Your Best T1D Year

Epizode

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  Pre-Bolusing for a Picky Toddler with Type 1 Diabetes | Combo Bolus 19.08.2026 6min

  Your toddler asked for the macaroni, then looked at it like you served packing peanuts and demanded the one other food in the house, and you've got insulin on board for a meal that just got canceled. This episode is for the parents dosing into pure chaos.Neil pulls the playbook straight from the pediatric diabetes guidelines. The split: dose for the part you're sure they'll eat, then give the rest after. ISPAD recommends a combo or dual-wave bolus for uncertain eaters, part before, the rest over 20 to 40 minutes once you see what got eaten. And there's good news in the research, a systematic review found that pre-meal dosing, when you can pull it off, lowered the after-meal peak and even lowered A1C, with no increase in lows. Keep fast carbs on the table, always.In this episode:The split-dose strategy for a kid who might not finishThe ISPAD combo/dual-wave bolus for uncertain eatersThe research: pre-meal dosing lowered peaks and A1C with no extra lowsWhy fast carbs on the table are non-negotiable with little onesThis Week's Challenge: For the parents, try the split on one unpredictable meal. Dose for what you're sure they'll eat, then top up after. Notice how much less terrifying that is.Helpful resources and newsletter: https://yourbestt1dyear.comConnect with Neil: TikTok: https://tiktok.com/@the.betes Instagram: https://instagram.com/thebetes Facebook: https://facebook.com/neilgreathouse LinkedIn: https://linkedin.com/in/neil-greathouse-a607b912 Website: https://yourbestt1dyear.comBooks on Amazon: Type 1 Diabetes – One Day at a Time: https://a.co/d/6UHooWJ Type 1 Diabetes – True Stories: https://a.co/d/dfIlyI1
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  Pre-Bolusing & Why Your Tech Can't Save You Alone // Natalie, Bellini, DNP 17.08.2026 54min

  She stopped counting years with type 1 a long time ago. Natalie Bellini counts days... more than 20,000 of them. This week Neil finally gets his dream guest: Natalie Bellini, DNP, FNP-BC, BC-ADM, CDCES, nurse practitioner, assistant professor of medicine at Case Western Reserve University, and program director for diabetes technology at University Hospitals in Cleveland. She has lived with type 1 diabetes for 55+ years, her husband has it too, and she still uses the word pre-bolus a dozen times a day with the people she treats.This is the pre-bolusing conversation for the rest of us. Natalie breaks down why the two hours after each meal (that's six hours of your day) quietly decide your time in range, why even the best automated insulin delivery system can't catch a meal it never saw coming, and the baby-step way to start pre-bolusing when fear of lows has kept you on the sidelines. Then she gets real about the parts of care nobody talks about: meeting patients where they are, why having diabetes doesn't automatically make you a better clinician, and the screening mission she helped build with her own family's blood work.In this episode:What pre-bolusing actually is in plain English... your carbs are fast, your "rapid-acting" insulin is not, and timing is how you stop the chaseWhy post-meal spikes are 25% of your number, and where pre-bolusing lands on Natalie's top-four list for a 20-minute appointmentThe baby-step method: pick one meal (breakfast is the easy win), start with 10 minutes, split the dose, treat the high first, and know when NOT to pre-bolus"Your diabetes is a two-year-old"... why AID pumps still need you to announce meals, and what a missed pre-bolus looks like on your CGMThe rookie mistake that makes people quit (too much insulin up front, usually at a restaurant), and how little swings beat big onesHer screening passion: three blood tests at ages 2, 6, and 10 can catch 80% of kids on the path to type 1 before DKA ever happensTrue or False, a Diabetes Confession Booth for the ages (she borrowed her husband's insulin pump at dinner... it works), and a tie of the Fastest Five Minutes world record (29 answers!)This Week's Challenge: Pre-bolus one meal. Pick a day you're not working, keep carbs within reach, treat the high first, and start with just a little insulin up front... even five minutes early counts. Trust the behavior, then watch the curve change. Slow and steady wins this race.Learn more about Blue Circle Health, get care, give care, or join the movement: https://bluecirclehealth.org Helpful resources and newsletter: https://yourbestt1dyear.com Connect with Neil: TikTok: https://tiktok.com/@the.betes Instagram: https://instagram.com/thebetes Facebook: https://facebook.com/neilgreathouse LinkedIn: https://linkedin.com/in/neil-greathouse-a607b912 Website: https://yourbestt1dyear.com Books on Amazon: Type 1 Diabetes – One Day at a Time: https://a.co/d/6UHooWJ Type 1 Diabetes – True Stories: https://a.co/d/dfIlyI1
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  Pre-Bolusing and Still Spiking? Check Your Carb Count | Type 1 Diabetes 14.08.2026 6min

  You pre-bolus. You give it the 15 minutes. You watch the arrow. And you're still spiking. Don't throw out the challenge, that spike is a clue. Neil puts on the detective hat, because timing is huge, but it isn't the only dial on the dashboard.If your timing's perfect and you're still climbing, the amount may be the problem, and the most common culprit is the carb count. A study by Brazeau found that adults with type 1, averaging 21 years of experience, were off by about 15 grams of carb per meal, roughly 21% of the plate, and underestimated 63% of the time. Neil walks through the other usual suspects too, fat and protein, stress, hormones, and exercise, and how to troubleshoot with your care team.In this episode:Why perfect timing doesn't always fix a spikeThe Brazeau study: even veterans miss carb counts by about 15 gramsThe other suspects: fat, protein, stress, hormones, exerciseHow to play detective on one meal without changing doses soloThis Week's Challenge: If you're pre-bolusing well and still spiking, play detective on one meal. Weigh or honestly eyeball the carbs, see if the count was off, and bring what you find to your care team.Helpful resources and newsletter: https://yourbestt1dyear.comConnect with Neil: TikTok: https://tiktok.com/@the.betes Instagram: https://instagram.com/thebetes Facebook: https://facebook.com/neilgreathouse LinkedIn: https://linkedin.com/in/neil-greathouse-a607b912 Website: https://yourbestt1dyear.comBooks on Amazon: Type 1 Diabetes – One Day at a Time: https://a.co/d/6UHooWJ Type 1 Diabetes – True Stories: https://a.co/d/dfIlyI1
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  Fiasp, Lyumjev & Afrezza: Do You Still Need to Pre-Bolus? | T1D 12.08.2026 7min

  "Neil, I use Fiasp, or Lyumjev, or Afrezza, do I even have to wait?" Great question, and this episode gets genuinely nerdy about the answer. Fiasp and Lyumjev are ultra-rapid analogs, built with ingredients (niacinamide in Fiasp, citrate and treprostinil in Lyumjev) that speed up subcutaneous absorption. Afrezza is inhaled Technosphere insulin with a Tmax around 12 to 15 minutes that delivers more than half its effect in the first hour, versus about 10% for regular rapid insulin.So the fast insulins shrink the pre-bolus window. But here's the honest part: most people aren't on them, and standard rapid insulins like Humalog and Novolog are excellent. The whole point of the challenge, timing, is the great equalizer. Know your insulin, and you know how big your head start should be.In this episode:The pharmacology of Fiasp, Lyumjev, and Afrezza, in plain EnglishWhy inhaled Technosphere insulin peaks in about 12 minutesWhy the fast insulins shrink, but don't erase, the pre-bolus windowWhy standard rapid insulins still run beautiful numbersThis Week's Challenge: Know your insulin. Look up, or ask your care team, roughly how fast the insulin you take starts working. That one fact tells you how big your head start should be.Helpful resources and newsletter: https://yourbestt1dyear.comConnect with Neil: TikTok: https://tiktok.com/@the.betes Instagram: https://instagram.com/thebetes Facebook: https://facebook.com/neilgreathouse LinkedIn: https://linkedin.com/in/neil-greathouse-a607b912 Website: https://yourbestt1dyear.comBooks on Amazon: Type 1 Diabetes – One Day at a Time: https://a.co/d/6UHooWJ Type 1 Diabetes – True Stories: https://a.co/d/dfIlyI1
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  Do You Still Pre-Bolus on a Closed-Loop Pump? | Control-IQ, Omnipod 5 10.08.2026 5min

  If you're on a closed-loop system, Control-IQ, Omnipod 5, or Loop, you've probably wondered whether the algorithm means you're off the hook for pre-bolusing. Neil has to be the one to tell you: you still do it. These systems are an incredible co-pilot, but they're not a self-driving car you can nap in.Here's the reason, with a real number. In Omnipod 5 data, when people skipped the meal bolus, the algorithm poured in about 16% of their total daily insulin over the four hours after the meal trying to catch up, and it still couldn't stop the spike. These hybrid closed-loop, or automated insulin delivery (AID), systems are reactive, they respond after glucose rises. The guidance to bolus 10 to 15 minutes early is published, not opinion.In this episode:Why closed-loop pumps still need you to pre-bolus your mealsThe Omnipod data: the algorithm used ~16% of daily insulin and still spikedWhy AID systems are reactive, not predictiveWhy bolusing TOO early can backfire on a closed loopThis Week's Challenge: If you're on a closed-loop system, give your meal dose about 10 to 15 minutes before dinner and watch how your system rides along. Compare it to dosing at your first bite.Helpful resources and newsletter: https://yourbestt1dyear.comConnect with Neil: TikTok: https://tiktok.com/@the.betes Instagram: https://instagram.com/thebetes Facebook: https://facebook.com/neilgreathouse LinkedIn: https://linkedin.com/in/neil-greathouse-a607b912 Website: https://yourbestt1dyear.comBooks on Amazon: Type 1 Diabetes – One Day at a Time: https://a.co/d/6UHooWJ Type 1 Diabetes – True Stories: https://a.co/d/dfIlyI1
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  Missed and Late Insulin Boluses: What to Do | Type 1 Diabetes 07.08.2026 6min

  Some nights you do everything right and it still goes sideways. The dinner party, the cookout with the moving-target food, the night you're so fried you only remember to bolus while scraping the plate. This is permission day. Missing doesn't mean you failed the challenge, it means you have a life with other humans in it.Neil gives the real-life moves for the messy nights, and grounds them in data. Remember that 27% of meals get a late or missed bolus? Here's the kicker: young people with type 1 who never miss their boluses were 24.5 times more likely to be in excellent control than poor control. So catching a forgotten dose and taking it late isn't damage control, it's the single biggest difference-maker on the board. A late bolus beats a no bolus every time.In this episode:Real-life moves for social meals, cookouts, and buffetsWhat to do the night you completely forget to bolusWhy kids who never miss boluses were 24.5x more likely to be in great controlWhy consistency, not perfection, is the whole secretThis Week's Challenge: Have one of those messy nights, and practice not spiraling. Miss it, catch it, move on. Prove to yourself one imperfect night doesn't torch the whole thing.Helpful resources and newsletter: https://yourbestt1dyear.comConnect with Neil: TikTok: https://tiktok.com/@the.betes Instagram: https://instagram.com/thebetes Facebook: https://facebook.com/neilgreathouse LinkedIn: https://linkedin.com/in/neil-greathouse-a607b912 Website: https://yourbestt1dyear.comBooks on Amazon: Type 1 Diabetes – One Day at a Time: https://a.co/d/6UHooWJ Type 1 Diabetes – True Stories: https://a.co/d/dfIlyI1
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  Why Pizza Spikes Your Blood Sugar at Midnight | Fat, Protein & T1D 05.08.2026 6min

  Some meals spike you and move on. Pizza spikes you, waves goodbye, and comes back four hours later like a horror-movie villain. If you've ever been 110 at bedtime and 260 at midnight, this episode explains the ambush, and it's backed by real research.A 2013 study led by Howard Wolpert in Diabetes Care fed people the same carbs, but one meal was high in fat. The high-fat meal required about 42% more insulin over the following five to ten hours and drove hyperglycemia for hours, even with extra insulin. The reason is that fat slows gastric emptying, so glucose trickles out over hours instead of arriving at once. Neil explains the tools that help, extended, combo, and dual-wave boluses, and why carb-counting math alone can't cover pizza.In this episode:Why high-fat meals like pizza cause a delayed, second-wave spikeThe Wolpert study: 42% more insulin for a high-fat meal, same carbsHow fat slows gastric emptying and stretches out your glucose riseExtended, combo, and dual-wave boluses, explained simplyThis Week's Challenge: Next time you eat a high-fat meal, just watch what happens two, three, four hours later. Witness the second wave, then ask your care team if an extended bolus makes sense for you.Helpful resources and newsletter: https://yourbestt1dyear.comConnect with Neil: TikTok: https://tiktok.com/@the.betes Instagram: https://instagram.com/thebetes Facebook: https://facebook.com/neilgreathouse LinkedIn: https://linkedin.com/in/neil-greathouse-a607b912 Website: https://yourbestt1dyear.comBooks on Amazon: Type 1 Diabetes – One Day at a Time: https://a.co/d/6UHooWJ Type 1 Diabetes – True Stories: https://a.co/d/dfIlyI1
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  How to Pre-Bolus at Restaurants and Takeout | Type 1 Diabetes 03.08.2026 6min

  "It'll be right out" might be the most cursed sentence in all of type 1 diabetes. August is about making your pre-bolus habit survive the real world, and we start with the hardest place to do it: restaurants and delivery, where you don't control the clock. Neil's move is simple, wait for proof of life. Dose when you can actually see the food heading your way, not a second sooner.And here's why it matters, with real numbers. Researchers found that 27% of meals get a bolus that's either late or skipped, and eating out is one of the biggest reasons, because you can't time what you can't predict. A 2024 study found that later dosing meant lower time in range all evening. So "I'll bolus whenever the food shows up" isn't harmless, it's a measurable hit to your numbers.In this episode:The one rule for pre-bolusing when you don't control the clockWhy 27% of meals get a late or missed bolus (ADA data)How eating out quietly tanks your time in rangeThe "wait until you see the food" strategy for restaurants and deliveryThis Week's Challenge: One restaurant or takeout meal. Practice the "wait until you see it" move, dose when the food is in front of you or clearly on its way.Helpful resources and newsletter: https://yourbestt1dyear.comConnect with Neil: TikTok: https://tiktok.com/@the.betes Instagram: https://instagram.com/thebetes Facebook: https://facebook.com/neilgreathouse LinkedIn: https://linkedin.com/in/neil-greathouse-a607b912 Website: https://yourbestt1dyear.comBooks on Amazon: Type 1 Diabetes – One Day at a Time: https://a.co/d/6UHooWJ Type 1 Diabetes – True Stories: https://a.co/d/dfIlyI1
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  Start Pre-Bolusing With Just 5 Minutes | Type 1 Diabetes Habit 31.07.2026 7min

  You do not have to be a pre-bolus athlete on day one. If "10 to 15 minutes" felt like too much, Neil takes the pressure all the way down: start with five minutes. Even five to seven minutes of head start beats dosing with your first bite, because insulin is a slow sunrise, not a light switch. Then you build, five, then seven, then ten, creeping up to your sweet spot.Neil closes out month one with the posture that makes this stick: observe, don't judge, and beat the forgetting with a system, tie your dinner dose to something you already do every night. He also recaps the whole month and previews August, where we make this habit survive real life, restaurants, the tech, and the kids' table.In this episode:Why even a 5-minute pre-bolus beats dosing at your first biteHow to build from 5 minutes up to your personal sweet spotBeating the forgetting by stacking the dose onto an existing habitA full recap of month one, and a preview of AugustThis Week's Challenge: Keep pre-bolusing dinner. Start at five minutes if that's your comfort zone, build toward your number, and stack it onto a habit so you don't forget.Helpful resources and newsletter: https://yourbestt1dyear.comConnect with Neil: TikTok: https://tiktok.com/@the.betes Instagram: https://instagram.com/thebetes Facebook: https://facebook.com/neilgreathouse LinkedIn: https://linkedin.com/in/neil-greathouse-a607b912 Website: https://yourbestt1dyear.comBooks on Amazon: Type 1 Diabetes – One Day at a Time: https://a.co/d/6UHooWJ Type 1 Diabetes – True Stories: https://a.co/d/dfIlyI1
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  Why Dinner Is the Best Meal to Start Pre-Bolusing | Type 1 Diabetes 29.07.2026 5min

  If pre-bolusing were a video game, breakfast would be the level everybody rage-quits on. You're rushed, half asleep, and half of us don't even eat it. So we don't start there. We start on the easy level: dinner. Neil makes the case that dinner is the cheat code for learning to pre-bolus.Three reasons: you see it coming (you've had all day to plan), you're usually home and control the clock (which kills the "I dosed and the food never came" fear), and you've got time while it cooks. Then the simple how: check your number and arrow, dose about 10 to 15 minutes before you eat, watch the arrow, and eat, with fast carbs on the table as backup. Check, dose early, watch, eat.In this episode:Why dinner is the smartest meal to start pre-bolusingThe four-step dinner pre-bolus routine, kept simpleHow being home removes the biggest pre-bolus fearWhat to compare against your day-one "before" numberThis Week's Challenge: This is the week. Pre-bolus your dinner. Check, dose 10 to 15 minutes early, watch the arrow, eat, net on the table. Then compare your two-hour number to where you used to land.Helpful resources and newsletter: https://yourbestt1dyear.comConnect with Neil: TikTok: https://tiktok.com/@the.betes Instagram: https://instagram.com/thebetes Facebook: https://facebook.com/neilgreathouse LinkedIn: https://linkedin.com/in/neil-greathouse-a607b912 Website: https://yourbestt1dyear.comBooks on Amazon: Type 1 Diabetes – One Day at a Time: https://a.co/d/6UHooWJ Type 1 Diabetes – True Stories: https://a.co/d/dfIlyI1
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  Pre-Bolusing, Fear of Lows, and What Your Endo Really Sees on Your CGM // Dr. Monica Gomberg from Blue Circle Health 27.07.2026 56min

  We all know we're supposed to pre-bolus. We've known for years. So why do almost none of us actually do it? This week Neil steals an hour with Dr. Monica Gomberg, board certified endocrinologist at Blue Circle Health and, as far as this podcast is concerned, America's Endocrinologist.This is the conversation you wish you could have if your endo appointment lasted longer than 15 minutes. Dr. Gomberg breaks down what pre-bolusing actually is in plain English, why the fear of going low is real trauma and not weakness, and the smallest, safest way to start if you've been burned before. Then she takes the doctor hat off entirely: why she walked away from private practice to help build Blue Circle Health, what she wishes she could say in every appointment, and why the system, not you, is the thing that's failing.In this episode:What pre-bolusing is and why timing matters (hint: your food is faster than your insulin)The two real reasons we skip it... life happens, and fear of lows. Neither one makes you lazyThe smallest first step for someone who's never pre-bolused: one familiar meal, a safety net, and permission to start with just five minutesWhen you should NOT pre-bolus (gastroparesis, high fat and protein meals, exercise timing)What a missed pre-bolus actually looks like on your CGM, and why your pump can't fix it alone, even in automated modeWhy the 15-minute appointment fails patients AND doctors, and how Blue Circle Health defines care differently (community, insurance help, keeping the lights on... all of it counts)True or False, the Diabetes Confession Booth, and a new Fastest Five Minutes world record (29 answers!)This Week's Challenge: Pre-bolus dinner. Start wherever feels safe, even just a few minutes early, even with a split dose. Carbs on the table, eyes on the arrow. You've got the net now. Time to use it.Learn more about Blue Circle Health, get care, give care, or join the movement: https://bluecirclehealth.orgHelpful resources and newsletter: https://yourbestt1dyear.comConnect with Neil: TikTok: https://tiktok.com/@the.betes Instagram: https://instagram.com/thebetes Facebook: https://facebook.com/neilgreathouse LinkedIn: https://linkedin.com/in/neil-greathouse-a607b912 Website: https://yourbestt1dyear.comBooks on Amazon: Type 1 Diabetes – One Day at a Time: https://a.co/d/6UHooWJ Type 1 Diabetes – True Stories: https://a.co/d/dfIlyI1
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  You're Closer to Pre-Bolusing Than You Think | Type 1 Diabetes 24.07.2026 4min

  A short, warm one before the start line. Neil reminds you how far you've already come. Three weeks ago, pre-bolusing was a scary thing you knew you should do and didn't. Now you've named the fear, you understand why the spike happens, you've seen the studies, and you've practiced reaching for the safety net. You've already done the hard parts.Neil is also honest about what starting actually looks like, and it's not fireworks. It's quiet. You dose a few minutes before dinner, you eat, you look up two hours later, and your number is a little flatter than usual. That's the whole event. It's a small habit, built one boring dinner at a time, until one day you forget it ever scared you.In this episode:Why you've already done the hardest parts of pre-bolusingWhat starting actually looks like (hint: not fireworks)How a small daily habit quietly changes your numbersGetting ready to take your first real pre-bolusThis Week's Challenge: Pick the night. Find the dinner where you'll be home, relaxed, and in control of the clock, and decide, that's my first one. Don't even do it yet. Just pick it.Helpful resources and newsletter: https://yourbestt1dyear.comConnect with Neil: TikTok: https://tiktok.com/@the.betes Instagram: https://instagram.com/thebetes Facebook: https://facebook.com/neilgreathouse LinkedIn: https://linkedin.com/in/neil-greathouse-a607b912 Website: https://yourbestt1dyear.comBooks on Amazon: Type 1 Diabetes – One Day at a Time: https://a.co/d/6UHooWJ Type 1 Diabetes – True Stories: https://a.co/d/dfIlyI1
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  3 Moves That Make Pre-Bolusing Safe | Avoid Going Low | Type 1 Diabetes 22.07.2026 5min

  Consider this your permission slip, signed by 34 years of mistakes. If you pre-bolus and the food shows up late and you start to drop, you are allowed to eat a few fast carbs to hold steady and cover them later. That's not failing. That's the move. Neil lays out the three-part safety system that turns pre-bolusing from a leap of faith into a thing you just do.Move one: catch an early drop with fast carbs. Move two: know when NOT to pre-bolus at all, when you're low or dropping, before cardio, when the food's timing is a mystery, or when you're queasy. Move three, the pro move: let your starting number and your CGM trend arrow set your timing. Seatbelt, airbag, backup camera. With these in place, pre-bolusing stops being scary.In this episode:The one move that catches an early low before it happensWhen you should NOT pre-bolus (exercise, restaurants, feeling low)How your CGM trend arrow tells you when to wait and when to eat firstWhy these three moves make pre-bolusing nearly foolproofThis Week's Challenge: Keep the fast carbs on the table. If your number's on the lower side before dinner, eat a couple bites first, then dose. Practice "eat a little, then insulin."Helpful resources and newsletter: https://yourbestt1dyear.comConnect with Neil: TikTok: https://tiktok.com/@the.betes Instagram: https://instagram.com/thebetes Facebook: https://facebook.com/neilgreathouse LinkedIn: https://linkedin.com/in/neil-greathouse-a607b912 Website: https://yourbestt1dyear.comBooks on Amazon: Type 1 Diabetes – One Day at a Time: https://a.co/d/6UHooWJ Type 1 Diabetes – True Stories: https://a.co/d/dfIlyI1
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  Your Fear of Lows Is Costing You Time in Range | Type 1 Diabetes 20.07.2026 5min

  The fear of going low is real, and Neil would never talk you out of it. But it's also quietly running a tab, and the bill comes due in time in range. A 2024 study found that people with more fear of hypoglycemia dosed their meals later, and those later doses tracked with lower time in range and more time running high.Here's the part that should shrink the fear: in the studies that tested pre-bolusing, the lows did not go up. Not in the big pediatric review, not in the 15-minute study. Pre-bolusing isn't more insulin, it's the same insulin at a smarter time. And in a survey of over 1,400 people with type 1, 52% said their fear of lows dropped once they felt more confident dosing. We don't bulldoze the fear. We out-confidence it.In this episode:How dosing late quietly lowers your time in rangeThe research showing pre-bolusing did NOT increase lowsWhy confidence, not willpower, is what shrinks the fearBuilding the safety net before you startThis Week's Challenge: Before you sit down to dinner, put fast carbs on the table, within reach. You don't have to pre-bolus yet. Just get used to the net being there.Helpful resources and newsletter: https://yourbestt1dyear.comConnect with Neil: TikTok: https://tiktok.com/@the.betes Instagram: https://instagram.com/thebetes Facebook: https://facebook.com/neilgreathouse LinkedIn: https://linkedin.com/in/neil-greathouse-a607b912 Website: https://yourbestt1dyear.comBooks on Amazon: Type 1 Diabetes – One Day at a Time: https://a.co/d/6UHooWJ Type 1 Diabetes – True Stories: https://a.co/d/dfIlyI1
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  The Study That Proves Pre-Bolusing Works | 15 Minutes, 50 Points | T1D 17.07.2026 6min

  Today Neil stops saying "trust me" and starts saying "here's the study." A trial published in Diabetes Care found that dosing rapid insulin 15 minutes before a meal dropped the blood sugar peak to about 167, versus about 221 when dosing at the meal. That's a 50-point lower peak, from timing alone. Same dose, same food.Then the twist that keeps you from getting weird about it: a second study in Diabetes Technology & Therapeutics found 20 minutes early won at the one and two-hour marks, but 30 minutes early did NOT beat 15. There's a sweet spot, usually 15 to 20 minutes for most people on regular rapid insulin, and your exact number is yours to find. This is the proof that this one small change is worth it.In this episode:The Diabetes Care study: 15 minutes early cut the peak by about 50 pointsWhy earlier isn't automatically better (the sweet spot explained)The 15-to-20-minute window most people land inHow to start hunting for your own personal pre-bolus timingThis Week's Challenge: Get honest about your natural timing right now. When you sit down, are you dosing early, late, or mid-chew? Find your starting line.Helpful resources and newsletter: https://yourbestt1dyear.comConnect with Neil: TikTok: https://tiktok.com/@the.betes Instagram: https://instagram.com/thebetes Facebook: https://facebook.com/neilgreathouse LinkedIn: https://linkedin.com/in/neil-greathouse-a607b912 Website: https://yourbestt1dyear.comBooks on Amazon: Type 1 Diabetes – One Day at a Time: https://a.co/d/6UHooWJ Type 1 Diabetes – True Stories: https://a.co/d/dfIlyI1
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  Why Food Beats Insulin to the Finish Line | Pre-Bolus Science, T1D 15.07.2026 5min

  Half the planet is watching the World Cup, so Neil explains the mechanism of the post-meal spike in soccer terms. Your food is the striker, already past the defense. Your insulin is the defender who got subbed in late and is still jogging back. That mismatch is the entire reason you spike.This is the "how it works" episode. Regular rapid-acting insulin takes about 15 minutes to start, peaks around an hour, and lasts three to four hours. Your dinner carbs hit your bloodstream almost immediately. Dose them at the same time and the food scores before the insulin is even in the game. The fix is simply to put your insulin in first, so they arrive together and your CGM line stays flat and boring, which in type 1 is the dream.In this episode:How fast rapid-acting insulin actually works vs. how fast carbs hitThe pharmacokinetics of insulin timing, in plain EnglishWhy a "flat and boring" CGM is the whole goalHow pre-bolusing matches your insulin to your foodThis Week's Challenge: Keep watching the gap between your dose and your first bite at dinner, and now you know what it means. Every minute your insulin is behind, the food is on a breakaway.Helpful resources and newsletterConnect with Neil: TikTok | Instagram | Facebook | LinkedIn | WebsiteBooks on Amazon: Type 1 Diabetes – One Day at a Time | Type 1 Diabetes – True Stories
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  Pre-Bolus with @bolusandbiceps | Amanda Mueller 13.07.2026 1h 2min

  Everybody with type 1 diabetes knows they should pre-bolus. Almost nobody actually does it. In this episode, Amanda Mueller (@bolusandbiceps), certified personal trainer and T1D coach, breaks down why insulin timing is not a willpower problem... and how to fix it one meal at a time.Amanda was diagnosed with type 1 diabetes at 24 after landing in the ICU with DKA and a blood sugar over 1,000. She spent years checked out from her diabetes before strength training brought her back. Now she coaches women with T1D on exercise, insulin timing, and the hormone-blood sugar connection almost nobody talks about.We cover pre-bolus timing, fear of hypoglycemia, exercising after insulin, closed-loop pumps and why the algorithm doesn't save you at mealtime, and what to do when the food shows up late.Part of The Head Start pre-bolus challenge.What We CoverGetting diagnosed with type 1 diabetes as an adult (and why it hits different at 24)The DKA story: phantom baked-goods smell, the ICU, and a blood sugar over 1,000Diabetes burnout and the years Amanda disassociated from her T1DHow strength training rewired her relationship with the diseaseWhy she coaches women with T1D specifically (hormones, cycles, and insulin)Pre-bolusing 101: what it is and why timing beats mathThe research: dosing 15 minutes early can cut post-meal spikes by about 50 pointsFear of going low: the real reason your bolus is latePre-bolusing before exercise without crashing mid-workoutStrength training vs. cardio and what each does to blood sugarClosed-loop pumps (Tandem Mobi): why you still need to pre-bolus on an algorithmWhat to do when the restaurant food runs late (hint: it's not failing, it's adapting)About Amanda MuellerAmanda Mueller is an ISSA Certified Personal Trainer, Corrective Exercise Specialist, and Nutrition Coach living with type 1 diabetes since her diagnosis at age 24. Through Bolus & Biceps, she coaches women with T1D on strength training, insulin timing, and blood sugar management around exercise and hormones.Follow Amanda // Instagram: @bolusandbicepsHelpful resources and newsletter: https://yourbestt1dyear.comConnect with Neil: TikTok: https://tiktok.com/@the.betes Instagram: https://instagram.com/thebetes Facebook: https://facebook.com/neilgreathouse LinkedIn: https://linkedin.com/in/neil-greathouse-a607b912 Website: https://yourbestt1dyear.comBooks on Amazon: Type 1 Diabetes – One Day at a Time: https://a.co/d/6UHooWJ Type 1 Diabetes – True Stories: https://a.co/d/dfIlyI1
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  The Simple Fix for Post-Meal Spikes in Type 1 Diabetes 10.07.2026 5min

  SHOW NOTES: We’ve spent a week and a half in the problem, the spike, the loop, the fear. Today the sun comes out. Neil turns the corner to the fix, and it’s almost annoyingly simple: your food is fast and your insulin is slow, and when they start at the same time, the food wins the first hour. The fix isn’t more insulin or better carb counting. It’s timing.You give the insulin a small head start so it’s awake by the time the food arrives. Same dose, same dinner, different clock. That’s the whole name of the challenge, The Head Start. Neil keeps the science for next week and instead leaves you with hope: the early low you’ve been afraid of is a timing-and-preparation problem, and those can be solved.In this episode:The one-sentence reason you spike after mealsWhy the fix is timing, not more insulin or new gearWhat “The Head Start” actually means for your dinnerWhy the fear of the early low is a solvable problemThis Week’s Challenge: Notice the GAP. How long between when you dose and your first actual bite at dinner? For a lot of us, it’s zero. Just clock it.Helpful resources and newsletterConnect with Neil: TikTok | Instagram | Facebook | LinkedIn | WebsiteBooks on Amazon: Type 1 Diabetes – One Day at a Time | Type 1 Diabetes – True Stories
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  Every Reason You Don't Pre-Bolus (and why they're all valid) 08.07.2026 5min

  SHOW NOTES: Here’s the quiet part said out loud: the reason you don’t pre-bolus is not that you’re lazy or that you don’t care. It’s that it scares you. Neil names the specific fear at the center of the whole challenge, the fear of going low before the food arrives, and tells you the truth, 34 years in, it still scares him too.This is the episode nobody put in the pamphlet. The pamphlet says “pre-bolus 15 minutes before your meal” and leaves you alone with the little spike of panic when the arrow turns down and the food isn’t ready. Neil validates that fear completely, because it’s not a character flaw, it’s your survival brain doing its job. And then he promises what’s coming: not pretending the fear away, but out-preparing it.In this episode:The fear of hypoglycemia and why it stops us from pre-bolusingWhy that fear is normal, rational, and not a personal weaknessWhat the pamphlets never tell you about insulin timingHow we’re going to face the fear instead of ignoring itThis Week’s Challenge: The next few times you decide NOT to pre-bolus, catch yourself and notice what you’re feeling. Fear? Forgetting? No time? Just get honest about it.Helpful resources and newsletterConnect with Neil: TikTok | Instagram | Facebook | LinkedIn | WebsiteBooks on Amazon: Type 1 Diabetes – One Day at a Time | Type 1 Diabetes – True Stories
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  Fear of Going Low: The Real Reason You Don't Pre-Bolus 06.07.2026 5min

  SHOW NOTES: Here’s the quiet part said out loud: the reason you don’t pre-bolus is not that you’re lazy or that you don’t care. It’s that it scares you. Neil names the specific fear at the center of the whole challenge, the fear of going low before the food arrives, and tells you the truth, 34 years in, it still scares him too.This is the episode nobody put in the pamphlet. The pamphlet says “pre-bolus 15 minutes before your meal” and leaves you alone with the little spike of panic when the arrow turns down and the food isn’t ready. Neil validates that fear completely, because it’s not a character flaw, it’s your survival brain doing its job. And then he promises what’s coming: not pretending the fear away, but out-preparing it.In this episode:The fear of hypoglycemia and why it stops us from pre-bolusingWhy that fear is normal, rational, and not a personal weaknessWhat the pamphlets never tell you about insulin timingHow we’re going to face the fear instead of ignoring itThis Week’s Challenge: The next few times you decide NOT to pre-bolus, catch yourself and notice what you’re feeling. Fear? Forgetting? No time? Just get honest about it.Helpful resources and newsletterConnect with Neil: TikTok | Instagram | Facebook | LinkedIn | WebsiteBooks on Amazon: Type 1 Diabetes – One Day at a Time | Type 1 Diabetes – True Stories