I would find that more detrimental in the long term. So, thank you so much for that, by the way. This is the idea of metabolic flexibility. So, that's one benefit. Melanie Avalon: Awesome, so many exciting things. Regulates hormones and neurotransmitters. Nutrisense is the company, the app that is providing the prescription, the access to the CGM, and then their app syncs with your device and has a ton of information that you can learn about yourself. The brain, the pancreas, which can put out insulin. It's probably a natural adaptation. If people are eating fruit and they're taking a lot of digestive enzymes with it, would that potentially make it more sugary then? And if you're ever curious about your glucose values, you just have to scan your phone over the device, and then you can see an updated view of your glucose. I'm grateful to work with those types of customers every day. Some of the links are affiliate links, which simply means, if you decide to purchase through the links, I may receive a small percentage which can help make my blog, podcasts, and work possible. Whereas in long-term ketogenic person, you're no longer pumping out as much insulin, so your body's increasing glucose on its own. Powerfully lowers stress and increases alpha waves in the brain. You really have to figure out an experiment what one is going to work best for you because it's not as simple as everyone needs to follow keto, or everyone needs to follow low fat, high carb. You can put it on at home, you don't need your physician or anybody else to put it on for you. I just want to thank you so much for all that you're doing. The program does not include the cost of sensor insertion or removal, which is determined by the healthcare provider but typically runs $200-300 for insertion and $300-400 for removal and reinsertion. Let's say two hours later, compared to a person that only goes up to 120, but they stay there for five hours, like between those two situations, is one preferred? Available instantly. As you mentioned, I am a registered dietitian, and I started my career working in hospitals, particularly ICUs. Listeners, I cannot recommend enough at the very least doing a two-week trial and just getting a clear picture of everything. And that's why it's important to have real people there as well, so we can talk through that if anyone's confused. Which, by the way, when did you guys start it officially? After becoming frustrated with the traditional healthcare system, she helped start the company NutriSense where she is now the Director of Nutrition. Oh no... shit has hit the fan! Kara Collier: It does vary. Kara Collier: Yeah, in the US, the FDA has the legal authority to regulate both drugs and also medical devices. It was a little bit off, but it was fine. She has a background in clinical nutrition, nutrition technology, and entrepreneurship. I don't want to have a big carb meal every once in a while,” then it's probably not a big deal at all. Dr. Kirk Parsley – Sleep Q&A Part 1: Tackling Insomnia, Optimal Sleep Hours, Counting Sheep, Sleep Tracking, Alarm Clocks, Sleep Cycles, Men Vs Women, Sex And Sleep, Kids’ Sleep, Alcohol, And More! If for whatever reason you're waking up in the middle of the night, listeners, you briefly turn your phone off of airplane mode just to scan it. I think it would be a good idea. Optimise digestive function and efficiency. If it's high, but not too high, but for a longer period of time. Kara Collier: Yeah, they definitely have been testing out all types of devices. This has been studied, and it tends to only have on average about a 50% sensitivity. I've done three FreeStyle Libres now, and I have been checking them against my own blood glucose-- Sorry, everything's [unintelligible [00:15:18] my head, blood glucose monitor. As FDA said, the CGMs are medical devices, so they regulate them and they say it needs to have a prescription, where something like a glucometer that you're actually drawing some blood from your finger is not a medical device, according to the FDA, so you can buy it over the counter. It all happens through the in-app chat. The one I put on a few days ago, it actually seems to be high by about 20 to 30. In those moments, you might have glucose excursions that are way, way higher than somebody who doesn't have physiological insulin resistance. Essentially, what that says to me is there's this group of people who respond really well to one, and then there's a subset of that that doesn't. I as well did not anticipate-- like you said, people think, “Oh, I don't need to talk to a dietician.” But the communication has just been so-- I mean, I don't know if I can say names. Melanie Avalon: I know, I was like, “This is the best moment ever.” I was happy to see because, like I said, I was researching insulin, and it seems that below, I don't know what your optimal level would be. How can we perfect accuracy to the best that we can? Why some women, it does reach dangerous levels and potentially can make them prediabetic or have issues with diabetes later, and some women are fine? That's really what it comes down to. Your complete guide to Paleo and Intermittent Fasting! Above 180 is when that is an abnormal response where glucose is getting higher than it should in a healthy metabolic system, even to a high sugar load. I put it on, I was like, “Wait, what?” You don't even feel it. Those changes in glucose, the trends, the shifts in your values, that is very precise because they're FDA regulated. I'm assuming your insulin sensitivity, things like that. Synergizes with any other stimulant and cholinergic. Do you know why? Kara Collier: Yeah. These statements have not been evaluated by the FDA. Then the body is raising its endogenous glucose production. There's not one cause of insulin resistant, there's not one solution, there's not one diet. I felt it couldn't make the difference I was looking for in that system. The Eversense® Continuous Glucose Monitoring (CGM) System is indicated for continually measuring glucose levels in persons age 18 and older with diabetes for up to 90 days. Kara Collier: Yeah. For anemia, wouldn't they be dying sooner so you might see a lower HbA1c when really--, Melanie Avalon: Of course, in anemia, they might think their A1c is fine, but there actually might be problems because the blood cells are--. Melanie Avalon: I also wonder if there's a context of higher glucose in a fasted state, which presumably would probably have a lot of anti -inflammatory signals going on with that, compared to that exact same blood glucose level in a fed state, which probably looks very different as far as sirtuins and all of that. As you noted, when you wear a CGM, you realize that your glucose fluctuates quite a bit. Increases physical performance and possess unique nootropic properties. So, it's a gradual rise or gradual fall, but you don't see these little nuance fluctuations. This is where all the research associated with elevated fasting glucose values. So, it amplifies a problem you might have. I don't want to feel I can't eat carbs ever. The brain is typically sending these messages. If it's me, personally, I don't want to see the physiological insulin resistance because I really want to be metabolically flexible and be able to use both fuels. The Fasting-Mimicking Diet: Eat Your Way Through A Long Fast? And that's one of our big picture goals down the road is to keep integrating with other data that gives you a good holistic view of your metabolic health. In other countries, in Europe, in Canada, in Australia, you can get these devices over the counter, you don't need a prescription. I don't know if you've ever noticed this, but sometimes I'll take a value on one finger versus the other finger and they're different. If you can see it's off, you want to be able to adjust the values, but the app that comes with the Libre does not allow you to do that. The last interview I did was with Dr. Benjamin Bikman who wrote a new book all about insulin resistance, and it's just really mind-blowing. I will put links to all of that in the show notes. 100 TIMES MORE EFFECTIVE WITH STATE-OF-THE-ART ULTRAHEPA. But the glucometers themselves have a little bit of variability. So, that's the standard use case. How much did my glucose rise or fall after a meal? But if you think about physiology, we tend-- in a healthy system, so not somebody who's showing metabolic dysfunction or insulin resistance, we start to see people shift from that post-absorptive state where you're metabolizing food, you're stimulating all these different pathways, you tend to shift to more of the fasting pathways at about three to five hours after eating. I got a lot of questions about interpreting the data because a lot of people in my group actually said they did have access to a FreeStyle Libre through their doctor, and they were wanting to know what was the difference of having the nuisance app. I've been telling you guys about it. A continuous glucose monitoring system (CGMS) is designed to offer a continuous readout of the glucose levels in the tissue fluid, and in order for the device to work, you will insert a sensor beneath your skin, similar to that of a needle stick, according to Diabetes Self-Management. Again, it's really hard to generalize an exact amount of carbohydrates and when that would be best to consume because I really can't emphasize enough how different we all are, and that's exactly why I think this data is so important, because everybody responds a little bit differently. Melanie Avalon: I love this. There's this idea of glucotoxicity, so a glucose value in the bloodstream at a certain amount at any point in time, can be damaging to our endothelial cells. You don't forget that that data is there. We used to think that it did. So, if you have one spike to 140, every once in a while, that is no big deal. I will say the research is not in-depth. It's easy for an MD to assess, yes or no, abnormal, not abnormal, where if we just put a CGM on somebody and were like, “Go live your normal life for two weeks and then we'll look at your results.” That require somebody to really specialize in interpreting and understanding like the daily nuances and CGM data, and I just have a feeling that that won't be part of like a standard diagnostic panel because it just doesn't seem realistic. We usually recommend-- if you have a glucometer at home, if you have something to double-check, doing it on that second day in the morning when you're fasted to see how it compares. Obviously, it's a little bit more expensive, because you're not committing at all. I've just realized, wow, one marker at this one time with a blood draw, or a prick or a blood glucose monitor is so different from seeing it, how it changes 24/7. So, I have a CGM update. It's not just something you're going to jump to a diet for two weeks and then jump to something else. So, it's a good place to start if you're not sure. We can all do better by eating more whole foods and avoiding anything processed. Just like if you took a finger prick from the blood value in your hip versus your finger, they're not going to perfectly match either, because you're just drawing it from different areas. Kara Collier: Yeah, absolutely. How do they all talk to each other? If you have bigger goals as well, where it's like you maybe really want to lose weight, or you want to get your glucose values down, maybe you already know they're in pre-diabetic levels, or you have these bigger picture goals, it takes more than two weeks to realistically make progress on those things. Melanie Avalon: So, it's in the context of eating, not the fasting, or it does happen in the fasting as well? That's a problem as opposed to something at 5% is normal amount of glycation on a hemoglobin molecule. This page contains fees and charges for Dietitian and Nutritionist services in our Canberra and Perth practice locations. So, using those muscles, building those muscles up is really helpful for this as well. Kara Collier: Yeah, that's a good question. So, you're not having those symptoms, and that's normal. Ketones and direct-to-consumer labs that you can order from the app, and then the information is there. Optimises all hormones associated with longevity and performance. Essentially, the alcohol is interfering with the glucose homeostasis because the liver is prioritizing alcohol detoxification. Save my name, email, and website in this browser for the next time I comment. And then peripheral insulin sensitivity decreases as well, because you're not needing to use it. By, October 22, 2020 / And then you can retest, and the results come back normal. We're trying to build an app that helps the person who doesn't necessarily have diabetes and is really focused on these other goals make use of this data. I am so grateful for a wonderful woman named and I just learned how to say her name correctly, Kara Collier, for founding this amazing company called Nutrisense. Kara Collier (Nutrisense): Continuous Glucose Monitoring (CGM), Blood Glucose Vs HbA1c, Blood Sugar Toxicity, Reactive Hypoglycemia, Gestational Diabetes, Low Carb Vs Low Fat Diets, Insulin Resistance, And More! How does it work? Because you guys do offer a lot of different plans for that. While they're sleeping, it's that 110, 115. Your body's constantly trying to raise it if you need to fuel an exercise, or lower it if you're pumping out too much, or if you just ate a bunch of carbohydrates or something. I just don't know if you have any thoughts on all of that. 1:11:15 - breastfeeding effect on insulin resistance, 1:17:15 - fructosamine vs hbA1c vs albumen, 1:19:05 - reactive Hypoglycemia vs fasted hypoglycemia, 1:25:15 - Digestive Enzymes effect on glucose. I'm actually interviewing Levels tomorrow. 24:05 - INSIDE TRACKER: Get The Blood And DNA Tests You Need To Be Testing, Personalized Dietary Recommendations, An Online Portal To Analyze Your Bloodwork, Find Out Your True "Inner Age," And More! So, your glucose might spike more in your bloodstream like 15 minutes after eating, and it might show up in the interstitial fluid 30 minutes after eating because there's a little bit of a lag time due to that diffusion. We start to see that risk increase in those higher fasting glucose values. What was your journey like that led you to where you are today with having this interest and monitoring blood glucose, CGM, and forming the company, Nutrisense? Interestingly, again, going back to the idea of traditional medicine versus optimal health, nobody-- World Health Organization, American Diabetes Association, they do not recognize peak glucose value as something of significance. All of these conditions can be linked back to our metabolic health. A lot of times, especially if you're stimulating ketones, or if you're eating a lot of protein, you might be also stimulating a little glucagon with that. You're burning calories, your body is in a high metabolic demand. Drug free intervention to improve sleep, in the modern world. I believe this is an unfortunate thing, and this is specific in the USA. So, there can be reactive or functional, which is typically after a meal. Your glucose can decrease a little, so that is not hypoglycemia. Do you think it's a matter of just personal biology or diet during pregnancy? Kara, thank you so much for being here. That's the thing where if the physiological insulin resistance, if you're never giving your body carbohydrates, we decrease our insulin sensitivity at a cellular level, because we don't need it as much, and so that's physiological insulin resistance, where if you're giving your body a lot of carbs all the time, your cells become really insulin sensitive because it knows it needs to really pull on that pathway, because it's having to use it a lot. There's actually really interesting research to show that a healthy metabolic system is constantly fluctuating all day, like up and down 5 to 10 points. How can they be made available now? So, the sensors, and this is across the board. And then after eating, and I guess this would probably depend massively on what you're eating. We have a chatbot on our website, and somebody will be able to send you pricing and set you up with that. by Gary Scheiner | May 6, 2015. But also, it tends to be pretty unreliable, again, it's making that assumption that a red blood cell, which has the hemoglobin lasts for 90 days, but there are a lot of situations and conditions that alter our red blood cell life. Average glucose value overall is closer to about 100, which is very healthy and normal. Anemia, which is very common, is going to alter how long your red blood cell lives. If you think about it just from adaptive ability standpoint, the body's like, “Well, I need to make sure I always have glucose coming in, and you're not giving it to me from food. When I really felt like, lot of those people didn't need to be there. Sue, for example, says, can she get a how-to interpret readings. May support feelings of relaxation, without causing sedation. Learn more at diabetescare.abbott. There's Abbott, who makes the FreeStyle Libre that we use. So, only about 50% of the time, is it truly matching with your average glucose values when they're measuring it with more sophisticated, like clinical research measures. So, if you're A1c is 5.8%, that's technically prediabetes, but you do a lot of things right, then I'm going to take that with a grain of salt, and I want to see CGM data, I want to see all these other metrics that assess metabolic health because it could just be a false negative, and it could just say, like maybe you have anemia, or maybe you're following a ketogenic diet. Melanie Avalon: Quick question about that. If you feel like you're in a good place there, then it might just be this natural adaptation. So, that's a long-winded answer about maximum glucose value, why we want to stay below 140 most of the time. And that doesn't mean you're insulin resistant, it just means that you had a lot of sugar that you just consumed. Kara Collier: Yeah, it's a three-month reflection. 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