Thread by @DocRunner1

I’ve been “lent” a #cgm (continuous glucose monitor) so I’m fascinated to see what I can learn over the next 2 wks about how my life affects my sugar
I’m NOT diabetic or pre-diabetic and plan to monitor the impact of different foods and activities
@grahamsphillips @Diabetescouk

1st observation is that application of #cgm is painless and adherence to skin is secure
Surprised my ave glucose is 6.3mmol/l
3 x glucose by finger prick finds #cgm over-reads by 0.9-1.5mmol/l (have allowed for 10min delay in #cgm but assumes sticks accurate) 🤔
@DrScottMurray

Effect of exercise: 50min hard interval session running in the pinewoods shoots my glucose up to 9.8 from 5.9 just before I set off. In <1 hour it’s back to 5.9
Conclusion: Exercise puts my sugar up. Surprised at this but @lowcarbGP noticed the same

#cgm is easy to use and works very well with using my iPhone7 rather than the sensor. Keep my phone with me so it’s handy. Also works with Android 5 (or later)
Applying the #cgm to my arm over my triceps means it’s less likely to be knocked off than if stuck on the outside of arm

Yesterday’s spike of 8.8mmol/l caused by eating 2 sweet Victoria plums 😳
However, big bowl of braised lentils with shredded duck for dinner didn’t cause a spike and neither did this morning’s breakfast of kefir, full fat Greek yogurt with strawberries, raspberries and mixed nuts

Will be experimenting over the next 12 days with various foods
Will try beer and @lowcarbGP suggests muesli
Reasonable suggestions and comments welcome
2 large glasses of red wine last night DIDN’T ⬆️ my blood sugar 👍😜
Putting my body on the line so you don’t have too 😉

@lowcarbGP At request of @Gaylegerro had my 1st @McDonaldsUK in 20 yrs
Hate adding to their profits. Ordered BigMac, large fries, choc milkshake + apple pie
Sugar peaked at a whopping 12.3 !😯
Feeling sleepy😴
Testing Alpen tomorrow
Looking forward to ending this..
@Food_campaignUK @HughFW

It gets worse. A 2nd glucose spike after my “tasty” @McDonaldsUK lunch.
Will leave it 30 years until my next visit.
Seriously though, the “restaurant” was packed with kids and families. What are we doing to the health of the population? 🤔

After yesterday’s double spike (“M” for McDonald’s), relieved that home-made Thai curry with salmon, lots of butternut squash and coconut milk (no rice, obvs) didn’t register. Always wondered if squash (technically a fruit I think, not a legume??) was ok for me - seems it is 👍

.@lowcarbGP suggests 120g Alpen for breakfast
Glucose high of 9.0 but ⬆️ for 2 hrs😯
Perhaps not a surprise as contains 66g carbs (of which sugars are 21g) per 100g (21% sugar!!!)
My good sized bowl had 25g (over 6 teaspoons!) sugar
Will compare with No Added Sugar Alpen tomorrow

@lowcarbGP Huge omelette for lunch at 12:45pm. 3 big eggs, 150g ham, 60g cheddar cheese and 2 fermented cucumbers (excellent source of vitamin K2). Delighted to see my sugars actually drop over next 2 hours
This is in stark contrast to the Alpen muesli spike this a.m.
Trying grapes next....

@lowcarbGP A request of @katiarcher I had 250g of grapes this afternoon.
@lowcarbGP calls grapes "little packets of sugar"
Caused my glucose to rise to 8mmol/l but not as high as I would have thought

@lowcarbGP @katiarcher Swam 3km this evening (7pm) in open water. Hard, sustained effort. Delighted Freestyle Libre survived under my wetsuit 👍
Suprised to see only a very small ⬆️ in glucose then a ⬇️
A very different picture from running high intensity intervals 2 days ago which caused a big spike

@lowcarbGP @katiarcher Tomorrow will try No Added Sugar Alpen for breakfast to see if my sugar spikes any less than with the Original version I ate today
Original Alpen has 66g carbs (21g sugar)/100g. No added sugar Alpen has 63g carbs (16g sugar) - not much less
Both have wheat, oats and raisins

@lowcarbGP @katiarcher Comparison of Original Alpen muesli v No Added Sugar Alpen:
Both ⬆️ my blood sugar for 2 hours. A slightly lower spike with No Added Sugar Alpen but not much and it tastes like cardboard 🤢
Clearly, neither is good for me
Decided to avoid both (forever!)
Sourdough bread up next

@lowcarbGP @katiarcher Several of you asked me to try sourdough bread.
Turns out it causes a similar glucose spike to muesli. A real shame as sourdough is the one high carb thing I miss (crave!) most
Beginning to see @lowcarbGP is correct (again!):

COMPLEX STARCHY CARBS ⬆️GLUCOSE JUST AS MUCH AS SUGAR

For anyone interested in how different types of breads compare, @lowcarbGP has produced a great infographic, endorsed by NICE comparing the sugariness of different breads

phcuk.org/wp-content/upl…

@lowcarbGP Tonight's enormous dinner: Stir fried peppers, kale + fab chicken from @herbfed with guacamole and grated cheddar. Also 2 glasses red wine + coffee with cream.
No impact on my blood sugar at all

CONCLUSION: I can eat fantastic, tasty, real food without putting my glucose up👍

@lowcarbGP @herbfed Several people wondered if consuming more fat with cereal reduces the sugar spike
Same breakfast on 2 days:
On left with 200ml semi-skimmed milk
On right with 200ml single cream
CONCLUSION: Increasing the fat content does seem to reduce spike in glucose
This really surprises me🤔

@lowcarbGP @herbfed 2 similar exercise sessions - high intensity intervals

Running on L
Swimming on R
Both at max effort

CONCLUSION: Unlike running, swimming does not seem to cause a spike in my glucose. I wonder why 🤔
Can you explain @ProfTimNoakes ?
Perhaps running is more stressful on the body

@lowcarbGP @herbfed @ProfTimNoakes Asked by somone if I could see the impact of an apple.
It caused a small spike to 8mmol/l - less than the spike of 8.8mmol/l after 2 sweet Victoria plums

Conclusion: Some fruit is sugary

Interestingly, strawberries and raspberries don't ⬆️ my sugar at all

@lowcarbGP @herbfed @ProfTimNoakes This fits with the infographics of @lowcarbGP which are endorsed by @NICEComms

phcuk.org/wp-content/upl…

@lowcarbGP @herbfed @ProfTimNoakes @NICEComms Dinner: Low carb bacon + mushroom risotto (no rice), diced celeriac, soffritto (onion, carrot and celery), mascarpone + parmesan, 2 🍷then coffee + cream and 30g of 85% dark chocolate 😋
SUGARS DROPPING !!!

Root vegetables are fairly high glycaemic load but celeriac seems OK👍

@lowcarbGP @herbfed @ProfTimNoakes @NICEComms @KatieCaldesi @JennyNutrition @paleowithmrsp Many requests for me to try porridge. Had nothing on it (yuk) to remove variables. It took my glucose from 5.1 to just over 8mmol/l with a sustained rise for 2 hours
Conclusion: Porridge puts my sugars up in a similar way to muesli.
Perhaps not a surprise as both made with grains

@lowcarbGP @herbfed @ProfTimNoakes @NICEComms @KatieCaldesi @JennyNutrition @paleowithmrsp Great infographic from @lowcarbGP shows why my blood sugar went up.
150 ml of oat porridge causes a rise in blood sugar the same as 4.4 teaspoons of sugar 😳
Will be experimenting with pasta including pasta chilled overnight.
Putting my body on the line so you don't have to 😉

@lowcarbGP @herbfed @ProfTimNoakes @NICEComms @KatieCaldesi @JennyNutrition @paleowithmrsp Pasta carbonara for lunch: 120g dried pasta, ham, egg + parmesan
Caused very high and prolonged spike in my blood sugar

Have been asked to test the impact of chilling cooked pasta overnight then reheating, so I've cooked 120g of pasta, now chilling for an identical meal tomorrow

@lowcarbGP @herbfed @ProfTimNoakes @NICEComms @KatieCaldesi @JennyNutrition @paleowithmrsp Once again, it's not a surprise to see such a high spike in blood glucose as we know that pasta has a high Glycaemic Load (see GI of spaghetti in the table). 180g spaghetti has the same effect as consuming 6.6 teaspoons of sugar
phcuk.org/wp-content/upl…

@lowcarbGP @herbfed @ProfTimNoakes @NICEComms @KatieCaldesi @JennyNutrition @paleowithmrsp I've been wondering about the effect of chickpeas on my blood sugar. After a tasty meal of courgette + chickpea stew on a bed of kale at 18:45, it turns out that chickpeas don't cause my sugar to rise. Yeah!
I love chickpeas and use them a lot so very relieved 😀👍
@HelenHeat0n

@lowcarbGP @herbfed @ProfTimNoakes @NICEComms @KatieCaldesi @JennyNutrition @paleowithmrsp @HelenHeat0n 2 different runs but same distance, duration and terrain:

On Left, high intensity intervals at max effort
On Right, a social run with friends

Bigger spike in blood glucose with high intensity work out. Perhaps not surprising.
Presume it's a respone to ⬆️ adrenaline and cortisol

@lowcarbGP @herbfed @ProfTimNoakes @NICEComms @KatieCaldesi @JennyNutrition @paleowithmrsp @HelenHeat0n @johnsprackland @hayleylever Comparison of pasta

2 identical meals EXCEPT:

Bottom graph is pasta carbonara, 120g freshly cooked dried pasta
Top graph is 120g dried pasta, cooked, chilled overnight and reheated

CONCLUSION: Cooking, chilling then reheating does reduce the height of my glucose spike (a bit)

@lowcarbGP @herbfed @ProfTimNoakes @NICEComms @KatieCaldesi @JennyNutrition @paleowithmrsp @HelenHeat0n @johnsprackland @hayleylever @DrMichaelMosley @MrCaldesi @CassellCath Made from wheat, pasta is really starchy

I shouldn't be surprised that it put my sugars up
Starch (eg in potatoes, rice, wheat, oats) is made up of a simple string of glucose molecules "holding hands" and our bodies rapidly break it down into glucose

Here's a starch molecule:

@lowcarbGP @herbfed @ProfTimNoakes @NICEComms @KatieCaldesi @JennyNutrition @paleowithmrsp @HelenHeat0n @johnsprackland @hayleylever @DrMichaelMosley @MrCaldesi @CassellCath Dinner:
Bolognese made with high fat (20%) minced beef (butcher makes it specially for me), buffalo mozzarella, tomato salad with olive oil on a bed of steamed courgette

No rise in blood sugar at all

Meat hasn't put up my sugar: I've tested minced beef, ham/bacon, duck +chicken

@lowcarbGP @herbfed @ProfTimNoakes @NICEComms @KatieCaldesi @JennyNutrition @paleowithmrsp @HelenHeat0n @johnsprackland @hayleylever @DrMichaelMosley @MrCaldesi @CassellCath Early morning, life-enriching, 1 mile sea swim with Formby Sea Swimmers
Gorgeous day
Water temp 18℃
Tiny rise in blood sugar to 7.5mmol/l then quickly back to normal

Conclusion: Spending time in beautiful outdoor spaces is hugely important for my wellbeing👍

@lowcarbGP @herbfed @ProfTimNoakes @NICEComms @KatieCaldesi @JennyNutrition @paleowithmrsp @HelenHeat0n @johnsprackland @hayleylever @DrMichaelMosley @MrCaldesi @CassellCath My son's 21st so we kick off with 2 pina coladas (Malibu, coconut cream + pineapple juice, both of which cause a spike of 7.6mmol/l in my sugar
Sure the pineapple juice is the major cause as all fruit juices are very sugary, 200ml apple juice has aquivalent of 8.4 teaspoons sugar

@lowcarbGP @herbfed @ProfTimNoakes @NICEComms @KatieCaldesi @JennyNutrition @paleowithmrsp @HelenHeat0n @johnsprackland @hayleylever @DrMichaelMosley @MrCaldesi @CassellCath Deconstructed roast dinner
Roast pork, crackling, apple sauce (no sugar), broccoli, mashed carrot/swede + butter

Note: NO ROAST POTATOES!! Will cook some tomorrow to isolate the impact they would have had

Conclusion: Roast dinner doesn't affect my sugars IF I AVOID POTATOES

@lowcarbGP @herbfed @ProfTimNoakes @NICEComms @KatieCaldesi @JennyNutrition @paleowithmrsp @HelenHeat0n @johnsprackland @hayleylever @DrMichaelMosley @MrCaldesi @CassellCath Breakfast at 06:30, 200g full (10%) fat Greek yoghurt + rasperries scattered with almonds, pecans, hazelnuts, coconut, flax, pumpkin and chia seeds

No sugar spike at all!

Delicious and filling. Swam 2 miles and didn't feel hungry

NB You need to search for 10% fat greek yoghurt

@lowcarbGP @herbfed @ProfTimNoakes @NICEComms @KatieCaldesi @JennyNutrition @paleowithmrsp @HelenHeat0n @johnsprackland @hayleylever @DrMichaelMosley @MrCaldesi @CassellCath Just eaten 296g freshly roasted potatoes for lunch (doing this so you don't have to!!!) and sugars already beginning to rise. Watch this space....

@lowcarbGP @herbfed @ProfTimNoakes @NICEComms @KatieCaldesi @JennyNutrition @paleowithmrsp @HelenHeat0n @johnsprackland @hayleylever @DrMichaelMosley @MrCaldesi @CassellCath Deconstructed roast dinner. Graph on left (flat line) after full roast dinner WITHOUT roast potatoes and on right (spikes at 9.8mmol/l) after roast pototoes alone

Conclusion: I can enjoy a full roast dinner but I should avoid the roast potatoes

GRAPH OF THE MONTH:
This patient of mine does brilliantly with #LCHF but he is addicted to bread and potatoes. Every 1-2 years he falls off the wagon and his HbA1c shoots up
A brief chat at the surgery and he’s back on track (at least for another year of so!)

Dinner: meatballs made with fab mince from cattle reared on wild grassland by @TheHornedBeefCo 👍
Mashed carrot + swede with fresh tomato sauce

Conclusion: Again, meat doesn't seem to spike my sugar and neither does carrot + swede. A surprise to me as they're root vegetables

Drunk a can (330ml) of full sugar @CocaCola 40mins ago and my blood glucose is shooting up.
More soon.....

@CocaCola @HughFW @DrAseemMalhotra @ProfTimNoakes @drandyphung @CassellCath @lowcarbGP @realfoodrocksUK 330ml full sugar @CocaCola_GB ⬆️ my blood glucose to nearly 12mmol/l 😳
And I don't have diabetes - yet!

Anyone surprised? I'm not.

Many of my patients diagnosed with Type 2 diabetes were drinking lots of fizzy drinks 🤔

Will be drinking a can of @DietCokeGB later today

@CocaCola @HughFW @DrAseemMalhotra @ProfTimNoakes @drandyphung @CassellCath @lowcarbGP @realfoodrocksUK @CocaCola_GB @DietCokeGB Huge blood glucose ⬆️ with Original Coke, none from Diet Coke. The former contains a massive 35g (nearly 9 teaspoons) sugar 😳
"You can't beat the feeling" say @CocaCola but perhaps you can beat diabetes by avoiding it
"Have a coke and a smile" (if you still have your teeth)😉

@CocaCola @HughFW @DrAseemMalhotra @ProfTimNoakes @drandyphung @CassellCath @lowcarbGP @realfoodrocksUK @CocaCola_GB @DietCokeGB @RewardsProject @jamesgoolnik Last night's dinner of pan-fried wild salmon with braised peas and cabbage in a cream sauce didn't affect my blood sugar at all

Conclusion: Green veg is fine for my blood sugars - I've tested cabbage, peas, broccoli and kale so far. Salmon seems fine too 👍

@CocaCola @HughFW @DrAseemMalhotra @ProfTimNoakes @drandyphung @CassellCath @lowcarbGP @realfoodrocksUK @CocaCola_GB @DietCokeGB @RewardsProject @jamesgoolnik Asked to try whole milk by some of you so had 1 pint instead of breakfast
No impact on my blood sugar at all

Conclusion: Now tested a number of dairy products eg milk, cream, cheese (cheddar, parmesan, mascarpone, mozzarella), butter + eggs.
None affect my blood sugar at all🤔

@CocaCola @HughFW @DrAseemMalhotra @ProfTimNoakes @drandyphung @CassellCath @lowcarbGP @realfoodrocksUK @CocaCola_GB @DietCokeGB @RewardsProject @jamesgoolnik At your request have tried 500ml of @innocent Smoothie which sent my sugars ⬆️⬆️⬆️

It's a worry for me that these drinks are marketed as "healthy options". Often to children

At 12g sugar/100ml, my 500ml drink contained the equivalent of 15 teaspoons of sugar 😳

@CocaCola @HughFW @DrAseemMalhotra @ProfTimNoakes @drandyphung @CassellCath @lowcarbGP @realfoodrocksUK @CocaCola_GB @DietCokeGB @RewardsProject @jamesgoolnik @innocent @DrMichaelMosley

@CocaCola @HughFW @DrAseemMalhotra @ProfTimNoakes @drandyphung @CassellCath @lowcarbGP @realfoodrocksUK @CocaCola_GB @DietCokeGB @RewardsProject @jamesgoolnik @innocent @DrMichaelMosley @jen_unwin @CampbellMurdoch Fantastic halloumi cheese with chilli from @YorkshireCheese served with green beans, chickpeas + lots of homegrown tomatoes dressed with olive oil 😋
No impact on my blood sugar at all
Conclusion: I could eat this sort of simple, healthy, gorgeous food every day (and usually do)

@CocaCola @HughFW @DrAseemMalhotra @ProfTimNoakes @drandyphung @CassellCath @lowcarbGP @realfoodrocksUK @CocaCola_GB @DietCokeGB @RewardsProject @jamesgoolnik @innocent @DrMichaelMosley @jen_unwin @CampbellMurdoch @YorkshireCheese A (now) predictable (normal) brief spike in blood sugar during a hard 5km run @Southportpkrun
I've met so many amazing people @parkrun whose lives have been transformed by the weekly 5k events

I've written about my most inspirational, unsung heres here👇
blog.parkrun.com/uk/2018/12/10/…