Why we all need to keep blood sugar low, and how CGM can help us do that

I’ve talked about using a continuous glucose monitor before as it’s something I think would benefit everyone, healthy or not. I saw this article recently, which shows that high blood sugar levels seem to “reprogram” stem cells in bone marrow, which develop into white blood cells. These were found to be more inflammatory than when developed at times of lower blood sugar, and the researchers theorized that this could explain why diabetics who control their blood sugar levels still have a higher risk of heart disease and other inflammatory diseases – their macrophages (type of white blood cell) remain inflammatory and can contribute to atherosclerosis (plaque in the arteries). whether this happens in people without diabetes but who have spikes of high blood sugar remains to be investigated, but I highly suspect this is the case.

The reason for this is because diabetes isn’t a black and white issue. The diagnosis of diabetes is based on an arbitrary level of blood sugar, but the problems with blood sugar exist on a spectrum. The higher your blood sugar, the more problems whether or not you receive the diagnosis of “diabetes”. Diabetics simply have blood sugar so high and uncontrolled that it massively increases their risk of complications, enough to require treatment by our current medical model. As I explain below, even “Healthy people” can have dangerous blood sugar spikes which cumulatively can cause ill health. Just because it’s not bad enough to be labelled as a disease, doesn’t mean it’s optimal.

So why should you get a CGM if you’re a non diabetic?

First of all, many people are living with pre-diabetes or diabetes without even knowing it. By the time you experience symptoms such as excessive thirst and urination, fatigue, delayed wound healing etc you are already in “dangerous” territory. The sooner you address the problem, the better the outcome.

But even before being at “pre-diabetic” diagnosis level, a steady up climb of blood glucose levels spells trouble. This study showed that there is high glucose variability in non diabetics, measured using CGM. In a quarter of these people, blood sugar levels reached above 140mg/dL (7.8 mmol/l)up to 15% of the time. This level is considered prediabetic, and the more time your sugars are this high, the more damage is being done to your body. Dr Peter Attia, (a highly respected anti-aging doctor) has argued that for optimal health you should *never* go above 140 mg/dL).

Whether you are diabetic or not you want your blood glucose levels to be as low as possible. High glucose variability in non diabetics is associated with higher all cause mortality , and high insulin levels are strongly associated with Alzheimers disease , cancer mortality and cardiovascular disease in non-diabetics. High glucose is even linked to worse outcomes in hospitalized Covid patients. If you want to prevent death from the major killers (or reduced quality of life in your final years), you absolutely want to keep your blood sugars low, and the only way to do that is to measure and track your glucose and see how it responds to various foods. You can’t change what you don’t know. Don’t forget that individual microbiomes and genetics can influence your response to foods (which is why concepts like low GI are generally not very useful) – for example my blood glucose spikes if I eat oats…therefore I avoid eating oats.

While most people can and should learn how to keep their blood sugar stable by testing themselves with a CGM, there are doubtless some people who should be cautious, in particular those with eating disorders who might not benefit from even more scrutiny of what they eat.

This is the future of personalised medicine, but you don’t need a doctor to measure this. In fact, it is highly unlikely your doctor will even routinely measure your static blood sugar levels if you’re healthy, because most are not aware of the research in non-diabetics, and resources for preventative medicine are limited. Unfortunately our healthcare system is geared up to treat symptoms once a disease process has already established itself rather than preventing it in the first place, but this doesn’t mean that you can’t take control of your own health. There are many CGM products on the market, such as Freestyle Libre (which I’ve used), Dexcom, Eversense etc. The best thing to do is get a monitor, and note how various foods and meals impact your blood sugar. The most alarming insights I noticed with my tracking are that sleep disruption has huge effects on my blood sugar (a reminder to eat lower carb on such days), and that things like fruit cause spikes unless eaten with fat and protein. What insights will you find out?

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