How med schools approach metabolic health, nutrition, & behavior change
Recent medical school graduate Dr. Elias Eid sits down with Dr. Kelley-Chew, Levels’s head of clinical product, to discuss training, personalized insight, and the future of CGMs.
Ben Grynol: Elias Eid was a fourth-year medical student at the University of Central Florida. He had heard about Levels and he’d been living with type 1 diabetes for more than 22 years.
He thought, “Hey, why don’t I reach out to Dr. Casey Means, one of the co-founders of Levels, because she has a similar background, and she has a lens on CGMs?” That DM ended up leading to a number of conversations, eventually with Lauren Kelley-Chew, head of clinical product at Levels.
For Elias, using a CGM has been integral. He can’t imagine what people with diabetes would’ve done in the past without them. He sees the value, and he sees a future where more people can and should wear CGMs so that they can realize what lifestyle choices they can make in order to optimize their metabolic health and their glucose levels.
It’s always fun to hear from people within the type 1 community and people who relate to Levels in many different ways.
Metabolic Health as a Window into the Body
Dr. Lauren Kelley-Chew: I’m very excited to be here with Elias, who just graduated from the University of Central Florida medical school and who will be starting a residency in emergency medicine. He’s also living with type 1 diabetes and is super passionate about health tech and metabolic health.
I get to relive my med school years a little bit, but also hear a firsthand account of how nutrition, food as medicine, lifestyle intervention, and chronic disease are being approached in medical education, and how students interested in health tech and holistic health are shaping their career paths.
How did you get connected with Levels?
Dr. Elias Eid: Thank you for having me. I’m super stoked for this. I got involved with Levels because I saw them on Instagram, and I just sent a DM, and I got a response, which was surprising. I was super interested in this technology.
I said, “Hey, I’m a diabetic. I’m a med student.” I think I was in my second or third year at the time, and ended up on a Zoom call with some of the founders. It was supposed to be a 15-minute call. It went on for almost an hour.
I was already involved in this space. I’m an athlete by background, went into medicine, and next thing you know, got involved with Casey. We wrote an article together about my experience with type 1 diabetes. That was pretty exciting to see.
Now that I’m approaching graduation, I reached out again. I’m able to recap how med school prepared me for life in metabolic health and endocrine health. Now we’re here.
Dr. Lauren Kelley-Chew: Was your passion for metabolic health something you’ve had your whole life, or is that something that evolved over time, and maybe even increased while you were in medical school?
Dr. Elias Eid: I’ve always been interested in this space. Living with type 1 diabetes, I’ve realized that the problems my peers and colleagues were suffering from—fatigue, foggy cognitive ability, general life, feeling crummy, having to rely on caffeine to get through our days—were the same problems I have as a type 1 diabetic. Mine are just magnified tenfold. This actually helps, though, because I’m also able to better detect minor changes, living as a diabetic. That’s what really got me excited, especially as the CGM technology has evolved.
I’ve been diabetic since March of 2000. I started off using a finger prick to monitor blood glucose, which I checked every two hours. The data really wasn’t there to even figure out what was going on. The first canisters only lasted three days. Now, they tend to last seven, but we’re working up to 10 and 14. They’re getting better and better. The data is more readily at our fingertips. And it’s real-time data.
I noticed that just being a diabetic really impacted my physical health, physical fitness, and energy. I can see that reflected in the trends of my graph. That’s why I got super passionate about it, and started advocating it to my friends and family.
But it wasn’t until finding Levels that I thought, “Oh, wow.” This type of technology can be used for the healthy 20- and 30-year-olds, or the healthy people that think they may not need it. That data is now there, and we can learn a whole lot more about ourselves with this technology. I’m so excited to see it grow.
Dr. Lauren Kelley-Chew: When you started advocating for this technology and for awareness around blood sugar control and the impacts on fatigue and all of those other things you mentioned, what was the receptivity of your peers?
Dr. Elias Eid: It was split. The people who are really into the space, like the runners and CrossFitters, thought it was awesome. Most people are now wearing Apple watches, sleep monitors, or some sort of smart device. These people thought it was cool. I think the implantable component was definitely a step for them.
Then there was the other crowd that thought, “Well, I don’t really need that. I’m healthy. No diabetes, no endocrine dysfunction. That’s for older people. I’m young and healthy.” They were in it for fun.
Metabolic Health, Med School, and a Disconnect
Dr. Lauren Kelley-Chew: There’s the diabetic experience, but there’s also just the experience of medical school in general, and for everyone as a person. How challenging has it been for you to manage blood sugar despite the extremely rigorous, unpredictable schedule of being a medical student?
Sometimes, you’re in surgery for 10 hours, and there’s a lot of things that aren’t under your control. How did you handle that? How did you see your peers handling that?
Dr. Elias Eid: It’s extremely difficult. I don’t know how I would have been able to do it without the CGM technology, without the real-time data. Even right before this podcast, I noticed my sugars were going low. I thought, “How are you able to live an optimized life without having that real-time data?”
I see the data on my watch. I need to know what’s going on in my body to be able to be the best person I can be. In surgeries, sometimes I put the watch on the nurse and said, “Hey, look at my watch and let me know what’s going on.”
It’s not just limited to diabetics. I don’t think people realize this. In medical school, we learn that our body can put up with a lot of beating until it can’t. Then, all of a sudden, we have all these illnesses. But what’s going on in our bodies from point A to point Z?
Maybe you had a great day today. You went to the gym; you had a great afternoon. But then by mid-week, you don’t feel so good. Why? What happened between Monday and Wednesday? Without these tools, we just don’t know.
It’s extremely difficult, but you have to be very conscientious of the data and trends, and actively try to seek. You have to try to learn what’s going on.
Dr. Lauren Kelley-Chew: You’re basically becoming a pro in your own pattern recognition and how it feels in your body, staying attentive to every detail. When I first started using a CGM, it was life-changing. You realize how much every little thing matters. You also realize how much our bodies put up with.
I realized I had been going through years of high blood sugar for large portions of my day. Thankfully, it felt like my body was still relatively healthy. But at some point, your body tires out, and the strain is seen more.
How, if at all, are medical schools teaching metabolic health, nutrition, and essentially being the captain of understanding what’s happening to your own body?
Dr. Elias Eid: I think it’s lacking, for sure. Although, I saw a survey. The national average for US medical schools is less than 20 hours in nutrition. That’s next to nothing. I think there are some efforts made, but it’s more of, “Yeah, focus on your health.”
I’ve always said that as doctors, we do not practice what we preach, like healthy living or a balanced lifestyle. We know how to preach it, but I don’t think there was one surgeon I saw during my clinical rotations that was not hyped up on caffeine or sleep-deprived. You can tell this is not a physically healthy human being. This is not the ideal fitness, or human peak performance.
We’re lagging a little bit behind, but it’s not something anyone denies. It’s almost like cognitive dissonance: We know about it, but we don’t really do it. We brush it off, thinking, “Hey, we’re trying. This is how medicine is, and this is how it was and how it’s going to be.” Some people in the newer generations can acknowledge this. We think, “Hey, this is probably not the best thing we do to ourselves.” But we’re not bothered.
A Systemic Gap
Dr. Lauren Kelley-Chew: It has been many years since I went to medical school, but my memory is that it was relatively well-acknowledged that so many of the chronic conditions rampant in the US, and in the world, are reversible, preventable, and manageable by lifestyle intervention. It could have depended on what specialty you were in, but certainly in the primary care field, and really across the board, behavior change is one of the most powerful tools that physicians have.
And yet, we don’t receive any education about how to do that. Even the basics on nutrition science or the research there is typically not covered. There’s acknowledgement that diet and lifestyle are huge factors. But there’s still so much research looking for a “magic pill” for all these things. We know in large part what we can do to help with these conditions, and yet we’re not training our physicians to help patients do that. Why do we see this gap?
Dr. Elias Eid: I thought about this a lot and I distilled it down to a very clear answer: a lack of data. I’m passionate about this space for one reason alone: I have a lot of friends. They go to the doctor once a year, and say “Oh, my annual labs are perfect.” Then they come back next year.
But then we all hit 50. About 37 million Americans have diabetes, the vast majority of which is type 2, and over a third of the country has prediabetes. Many of us will get some sort of cardiovascular disease or suffer from liver and kidney dysfunction. Why? Let’s say your fasting blood sugar, your annual A1C, is perfect. You go to your doctor, and say, “Hey Doc, I’m fine.” One thing that most doctors, and even most endocrinologists, aren’t checking is, for example, insulin levels.
Let’s say a normal insulin level is five; you check your insulin level, and see it is at 20. “Doc, I have a normal A1C. My blood sugar is fine. I’m healthy. I’m not going to get diabetes,” you say. But your pancreas is putting out four times the amount of insulin to get the same results. Eventually, do that for 10, 20, 30 years, add in a little genetic predisposition, a little junk food on the side, maybe less physical activity.
One day, your pancreas says, “I’m done. Why should I work four, five, or six times harder?” In my pre-med years, and even in my medical school years, I worked in a lot of endocrinology offices. There were a few doctors who would check insulin levels, and you would be amazed at the level some pancreases had to work.
Our bodies are working on overdrive. It’s like getting a car, and never changing the oil. Once you get 50,000 miles, your motor blows out, the transmission goes out, and you’re scratching your head, thinking, “What happened?” There was a whole lot we just weren’t aware of, and that’s the problem.
The reason for this disconnect is, historically, that the data was based on a fasted blood draw once or twice a year. That was it. That was all that medicine could offer. This is no longer the case. We have minute-to-minute, real-time data. We went from pricking your finger every two hours to get a blood glucose reading, to now getting one every five minutes. The technology’s only getting better. It’s getting smaller. It’s getting more accurate.
Even just a couple of years ago, you’d have to calibrate these sensors. Now, they’re calibration-free. It’s insane how the technology is advancing. Medicine better jump on board, because there’s a reason why big tech is putting money into this space. It is a growing field that’s adding value to people’s lives. We need to focus more on the real-time data changes and recognize those trends. Then we can add intervention.
Dr. Lauren Kelley-Chew: In situations where people aren’t doing fasting insulin testing, or you see a normal A1C, but it’s pretty clear from your evaluation of the patient that it’s likely there’s insulin resistance happening under the surface, how have you had to advocate for the attending to order different labs or change their perspective on the patient?
Dr. Elias Eid:
They’re never as impactful as you want them to be. Usually, this conversation is built around weight loss. Our own personal biases also play a lot into it. Many times, the patients themselves are not necessarily in their best possible state.
Then you’re trying to think back to the literature, and what proves weight loss. Let’s be honest. We think, “Hey, we’re preaching this literature, but I can’t even practice that.” It’s hard. As a human being, it’s similar to telling someone, “Stop smoking,” when you yourself smoke. They’re not really going to do that because you can’t do it yourself. You don’t deny it, but shift the conversation to things you feel more comfortable with.
> Insulin resistance is, I think, the most underrated biomarker that we are not looking at.
I’ll say, “We’ve got to increase your insulin levels or fix what you’re eating. Maybe try keto. Maybe try this. Maybe try that.” We’re not addressing the main issue, and the issue is insulin resistance.
Insulin resistance is, I think, the most underrated biomarker that we are not looking at. I’m sure there are many more—cortisol levels, epinephrine. But I think insulin resistance is an great first biomarker that a lot of physicians are not really aware of, because it’s not how they were trained. Sometimes, people are not motivated enough to learn these new things. That’s why it’s important to have podcasts like these to really advocate for this view.
CGMs as a Gateway for Hyper-Individualized Care
Dr. Lauren Kelley-Chew: I think the experience of many medical professionals is that they’re on this rapid treadmill of practice. There isn’t much free time. This is a whole other conversation we’ll have to do a second podcast around.
The training process and the practice for many clinicians is just not conducive to health. It’s unfortunate, because we’re asking people to help other people with their health while we’re essentially structurally causing them to not be able to live healthy lifestyles themselves. It’s a really big problem.
You have seen the power of CGM in your own life. What are some ways you see CGMs being applied in the clinic, for patient populations, and maybe also for provider populations?
Dr. Elias Eid: As it becomes more accessible, the cost can go down, and availability goes up. I would say,”It doesn’t hurt. Throw it on.” The clinicians I worked with who did advocate for these things wore it themselves. When patients see their doctor also try to better their personal life, they want to do that, too.
It’s about increasing access. Historically, sometimes people have thought, “This is only for clinical use.” I say, “No, this is great for everybody.” People should not worry about CGMs only if they’re diabetic. I put my parents on one. People should be wearing a CGM.
We have all this data. How do we make sense of it? What does it all mean? All these numbers that go up and down, what does that mean in my life? What should I be changing? What could I be doing throughout my day? How is it affecting my sleep? How is it affecting my work? How is it affecting my relationships?
We can’t figure those things out until we get all of this data to recognize those trends. Then we can say, “Okay, this is a pivotal point. If I make this intervention, then we can affect the downstream.” There’s a lot to unpack, but we definitely need to get people aware and excited. Using the technology is the first step.
Dr. Lauren Kelley-Chew: Historically, some of the resistance to adoption of technology in traditional clinical settings has been from the physician’s perspective. They realize there’s going to be all this data they’re now going to have to deal with. A patient encounter might be 15 minutes, and often less. In that time, they have to see the patient, make a plan, and do all the documentation for the insurance side of things.
There’s been a lot of fear that adding wearables and data from these other sources is just going to make it even more difficult to provide patient care. My hope is that software, whether it’s Levels or other things, will do some of that work for physicians so that in the end, they’re just seeing the most pertinent information. Most of the control and power is on the side of the patient, who’s living in the details every single day.
For people in medical school, or who just have really busy lives, are there hacks or strategies that you used during training to regulate blood sugar and keep things as consistent as possible despite a completely unpredictable schedule, very little sleep, and limited access to the food you wanted to eat?
Dr. Elias Eid: Don’t adopt the thinking of someone who doesn’t have the results you have. What do I mean by that? I have a lot of friends in the bodybuilding world, and that’s my community. We also have this rule of thumb: You don’t go to the gym and ask someone how to get in shape if they don’t look how you want to look. You don’t ask a broke person how they became rich. It’s the same idea.
A lot of the mainstream nutritional information is not necessarily giving people the results they want. For example, oatmeal is believed to be a great breakfast. The media says it’s low in cholesterol, this, that, and other thoughts from all the added figures they include. As a diabetic, oatmeal was a horrible thing for my sugar, and that’s corroborated by my fellow diabetic friends.
Dr. Lauren Kelley-Chew: Same with me.
Dr. Elias Eid: I don’t care what I do. When I eat oatmeal, there’s a spike and a dip. In high school and college, I’d be in a bad mood when I got to school. Anytime I was having a bad day, this is truly what I attribute it to. This was before the CGM.
My mood swings are correlated to my sugars. I switched to Cream of Rice. You will not believe the difference. For me, white rice, not brown rice, works. This is just anecdotal. It shows the power of a CGM, the power of, “Hey, I don’t know the exact science of it, but anecdotally, it’s working.” I get my insulin 15 minutes before. I’m riding like a wave. I’m great. I put some berries in there. I put in some honey. It tastes great.
Mainstream health media have good intentions. People are trying to give good information. But we’re all so different. We’re all from different backgrounds, have different genetics, and have different socioeconomic backgrounds. It’s not one-size-fits-all. We need to really see.
If oatmeal works for you, awesome. If your figures are awesome, enjoy it. If Cream of Rice is not good, try sprouted grains, maybe some whole wheat. Experiment. Then, every time you have a mood swing, I would challenge you to look at that graph. I will bet you good money there’s going to be a fluctuation preceding that.
It’s transformative to give people the power to look and see, “What am I doing in my day-to-day life?” It takes a certain level of discipline, and it definitely takes some getting used to.
> It’s transformative to give people the power to look and see, “What am I doing in my day-to-day life?”
Dr. Lauren Kelley-Chew: Some of these things people wouldn’t necessarily attribute to blood sugar, but they’re experiencing them every day. Mood is such a good example of that. I have one friend who always thought it was just her personality to have these mood swings. When she went on CGM, she realized that it was actually blood sugar dips. It was directly correlated.
As soon as she leveled out her blood sugar, those mood swings went away. This was a personality she thought was hers her entire life. She thought she was just the kind of person that has that. It’s really empowering to realize that there’s so much happening in our bodies that we can alter if we want to. It’s possible to do.
How did you decide to go into emergency medicine, and how are you planning to bring all of your knowledge and passion for metabolic health into that setting?
Dr. Elias Eid: I didn’t go into medical school thinking of becoming an ER doctor, but I fell in love with the fast-paced, real-time data. That’s really what I enjoy. I love the quick, actionable change. Although I also love endocrinology and metabolic dysfunction—I think they provide the answer to almost all of our chronic illnesses—but it’s a little too slow. I don’t want to get labs and wait a week. I want to look at things now.
I get more satisfaction from helping people in a more immediate way. Even during my interviews for residency, I spoke about my work with Levels quite a bit. I actually translated my interest for CGM and real-time monitoring into end-tidal CO2, which is the marker we use in the ER for early sepsis detection, sepsis management, and sepsis protocol.
There’s this theme of, “How can I get data quickly? How can I make sense of the data? Then what do I do about it?” That’s the theme I advocate for in this space. Get the data, analyze it. What does it mean? Now, what do I do?
The “what do I do?” part, fortunately, is all that matters. You want to lose weight? Okay. Let’s get a bunch of data. What is that? What does that data mean? How can we cause that to decrease your weight? That’s where that all ties in.
Listening to Your Body, and Finding Community
Dr. Lauren Kelley-Chew: One of the great things about emergency medicine is that you are meeting a lot of different people, and you’re meeting them at a moment in their life where there’s typically a high level of vulnerability. They’re having a crisis, which is what brought them to the emergency room.
There is a desire to change their health status, of course. It’s really cool that there will be people like you who are there who are trained to deal with the immediate issue, but also have this broader lens that there are probably things they can be doing that will really alter the course of their health in the long-term. You’ll have so many moments with people at this snapshot in time when they’re at this potential inflection point in their life, which is really powerful.
How can we start to inspire others in medicine to view blood sugar control, or metabolic health and food choices in general, as core to the facts of medicine, just as we do medications and other interventions?
Dr. Elias Eid: It’s starting with what people know, somewhere where there is common ground. There is evidence-supported medicine that uses this idea of metabolic function. For example, one lab test most clinicians don’t use, or don’t even know about, is called the GlycoMark. I think it is one of the most underrated lab tests. The GlycoMark is a lab test you do with your normal lab work. It looks at post-prandial sugar: After you eat, how high are your figures going before they come back down?
It can distill it down to a chart, like any other lab value. It gives you a number, and it can say, “On average, your sugars are going up to 215 after meals.”
As a diabetic, that’s what told me, “Okay, I’m not pre-bolusing enough. I’m not getting my input early enough. If I’m shooting up to 230 before it goes back down to 120 or 100 or whatever the case may be…Hmm.” But my A1C might still be fine. My trends might appear pretty good.
It’s just not widely used, but it’s there. Hyper-focused clinicians and experts in this space are starting to use that. To get people excited about these spaces, get them to start implementing what’s already there. Once they get comfortable with the utility, then you can bridge pay. This is where we can increase the utility of it.
It’s really hard to get someone who’s been talking medicine for 30 years. It’s like anything. As we get older, we get more set in our ways. That’s why it’s so important to, as the evidence increases, start implementing it. I would say this to people too. I’m a physician, yeah. I believe in evidence-based medicine, yeah. But you know what? I also don’t discount anecdotal experiences. I really don’t.
You can’t write off someone’s experience. If someone says X, Y, Z, take it into consideration. If they’re saying, “Hey, Cream of Rice is better than oatmeal,” maybe there’s something there. Maybe the literature doesn’t support it, but in medicine, there’s more we don’t know than we do know.
It may seem silly at first glance, but people are very responsive to their bodies. We need to listen to people and validate their concerns.
Dr. Lauren Kelley-Chew: It’s so important. Medical students are not taught how to listen in general, despite the fact that is one of the most powerful tools physicians have. In addition to that, there’s this sense that if something isn’t validated in the existing science, it’s not true.
The human body is a vast mystery, and we’re trying to find different windows into understanding it. Modern medicine has done incredible things, as have the traditions of Chinese medicine and other forms of healing. But for the vast majority, we just still don’t know. The person who knows each person’s body best is that person. Their experience is the most valid piece of data.
To the extent that it changes how clinicians are trained, we can take that as the beginning, and then use all the tools we have—whether technology, existing science, or new research—to create change around that existing core experience. That would be such a massive change in the practice of medicine, and certainly would create a lot more empathy.
Do you have advice for how medical students, premeds, residents, and physicians interested in technology can become part of this changing approach to medicine?
Dr. Elias Eid: Be bold and add value. This is an emerging space. No one’s going to hold your hand. I spend time on this outside of this podcast because I see utility in it, and I just love it. You become an expert in that field. The more you know about something, the more you’re able to share and collaborate. That adds value. As human beings, we appreciate someone who’s trying to help others. That’s the biggest step. If this is not your space, that’s fine. Find your space, and add value to it.
Fitness and health and wellness is a “thing” now. It’s popular in the young community. Ten or 15 years ago, there was a certain group of people who worked out to be healthy. But now, with social media and the metaverse and this and that, it’s cool to be fit. It’s a lifestyle thing.
It’s definitely something the new generation, and even those younger than me, are going to experience in a way that we never have. The internet and technology can help us keep each other accountable: “Hey, you didn’t go to the gym today. It would have alerted me that you went to the gym today,” or, “Hey, you didn’t get your steps in.” I think that’s the way people can become encouraged, by developing a community and feeling connected.
One thing I’ve learned in medicine is you don’t really know what it is to be alone until you’re in a room full of people and still feel alone. This idea of, “I want to be fit. I want to be healthy. I feel crummy. I’m not living my best life. I’m not living as my best self,” can make you feel so alone.
Companies like Levels are giving you a community to bear and validate your concerns. People can say, “Hey, this is what I’m experiencing. And this is why. Help me understand it.” That is such a huge relief to people. Once people have that community, they realize, “Wow, I have that space, that fallback, and I can figure out what’s going on with myself.”
Let’s be honest. Most of us don’t know what the heck we’re doing.” I’m literally figuring it out day-by-day. Having that community, I think, is definitely going to empower people to be bold, and then to advocate for whatever they’re passionate about.
Dr. Lauren Kelley-Chew: Thank you so much for saying that. I agree that the sense of aloneness is such a blocker to change and can be a very difficult experience. I hope people know that every single person, including every physician you’re encountering at a doctor’s appointment, is dealing with the same things you’re dealing with in some way. Every person has their own flavor and their own experience, but no one is exempt. The statistics show that.
More than 80% of Americans lack optimal metabolic health. When you go to the grocery store, you might feel very alone. But everyone is on this journey to some extent. And if not in this moment, in another chapter of their lives. I appreciate you saying that.
In 10 years, what do you hope the conversation will be like around these topics? What do you hope medical schools will be teaching?
Dr. Elias Eid: I think it’s going to be a lot different on the user’s end. As soon as these technologies become available to the general public at scale, that’s going to be the stimulus to wake up the medical community—change as a signal for change.
Already, medical schools are shifting to more technology-based learning. The traditional lectures and PowerPoints have already been phased out. The world is catching up to technology. That’s why it’s awesome to have gone through medical school, going to hopefully finish up residency, and then be able to be part of that technology space.
The world is changing, and you have to jump on board. We all have to bring our expertise, from engineering, from design, from product development, from clinical medicine. We all need to come together and use technology to scale that. That’s the only way we’ll be able to help as many people as we need to.
Dr. Lauren Kelley-Chew: Are there resources you think are good places for people to start learning?
Dr. Elias Eid: I follow a lot of fitness influencers and people who are health-conscious. There are a lot of new doctors on TikTok and Instagram. I actually really like a spine surgeon, Dr. Antonio Webb, from Texas. He has nothing to do with this space, but I’ve been watching him for years, seeing how he’s incorporated technology in his residency and fellowship. Now he’s an attending, doing really great stuff. I give a lot of kudos to the clinicians who blog while they’re doing their clinical medicine in life. I think, “How do you have time for all this?”
Don’t be afraid to take that step forward. Remind yourself that, “Hey, if they can do it, I can too.” You’re not better than anyone. No one’s better than you. We are all capable of greatness. We’re really the prisoners of our own minds, that, “Oh, I could never do that.” We can. We can all do it. And we have to encourage each other to do that, because that’s also something we don’t do enough.
Hope, Experimentation, and Finding What Works
Dr. Lauren Kelley-Chew: Especially in medical school. It depends on what medical school you go to, but clinical training can be so competitive. It can feel like a zero-sum game. If someone gets your residency spot, that person is now your competition. I just think, like you said, it’s not true.
The reality is there’s so much work that needs to be done across the board that there is more than enough for everyone. We’ll never get it all done, but encouraging each other is much better than competing with each other. Is there anything we haven’t talked about that you want to make sure we discuss?
Dr. Elias Eid: Just getting people to realize that this actually benefits your life. If you’re overweight, if you’re suffering from any sort of metabolic disease, getting involved in this space and seeking to figure out what’s going on with our bodies, it’s so important. That’s the point I really want to drive home to people. I want people to understand that what you’re going through is valid and real.
We’re all going through stuff. This offers hope for a lot of things we just don’t know about. This offers hope for feeling alone, or anxious.
When you’re not feeling like your best self, you’re going to feel depressed. You’re not going to be great. You lack energy. You’re not where you want to be. You’re leaving potential on the table. A lot of people don’t realize the feelings of sadness and depression.
That’s how the CGM technology ties into that. When you recognize, “Hey, I’m sad,” or, “I’m not in my best place possible,” it’s fixable. We just have to make sure we’re looking in the right ways. This is definitely a major avenue that has been neglected for so long, and only now are we able to start looking at it.
It’s this idea of hope. There is a solution. There is a way out. And we’re on the way. We’re actually doing this.
Hopefully, this paves the way for other groups and other people to get involved in this space and help contribute to that.
> There is a solution. There is a way out. And we’re on the way. We’re actually doing this.
Dr. Lauren Kelley-Chew: One thing I always share with people is that a CGM is incredibly powerful. I really believe in what we’re doing at Levels. For people who don’t have access to a CGM right now, there are things they can start doing tomorrow to help begin this path.
For example, taking walks after meals, or like you said, starting to notice mood swings and maybe altering the food you’re eating before them. Obviously, staying away from a lot of added sugar and processed carbs is important. There are things we can all do, and you don’t have to do them all at once.
I tend to go all or nothing. I think, “Okay, I’m balancing my blood sugar.” The next thing I know, I’m trying keto and I’m really in it. But there are also people who follow a more progressive approach, and that’s equally powerful and valid. Everyone’s on their own path, and there is hope. There’s a lot of reason for hope. The conversations surrounding blood sugar can be game-changing.
Dr. Elias Eid: Absolutely. I do want to say one thing that I think might help people: Cardio is so underrated. Do it.
During my clinical years, I was in surgery, waking up at 4:00 AM to be at the hospital by 5:00, doing pre-rounds. If I would go on a 10-minute run as the first thing I did when I got up, I would not need insulin with my breakfast. My breakfast was the same every morning during surgery.
Your body’s like a machine. That’s how I visualized it. When I ran first thing in the morning, I almost depleted my liver of the glycogen it had to fuel my run. Every single morning, your blood sugar goes up to get ready for the day. It didn’t have that glycogen because I used it for the run. Then I ate, and my body was living off of the sugars that I just had in my breakfast. I wouldn’t need insulin until about noon.
During my board exam, I couldn’t do the run. What do you think happened? I started needing more insulin, and it only went up. I even experimented with doing midday cardio. It didn’t have the same effect.
Again, this is all anecdotal. And that’s fine. If it’s anecdotal for you, go for it. It’s helping your life. I don’t think my body was tapping into its liver stores. I think it was tapping into the stores of the food I ate two, three hours ago. That’s why my sugars were not getting that same insulin sensitivity as when I was fasted.
That for me was a game-changer because I was able to give 10 less units of insulin. For a non-diabetic, your pancreas wouldn’t need to punch out 10 more units of insulin. Now you have a leaner machine. You’re more optimized. You’re not having to do so much to compensate. That was something I think non-diabetics, anyone, can do. Experiment with it. Do 10 minutes. Ride a bike. Go on a walk. Do it for a week.
Try it after a meal. Maybe that is when your body needs it. There’s no right or wrong answer, but do it and try it and look at the data. If you don’t have the data, go by how you feel. Trust me. How you feel sometimes is a better indicator than the data because that’s the most important thing.
Dr. Lauren Kelley-Chew: Such a great tip. Ultimately, the hope is that when people do have access to the data, they’re training themself to understand what they’re feeling in their body. That’s the ultimate goal, that we’re our own CGM. I also love your example because 10 minutes is really doable, and makes that much of a difference. It’s the amount of time it takes to listen to two or three songs on Spotify. It’s incredible.
Dr. Elias Eid: Pay attention. That’s so exciting because I’m experiencing that, and I’m a diabetic, and it changes. It’s huge. My morning is so much better. If you don’t have diabetes, you’ll be amazed at how much better your mood is. You won’t be stressed out going to work. You won’t be fighting with yourself. It really is amazing. I could talk about this stuff all day long.
Dr. Lauren Kelley-Chew: I love the phrase “pay attention”, because so much of health is about that. It’s paying attention to your own body. It’s paying attention to the world around you, to your choices, to the complexity of all of this. All of our choices are happening in such a complex environment that it’s not as simple as, “Oh, I decided to eat or not eat a good or bad food.” It’s so much more layered than that. Attention is the first step.
Thank you so much for having this conversation. It’s really inspiring to know that there are physicians like you who will be coming into the community and being a force in the conversation, in research, and in reshaping everything. Like you said, whether it’s about mood, fitness, endocrine health, or chronic disease, it’s amazing to see physicians with empathy, who are also super smart, enthusiastic, passionate, and hopeful.
Where could people find you if they want to follow you?
Dr. Elias Eid: I’m on Instagram, @imelias_. It’s exciting to be a part of this, and hopefully I can help more people and connect with others.
