I think the issues with overscreening are a really hard thing for most doctors to get, because they are extremely counterintuitive. @venkmurthy has some excellent tweetorials on issues similar to the (potential) overuse of CGM
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Does CGM qualify as "screening"? Isn't screening looking for something relatively rare? Metabolic dysfunction isn't rare and often goes undiagnosed. Gid - wasn't that exactly what was observed in the data you collected on "healthy" people presenting to hospital?
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True, but the patient group we looked at was an acute sample in an unhealthy population. The issue with screening is that it is all dependent on the denominator I'd have less issue with more use of CGM if it was only used by people with pre-diabetes/diabetes, for example
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Replying to @GidMK @MiriamBerchuk and
(In fact, we are advocating for more use of CGM for people with T2DM based on some prelim data that should be published soon. Not the same as general use for everyone though!)
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If I had to summarize how I see the conflict between the "CGM camps", it's a philosophical disagreement: those who believe that until threshold of HbA1c of 6 is reached, no intervention is required. Versus those who believe HbA1c represents a continuum of risk.
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That's certainly a question, but I'd say it's more about when you expect to see a benefit (particularly in terms of hard outcomes, like retinopathy) given that CGM can be quite expensive to use long-term
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What about periodic short term use of CGM to allow a personalized understanding of glycemic response to certain foods?
@segal_eran's work demonstrates it's highly individual. I know where I want my HbA1c to fall. CGM would allow me to figure out which foods help keep me there.pic.twitter.com/CH0Xlf89cq
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Generally I'm not very impressed by the promises of personalized nutrition at the momenthttps://medium.com/swlh/is-personalized-nutrition-a-waste-of-time-5f272f9633f2 …
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