The Glucose Never Lies® Podcast

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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 evolved
Why CE marking is not a quality standard for CGM accuracy
How the five-point accuracy scoring system works and what it requires from a device
Why only four devices currently meet the data sufficiency standard
What 20/20 and 40/40 agreement rates mean in real clinical terms
Why everyone using CGM for insulin decisions still needs a working finger-prick meter
The calibration debate: does the option to calibrate add safety or risk?
What ATTD 2025 revealed about fully closed loop systems — and who may not benefit
The case for GLP-1 in type 1 diabetes and why priority access matters
Abbott's continuous ketone monitor: opportunity, unknowns, and risks
AID system optimisation, insulin on board, and the GNL AID System Explorer
Chapters:
00:00 — Introduction: meeting Amanda, Beth and Tamsin
02:14 — Why the DSN Forum CGM comparison chart was created
06:47 — Turning complex CGM evidence into a practical scoring system
16:23 — How CGM choice works in real clinical settings
20:36 — Why finger-prick testing still matters — and the calibration debate
29:26 — What stood out at ATTD 2025
44:03 — AID systems, insulin on board, and the GNL AID optimiser
49:49 — Where to find the DSN Forum, the chart, and closing thoughts
Guests: 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.diabetesspecialistnu
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/jspfree2
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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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 isolation
The five study design questions that determine what accuracy data actually means
Why 20/20 and 40/40 agreement rates reveal what MARD cannot
Why meal and insulin challenges are essential for real-world accuracy testing
What CE marking does and does not guarantee about CGM performance
Why peer-reviewed, independent evidence is the gold standard — and how little of what is cited meets it
How study design quality shapes what we actually know about CGM risk
Professor Moser's perspective as a researcher who designs and runs these studies
Guest: 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/zTdTps42kQ8
Educational purposes only. Not medical advice. Always work with your diabetes care team.
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/jspfree2
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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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
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/jspfree2
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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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

GUE
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/jspfree2
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 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/ 

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/jspfree2
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.