Dear Dani Grace and Jude,
Note: This page is advice for Grace, Jude and John. For any other reader, it’s information only. No therapeutic relationship is formed – read this.
Grace and Jude, I was basking in the glory of finishing The Glucose Never Lies, when mummy said:
“Surely there needs to be a resources section where I can find all the guides?”
As usual, mummy is right.
Check out the YouTube Channel with all the videos
Here are the key resources, section by section:
- Dynamic Glucose Management Playlist – YouTube Channel
- Dynamic Glucose Management Infographic PDF
- Dynamic Glucose Management – original research article
- Mealtime Insulin Guide Playlist – YouTube Channel
- Mealtime Insulin Guide Infographic
- The ultimate guide to mealtime insulin dosing for type 1 diabetes
You will need Adobe to be able to use them, which you can get for a Computer, Android device or Apple device.
- Dexcom G6 – Exercise Carbohydrate Calculator
- Libre 1 & 2 – Exercise Carbohydrate Calculator
- Medtronic – Exercise Carbohydrate Calculator
- Dexcom G6 with pump – Exercise Carbohydrate Calculator
For more advanced exercise information.
Making exercise plans:
- Download these slides
- Watch the first video that explains the slide set
- Watch the second video that completes the slides
Type 1 Diabetes Exercise Calculators
- Download these slides
- Watch the video that explains the slide set
- Take the competency to get hold of the calculators
Automated Insulin Delivery (AID) System
Here are all the resources with the associated evidence-based base.
| Resources | Description |
| Step-by-step teaching guides | The educational content was developed using methods outlined in the ATTD consensus on AID technologies (1) and the UK Diabetes Technology Network’s Best Practice Guidelines (2). These resources cover a range of topics including AID expectations, hypoglycaemia and hyperglycaemia management, infusion site care, nutrition advice, CGM management, and analysis of downloaded data. Exercise management advice was based on the ISPAD 2022 Exercise guidelines (3) and a detailed practical guide (4). The materials also encompass GAME-SET-MATCH strategies for optimising TIR (5–7) and a Mealtime Insulin Guide for T1D. To cater to different learning styles, we included manufacturers’ PowerPoint presentations, YouTube videos, and various explanatory tools. Additionally, we produced brief educational videos (5-10 minutes) to ensure clarity and consistency in messaging, which are accessible on www.screencast-o-matic.com at an annual cost of approximately £100. Each AID System (780G, CAMS, CIQ, and OP5) received a custom teaching guide, reviewed by the respective manufacturer’s education team. The Diabetes Team and CYP participating in the education sessions continually evaluated and enhanced these materials over a six-month period. Download links: 780G OP5 CIQ CAMS (Under construction) |
| Survive and Thrive guides | A crucial tool for CYP was the customised “Survive and Thrive” PDF guide, individually created for each AID system through JavaScript coding and Adobe Acrobat DC (annual cost of ~£180). This interactive guide generates a personalised hypoglycaemia treatment plan (5,6) and calculates carbohydrate needs for exercise based on the user’s name and weight, using ISPAD’s algorithms (3). It includes QR codes that link to essential short videos (5-10 minutes) covering key management techniques. The “Survive” section of the guide focuses on managing hypoglycaemia and hyperglycaemia, obtaining accurate CGM readings, infusion site management, and essential kit items to carry. The “Thrive” section details crucial nutritional and exercise management strategies, incorporating GAME-SET-MATCH approaches for optimising TIR (5,6) and a Mealtime Insulin Guide for Type 1 Diabetes (T1D). Each AID system, including 780G, CAMS, CIQ, and OP5, has a dedicated version of this guide, which has been reviewed by the education team of each system’s manufacturer. The Diabetes Team, along with the CYP participating in the education sessions, continuously reviewed and improved these materials over a period of six months. Download links: 780G OP5 CIQ CAMS |
| Interactive School Careplans | Similar to the “Survive and Thrive” guide, we transformed AID school care plans into interactive PDFs with embedded videos, requiring an 80% competency score for completion, thus reducing the need for direct teaching by healthcare professionals (8). Download links: 780G OP5 CIQ CAMS with Dana CAMS with Ypso |
| AID starting settings calculator | We adapted the Automated Insulin Delivery (AID) starting dose calculator originally created by the University College of London’s Diabetes Team. This calculator is grounded in the insulin setting guidelines proposed by the ISPAD 2022 guidelines (9) and incorporates research on paediatric bolus calculator settings (10). Our enhancements to the calculator were informed by the ATTD consensus recommendations, allowing it to produce tailored initial settings for various AID systems that support smooth onboarding. Download links: AID Starting Settings Calculator Algorithms behind the calculator |
| AID download assessment tool | This starting settings calculator led to the development of a download assessment clinical tool. We integrated the calculator’s algorithms with our understanding of factors influencing automated mode and manual mode adjustments in AID systems (1). This tool provides users with insights into which settings affect each mode of the AID system. It also offers tailored suggestions for optimising glucose control. These suggestions are based on several factors: current TIR, total daily insulin dose, desired percentage of basal insulin, and the specific AID system in use. The tool thus serves as an efficient guide for clinicians in supporting CYP make effective adjustments to their AID systems. Download links: Download Assessment PDF tool |
| Google Forms | We developed Google Forms for AID system selection and pre-initiation education, incorporating teaching guide materials, current insulin settings, setup guides, links to AID simulator applications, and an automated quiz with an 80% pass requirement for progression to onboarding. The forms also facilitated efficient organisation of onboarding sessions. Download links: AID System Selection Google Form Prototype, 780G Pre-AID Education Google Form Prototype OP5 Pre-AID Education Google Form Prototype CIQ Pre-AID Education Google Form Prototype CamAPS FX (under construction) |
Exercise calculators (mmol/L)
- Exercise calculator – Medtronic 670G & 780G – mmol/L
- Exercise calculator – T-Slimx2 with Control-IQ – mmol/L
- Exercise calculator – CamAPS FX – mmol/L
Exercise calculators (mg/dL)
- Exercise calculator – Medtronic 670G & 780G – mg/dL
- Exercise calculator – T-Slimx2 with Control-IQ – mg/dL
- Exercise calculator – CamAPS FX – mg/dL
Hypo prevention and treatment charts for AIDS
- Hypo calculator – Medtronic 670G & 780G
- Hypo calculator – T-Slimx2 with Control-IQ
- Hypo calculator – CamAPS FX
Other AIDS resources:
- Download these slides
- Watch the video that explains the slide set
- If you want a deep dive look at my EXTOD and APS slides – Be warned this goes deep!
- Take the competency to get hold of the calculators
That’s it!
The site is now complete.
Grace and Jude, I hope you have not needed to read the blog.
However, if you have, I am confident you will have the skills to live a life where type 1 diabetes does not hold you back.
In fact, if you follow The Glucose Never Lies guides, you will be thriving not merely surviving!
I hope you realise I love you and that,
I put my soul into The Glucose Never Lies
If you want to know when a new section of blog is added, click here.
References
1. Phillip M, Nimri R, Bergenstal RM, Barnard-Kelly K, Danne T, Hovorka R, et al. Consensus Recommendations for the Use of Automated Insulin Delivery (AID) Technologies in Clinical Practice. Endocr Rev. 2023 Sep 6;44(2):254–80.
2. Griffin TP, Gallen G, Hartnell S, Crabtree T, Holloway M, Gibb FW, et al. UK’s Association of British Clinical Diabetologist’s Diabetes Technology Network (ABCD-DTN): Best practice guide for hybrid closed-loop therapy. Diabet Med. 2023 Jul 1;40(7):e15078.
3. Adolfsson P, Taplin CE, Zaharieva DP, Pemberton J, Davis EA, Riddell MC, et al. ISPAD Clinical Practice Consensus Guidelines 2022: Exercise in children and adolescents with diabetes. Pediatr Diabetes. 2022 Dec 1;23(8):1341–72.
4. Zaharieva DP, Morrison D, Paldus B, Lal RA, Buckingham BA, O’Neal DN. Practical Aspects and Exercise Safety Benefits of Automated Insulin Delivery Systems in Type 1 Diabetes. Diabetes Spectr. 2023 Mar 1;36(2):127–36.
5. Pemberton JS, Kershaw M, Dias R, Idkowiak J, Mohamed Z, Saraff V, et al. DYNAMIC: Dynamic glucose management strategies delivered through a structured education program improves time in range in a socioeconomically deprived cohort of children and young people with type 1 diabetes with a history of hypoglycemia. Pediatr Diabetes. 2021 Nov 17;22(2):249–60.
6. Pemberton JS, Barrett TG, Dias RP, Kershaw M, Krone R, Uday S. An effective and cost-saving structured education program teaching dynamic glucose management strategies to a socio-economically deprived cohort with type 1 diabetes in a VIRTUAL setting. Pediatr Diabetes. 2022 Jun 11;23(7):1045–56.
7. Pemberton JS, Gupta A, Lau GM, Dickinson I, Iyer PV, Uday S. Integrating Physical Activity Strategies to Lower Hyperglycaemia in Structured Education Programmes for Children and Young People with Type 1 Diabetes Improves Glycaemic Control without Augmenting the Risk of Hypoglycaemia. Smart CE, editor. Pediatr Diabetes. 2023 Jul 5;2023:1–8.
8. Pemberton JS, Collins L, Sands D. Oral Abstract 67: Virtual schools training package teaches 37% more staff and reduces the cost by 83% compared to face-to-face training during the COVID-19 pandemic. Pediatr Diabetes. 2022 Oct 1;23:3–43.
9. Sherr JL, Schoelwer M, Dos Santos TJ, Reddy L, Biester T, Galderisi A, et al. ISPAD Clinical Practice Consensus Guidelines 2022: Diabetes technologies: Insulin delivery. Pediatr Diabetes. 2022 Dec 1;23(8):1406–31.
10. Hanas R, Adolfsson P. Bolus Calculator Settings in Well-Controlled Prepubertal Children Using Insulin Pumps Are Characterized by Low Insulin to Carbohydrate Ratios and Short Duration of Insulin Action Time. J Diabetes Sci Technol. 2017 Mar 1;11(2):247.
