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Suggest guests or get in contact Jess Shaw was diagnosed with type 1 diabetes on the evening of the worst trial of her life, then spent ten years pretending she did not have it. Jess is an England netball international, living with type 1 diabetes. In this conversation with John she talks about keeping it quiet as a teenager, being sent home from a tour, a first England cap at a few days' notice, and what changed once she started talking about it. If you have ever hidden your diabetes to keep your place in a team, or you coach someone who might be, this one is for you. Chapters 00:00 Welcome: how John and Jess met 04:33 Diagnosis at 13: the Leeds trial 08:47 The first rules, and a lot of lows 15:08 Why the first messages stick 18:03 Moving to time in range 19:09 A low HbA1c that hid the lows 20:50 Ten years of hiding it 23:57 Sent home alone at 16 25:10 Why sport needs a diabetes policy 28:43 Super League, England and injuries 34:50 First cap against Australia 38:34 Game day on injections 43:20 Insulin on board and exercise 44:36 A closed loop overnight 46:43 Building a game-day routine 47:44 Commonwealth Games 51:06 Semi-finals and staying consistent 59:23 What John heard 64:21 Jess: you are not alone 69:24 Thanks from John Guest: Jess Shaw, England netball international, living with type 1 diabetes. Host: John Pemberton, founder of The Glucose Never Lies, a paediatric diabetes dietitian, and a person living with type 1 diabetes. A note on scope. Where John describes practice at Birmingham Children's Hospital, he is speaking in his clinical role there, and that sits outside GNL. It is a report of one specialist paediatric service, not GNL guidance, not a protocol, and not a recommendation to any other service or family. The support John gave Jess as an adult was through GNL's consultation service, not his NHS role, and her own diabetes team made the decisions about her treatment, including her pump. What Jess describes is her own experience. It is not a claim about what GNL, or any device, will do for anyone else, and it is not advice to anyone listening. Links Show notes: theglucoseneverlies.com/episode-44-jess-shaw-type-1-netball Watch on YouTube: youtu.be/x3zsbZuffCQ Previous episode: theglucoseneverlies.com/episode-43-tandem-control-iq-plus-mobi Grace, our AI diabetes educational adviser, did not write a word of this. Credited anyway. Ask her anything: theglucoseneverlies.com/gnl-grace Independent by design. The Glucose Never Lies® takes no sponsorship and no advertising. We run on education grants and listener donations. If this helped, buy the GNL a coffee (buymeacoffee.com/gnlfree). Follow: Website, Instagram, LinkedIn, John on LinkedIn, X Contact: collaboration, [email protected]; creatives, [email protected] For education only. Not medical advice and not a substitute for individual care; decisions about your care sit with you and your diabetes team. © The Glucose Never Lies Ltd, company number 16733595. All rights reserved.

Suggest guests or get in contact A pump can be technically excellent and still deliver mediocre results, because the two settings that decide the outcome are the ones most clinicians tune last. Laurel Messer, VP of Global Medical Affairs at Tandem Diabetes Care, returns to open the GNL AID series. She and John go through the real-world data behind Control-IQ's most powerful lever, what Control-IQ+ changes for the very young and the very high dose, the new sick day and extended bolus tools, the fresh FDA clearance for pregnancy, and the Tandem Mobi. IN THIS EPISODE - Why correction factor, not basal rate or target, is the setting with the biggest real-world effect on time in range (Messer 2023, n equals 20,764) - Control-IQ+, the total daily dose range extended to 5 to 200 units, opening the system to very young children and very high insulin users - Control-IQ+, the correction factor ceiling raised from 11 to 33 mmol/L (200 to 600 mg/dL) - The new sick day hack, a temp basal that runs without leaving automation - The extended bolus, up to eight hours, for high fat meals and delayed gastric emptying - Fresh FDA clearance for Control-IQ in pregnancy, and what the CIRCUIT trial found for time in pregnancy range - The Tandem Mobi, a matchbox sized on-body pump running the same Control-IQ algorithm CHAPTERS 00:00 Introduction, launching the AID series 01:43 Welcome back, Laurel Messer 03:55 The 2023 registry paper, correction factor as the secret sauce 10:40 A basal and correction factor formula in practice 12:39 Time blocks across the day, the dusk phenomenon 15:37 Control-IQ+, wider total daily dose range 17:27 Control-IQ+, correction factor ceiling raised 20:50 Recap, basal at 50 percent, correction factor as the dial 22:36 Temp basal with automation on, the sick day hack 26:32 Extended bolus, up to eight hours 28:17 The pizza test 30:23 The science, why fat blocks insulin 32:21 FDA clearance for pregnancy 36:06 CIRCUIT trial results 44:22 Sleep Activity in pregnancy 49:14 Introducing the Tandem Mobi 53:41 Mobi minimum fill and early feedback 57:16 Takeaways, the two levers to know GUEST Laurel Messer, VP of Global Medical Affairs, Tandem Diabetes Care. Host: John Pemberton, founder of The Glucose Never Lies and a paediatric diabetes dietitian, and a person living with type 1 diabetes. LINKS (all full absolute URLs) Show notes: https://www.theglucoseneverlies.com/episode-43-tandem-control-iq-plus-mobi/ Watch on YouTube: https://youtu.be/2Zq2XALSnYA Apple Podcasts: https://podcasts.apple.com/gb/podcast/the-glucose-never-lies/id1795741144 Spotify: https://open.spotify.com/show/2MlGlz2G8LsbDnuGtAh77W AID Algorithm Optimiser: https://www.theglucoseneverlies.com/aid-system-explorer/ Previous episode: https://www.theglucoseneverlies.com/episode-42-dice-2026-highlights/ ASK GRACE Have more questions? Ask GNL Grace, a diabetes educational adviser built by a team with skin in the game. Grace gets you 80 per cent of the way there with 20 per cent of the effort; the final 20 per cent takes self-discovery, guided by human expertise and trial-and-error learning. Check out Grace at https://www.theglucoseneverlies.com/gnl-grace/ SUPPORT THIS PODCAST The Glucose Never Lies is independent by design. We take no sponsorship and no advertising, so the podcast stays answerable only to the people who listen to it. If it has been useful, you can help keep it that way: drop a one-off tip, or set up a small monthly amount to keep the show ad-free. Either way, every penny goes back into making episodes. Buy us a coffee (one-off or keep-it-ad-free): https://www.buymeacoffee.com/gnlfree FOLLOW Website: https://www.theglucoseneverlies.com/ Instagram: https://www.instagram.com/theglucoseneverlies LinkedIn: https://www.linkedin.com/company/theglucoseneverlies X: https://twitter.com/GlucoseNLies DISCLAIMER This podcast is for education only. It is not medical advice and is not a substitute for individualised care from your diabetes team. This episode reflects the independent clinical perspective of John Pemberton; Laurel Messer speaks in her role at Tandem Diabetes Care. It is not an endorsement by GNL of any product. The Glucose Never Lies is a registered trademark of The GNL Ltd. Company No. 16733595. UK VAT No. GB 516 3272 08. Independent by design. The Glucose Never Lies® takes no sponsorship and no advertising. We run on education grants and listener donations. If this helped, buy the GNL a coffee (buymeacoffee.com/gnlfree). Follow: Website, Instagram, LinkedIn, John on LinkedIn, X Contact: collaboration, [email protected]; creatives, [email protected] For education only. Not medical advice and not a substitute for individual care; decisions about your care sit with you and your diabetes team. © The Glucose Never Lies Ltd, company number 16733595. All rights reserved.

Suggest guests or get in contact Suggest guests or get in contact John Pemberton was at Croke Park on 21 May for DICE — Diabetes Ireland Conference and Exhibition — Ireland's premier annual event for healthcare professionals working in diabetes. The day also saw the launch of the landmark National Policy and Services Review for diabetes in Ireland. John grabbed a microphone and seven conversations. This episode is all of them. Anjanee Kohli is Co-Director and Creative Director of The Glucose Never Lies® and the host for this episode. John Pemberton is founder of The Glucose Never Lies® and a paediatric diabetes dietitian at Birmingham Women's and Children's NHS Foundation Trust; he is also a person living with T1D. This episode reflects the independent views of both. This episode covers: Sinead Powell (Education and Support Coordinator, Diabetes Ireland): the COPE programme, emotional wellbeing in type 2 diabetes, language, stigma, and why information alone is never enoughKathy Breen (Clinical Specialist Dietitian and Dietetic Lead, National Diabetes Programme): what Language Matters looks like in practice, person-first language, and its inclusion in the new national strategyKate Gaievska (Clinical Manager for Advocacy and Research, Diabetes Ireland): why adult diabetes psychology services in Ireland are effectively non-existent, what the strategy commits to, and the long road of implementationProfessor Fidelma Dunne (University of Galway / National Clinical Trials Network in Diabetes): how clinical trials get funded, why real-world data matters, and why research is not the icing on the cakeChristine Newman (Diabetes Consultant, Galway): hybrid closed-loop in pregnancy, CGM for type 2, and the case for free glucose strips for gestational diabetesProfessor Derek O'Keefe (Consultant Physician and Professor of Medical Device Technology, UHG): Mochara, a bounded AI education tool that matched nurse and doctor performance in trials, ambient clinical documentation, intelligent dynamic triage, and what multimodal AI means for diabetes careDr Tomas Griffin (Consultant Diabetologist, Galway / DTN Ireland): what the strategy means for pump access, the DTN Ireland roadshow, and why every tier of hospital in Ireland is now starting pump therapyShow notes: https://theglucoseneverlies.com/ Have more questions? Ask GNL Grace, a diabetes educational adviser built by a team with skin in the game. Grace gets you 80% of the way there with 20% of the effort; the final 20% takes self-discovery, guided by human expertise and trial-and-error learning. https://theglucoseneverlies.com/gnl-grace/ Independent by design. The Glucose Never Lies® takes no sponsorship and no advertising. We run on education grants and listener donations. If this helped, buy the GNL a coffee (buymeacoffee.com/gnlfree). Follow: Website, Instagram, LinkedIn, John on LinkedIn, X Contact: collaboration, [email protected]; creatives, [email protected] For education only. Not medical advice and not a substitute for individual care; decisions about your care sit with you and your diabetes team. © The Glucose Never Lies Ltd, company number 16733595. All rights reserved.

Suggest guests or get in contact Every few months, The Glucose Never Lies stops and takes stock. No single guest, no single topic: three CGM Series episodes have landed since the last round-up, Grace has a new model, and John has appeared on two podcasts that are not his own. This episode covers all of it. Anjanee Kohli is Co-Director and Creative Director of The Glucose Never Lies® and the host for this episode. John Pemberton is founder of The Glucose Never Lies® and a paediatric diabetes dietitian at Birmingham Women's and Children's NHS Foundation Trust; he is also a person living with T1D. This episode reflects the independent views of both. This episode covers: - CGM Series catch-up: episodes 38, 39, and 40 in one conversation - The IFCC glucose stress test: what it measures, the CE-versus-FDA accuracy gap, and the car crash analogy for insulin-dosing sensors - The MDI generation gap: why people on injections have had one generation of CGM while pump users have had five - What 17 early adopters actually reported about Night Low Predict and Glucose Predict on the Accu-Chek SmartGuide - Grace's new model: a 30-day free trial for everyone, then Personal at £5 a month (£50 a year) and HCP at £20 a month (£200 a year); a £5 Buy Me a Coffee sponsorship opens a free account for someone on the waiting list - The near-bankruptcy moment: flat architecture to wiki retrieval layer, cost reduced to roughly five per cent - Why Grace has no memory by design: the deliberate reasoning behind a deliberate constraint - John on Diabetech (Gary Shiner's show, hosted by Justin): CGM international testing standards - John on Tomorrow's Medicine with Arseniy Arsentyev: how Grace was built, the antibody result that started it, and what nearly ended it - AI and healthcare work: the people who adapt, the people who hide behind procedure, and what cannot be automated Show notes: https://theglucoseneverlies.com/episode-41-cgm-series-grace-diabetech/ Before this episode, John appeared on: Diabetech (Gary Shiner's show, hosted by Justin): https://youtu.be/6sxM1HOxcP4?si=2B3lHzyjSBgPKYfb Tomorrow's Medicine with Arseniy Arsentyev: https://youtu.be/60MZGAk86NY?si=l3oF1J37EiI7fcCE Have more questions? Ask GNL Grace, a diabetes educational advisor built by a team with skin in the game. Grace gets you 80% of the way there with 20% of the effort; the final 20% takes self-discovery, guided by human expertise and trial-and-error learning. https://theglucoseneverlies.com/gnl-grace/ --- 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://www.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/ LinkedIn Anjanee Kohli: https://www.linkedin.com/in/anjanee-kohli-chohan-1b22a217b/ Instagram Anjanee Kohli: https://www.instagram.com/anjanee.dietitian X: https://twitter.com/GlucoseNLies Independent by design. The Glucose Never Lies® takes no sponsorship and no advertising. We run on education grants and listener donations. If this helped, buy the GNL a coffee (buymeacoffee.com/gnlfree). Follow: Website, Instagram, LinkedIn, John on LinkedIn, X Contact: collaboration, [email protected]; creatives, [email protected] For education only. Not medical advice and not a substitute for individual care; decisions about your care sit with you and your diabetes team. © The Glucose Never Lies Ltd, company number 16733595. All rights reserved.

Suggest guests or get in contact People on MDI have had one generation of CGM technology: a sensor that tells you what your glucose is doing now, with a 15-minute trend arrow. While pump users have moved through five iterations, injection users have been waiting. The Accu-Chek SmartGuide is the first attempt at a second generation - and this episode asks whether it delivers. Amy Jolley is a Highly Specialised Dietitian, Lead Educator at the Diabetes Technology Network UK, and Lead for the Young Adult and Transition Service at Salford NHS Foundation Trust. This episode is not endorsed by Roche Diagnostics, but the experience of a healthcare professional's experience of putting 17 people onto the SmartGuide in one week, running group onboarding sessions, and asking them to come back and tell her what actually happened. Her host, John Pemberton, is founder of The Glucose Never Lies® and a person living with T1D.  This episode covers: - Why MDI has been stuck at Generation 1 while pump technology moved through five iterations - Night Low Predict: RAG ratings, first-half versus second-half of the night, and how to teach it - Glucose Predict: the 45-minute action window versus the two-hour awareness window - What 17 early adopters actually reported back - How the 45-minute look ahead reduces the rage bolus - Why calibration is an educational opportunity, not a drawback - CGM market saturation and the DTN quality standard - The DTN Competency Assessment Framework: four tiers, self-assessment, a training passport for clinicians - GNL Grace in clinical practice: Amy's feedback from a specialist service supporting 700 AID users Show notes: https://theglucoseneverlies.com/accu-chek-smartguide-mdi-cgm-series/ Have more questions? Ask GNL Grace, a diabetes educational advisor built by a team with skin in the game. Grace gets you 80% of the way there with 20% of the effort; the final 20% takes self-discovery, guided by human expertise and trial-and-error learning. https://theglucoseneverlies.com/gnl-grace/ --- 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://www.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/ LinkedIn Anjanee Kohli: https://www.linkedin.com/in/anjanee-kohli-chohan-1b22a217b/ Instagram Anjanee Kohli: https://www.instagram.com/anjanee.dietitian X: https://twitter.com/GlucoseNLies Independent by design. The Glucose Never Lies® takes no sponsorship and no advertising. We run on education grants and listener donations. If this helped, buy the GNL a coffee (buymeacoffee.com/gnlfree). Follow: Website, Instagram, LinkedIn, John on LinkedIn, X Contact: collaboration, [email protected]; creatives, [email protected] For education only. Not medical advice and not a substitute for individual care; decisions about your care sit with you and your diabetes team. © The Glucose Never Lies Ltd, company number 16733595. All rights reserved.

Suggest guests or get in contact Michael Skarlatos from Abbott UK Medical Affairs joins John Pemberton for the second manufacturer episode of the CGM Series. A former diabetes specialist dietitian at University Hospitals of Leicester, Michael brings real clinical experience to an honest breakdown of the FreeStyle Libre 2 Plus and 3 Plus. This episode covers: - Why Abbott accuracy data qualifies these sensors for insulin dosing: ICGM approved, 20/20 performance ~95-96%, outside-40/40 error rate 0.2% - What 70% smaller means in practice: form factor, stigma, and the all-in-one applicator on Libre 3 Plus - Pump integrations now and the roadmap: CamAPS FX, Omnipod 5, and what is coming - Libreview: why Abbott moved off Glooko and what population health management enables - Libreview Pro in SystmOne and EMIS with SNOMED-coded CGM metrics - A critical data nuance: glucose measured every minute on the patient app but recorded every 5 minutes in clinical downloads - Continuous ketone monitoring: what Abbott has in development and who benefits most CHAPTERS 00:00 Introduction and CGM Series overview 00:57 Michaels background and Leicester NHS Trust 02:25 Moving from NHS to Abbott Medical Affairs 03:27 Accuracy credentials: ICGM approval and 20/20 performance 05:44 FreeStyle Libre 3 Plus: size and form factor 09:25 Pump integrations: CamAPS FX, Omnipod 5, and the roadmap 10:19 ICGM interoperability: US vs CE marking in Europe 12:05 Fifteen-day wear period 12:28 Abbott market history: free samples and patient-led adoption 14:04 Simplicity of onboarding and multi-language support 16:58 Starter clinics: taking onboarding off the HCP 19:33 Libreview and population health management 23:21 EHR integration, SNOMED codes, and QOF implications 25:46 Practical tips: Bluetooth connectivity and the app cache 29:23 Minute-by-minute data vs five-minute trend recording 30:58 Low glucose event thresholds and hypo underreporting 31:42 Continuous ketone monitoring: what is coming from Abbott 37:52 CGM beyond type 1 and patient advocacy 40:17 Closing thoughts LINKS Show notes: https://theglucoseneverlies.com/episode-38-freestyle-libre-abbott/ YouTube: https://youtu.be/IW1sa5APHU8 CGM Series: https://theglucoseneverlies.com/10-13-cgm-series/ GNL Explorers: https://theglucoseneverlies.com/gnl-grace/ Buzzsprout: https://www.buzzsprout.com/2451357/18982022 Apple Podcasts: https://podcasts.apple.com/gb/podcast/the-glucose-never-lies/id1795741144 Spotify: https://open.spotify.com/show/2MlGlz2G8LsbDnuGtAh77W This content is for educational exploration only. Not medical advice. 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. Independent by design. The Glucose Never Lies® takes no sponsorship and no advertising. We run on education grants and listener donations. If this helped, buy the GNL a coffee (buymeacoffee.com/gnlfree). Follow: Website, Instagram, LinkedIn, John on LinkedIn, X Contact: collaboration, [email protected]; creatives, [email protected] For education only. Not medical advice and not a substitute for individual care; decisions about your care sit with you and your diabetes team. © The Glucose Never Lies Ltd, company number 16733595. All rights reserved.

Suggest guests or get in contact Three months ago, GNL was a website full of excellent content that was genuinely hard to find. In Episode 38, John Pemberton and Creative Director Anjanee Kohli talk through what happened next: a complete website rebuild, five interactive explorers, the launch of GNL Grace, and the evidence base behind it, drawn from approximately 500,000 patient-days across roughly 1,300 people living with diabetes over more than 10 years. In this episode: CGM guide update and the five-out-of-five accuracy chartHow the five GNL Explorers work and how clinicians are using them in practiceGNL Grace: a bounded AI educational advisor built on 2,000 curated citationsGrace: a 30-day free trial for everyone, then Personal at £5 a month and HCP at £20 a monthReal-world validation: approximately 500,000 patient-days across roughly 1,300 people living with diabetes over more than 10 yearsWhy the skill of the future in healthcare is compassion, not knowledgePhil Hayes joining as Technical DirectorGNL merch and the Diabetes UK giveawayChapters: 00:00 Introduction01:55 GNL Grace announcement02:32 CGM guide and accuracy chart05:30 Phil Hayes and the explorer infrastructure09:40 GNL Grace: the six-layer bounded AI10:50 Grace tiers explained13:31 Grace Max: manuscript-grade output17:31 Real-world validation: the evidence base behind Grace19:58 The skill of the future is compassion30:09 What went wrong and lessons learned35:06 GNL merch36:10 ClosingLinks: Show notes: theglucoseneverlies.com/episode-38-quarterly-reviewGNL Grace: theglucoseneverlies.com/gnl-graceGNL Explorers: theglucoseneverlies.com/gnl-explorersCGM Series hub: theglucoseneverlies.com/10-13-cgm-seriesHost: John Pemberton. Director of Creativity: Anjanee Kohli. This content is for educational exploration only. It is not medical advice and cannot replace individual clinical guidance from your diabetes care team. Support GNL: https://www.buymeacoffee.com/gnlfree The Glucose Never Lies® is a registered trademark of The GNL Ltd. Company No. 16733595. UK VAT No. GB 516 3272 08. Independent by design. The Glucose Never Lies® takes no sponsorship and no advertising. We run on education grants and listener donations. If this helped, buy the GNL a coffee (buymeacoffee.com/gnlfree). Follow: Website, Instagram, LinkedIn, John on LinkedIn, X Contact: collaboration, [email protected]; creatives, [email protected] For education only. Not medical advice and not a substitute for individual care; decisions about your care sit with you and your diabetes team. © The Glucose Never Lies Ltd, company number 16733595. All rights reserved.

Suggest guests or get in contact Most people with T1D have switched their CGM high alert off. Not because they do not care - because it goes off every time they eat and there is nothing they can do about it. Episode 37 is about what Dexcom built to fix that. Adam Dawes, Senior Medical Affairs Manager at Dexcom UK and Ireland - and a former paediatric diabetes nurse specialist - joins John Pemberton for the third manufacturer episode of the CGM Series. An honest clinical conversation about the Dexcom G7 and ONE+, what separates them, and where Dexcom is heading next. This episode covers: - Dexcom G7 vs Dexcom ONE+: same hardware platform, different software, and what that means for matching the right sensor to the right patient - Delay 1st Alert: why it is one of the most underused alerts in CGM, how it eliminates alarm fatigue without reducing safety, and how John uses it himself - AID integrations: Tandem T:slim X2, Omnipod 5, mylife, and the Tandem Mobi - CGM for type 2 diabetes: the biofeedback argument and why immediate glucose feedback changes behaviour in ways a quarterly HbA1c never can - The Dexcom roadmap from ATTD 2026: 15-day sensor, Dexcom G8 next generation sensor, EPIC integration, Clarity updates, and generative AI - Why insulin dosing will never be a commodity market - and what people with T1D need to understand as new CGMs enter the UK - The FDA manufacturing findings: what happened, how Dexcom responded, and why the new Ireland factory matters Show notes: https://theglucoseneverlies.com/episode-37-dexcom-g7-one-plus/ | CGM Series: https://theglucoseneverlies.com/10-13-cgm-series/ Have more questions about CGM, the Dexcom G7 or ONE+? Ask GNL Grace: https://theglucoseneverlies.com/gnl-grace/ 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. Independent by design. The Glucose Never Lies® takes no sponsorship and no advertising. We run on education grants and listener donations. If this helped, buy the GNL a coffee (buymeacoffee.com/gnlfree). Follow: Website, Instagram, LinkedIn, John on LinkedIn, X Contact: collaboration, [email protected]; creatives, [email protected] For education only. Not medical advice and not a substitute for individual care; decisions about your care sit with you and your diabetes team. © The Glucose Never Lies Ltd, company number 16733595. All rights reserved.

Suggest guests or get in contact CGM Series | The Glucose Never Lies® Podcast Three of the UK's leading diabetes specialist nurses on why CE marking is not a quality standard for CGM accuracy, why data sufficiency must come before device comparison, and what ATTD 2025 revealed about where diabetes technology is heading. A frank, clinical conversation grounded in years of front-line practice — and the story of how the DSN Forum's five-point accuracy scoring system was built. In this episode: Why the DSN Forum created its CGM comparison chart and how it has evolvedWhy CE marking is not a quality standard for CGM accuracyHow the five-point accuracy scoring system works and what it requires from a deviceWhy only four devices currently meet the data sufficiency standardWhat 20/20 and 40/40 agreement rates mean in real clinical termsWhy everyone using CGM for insulin decisions still needs a working finger-prick meterThe calibration debate: does the option to calibrate add safety or risk?What ATTD 2025 revealed about fully closed loop systems — and who may not benefitThe case for GLP-1 in type 1 diabetes and why priority access mattersAbbott's continuous ketone monitor: opportunity, unknowns, and risksAID system optimisation, insulin on board, and the GNL AID System ExplorerChapters: 00:00 — Introduction: meeting Amanda, Beth and Tamsin02:14 — Why the DSN Forum CGM comparison chart was created06:47 — Turning complex CGM evidence into a practical scoring system16:23 — How CGM choice works in real clinical settings20:36 — Why finger-prick testing still matters — and the calibration debate29:26 — What stood out at ATTD 202544:03 — AID systems, insulin on board, and the GNL AID optimiser49:49 — Where to find the DSN Forum, the chart, and closing thoughtsGuests: Amanda Williams (Lead Diabetes Nurse, East Kent), Beth Kelly (Clinical Lead DSN, Wiltshire), Tamsin Fletcher-Salt (Lead DSN, University Hospital North Midlands). All core members of the Diabetes Specialist Nurse Forum UK. Links: Full show notes: https://theglucoseneverlies.com/episode-36-cgm-accuracy-dsn-forum/DSN Forum CGM Comparison Chart: https://www.diabetesspecialistnurseforumuk.co.uk/new-cgm-comparison-chartCGM Guide Part 2 — Assessing CGM Accuracy: https://theglucoseneverlies.com/assessing-cgm-accuracy-performance/GNL AID System Explorer: https://theglucoseneverlies.com/aid-system-explorer/Episode 35 — Professor Othmar Moser on CGM Study Design: https://theglucoseneverlies.com/episode-35-cgm-series-the-importance-of-cgm-accuracy-and-study-design-with-professor-othmar-moser/Educational purposes only. Not medical advice. Always work with your diabetes care team. 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. Independent by design. The Glucose Never Lies® takes no sponsorship and no advertising. We run on education grants and listener donations. If this helped, buy the GNL a coffee (buymeacoffee.com/gnlfree). Follow: Website, Instagram, LinkedIn, John on LinkedIn, X Contact: collaboration, [email protected]; creatives, [email protected] For education only. Not medical advice and not a substitute for individual care; decisions about your care sit with you and your diabetes team. © The Glucose Never Lies Ltd, company number 16733595. All rights reserved.

Suggest guests or get in contact CGM Series | The Glucose Never Lies® Podcast CGM accuracy is usually described with a single number: MARD. But a low MARD can hide significant risk if the study behind it was poorly designed. Professor Othmar Moser — one of the leading independent CGM accuracy researchers — explains what study design actually determines, why meal and insulin challenges are non-negotiable, and what people with type 1 diabetes and clinicians should look for when evaluating any accuracy claim. In this episode: What MARD is and why it misleads when used in isolationThe five study design questions that determine what accuracy data actually meansWhy 20/20 and 40/40 agreement rates reveal what MARD cannotWhy meal and insulin challenges are essential for real-world accuracy testingWhat CE marking does and does not guarantee about CGM performanceWhy peer-reviewed, independent evidence is the gold standard — and how little of what is cited meets itHow study design quality shapes what we actually know about CGM riskProfessor Moser's perspective as a researcher who designs and runs these studiesGuest: Professor Othmar Moser, Medical University of Graz, Austria. Leading figure in independent CGM accuracy study design and insulin-related exercise physiology research in type 1 diabetes. Links: Full show notes: https://theglucoseneverlies.com/episode-35-cgm-series-the-importance-of-cgm-accuracy-and-study-design-with-professor-othmar-moser/CGM Guide Part 2 — Assessing CGM Accuracy: https://theglucoseneverlies.com/assessing-cgm-accuracy-performance/CGM Guide Part 1 — How to Choose a CGM: https://theglucoseneverlies.com/select-continuous-glucose-monitor-cgm-understanding/Episode 36 — DSN Forum: CGM Accuracy and ATTD 2025: https://theglucoseneverlies.com/episode-36-cgm-accuracy-dsn-forum/Watch on YouTube: https://youtu.be/zTdTps42kQ8Educational purposes only. Not medical advice. Always work with your diabetes care team. 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. Independent by design. The Glucose Never Lies® takes no sponsorship and no advertising. We run on education grants and listener donations. If this helped, buy the GNL a coffee (buymeacoffee.com/gnlfree). Follow: Website, Instagram, LinkedIn, John on LinkedIn, X Contact: collaboration, [email protected]; creatives, [email protected] For education only. Not medical advice and not a substitute for individual care; decisions about your care sit with you and your diabetes team. © The Glucose Never Lies Ltd, company number 16733595. All rights reserved.

Suggest guests or get in contact How do some countries consistently achieve lower HbA1c and better outcomes in type 1 diabetes while others struggle — even with the same technologies? In this episode, John Pemberton speaks with Dr Peter Adolfsson, paediatric diabetologist in Sweden and lead author of the ISPAD 2022 Exercise Guidelines, about what actually drives population-level improvements in type 1 diabetes care. Full show notes: https://theglucoseneverlies.com/episode-34-building-high-performance-type-1-diabetes-care-technology-targets-and-equity-dr-peter-adolfsson/ KEY TOPICS • How Sweden’s national diabetes registry drives accountability and rapid improvement  • Why structured onboarding and early follow-up are essential for CGM and AID success  • The role of national collaboration between clinics to share best practice  • Why the highest HbA1c group should often be first in line for AID systems  • Moving toward time in tight range (3.9–7.8 mmol/L) as the next clinical target • Equity in diabetes technology: checking subconscious bias with real data • Why celebrating small improvements builds long-term engagement WHAT YOU’LL LEARN ✓ Why early investment in education and follow-up changes long-term outcomes  ✓ How national benchmarking between clinics improves diabetes care  ✓ Why targets matter — changing what you measure changes what improves  ✓ How to use AID systems strategically for people struggling with bolusing  ✓ Why the first two years after diagnosis are a critical window for glycaemic outcomes  ✓ The importance of psychology, social support, and multidisciplinary teams FUTURE OF TYPE 1 DIABETES CARE • AI-supported platforms that analyse CGM data continuously  • Clinics responding earlier when glucose control deteriorates  • Personalised therapy combining insulin with adjunct treatments (e.g., GLP-1RA)  • More flexible care models where stable patients may need fewer clinic visits 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. Independent by design. The Glucose Never Lies® takes no sponsorship and no advertising. We run on education grants and listener donations. If this helped, buy the GNL a coffee (buymeacoffee.com/gnlfree). Follow: Website, Instagram, LinkedIn, John on LinkedIn, X Contact: collaboration, [email protected]; creatives, [email protected] For education only. Not medical advice and not a substitute for individual care; decisions about your care sit with you and your diabetes team. © The Glucose Never Lies Ltd, company number 16733595. All rights reserved.

Suggest guests or get in contact Exercise guidelines for type 1 diabetes are built on research dominated by male participants. Professor Jane Yardley, a leading exercise physiologist, bridges the research gap between male and female exercise physiology in type 1 diabetes. This conversation reveals why carbohydrate recommendations systematically overestimate female needs, how menstrual cycle phases alter insulin requirements during exercise, why peripheral hyperinsulinemia creates unique barriers to fat loss, and how fasted morning exercise offers a low-risk, high-reward strategy for improving insulin sensitivity and accessing fat stores. Full show notes: https://theglucoseneverlies.com/females-exercise-t1d/ KEY TOPICS: • Why ~60-70% of females experience luteal phase insulin resistance (10-50% increased needs) • How AID systems struggle to keep up with rapid menstrual cycle changes • Why per-kilogram carb recommendations overestimate female athletes' needs • The peripheral hyperinsulinemia barrier: 4-8× higher insulin blocks fat release • Fasted exercise: zero planning, minimal hypo risk, maximum fat burning • Why muscle and bone health in your 20s-30s determines mobility in your 60s-80s • Menopause transitions and accelerated cardiovascular risk WHAT YOU'LL LEARN: ✓ Luteal phase exercise may require larger insulin adjustments ✓ Females use more fat as fuel — estrogen promotes fat oxidation ✓ Bolus insulin lasts 6 hours, not 2-4 (why "between meals" isn't truly fasted) ✓ Morning fasted exercise depletes glycogen and improves all-day insulin sensitivity ✓ How to overcome the fat loss barrier created by high peripheral insulin ✓ Why resistance training NOW prevents fractures and disability later ✓ Pregnancy exercise principles (sparse data, clear physiology) PRACTICAL STRATEGIES: → Fasted morning exercise: roll out of bed, black coffee, go — no adjustments needed → Luteal phase: consider 60-70% basal cuts (not 50%) for postprandial exercise → Start with LESS carbohydrate than guidelines suggest, adjust based on YOUR response → Build peak muscle/bone by age 30 — you can't make up for lost time at retirement → Post-meal walks in pregnancy: 15-20 min keeps glucose 7.8 mmol/L without extra insulin GUEST: Associate Professor Jane Yardley University of Montreal & Montreal Clinical Research Institute 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. Independent by design. The Glucose Never Lies® takes no sponsorship and no advertising. We run on education grants and listener donations. If this helped, buy the GNL a coffee (buymeacoffee.com/gnlfree). Follow: Website, Instagram, LinkedIn, John on LinkedIn, X Contact: collaboration, [email protected]; creatives, [email protected] For education only. Not medical advice and not a substitute for individual care; decisions about your care sit with you and your diabetes team. © The Glucose Never Lies Ltd, company number 16733595. All rights reserved.

Suggest guests or get in contact The menstrual cycle affects half of people with type 1 diabetes, yet it's nearly invisible in clinical guidelines, research, and technology design. Dr. Cecilia Nobili — a pediatric diabetology resident and researcher living with T1D — bridges the gap between lived experience and clinical evidence. In this episode, Dr. Nobili shares findings from her observational study of 170 women, revealing how different insulin delivery systems handle monthly hormonal shifts, which phases create the biggest burden, and why this represents a genuine gender gap in diabetes care. Full show notes: https://theglucoseneverlies.com/menstrual-cycle-t1d/  KEY TOPICS: • Why 60% of women on MDI experience ≥5% drop in time in range during luteal phase • How AID systems cut glucose deterioration in half — but aren't perfect • Why hypoglycemia when bleeding starts is often more burdensome than luteal phase highs • Practical strategies for each AID system (780G, Omnipod 5, Control-IQ, CamAPS FX) and MDI • The progesterone effect: why insulin resistance peaks before your period • How to anticipate changes and adjust proactively rather than reactively • Why this should be built into algorithms (but isn't) WHAT YOU'LL LEARN: ✓ The five phases of the menstrual cycle and their glucose impact ✓ Which AID systems show the most stability across cycle phases ✓ Target adjustments, boost functions, and profile switches that actually work ✓ Why pre-bolusing matters more during the luteal phase ✓ How to prevent the hypoglycemia tsunami when bleeding starts ✓ Why one bad day per month is not catastrophic Dr. Nobili's research is funded by a grant and represents the first multi-center study specifically examining menstrual cycle glucose patterns across insulin delivery modalities. This episode provides the structured guidance that should exist in every diabetes clinic — but doesn't. GUEST: Dr. Cecilia Nobili Pediatric Diabetology Resident, Turin, Italy Living with T1D  Multi-center researcher on menstrual cycles and glucose control Full show notes, practical checklists, and related episodes: https://theglucoseneverlies.com/menstrual-cycle-t1d/  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. Independent by design. The Glucose Never Lies® takes no sponsorship and no advertising. We run on education grants and listener donations. If this helped, buy the GNL a coffee (buymeacoffee.com/gnlfree). Follow: Website, Instagram, LinkedIn, John on LinkedIn, X Contact: collaboration, [email protected]; creatives, [email protected] For education only. Not medical advice and not a substitute for individual care; decisions about your care sit with you and your diabetes team. © The Glucose Never Lies Ltd, company number 16733595. All rights reserved.

Suggest guests or get in contact Professor Eleanor Scott, one of the UK's leading experts in pregnancy and diabetes, provides the evidence-based roadmap that cuts through the noise.  Full Show notes: https://theglucoseneverlies.com/pregnancy-t1d/ This episode covers the complete journey: pre-conception planning (why HbA1c 48 mmol/mol and 70% time in pregnancy range matters), the chaos of first trimester insulin sensitivity and hypos, the dramatic insulin resistance of trimesters two and three (where insulin needs can increase 3-5× baseline), and the instant drop in insulin requirements after delivery. Professor Scott explains why the pregnancy glucose target is tighter (3.5-7.8 mmol/L / 63-140 mg/dL) — babies are extremely sensitive to raised glucose, which increases risks of miscarriage, congenital malformations, preterm delivery, and large babies requiring neonatal intensive care. She also offers reassurance: if pregnancy is unplanned or glucose control isn't optimal at conception, early intervention still makes a substantial difference. Absolute risk of complications remains around 10% even with high HbA1c at conception — not inevitable. The technology discussion is critical: CGM is non-negotiable  But not all hybrid closed-loop systems are equal. CamAPS FX is the only system with robust RCT evidence (ADAPT trial) showing improved time in range, reduced gestational weight gain, smaller babies, and less maternal burden. It was developed specifically for pregnancy with adaptive algorithms and a personal glucose target as low as 4.4 mmol/L. The Medtronic 780G has a CE mark for pregnancy but didn't improve time in range in trials. Other systems aren't studied or indicated for pregnancy. Practical strategies include pre-bolusing 15-20 minutes, choosing mixed meals over high-GI foods, walking after eating, moderate carbohydrate intake (30-40%), and building routine to help algorithms (and your brain) adapt to rapid changes. For show notes, resources, and full transcript: https://theglucoseneverlies.com/pregnancy-t1d/ 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. Independent by design. The Glucose Never Lies® takes no sponsorship and no advertising. We run on education grants and listener donations. If this helped, buy the GNL a coffee (buymeacoffee.com/gnlfree). Follow: Website, Instagram, LinkedIn, John on LinkedIn, X Contact: collaboration, [email protected]; creatives, [email protected] For education only. Not medical advice and not a substitute for individual care; decisions about your care sit with you and your diabetes team. © The Glucose Never Lies Ltd, company number 16733595. All rights reserved.

Suggest guests or get in contact In this episode of Glucose Never Lies, John Pemberton welcomes Dr. Inge Van Boxelaer, endocrinologist and founder of Diabetotech, an independent education platform for diabetes technology. Together, they explore the critical role of education in maximizing the benefits of devices like continuous glucose monitors (CGMs), insulin pumps, and automated insulin delivery (AID) systems. Dr. Van Boxelaer shares her journey from clinical practice to creating Diabetotech, highlighting how access to technology isn’t enough—patients and healthcare professionals need structured, unbiased, and up-to-date training. The conversation covers how Diabetotech delivers short, modular courses, device comparisons, and CPD-accredited content, helping clinicians, educators, and people living with diabetes gain confidence and improve outcomes. Full Show notes: https://theglucoseneverlies.com/30-diabetotech-education/ Key topics include: Overcoming educational barriers to adopting new diabetes technologiesThe evolution of AID systems and CGMs, and their impact on daily managementHow flipped learning and modular education can save clinician time while improving patient competencyIndependent, consistent, and regularly updated resources for clinicians, patients, and care teamsWhether you’re a healthcare professional, a person living with diabetes, or part of a care team, this episode highlights why understanding the technology is as important as having it. Dr. Van Boxelaer also shares her vision for the future of diabetes education and how accessible learning can support better outcomes and fewer complications. Explore Diabetotech and its resources at https://www.diabetotech.com/ 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. Independent by design. The Glucose Never Lies® takes no sponsorship and no advertising. We run on education grants and listener donations. If this helped, buy the GNL a coffee (buymeacoffee.com/gnlfree). Follow: Website, Instagram, LinkedIn, John on LinkedIn, X Contact: collaboration, [email protected]; creatives, [email protected] For education only. Not medical advice and not a substitute for individual care; decisions about your care sit with you and your diabetes team. © The Glucose Never Lies Ltd, company number 16733595. All rights reserved.