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CGM research

stuarta

Member
Relationship to Diabetes
Parent of person with diabetes
Just had this pop up on my phone and thought I would leave it here

 
This seems to be related to the use of CGM by people without diabetes (eg the Zoe thing) where people without diabetes can become unduly concerned by perfectly normal glucose variation, and might drop some foods out of their menu because of a wobble they saw on a Libre.

These quotes seemed to outline the conclusion of the study?

Professor Javier Gonzalez from the Department for Health said, "CGMs are fantastic tools for people with diabetes because even if a measurement isn't perfectly accurate, it's still better than not having a measurement at all. However, for someone with good glucose control, they can be misleading based on their current performance.
"For healthy individuals, relying on CGMs could lead to unnecessary food restrictions or poor dietary choices. If you want to assess your blood sugar accurately, traditional methods are still the way to go. We want to better identify the sources of the error in CGMs so that we can improve their performance in the future and have active research on this topic."
According to Professor Javier Gonzalez from the University of Bath, the inaccuracy of CGMs can be attributed to several factors:
"CGMs may be inaccurate because they measure glucose in the fluid surrounding your cells, not directly in your blood. This can lead to discrepancies due to factors like time delays, blood flow, and how glucose moves between different parts of the body."
Helen Whitby, Company Nutritionist at Innocent Drinks, said, "Smoothies and whole fruits are packed full of natural goodness and provide steady energy without sharp blood sugar spikes. We're on a mission to make it easier to live well through the delicious goodness of fruit and veg and this research confirms that blending fruit doesn't affect its health benefits, contrary to some myths."

Interesting that Innocent Smoothies are referenced.I wonder if they may have been involved in the funding of the study.
 
Definitely and did feel it odd why 'general' people would be using CGM's if they don't have a need unless they are health conscious
 
Linky to paper here: https://researchportal.bath.ac.uk/e...onitor-overestimates-glycemia-with-the-magnit

I can't tell whether it's open access though as I am logged into ScienceDirect.

From what I can tell, it's partly pointing out what we already know, which is that CGMs typically overestimate actual BG and that there is a lag.

What is perhaps interesting is that even if they calibrate the data against fingerprick data this still results in an overestimate for all the smoothies, but less so for the glucose challenge (but the CGM underestimates the rise in this case).

However, it looks like they only used a single value pre-food/challenge (with steady state BG) and then subtracted that (i.e applying an offset), so no accounting for (potential) changes in the gradient of the calibration line (which visibly does sometimes occur with the libre2).

They conclude that the overestimation of BG may mean that using CGMs to estimate GI might push a foodstuff into a higher (worse GI band.)

There definitely appears to be a damping effect (not just the lag) in the response to BG, I wonder whether this is an actual physical lag (in the movement of glucose into the interstitial fluid) or something to do with the chemical/algorithm used by the CGMs.
 
A very interesting paper. Helpful for interpreting my CGM results when I get round to trying one.
 
Personally, I would take the conclusions from this paper with a large grain of salt. I have read several other studies that all conclude that CGM can underestimate as well as overestimate true blood glucose. This does not greatly surprise me as the sensor is only relying on measuring interstitial fluid and thus has no visibility into all the myriad other things that are going on in the patient's body that might have an impact on true blood glucose.

It does puzzle me why anyone would want to use a CGM unless he/she absolutely needed to. Before I acquired Type 1 diabetes, I cherished my ignorance of even the existence of such devices.
 
Under declarations…

Javier Gonzalez reports financial support was provided by Innocent Drinks.

He also

is a scientific advisory board member to ZOE and 6d Sports Nutrition; and has completed paid consultancy for The Dairy Council, PepsiCo, Violicom Medical, Tour Racing Ltd., the European Fruit Juice Association, and SVGC
 
It does puzzle me why anyone would want to use a CGM unless he/she absolutely needed to.

I do not test my glucose levels. A recent HbA1c shot up from 32 to 39. The last was back to 35. I am happy with that.
If there is another big swing for no obvious reason, I will try a CGM to see what is going on.
 
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It does puzzle me why anyone would want to use a CGM unless he/she absolutely needed to.
If I didn't have diabetes but knew about CGMs, I would be curious to try one.
I am not sure I would do much with the data unless I was an elite athlete (which I am certainly not) but my personality is the sort that likes to look at data when I know it exists.
 
If I didn't have diabetes but knew about CGMs, I would be curious to try one.
I am not sure I would do much with the data unless I was an elite athlete (which I am certainly not) but my personality is the sort that likes to look at data when I know it exists.
Yes, I am also someone who would routinely be curious and attracted to getting a better understanding of such potential data - even if Diabetes was not in my daily vocabulary.
 
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