I’m glad you finally got to the person like me who always had normal A1c but turned out to be a Reactive Hypoglycemic. I eat a single serving of most unprocessed carbs like sweet potato or plain oatmeal and my blood glucose spikes 300-400 and then crashes below 70 within 1.5 hours. I was constantly fatigued and blaming my endurance running. No! Some people have hidden, debilitating blood glucose variability. More doctors need to think of this!
I agree. And stories like yours have convinced me that CGMs can be a great tool to figure this out, including in people who test 'normal' when their doctor looks just at fasting glucose and HbA1c. That said, blood glucose spikes to 300+ mg/dL are very concerning. I hope you had a conversation with your doctor about that? And I hope the doctor did take this seriously? I obviously cannot diagnose you here, but just know that even a single spike like that should be considered indicative of diabetes, and should be treated. Best, Mario
Oatmeal it self is part of the problem you're sharing. We've been fed so much inaccurate information on food...especially food that's been designed to be shelf stable rather than healthy for human vitality.
I am the person you are talking in this video, obsessed with what to eat! If from one type of food I have high cholesterol, from other high HbA1c, I don’t know what to eat…. Thank you, looking forward for your new videos
Du kannst auch ein Video von Dr. Sten Egbert zum Thema Cholesterin anschauen. Er erklärt sehr gut, was es mit dem Cholesterin auf sich hat. Welches Cholesterin krank macht und warum ... Seitdem mache ich mir keine Sorgen mehr, sondern bekämpfe stille, chronische Entzündungen (ich habe erbliches hohes Cholesterin)
I so appreciate your message here! As someone who is led to overanalyze, your advice on how to work in harmony with our unique bodies and not obsess over data is very refreshing. Thank you again!
I agree with you , I reduced my H1AC for 10 to 6 in 3 months by closely monitoring and choosing right food that suits my body . No medicine just eat well and 1 hour of excercise
My continuous glucose monitor has been a life changer. One year ago, I went on this journey just to lose weight and discovered I had post bariatric hypoglycemia! I had no idea my blood sugar was tanking for almost 20 years post my bariatric surgery, the monitor help me to understand that I had a high sensitivity to carbs which made me gain weight so I eliminated at least 70 to 80% of my carbs and without doing anything else lost 30 pounds in less than a year. it’s been an absolute game changer for me and now I’m able to better manage my blood sugar lows
@@adamswift1747 I don’t mid at all….Less than 20 carbs per day have been the best option for me. I have success eating tart/sour or non-starchy fruit/vegetables like green apples, tomatoes, cucumbers, broccoli, cauliflower, grapefruit. I enjoy carrots in a stew, but probably should avoid them and cabbage actually makes me gain weight over night (inflammation) but doesn’t spike my sugar too terribly, thought it does taste sweet. And finally, I have not tried eating resistant potatoes or rice, but am really curious 🤣.
I don't fall in the category to be concerned enough to get myself a CGM but watching this has been so, SO educational and your content is exceptionally crafted, I'm an instant subscriber. Great video structure and well articulated, thank you.
Thank you for not over-humourising your presentation. American and British videos often shoehorn (often 'lame') humour into their videos to somehow keep viewers' attention.
Thank you SO MUCH for clarifying so much for me today! I am pre-diabetic and have become kind of obsessed with taking my glucose levels in the past week based on many different food types and hacks, like walking before or after a meal. My blood tests didn’t make sense to me till I watched this video about 3 times. So helpful. I am going to relax more about this.
Started using a CGM last week; very helpful information especially by your suggestion that one's glucose number is not the only measure to focus on as a measure of health.
Thanks for a sane dissertation - people get so obsessive about stuff. I have had type one diabetes for 58 years. Twenty years ago, when treatment was crude, to put it kindly, I was told that I was the best controlled patient in the clinic (a large, highly respected NHS teaching hospital): my average A1c during those years was 7%. I started developing symptoms of mild neuropathy (slight numbness in my feet) after about 40 years, and occasionally my annual eye scans showed mild background retinopathy, which didn't affect my eyesight. I decided to go for tighter control, and for the last 18 years my A1c has been less than 5%. I no longer have any neuropathy, and my latest eye scan reported mild backround retinopathy in one eye. My microalbumin/creatinie ratio is normal (normal kidney function). The best book on diabetes management, in my opinion, is "Dr Bernstein's Diabetes Solution" by Dr Richard Bernstein. He is a remarkable man, who has lived with type one diabetes for most of his life. He was advocating low carb for everyone - not just diabetics - from about 1990!
That's a remarkable health turn-around story, John. Congrats, and thank you for sharing. I am familiar with Dr. Bernstein, and do think his diet is a good approach for people with diabetes who are willing to follow his protocol long term. Cheers Mario
My wife initially had a fasting sugar level below 95 and an A1C of 5.8. She adopted a low-carb diet, eliminated sugar completely, and incorporated evening walks into her routine for three months. Surprisingly, her A1C increased from 5.8 to 6. We're puzzled as we expected it to decrease. Any insights on what might have caused this
I don't obsess over my meter because I'm not psychologically ill I am however far better physically thanks to this meter not only save me from multiple diseases progressing any further into kidney disease it has been a life changer for me and it should be part of everybody's life
Yes, I don't disagree. Figuring out which foods lead to actual spikes over 180 mg/dL can be very helpful to people, including those without diabetes. At the same time, I decided to include a bit of a warning in the video because many people take it too far. I have seen numerous people on social media share their 'spike' to 130 mg/dL or so, which in my opinion really should not be called a spike. I know of no data that suggest that such small bumps in blood sugar within the normal range from 70-140 mg/dL are harmful, and driving ourself nuts over any such small increase could well have other negative health consequences. Thanks for leaving a comment. Cheers Mario
I would test pre eating and then every hour for three hours after eating. Did this very over for months. It gave me a good idea of my insulin response.
Dear Dr Kratz (Mario), This video segment got me intrigued! I think your analysis concerning the improvement of carb tolerance seems to bare fruit with me! Since I watched your I decided to conduct my own experiment!! also the other reason as to why I decided to carry out this experiment was few years ago I was eating just about anything and without any restrictions just a balance diet with good mix and good choice of fruits, carbs, meat, chicken and fish etc. my HbA1c was ALWAYS around 7-7.2. But when I decided to go low carb I did noticed that every time I ate carbs or fruit my BGSL goes really crazy! for the last two weeks believe it or not: I started eating seasonal fruits such as Apricot with fresh dates and some strawberry at the same time and shortly after I go for walk my sugar level started to stablise!!!! to give you an example, today I had reasonably good meal mixed with broccoli, cauliflower with boiled dry broad beans and eggs all the the same time! to my delight when I checked the CGM on almost every 5 minutes my BGSL remained at 7.8 and slowly crept to 9.4. 30 minutes later dropped to 7.8!!! so I decided to push it a little and then had 5 fresh dates, slice of water melon and two apricots mixed with some Mascarpone cheese with some almonds and hazel nuts!! shortly after I went for a walk (4KM) and I noticed slowly but steadily my CGM was reading 9.5 and went up to 12! 30 minutes later dropped to 9.5 to 8.7 and now after three hours my reading was sitting at around 5.6!!!!!!! I think you're on the right road! Now I am able to enjoy carbs and fruits as before without having immediate spike! I think you are ABSOLUTELY RIGHT when you said the body COULD become carbohydrate intolerance. One Q; are you able to use few Type 2 volunteers using a CGM and try conduct an experiment using different different carb content food? Please do not use healthy people because in my opinion it defeats the purpose! Well done and many thanks. Greeting from sunny Europe! apology for the long reply!!
Yes, regularly eating some carbs (ideally low-glycemic index carbs that also have a lot of fiber and ideally also some protein, such as lentils) do help improve glucose tolerance at the following meal. There are many other ways to improving glucose tolerance though, as we will be discussing in the very near future. Hope this content will also be useful. Cheers Mario
Your response to carbs is very good👍 My HBa1c is 5.67%. Fortunately, all the other tests look good. I've worn CGM twice and it's been very helpful. I've seen big spikes with oatmeal and rice, pasta, etc. I'll be on a low carb diet from now on. I gave up processed foods a while ago, but I still eat "healthy" foods like brown rice, pasta, etc., which keeps my HBa1c levels up a bit too high. Keep up the good work! Thanks
This newer video may help you figure out exactly what it is about your glucose tolerance that allows for these spikes: ruclips.net/video/DVND90vQ0xI/видео.htmlsi=MfaZMFZmw1vXKQ_v Cheers Mario
Very useful advice for us all. Thank you. One aspect which causes so much confusion is how nutritional advice has changed over the last five decades. To the point where ‘do’s and don’ts’ become reversed in some if not many cases. Whilst at the same time the food industry is allowed to contradict this advice and still appear to free of sanction. The level of trust has been badly compromised, to a point where we might well trust no one. Hence the CGM and your need to counsel us accordingly.
When I just started this channel and blog, I wrote this here on my website: "Understanding how the food we eat affects our long-term health is surprisingly difficult to figure out. This field, unfortunately, has a history of drawing conclusions based on fairly poor evidence that later turned out to be at least partly wrong. The resulting back and forth between different diet approaches, each only weakly supported by scientific evidence, has led to confusion about how to eat. As a result, many have abandoned scientific evidence, with the argument that science hasn’t really provided the answers we need to understand how diet affects long-term health. And that abandonment has led to a rise in pseudo-scientific approaches to eating, superficial views that attribute complex diseases to a single food or dietary factor, and sales pitches for dubious diet programs or supplements. I have drawn a very different conclusion from the mistakes of the past. Yes, nutrition science is a difficult science, often forced to work with weak evidence. And yes, we have often drawn conclusions based on this weak evidence that later had to be revised. However, that does not mean that a non-scientific approach will be more likely to lead us to answers that are truly helpful for our health. It simply means that we need to apply scientific principles more rigorously. This relates to the conduct of the research, but particularly how we interpret the available data. My goal is to use this platform to raise the standard of rigor in how we read the scientific literature and the conclusions we draw from it." I still stand by that. And I do try to raise the standard of scientific communication by always presenting evidence that is based not just on one or two papers that support my argument but by looking at the totality of the evidence on any given topic. And I provide a more detailed discussion and all references in a blog post associated with each video. That is a ton of work, much more than it would be if I just filmed myself talking vaguely about some ideas, and it isn't being rewarded (yet?) because I am not good enough at making these videos concise or entertaining, but I do think this is the way to go if we want to find a way out of the confusion and misinformation pandemic. Thank you for your feedback. It's good to know this approach resonates with some people. Cheers Mario
@@nourishedbyscience excellent reply and reassuring that science is your guide. Taking anything back to basics and using science to guide one is certainly the only way. I will watch the early videos and catch up. Thanks
When I wanted to try a ketogenic diet last August, I used a Freestyle Libre for the first two months to understand what this diet does to my body and if I am bringing myself in danger at any given moment. The first three days I suffered from a keto flew and measured low blood glucose levels. Once I was passed this period, the CGM helped me lower calorie intake as I wanted to avoid periods of high glucose levels after meals. After a month, glucose levels were quite stable and I didn't purchase a third sensor. In October, I switched to manual testing on moments I was curious. As I wanted to continue with this diet, I purchased a blood ketones tester, a cholesterol tester, and a blood pressure tester as well. It is very interesting to understand what's going on in my body and to share my experience with my wife and our 8 year old twins. 😊
Thanks for sharing. Definitely commend you for considering several biomarkers of health. I am worried about this trend that I am seeing in the low-carb community that all diseases are attributed to elevated blood sugar and insulin resistance, while other established risk factors such as high serum lipids and high blood pressure are discounted.
I believe it's caused by a combination of nativity and the challenge of finding correct information online. I had near to zero understanding of what I was getting in to. I scavenged RUclips for information and it felt all so confusing. That was until the algorithm served me a video of Gil and it felt like coming home. And when he tweeted your insulin resistance video, I found the second reliable source of information. Thanks a lot, Mario You're a hero.
@@henkwerner You are too kind. I consider myself an apprentice at the art of science communication, as I clearly have a lot to learn to make these better (i.e., more engaging, more concise). But then, I just got started, and if being in academia for 20+ years has taught me one thing, it is that any worthwhile craft requires intense learning, work, and patience. The biggest problem in this space though is that there is a very wrong incentive structure, such that creators get rewarded for making bold or contrarian statements by getting more clicks, more followers. Creating content in a scientific way, with lots of qualifiers and cautious statements about cause and effect just isn't as sexy.
It isn't sexy "yet", because most people are not aware "yet" of the difference between misinformation and life-saving information. This will change over time. The RUclips algorithms also learn and will start promote high-quality information. Opinion leaders will mature and start promote those who share real, thus valuable, information. I have already shared the link to your channel, including motivation, with 4 people last week in personal messages. It's just a matter of time until you have pushed this snowball over the top of the hill.
@@henkwerner Let's hope that society at large will see the type of transformation you predict. Misinformation, particularly where it is used in a targeted fashion for political or for-profit reasons is, IMHO, one of the biggest obstacles to addressing our big societal and personal challenges. Also thank you for helping me reach more people. Much appreciated!
I use a CGM and occasionally use the prick method. They never match. CGM uses interstitial fluid to estimate blood sugar vs the prick method, which actually does measure the blood sugar levels.... thus making the prick method more accurate. That said... CGM is convenient and gives a better result than guessing. But if you want/ need an accurate reading sometimes, use the prick method as back up. Thank you for uploading and sharing.
In large studies, CGM data reproduce those of a finger-prick and hand-held glucose meter pretty well. However, they lag blood sugar whenever sugar levels change rapidly, i.e., after a meal. Cheers Mario
Thank you for this advice. I'm only 3 days diagnosed with being pre diabetic. I was eating ready meals and that made me feel drowsy after eating. Like my flavoured porridge was doing as well. So last night I had a fish pie with mash potatoes topping, but with lots of salad. And I didn't feel drowsy after eating it. But i do feel stupid and lazy for not bothering to remember and implement the basics of a balanced diet, for the last couple of years.
@@scfan7231 It's going OK. I got a slow cooker and fill it with frozen veg and chicken thighs or lea n beef cubes. Make chilli or bolognese. sometimes a have pasta whole grain with it as pasta is better than potatoes or rice. Sugar free Oats with frozen fruit is another of my favorites now. And Low calorie protein shake with a big dollop of peanut butter. stops the hunger and gives me the protein. I've had a few treats over Christmas, so will just eat one meat a day for a while as I have another blood test in January.
@@UbiquitousRomp I've been struggling to lose weight all of my life. I weighed 90kgs most of the time, now up to 100kgs (I think that's 200 lbs). I did some blood tests 3 months ago, found out I am slightly insulin resistant, and changed my diet. - added sugar = 0 (this week I cheated a lot because my dad gifted me chocolate and... need to get it somewhere away from me); also no artificial sweeteners (many increase insulin, says the internet) - put fibers in whereever they are removed; e.g. I eat whole grain pasta (found a brand that I enjoy), whole grain bread, but I still think they have less fiber than totally natural --> I supplement. The same if I eat white rice etc. pp. When I eat out, I have supplements. I did some other things, e.g. tried high-protein foods as mentioned on this channel. And observe myself, am I eating for distraction or for hunger? - As advised on this channel. And started sometimes to skip meals when I'm not feeling hungry. I attribute to the fibers that I started to feel fuller and eat less, after 2 months. I have now lost at least 3 kg in the last 3 weeks, mostly fat. And the blood tests massively improved. I like the idea of using a slow cooker with meat. I am very lazy with regards to cooking. So this might be for me. Thanks.
@@scfan7231 Go for the right size for a good sized meat. Frozen veg and frozen peppers are as high in nutrition as fresh and none gets wasted.... I use fresh onion and garlic though. Also like to add a few chilli flakes and Cayenne pepper to give it that winter warmer feel. And it's good for the blood. Good luck. It can be done.
Thank you for the very insightful video content. I wish I had found your video channel earlier. I have been wearing a CGM for more than a year to monitor my blood glucose level and every little increase in glucose level after a meal gives me anxiety. I am pre diabetic and am not on any diabetic medication. Just using diet to control my glucose level. Looking forward to watching more of your videos. Many thanks for your good work. Cheers!
I am absolutely passionate about helping people bring their blood sugar levels into the normal range and avoiding real blood sugar spikes (i.e., >180 mg/dL). BUT: I am equally passionate to let people know that little bumps in blood sugar are part of normal physiology and that there is little to no evidence that fluctuations within the 70-140 mg/dL range are harmful. There are some influencers right now who claim that any increase of more than 30 mg/dL (1.7 mmol/L) are harmful and should be avoided; I disagree with this, and I know that most of my professional colleagues also disagree with this notion. To me, the anxiety you describe is not just unnecessary, but also potentially harmful, and many people will unnecessarily make radical dietary changes to avoid such tiny bumps (and these radical changes may lead to other problems or at least dietary sacrifices that are uncalled for). Warm wishes, Mario
Hi, I purchased some CGMs to learn about my metabolism. My lipid blood panel had been disappointing for years. High triglycerides, low HDL values. I noticed high and long spikes after a high carb meal (pasta) followed by a load of sugar (dessert). Next, I took a standardised glucose load: 75 grams in water and followed the glucose spike. Then I knew for sure: pre diabetic 🚨 Later I varied food en drinks and checked blood sugar responses.
Triglycerides are commonly high when we have too much fat in our liver (watch my video on the personal fat threshold below if you haven't yet), but they are also commonly elevated in response to a diet too rich in refined carbs and particularly added sugars (soda, sweets, deserts etc.) These same foods would also contribute to blood sugar spikes, particularly in someone who is pre-diabetic, so what we know about your state would suggest that you would greatly benefit from cutting back on the refined, high-glycemic index carbs and particularly the added sugars. See my video about the glycemic index below as well. Best wishes, Mario ruclips.net/video/cP57oM8lBaU/видео.htmlsi=c7myP142_o6LCU7q ruclips.net/video/v1zCVE3ifn0/видео.htmlsi=nKt4m2VBIiA68bUy
@@nourishedbyscience hi Mario, thank you for your response! Probably sugar and refined carbs much more than fats. I purchased an accurate lipids tester years ago (ACON Mission Cholesterol 3 in 1). I never was able to get TG/HDL ratios below 3 or 4. Now something that is not rational or understandable, but it works, it also did in the past with other health issues. So, hold your fire! I occasionally visit a woman that can diagnose with "Touch for Health" or applied kinesiology. I do not claim that I understand HOW it works, but she solved issues before, also for my mother. My high TG was solved, mostly within week, with the following regime: * Chrome 'ionic drops' (a solution of chrome (III) chloride, a few hundred micrograms) * Vitamin E complex * beta 1,3 1,6 glucan * Riboflavin (vit B2) for improved methylation (homocysteine issue, MTTR gene defect). My ratio is now below 2. I absolutely understand strong doubts about this story, but I don't care because it's been solved now. 😊
00:27 🩺 Continuous Glucose Monitors (CGMs) offer almost continuous glucose level measurements, providing a convenient alternative to traditional blood sugar tests involving finger pricks. 02:32 🍎 Blood sugar response to food is just one aspect of diet affecting health; consider other measures like lipid levels, blood pressure, inflammation markers, and more for a comprehensive health assessment. 06:38 🍞 CGMs measure acute blood sugar responses to food, but they don't capture the long-term effects on glucose tolerance; optimizing glucose tolerance can help regulate blood sugar levels throughout the day. 09:38 🥦 Use CGM to test blood sugar responses to meals as you typically eat them; don't base conclusions on extreme experimental scenarios with isolated foods that differ from your regular eating habits. 11:58 📊 Differentiate between normal and elevated blood sugar levels based on clinical guidelines; maintain a perspective on what constitutes a healthy blood sugar range. 15:56 🧘♂ If your blood sugar levels fall within the normal range, maintaining a relaxed relationship with your CGM is key; obsessing over minor fluctuations might not significantly impact health in this category.
Thank you Mario for your response. You are right that I assumed an increase of blood glucose of more than 30 mg/dL (1.7 mmol/L) after meals are harmful. This always happens when I consume fruits e.g. only 3 strawberries and I am thinking of avoiding fruits altogether. Now I am more enlightened. Your passion about educating people on diabetes is commendable. Many thanks for the effort involved. Cheers!
The single biggest glucose spike I've seen with myself is when a scammer stole over 2k from me. I got my money back but for me, getting angry skyrockets my blood sugar which was kind of unexpected. My blood sugar doesn't spike more than 30 points when I eat because I restrict carbs. It shot up well over 60 points mad.
@@franny5295 OMG! same thing happened to me. I had a chat on phone with someone that turned out to be very stressful. My blood sugar spiked too. Very interesting to find this out.
I’m diabetic and use cgm. Have lost 40lbs from 160lbs. My bmi is 19.7. It’s impossible for me to lower my fasting sugar below 115. My hba1c has reduced from 8.2 to 5.9. There’s nothing I can do any more. I wear a CGM
Hi Sumit, You sound like you are disappointed, so let me first tell you that I think you have done an amazing job! Losing 40 pounds and reducing your A1c from 8.2% to 5.9% is wonderful, and 5.9% is barely above the normal range. Take a breath, and give yourself a pat on the back. You have every reason to be proud. Now, that said, there are certainly other things one could try. Pancreatic beta-cell dysfunction may still be an issue. Also consider that exercise is always helpful in helping the body regulate blood sugar, including walks after meals and also weight-bearing exercise to build up more muscle mass. And reducing carbohydrate intake can be an option. I'll publish videos on all of this in the near future. If you haven't, check out the most recent video on ways to keep blood sugar levels low and prevent spikes: ruclips.net/video/yg0Y3eNSANg/видео.html Cheers Mario P.S.: What I am sharing here is just a summary of the factors that affect glucose tolerance and blood sugar levels, not dietary or medical advice for you specifically. If you make major changes to your diet, make sure to first discuss these with a dietitian or physician.
@@angelikaharabin3628 Something else for both of you to consider: are you on a very low-carb or keto diet? In some people, this can lead to an increased dawn phenomenon, i.e., substantially increased glucose upon waking up. Cheers Mario
@@nourishedbyscience my diet is lowish carb but not ketogenic . I do time restricted eating. If I eat late Or high carb or heavy protein like beef , I can be in the diabetic range . Thank you for your answer !
I'm so so so excited to have found the Veri app and pair it with my Freestyle sensor! I knew something had to exist, thank you!!! Also, your video is super helpful.... subscribing!!
Yes, I just found the app Veri in the App Store. Unfortunately, it is $49.00 (canadian dollars) for a single month. If it was cheaper, I would try it. 😟
There is so much information about the elevated blood sugar levels and very little on hypoglycemia. Recently, I have been diagnosed with the reactive hypoglycemia, while the condition is nowhere near as serious as hyperglycemia, still, the symptoms of a sudden, unexplained drop of sugar are no picnic either. I am now waiting for the CGM monitor hoping that it will help me at least track these hypo episodes a bit better. Would be great to hear more about the reactive hypoglycemia and how to deal with it. Thank you! Hugs from Norway
Thank you, Monica. My newest video has some information about reactive hypoglycemias: ruclips.net/video/LVw60RIhbzg/видео.html Also, the next video that will post this coming week will be an interview with an MD who has a long history of struggling with reactive hypoglycemia. That said, reactive hypoglycemias can have numerous causes, and may have nothing to do with blood sugar spikes. It's always a good idea to try to get to the bottom of what causes your specific case by working with a knowledgeable physician, which it sounds like you are doing. Warm wishes from Bonn, Germany! Mario
@@nourishedbyscience Oh, you are welcome, it is nothing. I binge watched your videos and learnt so much. Thank you for the work you are doing and sharing the knowledge here. That is to be appreciated!
Also.. are you familiar with other types of diabetes? I was told I was prediabetic’ 3 months ago but after analyzing my numbers my dr thinks I have mody’ diabetes. My A1C it’s 5.9 and insulin 6.4.. she told me I don’t have insulin resistance but still gave me 2000 mg of metformin a day.. I get spikes of 175 after big meals and my fasting is always between 105-120 at home (dr blood test shows 101 twice) I am trying to find out what diet is best for me.. your videos have been so helpful. I feel a little overwhelmed at the moment.. not having health insurance makes everything difficult for example to get the genetic test” i need to find out if I am mody diabetic or attending some nutrition classes to learn how to balance meals
Great content ! One answer I didn’t get from the video or I might have missed it - is how to become more glucose tolerant, if one is prediabetic. Please advise. Thank you 🙏
I'm so glad I bumped onto your channel. I must've done something right to please the lords of RUclips for them to send me this way 😅 but seriously the whole internet seems to be infested with low carb/keto/carnivore diet fanatics and charlatans and it's such a breath of fresh air to hear some calm, sensible, non reductionist, evidence based information. Thank you for making these contents! Please keep up the great work! 😊
Thank you for the kind feedback. One issue I see with diet tribalism is that there are certain narratives within these tribes that get perpetuated by being repeated again and again, even though in many cases there is little evidence to support them (or even evidence to the contrary). I am worried that this could be harmful to health in the long term. Cheers Mario
@@nourishedbyscience diet tribalism. I live that. QUESTION: Ive recently begun keto. I think 20 carbs is too restrictive. I walk 3 miles in the evening after work and currently weigh 180. Down 4 pds in one week (probably from a 3 day fast before the keto). What do you think the range limit to go into ketosis is? I keep reading it's between 20to 50 carbs a day. That's a large range.
@@annjohnson4061 Typically, the recommendation is not to consume more than 50g of total carbs (incl. fiber) per day. I personally would find 20g per day too restrictive and hard to maintain for an extended period of time. Cheers Mario
@@nourishedbyscience so you think you can go into ketosis with 45 or so carbs? Is managing the amount your sugar spikes the same as keeping the sugar low enough for your body to burn fat instead of sugar?? Your explanations are so helpful but I'm stuck at how to understand how to understand whether it's the AMOUNT of sugar in the blood that decides whether our bodies will burn it for energy or the insulin response deciding NOT to put the sugar in our muscles and leave it in our blood to be used for sugar.
I am not the worlds greatest keto expert, and haven't researched this recently, but traditionally, insulin regulates ketogenesis. When you eat such a small amount of total carbs, usually on keto in the form of some vegetables or other whole foods such as nuts and seeds, which also come with fiber, your absolute changes in blood glucose and insulin are not going to be all that substantial, particularly if you distribute the 45g over 2-3 meals per day. Cheers Mario
I have insulin resistance and since high school have known I can't eat, for example, a lollipop. But so many foods that I'm told is good for bloodsugar, like oats, messes with my bloodsugar - meaning an hour after eating it I'm starving and feeling bad. So I got the monitor (today), to figure out for myself what my body can and can't deal with. I do realize it's going to be somewhat complicated because my bloodsugar levels can be influenced by what I ate yesterday, or even when I eat something. I can eat a slice of cake, but not in the morning.
That's a good use of a CGM. However, be careful with your sources of information. Oatmeal clearly isn't good for blood sugar. Check out the videos below: ruclips.net/video/v1zCVE3ifn0/видео.htmlsi=ut25KNGPhqsoTMoR ruclips.net/video/kxUP0zzBECA/видео.htmlsi=Oomw06RQF9HZQIvS You may also enjoy this video here to experiment with you meals to better understand your blood sugar responses: ruclips.net/video/yg0Y3eNSANg/видео.htmlsi=M31oQfJtkhXP-Pwt Best, Mario
I really enjoyed this video. I was recently started wearing a cgm and this video has helped me understand that I need to chill out over every spike. I'm taking your advice 😊
Excellent video. Still, the gap with looking at glucose in isolation is that we can’t be sure what is happening with insulin. We might be maintaining a relatively ‘normal’ glucose level but be severely hyper-insulinemic. I believe it was professor Roy Taylor who said that prior to the diagnosis of T2D there was a ‘long silent scream from the liver’. From your own figures quoted, I suspect you are metabolically healthy. An A1C of 4.7 is likely very normal. An A1C of 5.5 - whilst comfortably within the guidelines - likely points to an altogether different situation. I’d be prepared to wager that with an A1C at these levels, then the person is hyper-insulinemic. You would, for example, likely find that they suffer from hypertension (maybe not significant, but still higher than ‘normal’). They probably would also have elevated LDL. I’m basing these statements on my personal situation which might not translate to a bigger population, but these are themes I do see in lots of literature.
Yes, I think we are on the same page. You may know this already, but if anyone wants to understand the role of insulin resistance and the hyperinsulinemia that usually results from it in the development of hypertension, dyslipidemia, and glucose intolerance: ruclips.net/video/Fg3n-vi2t3Y/видео.htmlsi=1mPlIHu7LN7TioRD Cheers Mario
Thank you for this video - very informative. I have been wearing a CGM for 4 months (as a result of adopting a lower carb, keto, IF diet to lose weight and get healthier) and after losing 13 lbs (1/2 of the weight I need to lose), I have become somewhat obsessed with my bs readings (as was suggested to me by my husband lol). I am 58, not diabetic (although was gestational diabetic and type 2 diabetes runs in my family), I have an AIC at 4.2 and always felt I ate pretty healthy, but still always had 20-25 extra pounds on me so I decided to try wearing a CGM to see what different foods do to my blood sugar and determine if it just might be the combination of foods I am eating/maybe be insulin resistant? I generally run between 75-95 with the lower carb, no processed food, keto, IF diet I am doing, but do have occasional spikes to 120/130 when I go astray and eat bread, pasta or rice (2-3 times a week) and this concerned me. But, it never goes over 140. I guess I need to give myself some grace and not be so “tied down” to my CGM. I also realize that while eating better now, I still haven’t incorporated a regular exercise routine or some of the things that you have talked about that can help when I do eat carbs - like making sure the meal has a good balance of protein and fat as well as maybe some exercise such as a walk after eating a higher carb meal.
Sounds like you have pretty excellent glucose tolerance. If your blood sugar never exceeds 140 mg/dL in response to high-carb meals even though you are generally on a low-carb diet, that's quite remarkable (the low-carb diet should cause you to be - temporarily - more glucose intolerant, so usually I would expect some spikes in response to high-carb meals in someone a low-carb diet). Given your very low A1c, however, you may want to use your CGM to watch for hypoglycemic episodes (and if you have them often, discuss with your doctor) as well, not just high blood sugar levels. All the best, Mario
@@nourishedbyscience I have already experienced episodes of hypoglycemia for sure. I’ve had some days where it hovered in the upper 50’s and 60’s for quite a bit of the day. I even questioned whether I was having reactive hypoglycemia - I watched your video on that - but, I think I just wasn’t eating enough food, and/or the right foods all together. Probably not enough of the right carbs and protein. So, I’ve been keeping an eye on that and making sure it doesn’t get too low and stay too low. Thanks for reading my comment and responding 😊.
appreciate your attempt to provide balanced guidance in a world where get rich oriented influencers are extrapolating from their N=1 acute phase date only
I put my CGM just last evening at 8 pm. I don’t have any diabetes but I was eating mostly carbs all my 55 years. Accumulated some health problems. Because of that 7 months ago went on ultra low carbs diet, which is called carnivore. My glucose levels from 8 pm last night until morning were from 82 to 90. At 6 am I started my usual resistance training and glucose levels went up to 106 and stayed at around 95 even after I finished my workout at 7am. The most interesting thing was my breakfast. I had 4 beef cutlets, 5 boiled eggs and butter to my taste. My glucose levels were the same during my meal a one hour after at around 84, then at two hours went even lower few points and at around 3 hours went up to around 90. Now, 4 hours after, I checked the glucose and it was 74. I think, I have 13,5 days of interesting journey to research how my body responds to food. I will do some carb choices also. I thought, this information can be useful to someone
Thanks for sharing. It's worth noting that exercise commonly raises blood sugar levels, and low-carb high-protein meals such as your can lower blood sugar levels (because little glucose is coming into the body, while protein triggers a bit of insulin release). Cheers Mario
I think, depending on the workout intensity it is perfectly normal to have higher blood sugar because it spikes cortisol , a stress induced hormone (exercice is stress on the body). Your body gets ready to fight lol. As long as your workout doesn't last all day, it's perfectly healthy and well received by the body. I know it's been a while but if you read this, would love to hear more about your experience monitoring while on a carnivore diet.
What a great video. I'm starting to get sick of all these youtubers, crying about 'spiking' to 130mg/dl :D and concluding that certain food is 'not for them' :D
I have just found your channel and I am planning to go through all the videos, I really like your style of explaining. If you have not done a video on nocturnal hypoglycemia can you please do one. My blood surgar usually is in a very good range, glucose/insuline resistance tests are ok but sometimes I wake up around midnight with heart palpitation, head lightness and I am now trying to learn what do I need to do about it.
I see this as a dynamic interplay of physiological factors, basically hormones, responding to a glucose challenge in real time. While remaining within prescribed limits and preventing absolute spike values is good, understanding the delayed return to baseline and the slope therein tells a story in itself. Asking what can one do to make that delayed response reversible and more responsive is probably a way to look at it. In terms of predicting from spikes in 'normal' people I feel calculating the slope during major events like meals etc is probably useful. A study might be valuable.
I like how that as much as you respect the science, you encourage people to look at the big picture and not simply focus on a few isolated statistics and measurements to worry about your health or to avoid a specific food which could otherwise have other benefits. The way I see it, (medical) science isn't perfect and that's why it continually evolves as new technologies and discoveries are being made. All these markers indicate some correlation with certain health conditions, but there are many moving parts and your health isn't determined by one number any more than proving electricity comes from a light switch or that water comes from a faucet.
I've had blood sugar problems since at least when I was in 4th grade. In my twenties, I was diagnosed with reactive hypoglycemia after a six-hour glucose tolerance test. Years after that, I was told I had insulin-resistance. Then I was told I was prediabetic. That's where I've been for years now. I've never been able to figure out what causes spikes or plunges. It's completely inconsistent. I need one of these.
Thank you for the articulate and balanced presentation of this material. I decided to wear a CGM ( non diabetic ) for a couple weeks to glean more insight into my body’s response to lifestyle choices . I’ve noticed nocturnal hypoglycemia to the low 50’s between about 1-2 AM most nights . I wake up at this time ( can’t tell if it’s from the CGM alarming or my natural response ). Quality sleep has been an issue for many years , so I am curious how this may connect to my blood glucose . Do you have any insight into this ? Thank you for any pearls of wisdom:)
My first response is to be careful not to place too much trust into the CGM data from one sensor. I have used 7 FreeStyle Libre sensors, and they all tended to show hypoglycemic episodes in the first few days. Also, one was faulty, and showed glucose levels that were 40-50 mg/dL lower than actual blood glucose levels measured by a finger prick and hand-held glucose meter. One morning, I woke up and the CGM (incorrectly) suggested that I must have had died overnight ... If you use a CGM for 4 weeks or longer and indeed repeatedly find these low blood glucose levels at night, it may be a good idea to discuss this with a doctor. Could be related to a medical issue, so I don't think this is something you should tackle on your own. if it's not a medical issue, it may also be a good idea to discuss this with a good nutritionist or registered dietitian. Best, Mario
I just discovered your channel last night and I love all this info you give. You said in this video that your numbers hardly goes above 140. Are you diabetic? I just got a cgm and have been using it 5 days now. My numbers are way off. Always showing lower numbers. How accurate is yours?
As I describe in the video linked below, normal blood glucose concentrations in people with normal glucose tolerance are in the 70-140 mg/dL range about 98-99% of the time, and that is the case for me, even on a high-carb diet. So no, I do not have diabetes or even pre-diabetes. In fact, with an HbA1c (measure of long-time blood sugar levels) of 4.7%, I have excellent glycemic control and excellent glucose tolerance. ruclips.net/video/LVw60RIhbzg/видео.htmlsi=5Gk6emsmvAt3ZZ_j If you say your numbers are "way off", please know that there are two different units of measurement for blood glucose: mg/dL and mmol/L, 18 mg/dL = 1 mmol/L, so if your CGM shows glucose levels in mmol/L, you need to multiply these by 18 to compare them to mine, which are in mg/dL. The ideal range in mmol/L is 3.9 - 7.8 mmol/L. Best, Mario
@@nourishedbyscience Thank you for the quick response 😊 I double check my units and it’s right mg/dl. It shows Most of the time numbers around 80-100. My doctor thinks o have mody2 diabetes.. my Numbers are most of the time above 110 for sure 😅 120 most of the day
Brilliantly informative device. When i started my diet and lifestyle change it began with eating only meat, fish, eggs, certain high fat nuts, modest dairy, fungus, fermented foods and low starch vegetables. I then used a cgm for a month and a half to test various foods alone or in concert with meals to see my particular glucose response. Gave me real time tools to plan out my future and diet foundation as well as see how my blood sugar went was largely pretty flat most of the time and was really impacted by moderate exercise. I resorted to a regular glucose monitor after the month and a half and have used it ever since. Test now twice a day typically.
Great videos! It’s great to listen and learn science without an agenda. I would love to better understand how GMI correlates to A1c when they are associated with different average blood glucose levels? Ie a GMI of 5.7 is produced with an avg. BG of 102 on the Freestyle Libre app. while that would be an A1c of 5.2. Yet GMI is claimed to be the expected A1c. That’s confusing and isn’t explained in any literature I could find. Once again, Great channel.
VERY MUCH INFORMÀTIVE ...Excellent! I'm wondering if there will be any drawbacks to getting insulin to the blood through inhalation methods. As the the case of asthma. Will it affect the brain and lungs adversly?
It will all have to do with the Pharmacist in Preparation of the Insulin and whether it can be converted to be inhaled and have access to the system Through the capillaries up the nasal cavity or even in the lungs.
Loving your content. Thank you for providing concise and straightforward explanations! If you would consider addressing it...I am curious what your thoughts are for someone who is maintaining levels under 140 (usually around 120-125) after all meals. But doesnt return to pre-meal levels of 95-105 for up to 4-5 hours after meals. Levels just steadily rise to say, 125...maybe dip to 111-115 and steady rise to 126...back down to 115 then maybe rise to 121. Is this also a sign of insulin resistance and pre-diabetes? Bc the levels not returning to pre-meal amounts even though they are not spiking more than 140?
I don't think you have any major reason to be worried; these kind of responses are not indicative of prediabetes, and certainly not diabetes, assuming these meals do contain some carbs? It is important to interpret your glucose responses in the context of the type and amount of carbs you are eating, at least to some degree. Assuming your meals are normal mixed meals with some carbs, then it is reassuring that your highest peaks never, or rarely, exceed 140 mg/dL. That suggests a good beta-cell response, particularly in the so-called first phase, with which we mean the insulin secretion that occurs within seconds of eating carbs. However, ideally, glucose levels would drop back close to baseline about 2 hours after the first bite. That is assuming the meal is not a lengthy multi-course meal or, there is desert an hour after the main meal? If it's a normal single-course meal, and levels are still hovering wall above the baseline 2-4 hours later, then this could be indicative of some early stage insulin resistance. I would suggest the following video to figure this out: ruclips.net/video/OZtxodqOBbw/видео.htmlsi=q2h8V8pf0pC3DA4d And then this here to see if you have any exposure to any of the common causes of insulin resistance: ruclips.net/video/HYtnlRCq83s/видео.htmlsi=WsJpnyadvnujCOqH These videos here may also be useful if you don't know them yet: ruclips.net/video/Fg3n-vi2t3Y/видео.htmlsi=L50mik3a1rl0IBQ4 ruclips.net/video/cP57oM8lBaU/видео.htmlsi=d8nq8KSsqOAPfX9C ruclips.net/video/DVND90vQ0xI/видео.htmlsi=CNjFkzo_p51Vzc6v Anyways, even if you are slightly insulin resistance, this would be great to figure out now so that you can address the cause and avoid a later potential progression to prediabetes. Best wishes, Mario
One more point to add from my own experience; I always start the day with a full tank!! High blood sugar level 7-9, But at the end of the day and around the evening time it just drops automatically between 6-7??? My food is almost text book figures to your six hacks of reducing spike! I eat mostly one meal a day some time very light low carb breakfast if any, and my main meal is around 16:00 with large amount of veg ans salads plus meat! My two major takes from the CGM is that; Low carb is the way to go for me? any amount of carbs of sweets shoots my sugar level high PLUS the stress effect, this for sure raise it to around 10 -12! IO walk almost every day 4KM. I do not smoke or drink alcohol! I am 66 years of age with one of my thyroid gland was taken out! I did notice that since they removed it my sugar level went irregular! using my CGM the last month my average BGL was 8.3!
Keep in mind what I said in the glucose spike video: if you regularly eat low-carb, that by itself makes your body somewhat glucose intolerant, and you will then spike particularly high to any high-carb foods you do eat. Also, the very high glucose in the morning is the dawn phenomenon: it's normal that blood glucose rises in the morning, but that is known to be more pronounced an effect in people on very low-carb diets. Warm wishes, Mario
Hello Mario. I am afraid I am becoming a little obsessed with my CGM. My A1C 12 yrs ago was 8.8 and fasting was 109. I was also 100 lbs overweight. Glad to say I lost 112 lbs and brought down my A1C to 5.2 and kept the weight off. As I advance in age (I am 73 now), I am becoming increasingly worried about developing DM. It happened that I was between monitors for a few days and I was so afraid to eat except for eggs and salad.
I thought when my body felt shaky or muscles felt empty or I was hungry that my sugar levels had dropped. I am now wearing a CGM and am quite surprised to see that my glucose levels can be still in an optimal range or even high and are not correlated in the same way…. Low sugar = bad feeling…….. it must be something else or other hormones causing it. I wish I knew so much more about this topic. ❤
Yes, all of these things could be caused by other issues. However, also pay some attention to how rapidly your blood sugar drops. There are some data suggesting that the speed at which blood sugar levels change do affect our subjective well being and our hunger.
I use bucon nightrider with sensor as cgm to get readings and updates. blucon has feature of food insights to let me know which foods affect my glucose and how much which has helped me to better control and lose weight as well
An example would be lentils, or other legumes. They don't likely induce spikes, unless someone is extremely glucose intolerant. But they do lead to an increase in blood sugar levels that is greater than that in response to, say, meat, cheese, or eggs (which are not glycemic at all). So if we compared our glycemic response to a lunch of lentils to that of a lunch of meat, we would conclude that meat is clearly better. However, lentils are famous for triggering a potent second-meal effect, meaning that if you eat lentils at lunch, your glucose tolerance to DINNER will be substantially improved and you'll have a lower blood sugar response to dinner (all other things being equal). Cheers Mario
Although a CGM provides only one aspect, it provides insights about glucose in our system we have no other way of finding out. Why would anyone knowingly eat and end up with a spike above 180? And then continue that on a regular basis? And how long does it stay above 180 or elevated? For half an hour, an hour, or maybe several hours. Or maybe trying a combined foods that keeps you measurement above 140 for 3 hours or more? While eating bread, cheese, and eggs you had a maximum reading of 120, which might not be true for many people - especially those with Type 2 Diabetes. So the videos you were watching that suggested your glucose levels would significantly rise, probably were not intended for people without insulin resistance. However if someone thought they were normal, a significant rise could provide them meaningful information. A CGM is a very valuable tool. But like all tools, they should only be used by people that understand the benefits and detriments.
I agree that spikes over 180 mg/dL should clearly be minimized or - better - avoided altogether. Many people who are now sharing their CGM data suggest that these are not rare, not even among those who don't suffer from diabetes or pre-diabetes. At the same time, I am similarly concerned about health influencers who call a 30 mg/dL bump in blood sugar a spike, because that pathologizes normal physiology, and there is little evidence that any increase within the 70-140 mg/dL range has negative long-term health consequences. Cheers Mario
I’m glad you finally got to the person like me who always had normal A1c but turned out to be a Reactive Hypoglycemic. I eat a single serving of most unprocessed carbs like sweet potato or plain oatmeal and my blood glucose spikes 300-400 and then crashes below 70 within 1.5 hours. I was constantly fatigued and blaming my endurance running. No! Some people have hidden, debilitating blood glucose variability. More doctors need to think of this!
I agree. And stories like yours have convinced me that CGMs can be a great tool to figure this out, including in people who test 'normal' when their doctor looks just at fasting glucose and HbA1c.
That said, blood glucose spikes to 300+ mg/dL are very concerning. I hope you had a conversation with your doctor about that? And I hope the doctor did take this seriously? I obviously cannot diagnose you here, but just know that even a single spike like that should be considered indicative of diabetes, and should be treated.
Best,
Mario
Have you had gastric bypass?
@@lifelovejourney great question
Oatmeal it self is part of the problem you're sharing. We've been fed so much inaccurate information on food...especially food that's been designed to be shelf stable rather than healthy for human vitality.
I am the person you are talking in this video, obsessed with what to eat! If from one type of food I have high cholesterol, from other high HbA1c, I don’t know what to eat….
Thank you, looking forward for your new videos
I would suggest watch Dr berg to get an idea what foods can be beneficial. All the best.
Du kannst auch ein Video von Dr. Sten Egbert zum Thema Cholesterin anschauen. Er erklärt sehr gut, was es mit dem Cholesterin auf sich hat. Welches Cholesterin krank macht und warum ...
Seitdem mache ich mir keine Sorgen mehr, sondern bekämpfe stille, chronische Entzündungen (ich habe erbliches hohes Cholesterin)
I so appreciate your message here! As someone who is led to overanalyze, your advice on how to work in harmony with our unique bodies and not obsess over data is very refreshing. Thank you again!
I’m diabetic. Using CGM systems for 5 years now. I live changer for a diabetic. !!!
Which one do you use?
I agree with you , I reduced my H1AC for 10 to 6 in 3 months by closely monitoring and choosing right food that suits my body . No medicine just eat well and 1 hour of excercise
My continuous glucose monitor has been a life changer. One year ago, I went on this journey just to lose weight and discovered I had post bariatric hypoglycemia! I had no idea my blood sugar was tanking for almost 20 years post my bariatric surgery, the monitor help me to understand that I had a high sensitivity to carbs which made me gain weight so I eliminated at least 70 to 80% of my carbs and without doing anything else lost 30 pounds in less than a year. it’s been an absolute game changer for me and now I’m able to better manage my blood sugar lows
Thanks for sharing!
Cheers
Mario
What carbs do you eat, if you don't mind me asking?
@@adamswift1747 I don’t mid at all….Less than 20 carbs per day have been the best option for me. I have success eating tart/sour or non-starchy fruit/vegetables like green apples, tomatoes, cucumbers, broccoli, cauliflower, grapefruit. I enjoy carrots in a stew, but probably should avoid them and cabbage actually makes me gain weight over night (inflammation) but doesn’t spike my sugar too terribly, thought it does taste sweet. And finally, I have not tried eating resistant potatoes or rice, but am really curious 🤣.
I don't fall in the category to be concerned enough to get myself a CGM but watching this has been so, SO educational and your content is exceptionally crafted, I'm an instant subscriber. Great video structure and well articulated, thank you.
Thank you for not over-humourising your presentation. American and British videos often shoehorn (often 'lame') humour into their videos to somehow keep viewers' attention.
Thank you SO MUCH for clarifying so much for me today! I am pre-diabetic and have become kind of obsessed with taking my glucose levels in the past week based on many different food types and hacks, like walking before or after a meal. My blood tests didn’t make sense to me till I watched this video about 3 times. So helpful. I am going to relax more about this.
Started using a CGM last week; very helpful information especially by your suggestion that one's glucose number is not the only measure to focus on as a measure of health.
Finally, a video about glucose monitoring for non-diabetics that is actually useful! Thank you.
Thanks for a sane dissertation - people get so obsessive about stuff. I have had type one diabetes for 58 years. Twenty years ago, when treatment was crude, to put it kindly, I was told that I was the best controlled patient in the clinic (a large, highly respected NHS teaching hospital): my average A1c during those years was 7%. I started developing symptoms of mild neuropathy (slight numbness in my feet) after about 40 years, and occasionally my annual eye scans showed mild background retinopathy, which didn't affect my eyesight. I decided to go for tighter control, and for the last 18 years my A1c has been less than 5%. I no longer have any neuropathy, and my latest eye scan reported mild backround retinopathy in one eye. My microalbumin/creatinie ratio is normal (normal kidney function). The best book on diabetes management, in my opinion, is "Dr Bernstein's Diabetes Solution" by Dr Richard Bernstein. He is a remarkable man, who has lived with type one diabetes for most of his life. He was advocating low carb for everyone - not just diabetics - from about 1990!
That's a remarkable health turn-around story, John. Congrats, and thank you for sharing. I am familiar with Dr. Bernstein, and do think his diet is a good approach for people with diabetes who are willing to follow his protocol long term.
Cheers
Mario
My wife initially had a fasting sugar level below 95 and an A1C of 5.8. She adopted a low-carb diet, eliminated sugar completely, and incorporated evening walks into her routine for three months. Surprisingly, her A1C increased from 5.8 to 6. We're puzzled as we expected it to decrease. Any insights on what might have caused this
I don't obsess over my meter because I'm not psychologically ill I am however far better physically thanks to this meter not only save me from multiple diseases progressing any further into kidney disease it has been a life changer for me and it should be part of everybody's life
Yes, I don't disagree. Figuring out which foods lead to actual spikes over 180 mg/dL can be very helpful to people, including those without diabetes.
At the same time, I decided to include a bit of a warning in the video because many people take it too far. I have seen numerous people on social media share their 'spike' to 130 mg/dL or so, which in my opinion really should not be called a spike. I know of no data that suggest that such small bumps in blood sugar within the normal range from 70-140 mg/dL are harmful, and driving ourself nuts over any such small increase could well have other negative health consequences.
Thanks for leaving a comment.
Cheers
Mario
Thank you for the clarification as your report is unbiased unlike many who are biased towards selling the product because they benefit monetarily.
Thanks you for sharing a more holistic view of health.
Thanks for your support!
I would test pre eating and then every hour for three hours after eating. Did this very over for months. It gave me a good idea of my insulin response.
I needed this, being on my first try of a CGM
Best content on YT. Thank you Mario
Dear Dr Kratz (Mario), This video segment got me intrigued! I think your analysis concerning the improvement of carb tolerance seems to bare fruit with me! Since I watched your I decided to conduct my own experiment!! also the other reason as to why I decided to carry out this experiment was few years ago I was eating just about anything and without any restrictions just a balance diet with good mix and good choice of fruits, carbs, meat, chicken and fish etc. my HbA1c was ALWAYS around 7-7.2. But when I decided to go low carb I did noticed that every time I ate carbs or fruit my BGSL goes really crazy! for the last two weeks believe it or not: I started eating seasonal fruits such as Apricot with fresh dates and some strawberry at the same time and shortly after I go for walk my sugar level started to stablise!!!! to give you an example, today I had reasonably good meal mixed with broccoli, cauliflower with boiled dry broad beans and eggs all the the same time! to my delight when I checked the CGM on almost every 5 minutes my BGSL remained at 7.8 and slowly crept to 9.4. 30 minutes later dropped to 7.8!!! so I decided to push it a little and then had 5 fresh dates, slice of water melon and two apricots mixed with some Mascarpone cheese with some almonds and hazel nuts!! shortly after I went for a walk (4KM) and I noticed slowly but steadily my CGM was reading 9.5 and went up to 12! 30 minutes later dropped to 9.5 to 8.7 and now after three hours my reading was sitting at around 5.6!!!!!!! I think you're on the right road! Now I am able to enjoy carbs and fruits as before without having immediate spike! I think you are ABSOLUTELY RIGHT when you said the body COULD become carbohydrate intolerance. One Q; are you able to use few Type 2 volunteers using a CGM and try conduct an experiment using different different carb content food? Please do not use healthy people because in my opinion it defeats the purpose! Well done and many thanks. Greeting from sunny Europe! apology for the long reply!!
Yes, regularly eating some carbs (ideally low-glycemic index carbs that also have a lot of fiber and ideally also some protein, such as lentils) do help improve glucose tolerance at the following meal.
There are many other ways to improving glucose tolerance though, as we will be discussing in the very near future. Hope this content will also be useful.
Cheers
Mario
Thanks!
Your response to carbs is very good👍 My HBa1c is 5.67%. Fortunately, all the other tests look good.
I've worn CGM twice and it's been very helpful. I've seen big spikes with oatmeal and rice, pasta, etc. I'll be on a low carb diet from now on.
I gave up processed foods a while ago, but I still eat "healthy" foods like brown rice, pasta, etc., which keeps my HBa1c levels up a bit too high.
Keep up the good work! Thanks
This newer video may help you figure out exactly what it is about your glucose tolerance that allows for these spikes:
ruclips.net/video/DVND90vQ0xI/видео.htmlsi=MfaZMFZmw1vXKQ_v
Cheers
Mario
Very useful advice for us all. Thank you.
One aspect which causes so much confusion is how nutritional advice has changed over the last five decades. To the point where ‘do’s and don’ts’ become reversed in some if not many cases. Whilst at the same time the food industry is allowed to contradict this advice and still appear to free of sanction.
The level of trust has been badly compromised, to a point where we might well trust no one. Hence the CGM and your need to counsel us accordingly.
When I just started this channel and blog, I wrote this here on my website:
"Understanding how the food we eat affects our long-term health is surprisingly difficult to figure out. This field, unfortunately, has a history of drawing conclusions based on fairly poor evidence that later turned out to be at least partly wrong. The resulting back and forth between different diet approaches, each only weakly supported by scientific evidence, has led to confusion about how to eat. As a result, many have abandoned scientific evidence, with the argument that science hasn’t really provided the answers we need to understand how diet affects long-term health. And that abandonment has led to a rise in pseudo-scientific approaches to eating, superficial views that attribute complex diseases to a single food or dietary factor, and sales pitches for dubious diet programs or supplements.
I have drawn a very different conclusion from the mistakes of the past. Yes, nutrition science is a difficult science, often forced to work with weak evidence. And yes, we have often drawn conclusions based on this weak evidence that later had to be revised. However, that does not mean that a non-scientific approach will be more likely to lead us to answers that are truly helpful for our health. It simply means that we need to apply scientific principles more rigorously. This relates to the conduct of the research, but particularly how we interpret the available data. My goal is to use this platform to raise the standard of rigor in how we read the scientific literature and the conclusions we draw from it."
I still stand by that. And I do try to raise the standard of scientific communication by always presenting evidence that is based not just on one or two papers that support my argument but by looking at the totality of the evidence on any given topic. And I provide a more detailed discussion and all references in a blog post associated with each video. That is a ton of work, much more than it would be if I just filmed myself talking vaguely about some ideas, and it isn't being rewarded (yet?) because I am not good enough at making these videos concise or entertaining, but I do think this is the way to go if we want to find a way out of the confusion and misinformation pandemic.
Thank you for your feedback. It's good to know this approach resonates with some people.
Cheers
Mario
@@nourishedbyscience excellent reply and reassuring that science is your guide. Taking anything back to basics and using science to guide one is certainly the only way. I will watch the early videos and catch up.
Thanks
I am starting a trial as a hopefully healthy Senior and I found your advise to be reasonable and helpfull, thank you!
This sounds like the science behind diabetes and how exactly to control sugar spikes, very interesting,
When I wanted to try a ketogenic diet last August, I used a Freestyle Libre for the first two months to understand what this diet does to my body and if I am bringing myself in danger at any given moment. The first three days I suffered from a keto flew and measured low blood glucose levels. Once I was passed this period, the CGM helped me lower calorie intake as I wanted to avoid periods of high glucose levels after meals. After a month, glucose levels were quite stable and I didn't purchase a third sensor.
In October, I switched to manual testing on moments I was curious. As I wanted to continue with this diet, I purchased a blood ketones tester, a cholesterol tester, and a blood pressure tester as well. It is very interesting to understand what's going on in my body and to share my experience with my wife and our 8 year old twins. 😊
Thanks for sharing.
Definitely commend you for considering several biomarkers of health. I am worried about this trend that I am seeing in the low-carb community that all diseases are attributed to elevated blood sugar and insulin resistance, while other established risk factors such as high serum lipids and high blood pressure are discounted.
I believe it's caused by a combination of nativity and the challenge of finding correct information online.
I had near to zero understanding of what I was getting in to. I scavenged RUclips for information and it felt all so confusing. That was until the algorithm served me a video of Gil and it felt like coming home. And when he tweeted your insulin resistance video, I found the second reliable source of information.
Thanks a lot, Mario You're a hero.
@@henkwerner You are too kind. I consider myself an apprentice at the art of science communication, as I clearly have a lot to learn to make these better (i.e., more engaging, more concise). But then, I just got started, and if being in academia for 20+ years has taught me one thing, it is that any worthwhile craft requires intense learning, work, and patience.
The biggest problem in this space though is that there is a very wrong incentive structure, such that creators get rewarded for making bold or contrarian statements by getting more clicks, more followers. Creating content in a scientific way, with lots of qualifiers and cautious statements about cause and effect just isn't as sexy.
It isn't sexy "yet", because most people are not aware "yet" of the difference between misinformation and life-saving information.
This will change over time. The RUclips algorithms also learn and will start promote high-quality information. Opinion leaders will mature and start promote those who share real, thus valuable, information.
I have already shared the link to your channel, including motivation, with 4 people last week in personal messages. It's just a matter of time until you have pushed this snowball over the top of the hill.
@@henkwerner Let's hope that society at large will see the type of transformation you predict. Misinformation, particularly where it is used in a targeted fashion for political or for-profit reasons is, IMHO, one of the biggest obstacles to addressing our big societal and personal challenges.
Also thank you for helping me reach more people. Much appreciated!
Thanks for the video, I actually wanted to get a CGM for all the reasons you've highlighted, you have helped me get real with my life
Great content! Thoughtful, informative and pragmatic. I especially appreciate your gentle push to “chill”, and to think about things holistically.
I use a CGM and occasionally use the prick method. They never match.
CGM uses interstitial fluid to estimate blood sugar vs the prick method, which actually does measure the blood sugar levels.... thus making the prick method more accurate.
That said... CGM is convenient and gives a better result than guessing.
But if you want/ need an accurate reading sometimes, use the prick method as back up.
Thank you for uploading and sharing.
In large studies, CGM data reproduce those of a finger-prick and hand-held glucose meter pretty well. However, they lag blood sugar whenever sugar levels change rapidly, i.e., after a meal.
Cheers
Mario
My CGM reads 20 pts higher during fasting,but 20 pts lower during spikes, compared to the glucometer blood test.
Thank you for this advice. I'm only 3 days diagnosed with being pre diabetic. I was eating ready meals and that made me feel drowsy after eating. Like my flavoured porridge was doing as well. So last night I had a fish pie with mash potatoes topping, but with lots of salad. And I didn't feel drowsy after eating it. But i do feel stupid and lazy for not bothering to remember and implement the basics of a balanced diet, for the last couple of years.
Same here. Good luck!
@@scfan7231 It's going OK. I got a slow cooker and fill it with frozen veg and chicken thighs or lea n beef cubes. Make chilli or bolognese. sometimes a have pasta whole grain with it as pasta is better than potatoes or rice.
Sugar free Oats with frozen fruit is another of my favorites now. And Low calorie protein shake with a big dollop of peanut butter. stops the hunger and gives me the protein.
I've had a few treats over Christmas, so will just eat one meat a day for a while as I have another blood test in January.
@@UbiquitousRomp I've been struggling to lose weight all of my life. I weighed 90kgs most of the time, now up to 100kgs (I think that's 200 lbs). I did some blood tests 3 months ago, found out I am slightly insulin resistant, and changed my diet.
- added sugar = 0 (this week I cheated a lot because my dad gifted me chocolate and... need to get it somewhere away from me); also no artificial sweeteners (many increase insulin, says the internet)
- put fibers in whereever they are removed; e.g. I eat whole grain pasta (found a brand that I enjoy), whole grain bread, but I still think they have less fiber than totally natural --> I supplement. The same if I eat white rice etc. pp. When I eat out, I have supplements.
I did some other things, e.g. tried high-protein foods as mentioned on this channel. And observe myself, am I eating for distraction or for hunger? - As advised on this channel. And started sometimes to skip meals when I'm not feeling hungry.
I attribute to the fibers that I started to feel fuller and eat less, after 2 months. I have now lost at least 3 kg in the last 3 weeks, mostly fat.
And the blood tests massively improved.
I like the idea of using a slow cooker with meat. I am very lazy with regards to cooking. So this might be for me. Thanks.
@@scfan7231 Go for the right size for a good sized meat. Frozen veg and frozen peppers are as high in nutrition as fresh and none gets wasted.... I use fresh onion and garlic though. Also like to add a few chilli flakes and Cayenne pepper to give it that winter warmer feel. And it's good for the blood.
Good luck. It can be done.
One of the best Channel to create awareness: God Bless you and your family: Keep up the good work: Amen
Thank you, Javed. All the best wishes for you and your family as well!
Cheers
Mario
Thank you for providing the voice of reason!
Thank you for the very insightful video content. I wish I had found your video channel earlier. I have been wearing a CGM for more than a year to monitor my blood glucose level and every little increase in glucose level after a meal gives me anxiety. I am pre diabetic and am not on any diabetic medication. Just using diet to control my glucose level. Looking forward to watching more of your videos. Many thanks for your good work. Cheers!
I am absolutely passionate about helping people bring their blood sugar levels into the normal range and avoiding real blood sugar spikes (i.e., >180 mg/dL). BUT: I am equally passionate to let people know that little bumps in blood sugar are part of normal physiology and that there is little to no evidence that fluctuations within the 70-140 mg/dL range are harmful. There are some influencers right now who claim that any increase of more than 30 mg/dL (1.7 mmol/L) are harmful and should be avoided; I disagree with this, and I know that most of my professional colleagues also disagree with this notion. To me, the anxiety you describe is not just unnecessary, but also potentially harmful, and many people will unnecessarily make radical dietary changes to avoid such tiny bumps (and these radical changes may lead to other problems or at least dietary sacrifices that are uncalled for).
Warm wishes,
Mario
Hi, I purchased some CGMs to learn about my metabolism. My lipid blood panel had been disappointing for years. High triglycerides, low HDL values.
I noticed high and long spikes after a high carb meal (pasta) followed by a load of sugar (dessert).
Next, I took a standardised glucose load: 75 grams in water and followed the glucose spike.
Then I knew for sure: pre diabetic 🚨
Later I varied food en drinks and checked blood sugar responses.
Triglycerides are commonly high when we have too much fat in our liver (watch my video on the personal fat threshold below if you haven't yet), but they are also commonly elevated in response to a diet too rich in refined carbs and particularly added sugars (soda, sweets, deserts etc.) These same foods would also contribute to blood sugar spikes, particularly in someone who is pre-diabetic, so what we know about your state would suggest that you would greatly benefit from cutting back on the refined, high-glycemic index carbs and particularly the added sugars. See my video about the glycemic index below as well.
Best wishes,
Mario
ruclips.net/video/cP57oM8lBaU/видео.htmlsi=c7myP142_o6LCU7q
ruclips.net/video/v1zCVE3ifn0/видео.htmlsi=nKt4m2VBIiA68bUy
@@nourishedbyscience hi Mario, thank you for your response! Probably sugar and refined carbs much more than fats.
I purchased an accurate lipids tester years ago (ACON Mission Cholesterol 3 in 1). I never was able to get TG/HDL ratios below 3 or 4.
Now something that is not rational or understandable, but it works, it also did in the past with other health issues. So, hold your fire!
I occasionally visit a woman that can diagnose with "Touch for Health" or applied kinesiology. I do not claim that I understand HOW it works, but she solved issues before, also for my mother.
My high TG was solved, mostly within week, with the following regime:
* Chrome 'ionic drops' (a solution of chrome (III) chloride, a few hundred micrograms)
* Vitamin E complex
* beta 1,3 1,6 glucan
* Riboflavin (vit B2) for improved methylation (homocysteine issue, MTTR gene defect).
My ratio is now below 2.
I absolutely understand strong doubts about this story, but I don't care because it's been solved now. 😊
A message most needed, especially in the realm of YT! Thank you so much for educating us!!
00:27 🩺 Continuous Glucose Monitors (CGMs) offer almost continuous glucose level measurements, providing a convenient alternative to traditional blood sugar tests involving finger pricks.
02:32 🍎 Blood sugar response to food is just one aspect of diet affecting health; consider other measures like lipid levels, blood pressure, inflammation markers, and more for a comprehensive health assessment.
06:38 🍞 CGMs measure acute blood sugar responses to food, but they don't capture the long-term effects on glucose tolerance; optimizing glucose tolerance can help regulate blood sugar levels throughout the day.
09:38 🥦 Use CGM to test blood sugar responses to meals as you typically eat them; don't base conclusions on extreme experimental scenarios with isolated foods that differ from your regular eating habits.
11:58 📊 Differentiate between normal and elevated blood sugar levels based on clinical guidelines; maintain a perspective on what constitutes a healthy blood sugar range.
15:56 🧘♂ If your blood sugar levels fall within the normal range, maintaining a relaxed relationship with your CGM is key; obsessing over minor fluctuations might not significantly impact health in this category.
Thank you Mario for your response. You are right that I assumed an increase of blood glucose of more than 30 mg/dL (1.7 mmol/L) after meals are harmful. This always happens when I consume fruits e.g. only 3 strawberries and I am thinking of avoiding fruits altogether. Now I am more enlightened. Your passion about educating people on diabetes is commendable. Many thanks for the effort involved. Cheers!
The single biggest glucose spike I've seen with myself is when a scammer stole over 2k from me. I got my money back but for me, getting angry skyrockets my blood sugar which was kind of unexpected. My blood sugar doesn't spike more than 30 points when I eat because I restrict carbs. It shot up well over 60 points mad.
@@franny5295 OMG! same thing happened to me. I had a chat on phone with someone that turned out to be very stressful. My blood sugar spiked too. Very interesting to find this out.
Great thought provoking video. I just received my cgm to help me with prediabetes. This will help me better use the monitor.
Also check out this one here:
ruclips.net/video/DVND90vQ0xI/видео.htmlsi=BZbJ02fWX6MmB2kH
I’m diabetic and use cgm. Have lost 40lbs from 160lbs. My bmi is 19.7. It’s impossible for me to lower my fasting sugar below 115. My hba1c has reduced from 8.2 to 5.9. There’s nothing I can do any more. I wear a CGM
Hi Sumit,
You sound like you are disappointed, so let me first tell you that I think you have done an amazing job! Losing 40 pounds and reducing your A1c from 8.2% to 5.9% is wonderful, and 5.9% is barely above the normal range. Take a breath, and give yourself a pat on the back. You have every reason to be proud.
Now, that said, there are certainly other things one could try. Pancreatic beta-cell dysfunction may still be an issue. Also consider that exercise is always helpful in helping the body regulate blood sugar, including walks after meals and also weight-bearing exercise to build up more muscle mass. And reducing carbohydrate intake can be an option. I'll publish videos on all of this in the near future.
If you haven't, check out the most recent video on ways to keep blood sugar levels low and prevent spikes:
ruclips.net/video/yg0Y3eNSANg/видео.html
Cheers
Mario
P.S.: What I am sharing here is just a summary of the factors that affect glucose tolerance and blood sugar levels, not dietary or medical advice for you specifically. If you make major changes to your diet, make sure to first discuss these with a dietitian or physician.
I’m in the same boat with fasting blood sugar. Similar bmi
@@angelikaharabin3628 what I’m finding is that cutting fructose in all forms (not just sugar) is critical. My fasting sugar is down to 105
@@angelikaharabin3628 Something else for both of you to consider: are you on a very low-carb or keto diet? In some people, this can lead to an increased dawn phenomenon, i.e., substantially increased glucose upon waking up.
Cheers
Mario
@@nourishedbyscience my diet is lowish carb but not ketogenic . I do time restricted eating. If I eat late Or high carb or heavy protein like beef , I can be in the diabetic range . Thank you for your answer !
I really enjoy watching your videos and they solved many of my questions about blood glucose. Thank you for the scientific and clear illustration!
This was very helpful and a much deeper analysis than other information videos. Much thanks...
Thank you, i was gonna go in wrong direction and your video helped me course correct
Very helpful Thankyou!
I'm so so so excited to have found the Veri app and pair it with my Freestyle sensor! I knew something had to exist, thank you!!! Also, your video is super helpful.... subscribing!!
Yes, I just found the app Veri in the App Store. Unfortunately, it is $49.00 (canadian dollars) for a single month. If it was cheaper, I would try it. 😟
Very helpful!!
Such a good well reasoned explanation. I watched it for a second time and appreciated it even more. Thank you Dr. Katz!
Thank you for your video. Do you have any videos on how to improve glucose tolerance in the long term?
Very useful! Kudos for educating all of us on this important aspect of our health.
There is so much information about the elevated blood sugar levels and very little on hypoglycemia. Recently, I have been diagnosed with the reactive hypoglycemia, while the condition is nowhere near as serious as hyperglycemia, still, the symptoms of a sudden, unexplained drop of sugar are no picnic either. I am now waiting for the CGM monitor hoping that it will help me at least track these hypo episodes a bit better. Would be great to hear more about the reactive hypoglycemia and how to deal with it. Thank you! Hugs from Norway
Thank you, Monica. My newest video has some information about reactive hypoglycemias:
ruclips.net/video/LVw60RIhbzg/видео.html
Also, the next video that will post this coming week will be an interview with an MD who has a long history of struggling with reactive hypoglycemia.
That said, reactive hypoglycemias can have numerous causes, and may have nothing to do with blood sugar spikes. It's always a good idea to try to get to the bottom of what causes your specific case by working with a knowledgeable physician, which it sounds like you are doing.
Warm wishes from Bonn, Germany!
Mario
Excellent advice calmly delivered and gratefully received. Thanks Mario.
Thanks!
Thank you for the support, Serpil! Greatly appreciated.
Cheers
Mario
@@nourishedbyscience Oh, you are welcome, it is nothing. I binge watched your videos and learnt so much. Thank you for the work you are doing and sharing the knowledge here. That is to be appreciated!
Also.. are you familiar with other types of diabetes? I was told I was prediabetic’ 3 months ago but after analyzing my numbers my dr thinks I have mody’ diabetes. My A1C it’s 5.9 and insulin 6.4.. she told me I don’t have insulin resistance but still gave me 2000 mg of metformin a day.. I get spikes of 175 after big meals and my fasting is always between 105-120 at home (dr blood test shows 101 twice) I am trying to find out what diet is best for me.. your videos have been so helpful. I feel a little overwhelmed at the moment.. not having health insurance makes everything difficult for example to get the genetic test” i need to find out if I am mody diabetic or attending some nutrition classes to learn how to balance meals
Great content ! One answer I didn’t get from the video or I might have missed it - is how to become more glucose tolerant, if one is prediabetic. Please advise. Thank you 🙏
Thank you so much for all your videos 😊
I'm so glad I bumped onto your channel. I must've done something right to please the lords of RUclips for them to send me this way 😅 but seriously the whole internet seems to be infested with low carb/keto/carnivore diet fanatics and charlatans and it's such a breath of fresh air to hear some calm, sensible, non reductionist, evidence based information. Thank you for making these contents! Please keep up the great work! 😊
Thank you for the kind feedback.
One issue I see with diet tribalism is that there are certain narratives within these tribes that get perpetuated by being repeated again and again, even though in many cases there is little evidence to support them (or even evidence to the contrary). I am worried that this could be harmful to health in the long term.
Cheers
Mario
@@nourishedbyscience diet tribalism. I live that.
QUESTION: Ive recently begun keto. I think 20 carbs is too restrictive. I walk 3 miles in the evening after work and currently weigh 180. Down 4 pds in one week (probably from a 3 day fast before the keto).
What do you think the range limit to go into ketosis is?
I keep reading it's between 20to 50 carbs a day. That's a large range.
@@annjohnson4061 Typically, the recommendation is not to consume more than 50g of total carbs (incl. fiber) per day. I personally would find 20g per day too restrictive and hard to maintain for an extended period of time.
Cheers
Mario
@@nourishedbyscience so you think you can go into ketosis with 45 or so carbs?
Is managing the amount your sugar spikes the same as keeping the sugar low enough for your body to burn fat instead of sugar??
Your explanations are so helpful but I'm stuck at how to understand how to understand whether it's the AMOUNT of sugar in the blood that decides whether our bodies will burn it for energy or the insulin response deciding NOT to put the sugar in our muscles and leave it in our blood to be used for sugar.
I am not the worlds greatest keto expert, and haven't researched this recently, but traditionally, insulin regulates ketogenesis.
When you eat such a small amount of total carbs, usually on keto in the form of some vegetables or other whole foods such as nuts and seeds, which also come with fiber, your absolute changes in blood glucose and insulin are not going to be all that substantial, particularly if you distribute the 45g over 2-3 meals per day.
Cheers
Mario
Great perspective and practical advice. Wish I could find similar information about ketone levels in the blood.
I like your videos! I already watched a few and you are always very strict to the point, and very logical and informative. Thanks a lot!
Thank you for the very insightful video well balanced.
I have insulin resistance and since high school have known I can't eat, for example, a lollipop. But so many foods that I'm told is good for bloodsugar, like oats, messes with my bloodsugar - meaning an hour after eating it I'm starving and feeling bad. So I got the monitor (today), to figure out for myself what my body can and can't deal with.
I do realize it's going to be somewhat complicated because my bloodsugar levels can be influenced by what I ate yesterday, or even when I eat something. I can eat a slice of cake, but not in the morning.
That's a good use of a CGM.
However, be careful with your sources of information. Oatmeal clearly isn't good for blood sugar. Check out the videos below:
ruclips.net/video/v1zCVE3ifn0/видео.htmlsi=ut25KNGPhqsoTMoR
ruclips.net/video/kxUP0zzBECA/видео.htmlsi=Oomw06RQF9HZQIvS
You may also enjoy this video here to experiment with you meals to better understand your blood sugar responses:
ruclips.net/video/yg0Y3eNSANg/видео.htmlsi=M31oQfJtkhXP-Pwt
Best,
Mario
Great video, Thanks for sharing. Surly subscribed
I really enjoyed this video. I was recently started wearing a cgm and this video has helped me understand that I need to chill out over every spike. I'm taking your advice
😊
Thank you so much! This is very helpful information!
The educational value of a RUclips video is directly proportional to the number of times the speaker uses the future tense.
Forgive me that was meant as a criticism. It is inversely proportional.
Excellent video. Still, the gap with looking at glucose in isolation is that we can’t be sure what is happening with insulin. We might be maintaining a relatively ‘normal’ glucose level but be severely hyper-insulinemic. I believe it was professor Roy Taylor who said that prior to the diagnosis of T2D there was a ‘long silent scream from the liver’.
From your own figures quoted, I suspect you are metabolically healthy. An A1C of 4.7 is likely very normal. An A1C of 5.5 - whilst comfortably within the guidelines - likely points to an altogether different situation. I’d be prepared to wager that with an A1C at these levels, then the person is hyper-insulinemic. You would, for example, likely find that they suffer from hypertension (maybe not significant, but still higher than ‘normal’). They probably would also have elevated LDL. I’m basing these statements on my personal situation which might not translate to a bigger population, but these are themes I do see in lots of literature.
Yes, I think we are on the same page.
You may know this already, but if anyone wants to understand the role of insulin resistance and the hyperinsulinemia that usually results from it in the development of hypertension, dyslipidemia, and glucose intolerance:
ruclips.net/video/Fg3n-vi2t3Y/видео.htmlsi=1mPlIHu7LN7TioRD
Cheers
Mario
Thank you for this video - very informative. I have been wearing a CGM for 4 months (as a result of adopting a lower carb, keto, IF diet to lose weight and get healthier) and after losing 13 lbs (1/2 of the weight I need to lose), I have become somewhat obsessed with my bs readings (as was suggested to me by my husband lol). I am 58, not diabetic (although was gestational diabetic and type 2 diabetes runs in my family), I have an AIC at 4.2 and always felt I ate pretty healthy, but still always had 20-25 extra pounds on me so I decided to try wearing a CGM to see what different foods do to my blood sugar and determine if it just might be the combination of foods I am eating/maybe be insulin resistant? I generally run between 75-95 with the lower carb, no processed food, keto, IF diet I am doing, but do have occasional spikes to 120/130 when I go astray and eat bread, pasta or rice (2-3 times a week) and this concerned me. But, it never goes over 140. I guess I need to give myself some grace and not be so “tied down” to my CGM. I also realize that while eating better now, I still haven’t incorporated a regular exercise routine or some of the things that you have talked about that can help when I do eat carbs - like making sure the meal has a good balance of protein and fat as well as maybe some exercise such as a walk after eating a higher carb meal.
Sounds like you have pretty excellent glucose tolerance. If your blood sugar never exceeds 140 mg/dL in response to high-carb meals even though you are generally on a low-carb diet, that's quite remarkable (the low-carb diet should cause you to be - temporarily - more glucose intolerant, so usually I would expect some spikes in response to high-carb meals in someone a low-carb diet). Given your very low A1c, however, you may want to use your CGM to watch for hypoglycemic episodes (and if you have them often, discuss with your doctor) as well, not just high blood sugar levels.
All the best,
Mario
@@nourishedbyscience I have already experienced episodes of hypoglycemia for sure. I’ve had some days where it hovered in the upper 50’s and 60’s for quite a bit of the day. I even questioned whether I was having reactive hypoglycemia - I watched your video on that - but, I think I just wasn’t eating enough food, and/or the right foods all together. Probably not enough of the right carbs and protein. So, I’ve been keeping an eye on that and making sure it doesn’t get too low and stay too low. Thanks for reading my comment and responding 😊.
Well done and keep up the good work! I very much enjoy the science of your lectures¨!
appreciate your attempt to provide balanced guidance in a world where get rich oriented influencers are extrapolating from their N=1 acute phase date only
Thank you. I’ve learned a lot. I wish I had seen your video earlier. I’m now subscribed
Love the Bell Pepper conundrum- I am late to your channel- but super intrigued! Thank you.
Great point IQ solution point ON Doc 🎯
I put my CGM just last evening at 8 pm. I don’t have any diabetes but I was eating mostly carbs all my 55 years. Accumulated some health problems. Because of that 7 months ago went on ultra low carbs diet, which is called carnivore. My glucose levels from 8 pm last night until morning were from 82 to 90. At 6 am I started my usual resistance training and glucose levels went up to 106 and stayed at around 95 even after I finished my workout at 7am. The most interesting thing was my breakfast. I had 4 beef cutlets, 5 boiled eggs and butter to my taste. My glucose levels were the same during my meal a one hour after at around 84, then at two hours went even lower few points and at around 3 hours went up to around 90. Now, 4 hours after, I checked the glucose and it was 74. I think, I have 13,5 days of interesting journey to research how my body responds to food. I will do some carb choices also. I thought, this information can be useful to someone
Thanks for sharing. It's worth noting that exercise commonly raises blood sugar levels, and low-carb high-protein meals such as your can lower blood sugar levels (because little glucose is coming into the body, while protein triggers a bit of insulin release).
Cheers
Mario
I think, depending on the workout intensity it is perfectly normal to have higher blood sugar because it spikes cortisol , a stress induced hormone (exercice is stress on the body). Your body gets ready to fight lol. As long as your workout doesn't last all day, it's perfectly healthy and well received by the body. I know it's been a while but if you read this, would love to hear more about your experience monitoring while on a carnivore diet.
Our going to the Metabolic health conf's (Low Carb confs) and Anti--Aging confs is a next step lower then the ADA re the numbers!!! A1C
Thanks for the great contents. One question: Regarding the Veri app you mentioned at the beginning, is it available on iOS in the US? Thanks.
What a great video. I'm starting to get sick of all these youtubers, crying about 'spiking' to 130mg/dl :D and concluding that certain food is 'not for them' :D
I have just found your channel and I am planning to go through all the videos, I really like your style of explaining. If you have not done a video on nocturnal hypoglycemia can you please do one. My blood surgar usually is in a very good range, glucose/insuline resistance tests are ok but sometimes I wake up around midnight with heart palpitation, head lightness and I am now trying to learn what do I need to do about it.
Thanks, great video! Looking forward for more😍
I see this as a dynamic interplay of physiological factors, basically hormones, responding to a glucose challenge in real time.
While remaining within prescribed limits and preventing absolute spike values is good, understanding the delayed return to baseline and the slope therein tells a story in itself. Asking what can one do to make that delayed response reversible and more responsive is probably a way to look at it.
In terms of predicting from spikes in 'normal' people I feel calculating the slope during major events like meals etc is probably useful. A study might be valuable.
Sound advice!
I like how that as much as you respect the science, you encourage people to look at the big picture and not simply focus on a few isolated statistics and measurements to worry about your health or to avoid a specific food which could otherwise have other benefits. The way I see it, (medical) science isn't perfect and that's why it continually evolves as new technologies and discoveries are being made. All these markers indicate some correlation with certain health conditions, but there are many moving parts and your health isn't determined by one number any more than proving electricity comes from a light switch or that water comes from a faucet.
Thanks Dr.
Great work. Are there videos on how to improve glucose tolerance from your perspective?
Yes, many videos on exactly this topic coming.
Thanks for commenting.
Cheers
Mario
I was wearing a CGM and got too obsessed causing anxiety which then raises blood sugar. I took it off for my sanity.
I've had blood sugar problems since at least when I was in 4th grade. In my twenties, I was diagnosed with reactive hypoglycemia after a six-hour glucose tolerance test. Years after that, I was told I had insulin-resistance. Then I was told I was prediabetic. That's where I've been for years now. I've never been able to figure out what causes spikes or plunges. It's completely inconsistent. I need one of these.
Thank you
Thank you for the articulate and balanced presentation of this material.
I decided to wear a CGM ( non diabetic ) for a couple weeks to glean more insight into my body’s response to lifestyle choices .
I’ve noticed nocturnal hypoglycemia to the low 50’s between about 1-2 AM most nights . I wake up at this time ( can’t tell if it’s from the CGM alarming or my natural response ). Quality sleep has been an issue for many years , so I am curious how this may connect to my blood glucose .
Do you have any insight into this ?
Thank you for any pearls of wisdom:)
My first response is to be careful not to place too much trust into the CGM data from one sensor. I have used 7 FreeStyle Libre sensors, and they all tended to show hypoglycemic episodes in the first few days. Also, one was faulty, and showed glucose levels that were 40-50 mg/dL lower than actual blood glucose levels measured by a finger prick and hand-held glucose meter. One morning, I woke up and the CGM (incorrectly) suggested that I must have had died overnight ...
If you use a CGM for 4 weeks or longer and indeed repeatedly find these low blood glucose levels at night, it may be a good idea to discuss this with a doctor. Could be related to a medical issue, so I don't think this is something you should tackle on your own.
if it's not a medical issue, it may also be a good idea to discuss this with a good nutritionist or registered dietitian.
Best,
Mario
I just discovered your channel last night and I love all this info you give. You said in this video that your numbers hardly goes above 140. Are you diabetic? I just got a cgm and have been using it 5 days now. My numbers are way off. Always showing lower numbers. How accurate is yours?
As I describe in the video linked below, normal blood glucose concentrations in people with normal glucose tolerance are in the 70-140 mg/dL range about 98-99% of the time, and that is the case for me, even on a high-carb diet. So no, I do not have diabetes or even pre-diabetes. In fact, with an HbA1c (measure of long-time blood sugar levels) of 4.7%, I have excellent glycemic control and excellent glucose tolerance.
ruclips.net/video/LVw60RIhbzg/видео.htmlsi=5Gk6emsmvAt3ZZ_j
If you say your numbers are "way off", please know that there are two different units of measurement for blood glucose: mg/dL and mmol/L, 18 mg/dL = 1 mmol/L, so if your CGM shows glucose levels in mmol/L, you need to multiply these by 18 to compare them to mine, which are in mg/dL. The ideal range in mmol/L is 3.9 - 7.8 mmol/L.
Best,
Mario
@@nourishedbyscience Thank you for the quick response 😊 I double check my units and it’s right mg/dl. It shows Most of the time numbers around 80-100. My doctor thinks o have mody2 diabetes.. my Numbers are most of the time above 110 for sure 😅 120 most of the day
Do you have any info about this kind of diabetes?
Brilliantly informative device. When i started my diet and lifestyle change it began with eating only meat, fish, eggs, certain high fat nuts, modest dairy, fungus, fermented foods and low starch vegetables. I then used a cgm for a month and a half to test various foods alone or in concert with meals to see my particular glucose response. Gave me real time tools to plan out my future and diet foundation as well as see how my blood sugar went was largely pretty flat most of the time and was really impacted by moderate exercise. I resorted to a regular glucose monitor after the month and a half and have used it ever since. Test now twice a day typically.
Great videos! It’s great to listen and learn science without an agenda. I would love to better understand how GMI correlates to A1c when they are associated with different average blood glucose levels? Ie a GMI of 5.7 is produced with an avg. BG of 102 on the Freestyle Libre app. while that would be an A1c of 5.2. Yet GMI is claimed to be the expected A1c. That’s confusing and isn’t explained in any literature I could find. Once again, Great channel.
Well done….chart was helpful
Great video! Thanks
VERY MUCH INFORMÀTIVE ...Excellent! I'm wondering if there will be any drawbacks to getting insulin to the blood through inhalation methods. As the the case of asthma. Will it affect the brain and lungs adversly?
I am not sure I understand your question. Could you re-phrase?
It will all have to do with the Pharmacist in Preparation of the Insulin and whether it can be converted to be inhaled and have access to the system
Through the capillaries up the nasal cavity or even in the lungs.
Loving your content. Thank you for providing concise and straightforward explanations! If you would consider addressing it...I am curious what your thoughts are for someone who is maintaining levels under 140 (usually around 120-125) after all meals. But doesnt return to pre-meal levels of 95-105 for up to 4-5 hours after meals. Levels just steadily rise to say, 125...maybe dip to 111-115 and steady rise to 126...back down to 115 then maybe rise to 121. Is this also a sign of insulin resistance and pre-diabetes? Bc the levels not returning to pre-meal amounts even though they are not spiking more than 140?
I don't think you have any major reason to be worried; these kind of responses are not indicative of prediabetes, and certainly not diabetes, assuming these meals do contain some carbs? It is important to interpret your glucose responses in the context of the type and amount of carbs you are eating, at least to some degree.
Assuming your meals are normal mixed meals with some carbs, then it is reassuring that your highest peaks never, or rarely, exceed 140 mg/dL. That suggests a good beta-cell response, particularly in the so-called first phase, with which we mean the insulin secretion that occurs within seconds of eating carbs.
However, ideally, glucose levels would drop back close to baseline about 2 hours after the first bite. That is assuming the meal is not a lengthy multi-course meal or, there is desert an hour after the main meal? If it's a normal single-course meal, and levels are still hovering wall above the baseline 2-4 hours later, then this could be indicative of some early stage insulin resistance. I would suggest the following video to figure this out:
ruclips.net/video/OZtxodqOBbw/видео.htmlsi=q2h8V8pf0pC3DA4d
And then this here to see if you have any exposure to any of the common causes of insulin resistance:
ruclips.net/video/HYtnlRCq83s/видео.htmlsi=WsJpnyadvnujCOqH
These videos here may also be useful if you don't know them yet:
ruclips.net/video/Fg3n-vi2t3Y/видео.htmlsi=L50mik3a1rl0IBQ4
ruclips.net/video/cP57oM8lBaU/видео.htmlsi=d8nq8KSsqOAPfX9C
ruclips.net/video/DVND90vQ0xI/видео.htmlsi=CNjFkzo_p51Vzc6v
Anyways, even if you are slightly insulin resistance, this would be great to figure out now so that you can address the cause and avoid a later potential progression to prediabetes.
Best wishes,
Mario
One more point to add from my own experience; I always start the day with a full tank!! High blood sugar level 7-9, But at the end of the day and around the evening time it just drops automatically between 6-7??? My food is almost text book figures to your six hacks of reducing spike! I eat mostly one meal a day some time very light low carb breakfast if any, and my main meal is around 16:00 with large amount of veg ans salads plus meat! My two major takes from the CGM is that; Low carb is the way to go for me? any amount of carbs of sweets shoots my sugar level high PLUS the stress effect, this for sure raise it to around 10 -12! IO walk almost every day 4KM. I do not smoke or drink alcohol! I am 66 years of age with one of my thyroid gland was taken out! I did notice that since they removed it my sugar level went irregular! using my CGM the last month my average BGL was 8.3!
Keep in mind what I said in the glucose spike video: if you regularly eat low-carb, that by itself makes your body somewhat glucose intolerant, and you will then spike particularly high to any high-carb foods you do eat.
Also, the very high glucose in the morning is the dawn phenomenon: it's normal that blood glucose rises in the morning, but that is known to be more pronounced an effect in people on very low-carb diets.
Warm wishes,
Mario
Hi! I'm new here and your presentation is very informative! Did you test a non invasive method -laser- to measure blood glucose?
No, never looked into that? Have you?
Cheers
Mario
Hello Mario. I am afraid I am becoming a little obsessed with my CGM. My A1C 12 yrs ago was 8.8 and fasting was 109. I was also 100 lbs overweight. Glad to say I lost 112 lbs and brought down my A1C to 5.2 and kept the weight off. As I advance in age (I am 73 now), I am becoming increasingly worried about developing DM. It happened that I was between monitors for a few days and I was so afraid to eat except for eggs and salad.
thank you🙏🏻
I thought when my body felt shaky or muscles felt empty or I was hungry that my sugar levels had dropped. I am now wearing a CGM and am quite surprised to see that my glucose levels can be still in an optimal range or even high and are not correlated in the same way…. Low sugar = bad feeling…….. it must be something else or other hormones causing it. I wish I knew so much more about this topic. ❤
Yes, all of these things could be caused by other issues. However, also pay some attention to how rapidly your blood sugar drops. There are some data suggesting that the speed at which blood sugar levels change do affect our subjective well being and our hunger.
@@nourishedbyscience Thank you for responding. I am new and learning so much from our channel.
I use bucon nightrider with sensor as cgm to get readings and updates. blucon has feature of food insights to let me know which foods affect my glucose and how much which has helped me to better control and lose weight as well
You are awesome 👏
1 point of interest could be the difference between the measurment of blood glucose by a CGM, BGM at home and lab tests
Great Stuff. On Point 2 I'd love to see examples of this. I've never seen a food that spikes blood sugar but is good for long term glucose tolerance.
An example would be lentils, or other legumes. They don't likely induce spikes, unless someone is extremely glucose intolerant. But they do lead to an increase in blood sugar levels that is greater than that in response to, say, meat, cheese, or eggs (which are not glycemic at all). So if we compared our glycemic response to a lunch of lentils to that of a lunch of meat, we would conclude that meat is clearly better. However, lentils are famous for triggering a potent second-meal effect, meaning that if you eat lentils at lunch, your glucose tolerance to DINNER will be substantially improved and you'll have a lower blood sugar response to dinner (all other things being equal).
Cheers
Mario
Although a CGM provides only one aspect, it provides insights about glucose in our system we have no other way of finding out. Why would anyone knowingly eat and end up with a spike above 180? And then continue that on a regular basis? And how long does it stay above 180 or elevated? For half an hour, an hour, or maybe several hours. Or maybe trying a combined foods that keeps you measurement above 140 for 3 hours or more?
While eating bread, cheese, and eggs you had a maximum reading of 120, which might not be true for many people - especially those with Type 2 Diabetes. So the videos you were watching that suggested your glucose levels would significantly rise, probably were not intended for people without insulin resistance. However if someone thought they were normal, a significant rise could provide them meaningful information. A CGM is a very valuable tool. But like all tools, they should only be used by people that understand the benefits and detriments.
I agree that spikes over 180 mg/dL should clearly be minimized or - better - avoided altogether. Many people who are now sharing their CGM data suggest that these are not rare, not even among those who don't suffer from diabetes or pre-diabetes.
At the same time, I am similarly concerned about health influencers who call a 30 mg/dL bump in blood sugar a spike, because that pathologizes normal physiology, and there is little evidence that any increase within the 70-140 mg/dL range has negative long-term health consequences.
Cheers
Mario