Paul Saladino· MD
and this is why it is so important to wear a continuous glucose monitor
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The evidence is convergent. Multiple independent sources reach the same conclusion, the underlying mechanism is well-characterized, and even the field's most cautious voices treat it as worth doing.
and this is why it is so important to wear a continuous glucose monitor
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Bookmarking — the dossier-vs-overview split is the right call. Most of the time I want overview; sometimes I want receipts.
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this is why a cgm is really the um the gold standard in my opinion
what does this look like clinically for people it means that in those people who are medical metabolically broken if you have an elevated fasting insulin if you've worn a cgm and you've seen some postprandial uh insulin resistance that looks like postprandial glucose that will not lower and i'm going to show you guys some cgm's in a moment then you can pretty much say like you are you have metabolic dysfunction
I think this is a great set of data to triangulate with something like a fasting insulin and your lipids to get a sense of how metabolically healthy you are.
some measure of your insulin sensitivity and metabolic health is is paramount
I believe continuous glucose monitors are super valuable for understanding your insulin sensitivity and insulin resistance just by looking at the sort of phenotype the way that your postprandial glucose looks continuously throughout the day all of your glucose levels throughout the day you can get a sense of how insulin sensitive you are
So, with the use of the CGM, fasting glucose isn't going to be the best indicator. It's going to be the dynamic glucose. So, if you've eaten a carbohydrate heavy meal or or a simple carbohydrate, I shouldn't call it a big meal, but a simple carbohydrate like two pieces of bread, if your glucose levels aren't back down to normal by about two hours, that suggests a problem. So in my mind, the greatest utility of the CGM is to monitor the dynamic changes rather than the static where am I at every morning. That has less value. The dynamic changes are what has value.
Post-meal glucose spikes in non-diabetics drive long-term cardiometabolic disease independently of HbA1c.
Wearing a continuous glucose monitor leads to personalized dietary improvements that hold up beyond 12 weeks.
Continuous glucose monitors meaningfully change behavior in non-diabetic adults beyond the first month.
CGM use in metabolically healthy adults induces orthorexic-style dietary anxiety without health benefit.