[mangoman]

I recently had an unusual health event that resulted in me passing out. My wife, who is a physician, thought it might be hypoglycemia, since i'm at high risk for diabetes. She found a super friendly endocrinologist who put me on a CGM for two weeks. I never hit the hypoglycemia range during those two weeks, so it didn't really explain what my issue... but honestly the data was SUPER interesting. Just observing the various spikes made me make healthier choices, or noticing when I was feeling extra tired and seeing if that correlated to not having eaten for little while, or eating something sugary before.

It's sort of like tracking your steps when you first get a smart watch. It may not have been the reason you got the device, but seeing the data, people are encouraged to act on it, even if you don't have an acute issue. since I didn't have a prescription, I couldn't get one here (didn't want to go through some sketch online site). I tried to get one from my family in India, but the prices were really high and they couldn't get the fancier one that tracks straight to your phone, so I didn't get one.

I think this could be a god send for preventing pre-diabetic people who would take preventative steps if it weren't such a pain in the ass to measure consistently.

[aledalgrande]

I actually just got one of these CGMs after listening to Peter Attia's (audio)book Outlive and started monitoring my glucose and experimenting with meals and exercise to see what effects they have. Apart from the weirdness of having something attached to your skin, it's like having another watch and you won't notice after a while. It's pretty cool and a lot more people than just diabetics would benefit from this knowledge.

Like I just learned for example about resistant starches, of which one is cooled potatoes: I ate the exact same dish but the first time, right after cooking, my levels shot up (not abnormally but you should ideally never have spikes, so your body doesn't have to keep pumping insulin), and then the second time, reheated, it was like I didn't eat anything. I was surprised so I researched and found https://www.webmd.com/diet/what-to-know-resistant-starches

Everyone is different so I definitely suggest to try them out for a month and see what gives you spikes in your diet. Then try to get rid of those spikes.

[droopyEyelids]

You got me real curious about why this is.

I know there are waxy and starchy potatoes that have higher rations of amylopectin vs amylose starch respectively.

One interesting thing is that if you continuously mix an amylopectin potato, it turns into a gooey, ropey substance that we don't use much in western cooking but is how some Chinese mashed potatoes are supposed to be prepared. I wonder if that transformation affects the resistance of the starch.

I also wonder what exactly is making the cooled potato tougher to digest.

[throwup238]

> I also wonder what exactly is making the cooled potato tougher to digest.

https://en.wikipedia.org/wiki/Retrogradation_(starch)

[technological]

can you post link to the device which you brought

[aledalgrande]

I'm using an Abbott Freestyle 2, but any of the available big brands that have an app would work.

[mlrtime]

Probably a Dexcom G6/G7?

[cleandreams]

I am prediabetic and I have one. It's partly covered by insurance. By the metrics my estimated average glucose has gone down from 129 to 98 or so (normal). I haven't had my HbA1c in awhile.

I think they are amazing. It's been SO HELPFUL. However I don't think it makes sense for normal people. I am on a reddit group for prediabetes and it's not unusual that people who are underweight (anorexic?) and have completely normal metrics come in and post in an utterly freaked out state. These are people who are somewhat compulsive and anxious. I think that if you are normal for blood glucose having access to all this data can make you compulsive and anxious.

However, for me as a prediabetic, it is really useful. It tells you what’s going on with your blood sugar in real time with no ideology. In the beginning I was spiking from things that a nutritionist would say was OK. I found whole grains didn’t work for me. I was shocked at how much I spiked from oatmeal. What causes blood glucose spikes does not map directly to number of carbs and also every body is different.

After 6 mo of lowered carbs, weight training, and getting down to normal BMI, I can now eat SMALL portions of things like brown rice. My health has improved. It's great. IMHO all prediabetics and diabetics should have one, covered by insurance. It would really improve health and reduce complications.

[lawlessone]

>However I don't think it makes sense for normal people.

I agree , but if it's anything like gluten free foods, having more people buying that don't need to, might push prices down for you.

[TylerE]

What’s also surprising is what doesn’t. I’ve found for instance, that potatoes, even French fries, don’t do a whole lot to mine.

[michaelcampbell]

> I was shocked at how much I spiked from oatmeal.

Was it oatmeal, or what you ate oatmeal with (milk, sweetener, etc), or do you know?

[pwthornton]

The people at Levels, who do continuous glucose monitoring, say that oatmeal is one of the worst offenders.

You really need to spike your oatmeal with fats, protein, and fiber.

I regularly eat steel-cut oats for breakfast. My go-to is steel-cut oats, two tablespoons of Chia seeds mixed in (tons of fat and fiber), and a serving of mixed nuts and berries on top. On the side, I eat four scoops of powdered peanut butter mixed with water. This version of peanut butter is much higher in protein and much lower in fat and calories than normal peanut butter.

Doing all of this can keep the spikes to a reasonable amount (I also eat the powdered peanut butter first). Any kind of oatmeal by itself is bad. Instant oatmeal is worse. Instant oatmeal with all that sugar and stuff thrown in is terrible.

I suspect if you made your oatmeal with milk instead of water, it would help a lot, but I can't do this from being lactose intolerant.

[jkaplowitz]

Consider trying oatmeal with lactose-free milk. The number of lactose-free dairy products varies a lot around the world, but if you’re in a developed Western European or North American country, lactose-free milk itself is almost certainly available in at least two different fat levels. The most widely available brand in the US, but certainly not the only one, is Lactaid.

(Special mention: Germany has an impressive variety of lactose-free options. Even lactose-free Nutella equivalent, lactose-free cream cheese, and lactose-free mascarpone! Many lactose-free products in Germany have competition between the store brand, a major brand or two, and/or a brand or two focused on lactose-free.)

[cleandreams]

I've been wanting to try steel cut oats again but with chia. Chia seeds seem to help everything. Great stuff. Oats is one of the things I miss.

As for milk... I have issues with milk! I found out my morning latte by itself was raising my overall blood glucose. Milk seems to have a lot of sugar. Now (I feel guilty about this) I use heavy cream to which I get no spike at all.

You really need a CGM to figure this stuff out.

[specialist]

I LOVE heavy cream. But it's gotten so expensive and perishes faster than I like.

FWIW, I've mostly switched to coconut cream. My local restaurant supply has a few different brands. So I mix it up. I go thru a box of 12 cans every 2 months are so.

[michaelcampbell]

Interesting; where do you buy it? Here in the US the standard grocery store has "heavy whipping cream" which I use. A quart lasts me a week or more; it's only used for coffee for me, and the occasional recipe my wife will make.

But I'm surprised at its longevity.

[prirun]

> I suspect if you made your oatmeal with milk instead of water, it would help a lot, but I can't do this from being lactose intolerant.

I dunno about that: milk contains a lot of sugar. Water doesn't. You could add 3 tbsp of cream for an extra 150 calories (no protein, no sugar) vs 1 cup of milk at 150 cals, 8g protein, 12g carbs.

I add almond flour to oatmeal and protein shakes for an extra 100 cals of fat.

[michaelcampbell]

Thanks, I'm IF'ing and watching carbs so I don't eat breakfast, and have been avoiding oats when I DO eat "breakfast for lunch".

I boil it in water, but usually eat it with milk. I might try heavy cream though since I have that, and the chia is a good idea.

I have also made an oat "patty" by mixing oats with 1-2 eggs, salt/pepper to taste, shredded cheese if you're into that (I am), and microwaving.

[specialist]

Yes and:

Coconut oil, coconut cream, ginger (w/ dash of pepper), cinnamon, hemp seeds. Something different every day, to avoid boredom.

Sometimes I go savory, swapping meat for fruit.

Which peanut powder do you use?

[eternauta3k]

Also, instant oatmeal / rolled oats / steel cut oats / the whole dang oat?

[bakedoatmeal]

What is the connection between being at risk of diabetes and hypoglycemia? Wouldn’t a pre-diabetic be very protected from hypoglycemia?

[code_duck]

There is something called reactive hypoglycemia.

https://en.wikipedia.org/wiki/Reactive_hypoglycemia

It can occur for various reasons. Personally, I was developing adult onset type 1 (LADA) for a couple of years before I was diagnosed and I had all sorts of effects. While it was of course mainly effects of chronic hyperglycemia and shortage of insulin, I also had some episodes of hypoglycemia. Now that I’m on insulin, I’m very familiar with hypoglycemia resulting from an imbalance of exogenous insulin and carbohydrates. However, I looked back and realized this happened to me a few times before I was on insulin. I recall waking up a few times at night, sweating and shaking, and having a strong urge to consume food. I’d drink some juice or eat chips, feel better in 20-30 minutes and go back to sleep. This occurred after drinking alcohol, which makes sense as alcohol intensifies the effect of insulin and also prevents your body from releasing chemicals which raise your blood glucose level. I didn’t think much about it at the time but now I can see it was related to T1 onset.

My understanding is that essentially the body’s systems which regulate blood glucose are disrupted. This happens a with type 1 in general - not only problems with the system that produces and releases insulin to lower blood glucose by allowing it into cells, but also the part that does the opposite and release glucose to raise blood glucose levels. Sometimes the glucose-raising system doesn’t work at all while other times it’s inappropriately in overdrive. The same is true for the insulin releasing/glucose lowering system as it fails.

[veryfancy]

Wondered this too. Diabetics are at risk for hypoglycemia because of the insulin they take, not the diabetes itself. Maybe metformin for a prediabetic could have this effect?

[TylerE]

Nah, even as a full blown diabetic metformin doesn’t drive you low. It basically just makes the same amount of (naturally produced) insulin do more, essentially.

[pgporada]

even as a full blown type 2 diabetic*

[ijustlovemath]

No, diabetes is fundamentally a lack of ability to control your blood sugar. This means you get lots of highs but also lots of lows. It's a common misconception that diabetes just means your blood sugar is always high; rather, your sugar is high because your body no longer controls it actively.

[cstrahan]

I'm pretty certain you're mistaken here. Diabetes is specifically characterized by elevated blood glucose, either due to pancreas not producing enough insulin or your body becoming descensitized to insulin.

You will find that diabetics often do have low blood sugar, but that's because they overestimate how much insulin they need to inect, causing their blood sugar to go too low. The hypoglycemia in this scenario is not caused by diabetes, but rather a dangerous side effect of the treatment.

OP doesn't have diabetes, and (unless he's abusing insulin for body building purposes) isn't taking insulin. His postprandial hypoglycemia is likely a benign case of "reactive hypoglycemia" (https://www.mayoclinic.org/diseases-conditions/diabetes/expe...).

[bakedoatmeal]

Diabetes mellitus is an insulin problem- either a lack of insulin (Type 1) or insufficient response to insulin (Type 2). Insulin is responsible for lowering blood glucose. The hormones responsible for raising blood glucose (cortisol, IGF-1, glucagon, epinephrine) still function normally.

My understanding was hypoglycemia only occurs in diabetes in the presence of medications used to lower blood glucose (insulin formulations, sulfonylureas, etc.) and not because of diabetes itself, which when untreated invariably leads to hyperglycemia.

[TylerE]

It’s not either or, either. Some really unlucky folks end up with a hybrid and have both problems… they don’t produce enough insulin or react well to what they do.

[beanjuiceII]

You don't get lows from diabetes

[pgporada]

Are you being pedantic on purpose?

[lr4444lr]

What kinds of food intake/non-intake habits aside from the obvious culprits surprised you?

[rodly]

Long-term they will likely make no changes because human desire, habits and behaviors are rarely unknown to us.

The parent comment mentioned feeling tired after consuming something with a lot of sugar, was that really a mystery prior to using CGM? I doubt it.

Sure it's interesting to correlate to your perceived wellness (or lack thereof) with a wearable spitting out data but after the novelty of this discovery wears off my guess is that people will simply stop caring to check what they already know to be the case.

[dleink]

> Long-term they will likely make no changes because human desire, habits and behaviors are rarely unknown to us.

It seems like this thinking leads to desires, habits and behaviors remaining a mystery to us.

[dog_boxer72]

Is it really such a stretch to imagine that maybe some people really don’t correlate those things? People aren’t research papers, we have multiple cognitive distortions working all the time obfusticating the truth, but tech like this can help bypass them

[jeremiahbuckley]

My view: I’m busy, I have a lot of things I’m trying to figure out. For example, All of my free time should be spent getting better at AI programming. Seemingly infinite horizon.

I could carefully track a half dozen signals to correlate consumption to effect, but if the effect is “I’m tired and don’t have much willpower”, that’s hard to remember to track. I just haven’t built up that habit; heck I’m having a hard time keeping up the habit of light exercise.

I have a cousin who was diagnosed with some stage of diabetes; got a continuous blood sugar monitor; ended up losing a ton of weight. I’m definitely in the market for this—something to make it easier for me. It’s undoubtedly healthier for me than mainlining wygovey, which is another option on the table.

[sxg]

> The parent comment mentioned feeling tired after consuming something with a lot of sugar, was that really a mystery prior to using CGM? I doubt it.

They may not have known just how sugary that item was since most people don't bother to calculate the sugar content of everything they consume, but the CGM puts a number on it. That experience could be enough to change the OPs behavior. I agree that most people may not care to make behavioral changes in response to more data, but there are definitely other people who will.

[jxramos]

there is something powerful about the objective outside-of-self confirmation of something because it eliminates the doubt that can be casted as it all being in ones head. External confirmation is enlightening and motivating.

[o_____________o]

It's more than intake. It's food order, stress, sleep, context, and so on. Did you eat enough fiber, did you add more fat this time, did you drink the night before? Did you walk afterwards? Unless your life is extremely regimented and uniform, they provide a ton of data.

[temp_praneshp]

The ones on diabetic warehouse don't work well enough (https://www.diabeticwarehouse.org/collections/continuous-glu...? Or is that site sketch for you? I think you can just get one if you are willing to burn $500 (not cheap, but only in the price range of a higher-end smartwatch)

[vlabakje90]

Keep in mind that a single sensor will work for only a week or two, depending on the type. So it's not exactly right to compare the price to a smartwatch.

[temp_praneshp]

Ah okay, thanks for telling me that; I thought you keep recharging the battery every week from the description.

[pwthornton]

No. They are single-use, and it embeds into your skin with a probe.

[necovek]

I personally wouldn't mind having the data if a need comes up, but this is simply overtracking for no particular purpose.

Basically, our bodies go through much "turmoil" over the course of any day, and watching over one too many parameters is like getting hooked to TV or a video game.

Generally, medical science can mostly tell you what averages or most common patterns are, so if you do not line up with them and don't understand this, you can get overstressed.

So unless you are really someone who can objectively consider your readings combined with effects you might be seeing, I'd say don't do it.

[necovek]

And reading further, there is evidence of people getting worked up about what are not problematic readings in this very thread.

[lynx23]

Watching a heartrate monitor sometimes has the reserve-progress-bar effect. You know the deal. You realize the pump is on a hightened frequency, so you see what your smart watch says. And the more you watch it, the more anxious you get, so the rate stays more or less high.

[bookofjoe]

aka "white coat hypertension": https://www.mayoclinic.org/diseases-conditions/high-blood-pr....

[whatshisface]

Getting hooked on smooth blood sugar changes sounds like a possible counterweight to what our brains are designed to get hooked on... Oreos.

[ecoquant]

You also can't underestimate the possible behavior changes of seeing a massive blood sugar spike from oreos, causing less oreos to be consumed.

To believe measuring something doesn't change behavior is just wrong. We know this.

[TylerE]

More importantly for life style monitoring A1C is the more important number anyway, and doesn’t require wearing anything, just a simple blood test. It’s basically a 3 month moving average.

[RHSeeger]

At least for a diabetic, A1C is less looked at nowadays. With CGMs, we can lookt to see our time-in-range, highs, lows, and patterns. It's... amazing.

Plus, you can see just how much different types of foods directly impact your blood sugar. For example, white rice and pizza are crazy for raising glucose levels. I knew about pizza, but I had no idea that white rice what quite _that_ bad.

[salad-tycoon]

Doesn’t have to be white. Rice is how I helped screen my wife for gestational diabetes instead of that awful nukacola sugar slam they make pregnant women do and then check sugars at predetermined times when challenged with 50g rice or 50g sugar.

Anyways, yeah rice is basically the insulin dietary equivalent of sugar.

[oldgradstudent]

> My wife, who is a physician, thought it might be hypoglycemia, since i'm at high risk for diabetes.

Isn't hypoglycemia a side effect of insulin and other glucose lowing agent rather than of the diabetes itself?

[dkarras]

how is having low blood sugar a sign of pre-diabetes? I get frequent bouts of hypoglycemia.

[keymasta]

It could be related but I also want to weigh in here and say this. Hypoglycemia can occur with no relation to the other side of diabetic symptoms, i.e, hyperglycemia. In other words there are people who suffer from hypoglycemia without ever getting high blood sugar, and so they are not "diabetic" which would mean you can have issues from both directions.

[murukesh_s]

At some point a person's body may become resistant to insulin and start to need more insulin to have normal functioning (pre-diabetes), sometimes this causes large variation in glucose levels, though not as drastic as taking a medication. Eventually your body would adapt to it when you reach the diabetes phase.

[seesaw]

Were you able to find out what may have caused you to pass out ? I had a similar incident with no root cause. But that did set me on the path to become more healthy.

[melagonster]

Excuse me, this is stupid question. but can't you buy Freestyle Libre?

[TylerE]

Yes, but need a prescription.

[melagonster]

wow... I am sorry. in my country the condition is reversed. it cheaper than prescription version, so I ask it. good luck bro.

[hackernews1134]

Which county is that please? If you don’t mind sharing.

[yurishimo]

You can buy them OTC in most of western Europe.

[melagonster]

Taiwan, and Japan have same condition.

[jxramos]

definitely, catching the "quantified self" bug is a real thing!

[cheriot]

Thanks for confirming. Normal feedback on health habits is delayed by months/years and hard to trace back to specific actions so your story makes a lot of sense.

I might have to get over my dislike of needles :|

[mikenew]

It's more akin to a finger prick than a needle. Might still be a bit psychologically challenging but I've done it and it's really not bad at all.

[jorvi]

I'm not even diabetic but they always pre-check your blood during blood / plasma donating. I would say it doesn't even register as a pinprick and feels more like the percussive slap of a tiny elastic band.

[mikepurvis]

Ha, I would say quite the opposite, that the finger prick is my least favourite part of giving blood— it's ironic that taking a few drops could be that much worse than the big honking needle which draws an entire pint, but I guess fingertips just have a lot of nerve endings.

[RHSeeger]

As a diabetic, I've always found that the finger prick for testing my blood hurt more than the insulin needles.

[0_____0]

Not sure if the blood center people have a protocol for this but in athletic labs you can sample from the earlobe to take blood lactate readings