The Glucose Never Lies® Podcast

• 17 – GLP-1 in Type 1 Diabetes: beyond weight loss, towards metabolic therapy?

  Suggest guests or get in contactEpisode 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☕ Buy Me a Coffee💙 DonateGuest: Professor Viral Shah, MDProfessor of Medicine & Director of Diabetes Clinical Research, Center for Diabetes and Metabolic Diseases, IU School of MedicineAuthor of multiple clinical trials and consensus guidelines on GLP-1 and incretin therapies in type 1 diabetesIn 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 ResourcesOvercoming Insulin Resistance in T1DEight Causes of Insulin ResistanceSeven Ways to Combat Insulin ResistanceAutomated Insulin Delivery SeriesCGM SeriesGNL Podcast Episode 14 Overcoming Insulin Resistance

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

  Suggest guests or get in contactEpisode 16 — Diabetes & Driving: Why You Need to Be 5 to DriveShow summary PDF and full notes hereSupport The Glucose Never Lies® Podcast ☕ Buy Me a Coffee💙 DonateGuest: 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 OverviewDriving 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 Takeaways5 to drive: ≥5.0 mmol/L4.0–4.9 mmol/L: snack, then drive<4.0 mmol/L: treat → confirm >5.0 → wait 45 minutes once above 5Check every ≤2 hours — each check “expires” like a parking ticketGroup 1 drivers: CGM or finger-prick both acceptedGroup 2 drivers: finger-prick only (until law changes)Severe hypos: two daytime events in 12 months → you must self-declareResponsibility lies with the driver, not your clinicianResources and Further ReadingVisit The Glucose Never Lies — Episode 16 to access:DVLA INF294 — Insulin-treated diabetes and driving (official guidance)NHS England guidance on approved blood glucose metersDSN Forum CGM Accuracy Comparison ChartCGM Guides — The Glucose Never LiesAutomated Insulin Delivery Guides — The Glucose Never LiesListen or Watch - Click here to access your favourite provider, whether by video or audioDisclaimerIt does not replace official DVLA guidance (INF294). Rules may change. Always check the latest DVLA information before making decisions about driving.Prepared by John Pemberton Executed by the Legend that is: Professor Pratik Choudhary

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• 8a: 99 Problems (But Highs Ain’t One) — The 20 by 2 Rule

  Suggest guests or get in contactThis bonus Episode 8B is a family special — co-created with my daughter Grace. It takes the science of activity lowering glucose and flips it into something fun: a rap we call 99 Problems (But Highs Ain’t One).The key message? When you’re above 10 mmol/L (180 mg/dL), just 20 minutes of activity can drop glucose by 2 mmol/L (≈40 mg/dL). That’s the “20 by 2” (or 20 by 40) rule. But, Grace said 8 years olds don’t want to hear 20 by 2! They want to hear it in a fun way! So, she made up a rap, with the help of Chad! Here is the Chorus:If you’re having glucose problems, I feel bad for your son,I’ve got 99 problems but high glucose ain’t one — hit me.I know Dr Addala will be proud  If you enjoyed this, explore more:Episode 8 — Activity SnackingWant more on the science backing it up?CGM Accuracy & Insights SeriesInsulin Resistance SeriesFoundations — The Fundamentals of The Glucose Never Lies®Listen or Watch:The Glucose Never Lies Podcast → Buzzsprout | Spotify | Apple PodcastsYouTube ChannelFind out more at theglucoseneverlies.comFollow on socials: Twitter/X @GlucoseNLies | Instagram @theglucoseneverlies | LinkedIn John Pemberton

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• 15: C-Peptide - What type of type 1 diabetes do you have?

  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 T1DC-Peptide full article – click here  

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• 14: Overcoming Insulin Resistance in Type 1 Diabetes

  Suggest guests or get in contactIn 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 upThe 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 levelsInsulin resistance occurs in the liver, muscle, brain, kidneys, gut, and fat tissueMeasuring units per kilogram is a useful proxy for insulin sensitivityActivity is the most powerful modifiable factor for improving insulin sensitivityWeight loss, high-protein diets, and reduced saturated fat intake all help reduce resistanceGLP-1 and dual agonists (e.g., tirzepatide) show promise for T1D, but are not yet widely approvedSGLT2 inhibitors and pioglitazone offer targeted benefits but must be used with careA multifaceted approach is often needed to lower insulin needs and support healthChapters:00:00 - 02:10 | IntroductionJohn 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 T1DT1D 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 T1DDescribes 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 OctetIntroduces eight mechanisms of insulin resistance (based on Dr. Ralph DeFronzo’s work): Liver insulin resistanceMuscle insulin resistanceBeta-cell dysfunctionHyperglucagonemiaBrain insulin resistanceGut hormone dysfunctionFat cell dysfunctionKidney (renal) insulin resistance09:15 - 11:30 | Measuring Insulin ResistanceEuglycemic clamp = gold standard (not used in T1D).Use total daily insulin (TDI) per kilogram as a practical metric.Defines ranges:

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