Image: 2018.05 Low Carb and Low Carbon – Ted Eytan MD-1001 843 (View on Flickr.com)
This study published by Kevin Hall, PhD et al (Twitter: KevinH_PhD) was done in conjunction with a study he performed that I posted on previously. It showed people eating ultra-processed food tended to eat more than those that ate real food.
The subjects, who were not diabetic, wore continuous glucose monitors (CGMs) from two different manufacturers, the well known ones, at the same time.
The researchers showed significant differences between manufacturer CGM in response to the study meals given, as well as to oral glucose tolerance tests.
Our results suggest that … precision nutrition approaches seeking to personalize meals to minimize glycemic responses via one CGM do not necessarily recommend the same meals according to another CGM in adults without diabetes.Hall KD, Guo J, Howard R. Different continuous glucose monitors provide different personalized meal recommendations to minimize postprandial glucose in subjects without diabetes. [cited 2019 Dec 16];
CGM in non-diabetic people
Currently, continuous glucose monitors appear to be marketed to people with diabetes, for obvious reasons. However, a small (and growing group) of non-diabetic people have been using CGMs, including myself.
Little has been written about the use of CGM in the 88% of the US population who are not diabetic or prediabetic. Even thought pieces on CGM ignore its potential for prevention.
It’s possible that CGM may be a tool to help individuals understand which foods raise their blood glucose levels, and therefore forestall or pre-empt diabetes altogether.
My CGM experience, as a non-diabetic person
I grabbed the data from 1+ years of CGM and graphed it above. My glucose excursions are much less than the ones reported of the study subjects, who were not on low-carbohydrate diets like I am. On average, my blood glucose level traveled 6 mg/dl after meals.
I’m also reflecting on the sheer number of measurements obtained over the past year+ (over 40,000) and the fact that it’s possible for me to go back in time and know what my blood sugar level was at any moment in this past.
I wear one of the brands mentioned in the study ( I won’t mention the brand name because I do not promote third party products or services here.
I wrote about my year long experience in this blog post:Part 11: Wearing a Continuous Glucose Monitor as a non-diabetic Physician: The Experience (Updated for 2019) – Ted Eytan, MD
I have noticed that each sensor is a little different, perhaps related to placement. The researchers in this study noted differences related to body fat percentage of the subjects:
The mean within-subject discrepancy between the Abbott and Dexcom systems increased significantly with percent body fat (r=0.56; p=0.02) such that for each 1% increase in body fat the Abbott system resulted in a 0.49±0.19 mg/dl reduction in mean glucose as compared to the Dexcom system.Hall KD, Guo J, Howard R. Different continuous glucose monitors provide different personalized meal recommendations to minimize postprandial glucose in subjects without diabetes. [cited 2019 Dec 16];
It is good to see more work done in this area. There’s not enough data available to support a recommendation for every human wearing a CGM.
At the same time, like many other biometrics, some useful, some not, this one may make it into our lives embedded in smart devices. When/if that day comes, it would be nice to know the utility of these measurements and their role in preventing or managing metabolic disease.