CGMs for those without type 2 diabetes w/ Dr. Nicola Guess
Nov 27, 2023
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Dr. Nicola Guess, an RD and PhD researcher from Oxford, dives into the world of continuous glucose monitors (CGMs) and their implications for those without type 2 diabetes. She discusses the nuances of glucose dynamics and the misconceptions surrounding glucose data interpretations. Nicola emphasizes the importance of understanding individual glucose responses, especially regarding diet and exercise. Plus, she highlights the potential mental health impacts of CGM usage, advocating for a more holistic approach to health rather than fixating solely on glucose levels.
Continuous glucose monitors may mislead healthy individuals into fearing normal glucose spikes, impacting their dietary choices negatively.
A comprehensive approach to health should focus on overall well-being rather than solely on glucose levels, emphasizing dietary habits and metabolic health.
Deep dives
The Role of Continuous Glucose Monitors (CGMs)
The podcast discusses the rising use of continuous glucose monitors (CGMs) among individuals without diabetes, highlighting concerns around misinterpretation of the data they provide. Many patients believe that glucose spikes indicate unhealthy dietary choices and may inadvertently make worse food selections based on the readings from these devices. The speakers emphasize that the rise and fall of glucose levels, particularly after meals, is a normal physiological response rather than a cause for alarm. There is a distinct difference between temporary spikes after eating and chronic high glucose levels, which are linked to health risks such as prediabetes and diabetes.
Understanding Glucose Levels and Their Implications
Normal glucose levels and the diagnostic criteria for diabetes and prediabetes are discussed extensively, illustrating the significance of peak glucose levels following specific glucose tolerance tests. For instance, the speakers define boundaries for abnormal glucose readings, like prediabetes being indicated by a two-hour glucose level of 140 mg/dL. They stress that acute spikes in glucose that return to normal after a short period should not be concerning for healthy individuals, contrasting with ongoing elevated levels that point to insulin resistance. The conversation touches on how historically normalized reference values can mislead individuals into fearing occasional spikes rather than understanding their context.
Potential Risks and Psychological Impact of CGM Use
The psychological effects of using CGMs are scrutinized, particularly how they can induce anxiety in users who fear glucose spikes. Participants share anecdotal evidence of patients becoming overly concerned about their glucose levels, resulting in changes to eating habits and potentially harmful dietary choices. Notably, the conversation emphasizes that while monitoring glucose can provide useful feedback, it could also promote unhealthy behaviors if users are not adequately educated about what these metrics mean. The speakers caution against the notion that merely keeping glucose low is synonymous with better health, advocating for a broader understanding of metabolic health.
Beyond Glycemic Control: A Holistic Approach to Health
The discussion extends to the importance of addressing overall health rather than just focusing on glucose levels, particularly in the context of obesity, cardiovascular health, and other risk factors. The speakers argue that dietary recommendations should encompass more than just glycemic control, stressing the need to manage body composition and systemic inflammation as part of a comprehensive health strategy. They suggest that low-carb diets, while beneficial for some, can lead to another set of complications if not monitored correctly, particularly regarding cardiovascular health. The take-home message reinforces that a nuanced approach to lifestyle and dietary habits is essential for long-term health, contrasting conventional wisdom with emerging evidence.