Thank you for this info and your review of this in Prac Diabetes.
I have seen healthy normal weight patients exclude foods believing they were pre-diabetic/ insulin resistant from a normal glucose spike. At least now I can reassure them!
Really appreciate all this info. I had no idea that a CGM wouldn't be "the" single measure of blood glucose needed. So it's putting me off getting one completely now. My hb1ac is 35 (IFCC), I've been a bit worried about insulin resistance since considering my weight (63kg) and weekly training schedule (6 hours at Zone 2 a week and 15 hours including walking) and whole food plant based diet it really shouldn't be that high (I'm 39). I have a high genetic risk. So I was considering a CGM but I know I'd get neurotic about it.
I feel like the only way I'm going to avoid prediabetes/metformin as I age is to jump on the elliptical or spin bike after large meals. At least exercise is a pathway that works regardless of your genetics.
PS - continuous HRV measurements like the Garmin does is very good for knowing if you need extra calories. When mine is unusually low in the evening and my resting HR is low I know my autonomic system is sensing a calorie deficit, even if I don't get hungry . So if you don't want a CGM that's a good indicator.
These broader perspectives are so useful. The question, though, is how can we get these ultracrepidarians with huge social media followings to explore these issues with the neccessary rigour?
I so appreciate your focus on the *NUANCE* of all this, Dr. Guess. I think that what has yet to be defined is a "normal" blood glucose -- normal for *whom,* and under what specific context/circumstances? These details matter! Something that might be considered "pathological" under one context might be unremarkably normal (and, in fact, to be completely *expected*) under a very different circumstance. We are really only in the infancy of gathering larger data sets as more individuals with type 2 diabetes as well as (presumably healthy, active) athletes wear CGMs. But overall, I'm with you in that these devices can be genuinely helpful for some people while being neurosis-inducing and highly misleading for others. (I am actually a low-carb-oriented nutritionist and writer by profession, but I pride myself on being a voice of sanity and reason in a field that has become increasingly hyperbolic and ridiculous.)
By an amazing coincidence I was “diagnosed “ as having elevated A1C levels last week. I’m 67, but I do 4x4 HIIT runs several times a week and one SIT session every five days. I have zero risk factors. So this post was very reassuring. Thank you so much.
I wonder if HIIT being used in studies is throwing off a bit, most endurance athletes do a lot of long slow work/aerobic base building.
Thank you for this info and your review of this in Prac Diabetes.
I have seen healthy normal weight patients exclude foods believing they were pre-diabetic/ insulin resistant from a normal glucose spike. At least now I can reassure them!
Really appreciate all this info. I had no idea that a CGM wouldn't be "the" single measure of blood glucose needed. So it's putting me off getting one completely now. My hb1ac is 35 (IFCC), I've been a bit worried about insulin resistance since considering my weight (63kg) and weekly training schedule (6 hours at Zone 2 a week and 15 hours including walking) and whole food plant based diet it really shouldn't be that high (I'm 39). I have a high genetic risk. So I was considering a CGM but I know I'd get neurotic about it.
I feel like the only way I'm going to avoid prediabetes/metformin as I age is to jump on the elliptical or spin bike after large meals. At least exercise is a pathway that works regardless of your genetics.
PS - continuous HRV measurements like the Garmin does is very good for knowing if you need extra calories. When mine is unusually low in the evening and my resting HR is low I know my autonomic system is sensing a calorie deficit, even if I don't get hungry . So if you don't want a CGM that's a good indicator.
These broader perspectives are so useful. The question, though, is how can we get these ultracrepidarians with huge social media followings to explore these issues with the neccessary rigour?
I so appreciate your focus on the *NUANCE* of all this, Dr. Guess. I think that what has yet to be defined is a "normal" blood glucose -- normal for *whom,* and under what specific context/circumstances? These details matter! Something that might be considered "pathological" under one context might be unremarkably normal (and, in fact, to be completely *expected*) under a very different circumstance. We are really only in the infancy of gathering larger data sets as more individuals with type 2 diabetes as well as (presumably healthy, active) athletes wear CGMs. But overall, I'm with you in that these devices can be genuinely helpful for some people while being neurosis-inducing and highly misleading for others. (I am actually a low-carb-oriented nutritionist and writer by profession, but I pride myself on being a voice of sanity and reason in a field that has become increasingly hyperbolic and ridiculous.)
By an amazing coincidence I was “diagnosed “ as having elevated A1C levels last week. I’m 67, but I do 4x4 HIIT runs several times a week and one SIT session every five days. I have zero risk factors. So this post was very reassuring. Thank you so much.