Summary at [11:20] 1. Is a CGM (= Continuous Glucose Monitor) useful a) diabetics: yes b) prediabetic: can be c) with normal bloodsugar: not really. Real risk is cardiovascular, not glucose alone. Foods who spike glucose have other health benefits. 2. Take a holistic approach [1:50] a) glucose level is only one part of a healthy lifestyle b) bacon, eggs and grilled tomatoes are glucose friendly but not for cardiovascular risk, the gut microbiome, vascular function or your blood pressure c) real risk is cardiovascular, not glucose alone [2:36] d) glucose gets high after an intensive workout e) glucose after eating: in a healthy person it can go up to 7,8 millimoles per liter (= 140 mg/dl) [5:15] or even 11,5 (= 207 mg/dl) [11:10] - normal: a spike after 20 minutes and then goes down - You have to worry: * if it is still high 45 minutes after a couple of slices of bread or a small meal [10:00] -> take a test * or if it is still high two hours after glucose tolerance test [10:35] f) there is no evidence that having a flat glucose line after eating is desirable [6:15] g) possible correlation between VO2 max and fasting glucose [8:30] h) cutting carbs don't affects your fasting glucose that much [9:25] 3. GCM for somebody with T2D [11:24] - immediate feedback - motivation - plus a healthy diet - be wary of an exclusive focus on your glucose level. Because if a food flattens your curve doesn’t mean it is healthy -> take an holistic approach 4. prediabetes Hba1c-Test can say if you have diabetes or prediabetes. But it cannot say when your bloodsugar is high [3:35], so a CGM can help you a) if your fasting sugar is high [4:20]; [11:50] - vigorous physical activity - high fiber diet b) if after a meal your glucose level stays high [4:30] - dietary protein - low carb 5. With normal bloodsugar It does not really give you a health benefit. Response from "Nutrition Made Simple!" to this question in one of the thread under this Video: "I´m not aware of a reason to base dietary decisions solely on physiological glucose oscillations (neither seek nor avoid). The concern would be the unnecessary restriction of one's diet without a clear benefit in sight. for example restricting (most) fruit or legumes only to avoid glucose oscillations is hard to justify scientifically and suggests a fear based on incorrect information from social media"
So in the entire coverage, there are 0 downsides? 0? It's a great advance in technology and the use cases listed are great, as one would assume. But one thing that seems to be missing is in which patient population the CGM is (in)accurate, or not appropriate, and discussing why. Can it really be recommended to everyone with diabetes, without variance? From what I have seen, they seem less accurate in people with abnormal exercise and diet, whether it's good or bad. Like someone with extreme strength exercise, etc. In addition, there will obviously be lifestyle tradeoffs, but this does not appear to be discussed. Playing a contact sport where the monitor has a decent change of being hit implies you have to quit that as part of your life. It seems worth mentioning such, if it was considered worth mentioning they provide benefits like "motivation". (Also throw out scuba diving, snorkeling, any prolonged water activity, and potentially always walk around with bruises to the extent that people may ask if you're "OK at home"). As a T1D, downsides are apparent to me and are why I choose not to use one, and I have seen other patients discuss this as well. But it's almost impossible to see a doctor discuss the negatives whatsoever, and I'm curious why. My own doctor pressures me endlessly to use one, no matter what the HBA1c. If you dare suggest you're not interested in this perfect device, he will react terribly. I'd really respect a doctor who is open and honest enough to talk about when not to use. Even though this video does suggest avoiding usage with non-diabetics, there appears to be a blind spot for diabetics.
I know this video is about CMG, but honestly, I REALLY appreciate the arguments about spiking glucose... there are more and more people talking about fruits being bad because of the carbs and it's bad to 'spike your glucose', it's so nice that you inadvertently talked about this! Also, it really shows how if people don't understand what's going on, they can make unwise decision because they see levels spiking. Thank you!
I do agree, but at the same time, isn't it smart to control your aging through blood sugar control instead of letting it run free like a wild unicorn made of cotton candy? There are advantages to control, like more stable energy levels, better skin, better mood. Moreover a reminder "normal" does not mean "optimal", and once you tried the taste of optimal, it's hard to go back. That's why I didn't like the anecdote about the Italian woman. Like, do you like pizza? Find ways to make the dough less spikey, bish! I've seen plenty online. Teach your nephew or whoever to eat a salat with fiber and vinegar before the pizza and not to eat the whole pizza at once, as I did yesterday. Teach him that he has to go for a walk after eating a huuuge delicious ripe mango, go with him. It's all a matter of perspective. And of course I agree that processed foods are really the worse, even if you go for that walk.
Look, I listen to my body, and focus on my fructose intake is very relevant. Whenever I go for a brunch or something else the cravings begins to start 4-6 hours later and they stop only with fiber rich food like sauerkraut. I don't wonder why I got obese even with a lot of exercising. You can ignore your blood sugar, but obviously obesity, Alzheimer, neurological disorders are a mass effect in the world . I got get rid of a lot fat mass , sleepless nights but not my muscles. Eat your fruits as you like. For me they are simply sugar rich sweets , especially if they are easy to eat ( little fiber like water melons or
Great video. Dr Guess is such an effective communicator, her expertise is obviously extensive but she delivers complex information in such a digestibe way.
So glad to see a discussion on CGM's as this exact subject has been of particular interest to me. Also glad to hear that a flat glucose line is NOT necessarily a reccomended focus as one could lose focus on the big picture.
I used one in April 2021 when I was diagnosed as being pre-diabetic and I found it very useful as it showed which foods caused glucose spikes and how tweaking my diet brought my blood sugar levels back to normal.
What about CGM to detect insulin resistance? I have an A1C of 5.1, after years of low carb and intermittent fasting. However, before that, I had what I today know are symptoms of IR: huge cravings around eating hours, fainting when I'd delay a meal, BMI around 28 (now it's 24), high triglycerides and low HDL... No physician ever told me to check my insulin or glucose tolerance, I was eating way too much bread and pasta and pizza... maybe, with a CGM I could have found out earlier that I was heavily taxing my glucose physiology, despite the usual fasting glucose blood test being in the normal range.
She is making some huge leaps here. I wear a CGM. But that doesn’t mean I have a glucose-centric diet. On balance, I prefer to avoid spikes, but I wouldn’t eat unhealthy foods to do so. But I might vary my routine when I am eating healthy food that spike my glucose. I might take a walk afterwards. I might make a point to eat some extra protein with the meal. She seems to be convinced that lay people can’t make intelligent choices. To suggest that someone might avoid exercise because it spikes glucose is too ludicrous to merit a response.
I used one for about 4 weeks. It was interesting to see my glucose response to various conditions, especially exercise. I wasn’t always convinced it was accurate, so I also bought and used the typical finger poke type of monitor to compare. The CGM would often be too high or too low compared with the blood sample. The CGM would also often be sending dangerously low warnings to my phone during longer trail runs. One got down to 3.0. Since I had done that run dozens of time without passing out and since I was feeling fine, tired, but cognitively just fine, I ignored the warnings. But it was an interesting experiment. The one thing I was surprised at is the way the body pumps out glucose in the morning an hour or two before it’s time to wake up. And sometime even earlier than that.
I'm a type 1 so have years of experience with these monitoring systems. What they read is not blood glucose but lymphatic glucose, so when you do prolonged exercise your body will start pulling glycogen stores to maintain blood glucose levels. I trail run too and have had this happen when out on the trails, cgm says low but a blood test says 4.8.
The cgm reads glucose from the interstitial fluid not the blood, so the reading is expected to be about 15 minutes delayed from your finger prick, and glucose levels can change significantly in that time.
I'm not sure what the takeaway is?, there is a fear that people will misinterpret glucose spikes. I'd counter that by education not dissuading people using CGM. I myself have never used one but a person taking managment/interest in their health is always preferable to people having T2DM 10-20 years down the road. Annecdotes about extremes do little to tell us the effect on a wider scale (which hasnt been stuied yet in depth I know). In my opinion somebody using the monitor will be much more likely to optimise other areas of their lifestyle as there is a sense of control like Dr. Guess said at the beginning. Good discussion though.
You could also argue however that if people become super focused on "optimising" every variable in their diet, they will become miserable, and miss out on the bigger picture. Also, the obsession with transient glucose levels pathologies a perfectly normal process. There is no good evidence based argument for wearing them, unless you have diabetes or are prediabetic.
@@HWCWTD and yet an estimated 96 million Americans over 18 are pre-diabetic, so a tool that inspires less sugar and carb intake is a weird thing to do an "I"m skeptical" video about?
@@markmcgurl2885 it's not weird at all, as 1) carbs don't cause diabetes, excess energy intake does, 2) millions of Americans also have elevated blood pressure and LDL, and trying to micromanage your glucose levels as a healthy person may not be a great health strategy.
@@TasteOfButterflies what you say has a point - but no one knows the reason. However, once insulin resistance start developing your best approach is controlling BG as there is no easy way to measure insulin. Caught early with the help of a CGM most could correct this. And fasting insulin or Kraft test can be very useful also. You must be prescribing to a calorie is a calorie hypothesis - a heavily promoted lie by food industry and USDA that is now debunked by best clinicians and scientists. Assuming you need 2000 cal per day why not you only drink equivalent of coke per a month?
This is so interesting to listen to. The problem is, it helps those who listen and evaluate information in a more balanced way. It probably won't help those who are already on the fear of glucose spikes ride, despite the fact that this is an expert in the field.
So, what’s more damaging to the body? High glucose levels or the high insulin output needed to combat glucose spikes? Also, the A1C test is low if you have bouts of hypoglycemia after eating certain foods. You end up with a falsely low A1C. I think blood glucose readings are extremely important. How else would you know if your blood sugar is still elevated after 2 to 4 hours of eating? ‘Course you don’t need a CGM to know that, just a regular meter. Edit - I meant 2 to 4 hours AFTER eating. Not 2 to 4 hours OF eating. 😲
Why blame the CGM for the user misinterpreting the info? Continue to educate those you believe are reacting improperly to their results and leave the CGM's alone. The info they provide can be useful for any user if they understand it. Given the huge problem we have in this country, and worldwide, with Type 2 (and the oft-related obesity et al), if a little device on arms can help people keep or get their metabolic game in order, I think it should be strongly encouraged. Okay, I was responding to the first part of the video. Now that I've finished the rest, I see that both doctor's conclusions are, more or less, what I was saying, so NEVERMIND.
I’ve become a fan of Dr Guess. She along with my docs, suggested I eat more plant protein (seitan tofu tempeh) which the whole food-plant based approach does NOT really recommend (wfpb just says eat all whole food and sadly that didn’t work for me). I wish you had mentioned the Glucose Goddess. When I was diagnosed with prediabetes recently several people told me to follow her. There is a lot of good advice there. But definitely GG is all about flattening glucose spikes for everyone all day and every day. I became very frustrated with that approach. I will tell you though my CGM is awesome. I have learned my insulin sensitivity is very good in the am. Later in the day it’s a bit lax and I’m scheduling my workouts at that time.
Healthy individuals could use CGM to know personally which foods spike their insulin levels abnormally high. This way they could avoid regular consumption of certain foods or throw in some fibre with that meal. Ideally we have an Continuous insulin monitor to track. Waiting for such a product to come out.
But as she said if you focus is on healthy diet you don't need this since a healthy diet means that you have to introduce fibers on a daily basis. And if on occasion you don't, then that's not the end of the world. You won't become diabetic just because once a week, you eat pizza without plant fibers.
@@HereDiianas In general that is true . But there may be some foods we eat regularly that is in the category of healthy food which may be causing huge insulin spikes. Over time it may degrade insulin sensitivity.
I agree somewhat. I was diagnosed as prediabetic and got a prescription for a glucose monitor. It has been a game change for me. At least now I know which meals in my regular rotation were spiking my glucose and even causing hypo crashes. I’ve since made a few changes to my meals to get lower spikes and I’ve replaced junk food snacks with fruits and nuts.
Thanks for this amazing useful video .. Thanks again Gil for interviewing specialize people to give clear scientific answers away from the internet rubbish .. now i understand that spike is normal as long as you are healthy and nothing to worry about.
I am a little confused and I hope somebody can answer me. Dr. Guess says that glucose spikes are normal, and we don't know if glucose spikes are bad (they might even be helpful in some circumstances). Consistently high blood glucose is much worse. I get all that....what I am confused about is the following: As far as I know, one of the most basic advices is to avoid sugar and simple carbs because they spike blood glucose. One should eat whole grains because they lower glucose spikes and spread it over a longer amount of time. Why is that desirable, tho? Dr. Guess says that glucose spikes are completely normal. Whole grains lower the maximum of the blood glucose but then the time of elevated blood glucose levels is a bit longer. Consuming whole grains is associated with health benefit, when compared to simple carbs. What is going on here? If glucose spikes are fine, why are whole grains healthier (yeah there are some vitamins/minerals in whole grains but if that is the only difference, I am not impressed)
Really interesting to hear the comments on high fasting blood glucose levels in people who do a lot of exercise. This is relevant to me. In the last 2 years, following a git health scare I have radically reduced the amount of sugary, processed carb foods and generally processed foods. I follwed the Zoe program which uses a CGM to suggest glucose tolerance and bllod tests to see how quickly dietary fat is removed from the blood. As a result I have increased the amount of complex carbs I eat. Gut inflammation has reversed but my HBA1c has only dropped a small amount which leaves me at the boarder of normal/prediabetes range. I have often wondered if there is an exercise dimension here and as said I am interested by Dr Guess' comments. I totally agree with her comments about not getting too hung up on glucose control/monitoring. I do monitor, but am much more focused on a wide range of metrics.
If you are type 2 diabetic or pre - diabetic , you can still wear such a glucose meter , for example for half a year until you are no longer type 2 diabetic or pre - diabetic . You switch to a maximum of 2 meals a day and don't eat any snacks in between, and you watch what you eat (control via the glucose meter) so that your sugar-sugar level and insulin do not go too high. If you were to do this for a few months to a year, the chances that you would no longer be diabetic are more than considerable, because we now know that type 2 diabetes is reversible. Once you are no longer diabetic, you can stop wearing a glucose meter and start eating something more varied. As long as you don't go back to your old eating habits and don't eat all day long, stick to 2-3 meals a day and no snacks. I myself have completely reversed my type 2 diet and I am no longer a diabetic patient for almost two years. I did this without a glucose meter, just switching to 1 max 2 meals a day and low carb to no carb. I also started training with weights 3 times a week and cardio 4 times a week. I was diagnosed with type 2 diabetes and I immediately started eating differently and 5 months later I was no longer diabetic. And now I eat in an 8 hour time window (from 2 pm to 10 pm) about 2 to 3 times. All symptoms associated with type 2 diabetes have disappeared like snow in the sun. No medication was taken , just having an iron will was enough for me . im 54 years old men .
With low or no carbs then by definition you're eating much more dietary fat. Isn't a high fat diet the exact cause of diabetes in the first place? Too much fat in the liver, or the cell blocks insulin sensitivity, and too much fat in the pancreas causing less insulin production. I'm not challenging your choice of diet, just trying to get a better understanding of the subject. Good health to you.
She makes some fair points but they’re really targeted toward people with a limited nutritional understanding. If you’re well educated, using a CGM can be very helpful and I’d like to see more discussion about that.
Interesting stuff. I had borderline T2 4 years ago which is in remission due to weight loss, diet and exercise. (My A1c was 5.2%, 33 mmol/mol the last test.) I wore a CGM for a fortnight last year, and didn't find anything I thought was worth changing anything for. There was one spike which may have been slightly out of normal; the meal causing it was roasted sea bass with potatoes and rosemary. I love that meal; I still eat it. My assumption is that it will not kill me.
Spikes are fine, but its important to know what foods you respond to abnormaly. Some people get a glucose spike from artificial sweetner, but some dont. Would be good to know which group you are in .
I rode my bike to my annual physical blood draw about a 12-14 mile ride. I was fasted (but not fast on the bike) and when the results came in my blood sugar was high. My A1C was good and the urinalysis found ketones present.
Great , thanks for your continuous tireless efforts of keeping us informed of evidence base nutrition information. Wonder you can also talk about ‘metabolic therapy ‘for cancer including keto diet and intermittent fasting ( claiming ketosis and anti-glutamine effect),any scientific evidence?
Excellent - Dr. Guess is great. Even in pre-diabetes, there's the issue of how to interpret the CGM data, too (in light of the people who should know better and the "expert'" advice she mentions)
Is it the “area under the curve” that matters most? If your glucose spikes to 180 but it’s only there for 3 minutes, maybe that’s ok if insulin levels are under control.
My biggest question about CGM is the time frame to see changes. CGM is known to lag somewhat compared to blood tests, but I haven’t been able to find out the exact limits of that. This is of particular interest to me as I have an elevated, but not diagnostic, HgbA1C, and when I trialed a CGM, I saw postprandial spikes that seemed to last much longer than expected, and even had some odd ups and down, before settling to my fasting levels, quite a while later. But my fasting levels are solidly normal.
I wear one (lasting two weeks) each year just to have a rough idea of wear I'm at (median, mean, standard deviation, amplitude of peaks). And it doesn't really influence my diet.
Too bad that some people don’t know how to use a tool. Do we expect a monkey to use a sharp knife without monkey cutting itself? The woman that she refers to at the beginning doesn’t know how to use it and I wonder why you trash a tool using examples where user clearly doesn’t know how to use it. Isn’t this true for any tool? I think CGM is a must for diabetes patients. Can be a wonderful tool for pre-diabetes or people knowledgeable about metabolism. It is true that BG only provides half the story and the other half is insulin levels after meals. For that ideally people should do a Kraft test or at least a fasting insulin measurement.
The guys at "Mastering diabetes" are both type 1 and eat a whole foods plant based high carb diet to control their blood glucose and minimise their need for insulin. I don't see why spiking matters compared to having optimal fasting blood glucose. Glad the guest doctor talked about cutting out saturated fatty foods in this regard.
I think some people would like to know Which foods spike the levels of glucose oscillations (as normal) but then CRASH the levels afterwards (causing tiredness etc). Does rice make me crash more than potatoes for example...
I wonder if you can lose fat by using a GM to tell you it's "okay to eat", e.g. when your blood glucose falls to a target number... a way of ensuring you're actually hungry when you eat, not just bored or stressed...
I recently experimented with a CGM. Keep in mind that I am healthy. It blew my mind when I ate a bowl of yogurt, blue berries, strawberries, and honey and had a ZERO spike in glucose. I thought for sure it would spike like a mf. My fasting insulin is 1.8 and fasting c-peptide is 0.83.
I fell for this scary trap myself What about the claims that eating fats and carbs together causes diabetes??? For example of sweet potato with Walnut butter or coconut butter will cause diabetes?? A bowl of oatmeal with nuts and raisins will cause diabetes??? Is there any truth to eating carbs and fats together causes diabetes even if it's whole foods?? That's scary stuff!! But isn't carbs and fats a healthy combination?? I can't eat a bowl of oatmeal by itself I like having balanced meals,, proteins fats and carbs together
It's not true. What is probably true: processed foods high in both fat and sugar (like chocolate, cookies, donuts...) are more likely to cause cravings, overheating, compulsive eating, and weight gain. What is probably true: gaining weight beyond a certain threshold will cause a person to develop diabetes What isn't true: rumors that sweet potato with peanut butter will give you diabetes. The person who said this was either very confused or trying to promote a very unbalanced diet. Nuts are good. Sweet potatoes and oatmeal are also good. They don't become poison when combined.
I mean.... Not eating pizza is probably a good thing lol. Typically simple carbs and sugars are related to glucose spikes so ignoring those foods will likely result in more stable levels. I guess not a carrot because of a glucose spike may be what she's warning about, but still. I think CGMs can help quantify (some) bad eating and discourage it.
I suspect he's referring to supra-physiological spikes in people with underlying issues of glucose metabolism. I´d be surprised if he's concerned about physiological excursions after a meal in healthy people, which are completely normal
@@NutritionMadeSimple Hello! Thank you for the reply! Even for healthy normal fit people... any benefit?? Technically we can always have meals that wont spike glucose too much... eg: steak and salad or chicken and broccoli instead of chicken rice broccoli or sushi or 2 bananas etc..
@@AK-qg7mp other than the points made by Dr. Guess regarding insulin pulsatility, I´m not aware of a reason to base dietary decisions solely on physiological glucose oscillations (neither seek nor avoid). The concern would be the unnecessary restriction of one's diet without a clear benefit in sight. for example restricting (most) fruit or legumes only to avoid glucose oscillations is hard to justify scientifically and suggests a fear based on incorrect information from social media, but if someone were adamant, it may be possible to design such a diet in a health-promoting way e.g. with the help of an RD
I am looking for more background knowledge for the following. I am a 64 yo white male, DM2 that is insulin controlled. My last A1c was 6.1, current body weight is 313 lbs (6'-4") and interested in starting intermittent fasting to help with weight control. I am looking for more information on how to manage my insulin intake during IF. Any suggestions for information sources?
i'm fairly certain that eating pizza and beer and spaghetti and meatballs with garlic bread got me into this mess. mixing a high amount of carbohydrate with a copious amount of fat is is a bad idea. maybe on my birthday once a year, but generally i try to avoid eating like that.
Thank you for your videos! Forgive me if you already talked about this before, but I am interested about your opinion about whole food plant based diet (mostly if it should be for everyone how it is promoted now), also what is your opinion about some studies showing connection between dairy and cancer. I will be happy in the future see your videos for these topics.
Since no one has replied, I will. If you check out Nutrition Facts you'll get a wealth of information on WFPB diets. Everything is backed by good-science studies. On a personal note, it's the only thing that has made any improvement in my weight, waist circumference, lipids, diabetes and inflammation. I'm drinking the Kool-Aid and gone back for seconds, so take that for what it's worth. Wishing you good health.
I have postprandial syndrome, and I've been curious if a CGM would show a spike and sudden drop during one of these episodes. I haven't had one in a while because when I'm eating something sweet, I either make sure it's close to when I'm having a meal, or I'm sure to include some protein and/or fiber. I understand my body well enough to know that I can't have a couple donuts for breakfast, even as a rare treat, if I don't have some soy milk or other form of protein with it, or I'll be miserable if I don't eat for a couple hours. When I say miserable, I mean I experience feeling brain fog/hangry, lightheaded, cold sweats, and incredibly hungry.
I still think they are not very helpful unless your an insulin dependant diabetic trying to figure out how much insulin you need. It kinda reminds me of people who are pre-occupied with the weight on their scale even though they aren't overweight. If they gain a pound they panic and start dieting. Using a glucose monitor when you dont really needs it is the same thing really. Although I can see it as a use if your type 2 diabetic having trouble sticking to a diet plan since a great many people who are type 2 are like that as a result of poor lifestyle choices.
Hello Gil, greetings from Colombia . Im currently training for an IRONMAN but im changing my diet to only plants. Im aiming to get 1.2g of protein per kg but using plant based foods i pass the upper Limit recomended of folate or manganese. Should i be worried or are any ways to bypass this problem. Thanks a lot for all the information u give on your videos, because of you im trying to make this diet change in my life.
I feel this video is one sided and doesn't go into the subject anywhere deeply enough. Cgm's are a great tool. Educating people with respect to the very real positive aspects of using one would be more useful. Love your videos but this one seemed less balanced than what I expect from this channel.
Doesn't a good anti-oxidant status reduce the negative effect of high blood glucose? Like by causing less AGEs. So if the foods are high in anti-oxidants maybe it's not as bad. Also I wonder about the peroxidation of lipids. It is rarely talked about compared to T2D. Someone who eats low carbs/high fat may lower his glucose, but if that comes at the cost of more lipid peroxidation maybe that's not good either.
What's considered normal physiologic glucose excursions. the time points mentioned are after the standard OGTT, I wonder if there is any difference after the regular meal, ie postprandial glucose level( OGTT vs regular meal )?
The stuff she's discussing with the patient with the 5.1 A1C is the same thinking I had during my short stint in the world of carnivore and extremely low carb. Some of the ideas she talked about make me think she was specifically thinking of Dr. Pradip Jamnadas in his talk on TH-cam, "The Fat Lies". He would have you believe that virtually all heart disease is caused by diabetes and undiagnosed diabetes. I'd love to see a comprehensive fact check on that talk.
Using a cgm out of curiosity helped me to realize I have night time hypoglycemia. I’m not diabetic. There is so much information about insulin spikes going up but I’d love a video about hypoglycemia.
I have my routine gestational diabetes test in a month. I don't expect any issues but curious if it would be useful paired with dietary advice for those who are pregnant with gestational diabetes.
How are normal non diabetics getting access to CGMs? I have to get a prescription for mine. Do they doctor shop? Is there a black market? With more people who don’t need them driving the high cost?
where I live you need a prescription, but any doctor will write one upon request because there are no downsides to using a CGM-- other than the relatively exotic case of a perfectly healthy patient making herself miserable by *obsessive* avoidance of carbs
I'm pre-diabetic. I use one. The goal is to get to a non-pre-diabetic state. It's an experiment. Slowly, it seems to be working. It's like getting on a scale - it's an automatic feedback to your brain where you stand, instead of fooling yourself into an achievement you have not reached. I'm paying for my own, which I think medical insurance should pay for in terms of prevention. But as we all know, they are huge hypocrites who are solely based on profit. Follow me for more intelligence.
9:27 she thinks cutting carbs doesn't even affect ur fasting glucose that much. so i wonder, Gil, what affects ur fasting glucose? is it excess liver fat?
Regarding athletes, I bet on winners. Want a winner, need to start with data. CGM, heart rate monitor, smart watch, Vo2max testing, blood work,...more details the better. For powerlifters and strongman competitors I want to see them spike their glucose 12 times a day !!! I want to see they are force eating and even eating in the middle of the night to get BIG. When you see 6' 5" + 350 lbs + NFL player I can guarantee they are eating and eating to maintain the size. Data is for the young and healthy is great. CGM for healthly athletes is great for monitoring. I want to be 100% certain the eat that half gallon of Haagen dazs ice cream before going to bed. Data is always helpful. Even for the everyday housewife following a fitness plan, I want data to know when they cheat.
The whole idea around CGM for non-diabetics is rather….insensitive & hurtful for Type1 patients. Here we do it for sh*ts & giggles…but their LIFE depends on it. It’s…insulting
Hi...but why is it insulting? I've worn one a few times and have found it extremely helpful. I'm wearing one now and am planning on bringing my results to my Dr as I am getting exercise induced hypoglycemia and I'm not sure why (maybe perimenopause?). I would never have known if I didn't wear this. I also found out last time that having 'naked carbs' eg a croissant I spike to 13! But if I have it with fiber and protein it will only be around 7 mmol. I am sorry you have T1 but that shouldn't mean others can't benefit from this technology. Have a wonderful day 🙏
Terrific guest and interview. Regarding physiologic blood glucose range, this may be worth considering: *Keeping Blood Glucose In Range* th-cam.com/video/-_nXKpeZZFs/w-d-xo.html
The concern with everyone using these devices is that they need to get a life. Everyone nowadays is seeking that magic elixir to eternal youth, but that’s now how life works. And who in their right mind thinks blood glucose should remain flat? Sure, if you’re dead.
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Summary at [11:20]
1. Is a CGM (= Continuous Glucose Monitor) useful
a) diabetics: yes
b) prediabetic: can be
c) with normal bloodsugar: not really. Real risk is cardiovascular, not glucose alone. Foods who spike glucose have other health benefits.
2. Take a holistic approach [1:50]
a) glucose level is only one part of a healthy lifestyle
b) bacon, eggs and grilled tomatoes are glucose friendly but not for cardiovascular risk, the gut microbiome, vascular function or your blood pressure
c) real risk is cardiovascular, not glucose alone [2:36]
d) glucose gets high after an intensive workout
e) glucose after eating: in a healthy person it can go up to 7,8 millimoles per liter (= 140 mg/dl) [5:15] or even 11,5 (= 207 mg/dl) [11:10]
- normal: a spike after 20 minutes and then goes down
- You have to worry:
* if it is still high 45 minutes after a couple of slices of bread or a small meal [10:00] -> take a test
* or if it is still high two hours after glucose tolerance test [10:35]
f) there is no evidence that having a flat glucose line after eating is desirable [6:15]
g) possible correlation between VO2 max and fasting glucose [8:30]
h) cutting carbs don't affects your fasting glucose that much [9:25]
3. GCM for somebody with T2D [11:24]
- immediate feedback
- motivation
- plus a healthy diet
- be wary of an exclusive focus on your glucose level. Because if a food flattens your curve doesn’t mean it is healthy -> take an holistic approach
4. prediabetes
Hba1c-Test can say if you have diabetes or prediabetes. But it cannot say when your bloodsugar is high [3:35], so a CGM can help you
a) if your fasting sugar is high [4:20]; [11:50]
- vigorous physical activity
- high fiber diet
b) if after a meal your glucose level stays high [4:30]
- dietary protein
- low carb
5. With normal bloodsugar
It does not really give you a health benefit.
Response from "Nutrition Made Simple!" to this question in one of the thread under this Video: "I´m not aware of a reason to base dietary decisions solely on physiological glucose oscillations (neither seek nor avoid). The concern would be the unnecessary restriction of one's diet without a clear benefit in sight. for example restricting (most) fruit or legumes only to avoid glucose oscillations is hard to justify scientifically and suggests a fear based on incorrect information from social media"
thanks for putting this together!! (pinned the comment for the convenience of future viewers)
modern hero
So in the entire coverage, there are 0 downsides? 0? It's a great advance in technology and the use cases listed are great, as one would assume. But one thing that seems to be missing is in which patient population the CGM is (in)accurate, or not appropriate, and discussing why. Can it really be recommended to everyone with diabetes, without variance? From what I have seen, they seem less accurate in people with abnormal exercise and diet, whether it's good or bad. Like someone with extreme strength exercise, etc. In addition, there will obviously be lifestyle tradeoffs, but this does not appear to be discussed. Playing a contact sport where the monitor has a decent change of being hit implies you have to quit that as part of your life. It seems worth mentioning such, if it was considered worth mentioning they provide benefits like "motivation". (Also throw out scuba diving, snorkeling, any prolonged water activity, and potentially always walk around with bruises to the extent that people may ask if you're "OK at home"). As a T1D, downsides are apparent to me and are why I choose not to use one, and I have seen other patients discuss this as well. But it's almost impossible to see a doctor discuss the negatives whatsoever, and I'm curious why. My own doctor pressures me endlessly to use one, no matter what the HBA1c. If you dare suggest you're not interested in this perfect device, he will react terribly. I'd really respect a doctor who is open and honest enough to talk about when not to use. Even though this video does suggest avoiding usage with non-diabetics, there appears to be a blind spot for diabetics.
I know this video is about CMG, but honestly, I REALLY appreciate the arguments about spiking glucose... there are more and more people talking about fruits being bad because of the carbs and it's bad to 'spike your glucose', it's so nice that you inadvertently talked about this! Also, it really shows how if people don't understand what's going on, they can make unwise decision because they see levels spiking. Thank you!
The fear of glucose spikes in healthy people is a great example of the saying "a little knowledge is a dangerous thing".
I do agree, but at the same time, isn't it smart to control your aging through blood sugar control instead of letting it run free like a wild unicorn made of cotton candy? There are advantages to control, like more stable energy levels, better skin, better mood. Moreover a reminder "normal" does not mean "optimal", and once you tried the taste of optimal, it's hard to go back. That's why I didn't like the anecdote about the Italian woman. Like, do you like pizza? Find ways to make the dough less spikey, bish! I've seen plenty online. Teach your nephew or whoever to eat a salat with fiber and vinegar before the pizza and not to eat the whole pizza at once, as I did yesterday. Teach him that he has to go for a walk after eating a huuuge delicious ripe mango, go with him. It's all a matter of perspective. And of course I agree that processed foods are really the worse, even if you go for that walk.
Look, I listen to my body, and focus on my fructose intake is very relevant. Whenever I go for a brunch or something else the cravings begins to start 4-6 hours later and they stop only with fiber rich food like sauerkraut.
I don't wonder why I got obese even with a lot of exercising.
You can ignore your blood sugar, but obviously obesity, Alzheimer, neurological disorders are a mass effect in the world .
I got get rid of a lot fat mass , sleepless nights but not my muscles. Eat your fruits as you like. For me they are simply sugar rich sweets , especially if they are easy to eat ( little fiber like water melons or
Great video. Dr Guess is such an effective communicator, her expertise is obviously extensive but she delivers complex information in such a digestibe way.
So glad to see a discussion on CGM's as this exact subject has been of particular interest to me. Also glad to hear that a flat glucose line is NOT necessarily a reccomended focus as one could lose focus on the big picture.
I used one in April 2021 when I was diagnosed as being pre-diabetic and I found it very useful as it showed which foods caused glucose spikes and how tweaking my diet brought my blood sugar levels back to normal.
What about CGM to detect insulin resistance? I have an A1C of 5.1, after years of low carb and intermittent fasting. However, before that, I had what I today know are symptoms of IR: huge cravings around eating hours, fainting when I'd delay a meal, BMI around 28 (now it's 24), high triglycerides and low HDL... No physician ever told me to check my insulin or glucose tolerance, I was eating way too much bread and pasta and pizza... maybe, with a CGM I could have found out earlier that I was heavily taxing my glucose physiology, despite the usual fasting glucose blood test being in the normal range.
BMI doesn't indicate much.
She is making some huge leaps here. I wear a CGM. But that doesn’t mean I have a glucose-centric diet. On balance, I prefer to avoid spikes, but I wouldn’t eat unhealthy foods to do so. But I might vary my routine when I am eating healthy food that spike my glucose. I might take a walk afterwards. I might make a point to eat some extra protein with the meal. She seems to be convinced that lay people can’t make intelligent choices. To suggest that someone might avoid exercise because it spikes glucose is too ludicrous to merit a response.
I assume that she deals with a lot of ludicrous people.
I used one for about 4 weeks. It was interesting to see my glucose response to various conditions, especially exercise. I wasn’t always convinced it was accurate, so I also bought and used the typical finger poke type of monitor to compare. The CGM would often be too high or too low compared with the blood sample. The CGM would also often be sending dangerously low warnings to my phone during longer trail runs. One got down to 3.0. Since I had done that run dozens of time without passing out and since I was feeling fine, tired, but cognitively just fine, I ignored the warnings. But it was an interesting experiment. The one thing I was surprised at is the way the body pumps out glucose in the morning an hour or two before it’s time to wake up. And sometime even earlier than that.
Your cortisol spikes around that time and cortisol causes glucose to be released into your bloodstream by the liver.
I'm a type 1 so have years of experience with these monitoring systems. What they read is not blood glucose but lymphatic glucose, so when you do prolonged exercise your body will start pulling glycogen stores to maintain blood glucose levels. I trail run too and have had this happen when out on the trails, cgm says low but a blood test says 4.8.
The cgm reads glucose from the interstitial fluid not the blood, so the reading is expected to be about 15 minutes delayed from your finger prick, and glucose levels can change significantly in that time.
I'm not sure what the takeaway is?, there is a fear that people will misinterpret glucose spikes. I'd counter that by education not dissuading people using CGM. I myself have never used one but a person taking managment/interest in their health is always preferable to people having T2DM 10-20 years down the road. Annecdotes about extremes do little to tell us the effect on a wider scale (which hasnt been stuied yet in depth I know).
In my opinion somebody using the monitor will be much more likely to optimise other areas of their lifestyle as there is a sense of control like Dr. Guess said at the beginning. Good discussion though.
Nicely said.
Not knowing how to use a tool by some is not a reason to trash it by so called experts.
You could also argue however that if people become super focused on "optimising" every variable in their diet, they will become miserable, and miss out on the bigger picture. Also, the obsession with transient glucose levels pathologies a perfectly normal process.
There is no good evidence based argument for wearing them, unless you have diabetes or are prediabetic.
@@HWCWTD and yet an estimated 96 million Americans over 18 are pre-diabetic, so a tool that inspires less sugar and carb intake is a weird thing to do an "I"m skeptical" video about?
@@markmcgurl2885 it's not weird at all, as 1) carbs don't cause diabetes, excess energy intake does, 2) millions of Americans also have elevated blood pressure and LDL, and trying to micromanage your glucose levels as a healthy person may not be a great health strategy.
@@TasteOfButterflies what you say has a point - but no one knows the reason. However, once insulin resistance start developing your best approach is controlling BG as there is no easy way to measure insulin. Caught early with the help of a CGM most could correct this. And fasting insulin or Kraft test can be very useful also.
You must be prescribing to a calorie is a calorie hypothesis - a heavily promoted lie by food industry and USDA that is now debunked by best clinicians and scientists.
Assuming you need 2000 cal per day why not you only drink equivalent of coke per a month?
This is so interesting to listen to.
The problem is, it helps those who listen and evaluate information in a more balanced way. It probably won't help those who are already on the fear of glucose spikes ride, despite the fact that this is an expert in the field.
So, what’s more damaging to the body? High glucose levels or the high insulin output needed to combat glucose spikes? Also, the A1C test is low if you have bouts of hypoglycemia after eating certain foods. You end up with a falsely low A1C. I think blood glucose readings are extremely important. How else would you know if your blood sugar is still elevated after 2 to 4 hours of eating? ‘Course you don’t need a CGM to know that, just a regular meter.
Edit - I meant 2 to 4 hours AFTER eating. Not 2 to 4 hours OF eating. 😲
Why blame the CGM for the user misinterpreting the info? Continue to educate those you believe are reacting improperly to their results and leave the CGM's alone. The info they provide can be useful for any user if they understand it. Given the huge problem we have in this country, and worldwide, with Type 2 (and the oft-related obesity et al), if a little device on arms can help people keep or get their metabolic game in order, I think it should be strongly encouraged.
Okay, I was responding to the first part of the video. Now that I've finished the rest, I see that both doctor's conclusions are, more or less, what I was saying, so NEVERMIND.
I would like to see some videos on how much sugar from fruit is ok to be consumed.
I’ve become a fan of Dr Guess.
She along with my docs, suggested I eat more plant protein (seitan tofu tempeh) which the whole food-plant based approach does NOT really recommend (wfpb just says eat all whole food and sadly that didn’t work for me).
I wish you had mentioned the Glucose Goddess. When I was diagnosed with prediabetes recently several people told me to follow her. There is a lot of good advice there. But definitely GG is all about flattening glucose spikes for everyone all day and every day. I became very frustrated with that approach.
I will tell you though my CGM is awesome. I have learned my insulin sensitivity is very good in the am. Later in the day it’s a bit lax and I’m scheduling my workouts at that time.
“have learned my insulin sensitivity is very good in the am. Later in the day it’s a bit lax”. This is true for humans in general, not just you.
Healthy individuals could use CGM to know personally which foods spike their insulin levels abnormally high. This way they could avoid regular consumption of certain foods or throw in some fibre with that meal. Ideally we have an Continuous insulin monitor to track. Waiting for such a product to come out.
But as she said if you focus is on healthy diet you don't need this since a healthy diet means that you have to introduce fibers on a daily basis. And if on occasion you don't, then that's not the end of the world. You won't become diabetic just because once a week, you eat pizza without plant fibers.
@@HereDiianas In general that is true . But there may be some foods we eat regularly that is in the category of healthy food which may be causing huge insulin spikes. Over time it may degrade insulin sensitivity.
I agree somewhat. I was diagnosed as prediabetic and got a prescription for a glucose monitor. It has been a game change for me. At least now I know which meals in my regular rotation were spiking my glucose and even causing hypo crashes. I’ve since made a few changes to my meals to get lower spikes and I’ve replaced junk food snacks with fruits and nuts.
Thanks for this amazing useful video .. Thanks again Gil for interviewing specialize people to give clear scientific answers away from the internet rubbish .. now i understand that spike is normal as long as you are healthy and nothing to worry about.
I am a little confused and I hope somebody can answer me. Dr. Guess says that glucose spikes are normal, and we don't know if glucose spikes are bad (they might even be helpful in some circumstances). Consistently high blood glucose is much worse.
I get all that....what I am confused about is the following:
As far as I know, one of the most basic advices is to avoid sugar and simple carbs because they spike blood glucose. One should eat whole grains because they lower glucose spikes and spread it over a longer amount of time. Why is that desirable, tho? Dr. Guess says that glucose spikes are completely normal. Whole grains lower the maximum of the blood glucose but then the time of elevated blood glucose levels is a bit longer.
Consuming whole grains is associated with health benefit, when compared to simple carbs. What is going on here?
If glucose spikes are fine, why are whole grains healthier (yeah there are some vitamins/minerals in whole grains but if that is the only difference, I am not impressed)
Thanks, great video. Good that she mentioned the tech biohackers. They focus too much on mechanisms, and don't look at it from a holistic perspective.
Excellent !!!!
Please make videos more often
He's been making one a week!
@@chandebrec5856 If one is good two are better
@@rn5697 too much frequency might mean lower quality. 1 a week is a good middle ground.
I would love to hear this lady talk about what to do for high cholesterol.
Really interesting to hear the comments on high fasting blood glucose levels in people who do a lot of exercise. This is relevant to me. In the last 2 years, following a git health scare I have radically reduced the amount of sugary, processed carb foods and generally processed foods. I follwed the Zoe program which uses a CGM to suggest glucose tolerance and bllod tests to see how quickly dietary fat is removed from the blood. As a result I have increased the amount of complex carbs I eat. Gut inflammation has reversed but my HBA1c has only dropped a small amount which leaves me at the boarder of normal/prediabetes range. I have often wondered if there is an exercise dimension here and as said I am interested by Dr Guess' comments. I totally agree with her comments about not getting too hung up on glucose control/monitoring. I do monitor, but am much more focused on a wide range of metrics.
I would love to see a discussion between Dr. Guess and Peter Attia. I think there would be a lot of productive disagreement
Can't even if I wanted to. Only for diabetics
Love her. This is amazing. Will help so many people who have fallen for this harmful trend.
Great information from an actual scientist. Hope the ‘influencers’ in question see this and stop spreading misinformation
They won't, it's all about their TH-cam views.
If you are type 2 diabetic or pre - diabetic , you can still wear such a glucose meter , for example for half a year until you are no longer type 2 diabetic or pre - diabetic . You switch to a maximum of 2 meals a day and don't eat any snacks in between, and you watch what you eat (control via the glucose meter) so that your sugar-sugar level and insulin do not go too high. If you were to do this for a few months to a year, the chances that you would no longer be diabetic are more than considerable, because we now know that type 2 diabetes is reversible. Once you are no longer diabetic, you can stop wearing a glucose meter and start eating something more varied. As long as you don't go back to your old eating habits and don't eat all day long, stick to 2-3 meals a day and no snacks. I myself have completely reversed my type 2 diet and I am no longer a diabetic patient for almost two years. I did this without a glucose meter, just switching to 1 max 2 meals a day and low carb to no carb. I also started training with weights 3 times a week and cardio 4 times a week. I was diagnosed with type 2 diabetes and I immediately started eating differently and 5 months later I was no longer diabetic. And now I eat in an 8 hour time window (from 2 pm to 10 pm) about 2 to 3 times. All symptoms associated with type 2 diabetes have disappeared like snow in the sun. No medication was taken , just having an iron will was enough for me . im 54 years old men .
With low or no carbs then by definition you're eating much more dietary fat. Isn't a high fat diet the exact cause of diabetes in the first place? Too much fat in the liver, or the cell blocks insulin sensitivity, and too much fat in the pancreas causing less insulin production. I'm not challenging your choice of diet, just trying to get a better understanding of the subject.
Good health to you.
@@Joseph1NJ Nope, fat in the liver is mainly due to excessive fructose.
@@markotrieste I think @Joseph1NJ is talking about fat in the muscles, preventing the glucose from entering the cells. Not fat in the liver.
She makes some fair points but they’re really targeted toward people with a limited nutritional understanding. If you’re well educated, using a CGM can be very helpful and I’d like to see more discussion about that.
Interesting stuff. I had borderline T2 4 years ago which is in remission due to weight loss, diet and exercise. (My A1c was 5.2%, 33 mmol/mol the last test.) I wore a CGM for a fortnight last year, and didn't find anything I thought was worth changing anything for.
There was one spike which may have been slightly out of normal; the meal causing it was roasted sea bass with potatoes and rosemary.
I love that meal; I still eat it. My assumption is that it will not kill me.
Spikes are fine, but its important to know what foods you respond to abnormaly. Some people get a glucose spike from artificial sweetner, but some dont. Would be good to know which group you are in .
I rode my bike to my annual physical blood draw about a 12-14 mile ride. I was fasted (but not fast on the bike) and when the results came in my blood sugar was high. My A1C was good and the urinalysis found ketones present.
Great , thanks for your continuous tireless efforts of keeping us informed of evidence base nutrition information. Wonder you can also talk about ‘metabolic therapy ‘for cancer including keto diet and intermittent fasting ( claiming ketosis and anti-glutamine effect),any scientific evidence?
Excellent - Dr. Guess is great. Even in pre-diabetes, there's the issue of how to interpret the CGM data, too (in light of the people who should know better and the "expert'" advice she mentions)
Is it the “area under the curve” that matters most? If your glucose spikes to 180 but it’s only there for 3 minutes, maybe that’s ok if insulin levels are under control.
My biggest question about CGM is the time frame to see changes. CGM is known to lag somewhat compared to blood tests, but I haven’t been able to find out the exact limits of that. This is of particular interest to me as I have an elevated, but not diagnostic, HgbA1C, and when I trialed a CGM, I saw postprandial spikes that seemed to last much longer than expected, and even had some odd ups and down, before settling to my fasting levels, quite a while later. But my fasting levels are solidly normal.
I wear one (lasting two weeks) each year just to have a rough idea of wear I'm at (median, mean, standard deviation, amplitude of peaks). And it doesn't really influence my diet.
Too bad that some people don’t know how to use a tool. Do we expect a monkey to use a sharp knife without monkey cutting itself?
The woman that she refers to at the beginning doesn’t know how to use it and I wonder why you trash a tool using examples where user clearly doesn’t know how to use it. Isn’t this true for any tool?
I think CGM is a must for diabetes patients. Can be a wonderful tool for pre-diabetes or people knowledgeable about metabolism.
It is true that BG only provides half the story and the other half is insulin levels after meals. For that ideally people should do a Kraft test or at least a fasting insulin measurement.
The guys at "Mastering diabetes" are both type 1 and eat a whole foods plant based high carb diet to control their blood glucose and minimise their need for insulin. I don't see why spiking matters compared to having optimal fasting blood glucose. Glad the guest doctor talked about cutting out saturated fatty foods in this regard.
I think some people would like to know Which foods spike the levels of glucose oscillations (as normal) but then CRASH the levels afterwards (causing tiredness etc). Does rice make me crash more than potatoes for example...
Five star video!!!!
Awesome work thx so much 👏👏
THANK YOU !!
I wonder if you can lose fat by using a GM to tell you it's "okay to eat", e.g. when your blood glucose falls to a target number... a way of ensuring you're actually hungry when you eat, not just bored or stressed...
Hormones like leptin and ghrelin, not insulin, are much more relevant to hunger.
I recently experimented with a CGM. Keep in mind that I am healthy. It blew my mind when I ate a bowl of yogurt, blue berries, strawberries, and honey and had a ZERO spike in glucose. I thought for sure it would spike like a mf. My fasting insulin is 1.8 and fasting c-peptide is 0.83.
I fell for this scary trap myself
What about the claims that eating fats and carbs together causes diabetes??? For example of sweet potato with Walnut butter or coconut butter will cause diabetes??
A bowl of oatmeal with nuts and raisins will cause diabetes???
Is there any truth to eating carbs and fats together causes diabetes even if it's whole foods?? That's scary stuff!! But isn't carbs and fats a healthy combination?? I can't eat a bowl of oatmeal by itself I like having balanced meals,, proteins fats and carbs together
It's not true.
What is probably true: processed foods high in both fat and sugar (like chocolate, cookies, donuts...) are more likely to cause cravings, overheating, compulsive eating, and weight gain.
What is probably true: gaining weight beyond a certain threshold will cause a person to develop diabetes
What isn't true: rumors that sweet potato with peanut butter will give you diabetes. The person who said this was either very confused or trying to promote a very unbalanced diet. Nuts are good. Sweet potatoes and oatmeal are also good. They don't become poison when combined.
Super informative! Thank you!
Very informative.
I mean.... Not eating pizza is probably a good thing lol. Typically simple carbs and sugars are related to glucose spikes so ignoring those foods will likely result in more stable levels. I guess not a carrot because of a glucose spike may be what she's warning about, but still. I think CGMs can help quantify (some) bad eating and discourage it.
Her Guess is better than mine. 😇
the app should be able to calculate the area under the curve type of stats
is there any benefit of spiking glucose?... besides the few seconds of food enjoyment?
Dr Peter Attia is somewhat against spiking glucose
I suspect he's referring to supra-physiological spikes in people with underlying issues of glucose metabolism. I´d be surprised if he's concerned about physiological excursions after a meal in healthy people, which are completely normal
@@NutritionMadeSimple Hello! Thank you for the reply! Even for healthy normal fit people... any benefit?? Technically we can always have meals that wont spike glucose too much... eg: steak and salad or chicken and broccoli instead of chicken rice broccoli or sushi or 2 bananas etc..
@@AK-qg7mp other than the points made by Dr. Guess regarding insulin pulsatility, I´m not aware of a reason to base dietary decisions solely on physiological glucose oscillations (neither seek nor avoid). The concern would be the unnecessary restriction of one's diet without a clear benefit in sight. for example restricting (most) fruit or legumes only to avoid glucose oscillations is hard to justify scientifically and suggests a fear based on incorrect information from social media, but if someone were adamant, it may be possible to design such a diet in a health-promoting way e.g. with the help of an RD
@@NutritionMadeSimple Wow. Nice response. Very correct. Thank you again for all your work and help!
@@NutritionMadeSimple Nope: th-cam.com/video/ZapXw377t5s/w-d-xo.html
I am looking for more background knowledge for the following.
I am a 64 yo white male, DM2 that is insulin controlled. My last A1c was 6.1, current body weight is 313 lbs (6'-4") and interested in starting intermittent fasting to help with weight control. I am looking for more information on how to manage my insulin intake during IF. Any suggestions for information sources?
i'm fairly certain that eating pizza and beer and spaghetti and meatballs with garlic bread got me into this mess. mixing a high amount of carbohydrate with a copious amount of fat is is a bad idea. maybe on my birthday once a year, but generally i try to avoid eating like that.
Thank you for your videos! Forgive me if you already talked about this before, but I am interested about your opinion about whole food plant based diet (mostly if it should be for everyone how it is promoted now), also what is your opinion about some studies showing connection between dairy and cancer. I will be happy in the future see your videos for these topics.
Since no one has replied, I will. If you check out Nutrition Facts you'll get a wealth of information on WFPB diets. Everything is backed by good-science studies. On a personal note, it's the only thing that has made any improvement in my weight, waist circumference, lipids, diabetes and inflammation. I'm drinking the Kool-Aid and gone back for seconds, so take that for what it's worth.
Wishing you good health.
I have postprandial syndrome, and I've been curious if a CGM would show a spike and sudden drop during one of these episodes. I haven't had one in a while because when I'm eating something sweet, I either make sure it's close to when I'm having a meal, or I'm sure to include some protein and/or fiber.
I understand my body well enough to know that I can't have a couple donuts for breakfast, even as a rare treat, if I don't have some soy milk or other form of protein with it, or I'll be miserable if I don't eat for a couple hours. When I say miserable, I mean I experience feeling brain fog/hangry, lightheaded, cold sweats, and incredibly hungry.
That's exactly the reason why I'm getting a CGM monitor. I want to see the sudden spikes and drops.
I still think they are not very helpful unless your an insulin dependant diabetic trying to figure out how much insulin you need. It kinda reminds me of people who are pre-occupied with the weight on their scale even though they aren't overweight. If they gain a pound they panic and start dieting. Using a glucose monitor when you dont really needs it is the same thing really. Although I can see it as a use if your type 2 diabetic having trouble sticking to a diet plan since a great many people who are type 2 are like that as a result of poor lifestyle choices.
Hello Gil, greetings from Colombia . Im currently training for an IRONMAN but im changing my diet to only plants. Im aiming to get 1.2g of protein per kg but using plant based foods i pass the upper Limit recomended of folate or manganese. Should i be worried or are any ways to bypass this problem.
Thanks a lot for all the information u give on your videos, because of you im trying to make this diet change in my life.
doubt it'll be a problem at those levels from actual food. do make sure to get a reliable source of b12 if going entirely plant-based
I feel this video is one sided and doesn't go into the subject anywhere deeply enough. Cgm's are a great tool. Educating people with respect to the very real positive aspects of using one would be more useful. Love your videos but this one seemed less balanced than what I expect from this channel.
Excellent video. Any specific thoughts on CGMs and Intermittent fasting or TRE?
Did anyone else get an ad for a CGM before this video?
What do fruit have that vegetables don’t have? What do we lose by subbing lots veggies for fruits?
Doesn't a good anti-oxidant status reduce the negative effect of high blood glucose? Like by causing less AGEs. So if the foods are high in anti-oxidants maybe it's not as bad.
Also I wonder about the peroxidation of lipids. It is rarely talked about compared to T2D. Someone who eats low carbs/high fat may lower his glucose, but if that comes at the cost of more lipid peroxidation maybe that's not good either.
Is an a1c of 5.3 bad? There is diabetes in my family and I don’t want it so I got a cgm but it’s been causing anxiety.
What's considered normal physiologic glucose excursions. the time points mentioned are after the standard OGTT, I
wonder if there is any difference after the regular meal, ie postprandial glucose level( OGTT vs regular meal )?
The stuff she's discussing with the patient with the 5.1 A1C is the same thinking I had during my short stint in the world of carnivore and extremely low carb.
Some of the ideas she talked about make me think she was specifically thinking of Dr. Pradip Jamnadas in his talk on TH-cam, "The Fat Lies". He would have you believe that virtually all heart disease is caused by diabetes and undiagnosed diabetes. I'd love to see a comprehensive fact check on that talk.
Thanks for this. I was unpleasantly surprised when I saw Andrew Huberman seemingly promote CGM for healthy people.
Is there a way to measure post prandial lipidemia?
06:25 When you are trying to limit the absorption of fatty acids into the fat cell?
Using a cgm out of curiosity helped me to realize I have night time hypoglycemia. I’m not diabetic. There is so much information about insulin spikes going up but I’d love a video about hypoglycemia.
I heard( from Dr. Idz ) that meals that spike glucose are more likely to cause visceral fat gain. Is this true?
I have my routine gestational diabetes test in a month. I don't expect any issues but curious if it would be useful paired with dietary advice for those who are pregnant with gestational diabetes.
The levels of glucose of gestational diabetes aren't clearly defined for cgms so far
What if we have 4.3 fasting blood sugar and 1 and 2 hours after eating about 4.5-5.5 is that normal
Dr. Guess, what's your opinion?
Well I guess it's a good decision.
Is that your view on cholesterol too? Don't focus on. High LDL? By itself
5:07 HbA1c of less than 5.7% is normal.
How are normal non diabetics getting access to CGMs? I have to get a prescription for mine. Do they doctor shop? Is there a black market? With more people who don’t need them driving the high cost?
You can buy them. There is no prescription needed.
where I live you need a prescription, but any doctor will write one upon request because there are no downsides to using a CGM-- other than the relatively exotic case of a perfectly healthy patient making herself miserable by *obsessive* avoidance of carbs
p.s. another downside is cost, b/c if you are not diabetic your insurance company will likely not cover a CGM
9:31 has she really never heard of adaptive glucose sparing? Bizarre.
I'm pre-diabetic. I use one. The goal is to get to a non-pre-diabetic state. It's an experiment. Slowly, it seems to be working. It's like getting on a scale - it's an automatic feedback to your brain where you stand, instead of fooling yourself into an achievement you have not reached. I'm paying for my own, which I think medical insurance should pay for in terms of prevention. But as we all know, they are huge hypocrites who are solely based on profit. Follow me for more intelligence.
Most doctors don't tell you anything until its time start meds !
"Treat the patient, not the monitor."
It would cost £100 per month and I cannot afford that.
Wow I had a midnight whole Hawaiian pizza once b4, your my kinda girl 😍😂
If this technology exists then why hasn’t Apple put the sensor on the iwatch. Let’s go Apple. Lol
9:27 she thinks cutting carbs doesn't even affect ur fasting glucose that much. so i wonder, Gil, what affects ur fasting glucose? is it excess liver fat?
basically, yes, hepatic insulin resistance, which can be elevated by intrahepatic TGs accumulation among other factors
Regarding athletes, I bet on winners. Want a winner, need to start with data. CGM, heart rate monitor, smart watch, Vo2max testing, blood work,...more details the better. For powerlifters and strongman competitors I want to see them spike their glucose 12 times a day !!! I want to see they are force eating and even eating in the middle of the night to get BIG. When you see 6' 5" + 350 lbs + NFL player I can guarantee they are eating and eating to maintain the size. Data is for the young and healthy is great. CGM for healthly athletes is great for monitoring. I want to be 100% certain the eat that half gallon of Haagen dazs ice cream before going to bed. Data is always helpful. Even for the everyday housewife following a fitness plan, I want data to know when they cheat.
Precisely what is it that is found in nature that would jack up your glucose level? She's making claims that don't line up with reality.
The whole idea around CGM for non-diabetics is rather….insensitive & hurtful for Type1 patients. Here we do it for sh*ts & giggles…but their LIFE depends on it. It’s…insulting
Hi...but why is it insulting? I've worn one a few times and have found it extremely helpful. I'm wearing one now and am planning on bringing my results to my Dr as I am getting exercise induced hypoglycemia and I'm not sure why (maybe perimenopause?). I would never have known if I didn't wear this. I also found out last time that having 'naked carbs' eg a croissant I spike to 13! But if I have it with fiber and protein it will only be around 7 mmol. I am sorry you have T1 but that shouldn't mean others can't benefit from this technology. Have a wonderful day 🙏
The patches are inexpensive
The top two vendors of the phone apps charge $10 a day
😂😂😂
😡😡😡
$4000/year?
Nein danke
😂😂
Terrific guest and interview. Regarding physiologic blood glucose range, this may be worth considering:
*Keeping Blood Glucose In Range*
th-cam.com/video/-_nXKpeZZFs/w-d-xo.html
The concern with everyone using these devices is that they need to get a life. Everyone nowadays is seeking that magic elixir to eternal youth, but that’s now how life works. And who in their right mind thinks blood glucose should remain flat? Sure, if you’re dead.
She is a babe.