Continuous Glucose Monitor

#22

I am suggesting for behavioral changes people can benefit greatly from near real-time feedback even if it is not perfectly accurate. Even though HBA1c is much more accurate (I agree), the changes take too long to provide motivation for daily changes.

A couple of friends and I are all testing CGM including with some fasting and I would argue at least with N=3 that other than food and exercise we don’t see any important spikes and only food casuses a noticiable positive spike, so while some people might have more extreme stuff going on in their lives that cause spikes from that list of 22 me and my friends are not seeing that during a fasted state.

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Above is typical pattern for me (us) meaning no positive spikes other than food. Hard exercise in a fasted state drops my glucose noticably even to hpoglycemic levels. All those little spikes are not enough to noticably affect a large food level spike. Sure pasta might go from 150 to 155 or maybe 160, and yes rice might be 155 so someone thinks rice is better. But stopping eating pasta instead of rice at this time is not the end of the world for glucose manament. They will probably stop rice too pretty soon. Or if you read the glucose revolution book, you will just eat broccoli before your pasta and most likely solve your spike problems.

Again this type of information is not well documented so I can only use me and my friends as example that in a fasted state glucose is very flat slowly rising and falling. The dawn effect works on all of us. Cortisol kicks in or whatever and it slowly rises in the morning, again still not a meaningful spike. So unless I see more scientific studies showing large spikes from non-food related items, and especially occuring regularly, I would seem not so important for most people, but since I only have N=3 I could be wrong. I don’t trust the medical community on lots of this kind of stuff but do trust studies even though they maybe skewed as well.

I have seen one study that correlates strongly of BMI to fasting glucose levels. It was something like BMI 27 related to 93mg/Dl. But other studies while not directly focus on this say their is a strong correlation between BMI and fasting glucose. These are not the best studies but I can find some and provide them if you want. We also know that 90+% of T2 diabetics are overweight and usually very over weight, so weight and glucose levels are connected. Is BMI 25 reason to be concerned about glucose, directly maybe not, it’s not likely a problem yet but could be. I would say in this case fasting glucose levels might not be such a problem but what if 20 hours a day they are > 110, then fat burning might still be more challenging a CGM would point this out.

Now you bring up a good point, that I am pretty scientific and for a person that does not think so much about it a CGM might give less value and in some cases they might come to the wrong conculsions. My belief is that in almost all cases those wrong concusions would not out weigh the potential benefits but I have a very limited perspective. My experience with N=3 that food is closely aligned with glucose levels.

Secondly I also agree on supersapiens. It’s slighly possible it could add value but it also scares me to give advice with very limited information (although Coaches have to do this as well) But I would have to try it before I completely discredit it. Coach Andrea tried it for 2-weeks and did not see much value. Since science has not been able to clearly increase performance with a CGM yet, it’s a bit of wishful thinking.

#23

This is an viedo on T1 and T2 diabetics. I am not suggesting my advice for T1 (especially) or T2.

I also would say there are many things I don’t trust the medical community and as a first line of defence offering insulin to a T2 diabetic is very poor advice in my opinion. Or statins for raised cholesterol. Big pharma controls the medical community, many doctors say they are like the mafia, so you have to be very careful evaluating their suggestings. Steve Jobs was a very smart guy and I believe if he did listen to doctors he might be alive (might not) so I am not saying doctors are always wrong, but there is so much bad info especially when it comes to long term drug use that you have to be careful. Most doctors give terrible diet advice. Don’t eat eggs to lower your cholesterol. There is no proof any where that links dietary cholesterol to your LDL, and even using LDL as an argument has recently been proven totally wrong. Sorry a tangent. I would just use science not doctors / hospitals when it comes to food… :slight_smile:

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#25

I don’t see your TR post but no, for sure I agree people should not be using a CGM to determine if they are a diabetic. I agree 100% with that. If they use a CGM and think they might be, then they should go to a doctor :slight_smile: unless they have a plan to fix it quickly.

No, when I have not eaten for 18+ hours and start digging in my yard (I am building a pump track) after an hour or so my glucose sees a large drop every time. Sorry I pointed the arrow at the wrong place, it should have been the drop and that drop would have kept going down and I am breathing hard so closer to Z5 digging :slight_smile: I guess exercise can raise it as well I have seen Z2/Z3 raise it a little but still it’s not a spike its been gradual but yes to your point pasta could look higher than rice. Actually I have only tested a few times but my protien pasta seems to be higher than lots of sushi for me :slight_smile:

#26

While I understand your skepticism towards the medical community, especially in regards to their capture by the pharmaceutical industry, I think there is value there. There will be primary care doctors that keep up with research and care about their patients’ outcomes and there will be lazy doctors who don’t care. I think it’s easy for us non medical professionals to criticize practitioners who have to deal with humans day in and day out. Try explaining something complex to my mother and having her actually correct her behaviour. Good luck :joy:

Do I think natural interventions are more powerful than insulin and statins for most people? Sure, but drugs are useful tools, especially in acute situations. And how many people will actually enact and adhere to sustainably losing weight, having a good diet, and exercising? Given existing data, I don’t think it’s very encouraging. Human problems are difficult to solve, especially at scale.

Personally, I think Steve Jobs was a capable psychopath who thought he was always right. (The stories from his daughter’s book are shocking). When it came to medical interventions he was almost definitely wrong. I believe there was a fairly high success rate for his particular kind of cancer.

In regards to eggs and LDL, Derek of more plates more dates was saying how his own dietary experiments showed that he had a LDL sensitivity to eggs. He had high LDL while eating multiple eggs a day and after cutting them out, his LDL came down to normal while still eating red meat. Of course, this is not definitive but it speaks of genetic differences in sensitivities which of course makes broad recommendations even harder to make. And of course, LDL is just a single blood marker, not the end all and be all of anything.

#27

Regarding medical professionals I am 100% in agreement. I did not say that right meaning I do have a lot of skepticism for the system but a lot of respect and feel grateful to medical professionals themselves. It’s not their fault at all that big pharma and big food put heaving funding into misleading information, including health care professional advertising.

Also from what I have heard about doctors they got an extremely small amount of education on diet and have very little to zero continuing education on diet related matters. I would guess big pharma helps fund education since they are big contributors to American Heart Association and the rest… Combine that with being over worked and it makes it hard for most of them to devote lots of time to this. I am sure it happens but from what I have read and experience it is the exception rather than the rule.

I also agree you are right regarding doctors might feel they are doing the right thing by prescribing statins thinking that people won’t loose weight so this is the best solution. Doctors are very good at prescribing drugs and doing surgeries. If this is the best option then it’s fine. People go to doctors for advice and that advice tends to focus on drugs over diet and doctors are not in the position to guide people with regards to diet yet generally people blindly trust them. Again not exactly their fault but they are contributing to the problem.

I belive modern science has moved into supporting the idea that LDL is not the problem and that small dense LDL is the problem. I realize this is new information and needs to establish itself before the medical community can adopt it. Secondly even the major publications that doctors read are saying Statins don’t provide benefits in otherwise healthy people yet they are still prescribed for most healthy people that have raised LDL/cholesterol.

https://www.bmj.com/company/newsroom/for-most-healthy-people-benefits-of-statins-may-be-marginal-at-best/

My wife is very healthy, skinny, eats well, exercises a lot but has raised LDL (maybe good LDL, not sure yet, waiting to do specialized testing) and went to 4-doctors including a top heart expert and one said big pharma was the mafia but they all said they had to recommend statins.

I will have to read his daughers book.

Again with Dereks test, if he did not differenentate large fluffy LDL to small dense LDL that test might not be overly relelvant. Also I would say it is an outlier.

So examine.com is one of the leading sources of non-biased information. They take as many studies as they can find and only recommend stuff if there is a high level of consenses. They are highly regarded in the professional sports world. They are paid by customers and will not take money from sponsors to keep them honest.

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So to your point, yes it depends :slight_smile: But there is a general agreement that eggs are typically not a problem and should not be looked at negatively. Bad diets should be the focus.

#28

Here is a study of n=93 that showed clearly that 2 groups eating 1400 calories a day all with similar BMI, in the group eating a big breakfast lost more weight and had much lower glucose than the group eating large dinners, highlighting that reduced glucose seemed to support a larger loss than CICO by itself. Saying it’s all glucose/insulin is likely wrong but saying it’s only CICO would also be wrong at least in this study. Sorry just trying to get people to give a glucose focus a chance. Especially the BMI 25+ crowd. Not so sure of the relevance to the skinny cyclist trying to loose a few but still might be worth testing.

https://onlinelibrary.wiley.com/doi/10.1002/oby.20460

#29

A bit kludgy but someone bridged their CGM with their Apple Watch. Hopefully it’s even more streamlined in the future

#30

Yeah for Type 1 notifications are important but for driving behavior I don’t see any reason. I don’t have notifications on my phone so I don’t want an iWatch :slight_smile:

Here is more science supporting CIM / hormone model, even if the end result is reducing hunger (reducing calories)

#31

Greg Nuckols had comments on the paper starting at the 1:00:54 mark

It seems like he’s saying the paper is consistent with the standard energy balance model but seems to argue against it.

#32

As you and I have talked directly at length, my point is not trying to say calorie in vs calorie out is wrong, (that seems to be the debate everyone is taking) CIM vs CICO. That defeats the point from my perspective. My point is a focus on insulin can help a lot of people achive their weight goals with no pain :slight_smile: That might be from reduced carbs and that might be from meal timing or a combination of both.

My average daily glucose from 108 down to 92 in 8 weeks. This is significant, which has a direct relationship to reducing my insulin signficantly and I am not hungry eat what I want and hit my weight goals with no problem.

I am eating one meal giant meal a day of whatever I want now and switching to 2 soon, and other people that might be 2 or 3 meals a day but over 5-8 hour window. Or you could reduce carbs partially (follow the 10 hacks in my article) and have a longer window. This is where a CGM can help guide what you need to do with instant feedback, or you can just give it time.

You do need to be pretty motivated to learn to understand how to use the CGM to control reduce your average daily glucose/insulin.

#33

My only concern with these statements, is for the average person to interpreter the information correctly, and that the reduction is blood sugar level is related to change in diet and not related to other things that affect blood sugar levels such, such as vitamin B12, Stress, Weather, illness, sunburn or other minor injuries, hydration levels, ANY medication being taken, or change in physical activity which causes changes to insulin sensitivity, and of course, as insulin itself lowers blood sugar, the changes are pre-insulin release not post, and it’s a change of GI which is causing a more even conversion of blood sugar level, with the same amount of insulin used / body fat storage

Like I say, just concerned that people will have all the above covered before

[quote=“Alex, post:32, topic:1590”] to reducing my insulin
[/quote]

When like we know, reduced blood sugar level does not necessarily (if ever) indicate that less insulin was produced or used, when just like HRV (which I would consider a far simpler subject) we don’t have all the bases covered yet

#34

@Alex

I’m no medical professional but I think the reduction in average blood glucose is a good thing given that 108 was in the high range. If nothing else, the CGM read out seems to have allowed you to see that your blood glucose was a little high and ensure that your diet adjustments aren’t pushing you out of range.

It’s correct we’re not sensing blood insulin here but the endpoint change blood glucose does seem positive?

#35

Chris, obviously in type 1 there I does not need to be a correlation between glucose and insulin but in type 2 every study and thing I have read is there is a direct inverse relationship. Here is a supporting study as an example

I also believe while there can be other affecting factors “90%” of bigger trends like this will be related to diet and exercise. So far all the major CGM focused users and groups are seeing this that I am reading about.

I am seeing your point though that a CGM for the average less involved person might be too much info and confuse them.

I doible checked and I made a mistake I went from 104 to 92 not 108.

#36

Sorry actually 104 but yes, I am 100% sure this drop is associated with reduced chronic inflammation and weight loss so I can be pretty sure this is positive and will have long term health benefits.

#37

I also fully agree there are so many unique situations that my (and others) glucose generalizations run the risk of being wrong with specific individuals.

I don’t see any health risks as the four primary mix and match solutions are meal timing, food combinations/order, exercise and reducing processed carbs.

I still believe a glucose/insulin approach gives such an incredibly flexible route towards long term weight loss when the power of CGM devices can be harnessed (even better would be an insulin device).

#38

I didn’t say there wasn’t a link, my concern about these devices such as the Supersapients is that people will only look at one variable, such as the the link between blood plasma and insulin secretion and not look at the other variables such as as heat, here is a study on the effect of seasonal heat changes and blood sugar levels

and here is one about the effects of insulin reduction caused by stress in none diabetics

And I’m sure that I could go on with the other 50+ factors that affect blood sugar / insulin secretion, anyway, that is all I wanted to say on the matter, enjoy and thanks for the response

I

#39

Good point on stress, meaning I see the dawn effect of cortisol on glucose now and I know stress generally can have large effects on body systems. Supersapiens could ask about stress to partially rule that out, they could also look at RHR/ HRV and factor that in. I am not saying they do, I am just saying it’s possible. I am not personally seeing any correlation between HRV and glucose, and have pretty big HRV (stress) swings lately with too much exercise and not enough sleep :slight_smile: but I am n=1

That article on heat is focused on blood so a CGM might not have the same effects but again it might.

So levels is probably a better one to reference since they are more average Joe focused. Again they can look at changes and ask questions and make suggestions like. Hey you ate last night at 11pm and it seemed to raise your glucose all night and you did not get much fat burning in. We suggest you try not eating after 8pm.

#40

I should clarify again for this audience that I fully agree that performance and glucose such as supersapiens does not make sense at this time since there is no strong scientific correlation. supersapiens is exploratory science for professionals.

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#41

Ah you and me both brother

I think I made the mistake of not reading every post in this thread, and then presuming that it was a Sports Science thread rather than a health tread , CGM’s are amazingly powerful devices, but by selling to athletes as a sports enhancement device,I feel supersapiens are causing more problems that they are fixing, T1/T2 get a lot of help (at least used to in the UK) in understanding the results from, and I’ve seen a lot of posts along the line of “my BS is above 7.0mmol … am I about to die / I’ve stopped eating carbohydrates” (extra drama added), because the user doesn’t understand what they are looking at, very similar to the “my heart rate is about 100, I’m going to A&E” posts, except BS is a lot more complex to comprehend than HR, and requires a lot more user understanding / time research

#42

Yes. So I am finding a second potential benefit for a CGM. Many cyclists do high carb during trainining. I have a friend that I gave one of my CGM’s for 14-days. and he has found that on his cycling days his mean 24-hour glucose is like 110mg/Dl and he has crazy spikes and drops and drinks a coke when he thinks he is going to bonk and sees spikes of 160-175. He is a reasonably skinny cyclist in the on-season but this “smells” like a less than optimum glucose situation. His fasting glucose is like 85, but his spikes seem odd. Maybe it is 100% find but my feeling is he might want to get a glucose test from a lab/doctor. Also in the off season he gains weight and has the feeling something is off regarding diet in general.