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Foundations — Part 8

Fast and Slow Movers

Between meals, glucose can be nudged up or down by different tools and factors. Some act in minutes. Others take hours. Understanding the difference is the conceptual foundation for Dynamic Glucose Management.

Watch or read

There is a video that covers this material — or read on below:

Why this concept matters

Between meals, glucose can be nudged up or down by different tools. Some act fast — in minutes. Others are frustratingly slow — taking hours to have a meaningful effect.

Prioritising the fast movers between meals tends to produce better time in range, fewer glucose rollercoasters, and far less mental load. This is the overarching concept behind Dynamic Glucose Management.

When slow, blunt tools are replaced with fast, more precise ones, time in range (4.0–10.0 mmol/L or 70–180 mg/dL) can improve substantially. Moving away from slow movers also changes the experience of managing between-meal glucose — no more giving a correction and watching nothing happen for an hour, or treating a hypo and waiting for the rebound.

Learning why fast movers tend to outperform slow movers between meals is central to managing type 1 diabetes well.

Why isn’t this taught more clearly?

  • The benefits have only become clearly visible with widespread CGM use and real-world pattern data.
  • There is still an assumption that people won’t use short bursts of activity to adjust glucose between meals.
  • Structured education is often delivered by people who haven’t lived the frustration of a correction that moves nothing, or a hypo that won’t resolve.
  • This concept is not yet embedded in consensus or national guidelines — and guidelines tend to lag behind real-world experience.
  • Paradigm shifts need someone with skin in the game to demonstrate them first. Every major advance looks unusual until it becomes standard.

The summary graphics

These diagrams bring together what the Foundations guide has covered so far.

Fast and slow movers that reduce glucose between meals

Summary chart showing fast movers (such as short bursts of activity and fast-acting glucose snacks) versus slow movers (such as correction insulin and basal adjustments) for reducing glucose between meals.

Fast and slow factors that raise glucose between meals

Summary chart showing fast-acting factors (such as glucose tablets and fast carbohydrates) versus slow-acting factors (such as food still digesting and basal increases) that raise glucose between meals.

Putting them together

Combined diagram showing all fast and slow movers on a single chart — both those that raise and lower glucose between meals — and how they interact.

Understanding these diagrams thoroughly provides the mental model for Dynamic Glucose Management. They are worth returning to often.

This content is for educational exploration only. It describes average responses and general principles. It is not medical advice and cannot replace individual clinical guidance from your diabetes care team.

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