In this clip, Dr. Michael Snyder describes how changes in his own glucose regulation which he noticed with a continuous glucose monitor, converging with his knowledge of his personal genetic risks, ultimately led to a surprising diagnosis of type 2 diabetes. A proponent of the preventative health value of aggressively collecting data, Dr. Snyder's story is illustrative because, without his tracking of glucose, he may not have realized when the point at which his personal glucose management warranted seeking medical attention, potentially putting him at risk of more long-term deleterious effects.
"It's pretty clear that actually, 9 out of 10 people that have pre-diabetes actually have no idea. What that means is their glucose is starting to go out of control. They're not officially classified as diabetic yet, but they will be. And it turns out that 9% of the U.S. population is diabetic, but 33% are pre-diabetic." - Michael Snyder PhD
Dr. Snyder: I'm a believer you can't have enough data. More information is always better than less information. So what do we collect? Well, we do deep molecular measurements on me. Well, for example, we sequence, first of all, my DNA so I know what kinds of risk factors I might have, genetic risk factors. We also do very deep molecular measurements on me. Meaning we'll draw my blood and urine profile -- literally tens of thousands of molecules. We'll study my poop for the microbiome. And we do a lot with wearables that we'll, I'm sure, talk about today with smartwatches and other devices. In fact, I have eight of those devices I use every day.
Dr. Patrick: You've actually got a pretty interesting story. So you've sequenced your entire genome and you've learned some really interesting predispositions that you have and that actually turned out to be a pretty interesting story. Do you mind talking about that a little bit?
Dr. Snyder: Sure, yeah, no, actually, this big data collection has helped me several times. And the first was, in fact, from my genome sequence. So I sequenced my genome, it told me things I was at risk for. One of them was quite surprising, it said type 2 diabetes. And I'm not overweight, I exercise pretty regularly. And I thought well, you know, how can that be? I don't have a family history of type 2 diabetes so I wasn't too sure it was right. But I was, in fact, tracking my sugar levels, which is what happens when you get type 2 diabetes, your sugar levels go up as well as many other things.
And what we discovered actually, about nine months into the study after I sequenced my DNA we saw this risk from type 2 diabetes, my sugar actually was shooting up through the roof. And I was only following closely because of the fact that my genome told me I was at high risk. And in fact, when I first discovered this, I was going in getting a test for something called insulin resistance which is associated with type 2 diabetes. And the doctor actually, you know, she was skeptical, "Why are you here? You don't look, like, you have diabetes because I'm not overweight, you don't have family history, you know, doesn't make any sense." And I said, "Well, my genome said I have this going on."
And so she actually drew blood and my sugar levels were high actually, we were both surprised. In fact, she repeated the measurements and sure enough, they were quite high. And then it turns out there's insulin resistance. I wasn't insulin resistant. I was insulin sensitive. But my sugar was high so we measured it a week later and did some other tests, something called hemoglobin A1C. And sure enough, I had crossed the threshold and was classified as type 2 diabetic. So my genome tipped me off and then these other measurements actually, you know, basically discovered it.
What was pretty unusual about it was that it came up after a very nasty viral infection actually. About three weeks later, is when I was getting measured and that's when my sugar levels were rising. It's very relevant to the current pandemic, in fact, because a lot of people think that COVID might trigger type 2 diabetes. In fact, there's some evidence for that already. But this is the first demonstration that a viral infection could actually trigger a type 2 diabetes. And so in my case, I caught it because I was doing this deep profiling.
Dr. Patrick: So how common is it that you find people that are like yourself, I mean, I typically...you know, when you see someone who's healthy, active, you know, looks lean, how common is it to see that they may be metabolically unhealthy in terms of at least, you know, their glucose regulation?
Dr. Snyder: Yeah, well, on the glucose side, it's quite frequent actually. So we have some studies going on with something called continuous glucose monitoring. But backing up a little bit, it's pretty clear that actually, 9 out of 10 people who have pre-diabetes, so not yet diabetes, actually have no idea. What that means is their glucose is starting to go out of control. They're not officially classified as diabetic yet, but they will be. And it turns out that 9% of the U.S. population is diabetic, but 33% are pre-diabetic. And most of those pre-diabetic will go on to become diabetic and yet, they have no idea they're pre-diabetic. And so we think actually capturing that information is pretty darn important so that they can start getting their glucose under control long in advance of getting full-blown type 2 diabetes.
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