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

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

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 rocketscience, 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

4/8 The key to reversing type 2 diabetes is understanding which foods to avoid: which foodsyour 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)

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

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

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

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