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Posted by zdw 6 days ago

Continuous Glucose Monitoring(www.imperialviolet.org)
116 points | 116 commentspage 2
geor9e 5 days ago|
Here's a teardown of the Stelo CGM https://news.ycombinator.com/item?id=43145527
cynicalsecurity 6 days ago||
If you don't have diabetes type 1 or type 2, or temporary diabetes related to pregnancy, then you don't really need a CGM. CGM is a life-saving tool for people with diabetes type 1 mostly.

I was hugely ignorant of diabetes type 1 before my child suddenly was diagnosed with it. It's an absolute nightmare, a horrifying disease no one is taking about while there are millions of children affected by it worldwide - and the disease is spreading, getting worse every year. It's astonishing how many unknowns there are in this disease.

bix6 6 days ago||
I believe these cheaper devices are not very accurate ie accuracy range of 20% which is a fairly wide window. I’ve also heard there are many things that can impact your glucose even with the same meal like time of day, exercise, stress, sleep, etc. So if you actually want to find the patterns you’d need the expensive CGM over many months.
friendzis 6 days ago||
Does not really matter. You are interested in the trend, not absolute numbers, anyway, which, aside from having some "propagation delay", tracks blood glucose pretty well.
geor9e 5 days ago|||
It's not cheaper. And it has the best accuracy on the market. It's identical hardware and accuracy to the Dexcom G7, but different firmware settings to disable calibrations and extend session time. $100/mo for Stelo is about the same as the copay insured diabetics pay for Dexcom G7.
loremm 6 days ago|||
Is that true? I have no perspective but it's relied on by diabetics and if since they can't regulate it themselves, if the readings are off and they gave themselves insulin, they would know it is wrong. Maybe the OTC ones is different than the diabetic one but I didn't think so
djur 6 days ago|||
Stelo is basically just a consumer packaged version of the Dexcom G6, and in both cases they warn you to use a finger stick to verify unexpected readings. But finger sticks can be really inaccurate, too. For many diabetics it's not a life-or-death matter (only 1 in 4 type 2 patients end up using insulin), and the important thing is the trend over time.

I've personally found my CGM to be really useful in understanding the effect of diet, sleep, stress, etc. on my blood glucose, like the OP says, but you definitely get some weird readings sometimes. Yesterday a new unit told me that my blood glucose dropped below 70 for 2 hours. It definitely didn't! After a while it got itself straightened out in time to scold me for eating some corn chips.

nmehner 6 days ago||||
As a diabetic having alarms is the most important thing. Measurements are not that accurate (neither is the finger prick method: If sometimes get a difference of 20% comparing two measurements from both hands). But also the "ok" range of 3.8 mmol/L to 10 mmol/L is quite large and levels can rise/drop 20% in minutes. So it is still quite helpful.

With the CGM there is also an additional delay of about 15 minutes in the measurements. Mostly you want to be triggered when something strange happens and then you do a manual measurement to confirm.

A false alarm of low blood sugar is annoying, but it is a lot better than collapsing. You can relax a lot more if you know you will get an alarm.

bix6 6 days ago||||
Most T1Ds I know use a CGM now as they are much more accurate than they used to be. But they are expensive so insurance generally covers for T1D but not T2D. You can always double check with a finger stick though as that uses blood instead of interstitial fluid. My friend uses a Tslim which uses a CGM to adjust her insulin automatically.
privatelypublic 6 days ago||||
They're not any different. CGM's have issues- sometimes need to be calibrated against a finger stick (officially, they always need to be)

In the end though- it's still a bit of fungal extract painted onto an electrode, and an ADC that reads the value every so often. Like any other glucose monitor.

guerrilla 6 days ago|||
It doesn't need to be accurate, just consistent.
utopcell 6 days ago||
> accuracy range of 20% which is a fairly wide window

what backs this factoid?

bix6 6 days ago||
I’m having a hard time finding a proper comparison table but the top end CGM systems now seem to be around 8% MARD. This study is for BGMS but it shows a range of 2% to 20%: https://pmc.ncbi.nlm.nih.gov/articles/PMC9445334/
utopcell 6 days ago||
I share the author's enthusiasm about GCM devices. I am also finding that I need to change the over-patch long before the 15-day window because it gets messed up. I've found these [1] quite useful.

[1] https://www.amazon.com/dp/B0C4PKMJTN

imjonse 6 days ago||
The author does not seem to go into details, so I am curious what actually surprising conclusions can be drawn from wearing one of these devices?

Croissants and muffins being unhealthy should be no surprise. I am more interested in findings like food that gets a bad rap being not that unhealthy and supposedly healthy food being bad.

Llamamoe 6 days ago||
Pizza is much more nutritionally complete than you'd think, especially if it has meat(or beans, for some reason), the only real problem is people eat SO MUCH at a time.

People also refuse to understand that juice is basically sugar water with some extra flavor, vitamins, and antioxidants that don't change how unhealthy it is for you.

White rice is basically pure carbs with barely any nutrients.

Fastfood is heavily processed but often contains enough vegetables, meat, etc to not be that bad all things told.

hombre_fatal 5 days ago|||
> White rice is basically pure carbs with barely any nutrients.

You should fact check your intuitions about nutrition on cronometer.com.

2 cups of cooked white rice have 17% of the days nutrients for 20% (400) of the calories (2000cal/day). 47% of the day's iron, 33% of the day's folate. 20-30% of almost every B-vitamin. 25% copper, 65% manganese, 43% selenium, 14% of the day's zinc.

Also look at 500g of boiled potato. Someone in this thread called it pure carbs. Ok, pure carbs that give you 27% of the day's nutrients for just 18% of the day's calories? That's a great deal.

Llamamoe 5 days ago||
Other than folate and B12, the B vitamins are the most common nutrients, they're not really a point in rice's favor. And other than manganese, the other figures you quote are MUCH higher than the sources I'm looking at. Are you sure you're not looking at enriched rice, or an unusually nutrient-rich strain? Because rice absolutely is the least nutritive staple crop of the ones commonly consumed in the first world.
petesergeant 6 days ago|||
> White rice is basically pure carbs with barely any nutrients.

I am reasonably sure carbohydrates are nutrients.

jaggs 6 days ago||
One of the more interesting findings is the impact of combining different food intakes at the same time. It can have a significant effect in lowering spikes.
tptacek 6 days ago||
In a couple of cases, meals that I thought would be fairly healthy (or at least not terrible) were pretty terrible. There'll be some things that I'll avoid eating more than I had before.

Someone chime in with what they think these might be! Should I be eating less broccoli?

yegle 6 days ago|
King's Hawaiian Roll.

It doesn't taste like it contains a lot of sugars, at least not as sweet as other desserts like a cake. But two rolls (weight wise, very small amount) would send my glucose to sky high.

dbbljack 6 days ago||
if you don't need alerts for extreme high/low, i don't see the value of cgm monitoring... starch/grain/sugar spikes insulin, protein gives gentle raise within 3-5 hours, fat does next to nothing and does in around 7-9 hours. mixing a bunch of fibre/fat/protein into your starch and sugar makes the insulin spike less intense...

what are you guys learning about your super special non diabetic bodies that you can't learn with a $5 book of glycemic indices or a casual afternoon reading basic diabetes dieting advice?

tinyoli 6 days ago||
A bit an older post with more data on the topic: https://medium.com/better-humans/measuring-blood-sugar-as-a-...

TL;DR:

As a healthy, non-diabetic adult I wore a Continuous Glucose Monitor (CGM) to measure my blood sugar for two weeks

The sensor was convenient to use and painless to apply, and was barely noticeable during the two weeks it was on my arm.

In analyzing my blood sugar levels, I learned a lot about my body’s response to different foods and exercise; I could identify some foods that spike my glucose.

Two weeks is too short to make detailed improvements to my nutrition in order to stabilise glucose levels — further monitor and experimentation will be needed.

martind81 6 days ago||
What CGM device would you recommend for a first try?
stkhlm 6 days ago|
Which ever you can get from Dexcom or Abbott. They're pretty good all of them.

Dexcom Stelo is probably the easiest to get a hold of, and the one talked about in the article too.

mulle_nat 6 days ago|
People should get on the bike and start cycling for real (like burn 200W an hour). Their perception of glucose will flip 100%. Suddenly glucose is like the fuel to your body, that you can't cram enough into. Which means white bread in the morning, croissants (and coca cola with sugar) will be your friends. Quite frankly a much better lifestyle.
painted 6 days ago|
until you realize the sugar is also bad for your teeth, for example
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