Dr. Al Danenberg ● Nutritional Periodontist
August 9, 2020
When I was interviewed by Dr. Paul Saladino, we discussed the benefit of continuously monitoring my blood glucose levels. Dr. Saladino recorded a Podcast prior to his interview of me that was devoted to continuous glucose monitoring.
Continuous Glucose Monitoring
I’ve done some personal research, and I learned a bunch. The Continuous Glucose Monitor (CGM) is a device that will monitor glucose on a continuous basis. Although diabetics may know about this device and its data collection, the CGM is definitely not just for diabetic patients. You will learn much about your body if you know how your body is dealing with glucose. Carbohydrates in your diet and also gluconeogenesis, which is the natural generation of glucose from non-carbohydrate sources, affect the levels of blood glucose. Control of glucose through effective insulin sensitivity is critical for weight control, longevity, quality of life, and overall wellness and immune support.
The CGM is a small device that works through a tiny sensor inserted under the skin, usually on the arm. The sensor measures the interstitial glucose level, which is the glucose found in the fluid between the cells. It does not directly test the glucose in the circulatory system. However, the glucose levels in the interstitial fluid will lag the levels of glucose in the blood. The sensor tests glucose every few minutes.
My Experiment
I acquired the CGM made by NutriSense. This company provides the CGM to the general public. The device attaches to the skin with an adhesive. Believe me, there is no pain when you attach the device to your arm. A small pin-prick, and then it’s done. The transmitter in the CGM wirelessly sends the information to the NutriSense App that you download on your cell phone.
This is important: Some older cell phones are not compatible with the CGM. You must have an iPhone 7 (or newer) or an Android with a Near-Field Communication (NFC) chip.
Here is a 24-hour graph of my glucose levels on Saturday, 7/25/20. The red dots are morning coffee at 5:45AM, lunch at 11:40AM, and dinner at 4:15PM:
By scanning the device with your mobile phone that already has an active NutriSense App, the data will be transmitted to the App. The App will give you “push” notifications to remind you to scan at least every 8 hours should you forget.
The data is also transmitted to NutriSense where a dietician can help you understand the interpretation of the recorded data. You’ll understand how your glucose is changing in real time and in response to all types of variables, such as food, exercise, stress, and sleep. The App also calculates the variability of the glucose readings which is recorded as a Standard Deviation (SD). The CGM device works for two weeks; then, the device becomes inactive. You simply remove it from your arm and discard it. It can be thrown away in your trashcan.
Glycemic Variability
Glucose levels in the blood fluctuate. As I mentioned, this is known as glycemic variability (GV). I also stated that glucose levels in the blood will lead glucose levels in the interstitial tissues. Glycemic variability measured by the CGM refers to the swings in glucose levels in the interstitial tissues that occur throughout the day. The SD of glycemic variability is the biomarker that interests me.
If a person were only to take a glucometer reading at the start of a meal, an hour later, and maybe another hour after that, these readings would never show spikes between those readings. Also, you would have to prick your finger to get these readings each time – not for me.
Certainly, it would never be possible to know the glucose spikes and swings occurring during the remainder of the day or night. In other words, there would be no way to evaluate a person’s glycemic variability throughout the day unless it was measured continuously. That is what a Continuous Glucose Monitor is designed to do.[1]
Blood Glucose and Cancer
In 2018, a study showed that glycemic variability could promote both local invasion and metastatic colonization of pancreatic ductal adenocarcinoma.[2] Other studies have shown that high levels of blood glucose can raise the prevalence and mortality of many different types of malignancies.[3]
In another study published in 2019, researchers discovered that a large degree of glycemic variability created a high risk of future cancers among people without diabetes. The authors summarized that it would be wise to maintain a low level of glycemic variability for the prevention of future malignancies.[4]
Blood Glucose and the Immune System
In addition, a study published in 2018 suggested that increased glycemic variability would compromise the immune system by increasing proinflammatory cells as well as reducing the number of suppressive regulatory T cells and protective NK cells. The end result would be a higher susceptibility to infections compared to individuals with a low level of GV.[5], [6],[7],[8]
Glycemic Variability and Other Systemic Effects
The SD of glucose fluctuations is highly correlated with metabolic health. As I stated, a high standard deviation is a measure of high glycemic variability, which affects the risk of cancer and the robustness of the immune system. Some of the reported signs and symptoms of a high GV are:
- low or fluctuating energy levels
- intense food cravings, particularly for carbohydrates
- poorly regulated hunger cues
- risk of cardiovascular disease[9],[10]
- oxidative stress
- vascular damage
- peripheral neuropathy
- increase susceptibility to influenza[11]
Most research for GV has been done on diabetics, aiming for a glucose standard deviation of <30. In non-diabetics, the SD should be <20.[12],[13] Ideally, the SD for a healthy person with a healthy immune system should be <14.
My results using the CGM from NutriSense were impressive. I used the device for two continuous weeks. The SD of my glycemic variability over those two weeks was 10, which is excellent! Let me remind you that I have an incurable form of bone marrow cancer called IgA Kappa Light Chain Multiple Myeloma with severe bone lytic lesions.
During the entire experiment and at the end of the two weeks, I had frequent contact by email and Zoom chats with Carlee, one of the dietitians at NutriSense. She is extremely knowledgeable and helpful.
Bottom Line
Theoretically, I should have a significantly compromised immune system because my cancer is a malignancy of plasma cells. Plasma cells are bone marrow cells and are part of the adaptive immune system. These cells secrete large quantities of proteins called antibodies, which are created to remove specific antigens associated with specific infections and toxins invading the body. My malignant plasma cells are producing nonfunctional antibodies.
I have gone to great lengths to strengthen my overall immune system using my Unconventional Cancer Protocols. And this biomarker suggests that I have done a good job.
So, by monitoring my glucose fluctuations, I have another vital biomarker to identify the robust level of my immune system. If my glucose fluctuations demonstrated a high standard deviation, I would know that I needed to tweak my diet or other cancer protocols to reduce my GV. However, with a SD of 10, I am well-within the normal range for a healthy immune system based on this biomarker. And as I stated at the outset, a robust immune system is an important factor enhancing my body to heal naturally.
[1] https://diabetes.diabetesjournals.org/content/67/Supplement_1/1542-P
[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6154439/
[3] https://jeccr.biomedcentral.com/articles/10.1186/s13046-019-1309-6
[4] https://www.diabetesresearchclinicalpractice.com/article/S0168-8227(19)31097-6/fulltext
[5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6250017/
[6] https://pubmed.ncbi.nlm.nih.gov/26897277/
[7] https://onlinelibrary.wiley.com/doi/abs/10.1002/jcp.29228
[8] https://care.diabetesjournals.org/content/38/7/1356
[9] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4543190/
[10] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3743360/?report=reader
[11] https://mbio.asm.org/content/11/2/e02841-19
[12] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4455369/#!po=34.6154
[13] https://diabetes.diabetesjournals.org/content/67/Supplement_1/1542-P
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