Think Like A Pancreas...The Podcast!

What if the symptoms you’ve been told are caused by diabetes… actually aren’t?
In this episode 73 of Think Like a Pancreas—The Podcast, Integrated Diabetes Services clinicians Tavia Vital and Alicia Downs examine a frustrating and all-too-common issue in diabetes care… when medical symptoms are incorrectly blamed on diabetes—and the real diagnosis is missed!
From neuropathy and kidney disease to fatigue, pain, and hormonal issues, Tavia and Alicia explain why people with diabetes are frequently told “it’s your diabetes” even when other conditions would also fit. They reveal how systemic healthcare constraints, insurance coding, and time pressure can lead to misdiagnosis, delayed treatment, and unnecessary guilt for patients.
MEET YOUR HOSTS:
Tavia Vital BSN, BA, RN, CDCES is the Director of Intensive Diabetes Management for Integrated Diabetes Services. Tavia is a Registered Nurse, Certified Diabetes Care and Education Specialist, and Certified Trainer on most makes/models of insulin pumps and continuous glucose monitoring systems. Having lived with type one diabetes for over 40 years, she understands that each person’s experiences and needs are unique.
Alicia Downs,  RN, MSN, CDCES,  BC-ADM experienced years of mis-diagnoses and ineffective treatments that gave her the incentive to take the lead in her own health care and educate those around her. Alicia is passionate about providing educated compassionate informed and equitable care to all people.
WHAT YOU’LL LEARN:
✔️Blaming your diabetes rather than finding the true cause can create unnecessary emotional and physical stress.
✔️How non-diabetes conditions get mislabeled as diabetes complications
✔️The problem is often systemic. To investigate your potential diagnosis, your doctor needs to first provide a diagnosis.
✔️Your “neuropathy” is often treatable before it is debilitating.
✔️The importance of creating a team “us” with your medical professionals.
CHAPTERS
00:00 Welcome and introduction
03:01 Understanding the endocrine system
04:39 When it’s really NOT diabetes
07:32 Where the fault lies
12:16 The facts about diabetes related neuropathy
19:54 Rare conditions are not rare in the diabetes population
24:55 Reference ranges, diagnostic ranges, and prevention
29:20 When it wasn’t Tavia or Alicia’s diabetes
35:17 The questions to ask
39:53 One bad lab result doesn’t mean you have another disease
RESOURCES
Autonomic Neuropathy Screening Update for People with Type 1 Diabetes
CONNECT WITH US
🔵Website: integrateddiabetes.com
🔵 Follow on Social Media: @integrated_diabetes_services and @ integrateddiabetesservices on Facebook
🔵To work with the Integrated Diabetes Services Team , visit https://integrateddiabetes.com/how-to-start-the-process/ ,  or email info@integrateddiabetes.com
SUBSCRIBE AND REVIEW
If the podcast has helped you to live better with diabetes, please tell someone else how to find it! If you have a question, take a moment and ask! We reply to everyone. And then be sure to subscribe on Apple Podcasts, Spotify, or your favorite podcast platform to ensure that you never miss an episode!
 
Disclaimer
The information contained in this program is based on the experience and opinions of the Integrated Diabetes Services clinical team. Please discuss any changes to your treatment plan with your personal healthcare provider before implementing.

In Episode 72 of Think Like a Pancreas—The Podcast, the clinicians of Integrated Diabetes Services—Jennifer Smith, Dana Roseman, Tavia Vital, and Dr. Paula Diab—tackle a topic that is rarely discussed but deeply impactful: navigating perimenopause and menopause with type 1 diabetes.
Drawing from both clinical expertise and lived experience, these women unpack what many people are never told in the exam room about hormonal shifts, blood sugar volatility, insulin sensitivity changes, and the emotional toll of this life stage. They candidly share the frustrations of managing their own diabetes through perimenopause and menopause, while also offering practical insights, validation, and strategies that have helped them—and their patients—along the way.
This conversation brings clarity, compassion, and real-world guidance to a phase of life that too often leaves people with type 1 diabetes feeling confused, dismissed, or alone.
 
MEET YOUR HOSTS:
Jennifer Smith, RD, LD, CDCES is the Director of Lifestyle and Nutrition for Integrated Diabetes Services. She is renowned for her expertise in nutrition, diabetes education, and athletic performance. Having lived with type 1 diabetes since childhood, Jennifer offers unique insight into day-to-day diabetes management, pregnancy, sports nutrition, and technology integration.
Dana Roseman, MPH, CDCES, RDN, LDN, is the Director of Technology and Applied Research for Integrated Diabetes Services. Diagnosed with Type 1 Diabetes, she has spent nearly 20 years improving diabetes care through technology, research, and patient education—including expertise with insulin pumps, continuous glucose monitors, and hybrid closed-loop systems.
Tavia Vital BSN, BA, RN, CDCES is the Director of Intensive Diabetes Management for Integrated Diabetes Services. Tavia is a Registered Nurse, Certified Diabetes Care and Education Specialist, and Certified Trainer on most makes/models of insulin pumps and continuous glucose monitoring systems. Having lived with type one diabetes for over 40 years, she understands that each person’s experiences and needs are unique.
Dr Paula Diab PhD, CDCES is the Director of Weight Management at Integrated Diabetes Services. She is a Family Physician and Diabetologist who runs a multi-disciplinary practice specializing in the management of chronic diseases, particularly diabetes and obesity in South Africa. Her approach is to walk the journey with her patients and to allow them to manage their disease rather than allow the disease to define who they are.
WHAT YOU’LL LEARN:
✔️Menopause will make you think that you are doing something wrong after years of getting it right…but you aren’t!
✔️The inconsistency of hormonal fluctuations in perimenopause make it hard to nail down changes that may be required.
✔️ The value of finding other women to share your concerns with.
✔️Women with type 1 diabetes must take extra precautions to avoid bone issues found in aging.
✔️Self-care is not optional.
CHAPTERS
0:56 Welcome and Introduction
05:06 Menopause today is not what it was in your grandmother’s day
07:33 It isn’t your fault
09:00 The illusive nature of the onset of perimenopause and the havoc it creates.
12:21 How changing hormone levels impact your body
14:28 The domino effect of symptoms
18:41 Who do you turn to for medical help?
22:01 Menopause support
23:27 Understanding hormone replacement therapy
25:30 Mitigating your risk factors
28:12 Physical fitness after 50 is no longer optional
31:59 Tips for weight management in menopause and perimenopause
39:53 The impact of “menopause day” on diabetes management
41:59 Final thoughts
RESOURCES
It’s a New Year – forget resolutions or big giant goals.
The Power of Protein
Only About 5% of US Women Now Use Menopausal Hormone Therapy
The Power of a Team in Your Diabetes Weight Loss Journey – Integrated Diabetes Services
Weight management for people living with diabetes
CONNECT WITH US
🔵Website: integrateddiabetes.com
🔵 Follow on Social Media: @integrated_diabetes_services and @ integrateddiabetesservices on Facebook
🔵To work with the Integrated Diabetes Services Team , visit https://integrateddiabetes.com/how-to-start-the-process/ ,  or email info@integrateddiabetes.com
SUBSCRIBE AND REVIEW
If the podcast has helped you to live better with diabetes, please tell someone else how to find it! If you have a question, take a moment and ask! We reply to everyone. And then be sure to subscribe on Apple Podcasts, Spotify, or your favorite podcast platform to ensure that you never miss an episode!
Disclaimer
The information contained in this program is based on the experience and opinions of the Integrated Diabetes Services clinical team. Please discuss any changes to your treatment plan with your personal healthcare provider before implementing.
 

In episode 71 of Think Like a Pancreas—The Podcast, Integrated Diabetes Services founder Gary Scheiner speaks to innovator and entrepreneur, Aurelian Briner about the SNAQ app that he created for his wife, Loredana.
The conversation explores the app's development journey, its key features for carb counting and diabetes management, and the challenges faced in the digital health space. The Briner’s share how user insights and lived experiences have allowed them to continue to build the app to help a growing number of people living with type 1 diabetes.
MEET YOUR HOST AND HIS GUESTS:
Gary Scheiner, MS, CDCES is the owner and Clinical Director of Integrated Diabetes Services. He is an award-winning Certified Diabetes Educator, Masters-level Exercise Physiologist and person with type-1 diabetes since 1985.  Gary is also actively involved with many diabetes related organizations as a volunteer and clinical advisor.
 
Aurelian Briner is the CEO & Co-Founder of SNAQ. SNAQ is an AI-powered diabetes management platform that helps people make smarter mealtime decisions using its patented photo-based food analysis
WHAT YOU’LL LEARN:
✔️SNAQ was created by people living with type 1 diabetes for people living with type 1 diabetes…and they care.
✔️ The value of the SNAQ app during T1 pregnancy.
✔️The depth of the SNAQ app over uploading images to random AI programs.
✔️SNAQ app provides data only. They don’t show ads or share your data.
 
CHAPTERS
00:15 Welcome and introduction
06:23 Inspiration for SNAQ
08:11 The value of having a test subject as your wife
09:22 The key features of the SNAQ app
15:50 Features that will be getting an upgrade over time
21:00 The biggest challenges in marketing the SNAQ app
24:21 SNAQ app pricing
26:07 SNAQ vs Gary Scheiner
28:44 SNAQ tips for accurate results
29:53 Advice for diabetes entrepreneurs
 
RESOURCES
https://snaq.go.link/3B8Rc
The Ultimate Guide To Accurate Carb Counting
Food, Technology, and Insulin. Secrets of Successful Glucose Management
IDS Diabetes Experts, The Trynamic Trio Share Personal Experiences with Open-Source Automation
Entrepreneurism in the diabetes space
 
CONNECT WITH US
🔵Website: integrateddiabetes.com
🔵 Follow on Social Media: @integrated_diabetes_services and @ integrateddiabetesservices on Facebook
🔵To work with the Integrated Diabetes Services Team , visit https://integrateddiabetes.com/how-to-start-the-process/ ,  or email info@integrateddiabetes.com
SUBSCRIBE AND REVIEW
If you enjoyed this episode subscribe on Apple Podcasts, Spotify, or your favorite podcast platform to ensure that you never miss an episode.
Also, leave a review to let us know what you think, and share this episode with others who will enjoy it as well!
Disclaimer
The information contained in this program is based on the experience and opinions of the Integrated Diabetes Services clinical team. Please discuss any changes to your treatment plan with your personal healthcare provider before implementing.
 
 
 

In episode 70 of Think Like a Pancreas—The Podcast, Integrated Diabetes Services clinicians. Mental health professional, Kristi Paguio and registered dietitian, Dana Roseman unpack the complex relationship of food, insulin, and cultural pressures that can exacerbate disordered eating patterns.
They share their own experiences as women living with type 1 diabetes and provide strategies for improving your relationship with food, your body, and your insulin.
MEET YOUR HOSTS:
Kristi Paguio LMSW, LCSW, CDCES is a Mental Health Specialist. She has been working in the field of diabetes since 2007 as a licensed clinical social worker, diabetes care and education specialist, and certified specialist in obesity and weight management. Kristi has had the privilege of working with people across the lifespan who are impacted by diabetes. She has experience working with adults, children, athletes, pregnancy, and weight management. Kristi was diagnosed with type 1 diabetes in 2000 and has specialized in the mental and emotional aspects of diabetes since that time.
Dana Roseman, MPH, CDCES, RDN, LDN, is the Director of Technology and Applied Research for Integrated Diabetes Services. Diagnosed with Type 1 Diabetes, she has spent nearly 20 years improving diabetes care through technology, research, and patient education—including expertise with insulin pumps, continuous glucose monitors, and hybrid closed-loop systems.
WHAT YOU’LL LEARN:
 ✔️Disordered eating is a broad term that encompasses various unhealthy food relationships.
✔️ Cultural pressures can lead to unhealthy eating behaviors and perceptions of food.
✔️ Food should be viewed as a source of joy and connection, not just a means to manage diabetes.
✔️Normalize healthy eating for the entire family.
 
CHAPTERS:
00:40 Welcome and introduction
03:12 What constitutes disordered eating?
06:25 Cultural influences vs the needs of a healthy body
09:24 The “Food Police”
11:46 All foods fit in your diet
13:51 Helping someone experiencing disordered eating
18:05 Restriction vs Indulgence. Finding the middle ground when it comes to food.
20:33 The impact of judgement when you have diabetes
23:06 Why disordered eating is more common when living with diabetes
24:00 Seeking help for disordered eating with diabetes
RESOURCES
If you are seeking a team to assist you with issues surrounding disordered eating and your diabetes, Integrated Diabetes Services has a full team of professionals who are Certified Diabetes Care and Education Specialists who live with type 1 diabetes. They can help with all aspects of your self-care. Call 1 (610) 642-6055 or email info@integratedservices.com to schedule an appointment.
Articles: Eating disorders are on the rise.
SUBSCRIBE AND REVIEW
If this episode helped you or you have a question, take a moment to leave a short note. We love to hear from you! And then be sure to subscribe on Apple Podcasts, Spotify, or your favorite podcast platform to ensure that you never miss an episode!
Disclaimer
The information contained in this program is based on the experience and opinions of the Integrated Diabetes Services clinical team. Please discuss any changes to your treatment plan with your personal healthcare provider before implementing.
 

In episode 69 of Think Like a Pancreas—The Podcast, Integrated Diabetes Services founder, Gary Scheiner sits down with his personal endocrinologist to discuss what it takes to build a successful patient/provider relationship.
Listen to Gary’s conversation with Dr. Koch and learn how to build a successful partnership with your doctor, how to get the most out of your time with your endocrinologist and learn about the areas of care that even Gary could improve on.
MEET YOUR HOST AND HIS GUEST:
Gary Scheiner, MS, CDCES is the founder and Clinical Director of Integrated Diabetes Services. An award-winning Certified Diabetes Care & Education Specialist, Master’s-level Exercise Physiologist, and person with type-1 diabetes since 1985, Gary Scheiner has dedicated his professional life to improving the lives of people with insulin-dependent diabetes. He was named 2014 Diabetes Educator of the Year by the American Association of Diabetes Educators.
Gary earned a Bachelor of Arts in Psychology from Washington University in St. Louis and a Master of Science in Exercise Physiology from Benedictine University. He received his diabetes training with the world-renowned Joslin Diabetes Center. Gary serves on the faculty of several prominent organizations and the clinical advisory boards for a number of diabetes device manufacturers and pharmaceutical companies.
Cheryl Koch, MD is a diabetes & metabolism endocrinologist in Bryn Mawr, PA and has over 35 years of experience in the medical field. Dr. Koch has extensive experience in Thyroid Disorders, Diabetes & Glucose Monitoring, and Osteoporosis & Screening. She graduated from Penn State University College of Medicine in 1989. She is affiliated with medical facilities such as Hospital of the University of Pennsylvania and Lankenau Medical Center. .
 
WHAT YOU’LL LEARN:
✔️Every diabetes patient is different.
✔️Your doctor is human too.
✔️The value of making small changes.
✔️Your doctor’s job is to help. You don’t have to be perfect.
✔️Find an endo that is interested in you and matches your needs.
 
CHAPTERS:
00:50 Welcome and Introduction
07:56 The appeal of endocrinology
10:04 Staying up-to-date with diabetes advances
12:46 Getting  the most out of your endo visits
15:31 When it’s okay to break up with your endo
17:40 The value of CDCES in diabetes education
18:54 Areas that Gary Scheiner struggles with in his diabetes care
23:57 Dr. Koch’s parting advice for building trust with your endo
 
RESOURCES:
How To Find a Health Care Team You Love – Integrated Diabetes Services
The Power of a Team in Your Diabetes Weight Loss Journey – Integrated Diabetes Services
 
CONNECT WITH US
🔵Website: integrateddiabetes.com
🔵 Follow on Social Media: @integrated_diabetes_services and @ integrateddiabetesservices on Facebook
🔵To work with the Integrated Diabetes Services Team , visit https://integrateddiabetes.com/how-to-start-the-process/ ,  or email info@integrateddiabetes.com
SUBSCRIBE AND REVIEW:
If this episode helped you, take a moment to leave a short review. We love to hear from you! And then be sure to subscribe on Apple Podcasts, Spotify, or your favorite podcast platform to ensure that you never miss an episode!
 
Disclaimer
The information contained in this program is based on the experience and opinions of the Integrated Diabetes Services clinical team. Please discuss any changes to your treatment plan with your personal healthcare provider before implementing.

In this episode of Think Like a Pancreas—The Podcast, Integrated Diabetes Services clinicians, Gary Scheiner and Dana Roseman explore the impact of protein on people living with diabetes. the role and impact of protein in the lives of people with diabetes.
Listen as they share science-backed answers to common questions about protein’s role in blood sugar management, ideal protein sources, dietary balance, and long-term health.
MEET YOUR HOSTS:
Gary Scheiner, MS, CDCES is the owner and Clinical Director of Integrated Diabetes Services. He is an award-winning Certified Diabetes Educator, Masters-level Exercise Physiologist and person with type-1 diabetes since 1985.  Gary is also actively involved with many diabetes related organizations as a volunteer and clinical advisor.
Dana Roseman, MPH, CDCES, RDN, LDN, is the Director of Technology and Applied Research for Integrated Diabetes Services. Diagnosed with Type 1 Diabetes, she has spent nearly 20 years improving diabetes care through technology, research, and patient education—including expertise with insulin pumps, continuous glucose monitors, and hybrid closed-loop systems.
WHAT YOU’LL LEARN:
✔️Protein requires you to use the entire alphabet of amino acids.
✔️The value of having a consistent amount of daily protein.
✔️Protein becomes more important as you age.
CHAPTERS:
00:51 Welcome and Introduction
02:51 The role of protein in a healthy body
04:18 Better sources of protein
07:50 How much protein is enough for YOU?
11:28 What you should know about protein supplements
13:24 Bolusing for protein
18:51 Are you getting enough protein?
21:56 Can you ever have too much protein?
24:57 What you need to remember about protein and type 1 diabetes
RESOURCES MENTIONED:
Protein List from Integrated Diabetes Services
CONNECT WITH US:
🔵Website: integrateddiabetes.com
🔵 Follow on Social Media: @integrated_diabetes_services and @ integrateddiabetesservices on Facebook
🔵To work with the Integrated Diabetes Services Team , visit https://integrateddiabetes.com/how-to-start-the-process/ ,  or email info@integrateddiabetes.com
SUBSCRIBE AND REVIEW
If this episode helped you, take a moment to leave a short review. We love to hear from you! And then be sure to subscribe on Apple Podcasts, Spotify, or your favorite podcast platform to ensure that you never miss an episode!
Disclaimer
The information contained in this program is based on the experience and opinions of the Integrated Diabetes Services clinical team. Please discuss any changes to your treatment plan with your personal healthcare provider before implementing.
 

In this year-end special, host Gary Scheiner shares top moments from your three favourite episodes!
Number 3…Clinicians offer practical advice on glucose management in “Food, Technology, and Insulin.”
Number 2… Riva Greenberg discusses the illusion of perfect glucose control, challenging conventional thinking.
And the fan-favourite for 2025 was the episode when Gary and Dana Roseman compare leading CGMs in “Libre 3 vs Dexcom G7.” This beloved podcast helping listeners make informed choices.
MEET YOUR HOST AND HIS GUESTS:
Gary Scheiner, MS, CDCES is the owner and Clinical Director of Integrated Diabetes Services. He is an award-winning Certified Diabetes Educator, Masters-level Exercise Physiologist and person with type-1 diabetes since 1985.  Gary is also actively involved with many diabetes related organizations as a volunteer and clinical advisor.
Jennifer Smith, RD, LD, CDCES is the Director of Lifestyle and Nutrition for Integrated Diabetes Services. She is renowned for her expertise in nutrition, diabetes education, and athletic performance. Having lived with type 1 diabetes since childhood, Jennifer offers unique insight into day-to-day diabetes management, pregnancy, sports nutrition, and technology integration.
Dana Roseman, MPH, CDCES, RDN, LDN, is the Director of Technology and Applied Research for Integrated Diabetes Services. Diagnosed with Type 1 Diabetes, she has spent nearly 20 years improving diabetes care through technology, research, and patient education—including expertise with insulin pumps, continuous glucose monitors, and hybrid closed-loop systems.
Tavia Vital BSN, BA, RN, CDCES is the Director of Intensive Diabetes Management for Integrated Diabetes Services. Tavia is a Registered Nurse, Certified Diabetes Care and Education Specialist, and Certified Trainer on most makes/models of insulin pumps and continuous glucose monitoring systems. Having lived with type one diabetes for over 40 years, she understands that each person’s experiences and needs are unique.
Riva Greenberg is a multi-time author, columnist, and blogger. She has lived with type 1 diabetes for over 50 years and has presented her “Flourishing Approach” to healthcare professionals and people with diabetes all over the world.
 
WHAT YOU’LL LEARN:
✔️80% of your management is what you do over and over.
✔️Why it is impossible to “control” your blood sugars, but how you can positively influence them.
✔️The value of data when managing your diabetes care.
 
CHAPTERS
00:15 Welcome and introduction
02:28 Understanding your insulin
8:08 The value of understanding your typical meals
10:13 Meet Riva Greenberg
12:18 Why can’t diabetes and blood sugar levels be controlled?
15:25 Glucometer commercials should picture readings of 283 mg/dl
19:24 The evolution of CGMs
22:11 Dexcom G7 vs Libre 3+
CONNECT WITH US
🔵Website: integrateddiabetes.com
🔵 Follow on Social Media: @integrated_diabetes_services and @ integrateddiabetesservices on Facebook
🔵To work with the Integrated Diabetes Services Team , visit https://integrateddiabetes.com/how-to-start-the-process/ ,  or email info@integrateddiabetes.com
SUBSCRIBE AND REVIEW
If you enjoyed this episode subscribe on Apple Podcasts, Spotify, or your favorite podcast platform to ensure that you never miss an episode.
Also, leave a review to let us know what you think, and share this episode with others who will enjoy it as well!
Disclaimer
The information contained in this program is based on the experience and opinions of the Integrated Diabetes Services clinical team. Please discuss any changes to your treatment plan with your personal healthcare provider before implementing.

The Integrated Diabetes Services clinical team has explored a number of topics and spoken with many guests over the course of 2025. In this special episode, we share highlights from their three favourite episodes.
Number 3… When Type 1 Diabetes and Mental Health Collide. From Darkness to Resilience
Number 2… IDS Diabetes Experts, The Trinamic Trio Share Personal Experiences with Open-Source Application
Number 1…. Empowered Aging. Proactive Strategies for Seniors with Type 1 Diabetes.
MEET YOUR HOST AND HIS GUESTS:
Gary Scheiner, MS, CDCES is the owner and Clinical Director of Integrated Diabetes Services. He is an award-winning Certified Diabetes Educator, Masters-level Exercise Physiologist and person with type-1 diabetes since 1985.  Gary is also actively involved with many diabetes related organizations as a volunteer and clinical advisor.
Kristi Paguio LMSW, CDCES, CSOWM is a licensed clinical social worker, diabetes care and education specialist, and certified specialist in obesity and weight management. Kristi has been working in the field of diabetes since 2007 and has had the privilege of working with people across the lifespan who are impacted by diabetes.  She has experience working with adults, children, athletes, pregnancy, and weight management.
Kristi was diagnosed with type 1 diabetes in 2000 and has specialized in the mental and emotional aspects of diabetes since that time. 
Amy Sczepanski has been navigating life with diabetes since 1997 and is now adventuring her way from the redwoods of Eureka, California to her new home in Pennsylvania. Amy brings energy, empathy, and a sense of humor to her new role at Integrated Diabetes Services working with clients and clinicians alike. She is a proud cat mom, avid lover of all things outdoors, and is happily diving into work that she loves.
Jennifer Smith, RD, LD, CDCES is the Director of Lifestyle and Nutrition for Integrated Diabetes Services. She is renowned for her expertise in nutrition, diabetes education, and athletic performance. Having lived with type 1 diabetes since childhood, Jennifer offers unique insight into day-to-day diabetes management, pregnancy, sports nutrition, and technology integration.
Dana Roseman, MPH, CDCES, RDN, LDN, is the Director of Technology and Applied Research for Integrated Diabetes Services. Diagnosed with Type 1 Diabetes, she has spent nearly 20 years improving diabetes care through technology, research, and patient education—including expertise with insulin pumps, continuous glucose monitors, and hybrid closed-loop systems.
Tavia Vital BSN, BA, RN, CDCES is the Director of Intensive Diabetes Management for Integrated Diabetes Services. Tavia is a Registered Nurse, Certified Diabetes Care and Education Specialist, and Certified Trainer on most makes/models of insulin pumps and continuous glucose monitoring systems. Having lived with type one diabetes for over 40 years, she understands that each person’s experiences and needs are unique.
Kathryn Gentile-Alvarez, MS, ACSM-CEP, EIM II, CPT, CSNC, CDCES is the Director of Exercise Physiology, Teen/Young Adult Specialist for Integrated Diabetes Services. As a Certified Diabetes Care & Education Specialist and Exercise Physiologist, she specializes in sports performance, technology integration—including open-source and DIY systems—and counseling young people and families affected by type 1 diabetes. Diagnosed herself at age twelve, Kathryn holds degrees in Exercise Physiology from Ave Maria University and West Chester University, and certifications from ACSM and ISSA. Her work focuses on using advanced technology and personalized exercise prescriptions to help people with diabetes manage their health and thrive.
Joanne Milo has lived with Type 1 diabetes for 60 years and just launched a brand-new project called T1D to 100. This website is an incredible resource for people aiming to thrive with type one diabetes in every decade of life. Joanne is also well-known for her long running blog, the Savvy Diabetic, and helping to build the amazing loop and learn online community.
WHAT YOU’LL LEARN:
✔️You are not alone. Diabetes impacts more than just your physical health.
✔️Optimizing your diabetes outcomes can take a level of faith.
✔️ Healthcare wasn’t prepared for people living with type 1 diabetes to live longer, but after spending their lives advocating for improvements, they aren’t stopping now.
CHAPTERS
00:37 Introduction
03:10 Amy’s Mental Health Crisis
07:34 The Turning Point: A Cry for Help
10:38 Thoughts on Open-Sourced insulin delivery systems
12:43 Learning to trusting the technology
20:24 Joanne Milo highlights the worries of seniors with type 1 diabetes
26:59 How can we best serve the aging T1D population?
RESOURCES MENTIONED
The Savvy Diabetic
T1D to 100
 
 

In Episode 65 of Think Like a Pancreas—The Podcast, the Integrated Diabetes Services clinical team share why they became Diabetes Care and Education Specialists.
Some were inspired by life-changing healthcare professionals. Some were inspired by Gary Scheiner, but every clinician on the IDS team continues to be motivated by a desire to improve the lives of people living with diabetes.
MEET THE CLINICIANS:
Jennifer Smith, RD, LD, CDCES is the Director of Lifestyle and Nutrition for Integrated Diabetes Services. She is renowned for her expertise in nutrition, diabetes education, and athletic performance. Having lived with type 1 diabetes since childhood, Jennifer offers unique insight into day-to-day diabetes management, pregnancy, sports nutrition, and technology integration.
Dana Roseman, MPH, CDCES, RDN, LDN, is the Director of Technology and Applied Research for Integrated Diabetes Services. Diagnosed with Type 1 Diabetes, she has spent nearly 20 years improving diabetes care through technology, research, and patient education—including expertise with insulin pumps, continuous glucose monitors, and hybrid closed-loop systems.
Tavia Vital BSN, BA, RN, CDCES is the Director of Intensive Diabetes Management for Integrated Diabetes Services. Tavia is a Registered Nurse, Certified Diabetes Care and Education Specialist, and Certified Trainer on most makes/models of insulin pumps and continuous glucose monitoring systems. Having lived with type one diabetes for over 40 years, she understands that each person’s experiences and needs are unique.
Gary Scheiner, MS, CDCES is an award-winning Certified Diabetes Educator, Masters-level Exercise Physiologist and person with type-1 diabetes since 1985.  He is the owner of Integrated Diabetes Services and is actively involved with many diabetes related organizations as a volunteer and clinical advisor.
Kristi Paguio LMSW, CDCES, CSOWM is a licensed clinical social worker, diabetes care and education specialist, and certified specialist in obesity and weight management. Kristi was diagnosed with type 1 diabetes in 2000 and has specialized in the mental and emotional aspects of diabetes since that time. 
Kathryn Gentile-Alvarez, MS, ACSM-CEP, EIM II, CPT, CSNC, CDCES is the Director of Exercise Physiology, Teen/Young Adult Specialist for Integrated Diabetes Services. Diagnosed with type 1 diabetes at age twelve, Kathryn’s work focuses on using advanced technology and personalized exercise prescriptions to help people with diabetes manage their health and thrive.
Alicia Downs,  RN, MSN, CDCES,  BC-ADM experienced years of mis-diagnoses and ineffective treatments that gave her the incentive to take the lead in her own health care and educate those around her. Alicia is passionate about providing educated compassionate informed and equitable care to all people.
Anna Sabino MSW, CDCES has been living with T1D for over 30 years and proudly offers expert emotional health counseling for children, adults, and families with T1D.  Her areas of expertise include family dynamics, crisis management, anxiety, depression, burnout, and post-traumatic stress.
Dr Paula Diab PhD, CDCES is a Family Physician and Diabetologist who runs a multi-disciplinary practice specializing in the management of chronic diseases, particularly diabetes and obesity in South Africa. Her approach is to walk the journey with her patients and to allow them to manage their disease rather than allow the disease to define who they are.
WHAT YOU’LL LEARN:
✔️What influenced each team member’s decision to become a Certified Diabetes Care and Education Specialist.
✔️ How Gary’s team of specialists came together to create the Integrated Diabetes Services team that you know today.
CHAPTERS:
00:22 Welcome and introduction
01:05 Kristi’s why
02:46 Who changed Gary’s career path
03:46 When Tavia had to sit through a diabetes class
07:01 Paula’s Google search
09:03 From Fangirl to team member
12:15 The value of experiential knowledge
19:52 How life made Dana pivot her career
21:24 Jenny wanted to be a vet
24:36 I want to be Gary Scheiner!
CONNECT WITH US
🔵Website: integrateddiabetes.com
🔵 Follow on Social Media: @integrated_diabetes_services and @ integrateddiabetesservices on Facebook
🔵To work with the Integrated Diabetes Services Team , visit https://integrateddiabetes.com/how-to-start-the-process/ ,  or email info@integrateddiabetes.com
SUBSCRIBE AND REVIEW
If you enjoyed this episode subscribe on Apple Podcasts, Spotify, or your favorite podcast platform to ensure that you never miss an episode.
Also, leave a review to let us know what you think, and share this episode with others who will enjoy it as well!
Disclaimer
The information contained in this program is based on the experience and opinions of the Integrated Diabetes Services clinical team. Please discuss any changes to your treatment plan with your personal healthcare provider before implementing.

In Episode 64 of Think Like a Pancreas—The Podcast, Integrated Diabetes Services clinician Kristi Paguio sits down with Amy Sczepanski to discuss her remarkable mental health journey.
Amy candidly reflects on her experiences moving beyond suicide attempts to building a fulfilling life, highlighting pivotal moments that reshaped her path. The conversation delves into the transformative power of therapy, emphasizing the importance of addressing both mental and physical aspects of healing.
Together, Kristi and Amy explore how unconditional love, effective medication, and actively seeking support from the medical community play essential roles in overcoming despair and fostering well-being.
Listeners gain insight into the significance of self-acceptance, the value of supportive relationships, and practical strategies for nurturing mental health while living with type 1 diabetes.
Important Notice: This episode contains frank discussions about mental health crises, including suicide, as well as strong language.
MEET YOUR HOST AND HER GUEST:
Kristi Paguio LMSW, CDCES, CSOWM is a licensed clinical social worker, diabetes care and education specialist, and certified specialist in obesity and weight management. Kristi has been working in the field of diabetes since 2007 and has had the privilege of working with people across the lifespan who are impacted by diabetes.  She has experience working with adults, children, athletes, pregnancy, and weight management.
Kristi was diagnosed with type 1 diabetes in 2000 and has specialized in the mental and emotional aspects of diabetes since that time. 
Amy Sczepanski has been navigating life with diabetes since 1997 and is now adventuring her way from the redwoods of Eureka, California to her new home in Pennsylvania. Amy brings energy, empathy, and a sense of humor to her new role at Integrated Diabetes Services working with clients and clinicians alike. She is a proud cat mom, avid lover of all things outdoors, and is happily diving into work that she loves.
WHAT YOU’LL LEARN:
✔️How people hide their emotional pain behind their diabetes.
✔️Mental health struggles are hard to discuss with others.
✔️ When your mental health isn’t doing well, your diabetes won’t be doing well either.
✔️Professional therapy is more valuable than you think.
✔️There is no shame in taking medication for your brain health.
 
CHAPTERS
00:15 Welcome and introductions
03:10 Introduction to Amy's Journey
07:35 The Turning Point: A Cry for Help
13:26 Finding the helpers
15:22 Amy’s path of self abuse
18:42 The baby steps to Amy's healing journey
23:06 The Power of Shared Stories
25:33 Diabetes is the burden, not you!
27:57 Finding the right tools with your healthcare team
31:51 Tips for improved mental and physical well-being
35:13 The IDS team gets it
39:01 Final thoughts
RESOURCES:
Jenny Smith, Integrated Diabetes Services
CONNECT WITH US
🔵Website: integrateddiabetes.com
🔵 Follow on Social Media: @integrated_diabetes_services and @ integrateddiabetesservices on Facebook
WORK WITH US:
If you’re looking for real, personalized support for life with diabetes, you’re in the right place. Our team brings 269+ years of lived experience and 172+ years of professional expertise to the table—and we don’t say “we get it” lightly. Nearly 90% of our clinicians live with type 1 diabetes themselves, so when we talk about carb counting at midnight or troubleshooting a stubborn sensor… we’ve been there. If you want guidance from people who understand the science and the lived reality, give us a call or schedule an appointment anytime: https://integrateddiabetes.com/appointments/
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