Podcast
Your Best T1D Year
Hosted by Neil Greathouse · EN
Managing Type 1 Diabetes doesn’t have to be overwhelming.
Each 5-minute episode of Your Best T1D Year is packed with practical strategies, mindset shifts, and a little humor to help you feel more in control and less frustrated by diabetes.
Hosted by Neil Greathouse, this Monday, Wednesday, and Friday podcast delivers quick, relatable episodes that make learning about T1D effortless - so you can build small wins that lead to big changes.
📅 New episodes drop every Monday, Wednesday, and Friday.
🎧 Subscribe now and start making diabetes management feel easier - one small habit at a time.
79episodes
Episodes
Newest firstAll episodes
Fiasp, Lyumjev & Afrezza: Do You Still Need to Pre-Bolus? | T1D
2d ago00:07:32Tap to summarize"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
Transcribe →Do You Still Pre-Bolus on a Closed-Loop Pump? | Control-IQ, Omnipod 5
4d ago00:05:27Tap to summarizeIf 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
Transcribe →Missed and Late Insulin Boluses: What to Do | Type 1 Diabetes
1w ago00:06:32Tap to summarizeSome 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
Transcribe →Why Pizza Spikes Your Blood Sugar at Midnight | Fat, Protein & T1D
1w ago00:06:24Tap to summarizeSome 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
Transcribe →How to Pre-Bolus at Restaurants and Takeout | Type 1 Diabetes
2w ago00:06:16Tap to summarize"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
Transcribe →Start Pre-Bolusing With Just 5 Minutes | Type 1 Diabetes Habit
2w ago00:07:12Tap to summarizeYou 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
Transcribe →Why Dinner Is the Best Meal to Start Pre-Bolusing | Type 1 Diabetes
2w ago00:05:49Tap to summarizeIf 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
Transcribe →Pre-Bolusing, Fear of Lows, and What Your Endo Really Sees on Your CGM // Dr. Monica Gomberg from Blue Circle Health
3w ago00:56:54Tap to summarizeWe 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
Transcribe →You're Closer to Pre-Bolusing Than You Think | Type 1 Diabetes
3w ago00:04:43Tap to summarizeA 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
Transcribe →3 Moves That Make Pre-Bolusing Safe | Avoid Going Low | Type 1 Diabetes
3w ago00:05:55Tap to summarizeConsider 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
Transcribe →