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  #1   ^
Old Sun, Mar-17-19, 06:26
Kristine's Avatar
Kristine Kristine is offline
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Default What RDN/CDE Lily Nichols Learned From Wearing a CGM

I found this via Nina Teicholz's twitter:

CGM Experiment: What I Learned As A Non-Diabetic From Wearing A Continuous Glucose Monitor

TL;DR: It's pretty much what most of us would expect. You might not catch BG spikes with a finger stick glucometer.

Quote:
I was surprised after eating a big bowl of curry with chicken and vegetables and the tiniest serving of white rice (we’re talking ⅓ cup, friends), to see my blood sugar spike to the 130’s.

Even though the rice was leftover (therefore had been cooled for >12 hours, which converts a portion of the starch into “resistant starch”, which is praised as healthful for our microbiome and less-impactful on blood sugar levels), it clearly still spiked my blood sugar.

I repeated the same Thai food leftover meal the next day, just without the rice (so I’m sure there was still hidden sugar in the curry) and my highest peak was only 105. White rice and I are apparently not friends, even in portions that provide only 20 grams of carbs.

Sorry, everyone who’s #teamwhiterice. It doesn’t work for me.
Next, her "healthy" oatmeal experiment, and she specifies that "All things considered, this was NOT a large bowl of oatmeal and it was essentially NOT sweet, despite adding a little honey. (I say this to point out that the average person adds A LOT of extra sweeteners to their oatmeal, either with sugar/honey or dried fruit. My version would be unpalatable to many people.)"
Quote:
At first, I thought my blood sugar was doing ok after the oatmeal, but I then watched with horror on my Freestyle Libre as the readings climbed. When you scan the sensor, the Freestyle Libre reader shows an arrow next to the numerical reading with an up, down, level, or slightly up/down error, indicating your real time blood sugar trends. This was the ONLY time during the entire 10 days that I saw the straight up arrow, indicating my blood sugar was rising FAST.

My blood sugar went from 74 to a peak of 178 in an hour. By two hours, I was down to the 120s and by three hours, finally back down to 100.

What was interesting, though, is that I got ravenously hungry when my blood sugar started plummeting
.
Quote:
As you can recall, as long as blood sugar is back down to 140 mg/dl by two hours after eating, then you’re supposedly “in the clear” by conventional guidelines for diabetes/prediabetes. If a study has people measure their blood sugar only at 2 hours, you’re likely to miss the peak glycemic response in many people. Moreover, different people peak at different times, so without a million finger pricks or CGM, the results aren’t going to be very meaningful. (...) Imagine if you could go to the doctor, have a CGM sensor inserted on the spot, then return in 2 weeks to have your data analyzed and graphed using the criteria in this study. It would give us a much more nuanced look into your blood sugar regulation. It would also reveal what foods are great for your blood sugar and conversely, which ones are a glycemic disaster. This would be preventative medicine. Intervene before blood sugar levels are consistently in the diabetic range, before insulin resistance gets too severe, and before beta cell burnout.

Then again, this would be a royal pain for practitioners/insurance companies who like the black and white nature of single tests. I don’t think I’ll hold my breath waiting for this to become the standard of care.

Dr Gary Fettke's response, which gives me hope:
Quote:
Wearing a CGM is a game changer for everyone, with or without diabetes. When they become part of smart watches - game over for cereal and processed food industries.
Let's cross our fingers.
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  #2   ^
Old Sun, Mar-17-19, 10:22
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bevangel bevangel is offline
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Default

Fascinating read Kristina. Thank you for sharing. I'm heading up to Canada this summer to attend a music festival. Since apparently no prescription is needed for a GCM up there, I think I'll see if I can't find one to back with me.



I'd love to see a qualified researcher recruit a bunch of healthy people who already eat a variety of diets, outfit them all with GCMs to track their blood sugar, fitbits to track their activity-levels, and smart phones to take before-and-after pictures of all their meals and snacks and drinks. (Before and after pics so the researchers could more accurately gauge how much the subject actually ate.)



Given that so many Americans are already diabetic or pre-diabetic (based only on their HbA1C numbers), the researchers would probably have to recruit normal-weight college-age students to find enough allegedly healthy individuals.



But it could be a real eye-opener to see how various meals affect the BG of allegedly healthy people who are already used to eating those kinds of meals.



Seems like, at the very least, doctors would want to know what normal healthy BG numbers really look like and how normal healthy individual BG is affected by various foods. Clearly they don't yet have that info.


Maybe the manufactures of GCMs would be willing to fund such a study.
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  #3   ^
Old Sun, Mar-17-19, 11:14
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Meme#1 Meme#1 is offline
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Quote:

At first, I thought my blood sugar was doing ok after the oatmeal, but I then watched with horror on my Freestyle Libre as the readings climbed. When you scan the sensor, the Freestyle Libre reader shows an arrow next to the numerical reading with an up, down, level, or slightly up/down error, indicating your real time blood sugar trends. This was the ONLY time during the entire 10 days that I saw the straight up arrow, indicating my blood sugar was rising FAST.

My blood sugar went from 74 to a peak of 178 in an hour. By two hours, I was down to the 120s and by three hours, finally back down to 100.

What was interesting, though, is that I got ravenously hungry when my blood sugar started plummeting.
Quote:
As you can recall, as long as blood sugar is back down to 140 mg/dl by two hours after eating, then you’re supposedly “in the clear” by conventional guidelines for diabetes/prediabetes. If a study has people measure their blood sugar only at 2 hours, you’re likely to miss the peak glycemic response in many people. Moreover, different people peak at different times, so without a million finger pricks or CGM, the results aren’t going to be very meaningful. (...) Imagine if you could go to the doctor, have a CGM sensor inserted on the spot, then return in 2 weeks to have your data analyzed and graphed using the criteria in this study. It would give us a much more nuanced look into your blood sugar regulation. It would also reveal what foods are great for your blood sugar and conversely, which ones are a glycemic disaster. This would be preventative medicine. Intervene before blood sugar levels are consistently in the diabetic range, before insulin resistance gets too severe, and before beta cell burnout.


I had this happen a while back and wondered if it was normal. (I pricked and pricked and pricked to really see what was going on)
So is Nina diabetic or pre-diabetic, does anyone know?
Rising up to 170s, is that normal? Even though it drops back down to the normal range?
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  #4   ^
Old Sun, Mar-17-19, 11:16
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WereBear WereBear is online now
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Wow, what a find. And if it said bad things about Keto, it would be ALL over the place.
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  #5   ^
Old Sun, Mar-17-19, 11:22
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WereBear WereBear is online now
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Quote:
Originally Posted by Meme#1
I had this happen a while back and wondered if it was normal. (I pricked and pricked and pricked to really see what was going on)
So is Nina diabetic or pre-diabetic, does anyone know?
Rising up to 170s, is that normal? Even though it drops back down to the normal range?


She is a diabetes counselor with diet-managed cases of gestational diabetes and a family history.

Last edited by WereBear : Sun, Mar-17-19 at 11:36.
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  #6   ^
Old Sun, Mar-17-19, 11:34
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Meme#1 Meme#1 is offline
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Quote:
Originally Posted by WereBear
She had gestational diabetes.


Ohhhh so if I ate some dessert at a b-day party and that happened but not with rice, anybody know what that means?
Maybe that's just normal until the insulin shoots out to lower the BS?
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  #7   ^
Old Sun, Mar-17-19, 12:39
Kristine's Avatar
Kristine Kristine is offline
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Plan: Primal/P:E
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Quote:
Originally Posted by Meme#1
I had this happen a while back and wondered if it was normal. (I pricked and pricked and pricked to really see what was going on)
So is Nina diabetic or pre-diabetic, does anyone know?
Rising up to 170s, is that normal? Even though it drops back down to the normal range?

IMO, it’s normal, but still bad - like how it’s normal to have a nasty allergic reaction after you touch poison ivy or pass out after drinking a ton of alcohol. I think that’s what she was getting at - the diagnostic process doesn’t account for all of the potential damage being done to folks who are technically/diagnostically “normal”/non-diabetic.

Just to clarify, this isn’t Nina - it’s Lily Nichols, an RD and diabetes educator who specializes in gestational diabetes. She’s a LCer and quite slim - sounds like the exact person who “should” be able to tolerate some rice and oatmeal here and there. Pretty eye-opening.
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  #8   ^
Old Sun, Mar-17-19, 12:55
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cotonpal cotonpal is offline
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Quote:
Originally Posted by Kristine
IMO, it’s normal, but still bad -


Normal for a population that is eating a diet high in carbs and modern processed foods is not going to be the same as healthy or optimal. Normal would look a lot different if it was based on a population of people eating low carb.
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