This bonus Episode 8B is a family special — co-created with my daughter Grace.

It takes the science of activity lowering glucose and flips it into something fun: a rap we call 99 Problems (But Highs Ain’t One).

The key message?

When you’re above 10 mmol/L (180 mg/dL), just 20 minutes of activity can drop glucose by 2 mmol/L (≈40 mg/dL). That’s the “20 by 2” (or 20 by 40) rule.

But, Grace said 8 years olds don’t want to hear 20 by 2! They want to hear it in a fun way! So, she made up a rap, with the help of Chad!

Here is the Chorus:

If you’re having glucose problems, I feel bad for your son,

I’ve got 99 problems but high glucose ain’t one — hit me.

I know Dr Addala will be proud

If you enjoyed this, explore more:

• Episode 8 — Activity Snacking

Want more on the science backing it up?

• CGM Accuracy & Insights Series
• Insulin Resistance Series
• Foundations — The Fundamentals of The Glucose Never Lies®

Listen or Watch:

• The Glucose Never Lies Podcast → Buzzsprout | Spotify | Apple Podcasts
• YouTube Channel

Find out more at theglucoseneverlies.com

Follow on socials: Twitter/X @GlucoseNLies | Instagram @theglucoseneverlies | LinkedIn John Pemberton

Hosted by diabetes dietitian John Pemberton, this show blends science and real-life experience to make managing type 1 diabetes easier, clearer, and more human. Smart insights, practical tips, and honest conversations await.

It's all about C-Peptide and what it means for people living with T1D!

🕒 [00:09] Think all T1D is the same? Think again.

🕒 [02:14] Some people really do have it harder — and “brittle diabetes” might be real.

🕒 [04:37] Enter C-peptide: a marker of how much insulin your body still makes.

🕒 [06:10] Know your number:
• High: >200 pmol/L
• Intermediate: 30–200
• Low: <30

🕒 [09:11] Diagnosed young? You likely have lower C-peptide. John, diagnosed at 27, still has 220 after 10 years.

🕒 [10:20] High C-peptide = better time-in-range, fewer hypos, fewer complications.

🕒 [13:10] Why? More portal insulin + less glucagon = smoother control.

🕒 [14:01] Use your C-peptide to prioritise tech and tailor therapy (GLP-1s, HCL systems, nutrition).

🕒 [17:55] Most of all—be kind to yourself. It’s not weakness. It’s biology.

Key resources

Episode 14: Insulin Resistance and T1D

C-Peptide full article – click here

In this deep-dive episode, John Pemberton explores the misunderstood world of insulin resistance in people with type 1 diabetes. Drawing on years of personal experience, clinical expertise, and the latest research, he breaks down why insulin resistance matters—even in a condition defined by insulin deficiency.

Click here for the detailed 3-part write up

The episode walks through the 'Ominous Octet', eight mechanisms that drive insulin resistance, and explains how they impact blood glucose control, weight management, and long-term health. More importantly, it offers practical strategies to reduce total daily insulin dose through lifestyle changes, activity, nutrition, and pharmacological options.

Whether you're living with T1D, supporting someone who is, or simply want to better understand the complex interplay between insulin and the body, this episode provides clarity and direction.

Takeaways:

• People with T1D often require more insulin due to lack of portal delivery and higher peripheral levels
• Insulin resistance occurs in the liver, muscle, brain, kidneys, gut, and fat tissue
• Measuring units per kilogram is a useful proxy for insulin sensitivity
• Activity is the most powerful modifiable factor for improving insulin sensitivity
• Weight loss, high-protein diets, and reduced saturated fat intake all help reduce resistance
• GLP-1 and dual agonists (e.g., tirzepatide) show promise for T1D, but are not yet widely approved
• SGLT2 inhibitors and pioglitazone offer targeted benefits but must be used with care
• A multifaceted approach is often needed to lower insulin needs and support health

Chapters:

00:00 - 02:10 | Introduction

• John Pemberton welcomes listeners to Episode 14.
• Shares his background: living with T1D, creating the Glucose Never Lies Education Programme, and motivation from personal and family experiences.
• Introduces co-host Louise (not present in this episode).
• Outlines the episode focus: insulin resistance in type 1 diabetes.

02:10 - 04:35 | Why Insulin Resistance Matters in T1D

• T1D often leads to higher insulin doses.
• High insulin doses are linked to increased risk of cardiovascular disease and mortality.
• Importance of understanding and managing insulin resistance to reduce long-term health risks.

04:35 - 06:50 | The Metabolic Disadvantage in T1D

• Describes differences in insulin delivery: endogenous (via portal vein in non-diabetics) vs. exogenous (subcutaneous in T1D).
• Explains how peripheral insulin levels are 4–8x higher in T1D, contributing to insulin resistance.

06:50 - 09:15 | The Ominous Octet

• Introduces eight mechanisms of insulin resistance (based on Dr. Ralph DeFronzo’s work):
  1. Liver insulin resistance
  2. Muscle insulin resistance
  3. Beta-cell dysfunction
  4. Hyperglucagonemia
  5. Brain insulin resistance
  6. Gut hormone dysfunction
  7. Fat cell dysfunction
  8. Kidney (renal) insulin resistance

09:15 - 11:30 | Measuring Insulin Resistance

• Euglycemic clamp = gold standard (not used in T1D).
• Use total daily insulin (TDI) per kilogram as a practical metric.
• Defines ranges:
  • <0.4 units/kg = insulin sensitive
  • 0.5–0.7 = mild insulin resistance
  • 0.7–1.0 = moderate
  • 1.0 = high insulin r

In this episode of the Glucose Never Lies podcast, hosts John Pemberton and Louise discuss the intricacies of diabetes management, focusing on continuous glucose monitoring (CGM) systems. They explore various CGM features, including calibration, alarms, and connectivity with automated insulin delivery (AID) systems. The conversation emphasizes the importance of understanding individual needs when selecting a CGM, as well as the role of technology in enhancing diabetes care. The hosts also provide insights into the latest advancements in CGM technology and offer resources for further education.

Takeaways

• Continuous glucose monitors (CGMs) have evolved to include factory calibration.
• Optional calibration can be beneficial but requires accurate blood glucose meters.
• Alarm fatigue can hinder effective diabetes management.
• The Freestyle Libre is noted for its small size and long wear time.
• Dexcom products offer extensive connectivity with AID systems.
• Understanding individual needs is crucial when selecting a CGM.
• AI-driven forecasts in CGMs can enhance decision-making for users.
• Education and support are vital for effective diabetes management.
• Resources like the DSM Forum provide valuable information for diabetes care.

Chapters

00:00
Introduction to Diabetes Management

02:14
Continuous Glucose Monitoring (CGM) Overview

13:09
Understanding CGM Features and Alarms

21:27
Evaluating CGM Size and Connectivity

27:21
Final Thoughts and Resources

Key Resources:

CGM Series: CGM: The Bells and Whistles

Chart for CGM Devices (From May 2025): DSN Forum

Tim Street @ Diabettech

In this episode of the Glucose Never Lies podcast, hosts John Pemberton and Louise discuss the intricacies of diabetes management, focusing on continuous glucose monitoring (CGM) systems. They explore the importance of CGM accuracy, the standards set by regulatory bodies, and the significance of testing conditions in evaluating these devices. The conversation delves into various metrics used to assess CGM performance, including MARD, 20/20 and 40/40 agreement rates, and highlights the need for robust testing against capillary glucose to ensure effective diabetes management. The episode emphasises the importance of transparency in CGM studies and the future directions for standardizing testing protocols.

takeaways

• CGM systems are crucial for real-time glucose monitoring.
• FDA standards are currently the highest for CGM performance.
• CE marking does not guarantee device accuracy or reliability.
• Testing conditions significantly impact CGM accuracy results.
• The 20/20 standard indicates no risk for insulin dosing decisions.
• The 40/40 metric identifies high-risk readings in CGM data.
• Robust testing against capillary glucose is essential for accuracy.
• Standardization in CGM testing is needed for better diabetes management.
• Transparency in CGM studies is vital for healthcare professionals and patients.

00:00
Introduction to Diabetes Management and Podcast Goals

02:07
Understanding Continuous Glucose Monitoring (CGM) Systems

06:08
Evaluating CGM Accuracy and Performance Standards

10:09
The Importance of Testing Conditions in CGM Studies

14:13
Metrics for Assessing CGM Accuracy

18:03
Comparing CGM Systems Against Capillary Glucose

22:02
Future Directions for CGM Testing and Standards

Key Resources

CGM Series: Assessing CGM Accuracy Performance

Chart for CGM Devices (From May 2025): DSN Forum

Tim Street @ Diabettech

In this episode of the Glucose Never Lies podcast, hosts John Pemberton and Louise delve into the intricacies of diabetes management, focusing on continuous glucose monitoring (CGM) systems. They discuss the importance of understanding CGM accuracy, the significance of study design in evaluating sensor performance, and the key questions to ask when assessing the reliability of these devices. The conversation emphasises the need for robust testing conditions to ensure that CGMs provide accurate readings for insulin dosing decisions. The hosts also highlight the ongoing efforts towards standardisation in CGM technology to improve diabetes care.

Takeaways

• Continuous glucose monitors (CGMs) are crucial for insulin dosing decisions.
• Understanding study design is essential for evaluating CGM accuracy.
• Not all CGMs are created equal; performance varies significantly.
• Key questions to assess CGM accuracy include the study population and testing conditions.
• Robust testing conditions are necessary for reliable sensor performance.
• The importance of peer-reviewed data in evaluating CGM accuracy.
• Standardization in CGM technology is on the horizon.
• Healthcare professionals should be knowledgeable about CGM performance.
• A downloadable chart will be available to help users assess CGM options.

Chapters

00:00
Introduction to Diabetes Management

02:14
Understanding Continuous Glucose Monitoring (CGM)

05:11
Accuracy of Continuous Glucose Monitors

10:13
Evaluating Sensor Performance

15:45
Key Questions for Sensor Accuracy

20:31
Moving Towards Standardization in CGM

25:03
Summary and Next Steps

Key Resources

CGM Series: Understanding Risk Before Performance

Chart for CGM Devices (From May 2025): DSN Forum

Tim Street @ Diabettech

In this episode of the Glucose Never Lies podcast, John Pemberton shares insights from the ATTD 2025 conference, discussing advancements in diabetes management technologies, including automated insulin delivery systems and continuous glucose monitoring. He emphasizes the importance of early intervention with AID systems, the role of GLP-1 receptor agonists, and the impact of exercise and nutrition on diabetes control. The conversation also highlights the need for equitable access to diabetes technology and the improvements in quality of life that these innovations can bring.

Takeaways

• Automated insulin delivery systems can improve glycemic control and quality of life.
• Starting AID systems early can lead to better long-term outcomes.
• GLP-1 receptor agonists show promise for type 2 diabetes management.
• Exercise plays a significant role in managing diabetes effectively.
• Nutrition strategies are essential for optimizing insulin delivery systems.
• Equity in access to diabetes technology is a pressing issue.
• Continuous glucose monitoring devices are rapidly evolving.
• The future of diabetes management looks promising with new technologies.

Chapters

00:00
Introduction to the Podcast and Personal Journey

02:14
Insights from ATTD 2025 Conference

03:41
Advancements in Automated Insulin Delivery Systems

08:22
Exploring GLP-1 Receptor Agonists and Insulin Resistance

10:42
The Role of Exercise in Diabetes Management

14:07
Nutrition and Automated Insulin Delivery Systems

16:03
Quality of Life Improvements with AID Systems

17:55
Equity in Access to Diabetes Technology

19:18
Continuous Glucose Monitoring Innovations

24:05
Future Directions in Diabetes Management

Show Notes & Resources

• Full Show Notes - Episode 9: ATTD 2025
• 🎧 Download the Glucose Rap
• 📘 Insulin Resistance Guide
• 📊 CGM Accuracy Series
• 🎙️ Episode 8: Activity for Post-Meal Glucose Control
• 📎 Episode 6: Ten Tips to Optimise Time in Range with AID.

Welcome to The Glucose Never Lies podcast

In today’s episode, we explore a game-changing approach to glucose control—activity snacking. If you’ve ever struggled with post-meal spikes, found insulin too slow to bring down highs, or wondered how movement could help stabilise your blood glucose, this episode is for you.

I’ll be sharing the latest research on how small, frequent movements can supercharge insulin, improve time in range, and reduce glucose highs without the need for extra insulin corrections. We will discuss practical strategies such as the “3 every 30” method, which involves moving for three minutes every 30 minutes to maintain stable glucose levels. We will also cover the benefits of walking before or after meals to prevent glucose spikes and introduce the “15 by 2” rule, a simple technique to lower high glucose levels faster than waiting for correction doses to take effect.

Stay tuned to the end to hear: 99 Problems, But High Glucose Ain't One

In addition to these strategies, I will break down groundbreaking studies that demonstrate the impact of movement on glucose regulation. Whether you are living with type 1 diabetes, supporting someone who is, or simply looking to optimise your health, this episode is packed with valuable insights that you can put into action immediately.

Click here for more info and the show notes