Insights gained from the use of continuous glucose monitors (CGM) have revealed that many non-diabetic individuals exhibit transient spikes in blood glucose after consuming high-carbohydrate foods to levels normally only seen in insulin resistant or deficient diabetics. This observation has sparked significant interest in whether ‘glucose dysregulation’, characterised by both high variability (a known cardiovascular risk factor) and excursions (‘spikes’) above normal levels (e.g., 7.8 mmol/L or 140 mg/dL), could be actually causing many long-term diseases.

There is increasing evidence that high blood and tissue glucose levels may be an important risk factor for many non communicable diseases.

CGM monitoring should be considered in all patients affected by heart disease, in order to define glucotype and current glucose profile- both easily treated if 'unhealthy' .

This article is written for patients with an unhealthy (high) BMI who have undergone a metabolic health assessment where either their personalised CGP is found to be IIIC, meaning there is moderate glucose dysregulation. There may be an ambition to lower central fat stores, waistline and body weight.

In many non diabetic patients wearing a CGM we observe frequent glucose excursions over 7.8 mmol/L (140 mg/dL) often averaging more than two per day, and even some exceeding 10 mmol/L. This suggests that there are some challenges in the body’s processing of carbohydrates. Although these individuals are not formally classified as ‘diabetic’ or ‘prediabetic’ by current standards, research indicates that this degree of glucose dysregulation may increase the risk of developing Type 2 diabetes and, over time, glucose spikes may contribute to an increase in inflammation in key organs such as the heart and brain. Therefore, it makes sense to implement lifestyle and dietary changes to improve glucose control.