血糖监测
Continuous Glucose Monitoring

原始链接: https://www.imperialviolet.org/2025/06/29/cgm.html

作者不是糖尿病患者,他探索了非处方连续血糖监测(CGM),现在一个为期两周的传感器售价约为50美元。该设备通过弹簧加载的涂抹器涂抹,每5分钟无痛测量一次血糖,每15分钟传输一次到智能手机应用程序。该应用程序虽然功能齐全,但存在监管限制。作者获得了一些令人惊讶的见解,尤其是某些“健康”食物如何严重影响血糖,以及即使是轻度运动也能有效调节血糖。观察实时血糖水平的游戏化效应促使人们做出更健康的选择。应用程序的数据导出受到限制,但它与Apple Health集成,允许使用自定义代码进行XML导出和随后的CSV转换。传感器的使用寿命约为15.5天,易于拆卸,但去除粘合剂需要一些努力。虽然作者没有立即计划使用另一个传感器,但他们发现这种体验很有价值,游戏化效果惊人。

This Hacker News thread discusses continuous glucose monitoring (CGM) for both diabetics and non-diabetics. Users share experiences using CGMs to gain insights into how food impacts their blood sugar levels, noting surprising spikes from seemingly healthy foods like white bread, croissants, and dried fruit. They also discuss strategies like prioritizing fiber, fat, and protein before carbs, and the benefits of light movement after eating. Debate arises around the long-term health implications of glycemic spikes in non-diabetics, with some arguing that focusing solely on glucose spikes could be misleading, similar to the "fat makes you fat" misconception. Others emphasize the link between spikes, insulin resistance, and related diseases. The discussion also touches on the accuracy of CGMs, alternative blood glucose monitoring devices, and regional variations in diet and obesity rates. Ultimately, most agree that CGMs can be valuable for understanding individual responses to food and lifestyle choices.
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原文

Continuous glucose monitoring has been a thing for a while. It's a probe that sits just inside your body and measures blood glucose levels frequently. Obviously this is most useful for type 1 diabetics, who need to regulate their blood glucose manually.

(At this point, I would be amiss not to give a nod to the book Systems Medicine, which I think most readers would find fascinating. I can't judge whether it's correct or not, but it is a delightful exploration of a bunch of maladies from the perspective of differential equations.)

But CGMs have been both expensive and prescription-only. And I am not a diabetic, type 1 or otherwise. But technology and, more importantly, regulation have apparently marched on, and even in America I can now buy a CGM for $50 that lasts for two weeks, over the counter. So CGM technology is now available to the mildly curious, like me.

The device itself looks like a thick guitar pick, and it comes encased inside a much larger lump of plastic that has a pretty serious-looking spring inside. It takes readings every 5 minutes but only transmits every 15 minutes. You need a phone to receive the data and, if the phone is not nearby, it will buffer some number of samples and catch up when it can. The instructions say to keep the phone nearby at all times, so I didn't test how much it will buffer beyond an hour or so.

I've got both an Android and an iPhone, but for this the iPhone was a more convenient device. So everything following probably applies to both ecosystems, but I've only tested it in one.

The app is well made, although you can feel the lawyers & regulators hovering over every part of it. It gives you instructions about how to “install” the sensor, which you do by holding the big lump of plastic with the spring over a suitable spot on your body and then pressing the button.

It's not a large needle, but it's not trivial either. There is a soupçon of cyberpunk about applying it to yourself in the bathroom but, honestly, my first thought after pressing the button and hearing the bang of the spring releasing was, “oh, it didn't work.” Because I didn't feel anything at all. But when I lifted the applicator away, there it was. And after a little while it started providing readings.

It's held in place with some sticky plastic, and you can shower with it on. After a week or two the plastic does start to get a bit messed up. Honestly, I would have preferred to have replaced cover every few days, but I only got one in the box.

I placed it on the upper arm as suggested in the instructions. I put it a little bit further around and I didn't have any problems laying down on that side.

What did I learn? In a couple of cases, meals that I thought would be fairly healthy (or at least not terrible) were pretty terrible. There'll be some things that I'll avoid eating more than I had before. In the bucket of “things that should have been obvious but the effect is still stronger than I thought”: exercise really works. Even a brisk walk resets my blood sugar quite significantly. And the Hawthorne effect works even when you're doing it to yourself.

The app does not seem to let you export the data. However, at least on iOS you can connect it to Apple Health. And Apple Health does let you export all of your data as a big XML file. So a little bit of Go code later, I have a CSV of everything it recorded and per-day averages and variations.

The sensor will stop working after 15 and a half days. It says exactly 15, but I think it will give you another half day to switch over to another sensor. It comes out easily, although the sticky residue takes some effort to get off the skin.

I did not switch to another sensor. I will probably do it again, but I'll give it a while since, as I expected, most of the insights that I think I'm going to get, I got fairly rapidly. Honestly, I think the gamification of not wanting to spike my blood sugar was perhaps the most effective part of it. I still think it's cool that this is a thing now.

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