4 ms·

Are continuous glucose monitors a waste of time for people without diabetes?

17 points by jger15 5y ago

ingend88 5y ago
Which glucose monitor do you recommend ?
alphaoverlord 5y ago
I have absolutely nothing against CGMs, but the author confounds measurement error (which can happen in both blood tests as well as subcutaneous measurement which a CGM does), thresholding on a population level (I doubt anyone thinks an A1c of 4.5 and 5.6 are the same), and weak evidence of impact in actual health outcomes. It’s fun in the same way a Fitbit/Apple Watch is fun, but I don’t think one should oversell it’s utility.
deleted 5y ago
[deleted]
MichaelRazum 5y ago
What to do if you have often spikes of 180 or even 200 mg/ld but it returns to under 140 after 2hours? Can someone share insights. Sure avoid some food. But is it time to take some medicine? Or some radical measures? My consern is a bit that even doctors cant tell since according to the blood tests everything might be looking good.
- richcollins 5y ago
  Lose body fat. Stopping eating refined carbohydrates. Take the Kraft glucose insulin test to see if you have “diabetes in situ” https://www.meridianvalleylab.com/services/kraft-prediabetes-profile/ https://www.meridianvalleylab.com/services/kraft-prediabetes...
  - MichaelRazum 5y ago
    In my case nearly no body fat. Thanks for the link. Lets say prediabetes is diagnosed. What now? Kind of really hard to figure out what to do. Tried daytwo by the way, kind of accurate description. So trying to avoid food that produces a spikes. Not sure if that is enough. By the way one interesting thing. After hard workouts the responses are much better. So maybe one could just follow mothers advice, eat healthy and do sport.
    - andyfleming 5y ago
      One possibility can be Monogenic diabetes (aka MODY). Certain forms of it are more like a slowly onsetting type 1 diabetes. It can often be misdiagnosed.
    - freedomben 5y ago
      IANAD, but AFAIK all you can do is eat better and exercise. Honestly the eating better is like 85% of it anyway. I've been in the same boat for years now and I never eat just carbs by themselves, and I try to never exceed 35 carbs in a single meal. A lot more meat, a lot less bread. For me I'm almost better off eating candy than I am soft white bread (although neither is a good idea of course). I went keto for a while and that did seem to help, except I do really poorly with high fat foods. Now I just try to balance everything, lean high on the protein, and limit carbs to 35 per meal.
- DavideNL 5y ago
  Can you see a pattern in specific food/containing ingredients, eaten before your sugar spike? Some people with type1 diabetes for example, react weird to specific ingredients they are sort of “allergic” to, making their glucose level spike, while for others the same ingredients cause no spike at all. These ingredients don’t even contain that much carbs/sugar that would explain a glucose spike.
mgarfias 5y ago
I have the diabeetus (t2, well controlled, a1c under 7). I really want a CGM rather than sporadic testing throughout the day. Plus if I do something like a long bike ride, I’ll bonk and my glucose levels will drop like a rock, very suddenly (this is like 1hr in). I’d like a CGM to tell me the drop is coming, ahead of time, so I can do something about it. Unfortunately, my ins won’t cover it, as I’m well controlled. So my options are $300+/mon out of pocket, or suffer.

17 points by jger15 5y ago

Which glucose monitor do you recommend ?

I have absolutely nothing against CGMs, but the author confounds measurement error (which can happen in both blood tests as well as subcutaneous measurement which a CGM does), thresholding on a population level (I doubt anyone thinks an A1c of 4.5 and 5.6 are the same), and weak evidence of impact in actual health outcomes. It’s fun in the same way a Fitbit/Apple Watch is fun, but I don’t think one should oversell it’s utility.

deleted 5y ago

[deleted]

MichaelRazum 5y ago

What to do if you have often spikes of 180 or even 200 mg/ld but it returns to under 140 after 2hours? Can someone share insights. Sure avoid some food. But is it time to take some medicine? Or some radical measures? My consern is a bit that even doctors cant tell since according to the blood tests everything might be looking good.

richcollins 5y ago
Lose body fat. Stopping eating refined carbohydrates. Take the Kraft glucose insulin test to see if you have “diabetes in situ” https://www.meridianvalleylab.com/services/kraft-prediabetes-profile/ https://www.meridianvalleylab.com/services/kraft-prediabetes...
- MichaelRazum 5y ago
  In my case nearly no body fat. Thanks for the link. Lets say prediabetes is diagnosed. What now? Kind of really hard to figure out what to do. Tried daytwo by the way, kind of accurate description. So trying to avoid food that produces a spikes. Not sure if that is enough. By the way one interesting thing. After hard workouts the responses are much better. So maybe one could just follow mothers advice, eat healthy and do sport.
  - andyfleming 5y ago
    One possibility can be Monogenic diabetes (aka MODY). Certain forms of it are more like a slowly onsetting type 1 diabetes. It can often be misdiagnosed.
  - freedomben 5y ago
    IANAD, but AFAIK all you can do is eat better and exercise. Honestly the eating better is like 85% of it anyway. I've been in the same boat for years now and I never eat just carbs by themselves, and I try to never exceed 35 carbs in a single meal. A lot more meat, a lot less bread. For me I'm almost better off eating candy than I am soft white bread (although neither is a good idea of course). I went keto for a while and that did seem to help, except I do really poorly with high fat foods. Now I just try to balance everything, lean high on the protein, and limit carbs to 35 per meal.
DavideNL 5y ago
Can you see a pattern in specific food/containing ingredients, eaten before your sugar spike? Some people with type1 diabetes for example, react weird to specific ingredients they are sort of “allergic” to, making their glucose level spike, while for others the same ingredients cause no spike at all. These ingredients don’t even contain that much carbs/sugar that would explain a glucose spike.

mgarfias 5y ago

I have the diabeetus (t2, well controlled, a1c under 7). I really want a CGM rather than sporadic testing throughout the day. Plus if I do something like a long bike ride, I’ll bonk and my glucose levels will drop like a rock, very suddenly (this is like 1hr in). I’d like a CGM to tell me the drop is coming, ahead of time, so I can do something about it. Unfortunately, my ins won’t cover it, as I’m well controlled. So my options are $300+/mon out of pocket, or suffer.