The Head Start Finale + What's Next: The Steps Challenge | Type 1 Diabetes
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...
The episode, word for word
Eight weeks ago, you were spiking after dinner and quietly blaming yourself for it.
Today's the finale of The Head Start. And I could spend it recapping every single thing we covered. I'm not going to do that. You were here. You don't need me reading you back the syllabus you already passed.
Here's why I want you to stick around for this one anyway. Two messages landed in my inbox this week that say what these eight weeks were actually about, better than I could in an hour of talking. So I'm just going to read them to you. Names changed, the words are mostly theirs.
I'm Neil Greathouse, this is Your Best T1D Year, and this is the last episode of The Head Start.
The first one is from a woman I'll call Dana. She wrote:
"Neil. I've had type 1 for nine years and I honestly thought I was just bad at it. Every night, same movie. I'd make dinner, dose, and by the time we were doing the dishes I'd be 250 and furious with myself. My husband stopped asking how my numbers were because I'd bite his head off. I started this challenge mostly to prove it wouldn't work for me. Then week four, I pre-bolused my dinner, 15 minutes, like you keep nagging us to. We ate, I cleaned up, I looked at my CGM, and it said 140. Flat. And I cried at the kitchen sink. Not about the number. Because for nine years I believed the spike was my fault, that I just wasn't disciplined enough, and it turns out I was doing the exact right thing 15 minutes too late this whole time. I wasn't failing. I was just mistimed."
Dana. That wrecked me. And it's the entire point of this challenge in one message. You were never bad at this. You were mistimed. There is a galaxy of difference between those two words, and you just felt it at your own kitchen sink.
The second one is from a guy I'll call Marcus. Thirty-one years with type 1, so he's got me beat in stubbornness if not in years. He wrote:
"Confession, Neil. I have ignored the pre-bolus advice for three decades. Every endocrinologist, every educator, I'd nod politely and then do absolutely nothing, because one time back around 2003 I dosed early, my food came out late, and I bottomed out hard at a restaurant. Scared me off it for twenty years. Your fear week was the first time anybody told me that was normal, and then actually handed me the fix. Fast carbs on the table. Eat a couple bites first if I'm dropping. Such a small thing and not one person ever said it to me in thirty-one years. I've pre-bolused dinner every night for a month. My time in range went from the low 60s to 81 percent. Eighty-one. I'm a little mad, honestly. Mostly I just wish I'd had this sooner."
Marcus. Thirty-one years in, and you still made a leap most people never make. That's not a man who's behind. That's a man who's still growing. And I hope I'm doing the exact same thing at year thirty-four.
Those are two out of a whole stack just like them. Different people, same story underneath. You stopped blaming yourself, you changed one small thing, and it handed you back a piece of your life. And it isn't only your evenings. The research says every bit of time in range you gained is tied to protecting your eyes, your kidneys, and your nerves down the road. You bought yourself years this summer, a few minutes at a time. I am so proud of you I can hardly stand it.
Now, this is the part where I tell you it doesn't end here. The habit's yours to keep, and I'll keep showing up, Monday, Wednesday, Friday, because there's always a next thing. And I'm going to tell you exactly what the next thing is, because I'm genuinely fired up about it.
Starting in September, we're doing steps. That's it. Walking. No marathon, no spin class, no buying a single thing. Just moving your body a little more, on purpose, and watching what it does to your blood sugar.
And here's why it's the perfect sequel to what we just did. Pre-bolusing was about timing your insulin. Walking is about making that insulin work better. One walk, a single bout, can improve your insulin sensitivity, that's how well your body responds to the insulin you take, for the next 24 to 48 hours. That's published in Diabetes Care. And a short walk after a meal? Researchers found walking just 10 minutes after each meal lowered post-meal blood sugar more than one longer walk did, especially after dinner. So you time the insulin, then you take a little walk, and you've hit that post-dinner spike from both sides. A one-two punch on the exact thing we spent all summer fighting.
There's even a study where breaking up sitting with five minutes of light walking every half hour dropped the after-meal glucose rise by about 28%. Five minutes. Twenty-eight percent. That's almost rude how easy that is.
And here's why we're doing this now, in September and October, instead of waiting for some sad January resolution. Because the research is clear here too. As the weather turns cold and we all start moving less, blood sugar control quietly slips. On average, A1C is at its lowest in September and October, and it climbs to its highest in the dead of winter. So we are not going to wait for the slump and then try to claw our way out. We're going to build the walking habit now, while it's still nice out, and carry it straight through the cold like a coat we already own. And because this is type 1, doing it safely means watching for lows, and that's exactly what the challenge will walk you through. Pun fully intended. We'll do it together, step by step.
So stay in it. yourbestt1dyear.com, the newsletter's free, the resources are free, and the 1,500 people who did this with you aren't going anywhere. Whatever we take on next, come do it with us. The door's open, the light's on, and there's a seat with your name on it. Tape a little Believe sign over your kitchen door if you have to. It worked for a fictional soccer team, and it'll work for your dinner.
Your challenge, the last one of this challenge anyway. Keep pre-bolusing your dinner. That's it. Don't let the habit walk out the door with the challenge. It's yours now. You built it with your own hands. And if you're feeling good tonight, take a short walk after dinner. Consider it a little sneak preview of September.
Here's the honest, full-hearted truth to send you off. You are not doing a bad job at this life. You're doing a difficult job. An exhausting, relentless, invisible, round-the-clock job, and this summer you got measurably better at it. T1D is relentless. But managing it doesn't have to be. You proved that, with your own numbers, on your own kitchen table. I am so proud of you. I'm grateful you spent your summer with me. And I genuinely cannot wait to see what you take back next.
I'm Neil. This has been The Head Start. Go give your insulin a head start tonight, and I'll see you Wednesday, for whatever's next.
This is the episode script as read on the mic. It's education and encouragement, not medical advice. Talk to your care team before changing anything about your management.