1mo of 24hr CGM data streaming

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apod
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1mo of 24hr CGM data streaming

Post by apod »

I went ahead and pulled the trigger on an investment for 1 month of continuous glucose monitoring data. :ugeek:

I'd like to research different timings & preparations of carbohydrates to see how the different pieces interact in real-time with my gut and metabolism. I plan on investigating pre/post/intra workout carbs, low-fat vs high-fat meals, small vs large meals (eg. Mercola's "Peak Fasting" protocol), aerobic vs anaerobic vs hiit workouts, morning vs night carbohydrate intakes, different fruits & ripenesses / veg / grains / legumes, and starches prepared as cooked vs cooked + cooled. I'd also like to investigate some "glucose disposal" type pre-meal supplements, like ALA / Cinnamon / Whey / Etc.

I'm going to try to keep everything well measured and logged with relevant notes. Hopefully I'll get some useful data out of this and learn a few things.

I've been in fairly strict, uninterrupted ketosis for several months running, where I'm looking forward to trying a move toward a sort of low-gi moderately low-carb or targeted / cyclical ketogenic diet with strategic pre / post-workout carbohydrates.

Tomorrow morning, I'm going to inject a NFC sensor under my skin. :D Any ideas for things to try out while plugged in?
James
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Re: 1mo of 24hr CGM data streaming

Post by James »

Very cool, but I seriously doubt you'll get meaningful data. Digestive, postprandial, and general metabolic physiology takes some time to adapt to dietary intake. If you continually change your intake, and it looks like you have quite a long list of experiments, you won't get an idea of how you would respond to a habitual diet with these experimental variables. At best you'll get an idea of how you'd respond if you never ate a consistent diet.
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Re: 1mo of 24hr CGM data streaming

Post by JulieAnnie »

I am a Type 1 diabetic and have been using the DexCom continuous glucose monitoring system for several years. The most important things I have learned is that we can become insulin resistant for various reasons throughout the day. For example, if I eat more than 30 grams of carbohydrate at dinner, I become insulin resistant overnight and my normal background insulin level from my insulin pump is not enough and I wake up with higher than normal glucose levels and have to inject additional insulin to bring the levels back down. I also become insulin resistant during periods of stress (preparing for a presentation, illness, travel,etc.). If I take any type of steroid, even in a lotion, my resistance increases and I have to adjust insulin levels. Since I don't produce any insulin, I know exactly how much insulin I am using. My total daily dose of insulin averages about 30 units per day which is considered within normal ranges of someone with my height and weight. In a way, it's easier for me to know if I'm becoming insulin resistant than it is for normal individuals (non type 1 diabetics). My insulin levels have remained steady for 15 years and I intend to keep it that way. I doubt non Type 1 diabetics could glean a lot of useful info from using the Dexcom unless you are in a later stage of insulin resistance (type 2) and your pancreas does not produce enough insulin. However, you will see some interesting rises in glucose levels after a carb rich meal in early stages of type 2 diabetes. It would be more useful if there was a meter that measured insulin levels continuously.
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Re: 1mo of 24hr CGM data streaming

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James wrote:Very cool, but I seriously doubt you'll get meaningful data. Digestive, postprandial, and general metabolic physiology takes some time to adapt to dietary intake. If you continually change your intake, and it looks like you have quite a long list of experiments, you won't get an idea of how you would respond to a habitual diet with these experimental variables. At best you'll get an idea of how you'd respond if you never ate a consistent diet.
Perhaps 1mo will be too short of a window into my consistently inconsistent diet.

For a few days, I plan to just let the data run and eat my standard 2x meal 40g net carb HFLC diet. I'm anticipating a relatively stable 80-100mg/dL range (my last A1C was 4.9%) -- there shouldn't be any surprises here. This will set the baseline and let me see what glucose does overnight and before my meals via gluconeogenesis. I am curious to see if there are times in the day while practicing IF when serum glucose might experience brief periods of rising -- over the course of a month, I should notice this phenomenon if it's there.

I'd like to try a few low carb days using a large meal in a small eating window (maybe closer to the 80-100g net carb range, which I was doing for a while) and just see what happens. These would be very high fiber, very high fat meals, with a low amount of daily carbs put into a small window (eg. for a 3 meal a day diet, that might be the "per meal carbohydrate equivalent" as a 3-meal 300g+ total carbohydrate day.) The different foods here might have a big impact on the overall effect, although I tend to reach for the same foods when assembling these sorts of large "big-ass salad" type meals (eg. cauliflower, broccoli, onions, peppers, fennel, leeks, nuts, asparagus, avocados, tomato, zucchini, leafy greens.) The data should be clear enough to comparatively see how high glucose might rise when I eat a ton of low-GI veg covered in fat to weigh that sort of eating strategy against smaller meals or lower carb intakes. I can experiment a bit with different foods (eg. some fat covered legumes, and maybe some sweet potato or cooked+cooled potato with olive oil) to see where the boundaries are within that context and which alterations to that basic formula work better than others. Some sort of trend or overall peak glucose range should be visible in the data. I'm curious to see if some sort of post-meal low-level activity might help to attenuate the post-prandial glucose elevation.

I'm hoping to keep exercise set around 4-5d/wk and play with the post-workout meals to see what I can get away with -- what happens if I follow up with a few ripe bananas with a bowl of blueberries, freshly cooked beans, or whey protein + sprouted brown rice, vs a green banana + almond butter or cooked + cooled beans with fat. I'll have to play with it.

When the results aren't clear, I can re-run the same foods with permutations on the variables until I see some sort of trend. I probably won't get as much out of it as I'm hoping, but maybe a few interesting things or tricks will be gleaned.

I want to pick up some liquid Skin Tac adhesive before applying a sensor to see if I can improve my odds for keeping the thing glued on.

Live continuous insulin data would be great. I would love a monitor for continuous serum triglycerides (or serum sdLDL/LDL-P.) I have a nagging feeling that by trading carbs for fats, I'm trading post-prandial glucose elevations for post-prandial triglyceride elevations. If I recall from Attia's post, serum Ketone monitoring might be feasible, but there's no market for the technology.
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Re: 1mo of 24hr CGM data streaming

Post by Tincup »

apod,

You might be interested in this podcast where Mercola describes his use of a CGM. Not sure I agree with his interpretation on fasting being minimized - he see's a slight increase in glucose and thinks that means he needs to eat, but he is doing an excellent job of minimizing insulin (my own non CGM results show continued glucose decrease the longer I fast, even over days). As I recall, he said his fasting insulin was 0.2 or thereabouts. http://podcast.drpompa.com/episodes/115 ... tochondria
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Re: 1mo of 24hr CGM data streaming

Post by MarcR »

Love this thread! Great insights from everyone. I look forward to seeing your results, apod.
apod
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Re: 1mo of 24hr CGM data streaming

Post by apod »

So, here's some initial export data coming out of this thing. It looks like the accuracy is a little rough, but the trends should be there. Google spreadsheets does a great job of interpreting the scatter plot.

I had some pre-workout whey this morning around a fairly intense workout before hooking up the CGM. My first few hours of data were pretty high (130mg/dL ramping down to fasting 80 mg/dL over ~4hrs.) I'm not sure if that's an artifact from the initial calibration routine, or if gluconeogenesis was kicked into overdrive via whey+sprints+resistance training. I'll have to re-investigate soon...

It's cool looking at dinner today -- peak glucose of 90 mg/dL eating some scallops w/ pesto + leafy greens & veg + avocado + soaked hazelnuts as a sort of baseline HFLC meal.
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Re: 1mo of 24hr CGM data streaming

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Apod, do you mind if I ask how much it costs to do one month of continuous glucose monitoring? If you are so inclined, please PM me if you don't feel comfortable sharing this publicly.

My functional medicine MD would like for me to do this testing for two weeks, eating as I regularly do. Per my endocrinologist's nurse, insurance will only cover it if someone had diabetes, which I don't have.

Good luck with the testing!
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apod
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Re: 1mo of 24hr CGM data streaming

Post by apod »

alysson wrote:Apod, do you mind if I ask how much it costs to do one month of continuous glucose monitoring? If you are so inclined, please PM me if you don't feel comfortable sharing this publicly.

My functional medicine MD would like for me to do this testing for two weeks, eating as I regularly do. Per my endocrinologist's nurse, insurance will only cover it if someone had diabetes, which I don't have.

Good luck with the testing!
I'm currently running Abbott's device (Freestyle Libre), which is approved for use without a prescription in Europe but not quite ready in the US... The sensor location seemed a little more user-friendly with a slightly less scary looking needle. From the research, the Freestyle Lite seemed to be the most accurate device when I purchased, and I have good confidence in the company. The price isn't bad at the consumer level. It's something like 60 euros for a 2wk sensor (not horribly expensive when I'm used to blowing cash at good looking Whole Foods meat / seafood / produce, which just gets eaten up.) Although, I'm not quite sold on the accuracy just yet (I've heard the first 12-24hrs of data can be wonky.)

Here's some interesting overnight data -- I woke up much earlier than usual today ~6:30am, although I was in bed by 11pm. Hmmm. The low points seem a bit too low, I'll have to see what happens further along. It's kind of fun watching the thing go (perhaps I could use a slight averaging function between the points.) I read about a new wrist sensor that can monitor continuous blood alcohol levels -- how cool would it be if they could get some rough glucose monitoring data into a smartwatch?
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Last edited by apod on Fri Jun 17, 2016 10:13 am, edited 2 times in total.
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Re: 1mo of 24hr CGM data streaming

Post by ru442 »

apod wrote:not horribly expensive when I'm used to blowing cash at good looking Whole Foods meat / seafood / produce, which just gets eaten up.)
LOL! I am soooo guilty of this... like being in a candy store for me!! ;)
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