes during pregnancy, including optimizing glucose management, setting targets, and ensuring quality nutrition. Continuous glucose monitors (CGMs) provide valuable visibility into blood sugar levels and help make more informed decisions about insulin dosing. Automated insulin delivery (AID) systems can be beneficial in managing blood sugar levels during pregnancy, but individualization and close monitoring are necessary. Personalized care and individualized recommendations are essential throughout the pregnancy journey to ensure optimal health for both the mother and baby. Pregnancy hormones have a significant impact on glucose and insulin levels, leading to insulin resistance. Insulin resistance typically starts in the early days of pregnancy and gradually increases throughout the second and third trimesters. Managing insulin resistance involves adjusting insulin doses, pre-bolusing, and considering medications like metformin. Delivery timing for women with diabetes varies depending on individual circumstances and hospital protocols. Open discussions with healthcare providers are important to determine the best plan for a safe and healthy delivery. 00:00 Introduction and Pregnancy Journey 05:55 Preconception Planning and Assembling a Supportive Care Team 29:17 Managing Insulin Resistance with Technology 37:41 Medications and Strategies for Insulin Resistance 42:53 Timing of Delivery and Individualized Plans 49:50 Open Communication and Setting Realistic Birth Preferences More from Jenny: Integrated Diabetes Services Pregnancy with Type 1 Diabetes Resources Follow us on Instagram page, ⁠@yourdiabeticpregnancy⁠ To learn more about a T1D Pregnancy, enroll in the self-paced course, ⁠Your T1D Pregnancy Journey⁠. Need more personalized assistance? ⁠Apply for diabetes coaching⁠ with Allison, a certified diabetes educator and T1D mom. Disclaimer: Nothing you hear on the Sweet Expectations podcast should be a substitute for personalized professional medical or mental health advice. Please always consult your physician or other medical professional before making any changes to your diet, insulin dosages, or healthcare plan.

53 min
28/05/2024

Advocating for Yourself in a Diabetic Pregnancy, with Anna Sabino, CDCES, T1D

In this episode, I chat with Anna Sabino, CDCES and 35-year veteran with T1D, who shares her experience of managing type 1 diabetes during pregnancy. She discusses the challenges she faced after the loss of her first pregnancy at 20 weeks. Anna emphasizes the importance of assembling a supportive healthcare team and advocating for oneself throughout the pregnancy journey. She also highlights the need for self-care and giving oneself grace during this challenging time. Anna's story serves as a source of inspiration and encouragement for others considering a diabetic pregnancy. Takeaways Managing type 1 diabetes during pregnancy requires frequent adjustments in insulin dosages and close monitoring of blood sugar levels. Assembling a supportive healthcare team and advocating for oneself are crucial during the pregnancy journey. Giving oneself grace and prioritizing self-care are essential for managing the challenges of a diabetic pregnancy. Connecting with others who have gone through similar experiences can provide valuable support and guidance. Type 1 diabetes and pregnancy can be successfully navigated with proper care and support. For more: Follow Anna on Instagram Visit her website Follow our podcast's Instagram page, @yourdiabeticpregnancy To learn more about a T1D Pregnancy, enroll in our self-paced course, Your T1D Pregnancy Journey. Need more personalized assistance? Apply for diabetes coaching with Allison, a certified diabetes educator and T1D mom.

47 min
14/05/2024

3 Tips to Prepare for Pregnancy

Summary In this episode, Allison Nimlos shares her personal experience with diabetic pregnancy and offers advice and support for others going through the same journey. She discusses the importance of getting support from partners and other individuals who have gone through or are going through a diabetic pregnancy. Allison also emphasizes the need to start thinking like a pregnant person before actually becoming pregnant, in terms of diabetes management. Lastly, she encourages listeners to believe in themselves and their ability to do a good job in managing their diabetes during pregnancy. Click here to learn more and enroll in https://greaterthancc.thinkific.com/courses/the-t1d-pregnancy-roadmap. Takeaways Getting support from partners and others who have gone through a diabetic pregnancy is crucial for managing the journey. Start thinking like a pregnant person before becoming pregnant to ease the transition into pregnancy diabetes management. Believe in yourself and your ability to do a good job in managing your diabetes during pregnancy. Consider using U200 insulin and metformin to help with insulin resistance and blood sugar management during pregnancy. Staying active and maintaining a healthy lifestyle can greatly benefit diabetes management during pregnancy.

29 min

12 Episodes

Navigating the highs and lows of a pregnancy with pre-existing diabetes.

Creator

Allison Nimlos
Years Active

2K
Episodes

12
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Clean
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© Allison Nimlos
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Sweet Expectations