Your Best T1D Year

Episodes

• The After-Dinner Blood Sugar Spike, Explained | T1D Pre-Bolus Challenge 03.07.2026 5m

  SHOW NOTES: You counted the carbs. You took the right dose. Two hours later you’re 240, and you have no idea why. If that number breaks your heart a little, this episode is for you. Neil sits in the problem of the post-meal spike, the one that feels like a personal failing but almost never is.This is the roller coaster every person with type 1 diabetes knows: spike, correct, drift low, snack, climb again, and it’s 9pm and you’re stacking insulin and snacks in the dark. Neil makes the case that this whole loop usually traces back to one thing, the food got a head start and your insulin spent the first hour catching up. It’s not your discipline. It’s your timing. And timing is the most fixable variable in type 1.In this episode:Why the after-dinner spike feels like your fault but usually isn’tThe correction-and-crash loop that wrecks your eveningWhy the timing of your dinner bolus is the most fixable variable in T1DWhat this challenge is really trying to give you backThis Week’s Challenge: Keep noticing your blood sugar two hours after dinner. Peek at your number right before you eat, too. Two snapshots. Change nothing yet.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
• Why You Don't Pre-Bolus (you know you should) 01.07.2026 6m

  SHOW NOTES: You already know you should pre-bolus. Your endocrinologist has told you. Every diabetes educator has told you. And you still dose with your first bite, same as the rest of us. Neil Greathouse, who has lived with type 1 diabetes since 1992, kicks off The Head Start, an eight-week challenge all about pre-bolusing your insulin, by admitting he doesn't do it perfectly either.Here is the reframe that changes everything: pre-bolusing is not a knowledge problem. Almost nobody with type 1 needs it explained. It's a fear problem, a forgetting problem, and a "the food came late one time" problem. Over the next eight weeks, we fix it gently, using dinner as our meal, with about 1,500 people doing this challenge worldwide.In this episode:Why pre-bolusing is the most-ignored advice in type 1 diabetesThe real reason we don't do it, and why it isn't disciplineThe one stat that proves you're not the only one (more than 1 in 4 meals gets a late or missed bolus)Why we're building the whole challenge around dinnerThis Week's Challenge: Change nothing. Just notice your blood sugar two hours after dinner. We're taking a "before" picture before we change a thing.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
• While You Were Sleeping Challenge Finale 29.06.2026 6m

  SHOW NOTES:Eight weeks ago, Neil asked you to do one thing: write down how many hours you slept last night. That was the whole challenge. That was where it started. One number. And here we are.This is the finale of the While You Were Sleeping Challenge -- 24 episodes, 8 weeks, and the most thorough look at sleep and type 1 diabetes that Your Best T1D Year has ever done. Neil closes with the full arc: from mystery blood sugars and 3am wake-ups, to the 21% insulin sensitivity finding, to the dawn phenomenon, the sleep-blood sugar feedback loop, cortisol, Fear of Hypoglycemia, sleep stages, alarm calibration, pre-sleep routines, and the one habit that ties all of it together. Then he makes the case that should change how you think about sleep permanently.Sleep is not a passive rest state for people with type 1 diabetes. It is a metabolic tool. And now you have it.In this episode:The full While You Were Sleeping Challenge recap -- all 8 weeks, all the mechanismsWhy sleep is a metabolic variable, not just a wellness recommendation, for T1D peopleWhat "managing T1D while you sleep" actually means biologicallyThe one thing to carry forward from all 24 episodesWhat's coming next for Your Best T1D YearFinal Challenge: Share one thing you learned in the last eight weeks. Tag @thebetes on Instagram, or tell one person -- someone with T1D, or who loves someone with T1D. One ripple.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
• The One Sleep Habit That Improves T1D Time in Range 22.06.2026 6m

  SHOW NOTES:Eight weeks. Twenty-four episodes. The dawn phenomenon, cortisol, alarm fatigue, sleep stages, Fear of Hypoglycemia, CGM as a proactive tool. If Neil had to give you one thing to keep from all of it -- just one habit -- here it is: go to bed at the same time every night.This is not a joke, and it's not oversimplified. It's the finding from the 2023 T1D sleep study with 76 participants that Neil has been referencing throughout this challenge. Bedtime consistency was the dominant sleep variable associated with time in range -- not total hours, not sleep efficiency, not how many times you woke up. Consistent bedtime. Every extra hour of bedtime variability was associated with roughly 10% less time in range. And the effect runs both directions: more consistency, better glucose outcomes.We're in Week 8 of the While You Were Sleeping Challenge. Three days from the finish line.In this episode:Why consistent bedtime is the single most impactful sleep habit for T1D time in rangeWhat the 2023 research actually says -- and why it's the clearest finding in the whole challengeWhy your body doesn't know it's Saturday (and what that costs you weekly)The Jerry Seinfeld productivity method applied to your bedtimeHow to pick your time, commit to the 60-minute window, and start the streakThis Week's Challenge: Pick your bedtime. Say it out loud. Write it down. Commit to it through the end of the challenge -- including this weekend.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
• What "Good Enough" Sleep Actually Looks Like When You Have Type 1 Diabetes 19.06.2026 5m

  SHOW NOTES:Perfect is not the goal. This episode takes a stand on something that doesn't get said enough in health content of any kind -- and especially not in T1D content.If you've been measuring your sleep quality against general population benchmarks (the 8-hour standard, the 90% sleep efficiency score, the deeply uninterrupted ideal), Neil is here to tell you, with genuine care, that you've been holding yourself to the wrong ruler. T1D "good enough" sleep is its own category. You're managing a disease overnight. Your liver is running its 3am shift. Your cortisol is cycling. Your CGM is monitoring. Comparing your sleep to non-T1D benchmarks is not a useful exercise. And chasing perfect while managing T1D is a fast road to frustration. Meaningfully better is the goal.This is Week 8 of the While You Were Sleeping Challenge. We're almost at the finish line -- and this episode matters.In this episode:Why comparing T1D sleep to non-T1D population benchmarks doesn't serve youWhat "meaningfully better" looks like for someone managing overnight glucoseThe batting average analogy: what winning looks like when you're playing with T1D physicsHow to define your own version of sleep success -- one that accounts for what you're actually managingWhy "fewer interruptions than last month" counts as a real winThis Week's Challenge: Write one sentence: what would "better" sleep look like for you? Not perfect. Your version. One sentence.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
• How to Use Your Overnight CGM Data to Improve Sleep and Blood Sugar 17.06.2026 5m

  SHOW NOTES:You've been sleeping next to one of the most detailed health monitoring devices that exists. Every single night. For however many years you've had your CGM. It has been logging everything -- every rise, every drop, every 3am event, every overnight pattern. It has been very patient about all of this.Most T1D people use their CGM reactively at night. The alarm fires, you check, you respond or silence, you go back to sleep. What almost no one does is look at the full overnight graph proactively -- not to respond to a single moment, but to read the shape of the whole night. Your CGM shows you the dawn phenomenon, the post-exercise glucose drop, the cortisol spike, the active insulin tail. It has been a map this whole time. We've been treating it like a fire alarm.This is Week 7 of the While You Were Sleeping Challenge. This is the episode that changes how you use the device you already wear.In this episode:The difference between reactive and proactive overnight CGM useHow to read the shape of an overnight graph -- not just the morning numberWhat the dawn phenomenon, exercise drops, and cortisol spikes look like in your dataWhy your CGM graph is a map, not a report cardHow one minute of overnight data review can improve the next nightThis Week's Challenge: Tonight, look at last night's full overnight CGM graph. The whole shape. Not to judge it. Not to fix it. Just to see what was 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
• T1D Sleep Hygiene: The One Pre-Sleep Habit That Actually Makes a Difference 15.06.2026 6m

  SHOW NOTES:"Sleep hygiene" sounds like you're brushing your sleep's teeth. Nobody has ever said that phrase in a natural conversation. And this episode is not about a 12-step pre-sleep protocol that you'll implement on Monday and abandon by Wednesday when life gets in the way.It's about one thing. Just one. Because T1D brains are very good at building complicated systems -- we've been doing it since diagnosis -- and when we hear "build a routine," we design a fourteen-point optimization plan that fails by Wednesday, raises our cortisol, and disrupts our blood sugar. One anchor behavior, repeated consistently, is how habits actually form. You already have a pre-sleep T1D routine. We're extending it by about thirty minutes, in one direction.We're in Week 7 of the While You Were Sleeping Challenge.In this episode:Why multi-step sleep protocols fail and what actually sticks long-termThe three pre-sleep candidate behaviors that research supports for T1D peopleWhy "the one that feels manageable" beats "the one that seems most impactful"How to use your existing T1D bedtime routine as an anchor for one new behaviorWhat five nights of one habit actually tells you about whether it's workingThis Week's Challenge: Pick one of the three pre-sleep behaviors from this episode. Commit to it for five nights. Write down what you notice.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
• Late-Night Exercise and Blood Sugar: What Your Evening Workout Does to Your T1D Overnight 12.06.2026 7m

  SHOW NOTES:Your Tuesday 8pm HIIT class has opinions about your 3am blood sugar. The data is pretty clear on this. Neil is giving you fair warning before the episode starts.This episode covers the timing of exercise and its downstream effects on both sleep quality and overnight glucose in type 1 diabetes. Afternoon and evening exercise produce very different results -- not because exercise is bad for T1D management (it isn't), but because your core body temperature, cortisol rhythm, and post-exercise glucose patterns interact with your sleep in ways that depend heavily on when you moved. The 8pm workout can raise core temperature, spike cortisol, and set up a 2am glucose drop that fires an alarm -- all without any other mistake being made.We're in Week 7 of the While You Were Sleeping Challenge.In this episode:Why afternoon exercise (roughly noon to 6pm) supports better sleep and overnight glucose stabilityWhat high-intensity evening exercise does to core body temperature and cortisol levelsHow post-exercise glucose drops in T1D can create 2-3am lows and trigger alarmsWhat to look for in your overnight CGM data on workout days vs. rest daysHow even a modest timing shift can meaningfully change the overnight pictureThis Week's Challenge: What time was your last workout? Pull up your overnight CGM from that night. Did anything look different than your non-workout nights?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
• T1D Sleep Stages Explained: Why You're Exhausted After 7 Hours of Sleep 10.06.2026 6m

  SHOW NOTES:You slept seven hours. By any reasonable measure, that should be enough. You woke up feeling like you slept four. You weren't imagining it.This episode breaks down sleep stages -- light sleep, deep sleep, REM -- and explains exactly where type 1 diabetes disrupts the sequence. The most important stage, slow-wave sleep (NREM Stage 3), is where your body does its deepest repair work: growth hormone release, cellular recovery, immune restocking, brain waste clearance. T1D adults get measurably less of it. Not because of anything you're doing wrong, but because T1D interrupts sleep architecture in ways that are documented in the research and that most T1D people were never told about.This is Week 6 of the While You Were Sleeping Challenge. This is the episode that explains WHY you're tired even when the hours were there.In this episode:The 90-minute sleep cycle and what each stage actually does for your bodyWhy slow-wave sleep is the stage that matters most -- and why T1D adults get less of itHow every alarm, partial arousal, and cortisol spike sends your brain back to Level 1The difference between "not enough hours" and "disrupted sleep stages" -- they feel the same but aren'tHow to check your deep sleep percentage if you have a wearableThis Week's Challenge: If you have a wearable that tracks sleep stages, check last night's deep sleep percentage. The average for most adults is 15-20%. Just know your number.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
• Fear of Hypoglycemia: The T1D Sleep Problem That Doesn't Show Up in Your CGM Data 08.06.2026 7m

  SHOW NOTES:Your CGM says 115. Flat arrow. No active insulin. You've checked it twice. The number is completely fine. And you're still awake at 2:48am.This is not you being dramatic. This has a name: Fear of Hypoglycemia (FOH). It's a documented, peer-reviewed phenomenon in T1D populations -- a specific pattern of nighttime hypervigilance that persists even when blood sugar is stable. The anxiety is the disruptor, independent of the actual glucose level. And it's one of the most undernamed contributors to T1D sleep disruption.In this episode, Neil explains where Fear of Hypoglycemia comes from, why it makes complete sense that it developed, and why having the name for it changes how you relate to the 2am wake-up. Nobody told most T1D people this name. That's the problem this episode is here to fix.We're in Week 6 of the While You Were Sleeping Challenge.In this episode:What Fear of Hypoglycemia actually is and what peer-reviewed research says about itWhy the overnight hypervigilance response is a rational system with an irrational triggerThe difference between "I'm being irrational" and "I have a documented T1D sleep phenomenon"Why naming FOH changes how you relate to being awake at 2am with a perfect numberWhat comes next: what you can actually do about itThis Week's Challenge: Have you ever been awake at 2am with a completely stable blood sugar and still couldn't sleep? Just acknowledge that it happened. That's the whole challenge.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
• Cortisol and Blood Sugar: The T1D Overnight Connection You're Probably Missing 05.06.2026 7m

  SHOW NOTES:Cortisol isn't trying to ruin your blood sugar. It's trying to help. It has never once, in your entire life, acted with malice. It is a useful, important hormone that is -- in the modern world -- very confused about what an actual emergency looks like.This episode is about cortisol: what it's designed to do, what it's actually responding to in modern life ("quick question" emails at 10pm), and what it's doing to your blood sugar by midnight. For T1D people, cortisol-driven blood sugar rises don't get quietly compensated by a functioning pancreas. They land. And they land on top of whatever else was already happening overnight. Understanding the cortisol loop is the first step to interrupting it -- starting with the hour before bed.We're in Week 6 of the While You Were Sleeping Challenge. Solutions are building.In this episode:What cortisol is actually designed to do -- and why your lion never shows upHow cortisol raises blood sugar in T1D without the automatic pancreas feedback to catch itThe full cortisol loop: poor sleep raises cortisol, cortisol raises blood sugar, elevated blood sugar disrupts sleepWhy what you do in the hour before bed shows up in your midnight glucoseHow to start rating your pre-bed stress and looking for the pattern in your own dataThis Week's Challenge: Rate your stress level 1-10 before bed, three nights this week. Note your morning blood sugar each time. Look for the pattern.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
• How Bedroom Temperature and Blue Light Affect Blood Sugar in Type 1 Diabetes 03.06.2026 7m

  SHOW NOTES:Neil wants to be upfront: this episode is going to sound like wellness content delivered by someone standing in a field in linen pants. He knows. He can't control how it sounds. What he can tell you is that there's actual research behind all of it, it specifically applies to T1D glucose management, and he read most of it at midnight on his phone in bed with the screen at full brightness.Your sleep environment -- specifically temperature, light, and screen exposure -- directly affects the hormones that regulate both sleep and glucose. For T1D people, those hormones matter more because there's no backup system to compensate when they go sideways. Blue light at 10pm tells your brain it's daytime, suppresses melatonin, and raises cortisol. A warm room keeps your core temperature elevated, making it harder to drop into deep sleep. Both of these things are doing quiet work against your blood sugar while you're trying to rest.We're in Week 5 of the While You Were Sleeping Challenge.In this episode:How blue light from screens suppresses melatonin and triggers cortisol at 10pmWhy your phone screen registers as "daytime" to your brain's sleep-wake systemCore body temperature and its role in reaching deep sleep stagesThe research-backed temperature range for better sleep qualityOne practical environmental change to make tonight that doesn't require buying anythingThis Week's Challenge: Know your bedroom temperature. Tonight, put your phone face down one hour before bed. Not in another room -- just face down. See what happens.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
• Your Pre-Sleep Blood Sugar Check Is a Sleep Decision, Not Just a Safety Check 01.06.2026 6m

  SHOW NOTES:You already do this. You check your blood sugar before bed, glance at your CGM, maybe set a temp basal. You've been doing it for as long as you've had T1D. Here's the reframe: you've been doing it as a safety check. "Am I okay to go to sleep?" This episode argues it's also a sleep decision -- and that shift changes what you're actually optimizing for.Active insulin at midnight is a sleep variable. A correction dose from 9pm is still tailing off at 1am. That tail can create glucose variability that pulls you out of deep sleep without triggering an alarm -- a partial arousal that costs you sleep quality without you knowing it happened. The more stable your blood sugar heading into sleep, the fewer overnight alarms, the better your sleep architecture, and the better your insulin sensitivity the next morning.Welcome to June. Welcome to Week 5 of the While You Were Sleeping Challenge. This is where we start doing something about it.In this episode:How pre-sleep blood sugar affects sleep quality, not just overnight safetyWhat active insulin at bedtime does to your 1am and 2am sleep stagesThe 30-minutes-before-bed check and why timing makes a differenceHow pre-sleep glucose stability connects directly to tomorrow morning's insulin sensitivityStarting the feedback loop running in the right direction tonightThis Week's Challenge: Check your blood sugar 30 minutes before bed -- not right when you're about to sleep. Note the number and any active insulin on board. Do this three nights and see what the mornings look like.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
• T1D Sleep Challenge: Four Weeks In, What We've Learned 29.05.2026 6m

  SHOW NOTES:Four weeks ago, Neil asked you to do one thing: write down how many hours you slept. That was it. Just a number. And now here we are.This is the halftime checkpoint of the While You Were Sleeping Challenge. Neil does what any good coach does at halftime -- pulls everyone in, takes a breath, and goes over what we actually know. Because the first four weeks covered a lot: recognition, the 21% number, the dawn phenomenon, the sleep-blood sugar feedback loop, bedtime consistency, sleep architecture differences in T1D, and CGM alarm fatigue. And the goal today is to actually sit with what changed before we move into solutions.May was all problem and mechanism. June is different. June is where we build.We're in Week 5 of the While You Were Sleeping Challenge. If you're just finding this, jump in right here. You're not behind.In this episode:A full recap of Weeks 1 through 4 and everything established so farWhy problem-naming has to come before solution-buildingWhat the second half of the challenge covers (cortisol, Fear of Hypoglycemia, CGM as a proactive tool, pre-sleep routines)How to look at your own four weeks of data before June beginsWhat "paying attention" for four weeks actually produced, even if the tracking wasn't perfectThis Week's Challenge: What's one thing you noticed in the last four weeks? Not a conclusion. Not a solved problem. One thing you noticed. Write it in one sentence.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
• How to Adjust CGM Alarm Thresholds for Better Sleep with Type 1 Diabetes 27.05.2026 6m

  SHOW NOTES:When did you last actually look at your CGM alarm threshold settings? Not to silence an alarm. Not to check a number. To actually look at the thresholds -- the settings, the specific values, when they were last changed.If your answer is "when I first set up the device," this episode is for you.Neil walks through what CGM alarm thresholds are, why they're not permanent features of having T1D, and why the settings you're running right now may be calibrated for a different version of your management than the one you have today. Your diabetes has changed. Your time in range has changed. Your thresholds probably haven't. This is a practical episode -- no heavy science, just a straightforward conversation about settings you can actually look at and, when appropriate, adjust.We're in Week 4 of the While You Were Sleeping Challenge. This is the actionable follow-up to Monday's alarm fatigue episode.In this episode:What CGM alarm thresholds are and how most people originally set themWhy outdated thresholds create unnecessary overnight wake-ups even when management has improvedThe difference between thresholds optimized for daytime control vs. overnight sleepQuiet hours and do-not-disturb settings most CGM users don't know existWhy this conversation is worth having with your care teamThis Week's Challenge: Open your CGM app. Find the alarm threshold settings. Look at the numbers. Do they still match where your management actually 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
• CGM Alarm Fatigue in Type 1 Diabetes: How Your Alerts Are Wrecking Your Sleep 25.05.2026 5m

  SHOW NOTES:How many times did your CGM alarm last night? If you have to guess -- or if you're honestly not sure because your arm is doing the silence-and-go-back-to-sleep thing on autopilot -- that's alarm fatigue. And it's a documented, peer-reviewed phenomenon that's costing you sleep in ways that quietly compound every single night.This episode is about the complicated relationship T1D people have with CGM alarms. They're lifesaving. They're also, at times, genuinely maddening. There's a real, measurable difference between alarms that protect you and alarms that interrupt your sleep architecture without adding any safety benefit. Neil talks about how alarm fatigue develops, what it costs your sleep stages, and why the answer isn't to turn everything off -- it's calibration.We're in Week 4 of the While You Were Sleeping Challenge.In this episode:What alarm fatigue is and how it develops in T1D people over timeHow sub-threshold wake-ups disrupt sleep architecture without a full wake-upThe boy-who-cried-wolf problem in CGM management -- and why the wolf is still realWhy calibration (not silence) is the right responseThe peer-reviewed paper with a title that's definitely just a research paper titleThis Week's Challenge: Count how many times your CGM alarmed last night. Don't do anything about it yet. Just get the number.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
• What Type 1 Diabetes Actually Does to Your Sleep Architecture | Episode 200 22.05.2026 7m

  SHOW NOTES:200 episodes. Neil didn't plan on this. He definitely didn't plan on spending episode 200 explaining what your liver does at 3am without your permission. And yet here we are.This is the episode that contains the most important thing Neil has said in this entire challenge. Most T1D content talks about sleep in two ways: the safety angle (set your alarms right) or the wellness angle (get enough rest). Neither goes far enough. What the research actually shows is that T1D adults have fundamentally different sleep architecture than adults without T1D -- measurably less slow-wave sleep, higher overnight hormone levels, and a higher arousal index that keeps them closer to the surface all night. You're not bad at sleeping. You've been sleeping with a condition that literally changes how sleep works in your body. And nobody told you.This is Week 4 of the While You Were Sleeping Challenge. 200 episodes in. This one matters.In this episode:The documented differences in T1D sleep architecture vs. non-T1D adultsWhat slow-wave sleep is and why T1D people get measurably less of itWhat "arousal index" means and why it explains waking up tired after 7 hoursWhy endocrinologists and sleep doctors don't talk to each other (but should)Why episode 200 was the right moment to say this out loudThis Week's Challenge: Tell one person about this challenge. Someone with T1D, or who loves someone with T1D. One ripple.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
• Bedtime Consistency and T1D: Why Timing Beats Total Hours for Blood Sugar Control 20.05.2026 6m

  SHOW NOTES:You've been told to get eight hours. Here's what the research actually found.A 2023 study of 76 adults with type 1 diabetes tracked both CGM and sleep data for one week. The finding: sleep duration alone was not independently associated with time in range. What was? Bedtime consistency. Every extra hour of variability in bedtime was associated with roughly 10% less time in range. Your CGM noticed. It was taking notes.This episode reframes the sleep conversation for T1D: it's not just about how much you sleep. It's about when. Your body doesn't know it's Saturday. Your cortisol doesn't know it's Saturday. Only your social calendar knows it's Saturday -- and your social calendar is not in charge of your A1C.We're in Week 3 of the While You Were Sleeping Challenge.In this episode:The 2023 T1D sleep study and what it actually measuredWhy six people who each got 7 hours got six different resultsWhat bedtime consistency means practically -- and why it matters more than total hoursWhy weekend sleep timing is where this breaks down for most peopleThe 60-minute window and why it worksThis Week's Challenge: Try to go to bed within a 60-minute window of the same time, three nights this week. Not all seven. Just three.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
• The T1D Sleep-Blood Sugar Feedback Loop 18.05.2026 6m

  SHOW NOTES:Bad sleep makes your blood sugar harder to manage. Worse blood sugar disrupts your sleep. Worse sleep makes your blood sugar worse. You've been running a feedback loop -- without knowing it.This is the episode where things click. Neil connects all the pieces from Weeks 1 and 2 into the full picture: the bidirectional relationship between sleep and glucose management in type 1 diabetes. High blood sugar increases overnight bathroom trips. Low blood sugar fires the alarm. Glucose variability through the night disrupts sleep architecture even without a full wake-up. And the worse you sleep, the more your insulin sensitivity drops the next day. The loop is real. And here's what nobody usually says: you can interrupt it from either side.We're in Week 3 of the While You Were Sleeping Challenge.In this episode:The full sleep-blood sugar feedback loop in T1D, explained end to endWhy both high and low blood sugar disrupt sleep in different waysHow glucose variability affects sleep stages even without a full wake-upWhy you don't have to fix both sides of the loop at onceHow to pick one end of the rope and start pullingThis Week's Challenge: Pick one small thing to try before bed. Just one. An early blood sugar check, consistent bedtime two nights in a row, screens down an hour before sleep. Write down what happened in the morning.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
• The Dawn Phenomenon in Type 1 Diabetes: Why Your Blood Sugar Rises While You Sleep 15.05.2026 7m

  SHOW NOTES:You went to bed at a perfect 110. No active insulin. Flat arrow. You did everything right. You wake up at 182. Nothing happened -- no low, no alarm. You just slept. Except something did happen. You just weren't awake for it.This episode introduces the dawn phenomenon: the pre-dawn hormonal surge (cortisol, growth hormone, glucagon, epinephrine) that causes your liver to manufacture and release glucose into your bloodstream between roughly 3am and 8am, every single night, without your permission. For people without T1D, the pancreas handles this automatically and they never know it happened. For T1D people, the glucose just lands -- and then we stand in the kitchen at 6am holding an insulin vial up to the light, wondering what on earth went wrong.This is Week 3 of the While You Were Sleeping Challenge. We're getting into actual mechanisms.In this episode:What the dawn phenomenon actually is and what triggers itHepatic glucose output explained in plain English (and why it sounds like a Jurassic Park sequel)Why non-T1D people never notice this happening overnightWhat 34 years of blaming the insulin vial actually looked likeHow to start spotting the dawn phenomenon in your own overnight CGM dataThis Week's Challenge: Pull up your overnight CGM graph from last night. Do you see a gradual rise starting around 3 or 4am when your blood sugar was otherwise flat? Just look. Don't change anything yet.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