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Host: John Pemberton, RD
Guest: Dr Laurel Messer, PhD, RN 

Epidose page - Detailed show notes

Episode FAQ - Dr Messer answers the FAQ's (free Downlaod)

In this episode, Dr Laurel Messer joins John to break down the real science behind skin integrity, sensor performance, and the hidden link between skincare and safer automation. Drawing on leading research from the Barbara Davis Center, the Panther Program, and international AID consensus work, this conversation reframes device wear as both a biological and behavioural skillset.  

Your skin is not decoration — it is life-critical infrastructure.

What This Episode Covers 

• Why device-related skin issues are common, predictable, and preventable
• Mechanical vs chemical irritation, and how to distinguish both from allergic dermatitis
• The “Soap–Water–Dry → Rotate → Low & Slow” skin-protection framework
• Why skin damage leads to noisy CGM data and poor insulin absorption
• How to prepare skin for CGM and pump wear in children, teens, and adults
• Practical barrier strategies: wipes, films, and hydrocolloids
• Understanding Control-IQ: why the correction factor is the SUPERPOWER
• Time-block insulin tuning for evening surges, alcohol, illness, and real-life
• The future of Tandem: Control-IQ+, Mobi, patch options, & Libre 3+ 

Key Insights 

Skincare is diabetes care.
Healthy skin leads to better signal quality, fewer dropouts, more predictable insulin delivery, and improved algorithm stability. 

Rotation must be broader than most people think.
Use 6–10 zones and give each at least a week off. Children need even more structure due to limited real estate. 

Removal is where most damage occurs.
Dr Messer emphasises a wound-care approach: oil-based loosening, supporting the skin, and folding adhesives back on themselves — never pulling upward. 

Allergy and irritation are not the same problem.
Irritation improves with barriers and technique; allergy is reproducible, blistering, intensely itchy, and requires dermatology support and sometimes device change. 

Control-IQ’s performance hinge is the correction factor.
Across 20,000+ users, strengthening the correction factor improved responsiveness and time-in-range without increasing hypoglycaemia.  

Epidose page - Detailed show notes

Episode FAQ - Downlaod the best bits as Laurel answers the FAQ's 

For collaboration, partnerships, or press enquiries: John Pemberton — [email protected]

For creative, social, and production enquiries: Anjanee Kohli — [email protected]

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Join John Pemberton as he sits down with Dr Temi Olonisakin — the doctor who turned a lonely Type 1 diabetes diagnosis at 17 into a movement of connection, confidence, and pancakes.

From small brunch tables in London to dreams of Bali gatherings, Temi’s story shows how joy, representation, and community can change what it means to live with diabetes.

How one young doctor turned isolation into connection — building a joyful, inclusive community for people living with Type 1 diabetes.

Diagnosed at 17, Temi knows the isolation that hits just as independence begins. Years later she began bringing people together — from one-to-one coffees to full-scale Diabetes Brunch Live events — mixing friendship, advocacy, and education with a healthy side of pancakes.

It’s not about brunch. It’s about belonging, visibility, and joy.

Say hello to Temi on Instagram @temidiabeticdoctor and join her for Brunch!

Full show notes and links
 
Chapters

00:00 Diagnosed at 17 — the lonely years
 05:30 First coffees → first brunch
 12:20 From 9 to 26 — growth & facilitation
 16:40 “Bottomless brunches” & normalising spikes
 21:30 Brunch Abroad dreams
 24:30 Beyond London — plans for the North
 25:50 Doctoring & sustainable work
 31:20 Advocacy wins — getting the right tech
 38:30 Representation & equity
 45:40 What services for teens miss
 47:50 Wrap-up & reflections

For collaboration, partnerships, or press enquiries: John Pemberton — [email protected]

For creative, social, and production enquiries: Anjanee Kohli — [email protected]

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When sixteen-year-old Kirsten de Klerk was diagnosed with type 1 diabetes, she asked how long she’d have to live like this. Her doctor replied, “Every day for the rest of your life.”

Years later, that sentence became the fuel for change.

Sign the CGM Access Petition: In less than one-minute, you can change global access to CGM forever.

In this episode, John Pemberton talks with Kirsten about her journey from diabetes burnout to national advocacy, and how her work is now shaping a CGM Access Blueprint for South Africa — a model that could influence global policy.

Episode 22: show notes and links and consider buying the GNL a Coffee to the podcast independent.

They discuss:

• The emotional toll of diabetes burnout and the power of community.
• How the #LetterToMyDiabetes movement sparked a nationwide campaign.
• The reality of access inequality — 85 % of South Africans rely on public healthcare with only a few test strips a day.
• The creation of SA Diabetes Advocacy, gathering 14 000+ petition signatures for CGM funding.
• Why access without accuracy is false progress — and how unregulated devices put people at risk.

Kirsten and John explore what happens when lived experience meets evidence, and how persistence — not privilege — drives real change.

Together they outline three truths that every policymaker, clinician, and person with diabetes should understand:

1. Not all CGMs are created equally.
   Some systems are clinically validated for insulin dosing; others are not. Price competition must not compromise safety.
2. Inaccuracy harms you now.
   When CGMs fail to detect highs or lows, real people are put at immediate risk.
3. Inaccuracy harms you later.
   CGMs that systematically under- or over-report glucose create false reassurance — “70% time-in-range on one device might be 60% on another.”

Sign the CGM Access Petition: In less than one-minute, you can change global access to CGM forever.

Links & Resources:
🌍 Sign the CGM Access Petition (South Africa)

📊 DSN Forum UK – CGM Comparison Chart

🔬

For collaboration, partnerships, or press enquiries: John Pemberton — [email protected]

For creative, social, and production enquiries: Anjanee Kohli — [email protected]

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Professor Partha Kar joins The Glucose Never Lies® Podcast to unpack how the UK moved from research to reality in continuous glucose monitoring (CGM) and hybrid closed-loop systems (AID) — and how the same approach can be applied to any challenge in life or leadership.

Through openness, accountability, and courage, Partha helped create one of the fastest national tech adoptions in healthcare history. At the centre of that journey sits a practical philosophy anyone can use: the S-P-A-R-K Mindset, his Five-to-Drive-Change Framework.

It’s not just about diabetes care — it’s about how you make things happen.

Get the Full show notes and SPARK download

Help the GNL Podcast reman independent by buying the GNL a Coffee

Partha Kar on what matters:

• Implementation is where science becomes real
• Social media can be a listening system and an accountability engine.
• Accountability ≠ blame — transparency builds trust.
• Equity starts with measuring bias and publishing it.
• Language and leadership shape safety.
• Every change starts with a SPARK.

The S-P-A-R-K Mindset — Five-to-Drive-Change Framework

S – Start small, prove it locally
Change begins in your patch. Pilot, test, measure. Evidence beats opinion.

P – Put your skin in the game
If you believe in it, stand behind it. Take the risk, own the outcome.

A – Accountability, not blame
Use data to shine a light — RAG ratings, heat maps — but keep language neutral. Data should nudge, not shame.

R – Reveal through listening
True leadership starts with the community. Listen first; understand before you act.

K – Keep language human
Words shape behaviour. Talk with people, not at them. Better language builds safer systems.

Chapters

·        00:00 The CGM Journey: From Science to Street

·        04:15 Harnessing Social Media for Change

·        09:19 Accountability Without Blame

·        14:29 Implementation Science in Action

·        19:59 The Future of Diabetes Care

·        20:54 Seeing Bias in the Data

·        23:41 Paediatric Equality — Closing the Gap

·        25:10 Peer Learning from Sweden

·        28:00 Physician Associates — Safety and Scope

·        31:45 Patient Safety and Accuracy in Tech

·        35:35 Skin in the Game — Leadership With Consequences

·        37:57 SPARK Recap — Five-to-Drive Framework

Get the Full show notes and

For collaboration, partnerships, or press enquiries: John Pemberton — [email protected]

For creative, social, and production enquiries: Anjanee Kohli — [email protected]

Buy The Glucose Never Lies® a Coffee — help us stay independent and ad-free:

We’re an independent, evidence-based platform — free from sponsorships and commercial bias. Your support helps us keep translating science into understanding.

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Episode 20 — Standardization of Testing CGM Performance: The Nuts and Bolts

With Dr. Stefan Pleus (Institut für Diabetes-Technologie, Universität Ulm; Chair of the IFCC Working Group on CGM).

Full show notes and FAQ, and consider buying me a Coffee to keep pumping.

In this episode, we go deep into the future of continuous glucose monitoring (CGM) standards. Dr. Pleus explains why the FDA iCGM framework (2018) is no longer enough, what a robust international standard would look like, and why ISO standardisation by 2030 is essential if CGM is to:

• Be a reliable basis for insulin dosing
• Act as a trusted comparator in clinical trials
• Enable screening and early diagnosis of type 1 diabetes
• Provide consistency across devices for people with diabetes

Key insights from Stefan Pleus:

• Study design matters: if you avoid rapid glucose changes, results look good — but that’s not real life.
• Stress-testing requires minimum data in low, high, and rapid-change zones.
• Every comparator has bias: retrospective correction is essential to align results across manufacturers.
• With better study designs, today’s systems may appear less accurate — but only because we’re finally testing them properly.
• Global alignment between FDA and Europe is needed; without it, innovation risks stalling.

Why this matters:

 Without standardisation, insulin dosing, clinical trials, and diagnostics will remain inconsistent across devices. The 2030 opportunity is a global, reproducible framework that ensures fairness for users, clarity for clinicians, and valid results for researchers.

Full show notes and FAQ, and consider buying me a Coffee to keep pumping.

For collaboration, partnerships, or press enquiries: John Pemberton — [email protected]

For creative, social, and production enquiries: Anjanee Kohli — [email protected]

Buy The Glucose Never Lies® a Coffee — help us stay independent and ad-free:

We’re an independent, evidence-based platform — free from sponsorships and commercial bias. Your support helps us keep translating science into understanding.

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19 – iCGM vs eCGM vs Standardisation by the IFCC: CGM Regulation with Dr. Guido Freckmann

Full show notes and FAQ, and consider buying me a Coffee to keep pumping

Continuous glucose monitoring (CGM) has transformed diabetes care — but how do we know which systems are accurate, safe, and truly comparable? 

In this episode, John Pemberton is joined by Dr. Guido Freckmann (Institute of Diabetes Technology, Ulm; former chair of the IFCC CGM Working Group). Together they unpack: 

• Why CE marking in Europe is not a quality standard
• How the FDA’s iCGM framework (2018) was groundbreaking, but has limitations in study design
• Why the proposed eCGM model for Europe risks monopolising the market without fixing accuracy problems
• The IFCC’s roadmap towards a full ISO standard for CGM – robust, reproducible, and aligned with clinical reality

Full Show notes and FAQ, and consider buying me a Coffee to keep pumping

Key Themes & Watch-Outs

🔹 CE Mark ≠ Quality Standard

• CE marking is a regulatory pathway, not a guarantee of performance.
• Manufacturers can submit selective data, and the results are not public.

🔹 ICGM (2018): A Step Forward, But Outdated

• FDA iCGM rules set minimum standards, but study design criteria were vague.
• Devices can appear accurate by avoiding stressful glucose swings.

🔹 Why Standardisation Matters

• Standardisation would define not just performance metrics but also how studies are run.
• It would align CGM systems to the same comparator (capillary or venous) and reduce therapy discrepancies.

🔹 Capillary vs Venous Debate

• Capillary glucose reflects what people actually test and what their bodies are exposed to.
• Venous alignment risks giving a “false reassurance” of being in range.
• An agreement is needed: whichever is chosen must be standardised, with bias correction.

🔹 Clinical Impact

• Different CGMs can give the same time-in-range but very different HbA1c and complication risk.
• That undermines trust, confuses therapy adjustments, and makes clinical trial endpoints unreliable.

🔹 Looking Ahead

• CGM standardisation is in motion, but likely won’t be implemented before 2030.
• Until then, clinicians and people with diabetes need to scrutinise study design and remain critical of performance claims

For collaboration, partnerships, or press enquiries: John Pemberton — [email protected]

For creative, social, and production enquiries: Anjanee Kohli — [email protected]

Buy The Glucose Never Lies® a Coffee — help us stay independent and ad-free:

We’re an independent, evidence-based platform — free from sponsorships and commercial bias. Your support helps us keep translating science into understanding.

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What’s the difference between physical activity and exercise when you live with type 1 diabetes? And why does it matter? 

Full show notes & transcript: Episode 18 page 

In this episode, I’m joined by Prof. Othmar Moser, exercise physiologist, guideline author, and fellow person with type 1, to break down: 

• Why 10 minutes of activity after meals is the easiest, most powerful place to start.
• The 20/20 and 40/40 rules — how 20 minutes of light movement can drop glucose by 20–40 mg/dL (1–2 mmol/L).
• How CGM feedback makes activity tangible and motivating.
• The Before–During–After playbook for structured exercise:
  • Before: meal timing, prandial reductions, AID temp targets, basal adjustments.
  • During: safe glucose range, 3–20 g carb top-ups, when to fingerstick.
  • After: the first hour of hypo risk, late-night dips, protein strategy, and therapy-specific caveats (AID vs Pump vs MDI).

Full show notes & transcript: Episode 10 page

Explore the FAQ resource with all the key questions and diagrams: FAQ — T1D Exercise & Activity

Support the podcast
If this episode helps you or your clinic, you can fuel more episodes by buying me a coffee ☕ → https://www.buymeacoffee.com/jspfree2s 

About The Glucose Never Lies® Podcast
This podcast translates the latest diabetes science into practical, real-world steps. Honest conversations with the world’s leading researchers, mixed with the lived experience of people with type 1 diabetes.

Disclaimer:
This podcast is for informational purposes only and does not replace medical advice. Always consult your healthcare professional before changing therapy.

© The Glucose Never Lies® Ltd
 

For collaboration, partnerships, or press enquiries: John Pemberton — [email protected]

For creative, social, and production enquiries: Anjanee Kohli — [email protected]

Buy The Glucose Never Lies® a Coffee — help us stay independent and ad-free:

We’re an independent, evidence-based platform — free from sponsorships and commercial bias. Your support helps us keep translating science into understanding.

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Episode 17 — GLP-1 in Type 1 Diabetes: Beyond Weight Loss, Towards Metabolic Therapy

 Go to the Podcast page for all the notes, insights, and further reading & listening.

Subscribe to The Glucose Never Lies® and receive the Summary PDF with all the key take-home messages and practical implementation strategies. 

Support The Glucose Never Lies® Podcast
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Guest: Professor Viral Shah, MD

• Professor of Medicine & Director of Diabetes Clinical Research, Center for Diabetes and Metabolic Diseases, IU School of Medicine
• Author of multiple clinical trials and consensus guidelines on GLP-1 and incretin therapies in type 1 diabetes

In this episode, John Pemberton speaks with Professor Viral Shah, a leading researcher in incretin therapies, about:

• The unique challenges of type 1 diabetes (insulin resistance, glucagon, weight gain).
• The evidence for GLP-1s in T1D: up to 30% insulin reduction, weight loss, and improved time in range.
• Practical guidance for people with type 1 and healthcare professionals: insulin titration, MDI vs pump vs AID, nutrition, and risk–benefit.

Subscribe to The Glucose Never Lies® and receive the Summary PDF with all the key take-home messages and practical implementation strategies. 

Go to the Podcast page for all the notes, insights, and further reading & listening.

Related GNL Resources

• Overcoming Insulin Resistance in T1D
• Eight Causes of Insulin Resistance
• Seven Ways to Combat Insulin Resistance
• Automated Insulin Delivery Series
• CGM Series
• GNL Podcast Episode 14 Overcoming Insulin Resistance

For collaboration, partnerships, or press enquiries: John Pemberton — [email protected]

For creative, social, and production enquiries: Anjanee Kohli — [email protected]

Buy The Glucose Never Lies® a Coffee — help us stay independent and ad-free:

We’re an independent, evidence-based platform — free from sponsorships and commercial bias. Your support helps us keep translating science into understanding.

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Episode 16 — Diabetes & Driving: Why You Need to Be 5 to Drive

Show summary PDF and full notes here

Support The Glucose Never Lies® Podcast
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Guest: Professor Pratik Choudhary (University of Leicester, Leicester Diabetes Centre; Chair, DVLA Medical Advisory Panel on Diabetes) Host: John Pemberton (The Glucose Never Lies Podcast)

Episode Overview
Driving with type 1 diabetes is not just about safety. It comes with clear legal responsibilities.

We cover:

• The legal differences between Group 1 (cars, motorcycles ≤3.5 t, ≤8 passengers) and Group 2 (HGV, minibuses, passenger vehicles >3.5 t or >8 passengers).
• Why the law requires you to be ≥5 mmol/L before driving (“5 to drive”).
• The 45-minute rule: after treating a hypo, you must wait 45 minutes once you are back above 5 mmol/L.
• When CGM readings are accepted (Group 1) versus when only finger-prick testing counts (Group 2, currently).
• The importance of self-declaring severe hypoglycaemia: two daytime events in 12 months means you must report it.
• Practical tips: keeping your meter’s date/time accurate, carrying a backup meter, and setting CGM low alerts at 5 for long journeys.

Key Takeaways

• 5 to drive: ≥5.0 mmol/L
• 4.0–4.9 mmol/L: snack, then drive
• <4.0 mmol/L: treat → confirm >5.0 → wait 45 minutes once above 5
• Check every ≤2 hours — each check “expires” like a parking ticket
• Group 1 drivers: CGM or finger-prick both accepted
• Group 2 drivers: finger-prick only (until law changes)
• Severe hypos: two daytime events in 12 months → you must self-declare
• Responsibility lies with the driver, not your clinician

Resources and Further Reading

Visit The Glucose Never Lies — Episode 16 to access:

• DVLA INF294 — Insulin-treated diabetes and driving (official guidance)
  
  
• NHS England guidance on approved blood glucose meters
  

For collaboration, partnerships, or press enquiries: John Pemberton — [email protected]

For creative, social, and production enquiries: Anjanee Kohli — [email protected]

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We’re an independent, evidence-based platform — free from sponsorships and commercial bias. Your support helps us keep translating science into understanding.

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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 

 

For collaboration, partnerships, or press enquiries: John Pemberton — [email protected]

For creative, social, and production enquiries: Anjanee Kohli — [email protected]

Buy The Glucose Never Lies® a Coffee — help us stay independent and ad-free:

We’re an independent, evidence-based platform — free from sponsorships and commercial bias. Your support helps us keep translating science into understanding.

Follow The Glucose Never Lies®
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