Continuous Glucose Monitoring (CGM)
Episodes covering continuous glucose monitoring (cgm) — protocols, research, and expert discussions.
Wearable sensors that provide real-time glucose data, enabling personalized nutrition insights and metabolic optimization for both diabetics and health-conscious individuals
Evidence-Based Take:
CGM has revolutionized metabolic health tracking by providing real-time feedback on how food, exercise, stress, and sleep affect blood glucose. Many longevity physicians consider it one of the most valuable tools for metabolic optimization, recommending nearly every adult try it for at least a few weeks.
What the Evidence Shows:
- Individual variability: Even non-diabetics show highly variable glucose responses - ~24% spend significant time in prediabetic ranges
- Personalized insights: Same foods cause dramatically different responses in different people
- Behavior change: Real-time feedback effectively modifies eating patterns
- Subclinical detection: Can reveal metabolic dysfunction before standard tests
Honest Assessment:
CGM is a powerful biofeedback tool, but it's not something most healthy people need long-term. The recommendation: use it for 1-2 months to learn your personal glucose responses, then apply that knowledge going forward. The technology excels at showing you your specific triggers - which foods spike you, how exercise timing affects glucose, and how sleep quality impacts metabolic control.
Caution: Can promote anxiety or obsessive behavior in some individuals. Not recommended for those with eating disorder history.
Science & Mechanisms
How CGM Works:
A small sensor inserted under the skin measures glucose in interstitial fluid (the fluid between cells). Readings are taken every 1-5 minutes and transmitted wirelessly to a smartphone app.
Key Metrics to Track:
| Metric | Optimal Target | Why It Matters |
|---|---|---|
| Mean glucose | <100 mg/dL | Lower averages correlate with better metabolic health |
| Glucose variability (SD) | <15 mg/dL | High variability linked to oxidative stress |
| Peak glucose | <140 mg/dL | Spikes cause inflammation and glycation |
| Time in range (70-140) | >90% | Standard metric for glucose control |
The Glucotype Discovery:
Research has identified distinct "glucotypes" - patterns of glucose response that vary dramatically between individuals: - Low variability: Stable glucose, minimal spikes - Moderate variability: Some meal-related spikes, quick recovery - High variability: Large swings, slow recovery, prediabetic patterns
Roughly 24% of "healthy" non-diabetics show high-variability patterns, spending ~15% of their time above prediabetic thresholds - invisible to standard fasting glucose tests.
What CGM Reveals:
- Personal food responses (rice might spike you but not bread)
- Exercise timing effects (morning vs evening workouts)
- Sleep quality impact (poor sleep = worse glucose control)
- Stress response (cortisol elevates glucose)
- Meal composition effects (protein/fat with carbs blunts spikes)
Why This Matters for Longevity:
Chronic glucose elevations and high variability are associated with: - Increased cardiovascular disease risk - Accelerated aging (glycation of proteins) - Higher inflammation markers - Greater oxidative stress - Increased dementia risk
Episodes
Josh Clemente, founder and CEO of Levels, discusses surprising insights from continuous glucose monitoring. A former SpaceX systems engineer who led development of life support ...
About 33% of Americans are prediabetic but 90% don't know it. CGMs reveal that identical foods produce wildly different glucose responses across individuals, largely due to micr...
Dr. Casey Means discusses the importance of removing processed foods and prioritizing unprocessed animal and plant foods. Casey and her brother Calley Means are leading the figh...
Your glucose can look normal while insulin is 2-4x elevated. Covers the physical signs that reveal insulin resistance (check your neck), why strength training beats cardio for m...
Dr. Casey Means, a Stanford-trained physician and author of 'Good Energy,' explains how metabolic dysfunction is the root cause of most chronic disease in America, with 93% of a...
Dr. Tommy Wood makes his third appearance on Paul's podcast to cover brain health, dementia prevention, lipids, LDL cholesterol, continuous glucose monitors, and seed oils. As a...
Paul Saladino breaks down his March 2023 bloodwork, reviewing his levels and ratios while explaining which tests listeners should consider ordering and how to interpret results....
Dr. David Jockers connects blood sugar regulation, ketone production, and sleep quality to the brain's detoxification processes via the glymphatic system. He provides practical ...
Ben Greenfield welcomes back Jordan Rubin, founder of Garden of Life and Ancient Nutrition, to discuss his latest book The Biblio Diet. Rubin draws on biblical dietary principle...
Layne Norton, PhD, performs a detailed breakdown of a landmark 2025 systematic review and meta-analysis published in Advances in Nutrition examining whether aspartame affects gl...
Your glucose response to foods is highly individual - some spike to potatoes, others to grapes - making CGM data essential for personalized nutrition. Post-meal brisk walks (15-...
Chris Masterjohn presents the case for high-dose biotin supplementation, examining its effects on blood sugar regulation, cognitive function, and skin and hair health. He review...
Paul Saladino shares his complete bloodwork panel from April 2024, explaining which markers he orders and why. He covers MTHFR polymorphisms and supplementation decisions, gluco...