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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

#91

Post by esperent »

pedalpete wrote: post #81

Blood glucose is dependent on more variables than just what you eat. Decreased sleep slow-wave activity (not just sleep time, but the actual restorative function of sleep) significantly decreases next day insulin response [1]. This is my area (I work in neurotech/sleeptech), but other things that come to mind are changes in changes in gut biome, which can be altered by previous meals, and I assume is always in flux (…

> For those without diabetes, I always thought you'd use the CGM for a few weeks, figure out what your body responds to, and then sort out your diet.

This was my plan sometime in the next few months.

I think it's still a valid plan, just with some caveats. Anyway due to cost and annoyance I'm unlikely to wear a CGM for more than a couple of months. But that should be enough time to get usable data - like all body tracking data, I'll end up using it as guidance rather than rule.

The caveats are that I'll also need to track my sleep and workouts during that time and carefully look for patterns in the data related to all three.

I already know sleep and workouts are strongly correlated and not always in the way you'd expect. I did a strong HIIT class at 6pm last night, and due to a bit of crunch on personal projects it was my first proper workout in a week. My sleep tracker (Galaxy Watch 6) gave me a very poor sleep and energy score. 61/100 for sleep, 69/100 for energy. I normally score high eighties to low 90s in both.

These scores usually but not always match with my actual feeling. But today I also feel tired (it's 8am here now).

If I had a CGM, I'd also be keeping a strong eye out for unusual glucose response today.

This is more complex than I'd like it to be - I wish my body was as simple to read as just getting a single number like glucose response and making adjustments from that! But as a lifelong migraine sufferer who now has my migraines almost entirely under control by making lifestyle changes, I'm well aware that how my body responds is always a combination of many things. Stormy weather + ate cheese + slightly too strong coffee + stress from work = boom, migraine. Take away any one of those and maybe I wouldn't have got one. I fully expect my body's glucose response to be just as complex.

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

#92

Post by crazygringo »

kanjus wrote: post #41
crazygringo wrote: post #22

Earlier quoted context omitted.

> 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. Citation needed? I don't know what would lead to that conclusion. And it would seem to run counter to the entire history of the field of psychology, for example.

Can't find the citation, but remember gwern mentioning a study in one of his posts on replication that found that unintuitive findings tend to be both less replicable and more cited than intuitive ones. Psychology is the field that is most hit with replication failures and has a slew of unintuitive results that turn out to be malpractice.

Psychology is also the field with a slew of unintuitive results that have been repeatedly replicated as correct. And what is "intuitive" anyways? What was extremely non-intuitive a century ago is common sense today.

So that's why I question the assertion. You're right that there are tons of replication failures, but whether intuition correlates with replicability way doesn't seem relevant. Especially when the point of so much research is to look for currently "non-intuitive" things, so of course that's where more replication issues might exist. It doesn't mean you should stop researching in that direction.

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

#93

Post by sinuhe69 »

pedalpete wrote: post #81

Blood glucose is dependent on more variables than just what you eat. Decreased sleep slow-wave activity (not just sleep time, but the actual restorative function of sleep) significantly decreases next day insulin response [1]. This is my area (I work in neurotech/sleeptech), but other things that come to mind are changes in changes in gut biome, which can be altered by previous meals, and I assume is always in flux (…

What about the famous breakfast? One prevalent theory among nutritionists is that the breakfast has huge influence on the insulin responses during the day: a low carb/no sugar, high protein and fat breakfast will not spike your blood glucose level and therefore will lead to a more moderate response to meal intake during the day as opposite to a high carb breakfast. I think the study should control this variable as well.

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

#94

Post by burnt-resistor »

jzacharia wrote: post #20

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.

Chewing, acid production, gut microbiome, and possibly more.

I think it will/would take a lot of data to uncover the most important factor(s).

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

#95

Post by rigrassm »

coldpie wrote: post #15
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.

Right there with ya. The most frustrating aspect of the beetus for me is how inconsistent glucose/insulin responses are, drives me absolutely mad

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

#96

Post by rigrassm »

je42 wrote: post #25
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…

More data can help inform semi closed loop systems to deal with this variability. For example, AAPS has since version 3.2 dynamic IFS. ( https://androidaps.readthedocs.io/en/latest/DailyLifeWithAap... ) For me this works quite well

Still pissed my insurance stopped covering the Omnipod Dash last year, especially since the 5 is just an artificially locked down dash. Omnipod 5 automated mode is garbage compared to aaps

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

#97

Post by esdott »

As a long time diabetic (t1d) with direct relatives also afflicted with this horrible disease, it’s frustrating that we often miss the key factors in insulin resistance and fail to see how they fit in.

The level of serotonin and its interplay with our current level of immune response/inflammation in our body is the single best predictor of insulin resistance. That’s simply because every good thing you can do to lower resistance increases serotonin. Serotonin then decreases inflammation. When you exercise for a long period of time you are not only increasing your immediate availability of serotonin, you are also increasing your daily availability for serotonin.

Obviously it’s a little more complicated but from a big picture standpoint, either something is increasing inflammation in you today and increasing your insulin resistance or (hopefully) the opposite is happening and serotonin is moving your insulin through your blood stream like a mag lev train.

On a side note, I do love cgms.

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

#98

Post by sinuhe69 »

What about the famous breakfast? One prevalent theory among nutritionists is that the breakfast has huge influence on the insulin responses during the day: a low carb/no sugar, high protein and fat breakfast will not spike your blood glucose level and therefore will lead to a more moderate response to meal intake during the day as opposite to a high carb breakfast. I think the study should control this variable as well.

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

#99

Post by gcanyon »

pedalpete wrote: post #81

Blood glucose is dependent on more variables than just what you eat. Decreased sleep slow-wave activity (not just sleep time, but the actual restorative function of sleep) significantly decreases next day insulin response [1]. This is my area (I work in neurotech/sleeptech), but other things that come to mind are changes in changes in gut biome, which can be altered by previous meals, and I assume is always in flux (…

If a normal-weight person undergoes significant long-term sleep deprivation -- like >50% of nights on 4-6 hours of sleep over the course of decades -- what would the expected effect to be? And if the person's bloodwork nevertheless shows no particular signs of poor insulin response?

Asking for a friend.

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