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.
50episodes
Episodes
Newest firstAll episodes
Your Pre-Sleep Blood Sugar Check Is a Sleep Decision, Not Just a Safety Check
1w ago00:06:47Tap to summarizeSHOW 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
Transcribe →T1D Sleep Challenge: Four Weeks In, What We've Learned
2w ago00:06:33Tap to summarizeSHOW 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
Transcribe →How to Adjust CGM Alarm Thresholds for Better Sleep with Type 1 Diabetes
2w ago00:06:47Tap to summarizeSHOW 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
Transcribe →CGM Alarm Fatigue in Type 1 Diabetes: How Your Alerts Are Wrecking Your Sleep
2w ago00:05:38Tap to summarizeSHOW 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
Transcribe →What Type 1 Diabetes Actually Does to Your Sleep Architecture | Episode 200
3w ago00:07:50Tap to summarizeSHOW 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
Transcribe →Bedtime Consistency and T1D: Why Timing Beats Total Hours for Blood Sugar Control
3w ago00:06:55Tap to summarizeSHOW 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
Transcribe →The T1D Sleep-Blood Sugar Feedback Loop
3w ago00:06:19Tap to summarizeSHOW 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
Transcribe →The Dawn Phenomenon in Type 1 Diabetes: Why Your Blood Sugar Rises While You Sleep
4w ago00:07:16Tap to summarizeSHOW 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
Transcribe →Why Sleep Deprivation Hits Harder When You Have T1D
4w ago00:07:56Tap to summarizeSHOW NOTES:Sleep deprivation reduces insulin sensitivity in everyone. That's not a T1D-specific finding. Here's what is.In people without diabetes, the system has a feedback loop. Insulin sensitivity drops, blood sugar ticks up slightly, the pancreas compensates automatically, and the whole thing resolves before they're even awake. They make coffee, go about their day, and have no idea any of it happened. For T1D people, that feedback loop doesn't exist. The penalty just lands.This episode explains why the same sleep deprivation hits harder when you don't have a functioning pancreas to compensate -- and why T1D people have been quietly doing the backup system's job manually every single morning, often without realizing that's what they were doing.We're in Week 2 of the While You Were Sleeping Challenge.In this episode:How a healthy pancreas automatically compensates for sleep-related insulin sensitivity changesWhy the T1D body absorbs the full 21% impact without automatic correctionWhat "doing the backup system's job manually" actually looks like before the first cup of coffeeThe emotional reality of running on interrupted sleep while managing blood sugarWhat to add to your data tracking this weekThis Week's Challenge: On mornings after rough nights, notice if you had to work harder -- more corrections, more frustration, numbers that were less predictable. That's the 21% showing up in real life.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 →One Night of Poor Sleep Reduces Insulin Sensitivity
4w ago00:06:51Tap to summarizeSHOW NOTES:Here's the number: 21%.One study. People with type 1 diabetes. Sleep-deprived condition (4 hours) versus adequate sleep (8.5 hours). Same food, same insulin, same activities. The sleep-deprived group showed a 21% reduction in insulin sensitivity the next day. Every single participant.This is the episode Neil has been building toward. If you've ever had a day where your insulin felt slow -- where corrections didn't land, where you corrected twice before breakfast and were still running higher than expected -- this episode gives you a name for what was happening. And it changes how you respond to those mornings going forward.This is Week 2 of the While You Were Sleeping Challenge. This is the research drop.In this episode:The specific study on sleep and insulin sensitivity in type 1 diabetes -- and what it actually showedWhat a 21% reduction in insulin sensitivity looks like in real life (the bathtub analogy)Why the effect showed up in every single participant, not just someWhat LeBron James figured out about sleep that the rest of us are just now learningHow to use this information to give yourself grace on mornings after rough nightsThis Week's Challenge: Look back at your data from Week 1. On the mornings after your worst nights of sleep, did your insulin feel different? Did corrections land differently?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 →