Metabolic Science and CGM Technology

Capturing Life’s Complexities

We need a common-sense approach to metabolic health. Do all people need to eat an extreme low-carb diet? Probably not. But we do need to listen to our bodies and make good decisions. No good method currently exists to predict post-meal blood sugar responses. Glycemic index and glycemic load are not accurate methods for predicting blood sugar, as they place too much focus on food properties rather than individual responses. The complexity of our lives makes simplistic metabolic prediction extremely unreliable. We do not eat food in isolation - we eat before or after exercise, after a good or bad night’s sleep, at different frequencies and in different combinations of carbohydrates, proteins and fats. How do we take action in the face of this complexity?

Continuous glucose monitoring is about putting YOU back into the equation – it’s a tool that allows you to explore your unique metabolism in depth. You will discover that you tolerate some foods better than others, and you’ll see how sleep, exercise and stress impact your blood sugar. Your P4 physician will help you “connect-the-dots” in the face of this complexity, personalizing your dietary and lifestyle decisions.


The Science Behind CGM Technology

The Abbottt FreeStyle Libre flash CGM provides an indirect way of measuring blood sugar. The patch deploys a very small filament sensor under your skin - this filament sensor interacts with the glucose in your interstitial fluid and sends an electrical signal that predicts your blood sugar level. The gold standard method for checking blood sugar is drawing a tube of blood from a vein and sending it to a laboratory. CGMs are less accurate than the gold standard, but they are useful tools for seeing real-time glucose responses.


CGM Technology for Quantified Wellness

The Abbott FreeStyle Libre is FDA approved in adults with diabetes to inform insulin dosage decisions. At the P4Mi Clinic we use the exact same technology to help non-diabetic and prediabetic patients understand their unique responses to foods and activities, and to improve their everyday lifestyle decisions in order to prevent disease transitions and promote wellness.

87 million Americans have prediabetes, and we need innovative ways to help people prevent the onset of type II diabetes. CGM technology provides a new way to motivate people and guide them into healthier and more productive lives.


Glucotype Analysis: A New Tool for Understanding Metabolism

The current standard for assessing glucose metabolism relies on single time measurements (fasting blood sugar and 2-hour oral glucose tolerance test) or an approximate 3-month average (HbA1c). CGM data shows blood glucose fluctuations in real-time.

Looking at highs and lows in blood sugar offers a partial understanding of CGM data. Researchers at Stanford University recently defined a new way of thinking about glucose metabolism - the “glucotype.” They showed that some healthy people who do not meet criteria for diabetes or prediabetes can have severe blood sugar variability. This has practical importance because severe post-meal spikes in blood sugar are associated with oxidative stress, hypercoaguability (increases blood clotting tendency), endothelial dysfunction (damaged blood vessels) and inflammation.