Dr. Casey Means

So I think that's just fascinating to see that.

So looking what that ultimately the metric that we call that is area under the curve.

You want a low area under the curve, AUC, after a glucose spike.

So you want to spike and come down quickly.

If you shade the area under the curve, it's a small amount.

If you go up and then trail off for two to three hours, that's going to be a lot of shading under that curve.

And high AUC is associated with insulin resistance, basically.

Another thing that you can see is...

essentially glycemic variability.

And glycemic variability, GV, is a metric of how spiky your curves are.

Fasting paper out of Michael Schneider's lab at Stanford in 2018 called Glucotypes Reveal New Patterns of Glucose Dysregulation

totally landmark study but basically they put continuous glucose monitors on non-diabetic individuals who by standard criteria of diabetes do not have diabetes and he showed that on a cgm a continuous glucose monitor

You have these low variability people that are pretty much flat throughout the day with little teeny, little teeny rolling hills after their meals.

You have moderately spiky people, and then you have very spiky people who are going up, down, up, down, up, down, up, down.

When you correlate those different patterns of glycemic variability in non-diabetic people, you find that the spikier they are, the worse their biomarkers are metabolically across the board, insulin, triglycerides, et cetera.

So basically they're, they're showing signs through variability that

of underlying dysfunction that you would never know from a standard test.

Those are the people who I imagine are probably going to go on to develop diseases.

And yet, based on standard criteria, their doctor's telling them that they're fine, that they're all the same.

So he also showed in that study that