Should I get a CGM

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Brenita
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Should I get a CGM

Post by Brenita »

Hello,
I have been tracking my blood glucose and ketones with a KetoMojo meter, urine test strips and Biosense breath analyzer. My fasting blood glucose is mostly 90 - 110. I cannot seem to get it down with intermittent fasting, lchf and exercise. I am considering a CGM for the purpose of trying to target the foods or situations that give me glucose spikes.

I have been looking at serveral Nutrisense, Levels, Free Style Llibre and others. The pricing is all over the place. I currently use Cronometer to track everything, so I don't think I need the extra apps to track food, exercise, etc.

I want to get a CGM that does not require my Dr to give me a prescription. Not sure this is possible, I don't want this on my medical record.

Do you think a CGM will help me and do any of you have suggestions for which one to use? Really appreciate any information.
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Re: Should I get a CGM

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Brenita wrote: I want to get a CGM that does not require my Dr to give me a prescription. Not sure this is possible, I don't want this on my medical record.
You can get Libre sensors here without a script.

You can read sensor with your phone if it is one of these:
"What smartphones and operating systems are compatible with the FreeStyle LibreLink app?
FreeStyle LibreLink will only work with phones that meet the following minimum requirements:

• Android Operating System 5.0 and higher, Near Field Communication (NFC) capability
• iPhone 7 or higher, OS 11 or higher"

Otherwise you need one of their meters.

Dr. Mark Cucuzzella talks about the Libre quite a bit in this 2020 presentation.

My experience is you should disregard the first day or so of readings as they are notoriously inaccurate.

All that being said, you might be interested in the info below to use with your current blood glucose meter. Especially "Data Driven Fasting."

Australian engineer, Marty Kendall, has developed systems to help people lose weight (fat) and optimize their metabolism. Helping his type 1 diabetic wife optimize her insulin use and control her glucose sent him down this path. Analyzing data from her closed loop continuous glucose monitor/insulin pump system led him to understand one flaw in common approaches to weight loss. It is assumed that carbs have the greatest insulin response, protein has about half of that of carbs and fat has virtually none. What Marty observed is that fat has a longer impact on basal insulin and a large intake of fat will raise insulin levels over the course of the day. Everyone knows that insulin needs to be low during a period of time of the day for the body to access stored body fat.

Marty knew that the order of fuel use in the body is alcohol, ketones, blood glucose, liver and muscle glycogen (glucose), fatty acids in the blood, then body fat. When the non-body fat fuels are elevated, insulin and glucose are too. So Marty developed a system using a glucometer (blood glucose meter) as a fuel gauge. This system could also be used for individualized hunger training. Hunger training allows a person to get feedback as to whether their hunger feeling is due to low fuel on board, or something else. Marty calls this system, Data Driven Fasting.

Marty also observed that when people optimized their nutrition with nutrient dense foods, to optimize the intake of the important amino acids, vitamins and minerals, they consumed less total calories. This is because the body has nutrient sensing pathways that signal a person to eat till these nutritional requirements have been met. So Marty also developed a course to teach people how to optimize their nutrition, no matter their way of eating (from carnivore to vegan and everything in between).

Here are a number of links where you can explore this in more detail:

Data Driven Fasting: https://optimisingnutrition.com/data-dr ... Z45LJvkTRk

Hunger Training: https://optimisingnutrition.com/hunger- ... R_TjOP3cio

The best way to measure your weight loss progress (without the scale): https://optimisingnutrition.com/why-you ... ZXlNH8H4SU

Oxidative Priority: The SECRET to optimising WHEN and WHAT you eat (or the order in which fuels – foods – are used); https://optimisingnutrition.com/oxidati ... dO68NqJdoA

Want to lose fat? DON’T aim for stable blood sugars! (Why your CGM could be making you fat): https://optimisingnutrition.com/want-to ... 0k-kXDcLwk

What is nutrient density?: https://optimisingnutrition.com/nutrien ... 5PVqgAJz0I
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Re: Should I get a CGM

Post by NewRon »

Wow Tincup, that's amazing information, thanks!
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Brenita
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Re: Should I get a CGM

Post by Brenita »

Thanks Tincup.

So much information and it changes all the time as new research is done.

Has anyone here tried the Data Driven Fasting?
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Re: Should I get a CGM

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Brenita wrote: Has anyone here tried the Data Driven Fasting?
I have as a way to improve my blood sugar. I did not need to lose weight and have been keto adapted since 2009. I have helped my morning fasting BG, pre meal BG and especially post meal spikes.

The other thing that has helped is to follow my evening and any carby meal with 15 or more minutes of Zone 2 exercise after. See the paragraph with links on Z2, MAF & nasal breathing here. Zone 2 (and the others approximate it) is relatively mild pure aerobic. Exercise at this level can allow GLUT 4 transporters to transport glucose into the muscles without insulin.

The late Dr. Leonard Schwartz developed "Heavy Hands" exercise and more generally the idea of doing aerobic activity while using as much of the body musculature as possible (more here). I have generalized this concept and typically do something like this for Zone 2 exercise. This could be Heavy Hands (HH) walking at a brisk pace, using a Nordic Track skier or the skier with HH weights, a fan rower, a fan bike, my DIY version of Dr. Schwartz's "Pan-X" device and exercises (in my DIY case, I have separated suspension handles mounted below my climbing hangboard with lower and upper handles (would be like rings but handles instead) on each side. There are Pan-X videos in my link. Also calisthenics, suspension training, training with the T2-Isotrainer, or Bullworker Iso Flo., to name a few. Many ways to implement this concept. Many times, after my after dinner exercise my glucose is say 78 mg/dL (4.3 mmol/L), which sets me up for a good morning reading, too.
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Re: Should I get a CGM

Post by Brenita »

Tincup, Thanks again for the great info. I will study and implement. Hopefully this will help my BG.
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Re: Should I get a CGM

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Brenita wrote:Tincup, Thanks again for the great info. I will study and implement. Hopefully this will help my BG.
On the Data Driven Fasting, what they do is have you track your glucose BEFORE meals and upon waking for 3 days. Then they calculate a blood glucose target. You are then encouraged to not eat until your glucose drops to this level. This is set modestly low, to start with. Over time, as you hit this target, they will lower the target - based on your data. They have modifications for having exercised or being sick. What I've observed is my food quantity (calories) is correlated with my glucose before eating. When I drop calories, then the glucose will drop. This is a very brief summary. Also, participating in their groups, compliant people have experienced significantly lower glucose, all the way around: before, after and fasting.
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Re: Should I get a CGM

Post by shenmen100 »

Tincup,
Is there a simple formula for roughly figuring out Zone 2 HR as opposed to VO2max? I have listened to to Peter Attia podcast and trying to implement 30 minutes/2 times a week of zone 2 on my stationary bike with a guesstimate of HR 112-122 for a fit 64 YO?
I love the Data Driven information and will join one of his groups for a January "cleanse" after the holiday feasts.
You are always an amazing resource of useful information !
thanks
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Re: Should I get a CGM

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shenmen100 wrote:Tincup,
Is there a simple formula for roughly figuring out Zone 2 HR as opposed to VO2max? I have listened to to Peter Attia podcast and trying to implement 30 minutes/2 times a week of zone 2 on my stationary bike with a guesstimate of HR 112-122 for a fit 64 YO?
I love the Data Driven information and will join one of his groups for a January "cleanse" after the holiday feasts.
You are always an amazing resource of useful information !
thanks
Phil Maffetone's MAF heart rate is a reasonable approximation. It is nominally 180-age, but he does have qualifiers up and down. See here.

If I do even 15 minutes after dinner (or any carby meal). I generally end up with blood glucose after in the 70's or low 80's mg/dL (~4.2-4.7 mmol/L). I've made this a regular daily activity and my morning fasting glucose also responds and is commonly in the low 80's. I also do more other times of day for the adaptation benefit, but do the time following dinner specifically for the glucose lowering effect.
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Re: Should I get a CGM

Post by Brenita »

Tincup,
I joined the December DDF Challenge. It was amazing how simple it was and the information and guidance provided was very valuable. I will probably do this challenge a few more times. I also, do not need to lose much weigh just need to get the glucose in line. I am also signed up for the January Masterclass.

As you mentioned, I am trying the Z2 exercise after dinner. Hoping this will help.

Thank you so much for all this information.
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