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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

Support GNL: https://buy.stripe.com/9B63cx4UO3KEdKC0Sp7Re00

The Glucose Never Lies® is a registered trademark of The GNL Ltd. Company No. 16733595. UK VAT No. GB 516 3272 08.

Disclaimer

This podcast is for education and informational purposes only. It does not constitute medical advice and is not a substitute for individualised care.

The Glucose Never Lies® is independent by design

We do not accept sponsorships and advertising. We operate via education grants and donations from listeners who value independence. So, consider:
Buying the GNL a Coffee:
https://buymeacoffee.com/gnlfree

Enquiries

Collaboration: John Pemberton — [email protected]

Creatives: Anjanee Kohli — [email protected]

Follow The Glucose Never Lies®

Website: https://theglucoseneverlies.com/

Instagram: https://www.instagram.com/theglucoseneverlies

LinkedIn: https://www.linkedin.com/company/theglucoseneverlies

LinkedIn: John Pemberton: https://www.linkedin.com/in/john-pemberton-587104361/

X: https://twitter.com/GlucoseNLies

Disclaimer
This content is for informational purposes only and does not constitute medical advice.

© The Glucose Never Lies Ltd. All rights reserved.

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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

🔬 FIND Diagnostics – CGM Accuracy Factsheet

📘 GNL FAQ – CGM Regulation & Comparator Bias

📱 Follow Kirsten → @everydayisdiabetesday
| @sadiabetesadvocacy

🎧 Listen, learn, and share.
The CGM Access Blueprint begins in South Africa — but its lessons apply everywhere.

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

Support GNL: https://buy.stripe.com/9B63cx4UO3KEdKC0Sp7Re00

The Glucose Never Lies® is a registered trademark of The GNL Ltd. Company No. 16733595. UK VAT No. GB 516 3272 08.

Disclaimer

This podcast is for education and informational purposes only. It does not constitute medical advice and is not a substitute for individualised care.

The Glucose Never Lies® is independent by design

We do not accept sponsorships and advertising. We operate via education grants and donations from listeners who value independence. So, consider:
Buying the GNL a Coffee:
https://buymeacoffee.com/gnlfree

Enquiries

Collaboration: John Pemberton — [email protected]

Creatives: Anjanee Kohli — [email protected]

Follow The Glucose Never Lies®

Website: https://theglucoseneverlies.com/

Instagram: https://www.instagram.com/theglucoseneverlies

LinkedIn: https://www.linkedin.com/company/theglucoseneverlies

LinkedIn: John Pemberton: https://www.linkedin.com/in/john-pemberton-587104361/

X: https://twitter.com/GlucoseNLies

Disclaimer
This content is for informational purposes only and does not constitute medical advice.

© The Glucose Never Lies Ltd. All rights reserved.

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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 SPARK download

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

Support GNL: https://buy.stripe.com/9B63cx4UO3KEdKC0Sp7Re00

The Glucose Never Lies® is a registered trademark of The GNL Ltd. Company No. 16733595. UK VAT No. GB 516 3272 08.

Disclaimer

This podcast is for education and informational purposes only. It does not constitute medical advice and is not a substitute for individualised care.

The Glucose Never Lies® is independent by design

We do not accept sponsorships and advertising. We operate via education grants and donations from listeners who value independence. So, consider:
Buying the GNL a Coffee:
https://buymeacoffee.com/gnlfree

Enquiries

Collaboration: John Pemberton — [email protected]

Creatives: Anjanee Kohli — [email protected]

Follow The Glucose Never Lies®

Website: https://theglucoseneverlies.com/

Instagram: https://www.instagram.com/theglucoseneverlies

LinkedIn: https://www.linkedin.com/company/theglucoseneverlies

LinkedIn: John Pemberton: https://www.linkedin.com/in/john-pemberton-587104361/

X: https://twitter.com/GlucoseNLies

Disclaimer
This content is for informational purposes only and does not constitute medical advice.

© The Glucose Never Lies Ltd. All rights reserved.

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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.

Support GNL: https://buy.stripe.com/9B63cx4UO3KEdKC0Sp7Re00

The Glucose Never Lies® is a registered trademark of The GNL Ltd. Company No. 16733595. UK VAT No. GB 516 3272 08.

Disclaimer

This podcast is for education and informational purposes only. It does not constitute medical advice and is not a substitute for individualised care.

The Glucose Never Lies® is independent by design

We do not accept sponsorships and advertising. We operate via education grants and donations from listeners who value independence. So, consider:
Buying the GNL a Coffee:
https://buymeacoffee.com/gnlfree

Enquiries

Collaboration: John Pemberton — [email protected]

Creatives: Anjanee Kohli — [email protected]

Follow The Glucose Never Lies®

Website: https://theglucoseneverlies.com/

Instagram: https://www.instagram.com/theglucoseneverlies

LinkedIn: https://www.linkedin.com/company/theglucoseneverlies

LinkedIn: John Pemberton: https://www.linkedin.com/in/john-pemberton-587104361/

X: https://twitter.com/GlucoseNLies

Disclaimer
This content is for informational purposes only and does not constitute medical advice.

© The Glucose Never Lies Ltd. All rights reserved.

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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.

 
Quotes from the Episode

“CE marking is not a quality standard. You have to dig into study design — and that’s not practical for the average person with diabetes or most clinicians.” – John Pemberton

“CGM systems often perform worse at high rates of change than at stable glucose levels. That’s why stress-testing is vital.” – Dr. Guido Freckmann

“Different CGM systems can give the same time-in-range but very different HbA1c and complication risks. That’s unacceptable.” – John Pemberton

“Manufacturers can design studies to get good results by avoiding rapid glucose swings. Without rules, accuracy is only on paper.” – Dr. Guido Freckmann

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

Support GNL: https://buy.stripe.com/9B63cx4UO3KEdKC0Sp7Re00

The G

Disclaimer

This podcast is for education and informational purposes only. It does not constitute medical advice and is not a substitute for individualised care.

The Glucose Never Lies® is independent by design

We do not accept sponsorships and advertising. We operate via education grants and donations from listeners who value independence. So, consider:
Buying the GNL a Coffee:
https://buymeacoffee.com/gnlfree

Enquiries

Collaboration: John Pemberton — [email protected]

Creatives: Anjanee Kohli — [email protected]

Follow The Glucose Never Lies®

Website: https://theglucoseneverlies.com/

Instagram: https://www.instagram.com/theglucoseneverlies

LinkedIn: https://www.linkedin.com/company/theglucoseneverlies

LinkedIn: John Pemberton: https://www.linkedin.com/in/john-pemberton-587104361/

X: https://twitter.com/GlucoseNLies

Disclaimer
This content is for informational purposes only and does not constitute medical advice.

© The Glucose Never Lies Ltd. All rights reserved.

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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://buy.stripe.com/9B63cx4UO3KEdKC0Sp7Re00

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
 

Support GNL: https://buy.stripe.com/9B63cx4UO3KEdKC0Sp7Re00

The Glucose Never Lies® is a registered trademark of The GNL Ltd. Company No. 16733595. UK VAT No. GB 516 3272 08.

Disclaimer

This podcast is for education and informational purposes only. It does not constitute medical advice and is not a substitute for individualised care.

The Glucose Never Lies® is independent by design

We do not accept sponsorships and advertising. We operate via education grants and donations from listeners who value independence. So, consider:
Buying the GNL a Coffee:
https://buymeacoffee.com/gnlfree

Enquiries

Collaboration: John Pemberton — [email protected]

Creatives: Anjanee Kohli — [email protected]

Follow The Glucose Never Lies®

Website: https://theglucoseneverlies.com/

Instagram: https://www.instagram.com/theglucoseneverlies

LinkedIn: https://www.linkedin.com/company/theglucoseneverlies

LinkedIn: John Pemberton: https://www.linkedin.com/in/john-pemberton-587104361/

X: https://twitter.com/GlucoseNLies

Disclaimer
This content is for informational purposes only and does not constitute medical advice.

© The Glucose Never Lies Ltd. All rights reserved.

Suggest guests or get in contact

 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. 

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

Support GNL: https://buy.stripe.com/9B63cx4UO3KEdKC0Sp7Re00

The Glucose Never Lies® is a registered trademark of The GNL Ltd. Company No. 16733595. UK VAT No. GB 516 3272 08.

Disclaimer

This podcast is for education and informational purposes only. It does not constitute medical advice and is not a substitute for individualised care.

The Glucose Never Lies® is independent by design

We do not accept sponsorships and advertising. We operate via education grants and donations from listeners who value independence. So, consider:
Buying the GNL a Coffee:
https://buymeacoffee.com/gnlfree

Enquiries

Collaboration: John Pemberton — [email protected]

Creatives: Anjanee Kohli — [email protected]

Follow The Glucose Never Lies®

Website: https://theglucoseneverlies.com/

Instagram: https://www.instagram.com/theglucoseneverlies

LinkedIn: https://www.linkedin.com/company/theglucoseneverlies

LinkedIn: John Pemberton: https://www.linkedin.com/in/john-pemberton-587104361/

X: https://twitter.com/GlucoseNLies

Disclaimer
This content is for informational purposes only and does not constitute medical advice.

© The Glucose Never Lies Ltd. All rights reserved.

Suggest guests or get in contact

• 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.

• 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

• DVLA INF294 — Insulin-treated diabetes and driving (official guidance)
  
  
• NHS England guidance on approved blood glucose meters
  
  
• DSN Forum CGM Accuracy Comparison Chart
  
  
• CGM Guides — The Glucose Never Lies®
  
  
• Automated Insulin Delivery Guides — The Glucose Never Lies®
  
  

Disclaimer

Support GNL: https://buy.stripe.com/9B63cx4UO3KEdKC0Sp7Re00

The Glucose Never Lies® is a registered trademark of The GNL Ltd. Company No. 16733595. UK VAT No. GB 516 3272 08.

Disclaimer

This podcast is for education and informational purposes only. It does not constitute medical advice and is not a substitute for individualised care.

The Glucose Never Lies® is independent by design

We do not accept sponsorships and advertising. We operate via education grants and donations from listeners who value independence. So, consider:
Buying the GNL a Coffee:
https://buymeacoffee.com/gnlfree

Enquiries

Collaboration: John Pemberton — [email protected]

Creatives: Anjanee Kohli — [email protected]

Follow The Glucose Never Lies®

Website: https://theglucoseneverlies.com/

Instagram: https://www.instagram.com/theglucoseneverlies

LinkedIn: https://www.linkedin.com/company/theglucoseneverlies

LinkedIn: John Pemberton: https://www.linkedin.com/in/john-pemberton-587104361/

X: https://twitter.com/GlucoseNLies

Disclaimer
This content is for informational purposes only and does not constitute medical advice.

© The Glucose Never Lies Ltd. All rights reserved.

Suggest guests or get in contact

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 

Support GNL: https://buy.stripe.com/9B63cx4UO3KEdKC0Sp7Re00

The Glucose Never Lies® is a registered trademark of The GNL Ltd. Company No. 16733595. UK VAT No. GB 516 3272 08.

Disclaimer

This podcast is for education and informational purposes only. It does not constitute medical advice and is not a substitute for individualised care.

The Glucose Never Lies® is independent by design

We do not accept sponsorships and advertising. We operate via education grants and donations from listeners who value independence. So, consider:
Buying the GNL a Coffee:
https://buymeacoffee.com/gnlfree

Enquiries

Collaboration: John Pemberton — [email protected]

Creatives: Anjanee Kohli — [email protected]

Follow The Glucose Never Lies®

Website: https://theglucoseneverlies.com/

Instagram: https://www.instagram.com/theglucoseneverlies

LinkedIn: https://www.linkedin.com/company/theglucoseneverlies

LinkedIn: John Pemberton: https://www.linkedin.com/in/john-pemberton-587104361/

X: https://twitter.com/GlucoseNLies

Disclaimer
This content is for informational purposes only and does not constitute medical advice.

© The Glucose Never Lies Ltd. All rights reserved.

Suggest guests or get in contact

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 insuli

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