Why Food Beats Insulin to the Finish Line | Pre-Bolus Science, T1D

Why Food Beats Insulin to the Finish Line | Pre-Bolus Science, T1D

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 back. That mismatch is the entire reason you spike.

This is the "how it works" episode. Regular rapid-acting insulin takes about 15 minutes to start, peaks around an hour, and lasts three to four hours. Your dinner carbs hit your bloodstream almost immediately. Dose them at the same time and the food scores before the insulin is even in the game. The fix is simply to put your insulin in first, so they arrive together and your CGM line stays flat and boring, which in type 1 is the dream.

In this episode:

  • How fast rapid-acting insulin actually works vs. how fast carbs hit
  • The pharmacokinetics of insulin timing, in plain English
  • Why a "flat and boring" CGM is the whole goal
  • How pre-bolusing matches your insulin to your food

This Week's Challenge: Keep watching the gap between your dose and your first bite at dinner, and now you know what it means. Every minute your insulin is behind, the food is on a breakaway.

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Books on Amazon: Type 1 Diabetes – One Day at a Time | Type 1 Diabetes – True Stories


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Episoder(228)

Do You Still Pre-Bolus on a Closed-Loop Pump? | Control-IQ, Omnipod 5

Do You Still Pre-Bolus on a Closed-Loop Pump? | Control-IQ, Omnipod 5

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 st...

10 Aug 5min

Missed and Late Insulin Boluses: What to Do | Type 1 Diabetes

Missed and Late Insulin Boluses: What to Do | Type 1 Diabetes

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...

7 Aug 6min

Why Pizza Spikes Your Blood Sugar at Midnight | Fat, Protein & T1D

Why Pizza Spikes Your Blood Sugar at Midnight | Fat, Protein & T1D

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 exp...

5 Aug 6min

How to Pre-Bolus at Restaurants and Takeout | Type 1 Diabetes

How to Pre-Bolus at Restaurants and Takeout | Type 1 Diabetes

"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: rest...

3 Aug 6min

Start Pre-Bolusing With Just 5 Minutes | Type 1 Diabetes Habit

Start Pre-Bolusing With Just 5 Minutes | Type 1 Diabetes Habit

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 st...

31 Jul 7min

Why Dinner Is the Best Meal to Start Pre-Bolusing | Type 1 Diabetes

Why Dinner Is the Best Meal to Start Pre-Bolusing | Type 1 Diabetes

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 lev...

29 Jul 5min

Pre-Bolusing, Fear of Lows, and What Your Endo Really Sees on Your CGM // Dr. Monica Gomberg from Blue Circle Health

Pre-Bolusing, Fear of Lows, and What Your Endo Really Sees on Your CGM // Dr. Monica Gomberg from Blue Circle Health

We 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 Bl...

27 Jul 56min

You're Closer to Pre-Bolusing Than You Think | Type 1 Diabetes

You're Closer to Pre-Bolusing Than You Think | Type 1 Diabetes

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...

24 Jul 4min

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