Routine glucose monitoring may be unnecessary for people with Type 2 diabetes • Hacker News Board

Re: Routine glucose monitoring may be unnecessary for people with Type 2 diabetes

#41

Post by friedegg » Wed, Oct 30, 2019, 2:00 PM UTC

jp555 wrote: post #34

SpikeDad wrote: post #10

It wasn't for me. Individual anecdotal stories aren't evidence but without consistent feedback it's easy to get back into poor habits. When I eat a Twizzler and see my blood glucose spike at 180-200 FOR 1 TWIZZLER then it's the feedback I need. It's no different to me than frequent weighings. I'm sure some people don't need or want the feedback but for me it's essential. And using a CGM (I use 14 day Lifestyle) I can…

I'm glad you found something that works for you, but this is massively over-complicated for almost everyone. Constant glucose tracking is interesting, but completely unnecessary. EDIT - For most healthy individuals. It's like my father-in-law who obsesses over vitamins while he ignores being ~40 pounds overweight - he needs to simply eat less & move more, not keep reading articles until he uncovers some magic combina…

As a type 1 diabetic, I can tell you beef does not spike blood glucose and resulting insulin response just as much as rice as does. Protein usually takes about half the dosage for the same amount of grams (ie 10g of carbs / 5g of protein), and it does it more slowly. For many type 1 diabetics on non low-carb diets, protein is eaten in small enough amounts with large enough amounts of carbs that you usually don't factor it into your dosage.

Re: Routine glucose monitoring may be unnecessary for people with Type 2 diabetes

#42

Post by quantdev » Wed, Oct 30, 2019, 2:20 PM UTC

jp555 wrote: post #34

SpikeDad wrote: post #10

It wasn't for me. Individual anecdotal stories aren't evidence but without consistent feedback it's easy to get back into poor habits. When I eat a Twizzler and see my blood glucose spike at 180-200 FOR 1 TWIZZLER then it's the feedback I need. It's no different to me than frequent weighings. I'm sure some people don't need or want the feedback but for me it's essential. And using a CGM (I use 14 day Lifestyle) I can…

I'm glad you found something that works for you, but this is massively over-complicated for almost everyone. Constant glucose tracking is interesting, but completely unnecessary. EDIT - For most healthy individuals. It's like my father-in-law who obsesses over vitamins while he ignores being ~40 pounds overweight - he needs to simply eat less & move more, not keep reading articles until he uncovers some magic combina…

There is absolutely no way beef spikes insulin as much as rice does. Beef has zero carbohydrates and while some protein does convert to glucose, it is a slow process and thus the insulin response will still be much less than if one consumed the equivalent of carbohydrate in rice. This is further slowed by digesting the fat in the beef.

""Between 50–60% of protein becomes glucose and enters the bloodstream about 3–4 hours after eaten." Perhaps 50–60% of protein goes through the process of gluconeogenesis in the liver, but virtually none of this glucose enters into the general circulation."

http://journal.diabetes.org/diabetesspectrum/00v13n3/pg132.h...

Re: Routine glucose monitoring may be unnecessary for people with Type 2 diabetes

#43

Post by jp555 » Wed, Oct 30, 2019, 2:22 PM UTC

buckthundaz wrote: post #40

jp555 wrote: post #34

Earlier quoted context omitted.

I'm glad you found something that works for you, but this is massively over-complicated for almost everyone. Constant glucose tracking is interesting, but completely unnecessary. EDIT - For most healthy individuals. It's like my father-in-law who obsesses over vitamins while he ignores being ~40 pounds overweight - he needs to simply eat less & move more, not keep reading articles until he uncovers some magic combina…

>Beef spikes insulin just as much as rice does. Citation?

https://watermark.silverchair.com/1264.pdf?token=AQECAHi208B....

Re: Routine glucose monitoring may be unnecessary for people with Type 2 diabetes

#44

Post by jp555 » Wed, Oct 30, 2019, 2:22 PM UTC

friedegg wrote: post #41

jp555 wrote: post #34

Earlier quoted context omitted.

I'm glad you found something that works for you, but this is massively over-complicated for almost everyone. Constant glucose tracking is interesting, but completely unnecessary. EDIT - For most healthy individuals. It's like my father-in-law who obsesses over vitamins while he ignores being ~40 pounds overweight - he needs to simply eat less & move more, not keep reading articles until he uncovers some magic combina…

As a type 1 diabetic, I can tell you beef does not spike blood glucose and resulting insulin response just as much as rice as does. Protein usually takes about half the dosage for the same amount of grams (ie 10g of carbs / 5g of protein), and it does it more slowly. For many type 1 diabetics on non low-carb diets, protein is eaten in small enough amounts with large enough amounts of carbs that you usually don't fact…

Your point is valid, I should have specified "in most healthy individuals".

https://watermark.silverchair.com/1264.pdf?token=AQECAHi208B....

Re: Routine glucose monitoring may be unnecessary for people with Type 2 diabetes

#45

Post by jp555 » Wed, Oct 30, 2019, 2:29 PM UTC

quantdev wrote: post #42

jp555 wrote: post #34

Earlier quoted context omitted.

I'm glad you found something that works for you, but this is massively over-complicated for almost everyone. Constant glucose tracking is interesting, but completely unnecessary. EDIT - For most healthy individuals. It's like my father-in-law who obsesses over vitamins while he ignores being ~40 pounds overweight - he needs to simply eat less & move more, not keep reading articles until he uncovers some magic combina…

There is absolutely no way beef spikes insulin as much as rice does. Beef has zero carbohydrates and while some protein does convert to glucose, it is a slow process and thus the insulin response will still be much less than if one consumed the equivalent of carbohydrate in rice. This is further slowed by digesting the fat in the beef. ""Between 50–60% of protein becomes glucose and enters the bloodstream about 3–4 h…

Are you suggesting that insulin only responds to carbohydrate intake? I understand insulin plays an important role in shuttling all macronutrients from the GI tract into tissues, even if that action is somewhat different for fats, proteins, and carbs. (ie insulin binds to fat cells to reduce fat mobilization in a fed state)

Here you can see while its not the exact same, the insulin scores of beef & rice (brown especially) are very close to each other. Definitely much closer than most popular culture advice would suggest.

But it should also be said that this is for healthy individuals.

https://watermark.silverchair.com/1264.pdf?token=AQECAHi208B....

Re: Routine glucose monitoring may be unnecessary for people with Type 2 diabetes

#46

Post by James_Henry » Wed, Oct 30, 2019, 2:30 PM UTC

SpikeDad wrote: post #10

It wasn't for me. Individual anecdotal stories aren't evidence but without consistent feedback it's easy to get back into poor habits. When I eat a Twizzler and see my blood glucose spike at 180-200 FOR 1 TWIZZLER then it's the feedback I need. It's no different to me than frequent weighings. I'm sure some people don't need or want the feedback but for me it's essential. And using a CGM (I use 14 day Lifestyle) I can…

The NYTimes article isn't about continuous glucose monitoring.

Re: Routine glucose monitoring may be unnecessary for people with Type 2 diabetes

#47

Post by randcraw » Wed, Oct 30, 2019, 2:40 PM UTC

jwhite_nc wrote: post #21

SpikeDad wrote: post #10

It wasn't for me. Individual anecdotal stories aren't evidence but without consistent feedback it's easy to get back into poor habits. When I eat a Twizzler and see my blood glucose spike at 180-200 FOR 1 TWIZZLER then it's the feedback I need. It's no different to me than frequent weighings. I'm sure some people don't need or want the feedback but for me it's essential. And using a CGM (I use 14 day Lifestyle) I can…

Data drives me to do better.

This is the point. If you don't use the additional info somehow -- like eating or exercising differently based on info like BG fingersticks -- merely adding more info achieves zero.

That should be the takeaway lesson from this study. Just because some people stuck their fingers and gathered BG numbers three times a day does not mean they acted on that info to change their health. Until health pros make this clear to patients, that they need to actually use this info to adapt their lifestyle on a daily basis, there's simply no point in gathering daily info like this. And certainly not at a frequency of 3 or 4 times a day.

Once you've dialed in your lifestyle into regular eating and exercise habits, repeatedly gathering daily numbers is redundant overkill. Gathering BG numbers no more than one day a week should suffice, just to confirm you remain homeostatic.

Gathering info, by itself, changes nothing.

(BTW, I've had T2D for 15 years now. So I've walked the walk.)

Re: Routine glucose monitoring may be unnecessary for people with Type 2 diabetes

#48

Post by foxyv » Wed, Oct 30, 2019, 3:13 PM UTC

For those of you interested. Intensive Dietary Management of Type 2 Diabetes has been shown to be very effective at treating and often curing Type 2. Dr. Jason Fung runs the program up in Canada and has written a couple books about it.

My partner recently was declared cured of Type 2 by his very surprised endocrinologist after focusing on dietary management and fasting. His A1C is lower than mine now...

The Diabetes Code: ISBN 9781925548891

Re: Routine glucose monitoring may be unnecessary for people with Type 2 diabetes

#49

Post by graeme » Wed, Oct 30, 2019, 3:21 PM UTC

projektfu wrote: post #38

xianwen wrote: post #35

Earlier quoted context omitted.

Does a 14 Day FreeStyle Libre cost $130ish per month, or is $130ish a one time fee that one can use 14 Day FreeStyle Libre forever afterwards?

The device has a 14 day lifespan.

Interesting. So it’s fairly inexpensive to get one if you just want to gather data for a short period and get insights about the patterns.

Can you order them over the counter in Canada?

Edit: yes, you can: https://libre.myfreestyle.ca/

$97 CAD for a new sensor, not bad. That’s about $73 USD

Re: Routine glucose monitoring may be unnecessary for people with Type 2 diabetes

#50

Post by nycbenf » Wed, Oct 30, 2019, 3:57 PM UTC

Another anecdotal report but when I diagnosed with T2 early this year I went into overdrive testing after waking up, before bed, and 2 hours after every meal. My doctors said it was excessive but better than the alternative. I gradually learned how to eat without spiking my glucose and now that my a1c is down to 5.4 I've eliminated testing almost completely.