CGMs...Everything you ever wanted to know
 

As of July 4, 2020, Terrific talk by Dr Mark Cucuzzella (doctor who removed sugar from his WV hospital, USAF fitness expert, ultra-runner, all around nice guy) from the LC Denver event in March:
To Thine Own Self be True: CGMs Made Simple

https://youtu.be/2XJup5NOYT4

Patient stories, reviews of glucometers, new methods to track glucose readings, the brands of CGMs, how each track and work, 30 second demo how to place one on arm, Info for T1 and T2, and much more. He introduces this as "Narrative Medicine"...it does present the whole picture.
A shout out to Dr Richard Bernstein at end.


Mark is talking very fast and skipping some slides to get it all into 37 minutes...be ready to hit the stop button if need to write details. He had a .pdf of slides for attendees.

More about Dr. Mark. https://www.drmarksdesk.com/

This was a great presentation. :thup: I had deja vu, though... I know I saw it somewhere else right after the conference. Maybe DietDoctor? Worth watching a second time, though.

It is on DietDoctor, but new presentations are available only for members. When Low Carb Down Under posts on YouTube, the conference presentations (and Brendan's interviews :) ) are available to all.

This Is What I Need !!!

This is what I think a lot of people need. There's nothing quite like personalised, real-time data to demonstrate to people exactly what happens when they don't eat right.

In the Fat Fiction documentary they do exactly that: give CGMs to a few patients as part of an experiment. It was pretty eye-opening for all of them. I'd certainly be up for trying one myself someday.

Very timely posting! I just got a Freestyle Libre CGM which I haven't used yet. The tips about application of the sensor is helpful. I'm looking forward to getting a more continuous look at my blood sugars.

Mycie......how did you aquire one? Thru doc?

I see ads on TV.

And today, free from Low carb Denver, Dr. Ben Bikman, on flipping the switch from insulin resistance to type two diabetes.

https://youtu.be/YCVYyOju4UM

Ms. Arielle,

Yes, through my doctor. I'm a T2. I'm considered by the docs to be fairly well-controlled with A1c of 5.6, so I was afraid she would say no, but she just asked why I wanted it. I want to get back to my lower a1C of 2 years ago. She said we could try it for 6 months.

I downloaded the info off of the Freestyle website which showed her how to write the scrips. With insurance, I had a co-pay of $60 for 2 14-day sensors and $60 for the reader.

I may space out my usage. 1 month on, make some tweaks to diet and excercise for a bit, and then wear it some more.

You do have to double check with a finger stick, especially during first 24-hours of a new sensor. The readings can be all over the place. But if you aren't dosing insulin (I'm not), you can ignore the wonky readings and wait for it to settle.

So far, it's telling me what I already knew or suspected. Dawn phenomenon which takes a looooong time to clear. Exercising to empty glycogen stores helps a lot. Peanuts/peanut butter bad with a lingering result.

It's fun and aggravating at the same time!

Thank you for great details. A bit more than my primary can handle.

Perhaps finger stick is as valuable.

Helps me know where to put my money and effort.

Excellent summary presentation. Thank you, Janet. I had missed this one. Also, good news that Bikman has a book in the works: Why We Get Sick, due out this year. I'm looking forward to it given his lucid and descriptive presentations.

There may be a better thread than this one, but ...

I just compared my readings with the Abbott Precision glucometer, the built-in Freestyle Libre glucometer and the Libre CGM -- non-fasting, 5:00 pm. The readings were 85, 77, and 58(!) in American units.

My CGM readings have been consistently low this past week - 20 to 30 points lower than what the blood tests show. I don't know if I want to pay for more sensors if the readings are so far off.

N.B. The variation in CGM readings looks legit. My readings are mostly constant with variations for exercise and, of course, meals. Just the absolute reading is off.

Also, do the sensors go out of date? The current sensor is about 2 years old. I threw away the box, so I don't know if it says.

Any suggestions?

Thanks.

Though I have probably taken hundreds of BG readings since July 2020, I do not have a CGM. For the Data Driven Fasting I am doing, one is not recommended over the cheaper regular meters. Marty Kendall knows all about them since he is managing his wife's T1 with a CGM and closed loop insulin pump. Two years does seem a long time for a sensor (mainly because the strips expire in 6 months) but call the manufacturer customer service to ask or download a copy of the manual. I have read about CGM numbers off because of pressure on the sensor while sleeping.

Found the manual: https://www.freestyle.abbott/us-en/...t/overview.html

FAQ #3 in this Free book is about CGMs. https://www.datadrivenfasting.com/book

Marty's Optimising Nutrition thread is right below here.

I got a new prescription for the sensors and the readings are consistent now with a blood test.

BTW, the use-by-date is the end of July the year! So the age of the sensor could definitely make a difference.

An update....I have now heard from various sources, including my endocrinologist, that the Freestyle Libre tends to read a bit lower than a finger stick usually. This has been my experience.

But if you want to see an overall continuous pattern or see what certain foods do over a period of time, it works well for that. The Dexcom CGM is much more accurate, but way more expensive. That is one of the meters used by Type I diabetics where the extra accuracy is worth the extra price.

Learning a lot about CGM in the Data Driven Fasting group.

CGMs are not measuring your blood glucose: which is the desired format if you want to do the [DDF] challenge correctly. So yes: you should be checking your BG with a finger prick. There is no “easier” method available at this time for BLOOD glucose.

So...what is a CGM you may be asking yourself? A CGM measures interstitial fluid (the liquid that lies just beneath the skin). Because it can take 20-40 minutes for glucose to travel through your veins to change the glucose levels under the skin - your CGM readings will rarely if ever match your BG exactly. (Unless your BG has been the same for the last hour or so). Yes, it’s fantastic for showing you trends: i.e. whether your glucose is rising or steady or falling. But make no mistake. It’s not Blood glucose which is the most reliable.

Good description and important clarification. Interstitial fluid - between cells, would definitely take longer to show comparable BG levels after eating.

I get an upswing in my CGM readings within 5 - 10 minutes whenever I "exert" myself - from heavy resistance training to climbing the stairs.

Not sure what is up with that.

There is discussion about exercise here, though it says the lag may get longer...so ?

https://diatribe.org/exercise-well-...-strategies#lag

Also if you want more on CGMs, Marty posted a DRAFT of an article in Google Docs. This focused on how to lose weight with a CGM, not exercise, but adding it here anyway. Lots of info on brands.

https://docs.google.com/document/d/...gEdUpnCdbd5e98#

So much has changed in the CGM market in 3 years.
An accurate CGM is available for purchase in the US now…no prescription needed. No fingersticks (though should calibrate BG from interstitial fluid and capillary and venous blood.)

https://forum.lowcarber.org/showthread.php?t=485896