1/8 Continuous Glucose Monitors (CGM) and *type 2* diabetes - can they help?
A short thread...
Over the last 2 years I've found a 2-4 week opportunity for my patients to learn how their body reacts to different foods can be invaluable
But @NICEComms don't recommend in T2DM

A short thread...
Over the last 2 years I've found a 2-4 week opportunity for my patients to learn how their body reacts to different foods can be invaluable
But @NICEComms don't recommend in T2DM

2/8 CGMs have revolutionised monitoring of type 1 diabetes. Currently recommended by @NICEComms only for some *not all* with type 1 eg:
Frequent asymptomatic hypos >2x/week
Severe hypos >1x/yr
Loss of awareness of hypos
Very poor control
See
https://www.nice.org.uk/guidance/ng17/chapter/Recommendations#blood-glucose-management-2
Frequent asymptomatic hypos >2x/week
Severe hypos >1x/yr
Loss of awareness of hypos
Very poor control
See

3/8 My practice has now helped 92 people reverse their type 2 diabetes using dietary change; cutting out sugar + starchy carbs
It's not rocket
science, see my previous thread on how it can be done
https://twitter.com/DocRunner1/status/1202983490859470849?s=20
Here's our published research
https://nutrition.bmj.com/content/early/2020/11/02/bmjnph-2020-000072
It's not rocket


Here's our published research

https://nutrition.bmj.com/content/early/2020/11/02/bmjnph-2020-000072
4/8 The key to reversing type 2 diabetes is understanding which foods to avoid: which foods
your sugar + those that don't
This is almost impossible to know without real time feedback on the impact of different foods on sugar levels
(Technically CGMs read interstitial glucose)

This is almost impossible to know without real time feedback on the impact of different foods on sugar levels
(Technically CGMs read interstitial glucose)
5/8 The fab work of @segal_eran shows that generally sugars + starchy carbs (cereals, rice, bread, potatoes and pasta)
blood sugar but individuals vary greatly in their degree of response to foods
*You need to know what works/doesn't work for you*
See
https://twitter.com/DocRunner1/status/1277997266117234689?s=20

*You need to know what works/doesn't work for you*
See

6/8 I've found by lending CGMs to my patients with type 2 diabetes:
2-4 weeks alone gives enough info to revolutionise their understanding of how their diet impacts blood sugar
They can then decide their goals BUT NOW they have the knowledge, tools + motivation to achieve them
2-4 weeks alone gives enough info to revolutionise their understanding of how their diet impacts blood sugar
They can then decide their goals BUT NOW they have the knowledge, tools + motivation to achieve them
7/8 The cost of 1 or 2 CGM sensors (say £30-60) pales into insignificance when compared to the cost of medication for diabetes
My practice saves >£50k/year on diabetes drugs by supporting dietary/lifestyle change rather than jumping in with medication
https://nutrition.bmj.com/content/bmjnph/early/2020/11/02/bmjnph-2020-000072/F5.large.jpg
My practice saves >£50k/year on diabetes drugs by supporting dietary/lifestyle change rather than jumping in with medication
https://nutrition.bmj.com/content/bmjnph/early/2020/11/02/bmjnph-2020-000072/F5.large.jpg
8/8 So I'm interested in the thoughts of others about whether short term loan (2-4 weeks) of a CGM could help people with type 2 diabetes reverse or improve their condition
@Diabetescouk
ps No conflicts of interest to declare
I've never received £ from a pharmaceutical company
@Diabetescouk
ps No conflicts of interest to declare
I've never received £ from a pharmaceutical company