Your Fear of Lows Is Costing You Time in Range | Type 1 Diabetes

Your Fear of Lows Is Costing You Time in Range | Type 1 Diabetes

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, and those later doses tracked with lower time in range and more time running high.

Here's the part that should shrink the fear: in the studies that tested pre-bolusing, the lows did not go up. Not in the big pediatric review, not in the 15-minute study. Pre-bolusing isn't more insulin, it's the same insulin at a smarter time. And in a survey of over 1,400 people with type 1, 52% said their fear of lows dropped once they felt more confident dosing. We don't bulldoze the fear. We out-confidence it.

In this episode:

  • How dosing late quietly lowers your time in range
  • The research showing pre-bolusing did NOT increase lows
  • Why confidence, not willpower, is what shrinks the fear
  • Building the safety net before you start

This Week's Challenge: Before you sit down to dinner, put fast carbs on the table, within reach. You don't have to pre-bolus yet. Just get used to the net being there.

Helpful resources and newsletter: https://yourbestt1dyear.com

Connect 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.com

Books 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

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Episoder(252)

When You're Already High

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Walking With Insulin Still Working

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25 Sep 6min

The After-Dinner Ten

The After-Dinner Ten

Meet Neil's walking partner: Cora, a 5.9-pound senior Morkie whose hips don't lie and whose top speed is best described as eventually. Every evening, Neil, his wife Gina, and Cora take the after-dinne...

23 Sep 5min

You Don't Need The Gym

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Somebody sold all of us the same lie: that getting active means a membership, an hour a day, and a personality transplant. This episode formally cancels that belief system with receipts. Look at the e...

21 Sep 5min

The Movement "Snack"

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For once, a study on our actual people. Published in 2026 in Diabetes Technology and Therapeutics: adults with type 1 diabetes on insulin pumps sat for six hours straight on one lab day, and on anothe...

18 Sep 5min

Three Short Walks Beat One Long Walk

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Stop looking for 45 free minutes. They don't exist, and it turns out they were never the assignment. A 2013 Diabetes Care study by Loretta DiPietro compared one 45-minute walk against three 15-minute ...

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