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Continuous glucose monitors reveal variable glucose responses to the same meals

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Re: Continuous glucose monitors reveal variable glucose responses to the same meals

#11

Post by mjburgess »

csours wrote: post #8

Some assumptions are so obvious no one bothers to state them, or even remember them. Assumption: Medical professionals are trained to use Evidence Based Medicine (EBM). One might assume that EBM means something specific, and I'm sure it does, but that specific thing is different for different people. One thing that EBM sometimes means is: common sense is no substitute for evidence. There are uncountable times that co…

A counter-point, in a certain sense: when the conclusions of scientific papers (in these softer science fields), contradict common sense, they tend to be unreproducible; the ones which don't, are.

The problem with studying humans is, roughly, the central limit theorem doesnt work: properties of biological and social systems do not have well-behaved statistics. So all this t-test pseudoscience can be a great misdirection, and common sense more reliable.

In the case where effect sizes are small and the data generating process "chaotic", assumptions of the opposite can be more dangerous than giving up on science and adopting "circumstantial humility". (Consider eg., that common sense is very weakly correlated across its practicioners, but "science" forces often pathological correlations on how people are treated -- which can signficantly mangify the harm).

Re: Continuous glucose monitors reveal variable glucose responses to the same meals

#12

Post by [deleted] »

stranded22 wrote: post #6

Yep. My wife is T1D and this is infuriating for her. She’ll think that she’s cracked it, and then the next day, with the same meal at the same time, her sugar levels go high. Her words: there is nothing else where you have studied for over 30 years and STILL feel like you know nothing. It is incredibly demoralising for her sometimes - especially when she’s suffering also from a high/low sugar level. I have the upmost…

[deleted]

Re: Continuous glucose monitors reveal variable glucose responses to the same meals

#13

Post by pfortuny »

taeric wrote: post #5

Odd, I would have expected this to be somewhat the case? Specifically, I would expect your activity leading into the meals, along with your expectations of what you will be doing after, would have some impact? Probably more impact from how hungry you were going into a meal. If you were already sated, for example, I'd expect your body to largely try and push the meal through as fast as it can. Neat to see what other p…

People think medicine is Physics. They really do.

Re: Continuous glucose monitors reveal variable glucose responses to the same meals

#14

Post by ddorian43 »

stranded22 wrote: post #6

Yep. My wife is T1D and this is infuriating for her. She’ll think that she’s cracked it, and then the next day, with the same meal at the same time, her sugar levels go high. Her words: there is nothing else where you have studied for over 30 years and STILL feel like you know nothing. It is incredibly demoralising for her sometimes - especially when she’s suffering also from a high/low sugar level. I have the upmost…

How about just not eat carbs at all and have more consistent & lower blood sugar? (this was an interesting case https://www.youtube.com/watch?v=CG8UU7P8FBU)

I do keto diet long term but for other reasons, often the epilepsy version where it's more strict and higher fat.

Re: Continuous glucose monitors reveal variable glucose responses to the same meals

#15

Post by coldpie »

stranded22 wrote: post #6

Yep. My wife is T1D and this is infuriating for her. She’ll think that she’s cracked it, and then the next day, with the same meal at the same time, her sugar levels go high. Her words: there is nothing else where you have studied for over 30 years and STILL feel like you know nothing. It is incredibly demoralising for her sometimes - especially when she’s suffering also from a high/low sugar level. I have the upmost…

I'm also T1D and yep. That's how it goes. Despite having one of the same two breakfasts pretty much every workday for a decade, it's a crapshoot whether I'll be 300 (very high) when I get to work or 50 (very low) or 110 (good). I just have to adjust when I get in to the office. Most days I deal with it fine, but every once in a while I get fed up with it and want to throw something.

Re: Continuous glucose monitors reveal variable glucose responses to the same meals

#16

Post by taeric »

pfortuny wrote: post #13
taeric wrote: post #5

Odd, I would have expected this to be somewhat the case? Specifically, I would expect your activity leading into the meals, along with your expectations of what you will be doing after, would have some impact? Probably more impact from how hungry you were going into a meal. If you were already sated, for example, I'd expect your body to largely try and push the meal through as fast as it can. Neat to see what other p…

People think medicine is Physics. They really do.

I think I agree with the idea you are saying. That people think you can formulate our body to ignore a lot of the state that it holds.

I'll note that even basic physics has that problem. Try explaining to a 5th grader why a feather would fly in the same arc that a rock will take, if there was no air.

Re: Continuous glucose monitors reveal variable glucose responses to the same meals

#17

Post by endoblast »

One factor that scientific food experiments don't seem to include is gluttony. Presumably because it is subjective (though nonetheless real for that). Yet if people are motivated by the amount of comfort and/or pleasure they obtain from eating their favourite foods this may have an effect on their physiological response.

Re: Continuous glucose monitors reveal variable glucose responses to the same meals

#18

Post by francisofascii »

Sounds expected? If you are glycogen depleted, it will cause less of an insulin spike. This sounds like if you fill up the same type of car with 5 gallons of gas. Sometimes it reports full, and sometimes it doesn't. That sounds odd, until you accept that you are never fully sure the gas level you started at.

Re: Continuous glucose monitors reveal variable glucose responses to the same meals

#19

Post by blindriver »

I've been diagnosed with Type 2 diabetes and wear a CGM. I find that my blood glucose spikes much later than what is suggested. For example, I might eat a meal and my blood glucose doesn't spike until after 2 hours. When it spikes, I see the body react with insulin and it drives my blood sugar levels down, so I'm not sure if I actually do have T2D or if this is just how my body works.

Another thing I've noticed is that if I eat a very rice-heavy meal, my blood sugar levels may rise throughout the night. I don't think this is insulin-resistance but rather my body digesting the rice. You can't expect the body to digest all the rice in 2 hours, can you, there certainly must be parts that are protected from the stomach acid until much later in the digestion process. So that feeds into the high blood sugar levels overnight in my opinion.

I think if anything, CGMs have opened up the idea of what diabetes really is and how different bodies handle blood sugar. I think I'm borderline T2D, not full-on T2D despite what my doctor says, and I've started wondering if my blood sugar has always been high, but normal for me. On average it's about 120 mg/dL, but I do see my body react properly to new sources of blood sugar and drive it back to "normal" levels, so the idea that I have insulin resistance doesn't make sense to me.

Re: Continuous glucose monitors reveal variable glucose responses to the same meals

#20

Post by jzacharia »

Shouldn't come as a surprise - there are so many factors involved in glucose response to food that it's almost impossible to replicate a glucose response even with a controlled intake. Sleep, activity levels (before, after, during, even days before, etc), stress, hormones, all of these are major factors involved in how glucose is metabolized.
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