Last time I went for a routine medical checkup/blood work, the numbers showed me as just reached pre-diabetic stage. If you are not familiar with this diagnosis, it is nothing too alarming, as millions of people all over the world live in this state for decades. The medical industry's guidance at this stage is to "just watch", meaning no medication or change in lifestyle required. They will keep testing once a year to see if we actually become diabetic, after which medications will be prescribed. To me, this doesn't make sense, since this is the time to dig into the data to see what changes we can make in our diet and exercise routine so that the A1C numbers don't continue to trend up. Though things like reducing weight, exercising more and eating less carbs will all help, since each individual's metabolism is different, getting lot more data about our particular body/food/exercise habits to see what we can easily to tweak to go back to normal state is what makes sense to me.
To gather a lot of data, bought a Freestyle Libre CGM (Continuous Glucose Monitoring) system, that has a sensor that you attach to your body and a reader, using which you can read your blook glucose level in a second, whenever and as many times as you want. Till two weeks back, getting a CGM in the US usually required a doctor's prescription, whereas in other parts of the world, you can purchase one OTC (Over The Counter). The US FDA changed the rule couple of weeks back allowing OTC sales in US as well. Hopefully it will bring the price down. While there are a lot of models, types, version, the one I bought costs roughly $100 for the reader and $30 for the sensor that works for two weeks (exactly, to the minute). I got a second sensor, in case I mess up while putting on the first one. But it was easy to put on and so I have a spare one now, that someone else can use later.
You can find a lot of details about CGM online, and in YouTube videos. But here are a few photos/video explaining what I did.
https://photos.app.goo.gl/2q2qfHiXDTfPAoLV7
The Abbott Labs that sells this particular model wants you to create an account, and upload all the data to their cloud, so that they can analyze and give your results/recommendations. Since the EULA wants you to allow them to own/use the data however they want, forever, I felt uncomfortable and went through the painful process of entering all the data into a spreadsheet and doing the analysis myself. If you don't mind giving away your data, you can download apps available online, and use the provided USB cable to easily transfer the data to get the analysis done online.
This reader also has the interface to take glucose blood test strips to provide you the reading, though I didn't use it myself. There are newer versions of the device, where using the Bluetooth interface, data can be directly transferred to your phone and then on to the cloud, etc. I intentionally used a low-tech version where the reading stays in the handheld reader, that is about the size of pager, with a very easy to use, single button interface.
The sensor actually measures the glucose levels in the Interstitial Fluid rather than in the blood hemoglobin but is considered pretty accurate, since the reader can use a formula to covert (i.e. estimate) it to blood glucose level.
I took about 20 to 25 readings each day for the past two weeks and so have about 300 readings. The sensor you attach to your body does gather the glucose data continuously and so even if you don't read it so many times, when you do, it will transfer all the data to your reader. You can see it in the graphs the reader plots & shows you (see photos). But since the reader screen size is small, and since I wasn't transferring the data to the cloud, I am depending more on the 300 manual readings I took and recorded on a spreadsheet with notes on foot/activities.
Observations made are applicable mainly to me, since that is the reason to go through this process is to get a better understanding of our own specific (i.e. one person) metabolism. Still, I am listing a few salient points I gathered, since these insights may be useful for others to follow or may indicate the value & surprise findings you derive by going through this exercise. I defined my "normal range" as 70 to 120 mg/dL.
- Eating a cup of plain white Raman noodles (without adding any vegetables, proteins, flavors, etc.) causes a glucose spike close to 200. I used this as a baseline to test couple of theories.
- Eating the same plain noodles, preceded by a small salad, flattens the spike, limiting it to about 150.
- Eating the same plain noodles, followed by 20-25 minutes of moderate exercise (like brisk walking), flattens the spike, limiting it to about 150.
- White rice eaten with Sambar/rasam/butter milk (typical south Indian lunch/dinner) causes a spike close to 200.
- Preceding the identical meal with a small salad keeps it under 150.
- Alternately replacing white rice with cooked bulger wheat or brown rice eliminated the spike.
- Eating a small salad or protein, seems to coat/occupy your intestine preventing any subsequent carb/sugar coming in from causing a spike.
- Eating 1.5 slices of toasted whole wheat bread OR just one cup of south Indian rava uppuma caused a sharp spike. I think white bread would have caused even a bigger spike.
- I tried all types of food (Mexican, Italian pasta, pizza, black coffee, coffee with milk & sugar, fruit smoothie, pistachio nuts), different type of exercise (walk, jog, weights, stretches/sit-ups) and took readings to see how/what I can optimize to prevent spikes.
There are articles like this one that argues why common public should NOT do CGM, and how spikes after eating different food is quite normal, as long as the glucose level comes down on its own in the following hour. I do understand those points and my levels do come down. Still, being an engineer, I prefer & tend to measure, analyze, debug and fix issues before they become a crisis. I am hoping to use the collected data to modify my diet & exercise routines to see if I can go back to being normal (instead of pre-diabetic) next time I go for a checkup. If I can do that, I'd have gotten my money's worth, and this process will be in line with my goal of living a healthy life as long as I can without resorting to chronic daily medication just to lead a normal life. Will tell you how it goes after 6 months or 1 year.
If you are already an expert and have pointes for me, drop me a note.
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