Ok, this could actually change things (study where they gave CGMs to medical and dental students)

(Bob M) #1

Hat tip to Mark’s Daily Apple. Here’s a study where they gave CGMs to medical and dental students:

Metabolic health immersion study

Some of the results:

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This is a way to really change how medical doctors, dental students, and the like (say, nurses, not part of this group but another possible important set of students).

Imagine if every doctor, dentist, and nurse would do this as say a 1 or 2 credit class. There would be an almost immediate change in what they are recommending. (Of course, there will always be those who are so insulin sensitive that carbs don’t matter, but the vast majority are not going to be like that.)

Once you use a CGM for any length of time, you cannot “unsee” what you saw. You have that bowl of morning oatmeal and realize what that does to your blood sugar (hopefully seeing what it does to your appetite, too), and that’s something that is hard to explain away.

Something like this could cause a rapid change.

I’d love to be able to do this in a class of high school students.

Edit: I see one of the main authors was Nick Norwitz, who is a medical student and eats a low carb Med diet (he’s also an LMHR who discusses things with Dave Feldman).

#2

Maybe this should be mandatory for “nutritionists” as well. They often seem pretty clueless

(Robin) #3

Very cool. I have never used a CGM. I am able to pick up signals and eliminate culprits as needed. Or when something fluctuates unexpectedly. But seeing the numbers would probably make a big difference for many.

(Bob M) #4

You might THINK you can do that, but I doubt you can. For instance, I had soup from an Asian restaurant. I ordered it because it only had shrimp and vegetables, no rice, noodles, etc. Was shocked to see an explosion in blood sugar, which I did not feel at all. (Probably caused by a thickener, such as corn starch.)

Certain things like ice cream, I can tell that is too much of a shock to my system. But none of my Thanksgiving or Christmas meals, which cause my blood sugar to go way up, cause me to have any issues. I cannot tell that my blood sugar is up.

You might be different, of course. And, I think you’re a carnivore, so there is not a lot of reason to get a CGM.

But especially for all those folks who don’t have any idea what is happening to their blood sugar, a CGM would (might – there’s always those who have almost no response) be a shock.

(Robin) #5

I’m sure you’re right. I can see why they are valuable tools for tracking.

#6

In the supplemental material one can see the data. Their average glucose as measured by the CGM is quite high for many of the subjects.

Many also spent some time above 180 mg/dL.

It is a good thing they’ve been given the opportunity to “see” it!

However, I wonder if the shock had any long lasting effects. Sometimes we’re all enthusiasm for change, but with passing weeks and months, it all fades.

It is also my experience that whenever I use a CGM, I learn something and change something in my ways. It is a pity it is so expensive!

(Jane) #7

I only wore one once and I made some small changes to my diet because of the data. It was given to me by a diabetic friend - I am not diabetic so can’t get a prescription for one, which is needed to purchase in the US AFAIK.

(Bob M) #8

Yeah, they are currently way too expensive. There are supposedly a lot of companies that are close to having cheaper versions out, some in watches. When that happens, it’ll be great (for people who can afford expensive watches; but at least it’s a one-time fee).

I learned a lot when I had mine for a year. (I bought it from Sweden, without insurance, out of pocket.)

(Rossi Luo) #9

I think, you might be able to do that in my area easier that your area, because the students here can hardly challenge the order from the authorities.:sweat_smile:

(Bob M) #10

I think it would be interesting to have a small credit, pass/fail class to try this out. My kids get “fed” the whole “eat whole grains! exercise! eat lean meat! fruits and vegetables!” ideas in their health classes. This would be a way to say that that’s not true, without ever actually saying it’s not true.

Oh, that breakfast of whole grain oats and skim milk caused your blood sugar to skyrocket and you were starving 15 minutes later? That’s weird. I had no idea that would happen. (Speaking as someone who had that happen ALL THE TIME. But I’m sure there will be people for which they will get no blood sugar rise or hunger, but that’s also a training tool: why do some react poorly to this meal, and others don’t?)

Meanwhile, that breakfast of eggs and whatever meat I can get people to eat caused no blood sugar rise and a sustained feeling of fullness? Odd. I never would have guessed that. :grinning:

(Rossi Luo) #11

Yes, I found that too. Some people’s blood sugar don’t rise even eating fruits or milk, my wife is such a person, I measured her blood glucose after she eats fruits. I think the only explanation is related to genetic, some people are sensitive to glucose while the others resistance.

(Bob M) #12

There was a study out of Israel, where they used CGMs to try to recreate the glycemic index. The main problem? Different people had wildly different responses to the same food.

I always have trouble finding the original study, but this is a discussion and here’s what they came up with in the aftermath, an algorithm to try to gauge which foods you should or should not eat:

This is why I’d love to see a cheaper CGM come out, one that we can buy over the counter. (And in other countries, they can buy CGMs over the counter – I bought a year’s supply of the FreeStyle Libre in 2017 from Sweden.) This is from the cited article:

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CGMs available to everyone (well, every person wealthy enough to afford a watch or something like that) could dramatically change everything.

Edit: Now, WHY there are vast differences, I don’t know. I don’t doubt genetics plays a role, but I don’t have a good idea as to how much, nor do I know what gene snips would be important (nor do I know if anyone knows). I would assume “insulin resistance” plays a role, as would age, exercise level, etc.

I think even the order in which you eat can help. For instance, if you eat bread or other carbs at the end of the meal, some studies show lowered glucose and insulin as compared to the same meal eating the carbs at the beginning. Add a salad with vinegar or even just vinegar before a meal, and that will lower glucose and insulin from carbs. Go walking afterward, and that helps.

(Rossi Luo) #13

Agree, real-time monitoring can make people know their sensitive foods, and in addition to that, it can be a good “friend” reminding the person paying attentions when they can’t control themselves on eating.
The main cost of the CGM is the sensor, as I know, the sensor needs to use glucose oxidase to have chemical reactions to measure glucose, so it can’t be used for a long time, if some day, a sensor with long life can be invented, then its price might go down.
I have just searched a CGM and want to buy one for my mom, but I found that its cost is about Chinese $20 a day, I gave up as I can’t afford it.

Another way to lower the price is that, if lots lots lots of people use it, then the sensor can be sold in large amount, the seller can get enough profit even lowering the price. Such things happened a lot in China, mobile phone is a good example.

I was thinking how to make sensors by myself, as I know it’s quite simple, just some chemicals in side and a piece of electrical conductor inside, if someone knows how to get the chemicals, it can be easily reverse-engineering to make sensors by ourselves.

By the way, I just saw an article at https://engineering.mit.edu/engage/ask-an-engineer/how-do-glucometers-work/ in 2011, it says they were working on a new material to sensor the blood glucose like a tattoo, if such material can work work, CGM price can go down too. No idea where their progress.

(Bob M) #14

Whoa, $20/day is very expensive.

The main thrust for new CGMs is light wave/noninvasive. It just has a lot of technical hurdles: