My CGM data while on Rapamycin

[wrap-a-mice-in]

My CGM showed this saw-tooth pattern last evening after eating with my blood sugar spiking up and then down, then up, then down, X 4 of these up/down patterns over 3 hrs. That is a new pattern. I will monitor.

That’s fascinating - that’s what I saw the first day I took my dose too and what prompted me to start this thread.

The first spike was my meal. The red vertical line is when I first took 2mg and in the hours after my glucose spiked up and down multiple times before settling at a level ~10 mg/dl higher than usual similar to you.

Last night at ~1 AM (84 hours after the dose), my fasting glucose levels went back down to pre-rapamycin levels. I woke up in the 80s today which hadn’t happened since I started. I’m guessing the concentration in my blood has dropped to a level where it’s no longer affecting my pancreatic beta cells.

[RapAdmin]

@mchasemd

I captured the data and put it into SQL Server

Fantastic, thats the sort of effort needed to really parse out what is happening here.

That saw tooth pattern is very unusual, can’t say I’ve ever seen anything like that.

This is what my CGM typically shows (when I’m taking an SGLT2 inhibitor) - and its usually under-representing the real blood sugar measures (via finger prick) by 10 to 20 points:

[Neo]

That’s great. Are there any of them that also are more medically trained and/or have spent time on diabetes in their career - that might help as they’ll understand the beta cell biology

Perhaps also ask Matt K? He seems to really want to understand things relation to rapa and might go deep to really figure it out if he had not looked at it before.

[Krister_Kauppi]

Both Lamming and Sabatini has looked at the risk of glucose dysregulation so I think they are good. Maybe Peter Attia would be great to ask when I have in on. Matt is great but it will take a time before I have him on again because there are so many other guests that I need to interview But send that question as a proposal to the Optispan podcast because they are working on some upcoming AMA:s around Rapamycin.

[PBJ]

From what I see so far, even more reason to fast for a day after taking Rapa.

[mchasemd]

Here is mine from last evening. “Breakfast burrito” for dinner (scrambled eggs/bacon/gruyere cheese rolled up in a tortilla- the tortilla was a mistake!). But my exercise pattern requires lots of calories.

[drjoanne1953]

I am a Type 2 Diabetic and I was working my way up to the 6 mg dose/week and once I got to 4 mg/week I found that my blood sugar really went up. It had been going up steadily on 1,2 & 3 mg but 4 really made a difference I take Farxiga, Metformin 500mg twice/day and Ozempic. I do not want my Dr. to put me on insulin so I stopped my dose at 3 mg/week. I know it’s not what is recommended for longevity but I am hoping that taking some amount of the rapamycin will help some. If my A1C comes back way high I may have t cut it back still more. We shall see with my next blood test. I do wear a CGM constantly also.

[RapAdmin]

Hi and welcome to the site.

I would be hesitant to use rapamycin if I had diabetes and showed any signs of blood glucose disregulation.

In one of the few studies in mice where rapamycin actually reduced lifespan, it was in the diabetic mouse model.

Adjusting for gender differences, rapamycin increased the mortality risk 1.7-fold in both male and female db/db mice. End-of-life pathological data showed that suppurative inflammation was the main cause of death in the db/db mice, which is enhanced slightly by rapamycin treatment.

Full paper: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4906320/

[wrap-a-mice-in]

Mini-update: No new CGM data since my last 2 needed to be replaced early by Dexcom.

But last week I took 1mg and saw no effect on my BS. I expected this since my 2mg dose seemed to stop affecting my BS after about 2-3 days which from my understanding is the half-life of rapamycin.

I took 3mg last night before bed but was not wearing a CGM so I have no updates yet. My replacements should be arriving next week so I’ll have data for the next dose. I’ll probably do 3mg again.

Also, re: the survey on this forum showing only ~10% of people reported glucose dysregulation, I wonder how many people simply didn’t know when they responded to the survey because they aren’t using a CGM and aren’t aware of the acute glucose spikes which even regular bloodwork wouldn’t show if the dose is low enough. It wouldn’t show up in FBG and only move the needle slightly higher for hba1c if they only had dysregulation for a few days.

[drjoanne1953]

I wear a CGM because I am a Type 2 Diabetic. I started rapamycin several weeks ago, starting with 1 mg the first week, 2mg the second & so on. When I get up to 4mg my Blood sugar was way out of wack so I backed off to 3 mg but my morning fasting Blood sugar is 150 . When I was not on rapamycin it usually stayed below 130. Is there any benefit in even taking rapamycin at 3 or 2 mg? I do not want to mess with my diabetes Any data on taking low doses of rapamycin?

[Beth]

I have questions about spiking and what is acceptable for good heart health, etc.

I just started wearing a cgm again, which I hadn’t done for a few months, and it does appear that my spikes are a lot higher again.

In general, I try to eat things that don’t spike my glucose too often because I seem to spike very easily (my first day wearing a cgm a couple years ago, I had Thai veggies, tofu and rice and went to 230-ish)

Since then, I started metformin. I rarely have oatmeal/regular pasta/bread/rice these days, and while I do have spikes, until starting rapa in March, by eating my restrictive diet and taking metformin, I most often have kept my spikes controlled in the 140-150 (not the case if I have anything I shouldn’t). But this has all changed.

I also started berberine last week.

My spikes don’t last but I am going well above 150 quite frequently.

My question is:

In your opinion, what level of spikes are ok before you take action? (Additional drugs or even less ‘cheating’ with crazy things like healthy berries). Some say high spikes are fine if they come down quickly, but no one ever says what ‘high’ is… or how quickly ‘quick’ is.

And for a deeper dive… how many during the day, how long, what is a good baseline? I tend to eat between 6am-4pm, so I’m all over the place during that time, but from 6pm-6am, I’m mostly near 100-ish. (I can’t tell exactly because unless I just haven’t figured it out yet, you can’t go back and look at specific times and exact levels with the freestyle libre 3… you can easily get granular with the dexcom).

PS, I keep putting off my post rapa bloodwork because it involves a 40 minute drive and skipping my morning latte, so I’ve been lazy about it! I will do that in the next two weeks

[Barnabas]

@Beth

you can’t go back and look at specific times and exact levels with the freestyle libre 3

If you go to LibreView.com and create an account, you can see some nice reports and even download CSV spreadsheets with granular data.

[Beth]

THANK YOU! I was googling and watched videos but never found this… appreciate it!

[ng0rge]

@Beth

I have questions about spiking and what is acceptable for good heart health

For some very good info on blood sugar spikes and CGMs, see my post (and thread) here:
https://www.rapamycin.news/t/good-energy-new-book-by-casey-means-metabolic-health-mitochondria-and-cgms/14530/8?u=ng0rge

It says - If you just want to hear Casey Means’ insight on CGMs (useful) go to the Huberman podcast above and listen to the segment from 2:19:30 - 2:33.

And here’s the link to the YouTube podcast to watch those 13 minutes.

https://www.youtube.com/watch?v=8qaBpM73NSk&list=PL_v7HcCd-Od9povq_lcxMV_iXZ_waSK0y

[Beth]

I just watched and that was very interesting!

I wish they showed concrete examples when discussing this because I’m still not sure how my numbers fit in here, or any other conversations. I hear them say, it’s ok to spike if you come down quickly… but if spike too high (what number is that?) and you come down quickly, it’s a crash and that is bad…

[John_Hemming]

There is a threshold for the spike at around 8/140 which means a different metabolic pathway is being used.

[SilentWatcher]

@wrap-a-mice-in

Also, re: the survey on this forum showing only ~10% of people reported glucose dysregulation

As mentioned by @Angel_Myers, CGMs from Abbott and Dexcom can be inaccurate in the lower range of 80-120 mg/dL. You can use a conventional blood glucose monitor to confirm this.

Additionally, I recommend looking into lithium supplementation.

Correcting lipid/glucose side-effect

I have reduced my intake of rapamycin to once every 2 or 3 weeks to stabilize the negative glucose effect. Currently, I view this glucose intolerance as part of the therapeutic effects of the starvation-mimicking drug rapamycin (Once again on rapamycin-induced insulin resistance and longevity: despite of or owing to; Mikhail V. Blagosklonny). There are some studies that point out that “combination of lithium with rapamycin canceled the latter’s effects on lipid metabolism” (A triple drug combination targeting components of the nutrient-sensing network maximizes longevity). In my n=1 experiment, adding lithium orotate substantially stabilized the glucose side effect (take 1mg daily and 2-3mg on rapa-days).

[RapamycinCurious]

@Correcting lipid/glucose side-effect

There are some studies that point out that “combination of lithium with rapamycin canceled the latter’s effects on lipid metabolism”

There is a study that finds that — in fruit flies.

[John_Hemming]

@RapamycinCurious

There is a study that finds that — in fruit flies.

Which is why I think we need a bit more of a focus on multiple N=1 biohacking.

[Beth]

John, are you saying that after 140 is when I should worry? I wasn’t sure what 8/140 meant (the ‘8’)

I guess I need to consider taking a higher dose of metformin or perhaps consider adding acarbose that seems to be very popular here.