When I was diagnosed with pre diabetes, my endocrinologist told me, on my way out the door, that I should give him a call when I was ready to get on insulin. I left with the notion that diabetes was inevitable and it would be just a matter of time. Instead, I got a CGM. It has been 7 years since that diagnosis and I'm still not in need of any insulin!
With a Keto diet you would get a cure from Pre-diabetes or T2 Diabetes. No medications ever needed... let alone insulin that's only used for run-away Type 2 Diabetes. Give up eating sugar and refined Starches and the diabetes goes away.
So glad you shared this! More people need to hear stories of success. I wish our healthcare system could incentivise practitioners to guide people down a path like yours.
My CGM has taught me that poor sleep and stress as well as caffeine causes extreme spikes… for ME. Also, for ME fiber does nothing to blunt a spike and fat does help. Thanks for another excellent video.
That made me so cross, being told not to eat fatty foods while also reading that fat and protein slows the absorption of glucose. Felt like i needed to educate the educators. Told to eat whole grains and knowing any carbs spike my blood sugar, fibre or not.
Been using a CGM for almost a year truly believe in it it’s taught me a lot. I believe that everyone diabetic or not should wear a CGM for at least 30 to 60 days to truly see what goes in their mouth and how it is affecting their body, excited to see that CGM‘s will be over-the-counter instead of having to get them from a doctor through a subscription prescription. I tell everyone about the CGM and show them how to see the spikes and I do put it in my CGM app when I do have spikes what I had eaten that did spike it And to watch how quickly it comes down or doesn’t come down. Great lecture thanks for sharing.
Excellent lecture! I would LOVE that Dr Bikman makes a follow up lecture about CGMs to learn how to interpret them, what is a normal and abnormal spike, what it means if the spike is under 140 mg/dL but it lasts a long time. Does it mean that somebody is carb intolerant or insulin resistant? How long should somebody walk or do another kind of exercise after a meal to lower the glucose spikes? When Dr Bikman talks about the naysayers that say that when people see a glucose spike, they might be anxious about that, I will respond to that by saying that there is no better way to not get too anxious than being educated about how the body works, what to expect, what to do if we see many spikes or high spikes, etc… In Canada, we don’t have access, yet, to the over the counter CGMs like Dexcom Stelo or Abbott Lingo. I tried the Freestyle Libre 2 for 14 days but there is nothing in the manual that says how to interpret the data (especially for non-diabetics). Thank you very much, Dr Bikman, for what you teach us, this is life changing! ❤️
I have been wearing a Dexcom Stelo (OTC) CGM for 2 weeks, now. It has been a real eye opener! I have been a T2D for 20+ years, with a slowly deteriorating condition, and increasing medication. I have been on Keto, now, for 10 months, and it has helped, but it took the CGM to show the real effect of the various "Cheats", even snacking on Keto friendly snacks. Hopefully, I can get of the last of my T2D medications soon, now that I can see what's spiking my sugar.
I think my comment I just added is similar to yours a little bit. Did the “pre-d” affect your kidney performance? How about your cardiovascular system?
@@number6705 My kidney function has always been fine. I did have a heart attack, about 12 years ago, that was probably caused by my crappy diet and insulin resistance. I also lost my gall bladder, trying to follow a low fat diet. Other than that, I'm pretty healthy. I've lost over 20# on Keto, and have lowered my A1c from 9.0 to 6.3. It has been slow going, but I am getting there....
I have been using the Stelo CGM (over the counter) for 2 months now and the data has been incredibly insightful! I have been using it in conjunction with intermittent fasting and walking. I have learned a lot and would recommend it to anyone. It helps me in real time as I will see my numbers are heading up after a meal and it's an immediate incentive to stand up and do a bunch of squats or go on a brisk walk. Helpful in many other ways but that's just one example. Would love to hear more discussion on what numbers we should actually be striving for as info on that varies widely and is often stated in the context of someone who already has T2D, not someone who is trying to avoid it. Thanks for your channel! It's been very educational and helpful for me!
I'm six weeks into using a Stelo CGM...nice to see the 30 day number gradually (but too slowly) fall. Got to 113 (for 30 day), still a long way to go, but really nice to see the progress and result of experiments....and beginning to understand and somewhat see the associated insulin spikes from artificial sweeteners, sugar alcohols like Maltitol. Am glad to have discovered Allulose.
My doc grudgingly wrote a script for a CGM at my insistence. I am indeed learning a great deal about my own health. No more hiding behind ignorance. So thankful for the insulin I q classroom! Thank you!
CGM has been life changing device for me. i am using it since nov 2021. i diagnosed with T2D in 1991 and only after having CGM i could get my life back.
Age 82, my average glucose reading on Stelo is around 108. My A1C was at 6.4. My doctor is unconcerned about this saying diabetes is a SLOW disease and at my age, I’m in no danger. My opinion is, I’d like bring down my glucose levels from prediabetic. Triglycerides at 83. CGM is giving me feedback I can USE. At least I know that my diet is not spiking me a lot.
A1c rises with age. The "normal range" is not compensated for age. My son in his early 20's is 5.6, his Dr tells him he's fine. He's not, he is heading for early diabetes, can't get him to reduce carbs.
There is a simple calculation that converts average glucose level to derived A1C. Your numbers don't seem to match. An average glucose of 108 yields an A1C as 5.4. There are some reasons why yours might not match, including that blood A1C tests can be wrong.
@ I’m a big fan of influencing dietary changes with delicious alternatives. Eg. I make brownies with black beans instead of flour. Really, I doubt that your son would know they are low carb. Also I make cheesecakes in muffin pans so I can freeze these individual portions.. The keto version has 2 g. of carbs in them. I bet you can find foods to win him over. I’ve been keto for years and find it necessary to still have “treats.” There has not been sugar in my house for years….Great food is possible on keto. It’s a learning curve.
Check out a channel here on TH-cam called Beat Diabetes. The information provided by Dennis on that channel will help you reverse any blood sugar issues you may be having related to type two diabetes.
A month ago I found a CGM named Stelo and it’s affordable providing 2 on skin monitors for $99 with each monitor lasting 15 days. The free online app worked well providing instant continuous blood glucose levels, and daily average glucose level. It was interesting to see what foods would cause a spike in my blood glucose and how it varied like ice cream would spike my blood glucose when eaten alone but not with a meal. My first day I had an average glucose level of 114 mg/dl which is higher than I would have ever expected as I have been on low carbs, 100 or less/day, for several years. Wearing a CGM has been a great learning experience for me and really helped me see with objective evidence how my body reacts to my diet. I would highly recommend it to anyone looking to better understand the relationship between their diet and their blood glucose levels.
Ben, I wore a CGM for 1 month and learned a lot. I’m in Ketosis, eating once a day 3p.m. and working out fasted in the morning 5 days/week. My glucose was mostly flat. After I ate my one meal, my glucose actually went down gradually (very little carbs). One cool finding was a glucose spike after a hard weight-lifting workout. When I did cardio for 1 hour at zone 3, my graph was flat. When I added a 30 minute hard weight-lifting workout with very little rest after my 1 hour cardio workout my glucose spiked. These were the only times my glucose spiked for the month - after my weight lifting workouts. I understand the cause, and that it’s normal, but it was very cool to see the graph. Another finding was that my Stelo CGM was not very accurate when I first put it on when comparing to finger prick. I recommend not using it for the actual reading, but more for the relative rises and falls.
CGM data is invaluable - I've learned a ton in the last year about my metabolic situation by using a CGM and also consulting with experts - so glad you don't need a prescription any longer
Love using a CGM. I pay the $102 a fortnight just to monitor my Glucose levels. I am not diabetic, but love the data and by wearing it, I stay on track. I like to see a steady line. I eat mostly carnivore but when I try some other foods I watch what happens with the cgm closely. When I eat sugar, or bread my numbers rise and stay elevated for a long time... I don't like to see that. Yes, the CGM helps me eat sensibly...It's worth the money for me.
I have tested twice in the last five years as prediabetic, recently in June along with insulin resistance higher than I wanted. My GP said not too worry until it gets higher than there is medication, ugh. I bought an over the counter Stelo GCM, eye opener as to what foods, seemingly innocent, spiked my glucose and kept my average glucose too high. It is not what you think, desserts, junk food, pastries, it is bread, potatoes, rice, corn, fruit. What I have not done is tested the exercise after the meal for I exercise in the morning before food. At 72 I do not want to get Diabetes Type III. Remember in today's time, your strongest advocate is YOU.
It was pulling teeth to get my dr to prescribe an insulin resistance test, he finally did. My eye-opener, and his - I’m highly insulin resistant. I’m not overweight - looking at my 67 year old male body, you may say I’m 5-10 lbs overweight, maybe less. I’ve been ‘pre-diabetic’ for some years. I decided to buy the Stelo on my own, since insurance wouldn’t cover it. (They only cover it if you’re diabetic!!) I’ve worn it now for 2 weeks. Yes, eye-opener. Has your IR affected your kidneys or cardiovascular system?
My doctor gave me a CGM and I used it for 14 days. It was a great tool to see how I respond to foods I consume and how my exercise & sleep affected my BG. Unfortunately, Medicare will not pay or help pay for a CGM until you basically are diagnosed with full diabetics. I hope more important scientists (like you professor) and physicians push Medicare to pay for this important tool. Most people over 65 are insulin resistant so we seniors really need this tool.
You are correct about the spikes…… and sometimes depending on what you eat, it can average out (like over night) at a higher overall level than if you controlled it more. It has taught me much about what to eat, how much to eat, when to eat and how I will feel after eating ….. it has improved my health❤
Up until recently the only way you could get a CGM was by a Dr prescription. I’m pre-diabetic & also low carb for years but until I actually went to diabetic as diagnosed by my A1C my Dr didn’t write a prescription & that was only after she wanted me on metformin. I told her I would consider metformin but also asked for a CGM prescription. I found that my diet wasn’t the problem as much as my exercise, my BG spiked when I walk and really spiked if I run. I would not have known this without the CGM. It has been very helpful even with feedback on meals to tighten up my carb count. OTC CGMs will help everyone who is struggling with weight gain & BG rising.
@ From what I’m reading it’s okay if it does spike & eventually will also heal so spikes won’t be as high. Exercise actually lowers BS for most people so hopefully this will happen. I also just decided to only walk or row, no more running for now.
I go to the gym 5×/week, doing the Stairmaster along with various resistance machines; my BG always rises after a workout, perhaps the liver responding by producing glucose to fuel the muscles - it does rapidly come down within 30 minutes after the workout.
I don't eat junk food, however, with the help of a CGM I found many so called "healthy" foods were spiking my glucose levels, brown bread, steel cut oats, bran muffins, etc etc. Down 45lbs, can't believe anyone would think this is a bad thing.
Thank you for the video. Earlier this year, my functional doctor and I agreed that a CGM would be very helpful to monitor my pre-diabetic status, so I've been using Freestyle Libre 2 for more than 6 months. Range is set for 70 to 140. I also have Hashimoto's, low Ferritin, low B12, and high cortisol, stress, and quality sleep issues. While working on all of that, logging my meals has been so helpful to understand what is going on and self-accountability, and the doctor is linked to receive reports. My last HbA1c test still said I was pre-diabetic but my CGM average number was preferred by my doctor. I suspect my low Ferritin is affecting my red blood cell turnover. I'll be asking about that on my next doctor's visit in two months. It's important to note that there is a learning curve for CGM's, but it is not hard to do. Just need to educate oneself.
using a CGM for past two months and trying to keep my glucose in the 70-140 range has caused me to lose 12 lbs by decreasing my carbs, my BMI has gone from 25 to 23, and recently I have been eating a lot more fat to keep from losing any more weight. Recent blood work showed my triglycerides had fallen to 30.
Thanks for weighing in on this issue! I don’t use a CGM because my A1C and fasting insulin are very low. But my concern about laypeople who use them is that they lack understanding of the importance of insulin sensitivity. Just going off glucose levels might drive people away from healthy plant foods that would otherwise improve insulin sensitivity-especially whole grains, tubers and fruits due to the fiber, polyphenols and resistant starches’ effects on their microbiome.
One lousy night of only 4 hours sleep, was reflected as 20 point increase in my glucose numbers the following day. Stelo purchased from company. $99 for a 2 units that work for two weeks each. Not covered by Medicare because I don’t have diabetes. All this begs the question of WHY do conditions have to escalate to that level before people have access to data???
serious? follow the traces of money… big pharma does not make money with people who prevent diseases instead of taking drugs which make diseases worse (e.g. treat diabetes with insulin)
Thanks for the lecture. Having been diabetic2 for 12 years and tried really really hard to manage it with diet alone (not even metformin). The lecture made me get the cmg off the shelf one more time. This time absolutely no carbs -none. After two weeks average glucose is showing as 7.4mmol and estimated hba1c as 51mmol (6.8%) and still appears to be dropping - so hopefully soon I will be able to claim to be post diabetic:)
Using Libre2 CGM. Agree with what is being said. I would caution that it is good to see a look at your reaction to food and exercise, don't become obsessive about it. Libre2 measures the number of times you check your glucose. It's good to check at key times, checking every minute can be a negative consequence of this immediate view of one's glucose. Good video Dr. Bikman.❤
I'm curious if many who criticize CGMs don't want people more informed about their health because keeping a population sick is good business. If knowledge is power, they don't want you to have the power.
@jimrutherford2773 Some of the criticism is because CGMs are connected to Smart devices and therefore your information (health, personal etc.) is shared with others of which you have no control.
I got cancer. Take anastrazole to remove my estrogen because estrogen supported my cancer growth. The anastrazole caused me to become just a few points away from being diabetic. I started using a CGM and now am below prediabetic. Totally a believer in them!! If I could I would wear one the rest of my life.
Iong ago i stopped being able to judge my own hunger. I use my libreCGM, amongst the usual things, to check my glucose before i eat and if its a bit high, just don't eat. The exception being the dawn phenomena. Sometimes i need to eat something to stimulate my own insulin to bring down glucose. It also allows me to ride out slight hypos. Most recover themselves without eating anything. A bit of adrenaline works wonders. I used to have a mild hypo and would over compensate with too much food. I love this device. My 25 year diabetes is finally under control with a1c at 5.5. , 99% off insulin, its still available but hardly touch it and working on reducing other meds. Without the CGM the fine tuning would never have been possible
My CGM has been a literal lifesaver. I can drop into the 40s with no symptoms (hypoglycemic unawareness), and it's a huge key in knowing how I'm responding to the dose of insulin I take (varies with type of carbs). Without the alarm on my Dexcom 7, I'd be clueless until I was already dealing with severely altered response time. I still double check with a manual meter if I get some weird number, and the symptoms don't seem to match up. They are EXPENSIVE (Dexcom now has an over-the-counter model for people who aren't on insulin), but covered by Medicare since I'm on insulin, thank goodness.
I got a Stelo for a month. It was incredibly insightful. I tested a variety of things. It was amazing the things that spiked my glucose even a few keto excepted foods.
@@christaft3506 The Stelo as a one time purchase was $99. The app was simple. The only thing I didn’t like is it can’t be calibrated. So I did a few finger sticks during the month. The first sensor I used only had a variance of 1 point under and the second sensor was 2 points under. But, that is well within the variance of any finger stick reading .
@@minimize2optimize The experience was very eye opening. The only issue I had is that your phone (at least Iphone) has to be within 20 feet. I don’t take my phone to shower so it would lose connection and I sometimes had a little issue with my phone trying to get the connection back. 2 times during the month I had to have the phone forget the sensor and then go into the app to re pair them. I don’t know if the android version is the same as the ios still is a beta app.
@@christaft3506 $100/mo, easy to use, somewhat annoying to wear. I inadvertently dislodged one reaching out the car window to an ATM. I can't see wearing one 365 days a year unless medically required, but wearing it for 2 weeks a couple times a year is worthwhile.
Thanks for this Dr. Bikman. When I started a carnivore diet, I was taking Jardiance. I was concerned that my blood glucose would drop so low as to trigger Ketoacidosis, so I monitored for that.
I wore one for 11 days. Not one of those with real time readings to your phone, but one that had to be read after being worn. So for 11 days, I logged what I ate and when (not the amounts, but type of food). I also made notes on training. During these 11 days, I was mostly low carb, but wanted to see the effect of various carbs. By far, the biggest spike I saw, was from a bag of microwave popcorn (about 8mmol/L). Second came a small honey cookie (almost 7mmol/L). Whole grain pasta (75g dry weight) gave a 6mmol/L spike. My average was 5.2mmol/L for the period. Estimated A1c was 4.9% or 33 mmol/mol. In these 11 days, I had carbs on purpose in 4 meals in total. All other meals were my usual low carb meals (less than 30g/day on average). I ran regularly, and I observed a small increase, every time I ran. It would go from around 5mmol/L to about 6mmol/L shortly after starting my weekly long run (15k). So despite a fairly low carb diet, there was always sufficient glycogen in the liver, to release some for my working muscles.
I used a Dexcom G6 for two years during pre-diabetes, then Libre 2 and now 3 on keto. The Dexcom worked well, mostly. The Libre while keto, not so well. Sometimes it works well, many times, not so well. I've spoken to endocrinologist and Abbot. As it turns out, for people on keto, they don't claim good accuracy. The CGM uses the swings in blood sugar for calibration, but no swings, or "different" swings, and you have problems. So a word of warning, if you are keto or low carb, be skeptical. I'm not saying it doesn't work, just doesn't work good. Just recently, the Libre 3 PLUS was released, which claims, among other things, better accuracy at lower glucose levels. I'm on the second day with one, so we shall see. Don't see much difference yet. So to summarize, with 5 years of CGM, and keto, be cautious. And when you see MANY crazy values, test with a finger stick. I wish they worked better, but at least Libre, the jury is still out.
I just started my cgm yesterday. I'm on a zero carb carnivore diet. I have a pretty flat response but surprisingly this morning when I did my finger stick glucose test the result was 74 but my CGM said 115 Update 20 minutes later CGM is 96 and blood meter 87 so not such a wild disparity
What I found interesting is how much your glucose can rise just from normal activity - exercise, a hot shower, a tv show - they can bump it up 20 - 40 points no problem. Food OTOH can actually lower it - some high protein food will cause a dip in glucose - probably because you release insulin but didn't add glucose to your blood.
Hi professor! I'm from Brazil and in a mission to help my husband lower his TGs. Could you please talk more about the triglycerides and how they come about, etc... We are on keto for 2 months but his TGs are still up. Thank you so much for all your teachings.
Shocked that frustration drives it up...HIIT as well, and the cauliflower crust pizza at a local place, with a ten minute walk after, still left me under 100. If you cannot afford the sort of high-end phone you need for these, get a cheap old version kit, jab yourself every half hour once a week, and you can still collect similar n=1 data . Rich people don't grasp that the phone is the limiting issue. And CGM manufacturers don't grasp the poorest half need these most.
Dr Bikman, as usual, an excellent and easy to follow presentation, thank you for sharing your analysis. Question I have, how to modify the microbiom to have better outcome consuming food high on the glycemic index? Truly appreciate your due diligence presenting the facts of cell biology.
Dr. Bikman, my Endocrinologist gave me a diagnosis of reactive hypoglycemia, but never told me. I did show her my CGM stats which showed that my glucose would go way down into the 50's while I was sleeping. The alarm would go off quite often while I was sleeping. I was watching my carb intake, keeping it on the low side. She's also diagnosed me with insulin resistance. It's so hard to lose weight!! I've tried and tried. I can't seem to lose anymore than 7 pounds. I don't understand the reactive hypoglycemia. Can you help? Thank you so much for all you do to educate us!! God bless you!!
@@angelaschweyer5462 I also have reactive hypoglycemia. That was clearly seen in the CGM. I eat a very low carb diet. But even some keto foods spiked my glucose. If my glucose rise was more than 15 points my insulin response would quickly (aprox 30-45 minutes after meal) crash my blood glucose down 10-15 points lower than baseline. This would happen to me often every day. The night lows are not concerning as I do make ample ketones and am not symptomatic. My Endocrinologist has RX Ozempic low dose that has stopped all the food noise. So now with NO snacking only 1-2 solid meals I am having a more stable blood glucose and am finally feeling better. I have energy and feel happy.
Dr. Bikman, Do the study shows that different profiles and numbers of microbiome of individuals reflecting different levels of glucose spikes mean that in addition to insulin, gut health also affects glucose spikes? What types of microbiome exactly? Any ways to improve the profiles and numbers of those microbiome? Hope that you can educate us by doing another classroom video on this. Thank you!
Been using Stelo for 2 months. I would love more info on accuracy and patterns. Keeping peaks under 140 but hard to get avg under 95. I would like avg to be more like 80.
I learned that no matter what I do my blood sugar won't stay down. It'll be down to almost normal levels for a week and then without changing anything it goes up to average 165 for about three weeks after which it comes back down. The cycle then repeats. I've been eating one version or another of the phd for over twenty months and have put on about ten pounds.
@@shauna996 Retired and single. Not drinking coffee doesn't break the cycle. No gum disease(bleeding gums stopped shortly after starting to eat right). Inflammation? I've never lost any weight so I'm sure there is.
I just barely got an OTC Lingo CGM monitor and haven’t tried it yet. I would like to hear more from Dr Bikman on the differences he’s seen when it’s placed on the abdomen vs the upper arm. How soon, if ever do you think that Medicare and other insurances will be willing to pay for CGMs for anyone not on insulin? More information on how to interpret the data as someone else mentioned would be great.
Walk after meals, Don’t eat most of your carbs later in day, watch out for alternative sugars, Gummy vitamins may spike you, electrolytes that are flavored may spike you, freeze or refrigerate cooked carbs before eating and it may lower the spike. I use ACV capsules if I know I will be eating carbs. Good luck…. That is a few things I learned.
A quick question. I don’t know the flexibility of the body to change microbiomes with supplementation, but in theory, if they know what supplements create what microbiomes in the body, and they know which microbiomes correlate to which responses for a given food, then could you select a supplement/probiotic based on your typical preferred foods to reduce the sugar response?
Thanks Ben for the wonderful metabolic classroom as always. Could you please tell me specific things to be noted while wearing the CGM for the first time.
I have been using the old BG prick meters. Thank goodness for those prick tests I've been doing. I can see what spikes blood sugar and what doesn't in my meal. Dairy, including butter is out, it spikes insulin. And so does a few wild strawberries from my back yard. Fruit is out. Right now all of this has proven that I have to be as closest to carnivore as possible. Lots of fatty meats and eggs. I can get away with some coconut treats, like coconut butter, it gives me the slight sweetness without spiking blood sugar. So I treat myself to that once in a while.
I just got my first CGM (G7) yesterday. The good news? My glucose is pretty stable. No spikes or dips so far. The bad news? Most of the day it's stable between 105-135. Even doing VO2Max intervals at lunch it jumped to 127 (expected) but really didn't come very far down after. My A1C is 5.5, so that kinda makes sense. I live the low carb life pretty closely. I'm not sure what I'm doing wrong, other than maybe I need more work above zone 2 on the bike to burn off sugars and help insulin sensitivity.
I plan to use a CGM for similar, though I really want to measure ketones. I don’t think I get in ketosis even on lion diet for 6 months. But resistance training has given me better progress with weight loss than cardio. I think inflammation must be due to stress but I don’t feel stressed. I get 75-80 scores on sleep. I am 10 yrs menopause though and finding a dr to get on HRT. I don’t know what else I can do. I must have IR going on. My ankles like to stay kinda thick or a bit puffy and weight loss is hard. I’m on 12-16 hour fasts randomly now to try that approach and reducing calories because nothing else so far has corrected inflammation. Sounds like I may have permanent damage if glycation if I understand Bikman correctly that glycated cells can’t be undone. My A1c stays around 5.0 and I have very high HDL, and low Tri so my ratio is good. Anyway, I did lose some weight finally with resistance training. Cardio I like but I don’t lose weight on it. I’m going to get my fasting insulin to figure this piece of the puzzle! I’ve had about every other test done from DEXA to all the bloodwork and iodine.
Your blood sugar level is being regulated more by your muscles than by food intake, indicating gluconeogenesis is at play. This suggests your insulin sensitivity (or "insulin IQ") might be high. Glucose that’s “pulled” by the body behaves differently than glucose that’s “pushed” in by food. While blood glucose level is valuable information, it’s still just a scalar value that lacks a "direction" or context for how it’s being managed within the body.
@@JanLL Maybe it gives a hint though. I've been doing a LOT of Zone 2 work, mostly fasted, on the bike. I'm highly fat adapted now. That may be biting me on the butt. I did VO2Max intervals yesterday. My BG rose to 127 almost immediately, then kind of hung out there. I expected by the 4th interval it would start declining but it never did. After that it slowly declined down to the 80s and 90s and stayed there until this morning, which was great but that definitely feels like "push" more than "pull". I'm beginning to think my glycolytic system, via GLUT4, is extremely weak right now due to over-focusing on the Mitochondrial system via Zone 2. I also makes me wonder if I need to supplement with Creatine to improve that. My Dr. gave me the green light.
More information on why you feel the readings from a CGM are more important than A1C tests. I saw you had a very short video on that. From what friends with CGMs are telling me a finger prick test and the CGM can show huge differences in numbers. For those of us used to doing finger pricks what number ranges should we be working toward with a CGM?
I don’t understand the reluctance to use a CGM. I am a long time healthy user (Levels) and it allowed me to convince my wife to pay attention. She is not fit and needed to see how her diet was affecting her. Now we share a low carb lifestyle and can compare notes and plan great, healthy meals.
I have been on a journey the past few years to optimise my metabolic health. Low carb, intermediate fasting 18/6 and 10-15 hours a week of mixed exercise. I recently experimented with a CGM, and was confused by the higher than expected readings, compared to my actual blood work results. I’m wondering if this could be related to stress levels? For someone that works as hard as I do at my health, I did feel anxious due the elevated readings. Ben, could you please do a lecture on how stress can affect glucose levels?
If a clinical glucose test is ‘drink a standard solution and watch the spike with blood tests’, is it possible to duplicate the test at home with dextrose from the homebrew store and a CGM? (Understanding that it’s NOT a clinical test and one should always consult a doctor…)
hypothetically (I know you are not my doctor) If I have Type 2 D, (A1c 6.8, fasting glucose 150, fasting insulin 25), Will fasting be the most effective way to quickly reduce insulin resistance so my fat cells can be released and used for fuel? How do I fix the insulin resistance the fastest? 23:1 fasting with beef, butter eggs in the 1 hour eating window? Also - is my fasting insulin high because my fat cells are all full and insulin has to be at 25 to keep me in homeostasis? I want my fasting insulin to be less than 5 not 25. Again, 23:1 fasting with butter beef eggs in the eating window the fastest way to fix fasting insulin? I am trying this for six months and will see if my fat cells start to get burned. I think I should also do weight lifting and bike riding to a few times a week to force the clearing of glucose, even though I am not eating any carbs
What kind of glucose rise on CGM would be a concerning spike? (I m 56 y/o, Non-diabetic. HbA1c of 5.3) Generally, I try to keep 1 hr post meal peak CGM reading under 150 or 160mg/dL. Is 50 or 60mg/dL point rise considered unhealthy number to avoid? Would experiencing of 80 or 100mg/dL rise once or twice a week still be too high of number that I need to avoid? A lot of my favorite foods, ex: bread, noodles or ricecake, etc. will spike my CGM by 80mg/dL. Now I feel like I am pre-pre-diabetic, so to speak..
A truly healthy person would not spike more than 30 pts, I think. But then so few people are truly healthy! I could be wrong, though. It’s hard to find this info.
Dr Bikman - I just started on Stelo CGM past 14 days - my 1st CGM experience. I’ve been told I’m pre-diabetic for some years now by my family dr. NOT diabetic. I did get my HOMA-IR test, and I am very insulin resistant. 67 yr old male, looking at me you may say I’m 10 lbs overweight. I don’t get exercise. My kidney GFR function is off, I guess from years of “pre-diabetes”. Very confusing situation. What do I do? Is Keto recommended - latest data implies it is very effective in the CKD treatment..help!
Could u please do a video on MTHFR gene mutation? U have a brilliant mind, and I actually understand your teachings! I have compound heterozygous A1298C and C667T gene mutation. Any knowledge u can share on this topic would be greatly appreciated! (Love your content, if u can't tell)
I had a strange change in elevated numbers with my Stelo that I couldn’t explain. I wondered if it could be the Tylenol I had taken since I typically don’t take it. A little research confirmed. Another pharmaceutical was listed that I don’t recall. I also wonder if there are others that are unreported.
I have a family history of diabetes and have been told by my doctor that I am pre-diabetic. I asked her if I could get a CGM and she told me that they are only for diabetics and that my insurance wouldn’t cover it without a diagnosis of diabetes. I asked if I could get one to avoid getting diabetes. She didn’t seem too keen on the idea. Why???? Where can I get one?
Google Stelo and Lingo. They have CGMs for non-diabetic folks. They are sold over the counter with no prescription. I just purchased Lingo for $49 for a 14 day sensor. Already impressed with the data.
I've been using a Dexcom CGM for over a year. I had an older android phone and I kept getting warnings that the app wouldn't work with it. I have a new phone, and now the app is saying that it won't work with the latest android 15 software. I can't win! I do have a stand alone receiver, but it's a pain to use.
These would be awesome. But not available in the USA yet. They are being tested elsewhere currently. They are also testing with a lactate sensor the would be important information for athletes and exercise evaluation.
@@careyholm CKM for ketones exist. They don't measure insulin, but they might give some hints about it. Less ketones produced that used: insulin might be higher. More ketones produced than used (in fat/keto adapted state): insulin is probably low.
25 years with the NHS, I've never had my insulin checked but now I understand the mechanisms I can see that I've been very insulin and Leptin resistant for at least 3 decades. I hope that my insulin is behaving better now, low carb, big weight loss etc. but will never know the actual figures and I have no baseline value to compare. For many years it was eat, insulin, then feed the insulin. Eating in the middle of the night to counteract deep hypo me. I hope the NHS is catching up at last but I think it will take a whole generation to improve the treatment
Expert: Do not use a CGM, under no circumstances!!! ((( because they are eating my secured subscription like business away )) As an insuranec company, I would pay every person meeting some criteria 1 CGM per year ... because that would save billions in the future.
I’ve found it to be spot on generally. Been using it for 9 months and only 2 have have been wonky. Has been extremely accurate at predicting my a1c. There is a delay between finger stick and cgm, though. I’ve found that to be less of an issue as I brought my glucose under better control with keto and IF. Now that delay is barely noticeable.
Off topic but does anybody know how much the ketone body competing with uric acid for excretion raises uric acid levels? Im at 11 uric acid. 2.5 months strict keto under 20 total carbs, lots of omad, and a few 60 ish hr fasts worked in. Feel great. Decided to stop keto yesterday to see if that lowers it. Would like to keep keto as a tool when I need it. Its been great for my brain and weight loss. If the effect of ketones on uric acid excretion is huge, I need to know. supplementing 1000 mg vitamin c to help excretion and started drinking coffee.. How much allulose should I be mixing in there per day? I can eat under 400 purines a day, but it will get really tough if I cant eat alot of egg yolk due to the phosphorous. Anyone know any of these answers? I wouldnt have known any of this info with out Dr. Ben Bikman, thnx for posting this stuff up there.
Nevermind, just found the answet thanks. ketones in blood or urine are directly correlated and was the metabolic factor most influenced in a study of 1600 folks during long term fasting induced ketosis. lower levels of ketones means less uric acid. Maybe I can do a milder version of keto or cycle in and out? Never measured ketones. How best to go forward? just barely out of ketosis ? I dont want to muck up my insulin again, want to keep it low. Anyway thanks if anyone has advice..
Does anyone know if the Stelo CGM works with the Jitterbug/Lively T608G Android version 13? I see Stelo info says it works with this version of Android but sometimes phones can be picky.
Dr Bikman, please help to understand: Fasting insulin pmol/L 74.30 C - peptide pmol/L 889.00 HBA1c 5.3 Fasting Glucose mmol/L 6.11??? Any coments? How can it be? Man 48 year ok strict keto and 6 month strict carnivore. Today blood results. Thank You❤
YT channel nutrition with Judy (Judy Chow) has some brilliant chats about BG on carnivore. Gives multiple reasons for differences. I’ve been carnivore 2yrs and my HBA1c was 5.7, fasting insulin (which is a very variable number that a bad nights sleep can change drastically for instance). I had a Fructosamine blood test which checks for glycation over 3 weeks and not 3-4 months and it was an equivalent HBA1c of 4.8. The theory is that in some carnivore eaters the red blood cell lasts longer. My fasting blood glucose was also high and by wearing a CGM I realised that get a high dawn effect that can last many hours which effected my fasted blood morning blood test. Hope this helps
@@Tee667 thank you very much! It's just strange to me that the fasting glucose is so high and all the other indicators are within normal limits. It seems illogical. Cortisol is normal. Liver enzymes are normal.
Maybe health insurance companies need to be informed about the preventive medicine these devices represent. Most plans only cover the sensors if you are on insulin. Not everyone can afford to spend hundreds of dollars a month on sensors.
When I was diagnosed with pre diabetes, my endocrinologist told me, on my way out the door, that I should give him a call when I was ready to get on insulin. I left with the notion that diabetes was inevitable and it would be just a matter of time. Instead, I got a CGM. It has been 7 years since that diagnosis and I'm still not in need of any insulin!
With a Keto diet you would get a cure from Pre-diabetes or T2 Diabetes. No medications ever needed... let alone insulin that's only used for run-away Type 2 Diabetes.
Give up eating sugar and refined Starches and the diabetes goes away.
So glad you shared this! More people need to hear stories of success.
I wish our healthcare system could incentivise practitioners to guide people down a path like yours.
No Doctor prescribes insulin to people with pre-diabetes 🙄
My CGM has taught me that poor sleep and stress as well as caffeine causes extreme spikes… for ME. Also, for ME fiber does nothing to blunt a spike and fat does help. Thanks for another excellent video.
That made me so cross, being told not to eat fatty foods while also reading that fat and protein slows the absorption of glucose. Felt like i needed to educate the educators. Told to eat whole grains and knowing any carbs spike my blood sugar, fibre or not.
Been using a CGM for almost a year truly believe in it it’s taught me a lot. I believe that everyone diabetic or not should wear a CGM for at least 30 to 60 days to truly see what goes in their mouth and how it is affecting their body, excited to see that CGM‘s will be over-the-counter instead of having to get them from a doctor through a subscription prescription. I tell everyone about the CGM and show them how to see the spikes and I do put it in my CGM app when I do have spikes what I had eaten that did spike it And to watch how quickly it comes down or doesn’t come down. Great lecture thanks for sharing.
Because iam not diabectic, it will be costly and I only know of one right now. Iam hoping more come on the market so I can do the same.
It is now available without a script. Also affordable
@ellenhayes9280 ok I know this, but $400 a month is not affordable to most people
Stelo is available for $99 ($89 with subscription) in the US for 30 days of data.
@@christaft3506 There are at least two CGMs available over the counter for less than $100/mo in the US.
Excellent lecture! I would LOVE that Dr Bikman makes a follow up lecture about CGMs to learn how to interpret them, what is a normal and abnormal spike, what it means if the spike is under 140 mg/dL but it lasts a long time. Does it mean that somebody is carb intolerant or insulin resistant? How long should somebody walk or do another kind of exercise after a meal to lower the glucose spikes? When Dr Bikman talks about the naysayers that say that when people see a glucose spike, they might be anxious about that, I will respond to that by saying that there is no better way to not get too anxious than being educated about how the body works, what to expect, what to do if we see many spikes or high spikes, etc… In Canada, we don’t have access, yet, to the over the counter CGMs like Dexcom Stelo or Abbott Lingo. I tried the Freestyle Libre 2 for 14 days but there is nothing in the manual that says how to interpret the data (especially for non-diabetics). Thank you very much, Dr Bikman, for what you teach us, this is life changing! ❤️
I have been wearing a Dexcom Stelo (OTC) CGM for 2 weeks, now. It has been a real eye opener! I have been a T2D for 20+ years, with a slowly deteriorating condition, and increasing medication. I have been on Keto, now, for 10 months, and it has helped, but it took the CGM to show the real effect of the various "Cheats", even snacking on Keto friendly snacks.
Hopefully, I can get of the last of my T2D medications soon, now that I can see what's spiking my sugar.
I think my comment I just added is similar to yours a little bit. Did the “pre-d” affect your kidney performance? How about your cardiovascular system?
@@number6705 My kidney function has always been fine. I did have a heart attack, about 12 years ago, that was probably caused by my crappy diet and insulin resistance. I also lost my gall bladder, trying to follow a low fat diet. Other than that, I'm pretty healthy. I've lost over 20# on Keto, and have lowered my A1c from 9.0 to 6.3. It has been slow going, but I am getting there....
The purchase of a CGM has been the one thing that has seen my weight (down 15kg )and insulin resistance improve. I’m a believer
I have been using the Stelo CGM (over the counter) for 2 months now and the data has been incredibly insightful! I have been using it in conjunction with intermittent fasting and walking. I have learned a lot and would recommend it to anyone. It helps me in real time as I will see my numbers are heading up after a meal and it's an immediate incentive to stand up and do a bunch of squats or go on a brisk walk. Helpful in many other ways but that's just one example. Would love to hear more discussion on what numbers we should actually be striving for as info on that varies widely and is often stated in the context of someone who already has T2D, not someone who is trying to avoid it. Thanks for your channel! It's been very educational and helpful for me!
I'm six weeks into using a Stelo CGM...nice to see the 30 day number gradually (but too slowly) fall. Got to 113 (for 30 day), still a long way to go, but really nice to see the progress and result of experiments....and beginning to understand and somewhat see the associated insulin spikes from artificial sweeteners, sugar alcohols like Maltitol. Am glad to have discovered Allulose.
@@gregtaylor8310 It is really fascinating and helpful to work with real data from your actual body, isn't it?!?
My doc grudgingly wrote a script for a CGM at my insistence. I am indeed learning a great deal about my own health. No more hiding behind ignorance. So thankful for the insulin I q classroom! Thank you!
Another dr with the ‘God complex’
CGM has been life changing device for me. i am using it since nov 2021. i diagnosed with T2D in 1991 and only after having CGM i could get my life back.
Age 82, my average glucose reading on Stelo is around 108. My A1C was at 6.4. My doctor is unconcerned about this saying diabetes is a SLOW disease and at my age, I’m in no danger. My opinion is, I’d like bring down my glucose levels from prediabetic. Triglycerides at 83. CGM is giving me feedback I can USE. At least I know that my diet is not spiking me a lot.
A1c rises with age. The "normal range" is not compensated for age. My son in his early 20's is 5.6, his Dr tells him he's fine. He's not, he is heading for early diabetes, can't get him to reduce carbs.
There is a simple calculation that converts average glucose level to derived A1C. Your numbers don't seem to match. An average glucose of 108 yields an A1C as 5.4. There are some reasons why yours might not match, including that blood A1C tests can be wrong.
@ I’m a big fan of influencing dietary changes with delicious alternatives. Eg. I make brownies with black beans instead of flour. Really, I doubt that your son would know they are low carb. Also I make cheesecakes in muffin pans so I can freeze these individual portions.. The keto version has 2 g. of carbs in them. I bet you can find foods to win him over. I’ve been keto for years and find it necessary to still have “treats.” There has not been sugar in my house for years….Great food is possible on keto. It’s a learning curve.
Check out a channel here on TH-cam called Beat Diabetes. The information provided by Dennis on that channel will help you reverse any blood sugar issues you may be having related to type two diabetes.
Dr Bikman, you are such a blessing!
A month ago I found a CGM named Stelo and it’s affordable providing 2 on skin monitors for $99 with each monitor lasting 15 days. The free online app worked well providing instant continuous blood glucose levels, and daily average glucose level. It was interesting to see what foods would cause a spike in my blood glucose and how it varied like ice cream would spike my blood glucose when eaten alone but not with a meal. My first day I had an average glucose level of 114 mg/dl which is higher than I would have ever expected as I have been on low carbs, 100 or less/day, for several years. Wearing a CGM has been a great learning experience for me and really helped me see with objective evidence how my body reacts to my diet. I would highly recommend it to anyone looking to better understand the relationship between their diet and their blood glucose levels.
Mine Is way off. No food since yesterday at 3pm. This morning the stelo was 111. My glucose monitor blood was 82. Will not uy another one.
Ben, I wore a CGM for 1 month and learned a lot. I’m in Ketosis, eating once a day 3p.m. and working out fasted in the morning 5 days/week. My glucose was mostly flat. After I ate my one meal, my glucose actually went down gradually (very little carbs). One cool finding was a glucose spike after a hard weight-lifting workout. When I did cardio for 1 hour at zone 3, my graph was flat. When I added a 30 minute hard weight-lifting workout with very little rest after my 1 hour cardio workout my glucose spiked. These were the only times my glucose spiked for the month - after my weight lifting workouts. I understand the cause, and that it’s normal, but it was very cool to see the graph. Another finding was that my Stelo CGM was not very accurate when I first put it on when comparing to finger prick. I recommend not using it for the actual reading, but more for the relative rises and falls.
My largest glucose levels occurred also during heavy weightlifting, not after meals or during cardio excercise. Very interesting.
A CGM is my next step in getting an idea of how I respond to different foods.
CGM data is invaluable - I've learned a ton in the last year about my metabolic situation by using a CGM and also consulting with experts - so glad you don't need a prescription any longer
Love using a CGM. I pay the $102 a fortnight just to monitor my Glucose levels. I am not diabetic, but love the data and by wearing it, I stay on track. I like to see a steady line. I eat mostly carnivore but when I try some other foods I watch what happens with the cgm closely. When I eat sugar, or bread my numbers rise and stay elevated for a long time... I don't like to see that. Yes, the CGM helps me eat sensibly...It's worth the money for me.
I have tested twice in the last five years as prediabetic, recently in June along with insulin resistance higher than I wanted. My GP said not too worry until it gets higher than there is medication, ugh. I bought an over the counter Stelo GCM, eye opener as to what foods, seemingly innocent, spiked my glucose and kept my average glucose too high. It is not what you think, desserts, junk food, pastries, it is bread, potatoes, rice, corn, fruit. What I have not done is tested the exercise after the meal for I exercise in the morning before food. At 72 I do not want to get Diabetes Type III. Remember in today's time, your strongest advocate is YOU.
It was pulling teeth to get my dr to prescribe an insulin resistance test, he finally did. My eye-opener, and his - I’m highly insulin resistant. I’m not overweight - looking at my 67 year old male body, you may say I’m 5-10 lbs overweight, maybe less. I’ve been ‘pre-diabetic’ for some years. I decided to buy the Stelo on my own, since insurance wouldn’t cover it. (They only cover it if you’re diabetic!!)
I’ve worn it now for 2 weeks. Yes, eye-opener.
Has your IR affected your kidneys or cardiovascular system?
My doctor gave me a CGM and I used it for 14 days. It was a great tool to see how I respond to foods I consume and how my exercise & sleep affected my BG. Unfortunately, Medicare will not pay or help pay for a CGM until you basically are diagnosed with full diabetics. I hope more important scientists (like you professor) and physicians push Medicare to pay for this important tool. Most people over 65 are insulin resistant so we seniors really need this tool.
You are correct about the spikes…… and sometimes depending on what you eat, it can average out (like over night) at a higher overall level than if you controlled it more. It has taught me much about what to eat, how much to eat, when to eat and how I will feel after eating ….. it has improved my health❤
Up until recently the only way you could get a CGM was by a Dr prescription. I’m pre-diabetic & also low carb for years but until I actually went to diabetic as diagnosed by my A1C my Dr didn’t write a prescription & that was only after she wanted me on metformin. I told her I would consider metformin but also asked for a CGM prescription. I found that my diet wasn’t the problem as much as my exercise, my BG spiked when I walk and really spiked if I run. I would not have known this without the CGM. It has been very helpful even with feedback on meals to tighten up my carb count. OTC CGMs will help everyone who is struggling with weight gain & BG rising.
If it spikes when you walk what can you do about that? I mean you have to walk,?
@ From what I’m reading it’s okay if it does spike & eventually will also heal so spikes won’t be as high. Exercise actually lowers BS for most people so hopefully this will happen. I also just decided to only walk or row, no more running for now.
I go to the gym 5×/week, doing the Stairmaster along with various resistance machines; my BG always rises after a workout, perhaps the liver responding by producing glucose to fuel the muscles - it does rapidly come down within 30 minutes after the workout.
@@luiskaj2434 This is what I’m thinking happens as well.
I don't eat junk food, however, with the help of a CGM I found many so called "healthy" foods were spiking my glucose levels, brown bread, steel cut oats, bran muffins, etc etc. Down 45lbs, can't believe anyone would think this is a bad thing.
Thank you for the video.
Earlier this year, my functional doctor and I agreed that a CGM would be very helpful to monitor my pre-diabetic status, so I've been using Freestyle Libre 2 for more than 6 months. Range is set for 70 to 140.
I also have Hashimoto's, low Ferritin, low B12, and high cortisol, stress, and quality sleep issues. While working on all of that, logging my meals has been so helpful to understand what is going on and self-accountability, and the doctor is linked to receive reports.
My last HbA1c test still said I was pre-diabetic but my CGM average number was preferred by my doctor. I suspect my low Ferritin is affecting my red blood cell turnover. I'll be asking about that on my next doctor's visit in two months.
It's important to note that there is a learning curve for CGM's, but it is not hard to do. Just need to educate oneself.
using a CGM for past two months and trying to keep my glucose in the 70-140 range has caused me to lose 12 lbs by decreasing my carbs, my BMI has gone from 25 to 23, and recently I have been eating a lot more fat to keep from losing any more weight. Recent blood work showed my triglycerides had fallen to 30.
Thanks for weighing in on this issue! I don’t use a CGM because my A1C and fasting insulin are very low. But my concern about laypeople who use them is that they lack understanding of the importance of insulin sensitivity. Just going off glucose levels might drive people away from healthy plant foods that would otherwise improve insulin sensitivity-especially whole grains, tubers and fruits due to the fiber, polyphenols and resistant starches’ effects on their microbiome.
One lousy night of only 4 hours sleep, was reflected as 20 point increase in my glucose numbers the following day. Stelo purchased from company. $99 for a 2 units that work for two weeks each. Not covered by Medicare because I don’t have diabetes. All this begs the question of WHY do conditions have to escalate to that level before people have access to data???
serious? follow the traces of money…
big pharma does not make money with people who prevent diseases instead of taking drugs which make diseases worse (e.g. treat diabetes with insulin)
Thanks for the lecture. Having been diabetic2 for 12 years and tried really really hard to manage it with diet alone (not even metformin). The lecture made me get the cmg off the shelf one more time. This time absolutely no carbs -none. After two weeks average glucose is showing as 7.4mmol and estimated hba1c as 51mmol (6.8%) and still appears to be dropping - so hopefully soon I will be able to claim to be post diabetic:)
Using Libre2 CGM. Agree with what is being said. I would caution that it is good to see a look at your reaction to food and exercise, don't become obsessive about it. Libre2 measures the number of times you check your glucose. It's good to check at key times, checking every minute can be a negative consequence of this immediate view of one's glucose. Good video Dr. Bikman.❤
I'm curious if many who criticize CGMs don't want people more informed about their health because keeping a population sick is good business. If knowledge is power, they don't want you to have the power.
@jimrutherford2773 Some of the criticism is because CGMs are connected to Smart devices and therefore your information (health, personal etc.) is shared with others of which you have no control.
After having the glucose monitor for 4 months my husband is now off his diabetic medication
I got cancer. Take anastrazole to remove my estrogen because estrogen supported my cancer growth. The anastrazole caused me to become just a few points away from being diabetic. I started using a CGM and now am below prediabetic. Totally a believer in them!! If I could I would wear one the rest of my life.
Iong ago i stopped being able to judge my own hunger. I use my libreCGM, amongst the usual things, to check my glucose before i eat and if its a bit high, just don't eat. The exception being the dawn phenomena. Sometimes i need to eat something to stimulate my own insulin to bring down glucose.
It also allows me to ride out slight hypos. Most recover themselves without eating anything. A bit of adrenaline works wonders. I used to have a mild hypo and would over compensate with too much food.
I love this device. My 25 year diabetes is finally under control with a1c at 5.5. , 99% off insulin, its still available but hardly touch it and working on reducing other meds. Without the CGM the fine tuning would never have been possible
My CGM has been a literal lifesaver. I can drop into the 40s with no symptoms (hypoglycemic unawareness), and it's a huge key in knowing how I'm responding to the dose of insulin I take (varies with type of carbs). Without the alarm on my Dexcom 7, I'd be clueless until I was already dealing with severely altered response time. I still double check with a manual meter if I get some weird number, and the symptoms don't seem to match up. They are EXPENSIVE (Dexcom now has an over-the-counter model for people who aren't on insulin), but covered by Medicare since I'm on insulin, thank goodness.
I got a Stelo for a month. It was incredibly insightful. I tested a variety of things. It was amazing the things that spiked my glucose even a few keto excepted foods.
What was the cost factor for the month and how easy is the app to use
Thank you for sharing! I've heard mixed reviews. Did you find any issues with the app or the monitor itself?
@@christaft3506 The Stelo as a one time purchase was $99. The app was simple. The only thing I didn’t like is it can’t be calibrated. So I did a few finger sticks during the month. The first sensor I used only had a variance of 1 point under and the second sensor was 2 points under. But, that is well within the variance of any finger stick reading .
@@minimize2optimize The experience was very eye opening. The only issue I had is that your phone (at least Iphone) has to be within 20 feet. I don’t take my phone to shower so it would lose connection and I sometimes had a little issue with my phone trying to get the connection back. 2 times during the month I had to have the phone forget the sensor and then go into the app to re pair them. I don’t know if the android version is the same as the ios still is a beta app.
@@christaft3506 $100/mo, easy to use, somewhat annoying to wear. I inadvertently dislodged one reaching out the car window to an ATM. I can't see wearing one 365 days a year unless medically required, but wearing it for 2 weeks a couple times a year is worthwhile.
Thanks for this Dr. Bikman. When I started a carnivore diet, I was taking Jardiance. I was concerned that my blood glucose would drop so low as to trigger Ketoacidosis, so I monitored for that.
Jardiance is incompatible with carnivore diet. You are playing a dangerous game.
Thak you Mr Bikman!Interesting for me was how glucose went up because of intensiv Sport aktivity.
I wore one for 11 days. Not one of those with real time readings to your phone, but one that had to be read after being worn. So for 11 days, I logged what I ate and when (not the amounts, but type of food). I also made notes on training. During these 11 days, I was mostly low carb, but wanted to see the effect of various carbs. By far, the biggest spike I saw, was from a bag of microwave popcorn (about 8mmol/L). Second came a small honey cookie (almost 7mmol/L). Whole grain pasta (75g dry weight) gave a 6mmol/L spike. My average was 5.2mmol/L for the period. Estimated A1c was 4.9% or 33 mmol/mol. In these 11 days, I had carbs on purpose in 4 meals in total. All other meals were my usual low carb meals (less than 30g/day on average).
I ran regularly, and I observed a small increase, every time I ran. It would go from around 5mmol/L to about 6mmol/L shortly after starting my weekly long run (15k). So despite a fairly low carb diet, there was always sufficient glycogen in the liver, to release some for my working muscles.
I used a Dexcom G6 for two years during pre-diabetes, then Libre 2 and now 3 on keto. The Dexcom worked well, mostly. The Libre while keto, not so well. Sometimes it works well, many times, not so well. I've spoken to endocrinologist and Abbot. As it turns out, for people on keto, they don't claim good accuracy. The CGM uses the swings in blood sugar for calibration, but no swings, or "different" swings, and you have problems. So a word of warning, if you are keto or low carb, be skeptical. I'm not saying it doesn't work, just doesn't work good. Just recently, the Libre 3 PLUS was released, which claims, among other things, better accuracy at lower glucose levels. I'm on the second day with one, so we shall see. Don't see much difference yet. So to summarize, with 5 years of CGM, and keto, be cautious. And when you see MANY crazy values, test with a finger stick. I wish they worked better, but at least Libre, the jury is still out.
Professor Ben!!!❤❤❤
I just started my cgm yesterday. I'm on a zero carb carnivore diet. I have a pretty flat response but surprisingly this morning when I did my finger stick glucose test the result was 74 but my CGM said 115
Update 20 minutes later CGM is 96 and blood meter 87 so not such a wild disparity
What I found interesting is how much your glucose can rise just from normal activity - exercise, a hot shower, a tv show - they can bump it up 20 - 40 points no problem. Food OTOH can actually lower it - some high protein food will cause a dip in glucose - probably because you release insulin but didn't add glucose to your blood.
Hi professor!
I'm from Brazil and in a mission to help my husband lower his TGs.
Could you please talk more about the triglycerides and how they come about, etc...
We are on keto for 2 months but his TGs are still up.
Thank you so much for all your teachings.
Shocked that frustration drives it up...HIIT as well, and the cauliflower crust pizza at a local place, with a ten minute walk after, still left me under 100.
If you cannot afford the sort of high-end phone you need for these, get a cheap old version kit, jab yourself every half hour once a week, and you can still collect similar n=1 data . Rich people don't grasp that the phone is the limiting issue. And CGM manufacturers don't grasp the poorest half need these most.
Why would you need an expensive phone? I'm almost sure a used Galaxy S7 from 8 years ago will do?
Thank you sir!
Dr Bikman, as usual, an excellent and easy to follow presentation, thank you for sharing your analysis. Question I have, how to modify the microbiom to have better outcome consuming food high on the glycemic index? Truly appreciate your due diligence presenting the facts of cell biology.
Dr. Bikman, my Endocrinologist gave me a diagnosis of reactive hypoglycemia, but never told me. I did show her my CGM stats which showed that my glucose would go way down into the 50's while I was sleeping. The alarm would go off quite often while I was sleeping. I was watching my carb intake, keeping it on the low side. She's also diagnosed me with insulin resistance. It's so hard to lose weight!! I've tried and tried. I can't seem to lose anymore than 7 pounds. I don't understand the reactive hypoglycemia. Can you help? Thank you so much for all you do to educate us!! God bless you!!
I saw the diagnosis on my paperwork that went home with me. She just never explained it to me or told me she diagnosed me with that.
I can’t lose even one pound but I start one year ago carnivore diet and lost almost 20 pounds
Maybe get tested for insulinomas.
@@angelaschweyer5462 I also have reactive hypoglycemia. That was clearly seen in the CGM. I eat a very low carb diet. But even some keto foods spiked my glucose. If my glucose rise was more than 15 points my insulin response would quickly (aprox 30-45 minutes after meal) crash my blood glucose down 10-15 points lower than baseline. This would happen to me often every day. The night lows are not concerning as I do make ample ketones and am not symptomatic. My Endocrinologist has RX Ozempic low dose that has stopped all the food noise. So now with NO snacking only 1-2 solid meals I am having a more stable blood glucose and am finally feeling better. I have energy and feel happy.
@@hiicutiiepiiedo carnivore and lift weights ...insulin resistance goes down , insulin goes down ...sugar stays up . Problem solved .
Thank you for making this video. everything you say is spot on, and i appreciate the research studies cited.
Dr. Bikman, Do the study shows that different profiles and numbers of microbiome of individuals reflecting different levels of glucose spikes mean that in addition to insulin, gut health also affects glucose spikes? What types of microbiome exactly? Any ways to improve the profiles and numbers of those microbiome? Hope that you can educate us by doing another classroom video on this. Thank you!
Great to see you again
🎉
Been using Stelo for 2 months. I would love more info on accuracy and patterns. Keeping peaks under 140 but hard to get avg under 95. I would like avg to be more like 80.
Same
Please do a video on how to interpret the CGM numbers. What is an unacceptable spike both in magnitude and length
@@RogerL YES, I agree 200%. Please, Dr Bikman, make a video on how to interpret the CGM.
I learned that no matter what I do my blood sugar won't stay down. It'll be down to almost normal levels for a week and then without changing anything it goes up to average 165 for about three weeks after which it comes back down. The cycle then repeats. I've been eating one version or another of the phd for over twenty months and have put on about ten pounds.
Any stress in your life? Cortisol? Gum disease and inflammation?
@@shauna996 Retired and single. Not drinking coffee doesn't break the cycle. No gum disease(bleeding gums stopped shortly after starting to eat right). Inflammation? I've never lost any weight so I'm sure there is.
Excellent explanation. Thank you
Thanks, Professor!
I just barely got an OTC Lingo CGM monitor and haven’t tried it yet. I would like to hear more from Dr Bikman on the differences he’s seen when it’s placed on the abdomen vs the upper arm. How soon, if ever do you think that Medicare and other insurances will be willing to pay for CGMs for anyone not on insulin? More information on how to interpret the data as someone else mentioned would be great.
Wearing my stelo right now. About to go into my second month wearing it. Just getting started learning how things affect me.
On my second Lingo. It’s very very close to the readings from my Contour Next One👍🏼
Walk after meals, Don’t eat most of your carbs later in day, watch out for alternative sugars, Gummy vitamins may spike you, electrolytes that are flavored may spike you, freeze or refrigerate cooked carbs before eating and it may lower the spike. I use ACV capsules if I know I will be eating carbs. Good luck…. That is a few things I learned.
Everyone is different, I found carbs first thing in the morning were the worst glucose spikes.
@ I have to eat mine mid day. If I eat them at night, the baseline of glucose will be higher all night.
A quick question. I don’t know the flexibility of the body to change microbiomes with supplementation, but in theory, if they know what supplements create what microbiomes in the body, and they know which microbiomes correlate to which responses for a given food, then could you select a supplement/probiotic based on your typical preferred foods to reduce the sugar response?
Thanks Ben for the wonderful metabolic classroom as always.
Could you please tell me specific things to be noted while wearing the CGM for the first time.
I have been using the old BG prick meters. Thank goodness for those prick tests I've been doing. I can see what spikes blood sugar and what doesn't in my meal. Dairy, including butter is out, it spikes insulin. And so does a few wild strawberries from my back yard. Fruit is out. Right now all of this has proven that I have to be as closest to carnivore as possible. Lots of fatty meats and eggs. I can get away with some coconut treats, like coconut butter, it gives me the slight sweetness without spiking blood sugar. So I treat myself to that once in a while.
So u dont use a cgm?
Excellent
Please do a video about how cgms can help solve sleep quality issues and their limits.
Unfortunately for me I threw away $106.. Stelo was a total disappointment.
I just got my first CGM (G7) yesterday.
The good news? My glucose is pretty stable. No spikes or dips so far.
The bad news? Most of the day it's stable between 105-135. Even doing VO2Max intervals at lunch it jumped to 127 (expected) but really didn't come very far down after. My A1C is 5.5, so that kinda makes sense.
I live the low carb life pretty closely. I'm not sure what I'm doing wrong, other than maybe I need more work above zone 2 on the bike to burn off sugars and help insulin sensitivity.
I plan to use a CGM for similar, though I really want to measure ketones. I don’t think I get in ketosis even on lion diet for 6 months. But resistance training has given me better progress with weight loss than cardio. I think inflammation must be due to stress but I don’t feel stressed. I get 75-80 scores on sleep. I am 10 yrs menopause though and finding a dr to get on HRT. I don’t know what else I can do. I must have IR going on. My ankles like to stay kinda thick or a bit puffy and weight loss is hard. I’m on 12-16 hour fasts randomly now to try that approach and reducing calories because nothing else so far has corrected inflammation. Sounds like I may have permanent damage if glycation if I understand Bikman correctly that glycated cells can’t be undone. My A1c stays around 5.0 and I have very high HDL, and low Tri so my ratio is good. Anyway, I did lose some weight finally with resistance training. Cardio I like but I don’t lose weight on it. I’m going to get my fasting insulin to figure this piece of the puzzle! I’ve had about every other test done from DEXA to all the bloodwork and iodine.
Your blood sugar level is being regulated more by your muscles than by food intake, indicating gluconeogenesis is at play. This suggests your insulin sensitivity (or "insulin IQ") might be high. Glucose that’s “pulled” by the body behaves differently than glucose that’s “pushed” in by food. While blood glucose level is valuable information, it’s still just a scalar value that lacks a "direction" or context for how it’s being managed within the body.
@@JanLL Maybe it gives a hint though.
I've been doing a LOT of Zone 2 work, mostly fasted, on the bike. I'm highly fat adapted now.
That may be biting me on the butt. I did VO2Max intervals yesterday. My BG rose to 127 almost immediately, then kind of hung out there. I expected by the 4th interval it would start declining but it never did.
After that it slowly declined down to the 80s and 90s and stayed there until this morning, which was great but that definitely feels like "push" more than "pull".
I'm beginning to think my glycolytic system, via GLUT4, is extremely weak right now due to over-focusing on the Mitochondrial system via Zone 2.
I also makes me wonder if I need to supplement with Creatine to improve that. My Dr. gave me the green light.
More information on why you feel the readings from a CGM are more important than A1C tests. I saw you had a very short video on that. From what friends with CGMs are telling me a finger prick test and the CGM can show huge differences in numbers. For those of us used to doing finger pricks what number ranges should we be working toward with a CGM?
I don’t understand the reluctance to use a CGM. I am a long time healthy user (Levels) and it allowed me to convince my wife to pay attention. She is not fit and needed to see how her diet was affecting her. Now we share a low carb lifestyle and can compare notes and plan great, healthy meals.
Thank you so much ❤❤❤
Wore a CGM for a couple of months I found large differences between it and blood stick test.
You have about a 15min delay on the cgm ...it measures interstitial fluid and not blood
Yes, there is a delay.
I have been on a journey the past few years to optimise my metabolic health. Low carb, intermediate fasting 18/6 and 10-15 hours a week of mixed exercise. I recently experimented with a CGM, and was confused by the higher than expected readings, compared to my actual blood work results. I’m wondering if this could be related to stress levels? For someone that works as hard as I do at my health, I did feel anxious due the elevated readings. Ben, could you please do a lecture on how stress can affect glucose levels?
Stress can increase blood glucose.
Thank you❤
I guess I would want to know what a normal rise in glucose is after eating. If I was wearing a CGM, what would I be looking for?
If a clinical glucose test is ‘drink a standard solution and watch the spike with blood tests’, is it possible to duplicate the test at home with dextrose from the homebrew store and a CGM? (Understanding that it’s NOT a clinical test and one should always consult a doctor…)
hypothetically (I know you are not my doctor) If I have Type 2 D, (A1c 6.8, fasting glucose 150, fasting insulin 25), Will fasting be the most effective way to quickly reduce insulin resistance so my fat cells can be released and used for fuel? How do I fix the insulin resistance the fastest? 23:1 fasting with beef, butter eggs in the 1 hour eating window? Also - is my fasting insulin high because my fat cells are all full and insulin has to be at 25 to keep me in homeostasis? I want my fasting insulin to be less than 5 not 25. Again, 23:1 fasting with butter beef eggs in the eating window the fastest way to fix fasting insulin? I am trying this for six months and will see if my fat cells start to get burned. I think I should also do weight lifting and bike riding to a few times a week to force the clearing of glucose, even though I am not eating any carbs
Why would the microbiome in the large intestine be causing low or high responses?
The food doesn't get to the large intestine in the first 2 hours.
Inflammation, leaky-gut , insulin resistance?
@garnerblair5179 still probably nothing to do what's in the colon. Doesn't explain it. What about people without a colon?
What kind of glucose rise on CGM would be a concerning spike? (I m 56 y/o, Non-diabetic. HbA1c of 5.3) Generally, I try to keep 1 hr post meal peak CGM reading under 150 or 160mg/dL.
Is 50 or 60mg/dL point rise considered unhealthy number to avoid?
Would experiencing of 80 or 100mg/dL rise once or twice a week still be too high of number that I need to avoid? A lot of my favorite foods, ex: bread, noodles or ricecake, etc. will spike my CGM by 80mg/dL. Now I feel like I am pre-pre-diabetic, so to speak..
A truly healthy person would not spike more than 30 pts, I think. But then so few people are truly healthy!
I could be wrong, though. It’s hard to find this info.
Dr Bikman - I just started on Stelo CGM past 14 days - my 1st CGM experience.
I’ve been told I’m pre-diabetic for some years now by my family dr. NOT diabetic. I did get my HOMA-IR test, and I am very insulin resistant. 67 yr old male, looking at me you may say I’m 10 lbs overweight. I don’t get exercise. My kidney GFR function is off, I guess from years of “pre-diabetes”. Very confusing situation. What do I do? Is Keto recommended - latest data implies it is very effective in the CKD treatment..help!
Could u please do a video on MTHFR gene mutation? U have a brilliant mind, and I actually understand your teachings!
I have compound heterozygous A1298C and C667T gene mutation.
Any knowledge u can share on this topic would be greatly appreciated!
(Love your content, if u can't tell)
I had a strange change in elevated numbers with my Stelo that I couldn’t explain. I wondered if it could be the Tylenol I had taken since I typically don’t take it. A little research confirmed. Another pharmaceutical was listed that I don’t recall. I also wonder if there are others that are unreported.
Is there a classroom lecture on cortisol spike causing glucose/insulin spikes?
I have a family history of diabetes and have been told by my doctor that I am pre-diabetic. I asked her if I could get a CGM and she told me that they are only for diabetics and that my insurance wouldn’t cover it without a diagnosis of diabetes. I asked if I could get one to avoid getting diabetes. She didn’t seem too keen on the idea. Why????
Where can I get one?
Google Stelo and Lingo. They have CGMs for non-diabetic folks. They are sold over the counter with no prescription. I just purchased Lingo for $49 for a 14 day sensor. Already impressed with the data.
Please, could you tell us , what is glucose spike, what is normal. What level, you regard as abnormal.
I've been using a Dexcom CGM for over a year. I had an older android phone and I kept getting warnings that the app wouldn't work with it. I have a new phone, and now the app is saying that it won't work with the latest android 15 software. I can't win! I do have a stand alone receiver, but it's a pain to use.
CGM are all so expensive. I’d love one but cannot afford one as a T2D; I don’t qualify on insurance; over $2,000 then monthly fees.
There are OTC now. Stelo and Lingo. Around $49 for 14 days. I just intend to get one every so often.
The difference registered days into wearing it and several times.
Would a continuous insulin monitor have more value than a CGM?
These would be awesome. But not available in the USA yet. They are being tested elsewhere currently. They are also testing with a lactate sensor the would be important information for athletes and exercise evaluation.
@@careyholm CKM for ketones exist. They don't measure insulin, but they might give some hints about it. Less ketones produced that used: insulin might be higher. More ketones produced than used (in fat/keto adapted state): insulin is probably low.
25 years with the NHS, I've never had my insulin checked but now I understand the mechanisms I can see that I've been very insulin and Leptin resistant for at least 3 decades.
I hope that my insulin is behaving better now, low carb, big weight loss etc. but will never know the actual figures and I have no baseline value to compare. For many years it was eat, insulin, then feed the insulin. Eating in the middle of the night to counteract deep hypo me. I hope the NHS is catching up at last but I think it will take a whole generation to improve the treatment
Even more important than glucose monitoring if you are not diabetic, I’d think!
Expert: Do not use a CGM, under no circumstances!!!
((( because they are eating my secured subscription like business away ))
As an insuranec company, I would pay every person meeting some criteria 1 CGM per year ... because that would save billions in the future.
You should teach a course on Peterson academy
Just recorded them. They should release soon. Not sure of release dates.
@ I’m enrolling for sure, in nursing school now, this will be great to add!
I found the Libre 3 to be grossly inaccurate. Finger stick is accurate.
I’ve found it to be spot on generally. Been using it for 9 months and only 2 have have been wonky. Has been extremely accurate at predicting my a1c.
There is a delay between finger stick and cgm, though. I’ve found that to be less of an issue as I brought my glucose under better control with keto and IF. Now that delay is barely noticeable.
Off topic but does anybody know how much the ketone body competing with uric acid for excretion raises uric acid levels? Im at 11 uric acid. 2.5 months strict keto under 20 total carbs, lots of omad, and a few 60 ish hr fasts worked in. Feel great. Decided to stop keto yesterday to see if that lowers it. Would like to keep keto as a tool when I need it. Its been great for my brain and weight loss. If the effect of ketones on uric acid excretion is huge, I need to know. supplementing 1000 mg vitamin c to help excretion and started drinking coffee.. How much allulose should I be mixing in there per day? I can eat under 400 purines a day, but it will get really tough if I cant eat alot of egg yolk due to the phosphorous. Anyone know any of these answers? I wouldnt have known any of this info with out Dr. Ben Bikman, thnx for posting this stuff up there.
Nevermind, just found the answet thanks. ketones in blood or urine are directly correlated and was the metabolic factor most influenced in a study of 1600 folks during long term fasting induced ketosis. lower levels of ketones means less uric acid. Maybe I can do a milder version of keto or cycle in and out? Never measured ketones. How best to go forward? just barely out of ketosis ? I dont want to muck up my insulin again, want to keep it low. Anyway thanks if anyone has advice..
Does anyone know if the Stelo CGM works with the Jitterbug/Lively T608G Android version 13? I see Stelo info says it works with this version of Android but sometimes phones can be picky.
I question the accuracy of the over the counter ones.
The makers are the two leading medical CGM. The difference is just in the software that reads them.
Why does glucose go down after etoh intake?
In India they are very expensive. Prohibitively so.No doubt about their usefulness.
Dr Bikman, please help to understand: Fasting insulin pmol/L 74.30
C - peptide pmol/L 889.00
HBA1c 5.3
Fasting Glucose mmol/L 6.11??? Any coments? How can it be? Man 48 year ok strict keto and 6 month strict carnivore.
Today blood results. Thank You❤
YT channel nutrition with Judy (Judy Chow) has some brilliant chats about BG on carnivore. Gives multiple reasons for differences. I’ve been carnivore 2yrs and my HBA1c was 5.7, fasting insulin (which is a very variable number that a bad nights sleep can change drastically for instance). I had a Fructosamine blood test which checks for glycation over 3 weeks and not 3-4 months and it was an equivalent HBA1c of 4.8. The theory is that in some carnivore eaters the red blood cell lasts longer. My fasting blood glucose was also high and by wearing a CGM I realised that get a high dawn effect that can last many hours which effected my fasted blood morning blood test. Hope this helps
My fasting glucose was 5.9
You obviously still working hard to get your insulin down yes. Good for you!!!
@@Tee667 thank you very much! It's just strange to me that the fasting glucose is so high and all the other indicators are within normal limits. It seems illogical. Cortisol is normal. Liver enzymes are normal.
Maybe health insurance companies need to be informed about the preventive medicine these devices represent. Most plans only cover the sensors if you are on insulin. Not everyone can afford to spend hundreds of dollars a month on sensors.
CGM what if I don’t have smart phone?
My sister has Kaiser insurance - they won’t prescribe a CGM even though she has documented dangerous lows.
Everyone's body is different. No shit. Yet we're supposed to have the same blood pressure and cholesterol 😂
I have a Stelo. Today it showed 111. My glucose monitor blood showed 82. So this one is way off. Will not buy again.
I m diabetic for the last 24 years. My fasting insulin level is 4, but my post-breakfast glucose is always around 240. Is it Okay?