CGM Without Insulin? A New Study

Okay, so I have been saying this for years and now the New England Journal of Medicine basically backed me up, which I'm not gonna lie, feels pretty good. I am Dr. Ahmet Ergin. I am an endocrinologist at the Diabetes, Thyroid, and Hormone Center of the Treasure Coast in Port St. Lucie and this channel is SugarMD. Today, should you wear a glucose monitor, a CGM, if you have type 2 diabetes and you're not on insulin? Because a brand new study basically just came out on exactly that for years the thinking was that CGMs are for insulin users initially you start with type 1 diabetes and then type 2 diabetes on insulin because you need to dose right now how about everybody else well keep pricking your finger once in a while or when you remember whatever so no matter what the doctor says patients do whatever they want anyway most people just don't remember so let's be honest now this new trial is called CONNECT published October 14th in the New England Journal of Medicine. Adults with type 2 diabetes, not on insulin, treated in regular primary care offices, not even endocrinology offices. 22 practices across the U.S. Half got Dexcom G7 CGM, half got Usual Care, which is finger sticks. 56 weeks. And the results? Well, okay, let me get this right. The CGM group, their A1C, dropped from 8.8 down to 7.2. that is 1.6 points now the usual care group who were instructed to check their blood sugar more often went from 8.7 to 8 so they improved too but much less so 1.6 point versus 0.7 point in A1C reduction which by the way when you put somebody on a study and tell them to pay attention they're gonna do better right so they both paid attention but CGM group did more than twice as good as the finger stick group time in range and that's the time that your sugar basically sits between 70 and 180 that time in range is the golden number for you so it went up about five hours a day five hours that's a whole work day of better glucose now i have to be honest with you because um that's a deal right uh on this channel Dexcom funded the study now obviously they make the device that doesn't make the results wrong i'm a principal investigator in some of the studies you cannot just tilt a study easily because it is regulated by multiple boards and multiple places. Now it was only six months and the people who benefited most were the ones who started with the highest A1c. Now if your A1c is already 6.5, you're probably not going to see a 1.6 point drop because you don't have much room. But why does this work? I don't think it's magic. It's just feedback. Somebody gives you feedback, you're likely to do better. Now you eat a big bowl of pasta, right? And you watch the line shoot up like a rocket. You look at the CGM and you go, uh-oh, no, that's not good. At this point, I don't need to lecture you that what you just ate was not good for you. Seeing is believing, right? Now that graph literally lectures you. It's way more convincing than I am. But trust me, my patients ignore me all the time. I'm used to it. Then you start experimenting. You take a 10-minute walk after dinner. You, not me, you take the walk. I told my wife today look i tell my patients to take the walk let's take the walk believe me i'm doing it now when they did that the spike is smaller you eat the protein and vegetables first right and the carbs last then you'll have a much smaller spike now you swap the white rice for i don't know what cauliflower rice okay maybe not everyone's doing that but you get it it turns diet advice into something that you can actually see so who should consider one if you have type 2 and you're not on on insulin and your A1C is above target. Honestly, I think a CGM is definitely worth talking about, especially if you feel stuck, especially if you don't really know which foods hit you the hardest. Because on YouTube, you're going to see one doctor saying that, oh, well, this fruit will be okay for diabetes. The other doctor will say, don't ever touch it. None of these is going to be true for every individual patient. Now, I have patients who like spike on oatmeal and then they just do fine weirdly with pizza. Not a recommendation, just saying. What about the cost? Medicare is still deciding about covering cgms for type 2 without insulin some commercial plans covered them right and there are over-the-counter cgms now no prescription needed so you can wear one for a couple weeks and learn your patterns um take a break and repeat here's where i will put in a plug because it fits once you see your post-meal spikes that's exactly the kind of glucose problem that our sugar md super berberine are designed to help with super berberine is the dehydroberberine and concentrated Ceylon cinnamon. Dehydroberberine is much better than regular berberine, and it works through your AMP kinase, which is the same energy-sensing pathway that metformin works on, but in a more natural way. The big meta-analysis of 37 trials found that berberine lowered A1c by about 0.6 points on average. Not a miracle. It's not an insulin, but it's a real reduction. And with a CGM, you can actually see whether it's helping you. But lifestyle first, walk after meals, protein first, sleep, then supplements, then medications if you need them. If you're in the Treasure Coast area in Port St. Lucie, Stuart, Vero Beach, we have a new office in Vero Beach. So please come see us. Bring your CGM and we'll actually help you understand your data better. You can call us at 772-398-7814 or book at tcendo.com and sugarmds.com for all of your supplement needs. And if cost is the thing stopping you, ask about our membership we have one flat monthly fee covering visits labs and wellness support drop a comment tell us have you tried CGM and what foods surprised you the most i read these i promise until i see you next time keep watching i'll see you in the next video