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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
#72Earlier quoted context omitted.
It is wonderful that we have things like CGM's and patients can establish their own baselines and their own evidence profiles on a high(ish) frequency basis. Such tools also enable studies that can be done at a scale and cost level that is reasonable and can push forward the communal knowledge base.
This is the idea behind the "Zoe" service: https://zoe.com/en-us 1. You wear a CGM for 2 weeks, and log everything you eat. 2. At the end, you get a personalized report about how different foods that you ate affect you, personally. And they can extrapolate to other foods that you didn't eat during the testing period. 3. Zoe's model gets better and better the more people sign up, and the more data they get.
> And they can extrapolate to other foods that you didn't eat during the testing period.
I would need to see an independent researcher confirm they can do this. As of now, I don't believe they can, and I'm not even sure the theory is reasonable.
Re: Continuous glucose monitors reveal variable glucose responses to the same meals
#73I'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 th…
I do _not_ have any sort of insulin resistance, and have worn a CGM for a while, a few different times.
(Purchased sorta 'just for fun', to evaluate my own metabolic responsiveness. I wrote about it once: [0])
if I moved around much after eating, my muscles would "soak" lots of glucose from my blood and the insulin change would be relatively low. If it was something sugary and I then went to sleep, it would be a big slow rise for a few hours of blood sugar, then insulin would seem to be released, and it would decline a bit, then flatten, then decline, until it went back to a regular level. When waking up, it would often by around 70 mg/DL, and even if I eat zero carbs (or am full-on fasting!) it would bounce up/around during the day. I appreciated that my body seemed quite capable of doing whatever it needed to do to raise my blood glucose levels. (They always go up when exercising, for instance, even if no food is consumed)
I think everyone would likely find the data interesting, it's so freaky customized to yourself, it cannot help but be interesting. They're expensive, so I think buying even one sensor and wearing it for 2 weeks or however long is worth it.
Re: Continuous glucose monitors reveal variable glucose responses to the same meals
#74Some 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…
If you think about it, Evidence Based Medicine is very much against Medicine 3.0 whereby individualized treatments/therapies are used.
Re: Continuous glucose monitors reveal variable glucose responses to the same meals
#75Yep. 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.
dad of an 8 y/o T1D here, and tbh, "how about just ..." is about the worst thing you can say to anyone dealing with this, especially given the subject of this post. things are just never the same. maybe they will be later in adulthood? i feel like i'm in a position to beta test this with my kiddo and i don't like it at all.
Re: Continuous glucose monitors reveal variable glucose responses to the same meals
#76Earlier quoted context omitted.
I just found out a friend was diagnosed with diabetes due to a sugar test while their a1c was still in the normal range. We’ve got a long way to go yet with diabetes research.
I mean, it is well known that A1c has a 3 month (usually) lag time assuming no hemolytic states. Could have been just caught early depending on what you mean by sugar test
No they already are in early stage fatty liver. This has been a long time coming and surprises no one. The only surprise is not failing the a1c.
Re: Continuous glucose monitors reveal variable glucose responses to the same meals
#77Earlier quoted context omitted.
I mean, it is well known that A1c has a 3 month (usually) lag time assuming no hemolytic states. Could have been just caught early depending on what you mean by sugar test
No they already are in early stage fatty liver. This has been a long time coming and surprises no one. The only surprise is not failing the a1c.
I guess I’m confused, A1c is a measurement used for diabetes, not fatty liver/nafld. Can absolutely be correlated with diabetes and elevated A1c but those are two independent things we seem to be talking about
Re: Continuous glucose monitors reveal variable glucose responses to the same meals
#78Earlier quoted context omitted.
I’m diabetic and manage it with a CGM and insulin pump (HbA1c at 6.8 after many years of struggles). For convenience and my experiment, I eat practically the same meals at lunch every day, precisely weighed, always starting from very similar morning glucose levels, and strictly respecting timing and consistency. I NEVER get the same response. Never. It’s an experiment I’ve been running on myself for a year. It’s usef…
Do you see any relation to physical exertion of the day before/after? What about mental signals, like "I'm going to be walking a bunch tomorrow"?
I am a developer and i work from home. In my experiment i ruled out “any kind of movement” :-D (no, i am not a bag of fat, only a lotto e “not in perfect shape”).
But. I can confirm that lot of stress and lot of coffe have a big and misurable effect.
Re: Continuous glucose monitors reveal variable glucose responses to the same meals
#79> if an individual eats the same meal on two occasions but starts with the vegetables on one occasion but not the other, this may lead to different glucose responses to the same meal within the same individual.
> Other behavioral and individual factors are known to influence CGM responses.[22][6] Postmeal physical activity — even as minor as leg fidgeting[23] and walking for a few minutes every hour — reduces postmeal glucose responses.[24] Sleep quality has also been associated with changes in postmeal CGM glucose responses.[25] Emerging studies are also uncovering the relationship between an individual’s gut microbiome and their postmeal glycemic responses.[26][27][28]
So basically it's the impact of the parasympathetic/sympathetic nervous system and the order of food ingestion that could induce different glucose response.
It's interesting because I assumed that beside the nervous system, whatever order we eat our food, it all mixes in the stomach and then start to process. Negating the importance of order but studies implies it does.
Re: Continuous glucose monitors reveal variable glucose responses to the same meals
#80Some 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…
Your take on Evidence Based Medicine (EBM) is wrong.
At the top of the evidence hierarchy is N-of-1 trials (and below that are high quality meta-analyses of trials). Nothing is more informative about treatment response in a person than testing it in that person. This is the heart of personalized medicine, and exactly for the reason you stated: Different interventions work differently for different people.
And any practitioner worth their salt is unsurprised by this headline. A great example is that illness and inflammation increase insulin resistance via counter-regulatory hormones.
You got one thing right, intuition often turns out to be wrong. That is why the vast majority experimental therapeutics built on great ideas never get passed initial testing.