I have just implanted a Dexcom G7. My plan is to have my ordinary diet tomorrow and then to take Rapamycin (not sure whether 2mg or 4mg, have not decided yet) on Thursday morning and see if there is any discernable variation. Is there anything else people would like me to try as part of this?
Once you’ve run this experiment, it would great to repeat whilst on with acarbose or Metformin
That’s a fantastic experiment to run — congrats on being able to do it, and thanks for reporting your results and taking requests!
The most informative things would seem to be:
- To not have an ordinary day, but an OGTT drink both days or a close equivalent;
- To test and report on the same meal (presumably not repeat Glucola) at the same time of day throughout the life of the sensor; and
- Since the sensor lasts 10 days, to repeat testing after a second dose, assuming that you take rapamycin at least once every 9 days.
I would appreciate any insights if there would a benefit from working out in the morning ?
I am quite consistent in what I eat. My breakfast tends to be a variation on a full English breakfast which I buy in a Weatherspoons pub in the suburb of Birmingham where I live (including weekends), for lunch I have chia seeds mixed in a smoothie and if I am not eating out for dinner I have a salad. To me one of the key things is to see any variation glucose handling on my diet. I am also comparing my glucose handling today to that of a year ago. (where my breakfast was the same)
I intend to have a blood test tomorrow at 1pm. I am not sure, however, that this lab actually tests glucose which is a nuisance, but I don’t have the spare time to drive to a lab that does.
I am probably the most infrequent Rapamycin user in that I take it roughly every 4 months, but I am likely to increase this, but not to any more frequent than every 4 weeks.
My current exercise habit is to do short bursts of exercise on an exercise frame (chinups, pullups etc), but not for that long. However, I often do them more than once in a day.
Hence I will be having the same breakfast every day, probably the same lunch 8/10 of the days and the same dinner 7/10 of the days.
However, I will happily slot in an OGTT drink on one of the days obviously not today, nor the day I take Rapamycin (as I want to compare Rapamycin on my normal diet to my normal diet without Rapamycin).
If I have an OGTT drink should I not eat breakfast? (I would assume so)
I do have a second 10 day G7 session I can use at some stage, but my wife and one of my children have gone away which makes it easier for me to do things to fit in with the schedule.
I will aim to have a glucose test from a lab next week at a time when I am still using the G7. I don’t intend calibrating it as I wish to maintain the values that it comes up with without calibration.
At the moment I have not decided whether to have 2mg Rapamycin or 4mg. I have found that Rapamycin causes a sleep disruption at 2mg. Hence I am tempted to stay with 2mg, but if it has an impact on glucose processing that may be greater and more visible at 4mg.
Was curious about what exactly is in a full english breakfast… so I searched it up…
Its not exactly a Full English, it is three rashers of well done bacon, one sausage, two slices of toast with butter and quite a few baked beans plus a couple of cups of tea.
The point is, however, it is not a “super veggie”. However, I have consistently had this sort of breakfast for quite some time (maybe 18 years). I moved onto it more regularly when I was elected to the UK Parliament and had my breakfast in the Members Tea Room. (in 2005).
I am quite pleased that whereas in early 2022 my glucose peaked around 10-11 mmol/L after breakfast it now probably does not go over the 7-8 range. This, of course, links to reductions in HbA1c.
FreeStyle Libre lasts for 14 days. What I hate is that the first two days are always abnormally high. So right now my 7 day average glucose is significantly higher than my 14 day, 30 day and 90 day. Next week my 7 day will be lower than all of them by a substantial amount.
Take Rapamycin at different times during the day: before/after breakfast, lunch and dinner, with and without EVOO and grapefruit. Effect of combination of Rapamycin with Acarbose or/and metformin on glucose will be very interesting also.
Thank you for the experiment!
I am, however, only taking rapamycin once in the 10 days.
I will do the OGTT on one of the days and maybe two.
I have taken 4mg Rapamycin (at 6.15am GMT). I am thinking of doing the OGTT tomorrow and then waiting for a couple of half lives (say coming to the day before the end of the session) before doing it again. Its difficult to tell as the immediate response from the G7 is not that usable (the cloud system is much clearer but runs about 3 hours in arrears), but it appears that the breakfast peak may be 1-2 mmol/L higher than normal.
Looking at these
I think Dexcom probably has the same issue as Freestyle in that it overstates the glucose level in the first day and a half. There is no reason why the overnight glucose was higher in the first two nights.
I am not going to calibrate the Dexcom because I don’t know what its algorithm would do to the data. Instead I will make my own notional adjustments.
It is not likely to be that precise, but I would estimates that Dexcom overstated glucose levels in tthe first two images by about 1 mmol/L. I think you can see that gradually correcting at the end of 5/4/23.
Hence if it is a linear error it also overstated the peak glucose by about 1 mmol/L. From the cloud my peak on 5/4 was 8.3 (adjust down to 7.3) at 10.09. According to my notes I had my breakfast supplements at 8.41. Today, however, I had my breakfast supplements (which is part way through breakfast having eaten the sausage which I eat before the bacon) at 8.55. Then glucose peaked at 8.8 mmol/L and 9.29.
I find this really interesting because it appears that Rapamycin is stopping some form of control system from responding until the glucose gets to a higher level and then a second system cuts in and knocks the glucose right down. Then it goes up again and there is a second peak at 10.34 at 7.7 mmol/L
I finished breakfast at 9.00 and walked home from the pub via the supermarket. When I got home I had a cup of tea with milk but no sugar. So the second peak on today’s Rapamycin breakfast was at 10.34 and the first peak yesterday was at a time which adjusted for delay in eating breakfast would have been 10.23.
What I think might happen over the next few days is that gradually as the Rapamycin disappears from my system that the initial peak will be brought under control and disappear. However, we shall see.
Sadly I have not noted down the timing of the lunch time chia seeds for either day so cannot look at the changes there.
Hopefully I will remember to drink a glass of dissolved sugar tomorrow morning rather than have breakfast. Its a bit sad really as I quite like my breakfast.
These monitors will not be accurate when it comes to glucose levels, but will be far more accurate when it comes to the delta of changes. In the US, the acceptable range for errors for gludose levels is at most 15%, I think.
If you want more accuracy for glucose levels, you can calibrate by getting more exact numbers from a finger prick. It seems like in your case, you care more about the deltas anyway, instead of actual gludose levels
I think the delta tells an interesting story.
I will go out in a bit to buy some sugar as I have not been able to find 100g of white sugar in the house. I am not looking forward to drinking the OGTT test and with it being something like 400 calories I will have to cut out my breakfast later.
I have, however, refrained from drinking tea with milk and instead have drunk a fruit tea. The shops open soon and I am planning on doing the OGTT drink at the same time that I had breakfast yesterday.
Over night the CGM reported on glucose levels staying a bit higher than was the case on the previous night, but we have a few more days to go. Using a half life of 60 hours 24 hours after getting a peak serum concentration would be just over 75% or equivalent to an initial dose of 3mg rather than 4mg.
Tomorrow will be 48 hours which should give just under 60% (57.4).
Edit 8.59 now drunk it.
Later edit 10.46 - Interestingly this also produces a double peak.I am currently on the way up to the second peak and I don’t know if it will be higher than the first (probably not). However, I will post the charts later today when they become available on the cloud.
I agree that these continuous glucose monitors are not entirely accurate. Unfortunately, the home finger prick’s are also inaccurate. I routinely got a 15 point difference using two different monitors with the same drops of blood. One fun thing with the levels app is that you can see your CGM reading every minute of the day. The last time I had my blood drawn for a glucose lab test both the GCM reading (at the moment the blood was drawn) and my lab results were identical — 79mg/dl.
My point in linking to a paper about the ISO standard is that if a finger prick gives a different value to a CGM you cannot be certain which is right. Hence I have not bothered to do finger prick tests to see what they are compared to the CGM.
So this is the response to 100g of sucrose. In the afternoon I went to the pub and had quite a bit to drink, but I am not sure that is obvious from blood glucose levels.
I find the double peak think quite interesting as I am pretty certain that is caused by Rapamycin. I put the implant into my upper arm this time which is a lot easier to handle (although harder to implant), Hence I will keep going on this until I get to an end.
According to Dexcom, “Dexcom G7 can complete warmup within 30 minutes, whereas other CGM brands require up to an hour or longer.” The Dex G6 took 2 h.
I used a g6 just over a year ago and the g7 is better and does warm up quickly, but it may also have an inaccuracy to start that reduces. I will tey to calculate this as we get to the end of this session. I have another session that i can uae and have not decided when to do this.