Dr. Ben Bikman

And so the glucose-centric paradigm has us miss the earliest –

metabolic canary in the coal mine, which is insulin.

So the sooner our paradigm with modern medicine includes insulin, then the earlier we can detect these metabolic problems in a person who's progressing towards type 2 diabetes.

But also it changes the treatment protocol too, because not to go off on a tangent too soon off the very first question here, but

The longer we ignore the insulin, the more the clinician may be tempted to push the insulin up even higher by giving, say, a type 2 diabetic an insulin therapy.

Now they're pushing the insulin from high to super physiological.

all in an effort to control the glucose, little realizing that in the process you are actually killing them faster.

Because so much of what kills the type 2 diabetic is not the hyperglycemia.

It's the hyperinsulinemia and the insulin resistance.

Yeah, right.

Yeah.

So to answer the question very directly, I'm an enormous advocate of CGM use.

The more we democratize access to CGMs, I think the better we put individuals in a position to be their own coach.

you know they don't need to have someone like me or you

berating them and telling them to change their habits and eat a little better when you see how your body's responding to what you're eating in the cgm enables that you end up making your own lifestyle changes so with the with the use of the cgm fasting glucose isn't going to be the best indicator it's going to be the dynamic glucose so if you've eaten a carbohydrate heavy meal or or a simple carbohydrate i shouldn't call it a big meal but a simple carbohydrate like two pieces of bread

If your glucose levels aren't back down to normal by about two hours, that suggests a problem.

So in my mind, the greatest utility of the CGM is to monitor the dynamic changes rather than the static, where am I at every morning.

That has less value.

The dynamic changes are what has value.

But beyond the use of the CGM, if a person's curious about their insulin resistance,