Should You Throw Your CGMs Away? What PTs Need to Know About Continuous Glucose Monitors.

 The TLDR:

• A new study by Hengist et al. (including Kevin Hall) investigated the reliability of continuous glucose monitors (CGMs) in adults without diabetes across four different dietary patterns.
• The study found a weak to moderate correlation between CGM readings and specific diets, with significant inter-individual and intra-individual variability in glucose responses to the same meals.
• The authors suggest that factors beyond diet, such as environment, hydration, and activity, likely contribute to the variability observed in CGM readings.

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Transcript: Hello everyone, Dr. Wells here from San Augustine Beach. Beautiful day here. Got a new study here from Hengist et al. One of the et als is actually Kevin Hall, one of my favorite nutrition researchers. The title is Imprecision Nutrition. Inter-individual variability of glucose responses to duplicate presented meals in adults without diabetes.

It's a mouthful, but basically they're looking at continuous glucose monitors in adults with varied diets and seeing how those diets impact their glucose. It's important because I know certainly in my physical therapy practice, I've seen a lot of my clients wanting to use CGMs, those continuous glucose monitors. You may have seen them, especially patients that have diabetes, they may wear them and it's becoming more popular in those that don't have diabetes.

Overall, I have not been a big proponent of them because I see there's so much variability within diets and a lot of the early studies that showed how reliable those studies were, or those devices were, often looked at like one food item presented, like a muffin or an egg or something like that. And that's not how we eat. Typically we eat a lot of varied foods. So what I like about this study is that it looks at meals and particularly four different diets.

The overall sample size was only 30, so it's small, but they didn't have diabetes like I mentioned before. The cool thing though is they looked at almost 1,189 different responses to four diets. Effectively, one was like a high-protein diet, another one was a predominantly plant-based diet. So it was nice to see some variability within the meals and it wasn't just like a high-sugar meal or a high-protein meal. And they used the patients or the subjects as their own controls, which was nice. What they found was basically there was a weak to moderate correlation of the glucose monitor and the specific diet. In other words, like the glucose monitor was able to accurately predict their glucose around 45% of the time. And there was a pretty wide range, anywhere from minus 29 to positive 32 milligrams per deciliter in glucose variability. So that's a pretty wide range.

And what they found was this variability was with the same person in the same diet often. So in other words, if I eat like a predominantly plant-based diet and then have my glucose measured afterwards and it was let's say 300, I could have that same exact meal maybe the next day and it would be possibly 330, right? Or 270. So there was pretty wide range of variability. And so what the authors suggested was that there was a lot of other factors at play with these continuous glucose monitors. There's the environment, there's water intake, there's also activity afterwards. So we know, at least I know, and we teach this in our courses and we talk about it quite a bit, is that when you've eaten, sometimes exercising after you've eaten helps to reduce that glucose spike as well. So that was one factor they didn't consider with this, even though this was an inpatient study. So it was done in a hospital. So the control, internal validity and controls are very high.

So anyhow, if you like this, check out our courses online. They're a great board-approved continuing education courses for physical therapists and hope you sign up soon and like and subscribe. Thanks. Bye.