The Glucose Never Lies®
The Glucose Never Lies® Podcast is brought to you by John Pemberton, together with Chad, his innovation partner who helps turn ideas into production. Behind the scenes, the creative team brings research, stories, and lived experiences of type 1 diabetes into an accessible format — combining science, storytelling, and strategy to help people live better with diabetes.
About Me
I’m John Pemberton — dad, husband, diabetes dietitian, researcher, and someone who’s lived with type 1 diabetes since 2008.
This podcast is my way of giving back. When my son Jude tested positive for type 1 diabetes antibodies, everything changed. I knew I had to act quickly and create a resource that was both comprehensive and easy to understand, so that anyone who might one day help manage his diabetes would feel supported. That’s how The Glucose Never Lies started — as an education platform to support my son’s future care.
Fortunately, his confirmatory test came back negative — but this doesn’t rule him, or my daughter, out. And since I was diagnosed at 27, I know just how real that risk can be.
The last two years have been the hardest of my life — battling depression, a functional motor disorder, and finally receiving an ADHD diagnosis. My journey back to health was made possible by the incredible support of my family, friends, and the wider diabetes community.
That experience taught me the power of giving. Written guides don’t work for everyone, but podcasts bring information to life in a real and relatable way. So that’s why I started this podcast — to make diabetes management engaging, practical, and fun.
I’ve been fortunate to work alongside some of the world’s leading researchers and thought leaders in type 1 diabetes, and I bring them onto the show to share their research, their stories, and their innovations.
You’ll also hear from people living with type 1 diabetes who are doing amazing things, and from advocates and clinicians shaping the future of diabetes care.
Here you’ll find guides, reflections, and conversations on everything from partying with T1D, continuous glucose monitoring and automated insulin delivery, to nutrition, exercise, insulin resistance, and childhood diabetes care.
Just to be clear — this podcast is for educational and informational purposes only. It’s not medical advice. Always consult your healthcare team before making any changes to your management.
I’m glad you’re here. Let’s get started.
The Glucose Never Lies®
14: Overcoming Insulin Resistance in Type 1 Diabetes
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):
- Liver insulin resistance
- Muscle insulin resistance
- Beta-cell dysfunction
- Hyperglucagonemia
- Brain insulin resistance
- Gut hormone dysfunction
- Fat cell dysfunction
- 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
