Dr. Casey Means

Non-diabetic individuals, when you have a CGM on, are going into the diabetic range and the pre-diabetic range a fairly significant amount.

And we would never know that if you weren't actually tracking like a movie of the glucose.

So glycemic variability, area under the curve, those are two things.

Another really interesting thing you can know from a CGM is Don effect.

So Don effect is...

basically a term in the literature for how high your glucose rises right when you wake up in the morning.

I don't know if you noticed this when you were wearing a CGM, but some people notice that the second they wake up, their glucose jumps up 5, 10, 20, 30 points.

What's happening here is that the cortisol awakening response to actually get you to wake up and get out of bed, that cortisol can cause you to dump a bunch of glucose from your liver because it's basically saying stress hormone, cortisol, we got to get up.

We need glucose to fuel the muscles.

Let's dump a little glucose.

So it's normal.

But what the research shows is that magnitude of Don effect is correlated with

insulin resistance.

So the more the dawn effect you're getting, I think it can signal maybe the more stress you're under, the more cortisol you have floating around, how big your cortisol awakening response is.

But also if you imagine if you're dumping all that glucose from your liver and your cells aren't taking it up well because you're insulin resistant, that response, that dawn effect is going to be higher.

I don't have the numbers right in front of me, but typically I would want to see a dawn effect, I think, of like less than 10 points.

So you wake up and you may very well see a rise.

This is absence of any food yet.

And you do not want to see that going up 20, 30, 40 points.

Some people see a little bump again with caffeine in the morning because it's more cortisol.