Optimal Numbers For Brain Health. Slides from the free webinar presented on April 15, 2022 https://youtu.be/llJz2dVc6F4

1. NUMBERS TO KNOW
Dr. Shabnam Das Kar, MD, FMNM
www.drkarmd.com
Monthly Webinar April 2022

2. Blood Glucose
Blood Pressure
Chronic Inflammation (Hs-CRP)
Waist Circumference
Sleep Duration
Sitting Risk
Eating Window
Omega 3 Index
Alcohol Intake
Social Isolation

3. • Why HbA1C is not the best measure
• Best numbers and how to measure them
• Time In Range
• Glycemic Variability.

4. • Wear a sensor
• Connected to an app/reader
• You can check BG without fingerstick

5. • TIR Time In Range
• GV Glycemic Variability

6. CGM-based targets for different diabetes populations.
Tadej Battelino et al. Dia Care 2019;42:1593-1603
©2019 by American Diabetes Association

8. Why Glucometer Readings May Not Capture
Important Information

9. Date of Download: 4/14/2022 Copyright © 2022 American Diabetes Association. All rights reserved.
From: Glucose Variability: Timing, Risk Analysis, and Relationship to
Hypoglycemia in Diabetes
Diabetes Care. 2016;39(4):502-510. doi:10.2337/dc15-2035
Fifteen-day glucose traces of two subjects who had identical HbA1c of 8.0% but different degrees of GV. High GV in subject 1 was reflected by
numerous episodes of both hypo- and hyperglycemia (A), whereas low GV in subject 2 resulted in no such episodes (B).
Figure Legend:

10. A major source of GV is the rapid onset of hyperglycemia due to the consumption of
carbohydrates.
www.dietdoctor.com

11. Compared with T2DM patients with
stable glucose levels, T2DM
patients with fluctuating glucose
levels exhibited significantly worse
performance on the Montreal
Cognitive Assessment, Trail Making
Test-B (TMT-B), and verbal fluency
test (VFT) and significant decreases
in degree centrality in certain brain
regions.

13. A depiction showing how patients with the same A1C value may experience different amounts of TIR.
Pamela R. Kushner, and Davida F. Kruger Clin Diabetes
2020;38:348-356
©2020 by American Diabetes Association

14. 70-130 (140) ng/dl (3.9-7.3/7.7) 90-100% of the time
OR
70-180 ng/dl (3.9-10) ?
GV 33% (36%)
This Photo by Unknown Author is licensed
under CC BY

16. Mehta, Ranjana K., Ashley E. Shortz, and Mark E. Benden. "Standing up for learning: A pilot
investigation on the neurocognitive benefits of stand-biased school desks." International journal
of environmental research and public health 13.1 (2016): 59.

17. • Lab test. Dried blood spot for RBC Omega 3 levels versus food frequency questionnaire.
Van der Wurff, Inge SM, et al. "Association between blood omega-3 index and cognition in typically developing Dutch adolescents." Nutrients 8.1 (2016): 13.
Ammann, Eric M., et al. "Erythrocyte omega-3 fatty acids are inversely associated with incident dementia: secondary analyses of longitudinal data from the
women's health Initiative memory study (WHIMS)." Prostaglandins, Leukotrienes and Essential Fatty Acids 121 (2017): 68-75.
Omega 3 Index

19. Blood Pressure
Chronic Inflammation (Hs-CRP)
Waist Circumference
Sleep Duration
Eating Window
Alcohol Intake

20. BG 150
mg/dl
Sleep 5.47
hours
Mood Steps 4501
BP 152/80
mm Hg

21. www.drkarmd.com