Continuous Glucose Monitoring
Is there any actual data on the long term use of these devices in non-diabetics?
This feels like geek bait, imo. A nice simple metric to obsess over, and to optimise. With a super simple (therefore presumably wrong) biological model to back up it's worth.
It seems to be, that nothing particularly good has come of prior trends in quantified self-health (for regular consumers, pun intended, at least); and this seems to come packaged with a very real risk of orthorexia.
For me the best insight learned from wearing a GCM is that a cardio exercise with 150bpm heart rate for 40min+ is probably not healthy. I would easily see my glucose level drop to below 80 mg/dL (5 mmol/L) 30min into the exercise. I always thought the exhaustion towards the end of my exercise was due to normal fatigue, and never thought it was caused by hypoglycemia.
Now I would exercise and closely monitor my glucose level, then adjust my intensity when it dip lower than 100 mg/dL (5.5 mmol/L). It made the cardio exercise much more bearable, and easier to stick to it as a daily routine.
Here's a teardown of the Stelo CGM https://news.ycombinator.com/item?id=43145527
If you use Android, you absolutely should try Juggluco (https://www.juggluco.nl/Juggluco/index.html)
It's open source and supports all CGM sensors that I know of.
It has the ability to "broadcast" your data to various destinations and has a built-in https server to export a quick summary view to share with your doctor. It also supports exporting to Abbot LibreView so your significant others can use the LibreView app to view your data.
Don't be intimidated by the UI: it's weird and seemingly outdated, but EVERY part of the UI has a dedicated "help" button that you can click and read for details.
Couldn't be happier since I ditched the Freestyle Libre app (it failed to open after an Android update).
I've been using "freestyle libre" devices on my diabetic cat, but they are quite expensive(~$110 AUD), and typically don't last the whole 14 day period before failing. Although I imagine they are much more reliable on a human.
I've stopped using them because it's just a bit too expensive, and my cat's diabetes is more stable now.
I opened up a freestyle libre 2, it has a EM9304 bluetooth SOC, and a TI RF430 NFC microcontroller, chatgpt deepresearch estimated the bill of materials to be about $5 USD[0].
Some companies[1] are developing reusable CGMs, the electronics are reusable, but the glucose oxidase probe, and applicator needle are still consumable. I'm not sure if that will bring the costs down much, it doesn't seem like the BOM is the main factor in the price of existing CGMs anyway.
[0]: https://chatgpt.com/share/686225c7-11ac-8005-aa4a-f420415e21...
CGMs are a great but if you wish to lose weight you have to create a calorie deficit as opposed to a surplus harder to do in our carbs heavy, sugar loaded, ultra processed foods dominated diets which are extremely unhealthy for us.
I know I went from a 7.1 A1C(type 2 diabetes) to a 5.3 A1C(no diabetes) in a little over a month by going on a Keto diet while laying off the carbs and exercising regularly. If you don't CGM or not you'll end up like the almost 1/3 of the US population or 98 million Americans who are currently pre diabetic looking to join the 38.4 million who are already full blown diabetics a condition often called the silent killer for good reason (heart disease, stroke, chronic inflammation, kidney disease, nerve damage, and vision loss). Chronic inflammation also thought to have a direct link with cancer
I wore a monitor for two weeks. As someone who basically does not eat processed food, including sugar, and has 4-5 meals a day always including vegetables/fiber it was not obvious that what I ate had any reliable impact on the count. It would go up and down seemingly at random throughout the day and night. The highest and most reliable spikes came when I was lifting weights. Likewise cardio, especially high intensity cardio made it drop to its lowest levels. The most interesting outcome was that the late afternoon hanger I often felt was not associated with a dip (or change at all) in blood glucose as I expected it would be, so that remains a mystery.
The author's mention of the Hawthorn Effect fascinated me; I hadn't considered that with devices your care team can monitor.
It will change a lot of lives when some device that doesn't draw blood can continuously monitor glucose, like a smartwatch.
The author does not seem to go into details, so I am curious what actually surprising conclusions can be drawn from wearing one of these devices?
Croissants and muffins being unhealthy should be no surprise. I am more interested in findings like food that gets a bad rap being not that unhealthy and supposedly healthy food being bad.
I share the author's enthusiasm about GCM devices. I am also finding that I need to change the over-patch long before the 15-day window because it gets messed up. I've found these [1] quite useful.
I believe these cheaper devices are not very accurate ie accuracy range of 20% which is a fairly wide window. I’ve also heard there are many things that can impact your glucose even with the same meal like time of day, exercise, stress, sleep, etc. So if you actually want to find the patterns you’d need the expensive CGM over many months.
In a couple of cases, meals that I thought would be fairly healthy (or at least not terrible) were pretty terrible. There'll be some things that I'll avoid eating more than I had before.
Someone chime in with what they think these might be! Should I be eating less broccoli?
A bit an older post with more data on the topic: https://medium.com/better-humans/measuring-blood-sugar-as-a-...
TL;DR:
As a healthy, non-diabetic adult I wore a Continuous Glucose Monitor (CGM) to measure my blood sugar for two weeks
The sensor was convenient to use and painless to apply, and was barely noticeable during the two weeks it was on my arm.
In analyzing my blood sugar levels, I learned a lot about my body’s response to different foods and exercise; I could identify some foods that spike my glucose.
Two weeks is too short to make detailed improvements to my nutrition in order to stabilise glucose levels — further monitor and experimentation will be needed.
What CGM device would you recommend for a first try?
What I find absolutely infuriating is that Abott (Freestyle Libre 1-3 devices) region locks their monitoring app depending on your region.
My father is T1 is uses the Libre CGM system for a couple years now. Libre users in the US and Europe can enjoy direct integration with their iOS devices, including constant updates and most importantly, notification alerts for dangerously high or low glucose levels, and it is even possible to share live updates of this with close family members or caretakers.
But none of this is available for my dad, as he lives in Brazil. Even though the product is same, he cannot download the iOS apps over the AppStore, as they are region locked.
I wore one, but had some trouble with the glue, by day 8 or so it seemed like it was on the verge of falling off, so I added some medical tape which annoyed my skin.
I suspect these devices will never go beyond 14 days at a time simply because of the glue issue. My skin was also pretty irritated once I removed the device, with some blood where the device sat.
If you chose to wear one, especially in the summer, work very hard at removing all oils from your skin before you apply it. Soap and water (preferably real soap, not SLS), and then alcohol to get everything.
I discovered that my wake/sleep cycle affected my blood sugar as much as, or even more than, what I ate.
If you don't have diabetes type 1 or type 2, or temporary diabetes related to pregnancy, then you don't really need a CGM. CGM is a life-saving tool for people with diabetes type 1 mostly.
I was hugely ignorant of diabetes type 1 before my child suddenly was diagnosed with it. It's an absolute nightmare, a horrifying disease no one is taking about while there are millions of children affected by it worldwide - and the disease is spreading, getting worse every year. It's astonishing how many unknowns there are in this disease.
People should get on the bike and start cycling for real (like burn 200W an hour). Their perception of glucose will flip 100%. Suddenly glucose is like the fuel to your body, that you can't cram enough into. Which means white bread in the morning, croissants (and coca cola with sugar) will be your friends. Quite frankly a much better lifestyle.
if you don't need alerts for extreme high/low, i don't see the value of cgm monitoring... starch/grain/sugar spikes insulin, protein gives gentle raise within 3-5 hours, fat does next to nothing and does in around 7-9 hours. mixing a bunch of fibre/fat/protein into your starch and sugar makes the insulin spike less intense...
what are you guys learning about your super special non diabetic bodies that you can't learn with a $5 book of glycemic indices or a casual afternoon reading basic diabetes dieting advice?
> "i would be amiss"
Huh, never seen that typo before. Should be "remiss"
I've been using a CGM on and off for the last year, and it has given me a whole new perspective about food and nutrition.
I discovered that a bunch of things I thought were reasonably healthy actually caused huge glycemic spikes -- e.g., white bread in the morning, croissants, dried mangos, excessive amount of fruits, etc.
I also discovered the importance of what you eat for your first meal in the day (either breakfast or lunch), or how to better order what you eat (fibers, fat and protein first, carbs last), light movement after eating reduces 20+ mg/dl, and more.
At this point I don't even need to wear a CGM every day; I can tell my glucose level just by thinking of what I ate earlier.
I still wear one when I'm traveling for work, as I know I'll have less control over food and calorie intake (airplane meals, restaurants, team lunches, etc).
ps: if you're interested in learning more even without using a CGM, strongly recommend "Glucose Revolution" [1].
[1] Glucose Revolution: The Life-Changing Power of Balancing Your Blood Sugar - https://www.amazon.com/Glucose-Revolution-Life-Changing-Powe...