CGM round #2

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apod
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CGM round #2

Post by apod »

I'm reluctantly thinking about trying a round #2 with a CGM sensor. I have an upper arm continuous glucose monitoring sensor box that expires at the end of December, so I'd like to use it up and see what I can learn.

The first round was interesting, although I didn't learn as much as I'd hoped. From what I remember on the first go-around: SuperStarch does not elevate my blood sugar at all when exercising and consumed pre-workout. My blood glucose climbs over the course of a day on a HFLC diet, reaching lowest while sleeping and highest from lunch through a few hours after dinner. There wasn't a clear benefit to doing 2 meals vs 3 meals vs 1 or 4. Sustained HFLC gives me some crazy glucose spikes when I break from the diet. Coffee seems to elevate my blood sugar. HFLC meals hit a big mound for me around 95-115 mg/dL that last for a couple hours, while a low fat meal tends to spike and drop. These sensors aren't very accurate out of the box, but the calibrated data shows very good comparable trends.

This next time around, I'm thinking of looking into either...

1 -- Mixed diet, ~150g net carbs/d at 50g per meal at 3 meals/d consumed with fat / fiber / protein to slow absorption. (Eg. 20-30% carb diet similar to the PerfectHealthDiet.) I might set into this diet a week or so before starting tracking to get used to it. In theory, this is a safe low carb intake that doesn't need to rely much on glucose disposal pathways and should promote insulin sensitivity (but, requires insulin secretion at every meal to deal with starches.) I could throw in some C8 MCT with the starches and maybe check serum ketones as well.

2 -- TKD. 15-25g of high-GI carbs right before exercise, and / or 15-25g of carbs right after exercise. Otherwise, HFLC. Perhaps this will avoid the physiological insulin resistance at the muscle level that I seem to experience and improve exercise performance as a nice minimal dose of peri-workout carbs. I've heard a lot of good things about this method of combining carbs + keto.

3 -- CKD / "LeanGains" / Carb Nite. HFLC, with occasional HCLF days after heavy training (resistance training sucks while wearing an upper-arm CGM.) This one could be interesting. (I could throw in some ALA / Cinnamon extract on carb load days.)

4 -- Low-Carb mixed diet with carbs skewed toward the night or the morning. (Maybe with more or less IF or exogenous ketones.) I've read several articles that mention carbs at the end of the day might be the best place to have them for hormones. I've also read competing theories that suggest carbs might make the most sense to consume at the beginning of the day when insulin sensitivity is higher. I could experiment with AM vs PM exercise.

5 --Low-Carb Low-GI diet. As many carbs as I can fit in from low-carb vegetables and a small amount of low-carb berries while avoiding starches and dense carb sources. This is probably fairly close to a keto mediterranean style diet, as many practice here. This is pretty similar to what I did on the last go around.

One sensor records 14 days of continuous glucose monitoring.

I tend to kind of float between these modes. Any recommendations or thoughts? :geek:
Hubbs
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Re: CGM round #2

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Apod,

As I am still struggling to find better ways of eating to stabilize my blood glucose spikes and drops, I find your CGM/diet experiment very informative and look forward to your new discoveries in the second round.

last month my doctor put me on a 5-day CGM (old model) test out that revealed most spikes over 200 happened after dinner, and I had hypos around 3-4pm as low as 42. The A1c for the week looked good at 5.2 but not so good because the hypos are rather dangerous. My doctor suggested I should eat a snack to bring my blood glucose to 120 at bedtime. But when I did that I ended up having FBG over 120 next morning so I scraped that. I would love to have a CGM that can alert me before a hypo. My doctor says insurance would only cover a CGM if I am insulin treatment dependent. But maybe I can purchase the CGM you use from Europe?

Recently its seems that if I eat some fruit or sweets ahead of my mail meal items It may get my pancreas work better to release insulin on time instead of two hours late, avoiding very bad PP BG spike. Although I can't be sure because when ever I thought I found a pattern my body will respond differently next time... Like last week when I had no choice but ate all sorts of carbs and sweets while on vacation in Mexico I had barely any bad pp BG spikes. Now back to the states I am have BG spike one day and no spike the next - while eating similarly.
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apod
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Re: CGM round #2

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Hubbs wrote:Apod,

As I am still struggling to find better ways of eating to stabilize my blood glucose spikes and drops, I find your CGM/diet experiment very informative and look forward to your new discoveries in the second round.

last month my doctor put me on a 5-day CGM (old model) test out that revealed most spikes over 200 happened after dinner, and I had hypos around 3-4pm as low as 42. The A1c for the week looked good at 5.2 but not so good because the hypos are rather dangerous. My doctor suggested I should eat a snack to bring my blood glucose to 120 at bedtime. But when I did that I ended up having FBG over 120 next morning so I scraped that. I would love to have a CGM that can alert me before a hypo. My doctor says insurance would only cover a CGM if I am insulin treatment dependent. But maybe I can purchase the CGM you use from Europe?

Recently its seems that if I eat some fruit or sweets ahead of my mail meal items It may get my pancreas work better to release insulin on time instead of two hours late, avoiding very bad PP BG spike. Although I can't be sure because when ever I thought I found a pattern my body will respond differently next time... Like last week when I had no choice but ate all sorts of carbs and sweets while on vacation in Mexico I had barely any bad pp BG spikes. Now back to the states I am have BG spike one day and no spike the next - while eating similarly.
It is pretty interesting looking under the hood here. I would bet that if I could wear something noninvasive that tracks glucose like an Apple Watch tracks heart-rate, I'd become much more of an expert on my own n=1 idiosyncrasies and larger patterns for what really works and what doesn't work. 2 weeks isn't a long time to run much data and get into a regimen, although I'm not quite OCD enough to delve too much deeper into a larger study... I do have this one sensor pack left. :D

I bet these sensors would be a lot more useful / comfortable if I had higher body fat on my triceps. It totally messes up my upper-body workouts when I've got a thumbtack stuck right in that muscle.

As mentioned earlier, the accuracy of the uncalibrated Freestyle Libre is not great out of the box. It's excellent for trends and comparing meals, but I wouldn't trust it to give me a fasting blood sugar measurement (initially, I thought my fasting glucose was running high, but it was just bad data coming out of the sensor.) You can set alerts to go off when you're spiking or going hypo, which is pretty cool. I think it's coming to the states relatively soon now that it's FDA-approved: http://abbott.mediaroom.com/2016-09-28- ... r-Patients

You can check prices on ebay.co.uk, although it might make more sense to go through a doctor.

I'd like to maybe look closer at pre-workout / post-workout carbs and high-fat days with a bit more carbs at night (and maybe a high-fat low-carb diet with a carb refeed.) I've been out of the HFLC keto scene for a while (up around 25-30% carbs), so I shouldn't have any issues with physiological IR. It would be cool to also check C8 MCT and Serum Ketones while eating carbs and watching glucose.
apod
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Re: CGM round #2

Post by apod »

Sensor #2 is live.
Image

It was funny at a meeting today, the client was showing off his nerd-skills with his new Alexa-enabled Amazon Echo... I had to one-up him by being wireless-enabled myself.
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Julie G
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Re: CGM round #2

Post by Julie G »

Ouch, brave boy! :shock:
apod
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Re: CGM round #2

Post by apod »

While I've got this thing running... are there any particular foods / supplements / meals / timings that anyone is curious to see with regard to post-prandial glucose readings? :geek:
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cdamaden
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Re: CGM round #2

Post by cdamaden »

Yes, could you weigh and eat a sweet potato and see what your response is? Then maybe with a meal. How long until you get your peak? Thanks!


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Chris
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apod
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Re: CGM round #2

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cdamaden wrote:Yes, could you weigh and eat a sweet potato and see what your response is? Then maybe with a meal. How long until you get your peak?
Any preference on Purple (Stokes) vs White (Jersey) vs Orange (Garnet), with / without skin, baked vs pressure-cooked vs boiled vs cooked + cooled (+ reheated), without fat or with fat (evoo / C8-MCT) around exercise or away from exercise? :D Lots of variables, I suppose.

I had some with dinner tonight, actually (not the prettiest meal.)
Image
The purple ones kind of remind me of the Peter Pan dinner scene when I'm scooping that onto my plate.
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cdamaden
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Re: CGM round #2

Post by cdamaden »

Funny! How about a plain baked garnet eaten after cooking?


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Chris
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apod
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Re: CGM round #2

Post by apod »

Here's some rough data coming out of the thing so far. Days 1-3
day1-3.png
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