Case 7: Diabetes

“A 37-year-old female with Type II Diabetes who can’t lose weight”

A 37 -year-old 230 lbs female who was told by her family practitioner that she was “pre diabetic,” instructed to lose weight and started on Metformin 500 mg twice a day. After a year and a half, she still had not lost any weight and now presented with complaints of increasing fatigue, loss of energy, insomnia and difficulty with memory and focus. Her Boston Heart Diagnostic test confirmed that she was diabetic and her fasting blood sugar was 275 (normal 70 -99) and her insulin level was 13 (5 -15); optimal level are in the 4 – 8 range.

Our priority was to make sure that she understood the impact that her diet and lifestyle choices were making on the control of her diabetes and cardiovascular health. The Abbott Libre Freestyle 14-day continuous glucose monitoring device (CGM) was ideal for this purpose.

This device is a small waterproof sensor applied on the back of the upper arm just above the elbow. The sensor instantaneously and continuously monitors their blood glucose level in real time for 2 weeks. The sensor is linked to your smartphone and registers your glucose level. You can access the glucose level by bringing your phone close to the sensor and it will be automatically scanned on to your 24-hour log. This is so sensitive that within minutes you will see your blood sugar begin to react to what you have eaten or what you have been doing. Food and exercise are the main variables that determine your blood glucose level. Within days you get enough feedback to begin to know “how to play the game.”
Below are her daily logs for Day 1, Day 7 and Day 14. You can see that she accomplished in 2 weeks what she had not been able to do in 18 months! She began to consciously limit her portion control and eliminate the mindless snacking that had been defeating her all this time. We highly recommend CGM to get patients started off in this fashion. Other helpful home devices are the metabolic scales, which show not only BMI but the percentages of body fat, lean muscle mass, body water, visceral fat and protein. Some devices even calculate a biological body age based upon your health and fitness parameters.