Your Brain Is 75% Water - Here's What Happens When You're Low
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The episode, word for word
Your insulin isn't broken. Your body just forgot how to deliver it.
Here's what I mean: when you inject or pump insulin, it doesn't go straight into your bloodstream. It sits in the fat layer under your skin, your subcutaneous tissue, and has to hitch a ride through tiny blood vessels to get where it needs to go.
But if you're dehydrated? Those blood vessels slow down. Blood flow drops. Your insulin is just sitting there, waiting for a ride that's running late. It's like standing at a bus stop in the middle of nowhere watching the schedule lie to your face.
And that's why your correction bolus from two hours ago still hasn't kicked in.
Today we're talking about why dehydration makes your insulin feel like it's stuck in traffic, and how to fix it.
My name is Neil Greathouse, and this is Your Best T1D Year.
Alright, welcome to Week 3 of the Hydration Challenge: Refilling What T1D Drains. If you're just joining us, you're not behind. Jump in right now. Drink more water than you did yesterday. That's the game.
So let's talk about insulin absorption.
When you inject or pump insulin, it doesn't go straight into your bloodstream. It sits in your subcutaneous tissue, that's the layer of fat and connective tissue between your skin and your muscles. From there, it has to travel through tiny blood vessels called capillaries to reach your bloodstream. Only then does it start working.
And here's the problem: blood flow to that tissue matters. A lot.
If your subcutaneous blood flow is high, like after exercise, or if you're warm, or if you're well-hydrated, your insulin absorbs faster. If your blood flow is low, like if you're cold, stressed, or dehydrated, your insulin absorbs slower.
Dehydration reduces blood volume. When your blood volume drops, your body prioritizes essential organs, brain, heart, kidneys. It pulls blood away from non-essential areas, including your subcutaneous tissue. So your insulin is just sitting there, waiting for a ride that's running late.
There's research out of Denmark that looked at factors affecting insulin absorption. They found that heat, exercise, and proper hydration all increase subcutaneous blood flow. Cold, smoking, and dehydration all decrease it.
Translation: if you're dehydrated, your insulin is slower. Period. It's not your pump. It's not your technique. It's your hydration.
Now, this doesn't mean you're going to fix every high blood sugar by drinking water. But it does mean that chronic dehydration makes every correction harder, every meal bolus less predictable, and every high blood sugar stick around longer.
Think of it like trying to stream Netflix on a slow Wi-Fi connection. The show's there. The content's loaded. But the buffering wheel just keeps spinning. That's your insulin when you're dehydrated.
You can't fix your beta cells. You can't make your immune system stop attacking your pancreas. But you can drink more water. You can increase your blood volume. You can give your insulin a better shot at getting where it needs to go.
Small habits. Daily progress. That's how this works.
Alright, real talk for a second. If you're sitting here thinking, "This is great, Neil, but I can't even afford my insulin right now, let alone worry about hydration," I need you to hear this.
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Alright, here's your challenge: drink a full cup of water 20 minutes before your next meal.
That's it. One cup. Twenty minutes before you eat. Let your body hydrate before you bolus. See if your insulin feels faster.
Track it. Snap a photo of your water bottle. Post it to your Story and tag @thebetes. Use #RefillWhatT1DTakes.
Go to yourbestt1dyear.com if you haven't signed up yet. Over 1,100 people are in. You're not behind. Start now.
Look, T1D is relentless. You can dose perfectly and still have a bad day. You can count every carb and still go high. You can do everything right and still feel like you're failing.
But here's the thing: unpredictable insulin doesn't have to be part of the deal. Slow absorption doesn't have to be your normal. You can't control your pancreas. You can't reverse your autoimmune disease. But you can drink more water. And when you do, your insulin moves faster. Your corrections work better. Everything gets a little more predictable.
You don't need perfection. You just need progress. One cup at a time.
I'll see you Friday.
Type 1 diabetes is relentless, but managing it doesn't have to be. New episodes drop every Monday, Wednesday, and Friday.
You're not doing a bad job, you're doing a difficult job. Nobody remembers easy.
Estimated Cold Open Hook: Bold declarative statement: "Your insulin isn't broken. Your body just forgot how to deliver it." "Shouldn't/Won't" Placement: (Saved for Friday) BCH Ad Length: 35 seconds
Humor Style: Sharper, observational
Mar 20 - 172
This is the script as read on the mic, lightly tidied for reading. Education, not medical advice. Talk to your care team before you change anything about your insulin.