Weird possibility of high blood glucose in athletes
Imagine we were comparing two guys: Brad and Leonardo. Let's say they have identical bodies, except that Brad has a much higher mitochondrial density then Leonardo (maybe that's because only Brad is an athlete that does a lot of zone 2 exercises). My question: is it correct to say that, after a meal, Leonardo's blood glucose level will be lower than Brad's? This seems weird, and probably the answer is no. But I have to ask that question, because one could reason that Brad's higher mitochondrial density would lead to a more efficient use of FFA and glucose, via the aerobic pathway, whereas Leonardo's lower mitochondrial density would lead to the use of more glucose, via the lactate pathway. In other words, it seems that Leonardo uses more glucose than Brad. Are Leonardo's cells really pulling much more glucose out of the blood? Where is the mistake in that reasoning?
Esophageal health/Acid reflux
May I request a deep dive on GERD/acid reflux and relation to esophageal health. My father is at the end of a long (3+ year) with metastatic esophageal cancer. I, like him, have had acid reflux my entire life. Naturally, I am concerned, but historically been stubborn to treat with PPIs (my father consistently used these drugs for years, mostly Prilosec), and the recent Zantac debacle increases my skepticism. I have found dietary diligence can help, interestingly high magnesium supplementation seems to help, and staying fit seems to help, but it is nevertheless a fairly persistent part of my life. Some advice on treatment, causes, and strategies for management would be much appreciated.
query re analyzing CGM peaks
You focus on 3 variables in looking at CGM stats -- average glucose, standard deviation, and peaks. The first 2 are easy to track from the Dexcom Clarity reports, but I would appreciate your input about exactly what metrics you track in yourself and patients and how you do this. Do you use a spreadsheet with different maximums and tick marks showing number of peaks each day at different levels? Do you also focus on duration of spikes above some baseline level? Obviously a "round trip" from baseline and back of 2 hours encompassing a spike to 120 suggests better metabolic health than 4 hours for the same level of spike. This is clearly very important but its hard to know how to measure it and thus control it better.