Using CGM to better understand metabolic health - Diet Doctor Podcast with Dr. Casey Means

Dr. Casey Means is on a mission to help us understand more about our metabolic health and how our food choices impact it. She's at the forefront of promoting the use of continuous glucose monitors (CGMs), to help us see how different foods affect blood sugar, and more importantly, show us what we can do about it.
Dr. Means' interest in blood sugar doesn't stop with food. In this interview, we also discuss how sleep, stress, and other factors can affect a patient's blood sugar response.
0:00 Introduction
1:55 Welcome, Dr. Casey Means
2:10 Dr. Means’ journey from surgical training to metabolic health
7:59 What people around Dr. Means thought of her transition
12:20 Technology in health care
16:15 What CGM is and how to use it
21:25 CGM to help clear confusions with food
27:49 Most people reacts differently towards food
33:15 Real data on CGM to help patients get better
36:46 What is the optimal glucose number?
40:09 Glucose level numbers according to Dr. Means
45:31 Glycemic variability
52:30 Blood sugar: goal and advice for patients
56:11 Reverse metabolic inflexibility
1:01:56 Does technology give patients useful information?
1:05:47 High blood sugar after HIIT exercise
1:08:52 Where to find Dr. Casey Means
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[@Paul-hi7nw]

Please bring Dr. Casey Means back. Bottom line: your interview with her was a great interview on all levels, great interviewer, great interviewee coupled with extremely interesting and relevant subject matter.

[@robertotorin289]

You all probably dont give a damn but does any of you know of a trick to log back into an instagram account..? I somehow forgot the login password. I love any tricks you can offer me.

[@harveysawyer2447]

@Roberto Torin instablaster =)

[@robertotorin289]

@Harvey Sawyer Thanks so much for your reply. I found the site thru google and im trying it out now. I see it takes a while so I will get back to you later when my account password hopefully is recovered.

[@robertotorin289]

@Harvey Sawyer it worked and I now got access to my account again. Im so happy:D Thank you so much you saved my ass !

[@harveysawyer2447]

@Roberto Torin No problem xD

[@TV-ur9gu]

Dr. Means, my GP prescribed a CGM as a breast cancer survivor. The data on my nutritional intake was invaluable to avoid long term recurrence. Major dietary adjustments were made.

[@lorettadillon-ham1574]

Fantastic that you had/have such an intelligent progressive doctor - thank u for sharing - it takes a special kind of doctor to not have dissonance drown out “what else is possible”

[@DarkMoonDroid]

@T V What kinds of adjustments?

[@jd01665]

Dr Boz kzbin.info/www/bejne/fHPSp3igl850hac has a ratio we can calculate by taking the glucose and dividing it by the ketones. I have recently purchased a CGM by Abbott that measures ketones with the strips. Not sure if there are continuous ketone meters available, but the calcualtion is glucose / ketones = a number. If you are under 20, you are in autophagy and it's supposed to be great for cancer. I am in the middle of a fast. Using an app called Fasten that shows me I am at 99.39 (so a little over 4 days) and I have a glucose of 70 mg/dL and a ketone of 6.3mg/dL so 70/6.3 = 11.11. 35:48 I like that Dr. Casey Means wants to jam all this info into a machine learning system. She's absolutely right. We can't do anything without measurements and we can't rely on any one doctor to do diagnostics. Google has lots of learning tools for people interested in doing this work. Check out what they have done with skin cancer: blog.google/technology/health/ai-dermatology-preview-io-2021/

[@kathya1956]

How do you know that was from your CGM?

[@TV-ur9gu]

@kathya1956 My Dr. Is a breast Cancer survivor also.She told me to keep my insulin down via CGM & and swim 🏊‍♂️ 3x a week. I'm now a 10 year survivor.

[@desertviews]

Almost decided not to watch this when I saw the one hour and eleven minutes. But after watching I have to say that I have never seen two people speak more clearly, more precisely, more simply, or more easy to understand than you two. Great discussion, absolutely excellent. Thank you.

[@bc8456]

I’m a T2 diabetic trying to get off Metformin via intermittent fasting and keto diet. I’m exploring the use of a CGM (Freestyle Libre 2) to get better data to manage my diet and exercise and came across this amazing video. I wish all dieticians and diabetes educators were required to wear a CGM for at least a month during their training. That would open their eyes to how faulty the food guides are!

[@skinnydee1886]

BC, is the CGM expensive?

[@dorsetboronia6744]

Skinny Dee…..here in Australia it. Is about $100 lasts 2 weeks. So basically $200 AU per month

[@kimberlee440]

With insurance, I pay $75/mo for 2 sensors (each sensor lasts 2 weeks).

[@user-ly9zn3dq7t]

😊😊

[@user-ly9zn3dq7t]

😅😅😅😅😊😢😅😮😅😮😮

[@greendeane1]

Good video but ... It is very difficult to get a CGM prescription (which you need.) My doctor said I have to be a Type II diabetic first. I said I was willing to pay the entire cost. Still no go. What the medical community is saying is I cannot be trusted with information about myself. How damnable.

[@dort5436]

CGM are expensive but I found on line doctors that will prescribe a CGM. So if you are willing to pay for the meter, look on online. If diabetes is an issue find a treating physician who uses them in practice. When you see someone wearing one, ask who for the name of their doctor

[@skinnydee1886]

Green Deane, My doctor said that he can't give me a prescription for a CGM because I'm a type ll diabetic who's NOT taking insulin.

[@SuzanneU]

@@skinnydee1886 I don't understand. You originally said that your doctor refused to prescribe a CGM for you because you first have to be a Type 2 diabetic. Then you said that your doctor refused the prescription because you are a Type 2 diabetic who is not taking insulin. The two statements are inconsistent.

[@skinnydee1886]

@@SuzanneU My comment is plain and simple English so it's NOT difficult to understand; please re-read.

[@Sweetest_of_Seven]

@@SuzanneU Skinny Dee did not post the original comment… it was Green Deane

[@rainerseidel3980]

Great information indeed! I‘m using CGM and also HRV as some kind of bio feedback tool in exactly the way mentioned. So far most people think I‘m nuts but this does really encourage me to go on. BTW: am in a mild keto / highly nutrition oriented way of eating since 15 months, lost about 85 lbs, got rid of many metabolic issues incl T2D, hbp, brainfog etc. And no longer need any big pharma medication (used to take 13 meds each day)..... Please keep on providing such helpful infos to us 😁🧡

[@artsiecrafty4164]

Then what’s the point of CGM?

[@rainerseidel3980]

@@artsiecrafty4164 to see immediately the effect of foods and the combination of food

[@Paul-hi7nw]

Congratulations on both your weight loss and your taking control of your many metabolic issues. I am trying to follow your lead. You are an inspiration to those of us who realize the path to solving these issues is through self-help, self-denial, and determination, not big pharma and chemicals.

[@rainerseidel3980]

@@Paul-hi7nw thanks for the friendly words! Surprisingly it‘s due to Corona that I have much more time to learn about these things. As an engineer I tried to follow the approch to investigate how things are working and learning to fix what goes wrong. So I started to learn the basics of micro biology and cell bio chemistry. After first being completely confused, suddenly everything felt in place and now I feel convinced to master chronic desease by my own knowledge. I‘d encourage everyone to learn and get rid of big pharma and big food.... in case there is a doctor who is supporting this : wonderful!

[@simonbevan4598]

Lord bless you and keep you His face shine upon you and be gracious to you and give you His shalom. ♡ blessings from nz Aotearoa land of the long white cloud ♡

[@briannanovak7831]

Sure wish I had gone to this doctor at the beginning of a full year of terrible vertigo. My ENT was no help at all. I had to figure out for myself that the whole thing was caused by inflammation. I stopped eating dairy completely and finally got rid of my dizziness.

[@skinnydee1886]

Thank you Brianna Novak 🙏🌹

[@louisag5410]

Great interview! Wouldn’t it be great if we also had a CIM (continuous insulin monitor). I heard Dr Bickman recently say that is years away... as more complex than CGM...

[@daraghosullivan1157]

Dr Means is onto something here. I hope it takes off. I just started using a CGM to educate myself on how food was affecting me, to understand the current state of my metabolism and then to motivate me to make better food and activity choices.

[@rhlang11]

what or which cgm id you purchase? tks.

[@daraghosullivan1157]

@@rhlang11 Freestyle Libre

[@rhlang11]

@@daraghosullivan1157 thanks. I assume it's been helpful? do you ever concerned that you are paying too much attention to the CGM or have you learned to live with it in a comfortable way? also, do you employ Levels?

[@my-yt-inputs2580]

Excellent informational topic. T2D myself controlled through diet. I am currently wearing a Freestyle Libre 14 day CGM. Great diagnostic tool. The huge issue however is accuracy of the sensor. I'm on a Facebook group for Freestyle Libre and constantly see posts about how inaccurate they can be. I myself have had one sensor reading 20 - 30 points low. The newer Libre 2 is supposed to be better but time will tell. I find I need to finger stick more often just to check accuracy. Supposedly accuracy can be affected by other conditions like hydration levels. The other major issue is the sensors falling off. Some people seem to have difficulty with the stickiness, or lack thereof, to their skin.

[@pattayapimp]

Dr. Casey is just amazing especially in her skill in explaining issues , thank for this interview 🙏🏻

[@yellowowl]

A true doctor! Thank you Dr. Casey for walking your path 😊

[@abancay3167]

Both of you are marvelous - the right questions and state-of the-art answers and explanations!

[@ahamoment3626]

Dr Casey you are so on target! So blessed to have a doctor like you in the medical profession. Just experimented with trying to adjust my glucose levels I've come to try many of the things you mentioned and they are spot on. Hoping to get a CGM on me soon so that I can find which foods are my triggers and how to eat them properly if at all. 👍

[@nomdeplume4543]

Excellent interview. MD gives a beautiful explanation of how CGM can be used. A lot of potential.

[@johngmccune]

One of the very best of your podcasts -- both of you were really helpful! Thanks!

[@patriciaterranova1074]

This interview with Dr Means was eye opening, and I’ll be following her in platforms!

[@gregoryburne5251]

Magnificent chat, Brett!! Great guest and great Interviewer. Go well.

[@mattolsson8816]

Thank you for this interview it's very helpful in understanding more about CGM's and more...

[@adorableadornments1101]

Excellent discussion. Thank you.

[@mannyradzky493]

Hugely fabulous interview. Thank you both. 👍👍

[@aprilek6003]

I think I am more insulin resistant in the am versus the evening. Dawn effect. Plus, I workout in the earlier part of the day which causes a increase in my blood glucose. I eat my carbs in my last meal of the day and have better glucose control and readings. I just started wearing a CGM and love it!!!

[@marlathelittlesore....9088]

Shes so amazing and knowledgeable! Thank you so much for having her on. I don't like the bionic idea of electronic health monitoring in general, but I think she has changed my mind! As soon as CGM and Oura ring tech is affordable for me, I'm going to access this. Speaking of....I wish she had talked about sleep health monitoring.

[@alanboo5664]

This is really amazing using CGM beyond just checking sugars. It gives better insight to our metabolic health and scientifically we can manage our objectives.

[@Vam1500]

Excellent discussion, both the questions and answers.

[@markiangooley]

“Healthy whole grain” is a phrase that may some day drive me to mayhem.

[@Hiltie1]

Brilliant video. Thank-you for sharing.

[@TresaWadsworth]

I’m just starting this journey and food pairing and timing is such an enlightenment to me. This was great! I’m going to get me a CGM for sure and writing everything down.

[@TomHamilton54]

I would like to know what she thinks about Dr Fung's idea that we shouldn't be measuring sugar but insulin.

[@teresashelley]

True. But if blood sugar is elevated your insulin is elevated. There is no continuous insulin monitor and we are years away from that.

[@apumaity4404]

Many many thanks Dr.🙏🙏🙏

[@aaronh305]

Great information. I really do wish more than ideal ranges and excursions were discussed. For new T2 diabetics like myself I feel like I have made huge progress in just 3 months but those numbers given as ideals seem deflating.

[@ildus48]

Thank you so much for your video. I am so happy that Dr. Casey sees the human body as a whole, i wish she was practising near me. I have researched the late Dr. Peats work, i love reading his articles, interviews also.

[@henryverghese2209]

Hi thanks for this video. our doctor also spoke to us about other benefits of CGM and no we have purchased blucon nightrider with freestyle libre sensor for continous glucose monitoring.

[@sharvo6]

Thanks! One of my favorite in the series. I'd like to hear more about her suggestion to combine foods to blunt glucose spikes vs glycation when combining protein and carbs.

[@cintiasilva468]

Docs... Amazing video. I just got my CGM and I'm, just like you, doc, starting to know myself. Sometimes I make some tests to see what happens when I drink a beer (and it's a bomb for my blood sugar, worst than almost everything else), when I have a slice of pie, etc. I am in love with all of that data. I made a 48h fasting and I realized that if I keep my ketogenic diet, with two meals a day, it's better then when I fast for this long period. And exercises .. when I do HITT or workout my blood glucose rases more then when I eat. Thanks for this video. I really loved. 💕

[@abancay3167]

I've had my CGM for five days - it's more addictive than KZbin! I'm checking so many things I wasn't sure of. Love this device, even when it tells me I should never eat tiramisu again ☹️

[@dinoraven6289]

What about panettone 😂

[@darrenh5175]

Dr. Means is absolutely right. I wished more doctors would look at nutrition.

[@applerunner1184]

Really interesting - thanks to both for great content!

[@elizabethlavet3043]

Fantastic video/interview.

[@Susan_McG]

I'm a T2 diabetic, & my family always says, "You can't eat oranges? Bananas? Oatmeal? Just one piece of my homemade pie? Eating keto can't be healthy!" Tested my CGM on Thanksgiving morning with an 8 oz. orange for breakfast: my BG shot from 78 to 127 in 2 hours. Took an hour more to go back down to 88. I knew it would go up, but 50 points?! Got my CGM through NutriSense. Very expensive, but so worth it!

[@leovillegas8915]

great talk and tips for CGM user.

[@magbelgomez20]

Excellent video! So informative. Please do more videos about cgm

[@1rocknroy]

She is a handful. Thanks very much.

[@lindseym6534]

This is incredible thanks

[@eclecticcyclist]

Great interview. Refreshing to listen to a doctor who realises that modern technology promises to answer many of the questions that have intrigued doctors for a long time. Real time monitoring of multiple factors is the key and the more these monitors are used then the lower the cost wil be, so in a few years we won't have to take samples and send them away and wait for results because fitting real time monitors will become the standard approach, even sending the collected data to the doctor over the internet so that the doctor can respond quickly and maybe some conditions can be automated.

[@pj41]

If you see someone using one , they are probably a type 1 diabetic and would be appalled by your motive for your question - this coming from a type 1.

[@eclecticcyclist]

@@pj41 This tecnology applies to many problems and errr... did I ask a question?

[@pj41]

@@eclecticcyclist , I apologize for my comment/ I meant to be was answering someone else’s comment about “ how unfair that everyone can’t get a cgm. Your comment was insightful s - again I apologize.

[@donaldaltman929]

Great interview. Don’t stop

[@garyfinch1840]

2 key things are being missed here. 1. The Randle cycle is engaged by "pairing" fats with carbs in effort to reduce glucose response. 2. With Randle engaged your glucose response is very dependent on your current glycogen stores and or how active you are. Unless you are a baby, never mix your fats and carbs! Thanks Randle.

[@karlint39]

Great video. I'm a fan of you both! I've been consuming a lot of content about CGMs and "optimal" blood glucose numbers, and doing experiments on myself. I think it was Dr. Casey around 38:00 pointing out (correctly so) that the US health care system is very "reactive." I suppose annual physicals, if people get them at all, are preemptive, but it's not much. Since doctors in traditional healthcare are not incentivized to prevent illness (and therefore reducing the number of paying customers they have) what if there were a completely new system -- that focused solely on preventative medicine? With many of the same technologies, but a completely different focus. I suppose it is a fantasy, but it seems like it could transform society.

[@avuppala]

What a fantastic insight into so many topics. What are the various tests to find out the inflammation biomarkers?

[@Malcolm-Achtman]

As mentioned in the video, start with C-reactive protein. But be sure to request hsCRP, which stands for "high-sensitive C-reactive protein." Sometimes it's referred to as "Cardiac CRP."

[@iwaslike_Emilioooo]

I was recently told i was pre diabetic and insulin resistance. How do i find a Dr. Like her that truly cares about the bigger picture and not just medicine prescription? How would I go about finding the right Dr to see?

[@plumeria8357]

Fantastic interview. Hopefully the cost of a CGM will become more economical.

[@Angel-rv1mt]

Amazing timing. I was just talking to my husband at 3:09 am this morning (shift work) about CGMs and the benefits. I know next to nothing about them but told him from what little I’ve learned, I think we should request one. Then I receive a notification later for this video. I can’t wait to share this video with him.

[@karenshaw6637]

I use Ambrosia's Nightrider Blucon with the libre sensor. It helps me monitor glucose readings every 5 minutes without scanning and notifies me whenever it is out of range. Love this CGM combo!

[@skinnydee1886]

Karen, what's the reason for scanning every 5 minutes, and is it better? Thank you🙏

[@cindilacasa3291]

Great informative video. Could you recommend a good cgm? Thank you

[@dsf5956]

Awesome discussion!

[@miajones7109]

I have Blucon nightrider which helps me track my steps, calories, ecg, heart rate, data from other health apps and its really helpful

[@johnmadany9829]

I have a number of patients who have very steady glucose readings on the CGM. Adding ketone measurement works well as a surrogate for checking insulin levels.Increased ketone levels suggest relatively low insulin levels. Personally I have been wearing the Freestyle Libre for over two years now. A great tool.

[@dana102083]

Well done, doc! I'm in Canada and I wish I could access one just for a month of quick-fire trials! I'm 3 years into keto bit still curious. I usually can tell.something has more sugar if I get palpitations/increased noticeability of HR. 🖖

[@pippajoy]

Great info! It seems these glucose spikes boil down to an exponential world of inflammation and life threatening diseases. I am convinced that I have taken the right road to wearing a cgm for a healthier lifestyle, thank you to both of you! I started with being sick...becoming keto which developed into an interest for biohacking. Yes I went down that road. And here I am not eating carbs again. But now, I am at a cgm level neither a diabetic nor an athlete but with lesser inflammation. Please continue to help us keep our minds in the game and thank you for posting. I feel like it won't be long when a lot more people will get into the cgm game, tech will rise and hopefully drive the prices down, making it available to the mass. (I've the same hopes for solar and electric cars as well 👌)

[@ighfirlee]

Im not diabetic and I wear CGM to learn about my food intake. You can still eat carbs. Just eat veggies and proteins prior to eating ur carbs.

[@williampaulrogers9583]

What an interesting and informative interview, really excellent!

[@jaykana7677]

Very interesting, can you do a deep dive podcast using cgm's on a Keto/low carb diet. l am wearing one and readings are sometimes all over the place.

[@shelleynewood6841]

My fasting Glucose is about 100-105 and I have been low. Carb for about 6 weeks. I eat < 20 carbs a day. Years ago when I did low carb I could get down to 80. So something changed in the last 4 years.

[@bethwray116]

I would love to find a doctor in my area that totally understand all that this doctor has said.. She is great... I have issues with my blood sugar dropping to dangous level for unknown reason... (example, can eat the exact same foods, do the exact same thing... and one day randomly drop to 40-low 50's ) no one has been able to help me or figure this out. I use to be type 2, no longer have lost weight, had gastric bypass ryn... Maybe someone can give me some advise or point me in the right directions. I am located in Charlotte NC area. Hoping someone will read this ... and reply. Thank you Dr. Casey Means for all your research and caring!!!

[@jujugoketo3711]

Sign me up. Keto - low carb for 3 years. Would be fascinating to see how some foods (healthy ones like sweet potatoes) affect me now. I sincerely wish that my extended family could embrace this info with my help and wonderful KZbin videos like this one. I want everyone I know and love to age and live their best life. Sugar-carb addiction is making us all sick. And, most don’t realize that it is just as dangerous as narcotics…. Food industry continues to win.

[@dort5436]

Please see if Dr. Casey would study glucose and ketones levels. Would that help see more details of how the health body is handling foods and exercise?

[@annspires8380]

I would love to see an Allergist / Pulmonologist on these pod casts. People with environmental allergies and breathing conditions are constantly put on steroids and corticoid steroids to manage these conditions. My sugars while in the hospital on IV Solumedrol went over 460 and I've had similar readings before being put on Insulin. I've been on low carb since Dec 17 and have not seen readings above 146 since, I've even had a few readings in the high 80's! But, I'm really concerned about Spring, Summer & Fall. There has always been prednisone (minimum) and antibiotics when it gets really bad and my regular antihistamines don't keep it in check. I know I'm not alone in this. I've lost count of how many times I've been in the ER and Hospital (the nurses and Respiratory say "I remember you!") Histamine Sensitivity?? Please help.

[@Papkazz]

Think I read somewhere, that the high morning glucose could be attributed to cortisol spike during the night? (Where cortisol normally spike?)

[@rexswank6068]

Would be great if my GP would prescribe a CGM. He won't for whatever reason. I'm not diabetic so... Thanks for all the great info Dr Means.

[@coreyhakkarainen1381]

My

[@artsiecrafty4164]

Just go on. Low carb diet. Adding healthy fats and ditch the junk food carbs and sugar. Also seed oils are major culprits in raising blood sugar.

[@rexswank6068]

@@artsiecrafty4164 I did all that 5 months ago. I still want to track my numbers, geek stuff I guess.

[@mageshruthrapathy5928]

Yes I’m the same way. Would like to get one to understand how diff foods affect me. Rex, is there a way to get one without prescription?

[@hairway2heavensalon541]

Thank you

[@hughwalden1183]

Dr Casey mentioned the ideal range is 70-110 (with excursions to 140). Is this in mg/dl? My blood glucose using a cam at best 4-8mmol/l = ~80-160 mg/dl but A12 is est at 33mmol/l…

[@stefanweilhartner4415]

i would like to have that together with insulin and cortisol measurement. we can have high blood sugar from food or from high cortisol that increases gluconeogenesis. this is an important factor in insulin resistance too. in my case this keeps me from weight loss. now i incorporated walking to lower cortisol. i notice a huge difference regarding hunger. hunger is going down and that means fat burning went up.

[@Josh-pe5pl]

Bruce. I also would like advise me on the most effectivacious CGM for e and my tired heart. . I don't think it has to be as sophisticated owns. as mds , have suffered for far far too LONg for 15 yreaes

[@fidelfs]

I have a prescription and used CGM (freestyle libre). I might be only unlucky patient but I don't trust those readings. I managed and got rid of the Type 2 diabetes in 6 months. I have to keep those levels for a year to have the diabetes in remision. I changed my lifestyle, moderate exercise, alternate fasting, zero carbs, etc. So, after I was not concern with what I eat. I focus on improving my health. Blood pressure, weight, etc. I used the CGM to showed me the glucose level and understand when I was in Ketosis. It gave me a false sense of security, the readings are the worse case of accuracy. I talked with Abbot representatives about it, and they mentioned there is a +-15% from the actual real value. It showed my glucose levels were 50 to 70 mg/DL. I was so happy, that I was jumping all over my house. I noticed my blood pressure didn't change and I was not losing weight. I decided to check with my regular glucose meter. The real values were 90 to 110. Levels are beyond the accepted percentage. They sent new sensors, all of them have been inaccurate, and I cannot trust a machine that does not give factual values. It just make you feel better. In reality you are not doing as well as you thought. I lost weight around my arms and I have what is called "bat wings" or "chicken wings". Maybe that is the reason I cannot get a good reading, because all the hanging on my arms. I think the CGMs are an amazing tool, but still in their infancy and they need to improve. I stopped using it and went back to prick my finger.

[@audaxity]

Hi Tad, I just got a Libre2 sensor and was pleased that it was compatible with NFT enabled iPhone and the Abbot app does not require prescription. Accuracy does seem suspect. I’ve used an Abbot Precision Xtra for years and have noticed a 30 point difference : 93 with Libre2, 63 (mg/ml) with the Precision Xtra. This reading discrepancy was taken after workout then 18 hours of fasting. My ketones on the Xtra read 0.3 mmol/L. Just not believing the accuracy on this but as discussed in the video the readings below 120 are not considered as important to glucose control and may not have the accuracy focus. Also I was up at 1:00 am last night when the sensor registered under 70 mg/mL (66 when I scanned it. ). Gotta mind those alerts!

[@tanglaiseng6713]

I like cgm but cannot afford it. I had long period of hypertension and diabetes. Started to worry as hbp went up more than 200 frequently and kidney function was deteriorating. There wasn’t anything I could do even with the help from GP. They asked me to control diabetes but how? I started to cut carbs. Lost 10kg and HBa1c dropped from 7.8 to 6.1. 3 months after I met an amazing Dr who thought me how to put both into remission. No medications now for more than a year. Nothing worth to celebrate than this

[@davegrant7819]

What about post-prandial triglyceride spikes? I hear causes inflammatory response too. Never seems to get mentioned in functional medicine fora?

[@jacksonesq9992]

Only harmful in the context of high fat AND high carbs.

[@davegrant7819]

Thanks. Do you know of any studies that show this?

[@TREANIEBEAN]

Thus was such a great podcast! I am prediabetic and am fascinated by this. Why aren’t these cgms available to everyone? Why wait until someone is full blown diabetic? Seems like it would be a cost savings to providing these up front vs waiting until a person is diabetic - couldn’t you avoid expensive meds?

[@chaz6399]

Big Pharma and the medical industrial complex makes billions of dollars on diabetes. They have no interest in undermining their own profits by preventing diabetes. They only get paid when they sell a product or perform a service, so they don't want you to die but they don't want you healthy either. They want you to stay alive and sick so they can extract as much money from you as they legally can. It takes a while to wrap your head around how insidious the current system is, but once you "see it" everything makes sense. To be fair, modern medicine is fantastic for trauma and acute illness and some of the other medical technology is mind blowing. It's the treatment & management of chronic disease where the corruption is.

[@ericshubert2007]

Glucose monitoring is essentially a surrogate for insulin, which can miss early hyperinsulinemia, which is closer to the root problem (per Dr Kraft). Is anyone developing affordable on demand (continuous) insulin monitoring?

[@DarkMoonDroid]

Awesome!!

[@lynnwandering581]

what is the books casey mentioned motivated her? i’d like to read a few. any suggestion?

[@dort5436]

Dr. Fung is an easy read.

[@highrzr]

Very nice insights. For me, I keep it simple. I just don't eat any fruit except for a few tomatoes. Your body does not need any dietary glucose and fructose.

[@suchitaarora6794]

CGM gives better insight to sugars and helps to control diet very well through its functions in app

[@Snapkrackpop]

does HIIT exercise keep BG elevated for 24 hours?

[@chadaitken5476]

At 49:50 Dr Means says “When insulin is around (sugar) must be around to use for energy, the body says why burn fat? Very insight!

[@jacksonesq9992]

Basic biology.

[@Malcolm-Achtman]

I remember Dr. Eric Berg making this very point in one of his videos (about 5 years ago).

[@inikalinden7335]

Can someone help me: my glucose levels are never below 86, even when fasted for 2days. They spike highestly to 110, usually stay between 86 and 100. so whenMeans sad she tries to stay between 70 and 90 does that mean my glucose levels are already high? Since 90 seems to be my ratio

[@JD-rc6lq]

Ive been reading about the Eversense E3 CGM made by Senseionics. It is implanted and lasts 6 months. Anyone have feedback?

[@igilistephen6149]

How can I get it, 4rom Italy

[@elikiandlaveniadrodrolagi8430]

so where can i buy a CGM ?

[@CarnivoreDMD]

Volume is too low but great content!

[@LuciaParoni]

I have a question: when we use sweeteners, is there a change in blood glucose?

[@dietdoctor]

This depends on the person, but generally, there is no glycemic response with our top 3 recommended sweeteners, which are stevia, erythritol, and monk fruit. However, it's always best to test yourself to know for sure. www.dietdoctor.com/low-carb/sweeteners --Kerry

[@itsagoodday2165]

@@dietdoctor What about Swerve?

[@samuelbrainsample]

I don't have T1D or T2D so I can't get a CGM without paying through the nose (Dexcom G6 is $1200+), but I'd really like to get one. Options?

[@Clemmons777]

Dr Means’ company prescribes and sells CGM’s….not cheap but great to have. Look it up….Levels is the name of her company.

[@belwynne1386]

My senors cost $200 for three 10 day units at cvs. The transmitter cost $50 with a coupon and lasts 90 days. You could wear one ten days a month.

[@samuelbrainsample]

@@belwynne1386 What brand? Where can I get this coupon?

[@belwynne1386]

I have a Dexcom 6 and my CVS pharmacist found the coupon for the transmitter. You might try Good Rx if you can talk your physician into giving you the script directly. The integration with my i watch and i phone is exceptional. I am getting really actionable data and improving my by reading’s virtually daily.

[@ashleydsloan]

What is the website she recommends. She says it so fast Ive tried to relisten a few times and I still can't get it

[@tamarabrown4570]

www.levelshealth.com/blog

[@Guitarlvr01]

They’re in beta still, but NutriSense is available now.

[@Gorman-84]

Great discussion. Too bad you both have to talk around or soften parts of your message. I understand why, so keep getting the message out there! I often hear about the "normal" glucose curve. I am heavy into ketosis and nowhere close to the "normal" curve. I very much appreciate you talking about my "normal". Until recently, I could not figure why my blood sugar did not fit anybody else's curve. Finally, I saw a discussion about people who operate in ketosis nearly all the time. I found out that people in heavy ketosis, generally have a very flat curve w/ no such thing as a spike. My morning BS is about 105. Seems high, but it stays there and slowly trickles lower until I eat usually mid-afternoon. When I eat a meal (no carbs), my BS drops 20 points. I operate the remainder of the day at 85 ish. Thanks for confirming what I recently found out was my "normal". My last A1C was about 5.5 several months ago. I average probably < 5g carbs per day. Occasional excursions from this. If a study comes out, please let us know. I would even volunteer. 😁

[@mikecowen3448]

Dang, I wish I had smart Doctors like these two around. Mine do look at me like I have two heads when asking for advanced insulin tests.

[@lorettadillon-ham1574]

41:40 I believe this is the key .... the late Joseph Kraft knew it was the “sign post”, Ben Bikman knows it’s the “key sign post” and I know it’s the marker... what I’ve learned here is the influence of day to day life (stress, mood and biome, sleep,, food, activity and food pairing) so interesting and the direction I am absolutely moving toward. Looking forward to the global connections ahead 👩🏻‍🦳🌟💕

[@jacksonesq9992]

You sound like yet another quivering neurotic. No doubt you’re a masker.

[@monthapril6441]

This is such valuable information. But what about privacy concerns? Our medical info is private and do not want it sold to 3rd parties.

[@MonkeyPunchZPoker]

Anyone know how much these CGMs costs without factoring insurance?

[@belwynne1386]

My Dexcom 6 cost $200 for 30 days sensors plus $50 for a transmitter that lasts 90 days.

[@lynnwilliams5432]

I always think of the long periods of recovery with surgery but recovering from ruptured appendix at age of 4 yrs ,I am here typing bc I had it done.

[@ak81]

I tried food sensitivity test and the result to stop eating all the food I usually eat. That’s all my blood could read 😂😂😂

[@hormigabrava74]

How do i convince my doctor/insurance to prescribe CGM? That has been an impossible task

[@itsagoodday2165]

I hear you. My doc said i don’t need HOMA IR test because i am still under 100... i was at 99. She was offended i asked her about testing my insulin.

[@GIJane2U]

Was she "offended" or "embarrassed" she didn't consider doing the test

[@johng9382]

My fasting glucose used to be in the 85-95 range until I started LCHF diet (semi low carb, about 100 grams per day) with int. fasting. Now, my fasting glucose is 100-105. But an hour after eating a full meal with around 50 grams of carbs, my glucose drops to low 90's. I think this is called adaptive glucose sparing. I think I'm healthier now even though my fasting glucose level is over 100, compared to her goal of 70's-80's. Comments?

[@jacksonesq9992]

Yes. Higher baseline glucose, but without the massive spikes. It’s the massive spikes that are harmful.

[@mpoharper]

I have been using a CGM for 10 days. So interesting. I can see that exercise lowers blood glucose, as does my immediate response to eating a low carb meal. My Glucose is quite variable at night ranging from high 80s to 110 or a bit higher. The variability at night is greater than the variability from eating. Rarely see spikes from eating, but if I do a walk takes care of it.

[@stefanweilhartner4415]

the protein in the meal also results in insulin release that can lower blood glucose

[@kathya1956]

@@jacksonesq9992after a hiit class I get up to 250.

[@davepaul8975]

A lot of generalities with hints of research references none of which are included. With the exception of the mention of Dr. Michael Snyder's work at Stanford. As Sergeant Joe Friday would say "Just the Facts" and be specific. Please. PS what about the work that Dr. Kraft did in the 1960s coined the Kraft Test.

[@yay-cat]

OMGeee i’m such a data junkie 😹 I want to know how glucose affects menstrual cycles. I managed a perfect keto month (doesn’t happen often I cheat a bit); and then had a much shorter cycle and horrendous period cramps. Maybe I was overdoing the protein, who knows. But this dietary variability causing cycle variability causes a bit of havoc because I try to adjust my exercise and ADHD medication depending on what cycle phase I’m in. More data means better guesses so I’m in for the win!

[@sandrasieber5157]

A lot of women find they need to add in carbs to have a normal healthy ovulation and cycle. Check out the book the period repair manual by dr. Lara briden. She talks about exactly what you’ve shared 💕