Lessons from the Ketoverse

Looking Under the Skin: The CGM Revolution

• Graham • Season 1 • Episode 6

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Have you ever wondered what's really happening inside your body when you eat certain foods? Stephen's journey with continuous glucose monitoring (CGM) technology reveals the profound insights these devices can provide—not just for those with diabetes, but for anyone seeking optimal health.

Stephen takes us through his transformative experience using a CGM for over a year while following ketogenic and carnivore diets. This small wearable device has completely changed his approach to managing type 2 diabetes, allowing him to lower his A1C from dangerously high levels to near-normal range without medication. The real-time glucose data provides immediate feedback on how different foods, stress levels, sleep quality, and exercise affect blood sugar—creating a personalized roadmap for health optimization.

Perhaps most eye-opening is Stephen's revelation about non-food factors that impact glucose levels. During one particularly stressful incident, he witnessed his glucose levels double within minutes—demonstrating how emotional stress can be as metabolically disruptive as poor food choices. Similarly, sleep disturbances often manifest as morning glucose spikes, while different exercise types produce unique glucose responses. The CGM makes these invisible processes visible and actionable.

For those following ketogenic or carnivore diets, a CGM validates dietary choices while identifying unexpected triggers. Stephen introduces the concept of "designer glucose"—using CGM data to create a completely personalized approach to food timing, exercise patterns, and stress management based on your unique physiological responses. While these devices were developed for diabetes management, they represent a powerful preventative tool that can help anyone avoid metabolic dysfunction before problems develop.

Ready to take control of your health with objective data rather than generic advice? Try using a CGM for even a short period to discover your body's unique responses and create a truly personalized approach to nutrition and lifestyle. Your body is constantly speaking to you—a CGM simply helps you listen more clearly.

Speaker 1:

Welcome to Lessons from the Keto-Verse. Join Stephen and Graham as they explore the keto lifestyle with tips, science and stories to boost your health. This podcast isn't medical advice. Consult your healthcare advisor for any health-related issues. Get ready to fuel your primal power.

Graham:

Thank you everyone for joining another episode of Lessons from the Keto-Verse. Today we are talking about continuous glucose monitors, or CGMs, and how can you use it towards building a healthier lifestyle. I'm going to start off by introducing Stephen. Stephen say hello, hello everyone. Thanks for joining us again.

Stephen:

We certainly appreciate your interest.

Graham:

All right, so let's get started what I'm going to do. Stephen has a ton of experience in this area, and so I'm going to be leaning heavily on Stephen's experience and expertise. He's been using a CGM for the past year and a bit, so he's had sort of an excellent data set to be able to share the results with and share the experience with the audience. To share the results with and share the experience with the audience. And I'll start off with sort of a large language model definition of what a continuous glucose monitor is, just to set the stage.

Graham:

So a continuous glucose monitor, or CGM, is a small wearable device that tracks your blood sugar, which is glucose levels, in real time, 24-7, by measuring glucose in the fluid under your skin. Unlike a traditional finger stick test where you're actually drawing blood, cgms provide ongoing data showing trends, spikes or drops in glucose levels, often through a smartphone app or receiver, so you can actually watch it almost real time. For people with type 2 diabetes, cgms offer insights into how food, exercise, stress or sleep affect glucose, helping them make informed choices to manage their health. Although a CGM tracks blood glucose, it can also provide insights into how your insulin is behaving. Insulin is produced by the pancreas, and this is in response to spikes in sugar, because sugar in our blood can be very dangerous for us. The cells in the pancreas release insulin into the bloodstream to regulate blood sugar levels by helping cells absorb glucose for energy or storage into those cells in the body.

Graham:

So again, we're going to be leaning on Stephen's experience and expertise here. I've got a couple of questions for him and let's see where the conversation goes. So question number one, stephen, for you, based on your experience, can you explain what a continuous glucose monitor is and how it differs from traditional finger stick testing for somebody with type 2 diabetes who's new to this technology?

Stephen:

Yeah, just to reiterate, a continuous glucose monitor, or what we short form into CGM, is a small wearable device. It's a disc that has a tiny needle that is injected into your skin and it tracks your blood sugar. Now, the way it differs from a traditional finger stick test yeah, go ahead. Sorry about that, no worries. So the way it differs from traditional finger stick testing is that when you wear a CGM, it is doing that monitoring and telling you with roughly a 15 minute delay how your sugar is doing, as opposed to the sometimes painful repetitive checking of your blood sugar that's required with the sticks. And the sticks are quite expensive and it's sometimes impractical. And it does. Actually, after you've used it on your finger several times, it starts to be quite uncomfortable because any pressure in that area can cause bleeding to resume and generally bruising and other issues. So it's not a very pleasant experience, whereas the CGM, you don't even really notice it. In fact it's so subtle you have to be careful you don't knock it off.

Graham:

Excellent. And so tell us, stephen, how can a CGM, or continuous glucose monitor, specifically help people with type 2 diabetes, particularly those following a ketogenic or carnivore diet? How can it help manage their blood glucose levels more effectively?

Stephen:

Well, one of the great benefits with the CGMs is because they are approximating what's happening in near real time. It gives you an opportunity to look at how your body is reacting to as you had highlighted earlier, to stress to the consumption of food, to lack of exercise or if, in fact, you're lifting weights, typically your sugar will actually go up because you're pulling, you're sending a signal to the body to actually flood your bloodstream with sugar so you can use it to actually lift weights. So, which is a physiological reaction which is very normal, what we want to avoid with the CGM and why it's so helpful, specifically for ketogenic and carnivore diets, where typically, typically, when you're on those more strict diets if I have been now for several months you will not see as much a spike initially as you would if you're consuming ultra-processed food or foods laden with sugar. So one of the great benefits for sure is that one. You should be reassured by the ketogenic and carnivore diet with your own body, because you'll see that it's quite stable when you consume food and you'll know right away, if you see a spike, that you know what it was that's caused it.

Stephen:

It may not be the food. It could be the stress associated or leading into that meal. It could be. If you're practicing, as I do, with intermittent fasting, sometimes you'll get a cortisol rise which is not measured by the CGM but will show up as a remarkable amount of sugar increase for what appears to be no apparent reason. You don't have food in your stomach and that sort of thing. So often that can be attributed to stress and you can sort of self-diagnose if you're in a stressful situation you will see it rise. So all of that helps you make more of an informed decision about how your lifestyle is being affected through the consumption of food or just in general. And that CGM is really like an electronic doctor that's walking around and advising you on exactly what your body is doing.

Graham:

Amazing and one of the things that was really eye-opening to me, because obviously, going down this journey, I started to understand which foods are more likely to cause a spike in blood sugar.

Graham:

You were literally watching which foods cause a spike, but after you know, I learned from you that actually stress and how good a sleep you get can actually have a big impact on your blood glucose levels as well. I think that's something really important for the listeners to take seriously, because if you have a very stressful life and you are not getting a great amount of sleep, then changing your eating lifestyle isn't necessarily going to get you across the finish line as well or as effectively as if you had your sleep and your stress levels within an acceptable range. An acceptable range and I wanted to jump on to given the fact that our podcast focus is on the ketogenic way of eating or low-carb, high-fat, how does a CGM provide insights into how dietary choices like keto or carnivore impact blood glucose in real time? So maybe you can mention some of the foods that cause unexpected glucose spikes that maybe people aren't totally aware of.

Stephen:

Certainly, Every person's body will react differently to foods outside of the more obvious ones. If you're consuming ultra-processed foods, if you're having anything with sugar it doesn't matter, by the way, whether the sugar is coming from a natural source or a source that is manufactured. So take high fructose corn syrup. You'll note in your CGM right away that there will be a massive and very quick onset of a sugar spike, which people generally don't realize, even if they're not diabetic, is very unhealthy. It's causing a metabolic process in your body that is actually quite damaging and can promote oxidative stress.

Stephen:

One of the things that any person should be trying to avoid, and particularly a diabetic, is these inherent spikes. Now there's strategies you can use around the dietary process that we've touched on before. So, for instance, if you're focusing more on keto rather than the strict carnivore, then you would go to an ancestral diet process that's more common to what we experienced over the last half century, and that is, you consume your salads, which will create almost a cushion to use a non-medical word a cushion in your stomach to slow the absorption rate of the foods that follow, Meaning that you start with your salads, then you add your proteins, then your high fats and if, for some reason, you are going to consume something that may be sweet, although it's good to limit the quantity of it, the safest way to reduce the likelihood and this can, according to the glucose goddess, can be upwards to 70% reduction in the potential spike by just simply practicing a method of consuming food the way I just described.

Graham:

So, Stephen, maybe you can take us back to a little over a year ago when you, you know, the day before you ever had actually tried CGM for the first time. Maybe you can help the audience understand what are some of the first steps someone with type 2 diabetes should take to start using a CGM, including any conversations you recommend they might have with their health care provider, if you believe that that's something that you would encourage.

Stephen:

Yeah. So with respect to the health care provider, naturally, if they write you a script, depending on your health care insurance, from your employer or from something, perhaps you're funding yourself. More often than not. If you're and I know it's the case in the US and Canada if you're in a situation where you require this because you're deemed a diabetic and usually it's three HA1Cs that are required, depending on the province and the country or the state, but generally if you have three and, based on our ratings, if you have three blood results that show that you're above 7.2, for instance, they're going to deem you as a diabetic. Really, anything between 6.6 and 7, they pretty much consider you a diabetic. Anything between 6.6 and 7, they pretty much consider you a diabetic. 6.0 to 6.5 or 6.1 to 6.5 is considered pre-diabetic. So generally, the determination is that in fact, you're a diabetic.

Stephen:

The CGM should be a natural conversation with your healthcare provider because it's engineered for type 2 diabetics. There are roughly two major manufacturers of these items that I'm aware of, and the one that I use is quite well known from Abbott Laboratories, and it was research that I did on my own. I had already had the media glucose testing with the sticks, which again, as I was earlier asked, caused quite a bit of discomfort. You're not overly encouraged about stabbing yourself with a needle to check your blood. There's some anxiety associated with that, for sure Whereas with the CGM one of the benefits you can see with your healthcare providers you can get on with your day and just do a quick check after a meal and when I say after a meal, you're going to see a rise in your sugar. It should normalize back to where it was after two hours. If you're to your earlier point, getting a good insulin response, it shouldn't prevail for three or four hours after. And the one thing that I find particularly beneficial is if I have eaten something, perhaps, that had hidden sugar that wasn't disclosed, I'll see it in my CGM, which gives me the option of going for a walk after that meal and managing it down.

Stephen:

I still believe the best way to naturally manage your sugar is to do something as simple as walk for 10 or 15 or 20 minutes, and the CGM is great for that because it'll actually show the decline of your sugar as you continue to exercise.

Stephen:

For instance, last night I jumped on my elliptical because my sugar showed insanely high ratings, and I wasn't entirely sure why, because I'd been fasting for most of the day and I believe there was a combination of factors, one of which was because I had been fasting and probably had an elevation in cortisol and that caused the first bit of food that I was eating to almost cause almost like an overreaction of my system.

Stephen:

So I then went and did approximately 50% more exercise than I normally would do on the elliptical, which was about three miles, and my sugar came back to normal. And one of the things I would advise too is that these are not perfect in terms of their technology, so it's always good to still have a proper stick glucose test so that you can verify that if the result you're getting from the CGM is in fact consistent with your meter, because obviously taking the blood sample gram is very conclusive to like 99%, whereas the CGMs at times can be off a little bit and certainly will lag a trend if your sugar is rising or dropping. So those are one of the things that you have to be conscientious about understanding when it comes to CGMs.

Graham:

Very good insight. I actually wasn't aware that the finger stick was the most accurate way of getting that data, so that's really good for myself and the listeners to know. So for listeners who are thinking about getting a CGM or maybe they're just starting out, how should they read and interpret the CGM data, like time and range or glucose trends, so that they can make informed decisions about their diet or lifestyle? How do they turn the data into knowledge and, hopefully, action?

Stephen:

Yeah, so very, very good point. When people are first starting out, there is a tendency and I'm certainly an example, and I had a male nurse explain, because this particular person had a lot of experience with his patients that had been using these CGMs and he said you know, one of the key things is not to become, as he described, neurotic about your research and analyzing it. I'm sure I'm way above the norm. I'll candidly admit that, because it's just a nature of my personality. I want to know what the food is doing to my body. I want to know in a particular situation, how, based on how I'm feeling in that moment, if it's reflected in my sugar, I'm rarely surprised. I can actually feel like yesterday when my sugar was in the 12s and things and rising. You know, I said to my wife I've got to get on the elliptical, I don't feel well, and so it started to present symptoms, Graham, that were consistent with almost like a flu. And it sounds counterintuitive In the absence of a CGM. If I was feeling that way, I would probably go and lie down, which is the worst thing I could have done, because then I'm not processing the sugar in my bloodstream. So the beauty of the CGM, in my opinion, is that it allows you to make a decision in near real time for what actually is happening to your body, Whereas, conversely, before I had a CGM, I either had to psych myself into using one of these sticks and checking my blood, which I think I'm probably at least a baseline norm of I wouldn't do it.

Stephen:

I'd only do it when I absolutely felt I needed to, and sometimes my wife would even say to me oh, when's the last time you checked your blood?

Stephen:

So sometimes the only time I found out that my sugar was elevated was the trend line for my A1C, which by then is too late because I've had these up and down spikes and done damage to my organs for 90 days.

Stephen:

So last night I caught this, understood it, did the analysis and all the data was recorded in my CGM for me to analyze. So when I ate, what I ate and all of this you put in manually, but it tabulates all this information and you can get great insight into, okay, well, I know tomorrow when I eat I have healthy meal that's dense and satiating, like the carnivore diet and the keto diet provides. Because if you and this is a really interesting example if you fast, and then the first thing you eat is McDonald's or something that we all know is not healthy, you will get a horrendously high spike and you will feel very unwell because you're not giving your body the nutrition it needs because of the fast. So sometimes the insulin reaction can be quite aggressive and although the CGM doesn't measure insulin, the knockdown effects of high sugar obviously can reflect information related to insulin that can be later tested in a lab, if you think that you're starting to redevelop insulin resistance, for example.

Graham:

Excellent. And so, stephen, what are some of the beginner mistakes that people might make with a, you know, with a CGM, and how can they avoid those potential mistakes? Or what kind of learnings can you provide to help people get the most accurate and useful data that they can actually do something about?

Stephen:

You know, it's really interesting because it's kind of over the course of the year, because I'm in the gym three, four times a week and even my doctor when I was diagnosed and my newest family doctor looking at me. I don't fit a stereotypical profile for a diabetic. I'm not overweight, in fact just the opposite. I'm not what they call skinny fat either. I don't consume a lot of alcohol and I drink water with lemon to deal with any potential fatty liver consequences. I see a naturopath. I have my blood work done on a regular basis. I don't fit the profile. And between walking and going to the gym I'm probably averaging somewhere between 30 to 70 minutes a day and the recommended amount is 70, I believe, 70 to 150 minutes a week. So I'm well above that. And just my lifestyle in the country as well. I do quite a bit of stuff outside when we're not overwhelmed with bugs, so again, I'm giving myself lots of opportunities to burn off calories and still I'm still a managed diabetic.

Stephen:

It begs the question well, how can this be and the CGM will give you evidence to support what it is exactly that's going on at the time. Are you stressed out? Are you sitting too much? Are you engaged in activities that perhaps are overworking your brain, but your body's idle, and so you're able to see. Well, you know what it's time for me to get up and walk around the house if the bugs are as bad as they are right now here, or do something on an exercise machine or row machine. I have both.

Stephen:

So you can generally look at this CGM as a means of indicating oh okay, well, this is how I avoid this particular spike, and I call it taking the head off the snake. If the snake is venomous and poisonous which is how I characterize diabetes by seeing that spike, I'm like oh yeah, okay, well, you know what. I'm going to take control of that by jumping on the elliptical and within 20, 25 minutes I'll see a change in my sugar because there's a 15 minute delay. So already with the first pedal or two, I'm working in the right direction. You just won't see it initially in the CGM results and soon enough, after 20, 25 minutes of light work on the elliptical or just a light walk, it's amazing how quickly your sugar will normalize after a meal or after a stressful situation.

Graham:

Yeah, I'm reminded of that every time I go for a walk. Now I can kind of hear you encouraging me along, knowing it's having an instant effect on my blood sugar levels and insulin response, which is very satisfying. So our audience includes active individuals, including some in the military. How can the CGM data help optimize exercise routines for better glucose control and are there differences in how exercise impacts glucose on a low-carb diet?

Stephen:

Yeah. So if we take the military as an example, I mean one of the advantages to using a CGM is, I would describe as preventative. I'm not entirely current. It's been a number of years since I was in the military. Whether or not what they call a medical classification will impact your file with the diagnosis of diabetes I'm not clear on that for Canada or the US, but let's presume that it's in your best interest to stay as healthy as you can. If you wish to stay in what they call your promotional window, meaning that you have the opportunity to move up the ranks, and that's likely going to be in question if you have any significant health concerns, you can end up with a medical category that prevents you from being promoted.

Stephen:

Generally, military people would be incentivized to be as healthy as possible, also by the nature of their work that they want to be at the very best, because the demands that are required in the military can be extreme at times, especially in our current world climate. So that would be one incentive. I think that most military people would align with. Most people who are in the military are task-centric and task-oriented and enjoy the ability to control or manage outcomes, especially as they relate to their own physical health. So certainly the CGM, they'll know through their exercise routines that they have better glucose control and certainly that particular types of exercise have different impacts on glucose, for instance.

Stephen:

And again I want to stress that there's nothing wrong with weight training. Just the opposite is quite good for you because you're building a metabolic resistance, you're building that agility in your system to be able to deal with different forms of stress. And again, this is acute stress on the muscles, which will cause sugar to go to the muscles, which will increase the amount of glucose that was resident in fat and push it the pancreas will push it into your bloodstream so you can use that energy to actually lift those weights. I mean, it's an important process, it's a natural process. What's more subtle and more appropriate for after meals is for an individual to go for a walk and help the body naturally process the glucose that's in the food. That's about the healthiest thing I've learned from using a CGM for me, and there would be no way for me to be able to state that if I didn't wear a CGM every day.

Graham:

Nice and let's move from exercise over to stress and sleep. We talked about this already, so we've already heard that stress and sleep we talked about this already, so we've already heard that stress and sleep can affect glucose levels. Can you explain how CGMs can help users understand these factors and manage them in the context of type 2 diabetes?

Stephen:

Yes, a great question. Even this morning I noticed that my sugar, probably from the night before when it was quite erratic again while I was fasting, and perhaps because sometimes we're affected. Incidentally, I want to mention, before getting directly to the question, for the benefit of of the listeners, that if you, if you eat perhaps less healthy to what your typical diet would be, on a call it this weekend, this on a Saturday on, you may not see much of an impact on Saturday, but you'll have a legacy effect. In Sunday and Monday You'll still be trying to get your sugar back under control because there'll be indices that will show up that are not consistent with what you've normally experienced. They will pop in there and you'll go wow, you know, my sugar seems really high and I haven't even eaten for the last six hours, or I fasted last night. So again, the CGM allows you to do that self-analysis, that self-diagnosis, and go okay, well, what is it that changed? Well, I didn't get much sleep. Okay, well, that's certainly a factor, because when we're overtired, it puts a load on our system and stresses us, and what's the consequence of that? It's cortisol. So when cortisol is released, it's absolutely going to cause an elevation in sugar. Why? Because that's what cortisol does.

Stephen:

Cortisol is a stress hormone, so cortisol tells the body which is appropriate when we are in stressful situations to again much like food is secrete more glucose into the body to use it. The problem with the stress hormone is we don't actually need it. So what happens is that elevated glucose sits in your bloodstream to no effect. It's not actually being used by anything. So if we took a simple example from an oversimplified example from the history of humanity, being chased by something that was threatening and we didn't have the means to protect ourselves other than running, then it was very appropriate for our body to release cortisol and fire neurons and shoot high glucose into our system, because it was our fight or flight response. This is the difference between the parasympathetic and sympathetic body systems. So when we're in an elevated state of stress that is chronic, we're always in that fight and flight response, which is highly, highly, highly oxidative for our bodies and can lead to things like diabetes and cancer. We all know that.

Stephen:

There's plenty of research material that the readers can look into on their own to discover what the root causes are. The quality of our food is a root cause. So what we're really trying to do with the CGM is going okay. Here's my baseline. These are the things I've done, whether good, bad or indifferent in terms of food, in terms of stress, in terms of sleep and, specifically, as we talk about sleep and stress, what really what we're saying is what can I do now that I know that it's probably just as bad as a piece of pizza?

Stephen:

Do, now that I know that it's probably just as bad as a piece of pizza, if that's what you had, what can I do about it? Well, in my case, it's mindfulness. So you used a great example earlier, graham. You said hey, steve, I go for a walk and I think about you and I practice grounding and I think about being in a state of grace and thinking about as I walk through the woods, I'm grounding, I'm in nature, and so forth.

Stephen:

These are all very important things, whether it's Japan and in the Far East, all the way to the West. They've proven time and time again that being out in nature and getting fresh air, as our parents used to describe it, is very, very important to resetting our metabolic rate, and you will see that in the CGM. You'll see, as you're walking and doing these things and relaxing, that your sugar will drop. You'll see, too, when you're wearing a CGM. I had an example where I was building a timber frame structure with a contractor and he slipped and threw a 200 and some pound beam at me and I had to catch it on a 14 foot ladder, which was just way too much weight, and I saw my baseline sugar double. In 20 minutes. I went from 6.1 to 12.8. And that was a great example, a terrifying one, but a great example of just how responsive our bodies are to highly stressful situations.

Graham:

Wow, that could have ended up much worse, so I'm glad it didn't. You had actually touched on this a little bit earlier. When you're doing a finger prick test, you're getting an instant and up-to-date result. But you kind of touched on the fact that, because CGMs measure interstitial fluid, which is the fluid just below the skin, not blood glucose directly, which this can cause slight delays or maybe even discrepancies in the results. How should users account for this when making decisions around food and when to eat?

Stephen:

Yes, it's so important because I had that precise example this morning. Here I was, I fasted, I saw a glucose rise yesterday, didn't feel well enough to even eat to combat it, so I just decided to ride it out and fast, because at least I get the benefit of antophagy, because I would have been fasting for about 17 to 20 hours by the time I ate this morning, and I'm an early riser. So by the time I ate today I was already up for about four hours and or possibly five. And when I ate I ate the usual carnivore, which was bacon and eggs and high fat Greek yogurt, and I didn't see any rise actually in my sugar at all. In fact it went the opposite way, which is astounding because my sugar was trending to eight and change again, and which is high even with the was trending to eight and change again, which is high even with the Don phenomena, and the Don phenomena is the natural process of your body when it switches from be as high as mine was evidence with the CGM.

Stephen:

So I alternate between fasting, extended fastings and in the traditional definition that's more than 24 hours.

Stephen:

But I don't do that because I'm too cortisol sensitive, so I'll do a fasting for 12 hours and 12 hours. So, for instance, I'll have breakfast and then I won't eat again until seven o'clock at night, and now that means that I'm taking a 12, 12 hour break on food. In between I won't get into a state of antophagy unless I'm doing more of the 18 to 20 hour range minimum, so I kind of alternate. So yesterday would have been an example of taking advantage of the ontophagy, which is essentially cleaning out, call it, the dysfunctional cells that are in the body, giving the body a chance to go into a pure healing mode because it's not worried about trying to digest food and deal with that sort of thing. So you know, this was a very productive overall result that I was able to, in 24 hours, go from dangerously high sugar in my opinion and a doctor's opinion to something far more moderate and to turn it into an advantage, all because of the data I was getting from the CGM.

Graham:

Very, interesting data, stephen. The ketogenic diet is low in carbohydrate foods. By design, carbs turn into glucose and therefore somebody on a carnivore or ketogenic diet should have results of lower blood sugar levels over time, over time. Now that you've had a CGM for over a year and you've been doing the keto carnivore lifestyle for, I think, even longer than that, are there unique benefits or challenges when using CGMs alongside a ketogenic or carnivore diet, particularly for people who have type 2 diabetes?

Stephen:

I don't believe there is. I think, a different way that I would approach answering that question is to use myself as an example. When my sugar was out of control, it exacerbated my anxiety and caused even more cortisol to be released because of my PTSD, and so it was a vicious cycle, and so my IBS would react, which would cause further anxiety, especially if I was traveling somewhere where you know. All of a sudden I required a restroom. You know that's a difficult thing if you're on the road and traveling in an area that you're not familiar, or if you're sitting in an airport or you're about to get on a plane, so you can imagine how difficult that can be. What I found is extraordinary over the last year of this healing process, I've had diabetes or diagnosed with diabetes since I was 50. I'm now 58. They say that you probably have had diabetes for 10 or 15 years before it's actually diagnosed, only because the symptoms are usually what draw people like me into the doctor to say, hey, I'm not feeling well and I seem to be packing on weight, and that's when they discover you've got a glucose problem or you're having issues with healing. It's taking longer for abrasions or cuts to heal, or you're getting neuropathy in your feet. So all of these things are leading to this metabolic dysfunction and the consequences that it's having on your organs and when your skin and nerves are certainly a component of that. So I think generally, whether it's keto or whether it's carnivore, or if you're wanting to see if cutting out ultra processed foods and moving towards keto, carnivore for you, you're going to see encouraging results in your sugar, at least a trend line to suggest that notwithstanding. You know if you have a particularly stressful day, you could throw out you know, the food part of it per se. But still better outcome than you would have if you were continuing, as I was, to try to find your way with ignorance and only relying on your A1C results every 90 days, which are stressful in themselves, to find out whether you're doing better.

Stephen:

And again, my objective always, graham, was to make sure that I could find a natural solution, because trying the drugs that they initially put me on made me even more sick, made my IBS worse, increased my anxiety, destroyed my quality of life. I had a difficult time going out to even go get groceries unless I had not eaten for at least 16, 17 or 18 hours like literally, so that there was nothing in my system that could cause a IBS flare up. So that's not a way to live your life and I'm grateful that you know companies like Abbott Laboratories have created these things because I can make these adjustments and continue to build on the knowledge. And it captures all that information for you. So it will show you days in range, show percentage in range, it will show your trending A1C and, yes, as you had asked earlier, sometimes those are wrong. I've got my real blood test results and sometimes they've been actually lower in reality to the CGM A1C rating and other times it's been slightly higher.

Stephen:

So one of the important things I want to touch on is where you wear the CGM. They were engineered to be worn in the fatty tissue at the back of the arm. The problem for some of us and I'm certainly in dialogue with Abbott Laboratories on a regular basis about this I don't have fat there on my body because I've been lifting weights since I was 16. I have to put it in other areas of my body that it has not actually been proven to work Like, for instance, I have it now in what people would call the love handles.

Stephen:

I have it in that area of my body, because even behind my shoulder blades I ran out of fatty tissue and I was bending the needles all the time and that's quite painful.

Stephen:

It's like a fish hug and you end up rolling over on it in the middle of the night and it will wake you because it's and when the needle's bent, it doesn't register your blood sugar properly. So now you're getting bad data into your system. So and I know both manufacturers that we use in North America are really good at replacing them when that happens and they also have a tendency to fall off. So one of the things that athletes can use is the Nexcare Tegaderm, which is like a clear bandage that you can put over the CGM for the two-week period. And I would strongly advise people to not put the CGM in the same spot, graham, because you will get a skin irritation with the Tegaderm, especially because you're covering up the skin for two weeks and your skin needs to breathe. So it's best to if you can, move it to the opposite side of the body in the same location, if that's an area where you're getting pretty good rating.

Graham:

Really good to know. I actually didn't know that either. If that's an area where you're getting pretty good rate, Really good to know. I actually didn't know that either. So, thinking about our listeners, sort of you know, some people at home might be thinking I'm looking to put my type 2 diabetes in remission, or I'm not quite diabetic, maybe I'm pre-diabetic, or maybe it's just going in that direction, which was the scenario that I was in a couple of years ago. So you know, people just wanting to avoid getting that diagnosis altogether through diet. How can a CGM support long-term glucose monitoring and help track progress towards reducing medication or achieving remission? Based on your more than a year's experience, yeah, I'm sorry.

Stephen:

I'm going to have to ask you to repeat that. For some reason I wasn't able to hear that.

Graham:

Yeah, absolutely so. Listeners at home that are looking to put their type 2 diabetes in remission. Or they are pre-diabetic and don't want to get that diagnosis, or they're on their way to being pre-diabetic and they want to avoid that diagnosis altogether through diet. How can a CGM support long-term glucose monitoring and help track progress towards reducing medication or achieving that remission?

Stephen:

Well, I think there's two elements to that. I think first and foremost is the short term. I've had a few friends that say well, you know, I'd be interested to see what my body's doing. These things are pretty expensive. They're $120 Canadian for just two weeks. That seems like a lot of money. And I ask well, what do you think dialysis costs? And what value do you put on your eyesight? Because I have a friend who's losing his eyesight from diabetes and has needles injected directly into the eyeballs to prevent going blind. So, and how much do you like your toes? I mean, for me my situation may be different than others economically, but there are a lot of things I can cut out of my life, including a tank of gas to have the CGM if that's what it came down to Because, again, the impact on the quality of life, I think, necessitates having it.

Stephen:

As far as the longer term, of course, you know, here I am on a trend line over the course of the last year where I'm essentially ignored by the diabetic clinic here locally, which is a good thing. It's the club you want to be kicked out of, because my sugars, without any medication, are either non-diabetic or pre-diabetic, and the last time my sugar was out of control, I was in the high nines and that was my A1c. So my A1c is now hovering between 5.8 and 6.2, which is considering the fact that I was a full-blown diabetic and I'm now doing it naturally. I mean literally what we're describing here today. The worst thing is going to happen to you, diabetic or not, is you're going to get healthier and you're going to see the results as you age. That will show up in different ways in terms of your quality of life, the energy that you have during the day, you know.

Stephen:

It naturally leads to the question in terms of long-term and I kind of refer to Dr Addy on this is how do you define healthspan and how do you define lifespan? I mean, if the last 20 years of your life are suffering as a uncontrolled diabetic that's highly medicated, with all the consequential side effects, is that what you want? Enjoy what it is you believe you enjoy, until you get to a situation like me where even the things you thought you enjoy are literally making you extremely sick. So that's certainly the path I took out of ignorance. But the whole point of what you and I are trying to do is to say to people okay, maybe you're not a diabetic, but maybe it wouldn't hurt to have your sugar monitored for a couple of weeks and just see how food affects you and just cut that food out.

Stephen:

Maybe you can't eat mangoes. Maybe you get a bad reaction from watermelon, despite its fiber density. You may be the kind of person that can't eat many blueberries, or strawberries react in a strange way to your sugar, regardless of stacking, as they call it, which was what we described earlier, with salad, protein, high fat and then fruit. So these are all insights that you can engineer. I call it kind of designer glucose Graham that you can design a solution that is more holistic with respect to your physical health, your mental health, brain fog, well-being and just general health, in a way that puts you in the driver's seat, because you have the information long before your doctor would ever have it. You're dealing with only a 15-minute delay and I'm highly incentivized, just by the nature of my personality, to be in a state of constant improvement or continuous improvement, and this constant glucose meter gives me the information I need to minimize the consequential short-term spikes and the very consequential long-term impacts of having these daily spikes in food unknowingly affect my health, as it had over the last number of years.

Graham:

Love the term designer glucose. Stephen, I've got an idea for a t-shirt for you in the future. It sums it up so nicely, and so the ketogenic lifestyle, like any lifestyle change, can be trying at times. How can a CGM, how can CGM data, empower listeners to stay motivated with their ketogenic or carnivore diet and make sustainable lifestyle changes?

Stephen:

in your experience, I think it has to be a little bit of self-reflection again and determining well, what is your mission statement? What are you trying to achieve? And to be kind to yourself through that process. You're going to have setbacks. There are times when you have friends over, as I did on the weekend, where you may indulge a little more than normal, you may stay up a little later. You may put more stress on your body as a result.

Stephen:

None of us are saying that we need to lock ourselves away in a closet. No one is saying, oh, you can't go on a cruise now and have a piece of cake, but you're going to watch what that piece of cake does and maybe next time you decide it's not worth it because maybe you feel like you have the flu. And I actually want to jump on that for a second. And I'm touching wood to make sure that, metaphorically or otherwise, that I don't invite something in. You know, they say words are. We call words spelling because the cast spells.

Stephen:

But I have been without any form of illness for this entire period. I've been wearing a CGM and I don't think that's coincidental. I think it's by design, because my body is not being redirected. I'm not doing things to my body that compromise my immune system and so, consequently, despite the flus that went around over the winter, despite the colds that are going around now, the gastrointestinal issues that I used to get when I used to get sick, pre-diagnosed diabetic, or even as a diabetic, I would get it way, way worse than anyone else in the family, because I was immunocompromised.

Stephen:

Now that I have these things under control, that's not the case, and so I'm repairing my body and creating a call it a preventative shield by the nature of my lifestyle, and I find that highly inspiring. I find it and hence the whole reason why we're sharing this with other people, because I believe I'm not alone in this when you have the contrast of where you know you literally have to know where washrooms are around, a visit for groceries, because your sensitivity is that severe to where you don't even think about it anymore, which is what most of us take for granted until we can't. And I'm quite confident that one of the terrible things about diabetes and having high elevated sugar is, at a certain point, it's so much sugar in your bloodstream, your body just goes. We're going to let go of everything, we're just going to get rid of it, and it'll come. Obviously they know that it comes through urine, but I also think you know it'll cause these the consequences of IBS as well.

Graham:

Such a good point around. The fact that you're, on a daily basis, putting yourself in the most optimal state means that your body's immune system, potentially, is also in the most optimal state, and you've seen firsthand results of that. We've talked in previous podcasts about the fact that the one you know, maybe unintended consequence to all this and I think we'll talk about this more in a future podcast but one of the unintended consequences to this is we just don't get as sick as we used to or at all, and that is that's another club that you do want to get kicked out of is the getting sick all the time club. So, stephen, last couple of questions here Are CGMs only for type two diabetics or can anyone benefit from this amazing tool regardless of whether they have that diagnosis or not?

Stephen:

Yeah. So before I answer that question, I will say I am not paid, endorsed or endorsing any particular CGM. I can only speak to the one that I use. So I say this with the highest degree of transparency. I am not on anyone's payroll, but I know for a fact because I'm probably on a friendly list to the call center for Abbott Laboratories because I'm always asking similar questions.

Stephen:

Well, how come you guys don't promote this for other, like just healthy people, as a preventative measure, or as I'm suggesting? I even suggested to you you know that, graham. I said, hey, let me give you one of mine, wear it for a couple of weeks and see what happens. And I know you're open to that, but lots of people are not. And what I find, sometimes even, is that people are reluctant to get the information that they would need because they're afraid of what they're going to find out. And the problem with that is that we know from people with cancer and other really serious illnesses that more often than not they've avoided going to the doctor for an extended period until they have an incident.

Stephen:

And I was no different. I mean, I didn't know there was anything wrong with me until they told me I was a diabetic. I was going to the gym, I was walking, I had a sure busy lifestyle with, at the time, much younger kids, but I mean I was doing what I thought everybody else was doing. It's just that my body reacted differently and I had a legacy of other traumas that probably made me more sensitive to it than others. So, yeah, I'm a strong advocate for people to wear these things. I wished I had this 10 years ago because I probably wouldn't have continued intermittently and unknowingly do damage to my body.

Stephen:

Do I believe that I've healed my body entirely? I don't know, but I certainly know I'm, in a way, better state than I would be otherwise. So, yes, I'm an advocate for people trying it just to see what would happen. They're not painful. It's way more painful pricking your finger, you know, six times a day to see what your glucose is doing. Then slap something on that you barely feel going in and you just have to be careful you don't knock it off and you have to be careful that you don't bend it. And it takes a little bit to get used to the app and, yes, you have to input your information into it and all that.

Stephen:

And be diligent about it. Yes sir, yes sir.

Graham:

I think I lost internet connection on my side, so why don't we try doing that question over again? I do apologize because that was a fantastic answer, but I know it stopped recording like three quarters of it. Diabetics, or, in your opinion, can anyone benefit, regardless of whether they have a diagnosis or not? And I think it's important to note that neither one of us are sponsored by any CGM companies. We're not on anybody's payroll. You have an experience with one of those tools or one of the brands, but, in your opinion, can anyone benefit, regardless of whether they have that type 2 diabetic diagnosis or not?

Stephen:

Well, a lot of these companies, or the two that I know of, I'm not quite sure. Why do not necessarily promote healthy people in using these devices? Because they haven't been tested on people that are healthy. But I don't understand why you, as an individual that isn't necessarily looking for a lab result, wouldn't at least try it to see how food affects you, to see how stress affects you. I mean, we do tests for sleep apnea and we have studies where they study you while you sleep.

Stephen:

I see this no differently so you can follow your regular pattern and lifestyle and see what it is you need to change in order to course correct and avoid the kind of illnesses that I have and often result with other people, and I've actually suggested this to people who say, hey look, I will. I even suggested this to you. I'll give you one of these try for two weeks and the worst that's going to happen is you'll be more aware of what your body is doing with the food that you eat and you'll be more mindful of stressors throughout your day. That affect your sugar now.

Stephen:

Maybe you can do something about it. Maybe you don't need to wear it after that. Maybe you get another one in six months and see if the same things are happening. But if you use it to correct your diet and to correct your lifestyle, then what's the worst thing that's going to happen? You're going to be healthier.

Graham:

Amazing and this is the last question, but I think it's an important one you had mentioned a couple of downsides to the CGM, because we obviously have talked about a lot of the upsides and, like anything, there's going to be some downsides. One you mentioned cost potentially, and that's if insurance isn't covering it, and the potential skin issues with actually having to press this into the slightly below the skin. Are there any other downsides that you've experienced, or did we cover them with those two?

Stephen:

Well, there's one other thing that I just thought of, because the app is tied to your phone. One of the things that some people can find annoying is if you forget your phone and leave it somewhere and you walk away and you're too far from the connection between the cgm and your phone, you'll lose that data, and so it can be a little bit annoying sometimes, because then you have to rescan the sensor with your phone the back of your phone and it'll make a little beep noise saying it's recaptured the data, but you may lose a bit of data, but most people.

Stephen:

I don't think it's a huge lifestyle impact because most people walk around with their phones anyway, so you're just a little bit more conscious of that, if you're wanting true data as clean as possible. You know true data as clean as possible.

Graham:

That's, I think, the first time that I've heard our phone addiction is actually a net benefit, first time that I've heard our phone addiction is actually a net benefit. That might just be the only one, but I think you know one of the things that I have learned a lot from you, stephen, and just you know other podcasters talking about the benefits of CGMs is it's about taking your health matters into your own hands. You now have the control versus leaving it up to somebody else and unfortunately I think I can speak for Stephen confidently and myself it's critical to take these matters into your own hands. That's how Stephen and I finally ended up getting the results, the real results that we experienced. When we relied on other people, when we relied on mainstream advice that, you know, may or may not be conflicted we weren't getting the results that we needed.

Graham:

Once we dug into our results in my case, I dug into the mechanisms behind what causes high A1C and some of the other blood markers that I was experiencing. You did that. You also took matters into your own hands by, you know, taking control over the CGM data and looking at it yourself. You ended up being your you know your best healthcare worker and at the end of the day, everyone in the healthcare system are looking to do the right thing. They are motivated in the right way, in my opinion, but they are, at the end of the day, secondary support compared to you taking those health care matters into your own hands.

Graham:

And I know because Stephen and I were able to do that we saw a much different version of ourselves on the other side and continue to do so and really encourage others to take control, because, at the end of the day, you do have some choices, you do have some options and hopefully this podcast gives you some tips and tricks on. You know what those options are to take more control over your health. Stephen, excellent summary of you. Know how people can use a CGM and how they can use it for their advantage. Is there anything else you want to share before we end the podcast?

Stephen:

No, I think we covered everything, graham, and I really appreciate the opportunity. I think you did a great summation there at the end, I couldn't have said it better.

Graham:

Amazing. Well, thank you everyone listening to another episode of Lessons from the Keto-Verse. We hope you enjoyed the episode and learned a little bit. You know, feel free to drop some comments. If you have any questions for Stephen on his experience, he'd be more than happy to respond. Thanks everybody. Thank you, stephen, and we will talk to everybody next time.

Speaker 1:

Thanks for tuning into Lessons from the Keto-Verse. Join Stephen and Graham next time for more keto tips and stories to fuel your health. Subscribe, share and let's keep the keto vibes going.