I found out 40% of people with "normal" fasting glucose are actually pre-diabetic on CGM. Should I be alarmed?

The finding, from Levels Health's research data, is real and clinically important. It tells you that the standard fasting glucose diagnostic cutoff (100 mg/dL for impaired fasting glucose) misses a substantial portion of men with meaningful postprandial glucose dysregulation. These men have normal fasting glucose because their bodies compensate efficiently in the fasted state but struggle with carbohydrate loads. The CGM catches what the single fasting measurement misses.

Whether you should be alarmed depends on what your CGM shows. If your fasting glucose is 88 mg/dL and your post-meal peaks stay below 130 mg/dL, that statistic does not apply to you. If your fasting glucose is 94 mg/dL and your post-meal peaks hit 160 mg/dL three times a day, you are in the group that statistic describes, and the appropriate response is not alarm but action: reduced refined carbohydrate intake, post-meal walking, and a fasting insulin test. These are manageable findings that respond well to lifestyle intervention at this stage. (Dunnigan et al., Lancet Diabetes and Endocrinology, 201930325-5/fulltext))

Cardiologist's calibrated position, Solid (1) for the prevalence finding. Promising (2) for the significance of CGM-detected pre-diabetic patterns in otherwise healthy men.

What to do: If your post-meal peaks are regularly above 140 mg/dL, treat this as an early metabolic signal worth addressing rather than a diagnosis to fear. Lifestyle interventions at this stage are highly effective.

For the full picture, read The CGM on Your Arm Doesn't Know Your Arteries.

## Category 18: hs-CRP / Inflammation
Deep Dive: Inflammation's Invoice