Episode 29: The Behaviour Change Playbook for Type 1 Diabetes

Five principles that make change more likely to stick with T1D — without shame, perfection, or New Year fantasy maths.

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Why this episode exists

Lots of people start January with motivation — then reality happens: hunger, fatigue, alarms, hypos, stress, and the brutal truth that type 1 diabetes punishes “good behaviour” often enough to make you want to stop trying. In this episode, John and Vanessa unpack a behaviour-change playbook that works with human psychology (and diabetes physiology) rather than demanding heroic willpower.

The five principles

  • Principle 1 — Design beats discipline: build systems that reduce daily decision load.
  • Principle 2 — Cues beat grit: prompts in the environment outperform “remembering”.
  • Principle 3 — Reduce threat before effort: if it feels too hard or scary, avoidance wins.
  • Principle 4 — Hawk or Owl, Carrot or Stick: pick accountability and feedback that actually fits your nervous system.
  • Principle 5 — Community support, not shame: small, safe networks beat noisy online perfection theatres.

Key takeaways (the stuff you can actually use)

1) Design beats discipline

Willpower is finite for everyone — and type 1 diabetes burns through it faster because the cognitive load is relentless. The fix isn’t “try harder”, it’s reducing the number of fresh decisions you need to make each day.

  • Turn repeated choices into default rules (e.g., simple pre-bolus waits based on glucose + trend, or exercise dose heuristics you already trust).
  • Make goals concrete and realistic (SMART goals are useful here — but only if they reduce pressure rather than create it).
  • Think in “next step” goals (e.g., 30% → 40% time in range) rather than fantasy leaps that trigger avoidance.

2) Cues beat grit

Humans take the path of least resistance. If the environment doesn’t prompt the behaviour, you’re relying on memory under fatigue — which is basically a practical joke.

  • Place “the thing you forget” next to “the thing you always do” (Vanessa’s example: supplements next to the kettle; you can apply the same logic to diabetes tasks).
  • Piggyback new behaviours onto existing routines (shower → insulin cue; brushing teeth → injection pen cue; snack cupboard → insulin reminder).
  • Kids often need visual, funny cues; adults often need friction removed and prompts made obvious.

3) Reduce threat before effort

If the goal feels too big, too shaming, or too emotionally loaded, avoidance behaviours rise — especially in diabetes, where you can do everything “right” and still get punished by a random 15 mmol/L.

  • Lower the demand level until you can engage without dread (small wins first, then scale).
  • Reframe CGM from judgement to data: “this isn’t a moral grade, it’s information”.
  • Use learning language: “What happened? What’s the likely driver? What’s one tweak for next time?”

4) Hawk or Owl, Carrot or Stick: pick what clicks

Accountability isn’t one-size-fits-all. Some people thrive with frequent check-ins (“hawk”). Others do better with spaced reflection (“owl”). Same with feedback: some want blunt truth, others need encouragement first or they’ll shut down.

  • Choose the support style that fits you — not the one you think you should need.
  • Make it explicit: how often do you want check-ins, and what style of feedback helps rather than harms?

5) Community support, not shame

Diabetes is isolating, and isolation increases burnout and avoidance. But “community” can either heal or harm depending on whether it’s psychologically safe and reality-based.

  • Small, trusted groups beat huge algorithmic spaces where nobody has accountability.
  • Share the bad days as well as the good days — it normalises reality and reduces shame.
  • The goal is support and learning, not comparison and perfection theatre.

Actionable “mini worksheet” for 2026

Step 1 (Design): What is one behaviour you want to change?

Step 2 (Reduce threat): What is the smallest version of that change you could do for 7 days without dread?

Step 3 (Cues): What existing routine will you piggyback onto — and what physical cue will you place where you can’t miss it?

Step 4 (Accountability): Do you need a hawk or an owl — and do you respond best to carrot or stick?

Step 5 (Community): Who is one person (or small group) you can be honest with this week without shame?

Guest

Vanessa Haydock — The Diabetic Health Coach. Psychology + applied behaviour analysis background, certified behaviour analyst, personal trainer, and coach supporting people with type 1 diabetes with sustainable behaviour change. Find Vanessa at:

Disclaimer

The content available in the The Glucose Never Lies® guides is for informational purposes only. Reading or listening to the content does not constitute medical advice and is not a substitute for individualised care, and does not create a clinician–patient or therapeutic relationship with The Glucose Never Lies® or any guest. Always discuss any changes to your diabetes management with your healthcare team.

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