As the Ancient Greek saying goes, know thyself. And there’s no better way to know your metabolic health than to connect yourself to a CGM. A Continuous Glucose Monitor is a device you attach to your body. Once connected it shows you 24/7 via your smart phone, exactly what the glucose levels in your body are doing. You can see in real time what happens when you exercise, when you sleep, when you sit, and most importantly, how different foods you eat effect your blood sugar levels. I’m doing a 30 Day N=1 Experiment with my Dexcom G6 CGM in an effort to better understand and optimize my own health. Keep in mind this experiment is all in the context of a low carb or extremely low carb ketogenic diet.
5. Your Quality of Sleep Effects Your Glucose Levels
It’s been one week since I connected myself to the Dexcom G6. In that time I have had some good and poor sleep. It’s still early in my experiment, but it does appear when my sleep quality is poor my glucose tends to trend and stay higher throughout the day. It’s still all between the range of 4.0mmol/L and 7.0mmol/L, but when I have poor sleep (under 6 hours) my day time average tends to sit around 6mmol/L. Yet with quality sleep, 8 hours, asleep by 10:30PM for example, it’s more consistently in the 5mmol/L range. It seems my quality of sleep directly impacts my insulin sensitivity, glucose response to food and my average fasting glucose levels. My post postprandial increase in blood glucose also seems more noticeable even eating an extremely low carb ketogenic diet.
4. A Carnivore Diet isn’t Necessarily Ketogenic
This past year I’ve been experimenting with a Carnivore Diet. By spot testing my ketones, it seemed that eating a higher protein, lower fat, low carbohydrate carnivorous diet had me in Nutritional Ketosis. Logic being that my body would be burning my own body fat for energy (while I’m at a calorie deficit) which would in turn generate ketones to make up the difference in my daily metabolic energy requirements. Interestingly enough, that does not seem to be the case in my scenario. I may have been generating mild ketones at different points in the day (0.5 mmol/L BHB), I was never in true continuous day after day nutritional ketosis.
I’m a huge fan of protein and believe every one needs to eat more of it, but my higher protein 2 Meals a Day (75 – 100g of protein per meal), were hindering me from achieving nutritional ketosis. With protein heavy meals my body either starts generating glucose from excess protein or releasing too much glucagon for me to maintain ketosis. Either way, it decreases my levels of BHB and puts me back in glycolysis (sugar burner mode). There is still debate on whether gluconeogenisis is supply or demand driven, but I can say in my personal context, that after about 50g of protein per meal, it’s going to increase my glucose enough to potentially push me out of ketosis.
3. The Dawn Effect of Glucose
The dawn phenomenon, also called the dawn effect, is used to describe an early-morning increase in blood glucose — usually between 2 a.m. and 8 a.m in individuals with diabetes and pre-diabetes. Personally, I may have never been diagnosed with pre-diabetes, but if you’ve seen pictures from me in 2015 you can tell that I was very overweight actually borderline obese based on my BMI. Let’s just say I was not feeling well and was potentially pre-diabetic. With the CGM it seems that every morning between 6:00AM and 10:00AM my blood glucose rises about 1 – 2mmol/L. Usually during a good nights sleep I will get down to 4.4 – 4.7mmol/L, but by the time 8 – 10:00AM rolls around and I’m still fasted, it comes up to about 6.0 – 7.0 mmol/L and on poor sleep days it’s worse. This makes me wonder if that’s the reason I’m never hungry for breakfast in the morning. Coffee and a little heavy cream seems to keep me satiated until the afternoon. Makes me also wonder if I should be training at the gym in the morning instead of evening…
2. My Estimated HBA1C is 5.3%
For people without diabetes, the normal range for the hemoglobin A1c level is between 4% and 5.6%. As I’ve always wondered what my HBA1C levels are, it has been very enlightening to actually see it for myself by tracking my blood glucose. My main goal for wearing this CGM for the next 30 days is to actually decrease my HBA1C. I intend on doing it through exercise, an extremely strict ketogenic diet (200g fat, 100g protein, under 20g carbs [no net carbs] daily), fat fasting and a 7 day water/electrolyte fast. I’ll comment more on this in my 30 day post. My HBA1C numbers may not be as interesting for some people, but I’m glad to know that if I was ever diabetic, according to my current numbers, I am no longer.
1. Eating Late at Night is a Terrible Idea
I can say with confidence that my body’s ability to process food in the evening is significantly worse than during the day. Maybe that means I’m more insulin resistant at night, I’m not sure. There were two days in which I consumed a meal at around 8:00 – 9:00 PM (I normally go to sleep around 10:30 PM). Both of these evening meal times were when I hit the highest numbers on my CGM (7mmol/L+ range). These meals were not any higher in carbohydrates than my other meals, yet they had a significantly stronger impact on my blood glucose then when I ate the meal in the afternoon. For context, I’m consuming only ribeyes, butter, heavy cream, cheese, eggs, and bacon… although I may be compelled to eat an avocado.
*Bonus: I Sit WAY Too Much
During this experiment I’m tracking my blood glucose, food, fasting, and activity every hour. I’m also spot checking my blood BHB Ketone levels. As I’m tracking my activity I’ve noticed that I’m always sitting. Outside of playing soccer once a week, going to the gym a few times and the occasional walk, I am constantly sitting down. On the couch, at the computer, at the table, and driving in my car. So I’m going to start implementing strategies to keep me on my feet, walking and moving more everyday. I’m also going to also implement a standing desk, turn my fit bit back on to get me to stand up more and walk around every 50 minutes for 10.
The main take away’s I’ve come to realize from this 7 Day N=1 experiment is that it’s extremely important to track your blood sugars if you truly want to know your metabolic status and optimize for longevity health. You might think something is going on that is entirely different than what is actually happening inside your body, data doesn’t lie. Realizing that I was never actually in nutritional ketosis while doing carnivore is making me rethink the formulation of my carnivore diet. Amber O’Hearn may be onto something with her KetoAF. I will continue testing my BHB levels with my Precision Neo during the 30 day experiment.
Stay tuned for further updates over the next month.
– Shane Lamotte