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 Blue Circle Health and, as far as this podcast is concerned, America's Endocrinologist.
This is the conversation you wish you could have if your endo appointment lasted longer than 15 minutes. Dr. Gomberg breaks down what pre-bolusing actually is in plain English, why the fear of going low is real trauma and not weakness, and the smallest, safest way to start if you've been burned before. Then she takes the doctor hat off entirely: why she walked away from private practice to help build Blue Circle Health, what she wishes she could say in every appointment, and why the system, not you, is the thing that's failing.
In this episode:
- What pre-bolusing is and why timing matters (hint: your food is faster than your insulin)
- The two real reasons we skip it... life happens, and fear of lows. Neither one makes you lazy
- The smallest first step for someone who's never pre-bolused: one familiar meal, a safety net, and permission to start with just five minutes
- When you should NOT pre-bolus (gastroparesis, high fat and protein meals, exercise timing)
- What a missed pre-bolus actually looks like on your CGM, and why your pump can't fix it alone, even in automated mode
- Why the 15-minute appointment fails patients AND doctors, and how Blue Circle Health defines care differently (community, insurance help, keeping the lights on... all of it counts)
- True or False, the Diabetes Confession Booth, and a new Fastest Five Minutes world record (29 answers!)
This Week's Challenge: Pre-bolus dinner. Start wherever feels safe, even just a few minutes early, even with a split dose. Carbs on the table, eyes on the arrow. You've got the net now. Time to use it.
What is Your Best T1D Year?
Managing Type 1 Diabetes doesn’t have to be overwhelming.
Each 5-minute episode of Your Best T1D Year is packed with practical strategies, mindset shifts, and a little humor to help you feel more in control and less frustrated by diabetes.
Hosted by Neil Greathouse, this Monday, Wednesday, and Friday podcast delivers quick, relatable episodes that make learning about T1D effortless - so you can build small wins that lead to big changes.
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