Optimize Your Nutrition and Behavior with CGMs | Dr. Peter Attia on Managing Glucose

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Peter Attia, MD (@PeterAttiaMD), is the founder of Early Medical, a medical practice that applies the principles of Medicine 3.0 to patients with the goal of lengthening their lifespan and simultaneously improving their healthspan. He is the host of The Drive, one of the most popular podcasts covering the topics of health and medicine.
Dr. Attia received his medical degree from the Stanford University School of Medicine and trained for five years at the Johns Hopkins Hospital in general surgery, where he was the recipient of several prestigious awards, including Resident of the Year. He spent two years at the National Institutes of Health as a surgical oncology fellow at the National Cancer Institute, where his research focused on immune-based therapies for melanoma.
His new book is Outlive: The Science and Art of Longevity (3/28): www.amazon.com...
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ABOUT TIM:
Tim Ferriss is one of Fast Company’s “Most Innovative Business People” and an early-stage tech investor/advisor in Uber, Facebook, Twitter, Shopify, Duolingo, Alibaba, and 50+ other companies. He is also the author of five #1 New York Times and Wall Street Journal bestsellers: The 4-Hour Workweek, The 4-Hour Body, The 4-Hour Chef, Tools of Titans and Tribe of Mentors. The Observer and other media have named him “the Oprah of audio” due to the influence of his podcast, The Tim Ferriss Show, which has exceeded 900 million downloads and been selected for “Best of Apple Podcasts” three years running.
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[@nathanas64]

This device is ingenious and I would urge everyone to get a prescription for it and monitor their glucose. It not just for diabetics. I was prediabetic and it taught me how my body reacts to certain foods. It also reinforced my knowledge of the importance of exercise. Glucose too high .. go for a quick walk. This has to be one of the top inventions of the decade !

[@jennifercline6866]

Was prediabetic over a decade with little help from Dr. This would have made a big difference. Type 2 now, just started a CGM.

[@shalomagape5457]

How did you get yours? Which one?

[@nathanas64]

@@shalomagape5457 gotta get a prescription from your doctor. I got the Libre3.

[@MyraLee-c4r]

I laughed at this when you mentioned people are so surprised at what spikes their blood sugar when they start wearing a CGM. This is SOOOOOOO true! Wearing a CGM for me was a total game changer in terms of understanding my body and what I am putting in it and how to optimize my health

[@bigglyguy8429]

I was shocked to find being horny spikes my blood sugar. I had no idea!

[@patriciacrawford6435]

I am a pre-diabetic and am wearing a CGM for six months via Signos. My glucose levels are important for a few reasons. I know what damage spikes do, and I am learning how to eat without causing spikes. Also, it's a type of accountability. Before my CGM, my fasting glucose was 115 or higher. It is now around 88.

[@归来少年]

which CGM do you use? any recommendation? thanks

[@patriciacrawford6435]

@@归来少年 I am using the Dexcom G7, and I like it. I previously used the Freestyle Libre, and actually had a sensor fail, and one fall apart. This one has had none of those problems.

[@barrymonteiro8893]

What a clear explanation of glucose levels, A1C and the benefits of CGMs. Thanks for this informative content.

[@ericasmith7231]

Great video! Yes any form of stress (working out, poor sleep, etc) spikes cortisol > spikes glucose > spikes insulin

[@jennifercline6866]

Learning that is very true, it's not only what you eat.

[@inigojuancarlos]

There's a study that came out last year about the comparison accuracy of these CGMs (Abbott vs Dexcom). The most accurate by measure when it comes to monitoring thier glucose is the latest Freestyle libre 3. Been using it for quite sometimes and it's so seamless.

[@sheila7814]

Can you get it if you do not yet have diabetes? Those of us that are borderline would like it too. Is it expensive? I have cancer and I think my cancer meds are making my glucose go up. I’m not sure if my doc will prescribe it or not.

[@kevingold1091]

@@sheila7814 Yes, you can get it, but if you're not diagnosed as diabetic you'll have to pay for it out of pocket. I don't know if insurance would cover it with a diagnosis from you doctor of pre-diabetic. If you end up paying out of pocket, I would guess the out of pocket price is the same for everyone, although I suppose it could vary based on what pharmacy you get it from. I get mine from Publix and it's $41 per refill/sensor, which lasts 14 days, so a little over $82/month. I've found it to be well worth the price.

[@geneffaj]

@@sheila7814 Yes you can get it through a subscription program like Veri. Good luck, hun.

[@lisa1446]

I think our understanding in non diabetics is too simplistic. For example I wore one and my learnings were 1) I ate food and my blood sugar went up and went down, that's totally expected, and it didn't go up too high (i.e. after 90 minutes/2 hours my blood sugar was back to normal). 2) My hunger and cravings were in no way related to my blood sugar, often when I felt hungry my blood sugar was just fine, it was much more related to my macros of fibre and protein in my meals, even if there was a sweet element to it. 3) When I had a meal that was high fat my blood sugar didn't go up as high but it went up for LONGER. My dad is type 2 diabetic and eating high fat foods take his average up higher for longer and his Dr told him to stop it. So he went back from eggs in the morning to porridge and his average blood sugar was lower than on fats. 4) We can't discount that pre-diabetes is to do with body fat, low muscle mass etc. It's not necessarily all about carbs. 5) My highest blood sugars in the morning- when I want it to be down- was when i had bad sleep. My best fasting blood sugar was when I had good sleep. It's really not as simple as realising you eat raisins and your blood sugar goes up. Blood sugars going up and down are fine, it's the general whole foods, body fat exercise and sleep that have a big impact. Basically what I learned was to try and get a good nights sleep but that my blood sugar was pretty good at managing itself (for now).

[@soramame7528]

I’m a fit looking sugar addict. I love sweets and ice cream. I’m detoxing due to weight gain and currently I have no sugar cravings but if I wore the CGM, I would probably be scared for my life. I need to try it.

[@jonh9561]

The use of Continuous Glucose Monitoring systems (CGMs) has been completely transformative in understanding the differing affects that different foods have on me and as a Type 2 diabetic. CGMs were developed for Type 1 diabetics, but Type 2s should consider using them periodically when first diagnosed to help us to understand how food and exercise affects the body. There is about a 15 minute delay from eating something to see the effect on the CGM. The other great advantage that they offer, is that the daily recordings over the two week life of the sensor can be converted into a into a detailed report that you can file on your computer and send to your Dr. Its a massive leap forward in learning how to manage diabetes and one's overall health.

[@AngieLyke]

It also reinforces that when you eat a meal with carbohydrates eat the fats and proteins first. Then go for your fruit and vegetables or grains.

[@EdwardsNH]

The second Apple puts out a watch that measures glucose, I'm buying it. It looks like we should see that in the next 3 years

[@infamousboxer]

The new Apple Watch will have a glucose sensor monitoring

[@ashutoshsundaram26]

Waiting for it

[@DavidDavoDavidson]

How do you do that without some sort of injection site?

[@EricRobertstraveleric]

Color of light that can see just beneath the skin to get the readings

[@ShimonLobel]

Not happening reliably

[@mattmazzola]

Did anyone think Dr. Attias' eyes were open wider than expected? (you could see white all the way around for significant time) I almost felt like his face looked frightened, but yet his was voice was calm and relaxed. Strange mixture. Although I'm hoping we get to see more innovation in these CGMs. I expect the monitors to get cheaper and less invasive while maintaining quality and becomes as common as other wearable devices.

[@Brentwood620]

This post is just creepy. Why be so negative and unkind?

[@punjatti101]

You sound like a serial killer

[@solidgod1093]

He looks fine man. Saying this without judging as you seem hyper aware - were you microdosing or sth?

[@Delahoya_]

That’s normally the eyes of a sociopath.

[@glennwhitney1494]

Thanks - very clear and insightful.

[@deuteronomy3162]

Actually super helpful.

[@gustavojauregui2424]

I use sauna and pool.. will this affect the cgm?

[@ashleighblasey2262]

Heat will raise the numbers on your CGM.

[@MichaelAsgian]

I'm not diabetic, but I'm really interested in monitoring my glucose levels and just got a Stelo to experiment with. As an avid mountain biker, I'm concerned about how well the sensor will stay on during intense rides, given the sweat and movement involved. Also, how do you manage showering with the sensor on? Any tips would be appreciated!

[@999homerun]

My sensor fell off after 3 days. I called Abbot and received another at no additional cost. Then I bought waterproof clear adhesive plastic covers on Amazon which are working great so far.

[@carolcraig6053]

I have the G 7 love it

[@genenicotra2777]

what are your thoughts about Eversense the 180 day sensor. Its less know, but seems more flexible.

[@FLFlyGirl]

Dexcom, Freestyle, Levels, & Signos - Levels & Signos are targeted to non-diabetics. Is there any empirical data indicating the accuracy of the non-FDA approved CGM's?

[@jheckmann]

Levels uses Freestyle.

[@nicholasdefilippo8951]

Levels/Signos/NutriSense/Veri are just apps that read, analyze, package, and present data from Dexcom or Freestyle hardware.

[@WindsorJacob-g1d]

928 Jones Grove

[@SgtSam1]

It’s ridiculous how expensive the sensors are for CGM’s and how it’s nearly impossible to get insurance to pay for it. People can’t afford this stuff!

[@SgtSam1]

@@simongarner5340 of course we shouldn’t be scared of blood sugar spikes or Insulin. It’s a very helpful for many things in the body. With that said, non-diabetics should be learning about their how different foods affect their bodies too and CGM’s are a tool for doing just that. Not scared. Just want to be more informed. Wish it was more affordable.

[@SgtSam1]

@@simongarner5340 lol not scared, just informed. It’s information for learning more about your body. I’ve spent 15+ years doing this without a CGM. It can be done, but boy it would have been helpful to be able to get my hands on a CGM without breaking the bank.

[@SgtSam1]

@@simongarner5340 my original comment was never about or reflective of an opinion that blood sugar spikes are good or bad. Nor was it about people being scared of said spikes. It’s about the expense of CGM sensors. That’s the core of this issue for me. If people are interested in becoming more informed about their blood sugar, why not make it accessible? No part of me is concerned about people not paying attention to other metrics of their health just because they are more informed of their blood sugar. I don’t follow that logic.

[@SgtSam1]

@@simongarner5340 there’s approx 136 million people who would probably argue these could have been helpful to them before they reached the point of having ‘blood sugar issues’ lol

[@simongarner5340]

@@SgtSam1 Totally agree. If you have pre-diabetes then a CGM would be beneficial. You could argue that people with "pre-diabetes" fall into the category of people with blood sugar issues. My argument is for people who DO NOT have blood sugar issues LOL.

[@lizcademy4809]

I'm waiting for the first non-invasive CGM ... I can't deal with things inserted into my body.

[@roberthayden5103]

It’s like a patch with a small needle that is left through the skin. It’s smaller than the needle 💉 I use for insulin injections.

[@lizcademy4809]

​@@roberthayden5103 It's a psychological reaction, not physical. I know it's tiny and not detectable, my mind still can't deal with it.

[@marydotjpeg]

That's how I felt about the birth control that's inserted in the arm but for me was the simplest form of BC compared to other methods 😅 it was weird to get used to

[@Jddjdurjf]

Considering that around the world there are millions suffering an impoverished life through wars, disease and traumas of all kinds, kids included... you sound a bit pathetic.

[@lizcademy4809]

@@Jddjdurjf We all must live the lives we are given, and do our best to better ourselves and those around us. I'm an old lady now, and have a rare cancer which my doctors say will kill me (date unknown). Throughout my life, I have worked to make things better for many people. What have you done today?

[@bariswheel]

The Tom Morello of the MD clan.

[@kylej.lauterbach1753]

i just laughed hard

[@55mblindy]

😂

[@TribeOfCooks]

Peter and Tim turning us all into our own test mice 😂

[@irinacohen7071]

Nobody is making you do it... you didn't even have to watch it

[@hiddenbyfog3084]

@@irinacohen7071 but without them who would’ve thought! Anyway why respond like that to a joke?

[@herbalist36]

Can the average person afford the CGM???

[@judiek8995]

I just got a 6 month subscription for $1000.

[@DonutAgain]

It's about $2K or so, so it's like half month of rent money if you live in a big city, or close to the savings from canceling a trip or a purchase of new gadgets for the year. I am currently debating if I should buy myself a one year levels cgm subscription or should I buy the new MacBook pro with M3 chip for the holidays. Neither is necessary but nice to have.

[@MsQ275]

I am not diabetic or prediabetic and my health insurance covered it with a copay of $125/3 mo supply. The tough part was finding a doctor to prescribe this. I eventually saw a concierge DO for the script ($375, she doesn't accept insurance)

[@BeneCapone]

A Freestyle Libre 3 sensor cost around 65 USD and measures for 14 days.

[@solidgod1093]

I am healthy and only 30 and was considering it for a bit anyway as I’m a health nerd but am hoping that smartwatches will have it in a few years as they are working on that so not spending my money right now…

[@acj514]

I was wondering why are you giving waffles to your kids? They don’t need to stay away from sugar as you are?

[@BarneyR2]

My blood sugar goes down after i eat

[@AngieLyke]

Don't buy the watches don't bother and they are not accurate. Waste of money. Check all the KZbinrs out here who bought them and then tested them against their CGM and their glucose monitor

[@cc1694]

Freestyle is not CGM sydtem! So misleading!!!! ((((

[@isabelcanizares4693]

??

[@ethanconnor]

The FreeStyle Libre 3, to which I believe he was referring, is a CGM system

[@deniseappel7109]

It is. I have the Freestyle Libre 3 CGM.

[@jonh9561]

Abbotts FreeStyle Libre is a Continuous Glucose Monitoring system, in fact it was the first commercially available CGM that I know of.

[@jodyjackson5475]

I’ve used the freestyle 2 it’s good