Continuous Glucose Monitor
Dr. Neichoy:
Well, this section’s going to be on continuous glucometers or-
Dr. Schneiderjan:
CGMs?
Dr. Neichoy:
… CGMs. I think this technology was kind of saved for the really nerdy health and wellness people. I mean, when was the first time we used them? Personally, you and I.
Dr. Schneiderjan:
So they were originally for type 1 diabetics, then they started using one type two diabetics, but then the health and wellness world started embracing them. Yeah, we started ours about two years ago.
Dr. Neichoy:
Oh, no. Mine was longer than that, four years ago. All right. So let’s explain what it is first.
Dr. Schneiderjan:
I got mine on.
Dr. Neichoy:
Yeah, okay. There we go.
Dr. Schneiderjan:
So basically it’s a little disc that essentially I put a little alcohol and I deploy this disc, which has a little needle initially that goes in and then a little wick deploys into your subcutaneous tissue. The needle retracts, so all I’ve got is a little wick in there. So it’s nothing pokey or anything like that.
Dr. Neichoy:
What’s that wick doing?
Dr. Schneiderjan:
It’s basically sampling the glucose in my subcutaneous tissue, which translates into my bloodstream. So it kind of gives me a point in time, at any point, that I can check my blood sugar. Matter of fact, I’ll grab [inaudible 00:01:17].
Dr. Neichoy:
Okay. Let’s do that.
Dr. Schneiderjan:
What did I eat for lunch? We may not want to check it. I’m just joking.
Dr. Neichoy:
Yeah, do you want to let yourself be revealed here?
Dr. Schneiderjan:
So this is what we call a Libre. I’ve used [inaudible 00:01:30], two different ones. This one every eight hours I have to download the data. Okay, so I select it, watch, it gives me a little beep. It’s 92.
Dr. Neichoy:
92.
Dr. Schneiderjan:
Okay. Pretty good today. Yeah.
Dr. Neichoy:
Yeah, did you drink? Just one little blip. Was that blip this morning?
Dr. Schneiderjan:
It was this morning.
Dr. Neichoy:
So naturally waking up, cortisol boost-
Dr. Schneiderjan:
A shower can do that.
Dr. Neichoy:
So and that’s measuring your glucose level.
Dr. Schneiderjan:
Glucose. Now my insulin, glucose.
Dr. Neichoy:
All the things that glucose are called, blood sugar, glucose, any other terms?
Dr. Schneiderjan:
Those are pretty much it.
Dr. Neichoy:
Okay. So, I mean, diabetics know this stuff well but what we’re saying, what we’re talking about here is rolling this out for people to help them understand how they eat, not because they’re diabetics, right?
Dr. Schneiderjan:
Correct.
Dr. Neichoy:
Okay.
Dr. Schneiderjan:
So what we’ve seen is insulin, which keeps our blood glucose in check.
Dr. Neichoy:
Yeah. So glucose is toxic?
Dr. Schneiderjan:
Correct. So what we’re seeing is what drives a lot of our medical issues is high glucose and high insulin. One, the high glucose causes a lot of oxidated stress in our body. Would you agree?
Dr. Neichoy:
Mm-hmm.
Dr. Schneiderjan:
It drives a lot of our metabolic issues, particularly high insulin level, high blood pressures related, heart disease, all the hormonal issues like PCOS.
Dr. Neichoy:
Dementia, cancers.
Dr. Schneiderjan:
Alzheimer’s, all those things. And so it behooves us to keep our blood glucose and our insulin levels down as low as we can without symptoms. Do you agree with that?
Dr. Neichoy:
Yes.
Dr. Schneiderjan:
Or the normal range of what we would call.
Dr. Neichoy:
Specifically to target insulin sensitivity.
Dr. Schneiderjan:
Correct.
Dr. Neichoy:
Or metabolic flexibility, right? So ultimately your body doesn’t want sugar in your bloodstream because it’s toxic.
Dr. Schneiderjan:
It wants to keep it down.
Dr. Neichoy:
Yeah. So it wants to get that blood sugar, that glucose out of the bloodstream and put it in the liver, put it in the muscles, put it in the cells. But over time, after we push that button, I think I explained that as the, “Hey mom, hey mom, mom, mom, mom.”
Dr. Schneiderjan:
They ignore it.
Dr. Neichoy:
Yeah. The more they say it, the more you ignore it, right? So the cells start doing that to insulin. So the only way to get insulin sensitivity back is to stop saying mom so much or to stop putting so much glucose in your body, right? So how do we know … Because I tell people this all the time. It’s being more focused on what you eat versus how much. So focusing on what? And then from that, I extrapolate it to also being better in tune with how your body responds to the foods that you do eat. And that’s difficult to know.
Dr. Schneiderjan:
Until now.
Dr. Neichoy:
Yeah. And this is to me, the only tool outside of just being intuitive to how you feel after you eat. If I eat something and two hours later I can’t keep my eyes open, okay, that’s probably not good food for you, right? So the only other way is-
Dr. Schneiderjan:
That’s a food coma. I thought that was good for you, though.
Dr. Neichoy:
Yeah, Thanksgiving only. Thanksgiving only. But if it’s doing that, it’s basically creating a situation where your mitochondria can’t make energy. So you’ve temporarily paralyzed the mitochondria, in my opinion, that may not, yeah.
Dr. Schneiderjan:
No.
Dr. Neichoy:
Theory, theoretical. So outside of that, the only way to know is to get a little bit more invasive.
Dr. Schneiderjan:
Which to me, this has changed everything that I thought was healthy in the past, this showed me that I wasn’t on the right track, which was kind of hard to accept. So for example, remember my protein shake that I did for-
Dr. Neichoy:
Years?
Dr. Schneiderjan:
… as long as I can remember. So I’d get up every morning and this is what I taught my patients, this is what health looked like. I’d get up and I’d take pomegranate juice with blueberries, strawberries, some protein powder and I’d blend it and that was my breakfast. I started wearing the glucose monitor and all of a sudden I got this huge spike in the mornings.
Dr. Neichoy:
Tight spike, up, down or a little prolonged.
Dr. Schneiderjan:
It was big, big. And what it was, was the fructose glucose in the pomegranate juice, which pomegranates themselves have a lot of good stuff to them but if you-
Dr. Neichoy:
Pomegranate is the juice.
Dr. Schneiderjan:
The juice. And so what I realized I was becoming insulin resistant because I was doing that. I was eating a lot more sugar and carbs than I thought. And this started really showing me that my food choices were not good for me. And so it gave me instantaneous feedback and that’s what started changing … Maybe I need to do something different here. And I think for patients it’s awesome because it really gives you an idea of if you’re making good choices.
Dr. Neichoy:
I still remember the first time I put one on, I think you and I did at the same time, right? Or maybe I jumped off into it a little bit before you. And first day I put it on and that was a Dexcom, so it’s continuously giving you updates. And so I went to the movie theater with my little girls and family and got some movie theater popcorn, right?
Dr. Schneiderjan:
Low calorie?
Dr. Neichoy:
Oh yeah, low calorie. High fiber.
Dr. Schneiderjan:
Snack on that, that’s not a problem.
Dr. Neichoy:
Industry would tell you … I mean, it’s just 100 calories. Just do it. It’s just popcorn. And I think my glucose went to 188.
Dr. Schneiderjan:
Yeah.
Dr. Neichoy:
188.
Dr. Schneiderjan:
Crazy.
Dr. Neichoy:
I’m not a diabetic.
Dr. Schneiderjan:
It should stay under 120 ideally, maybe 150.
Dr. Neichoy:
Yeah. So the real kicker here is I didn’t realize it sent alerts. And so-
Dr. Schneiderjan:
She’s calling 911.
Dr. Neichoy:
Oh man, they thought I was dying, I guess. But it kept just pinging my phone, like ding, ding, ding, ding. And we’re in the middle of the movie and my wife’s like, punching me in the arm. What are you … turn that thing off. And I’m like, “I don’t know how, it’s continuous. I don’t know how.”
Dr. Schneiderjan:
This is what we do to our bodies every day.
Dr. Neichoy:
Yeah.
Dr. Schneiderjan:
I wish every patient had this ability. What other things surprised you?
Dr. Neichoy:
Just simple things like eating a meal I thought was healthy. It’s a meat. So whether it’s beef or chicken out at a restaurant. So I’m conscious, I ordered a steak with some vegetables, man, what a great-
Dr. Schneiderjan:
Yeah, you’re making a great choice.
Dr. Neichoy:
Even though I’m eating out, this is a great choice.
Dr. Schneiderjan:
Just the sauces.
Dr. Neichoy:
Well, not just the sauces but the oils.
Dr. Schneiderjan:
What they’re cooking it in.
Dr. Neichoy:
The inflammatory oils that they cook commercial food in, the vegetable oils, whatever. And I’m like, “I’m getting a glucose spike even though I’ve not had any excessive carbs.”
Dr. Schneiderjan:
Which, if you would’ve cooked that same meal at home, a meat and vegetable, what would happen?
Dr. Neichoy:
It would probably stay at 80.
Dr. Schneiderjan:
Yeah. Just flat as could be.
Dr. Neichoy:
I guess the other thing that was pretty crazy is seeing what your glucose does at night, specifically, I think with your sleep cycles. So seeing it when you first go to bed, you’re just eating whatnot and then see that thing dive into the 50s and you’re like, “Oh, at 50s …” I mean, medicine would tell you you’re going to die, glucose at 50. But no, your body tolerates that appropriately. I mean, not everybody can do that at first, at first. And then also seeing how exercise or stress or lack of sleep affects it.
Dr. Schneiderjan:
You become insulin resistant within 24 hours of a bad night of sleep. It’s pretty crazy. What about fasting?
Dr. Neichoy:
What about, I mean, I can go on and on about fasting but what specifically?
Dr. Schneiderjan:
My insulin resistance, there’s been two ways to clean up my insulin resistance. One is by better food choices, getting sugar out of my diet, things like that. But fasting has been the one miracle thing to reverse my insulin resistance. I did want to say this. You know another thing this did and it broke my heart. I used to love white chocolate mochas.
Dr. Neichoy:
Oh, I know. I knew that was your order.
Dr. Schneiderjan:
Yeah. It’s crazy what it does. I’m embarrassed to even show this.
Dr. Neichoy:
You have a recent one?
Dr. Schneiderjan:
No, I don’t. I’ve probably deleted it out of my memory.
Dr. Neichoy:
All right.
Dr. Schneiderjan:
But people are doing that every day.
Dr. Neichoy:
Oh yeah, like twice a day. Yeah, man. Give me a double pump, frappa, mocha.
Dr. Schneiderjan:
It’s terrible.
Dr. Neichoy:
Yeah. So two things to end. Number one, if you’re interested in doing this, where do I look to insurance coverage? And then the second thing, pricing.
Dr. Schneiderjan:
Yeah. Usually, unless you’re a diabetic, if you’re a type 2 diabetic or type 1, you do it through your primary care and insurances will to some extent pay for it. If you’re not, like in our case, we had to pay out of pocket but it’s well worth, I think, trying for three months. So I did levelshealth.com and basically you go there and you sign up and essentially you give them information. They send you the glucose monitor. There’s some videos of how to put it on, super easy.
Dr. Neichoy:
Which app to download.
Dr. Schneiderjan:
What app to download. And then what it does is, it scores basically your day, zero to a 100. You’re trying to get 100, meaning that you’re keeping your glucose down. And then also, you take pictures of your meals and it scores your meals zero to 10. A meal that’s really healthy is 10. And then, one that’s really bad is one. And so you really learn how to make good food choices. I think, I would say on the more expensive side but it’s worth it. I think it’s better than any diet program that you’re going to go sign up.
Dr. Neichoy:
So one month on levels, 399, 499?
Dr. Schneiderjan:
So you initially do, I think, it’s 299 to sign up and then it’s 199 per month.
Dr. Neichoy:
$199 per month.
Dr. Schneiderjan:
But you only need to do about three months to really get an idea.
Dr. Neichoy:
Yeah. I personally only did it for three or four months and I just focused on eating the foods that I normally eat. And so I learned a lot. You’ve elected to go pretty long term.
Dr. Schneiderjan:
I’m talking over a year because what I’ve found is it’s an accountability to me. When I have this thing on, I don’t make those bad choices.
Dr. Neichoy:
I’ve been around you on days you don’t have it on.
Dr. Schneiderjan:
I realize I need some, I need a thumb. Thumb on me, every now and then.
Dr. Neichoy:
Well just pay me $199 a month and I’ll just ridicule you every time you make a bad choice.
Dr. Schneiderjan:
I was going to tell … Because there’s one other thing I was going to say. Glucose monitor, food choices. Oh, I forgot it, though.
Dr. Neichoy:
Well, I just wanted to point out like, yes, there’s a bit of a sticker shock when you say, “Oh, I’m going to pay $199 a month for this thing that sticks in my arm.” But you learn so much and you don’t have to commit to a year with this thing. And then you look at things you spend money on, health and wellness wise, whether it’s Weight Watchers, Jenny Craig or this fat burning supplement or this jazz-a-size, whatever it is, we’re all spending money if you’re trying to lose weight. This was a pretty powerful one. Because it’s it’s expensive but it’s pretty powerful.
Dr. Schneiderjan:
It’s a powerful tool.
Dr. Neichoy:
To give insight to your food selection and what it’s doing to your body.
Dr. Schneiderjan:
You know, I really found this helpful is in patients that have just had surgery and just that not only the metabolic reset of surgery but also them all making good food choices afterwards. I wish our patients had … everyone I would do it because I think it would even be that much more powerful for them to solidifying good choices. Oh, this is what I was going to say. Great book, Glucose Revolution. Basically-
Dr. Neichoy:
You going to say her name?
Dr. Schneiderjan:
Oh, wow.
Dr. Neichoy:
Inchauspe, I think that was it. Anyways-
Dr. Schneiderjan:
Yeah. Great book. She basically wore this and wrote a book based off of it.
Dr. Neichoy:
She’s a pretty famous Instagram influencer just because she wears one of these things.
Dr. Schneiderjan:
And little tips and trips or tips and tricks on how to keep your glucose down and it’s real educational.
Dr. Neichoy:
Yep, all right. Good talk.
Dr. Schneiderjan:
Good talk.