Your Best T1D Year

Епизоде

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  The Movement "Snack" 18.09.2026 5мин

  For once, a study on our actual people. Published in 2026 in Diabetes Technology and Therapeutics: adults with type 1 diabetes on insulin pumps sat for six hours straight on one lab day, and on another day broke up the same sitting with three minutes of simple resistance moves every 30 minutes. On the movement snack day, their insulin worked measurably better. Nobody touched a pump setting.That's the movement snack: tiny bites of movement instead of one big meal of exercise you keep rescheduling. Calf raises while coffee brews. Squats between Zoom calls with the camera off. And the ADA's 2025 Standards of Care now officially recommend interrupting sitting every 30 minutes, which means your desk squats are evidence-based medicine now. This isn't 75 Hard. This is 8 Easy.In this episode:* The first sitting-break study done specifically in people with T1D on pumps* What a movement snack is, and why two minutes counts* The ADA's every-30-minutes recommendation, now official* How to hide movement inside a workday without anyone noticingYour challenge: pick a trigger and run one movement snack an hour for one workday. Two or three minutes, up and moving, back down. See what your afternoon line does.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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  Three Short Walks Beat One Long Walk 16.09.2026 5мин

  Stop looking for 45 free minutes. They don't exist, and it turns out they were never the assignment. A 2013 Diabetes Care study by Loretta DiPietro compared one 45-minute walk against three 15-minute walks after meals, same total time. The three short walks won on 24-hour blood sugar control, and the after-dinner walk did the most work of all.For everyone with type 1 diabetes who works, parents, commutes, or lives an actual life, this reorganizes everything. You don't need a block of time. You need three ten-minute cracks, and one of them, right after dinner, you already own if you did the pre-bolus challenge this summer. Same minutes, better numbers, and the only thing that changed was when.In this episode:* The DiPietro study: same walking time, dramatically better placement* Why post-meal walks beat any other timing for blood sugar* The after-dinner walk as MVP, and why it stacks on your pre-bolus habit* Finding the three cracks hiding in your normal dayYour challenge: add one after-dinner walk. Ten minutes, easy pace. Check your line at the two-hour mark and compare it to a normal night.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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  Exercising with Type 1 Diabetes // 34 Years of T1D and Still Moving (Arnie Bunch, the Blood Sugar Ninja) 14.09.2026 1ч 4мин

  Arnie Bunch has been living with type 1 diabetes since 1992, the same year Neil was diagnosed. He's a runner, the creator of the #bloodsugarninja, and the kind of friend who gives you the straight answer about the gear because he's actually worn it at mile 18. Two weeks into the Keep It Moving challenge, the science gets a face.This is the lived-experience episode. Before the researchers and the study data, Neil wanted you to hear a regular guy with a regular life talk about what moving, and not moving, actually does to this disease over decades. Arnie gets honest about the chair tax on desk days, the fear of lows that keeps so many of us parked, the habit that finally stuck after the ones that didn't, and a movement-plus-blood-sugar mistake he owns out loud. That's the evidence that doesn't fit in a journal.In this episode:Thirty-four years of type 1 in the short version: diagnosis, the grind nobody claps for, and where the relationship stands nowWhere movement actually fits in real T1D management... walker, runner, pacer-during-football-games, all of it countsThe chair tax: what desk days versus moving days do to insulin sensitivity, felt in a real body, not a labFear of going low with insulin on board... the number one reason people with T1D move less, and what Arnie would tell his younger, scared selfThe habit that finally stuck (after failing five times), and what was different that timeMovement on chaotic days: not the ideal schedule, the real oneTrue or False, the Diabetes Confession Booth, and the Fastest Five Minutes... friend editionThis Week's Challenge: One ten-minute walk after one meal. That's it. Your muscles have a side door that pulls sugar out of your blood with zero insulin, and the payout lasts up to two days. Take the deal.Know your type 1 diabetes risk with a painless cheek swab from T1D Scout: https://www.t1dscout.com Follow Arnie: Instagram: https://instagram.com/type_run_diabetic Everything else: https://linktr.ee/awbunch3 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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  The Bonus That Lasts Two Days 11.09.2026 6мин

  The fact this whole challenge is built on: when you move today, your insulin works better tomorrow. For 24 to 48 hours after movement, the muscles you used stay more sensitive to insulin. One walk buys you a bonus that's still paying out tomorrow night, like a Costco membership for your pancreas.And this year the receipts got enormous. A 2026 study in Diabetologia analyzed 428,058 real exercise sessions from 3,248 people with type 1 diabetes wearing CGMs. Every type of movement improved time in range over the next 24 hours: walking about 2 points, strength work almost 4. Neil also gives you the honest cost from the same study (time below range rose slightly on active days) and why that's exactly what the upcoming safety-net episode is for.In this episode:* The 24-to-48-hour insulin sensitivity window, explained simply* 428,058 real T1D workouts: the biggest exercise dataset our community has ever had* Walking vs cardio vs strength for next-day time in range* The honest tradeoff nobody selling fitness plans will tell youYour challenge: move ten easy minutes today, then pay attention tomorrow. A lot of people can feel the day-after difference once they know to look.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 Muscles Have a Side Door 09.09.2026 5мин

  The coolest piece of machinery you own, and nobody ever handed you the manual. Normally, sugar leaves your blood through a door that only insulin can unlock. That's type 1 diabetes in one sentence. But your muscles have a second door, a side door, and it opens when you move. No insulin required. It's the Home Alone house: the front door is booby-trapped and complicated, and the side door is just... open.Neil breaks down GLUT4 (the worst-named best friend in diabetes), why a walk can pull a number down all by itself, and why this mechanism works identically in every human body, which is exactly why the movement research applies to those of us with T1D. This is the episode that explains everything that follows in the Keep It Moving challenge.In this episode:* How muscle contraction pulls glucose out of your blood without insulin* GLUT4 explained in plain English, with appropriate mockery of the name* Why a 10-minute walk can visibly bend your CGM line* The great equalizer: why this science applies to every body, T1D includedYour challenge: use the door on purpose once. Walk easy for ten minutes after any meal, then peek at your CGM at the two-hour mark.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 3 Hour Sit 07.09.2026 5мин

  It's Labor Day, college football is back, and Neil just sat through a noon kickoff and surfaced at midnight. Perfect timing to explain what a three-hour sit actually does inside a body with type 1 diabetes: your leg muscles clock out, sugar hangs around in your blood, insulin works alone, and that stubborn afternoon high parks itself on your CGM. You might not have eaten your way into it. You might have sat your way into it.The hope: a 2012 Diabetes Care study found just two minutes of easy walking every 20 minutes meaningfully lowered blood sugar and insulin levels compared to sitting straight through. And the American Diabetes Association's 2025 Standards of Care now officially recommend breaking up sitting at least every 30 minutes. It's in the rulebook your endo reads.In this episode:* What happens to glucose and insulin during a long unbroken sit* The 2012 study: two minutes of strolling every 20 minutes moved real numbers* The ADA's new every-30-minutes guideline, explained in plain English* Why football Saturdays are a blood sugar event of their ownYour challenge: one time this week, catch yourself mid-long-sit and just get up for two minutes. Consider it a test drive.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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  This Number Will Surprise You 04.09.2026 6мин

  How many steps do you actually take on a normal day? Not your best day, a regular Tuesday. Check your phone, and prepare to appeal the ruling. In this episode Neil breaks down the gap between how active we feel and what the step count says, and why being busy and actually moving are two different things for blood sugar.Then two stats that change the whole conversation. Most adults with type 1 diabetes do not hit the recommended 150 minutes of weekly activity, and the number one reason in the research is fear of going low, not laziness. And that famous 10,000 steps goal? A 1960s Japanese pedometer slogan, not science. A 2022 Lancet Public Health study of about 47,000 adults found the big health benefits show up way before 10K.In this episode:* The real reason people with T1D move less, straight from the research* Where 10,000 steps actually came from, and what the science says instead* 47,000 adults, 40 to 50 percent lower mortality risk, no gym required* How to find your true step baseline this weekendYour challenge: two numbers at bedtime for a few days, your steps from your phone and your longest sit. That baseline is the only number you'll ever compete against here.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 Chair is Winning 02.09.2026 6мин

  Welcome to Keep It Moving, the new 8-week challenge for people with type 1 diabetes, and meet the villain: the chair. Nobody decides to sit for half a day. The chair decides for you, quietly, like a Netflix autoplay countdown, and your blood sugar pays the tax. Neil opens with his own confession: eight back-to-back Zoom meetings, a 4am run that turned into a fully sedentary day, and the insulin sensitivity drop he can feel by every afternoon.This is not a fitness challenge. No gym, no gear, no 10,000 steps. The problem is long, unbroken sitting, and the fix is smaller than anyone has told you. Starting now, right before the fall slump steals everyone's movement, about 2,000 people with T1D are getting ahead of it together.In this episode:Why sitting, not exercise, is the real blood sugar problem for most of usHow long unbroken sitting quietly raises insulin needs through the dayWhat the fall slump does to activity and A1C, and why we start in SeptemberThe before picture: the one number to notice this week without changing anythingYour challenge this week: change nothing. Just notice your longest unbroken sit each day. No guilt, no fixing. We're taking the before picture.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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  The Head Start Finale + What's Next: The Steps Challenge | Type 1 Diabetes 01.09.2026 6мин

  Eight weeks ago, you were spiking after dinner and blaming yourself for it. This is the finale of The Head Start, and instead of another recap, Neil reads two listener stories that say what these eight weeks were really about, one from a woman who cried at her kitchen sink the first time she saw a flat 140, and one from a 31-year veteran whose time in range jumped from the low 60s to 81%.Then Neil looks ahead. Starting in September, the next challenge is steps, just walking, and it's the perfect sequel to pre-bolusing. One walk can improve insulin sensitivity for 24 to 48 hours, a 10-minute walk after a meal lowers the spike, and breaking up sitting can cut the after-meal glucose rise by about 28%. We start in September and October, before the cold-weather slump, because A1C is at its lowest then and climbs through winter as we move less.In this episode:Two real listener stories on what pre-bolusing changed for themWhy time in range is protecting your health for years to comeA first look at the next challenge: steps and walking for T1DThe science of walking, insulin sensitivity, and post-meal blood sugarFinal Challenge: Keep pre-bolusing your dinner, it's yours now. And if you're feeling good tonight, take a short walk after dinner, a little sneak preview of September.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 at the Kids Table // Raising Kids with Type 1 Diabetes (Raquel Baron, Type One Together) 31.08.2026 58мин

  Raquel Baron was diagnosed with type 1 diabetes at five years old and left the hospital late to her own birthday party. Twenty-four years later, she's the founder and CEO of Type One Together, home of the T1D Babysitter List, now over 4,000 sitters nationwide who either live with type 1 or love someone who does. It started as one college student in Austin with 14 names written on a piece of paper. This week, Neil pulls up a chair at the kids table.This one is for the T1D parents. Pre-bolusing is hard enough as an adult. Try doing it for a picky toddler who might eat all the mashed potatoes, none of them, or hit the trampoline right after dinner. Raquel breaks down why chasing one perfect dose is the trap, how to dose for the carbs you KNOW they'll eat, and why splitting the dose into little swings beats swinging for the fences. Then she gets honest about the part nobody says out loud: why telling kids to hope for a cure can quietly backfire, and what she wants every worried parent to hear from the kid who grew up on the other side of it.In this episode:Why kids miss so many doses... research Neil shares shows more than 1 in 4 meals gets a late or missed bolus, and about half of snack boluses in kids never happenThe stat that stops you cold: kids who get their boluses on time are about 24 times more likely to be in excellent controlRaquel's "safe number" method: dose for the food you know they'll eat, keep an emergency treat in the pantry, and add insulin as the meal unfoldsThe pediatric guidelines that give parents permission to dose during or after meals for little ones... you are not failing if the 15-minute head start doesn't happenHanding off T1D responsibility in stages, from "press the button for me" at toddler age to the high schooler who wants the freedomCGM anxiety is real: why parents can't put the phone down, and the ten-minute timer trick from the Better Together communityDiabuddies, the babysitter question every parent forgets to answer, "hope isn't a strategy," and a NEW Fastest Five Minutes world record (30 answers, sorry Natalie)This Week's Challenge: Parents, pre-bolus for the safe number. Look at the plate, find the carbs your kid will absolutely eat, and get that insulin going. No bullseye required. Little swings win.Learn more about Type One Together, the T1D Babysitter List, and the Better Together community: https://www.typeonetogether.comHelpful 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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  The Pre-Bolus Challenge Recap: All the Science | Type 1 Diabetes 28.08.2026 5мин

  Previously, on The Head Start: a man admitted he's had type 1 for 34 years and still sometimes doses with his mouth full, and an entire audience realized the after-dinner spike was never their fault. This is the greatest-hits recap, and this time it comes with the receipts.Neil runs the whole arc, the fear, the junk drawer of reasons, why food beats insulin to the finish line, and then the science: 15 minutes early can cut your peak by about 50 points, the sweet spot is 15 to 20 minutes, and pre-bolusing did not raise lows. Plus the August numbers, 27% of meals get a late or missed bolus, a high-fat meal can need 42% more insulin, and even 20-year veterans miss carb counts by about 15 grams. Eight weeks, one real skill.In this episode:The full eight-week arc, from fear to flat linesThe headline studies and numbers behind pre-bolusingThe August real-life lessons: restaurants, pizza, tech, and the kids' tableProof of how far you've come since Episode 216This Week's Challenge: Pull up your two-hour numbers from week one next to now. Compare them side by side. That difference is your receipt. Keep 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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  How to Make Pre-Bolusing a Lasting Habit | Type 1 Diabetes 26.08.2026 5мин

  The challenge is almost over, so the real question is what happens next week, when Neil isn't in your ears three times a week. This episode is about making the pre-bolus habit last past the finish line, and it's grounded in habit science.A study by Phillippa Lally found it takes about 66 days on average for a behavior to become automatic, but the range is huge, 18 to 254 days. So if pre-bolusing still takes effort, you're not failing, you're on a normal curve. The best finding: missing a single day did not break the habit. Neil also makes the timely case for locking it in now, heading into back-to-school season, so the new routine gets built while everything's already being rearranged.In this episode:Why habits that last are the ones that got easy, not white-knuckledThe Lally study: about 66 days to automatic, and one missed day is fineHow to habit-stack your pre-bolus so it survives busy seasonsWhy back-to-school is the perfect time to lock it inThis Week's Challenge: Write down, somewhere you'll see it, the one reason YOU want to keep pre-bolusing. When motivation dips in a few weeks, that note is what carries 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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  What a Flat CGM Line Feels Like After Meals | Time in Range, T1D 24.08.2026 6мин

  Remember day one, when the after-dinner spike was just the rent you paid for eating? Now think about last week, when you pre-bolused, ate, and looked down at a flat, boring, beautiful CGM line. This episode is about that feeling, because that feeling is the whole point.Neil shares what people describe when it clicks, not the number, but "I didn't have to correct," "I wasn't cranky all evening," "I forgot I had diabetes for a couple hours." And he grounds it in the science: a 2019 study by Beck found that every 10% you add to your time in range is roughly a 0.6% drop in your A1C, and a re-analysis of the DCCT linked higher time in range to lower rates of microvascular complications, your eyes and kidneys. That flat line isn't just a calmer evening, it's years.In this episode:Why the first flat post-meal line feels so goodWhat time in range actually buys you, day to dayThe Beck study: every 10% more time in range ~ 0.6% lower A1CHow better time in range protects against long-term complicationsThis Week's Challenge: Catch one flat line and actually notice it. Don't scroll past your own CGM, look at it, and say, "I made that happen." Credit the win.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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  Is It OK to Dose Insulin After a Meal for Kids? | ISPAD Guidelines, T1D 21.08.2026 5мин

  Here's the permission slip every T1D parent needs: with a young child, dosing during or after the meal is not cheating. It's not failing at pre-bolusing. It is, in plain black and white in the international pediatric diabetes guidelines, an okay thing to do. Parents, exhale.The people who write the rules for kids with type 1, ISPAD, carve out a specific exception for infants and toddlers who are unreliable eaters. It's not a loophole, it's the guidance, built on the real risk of lows in tiny bodies. And the other direction is backed too, when you can dose before the meal, kids hit a lower glucose peak and a lower A1C, with no extra hypoglycemia. Before when you can, after when you can't, and both are in the book.In this episode:Why dosing after the meal is allowed for young kids (per ISPAD)The reason the guidelines built in the toddler exceptionThe research supporting pre-meal dosing when it's safeLetting go of the guilt you don't need to carryThis Week's Challenge: For the parents, let go of one piece of guilt. If you've been forcing an early dose and stressing about lows, try dosing right after the meal this week for what they actually ate, and bring it 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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  Pre-Bolusing for a Picky Toddler with Type 1 Diabetes | Combo Bolus 19.08.2026 6мин

  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 54мин

  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 6мин

  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 7мин

  "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 5мин

  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 6мин

  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