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...

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...

"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...

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...

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...

Some meals spike you and move on. Pizza spikes you, waves goodbye, and comes back four hours later like a horror-movie villain. If you've ever been 110 at bedtime and 260 at midnight, this episode explains the ambush, and it's backed by...

"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...

You do not have to be a pre-bolus athlete on day one. If "10 to 15 minutes" felt like too much, Neil takes the pressure all the way down: start with five minutes. Even five to seven minutes of head start beats dosing with your first bite...

If pre-bolusing were a video game, breakfast would be the level everybody rage-quits on. You're rushed, half asleep, and half of us don't even eat it. So we don't start there. We start on the easy level: dinner. Neil makes the case that...

A short, warm one before the start line. Neil reminds you how far you've already come. Three weeks ago, pre-bolusing was a scary thing you knew you should do and didn't. Now you've named the fear, you understand why the spike happens...

Consider this your permission slip, signed by 34 years of mistakes. If you pre-bolus and the food shows up late and you start to drop, you are allowed to eat a few fast carbs to hold steady and cover them later. That's not failing. That's...

The fear of going low is real, and Neil would never talk you out of it. But it's also quietly running a tab, and the bill comes due in time in range. A 2024 study found that people with more fear of hypoglycemia dosed their meals later...

Today Neil stops saying "trust me" and starts saying "here's the study." A trial published in Diabetes Care found that dosing rapid insulin 15 minutes before a meal dropped the blood sugar peak to about 167, versus about 221 when dosing at...

Half the planet is watching the World Cup, so Neil explains the mechanism of the post-meal spike in soccer terms. Your food is the striker, already past the defense. Your insulin is the defender who got subbed in late and is still jogging...

We’ve spent a week and a half in the problem, the spike, the loop, the fear. Today the sun comes out. Neil turns the corner to the fix, and it’s almost annoyingly simple: your food is fast and your insulin is slow, and when they start at...

Here’s the quiet part said out loud: the reason you don’t pre-bolus is not that you’re lazy or that you don’t care. It’s that it scares you. Neil names the specific fear at the center of the whole challenge, the fear of going low before...

Here’s the quiet part said out loud: the reason you don’t pre-bolus is not that you’re lazy or that you don’t care. It’s that it scares you. Neil names the specific fear at the center of the whole challenge, the fear of going low before...

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...

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...