Glucose and health
This phase of the study has now ended and the results were published in Cell.
You can also watch a short animation describing the research.
Why should I care about my sugar levels?
High blood sugar levels are a risk factor for many complications, such as type II diabetes, heart disease, and stroke. In addition, high blood sugar levels encourage our body to secrete more insulin, and more insulin means more sugar stored as fat, and thus more weight gain.

To avoid these harmful effects, we need to control our blood sugar levels. Since different people have different responses to food, we have to find out what our personal response are and plan what we eat accordingly.
What affects sugar levels other than food?
Sugar levels are mostly affected by what we eat, but also by stress levels and the amount of physical activity we do.

Stress causes our body to secrete the hormones adrenaline and cortisol, which promote the release of sugars from the liver, raising our blood sugar levels.

Physical activity requires energy, which is usually supplied to the muscles as sugar from the liver. The cells in the body of a physically active person are more receptive to glucose, so after eating, physically active people have a smaller increase in blood sugar levels compared to non-physically active people.
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Our study
Our study participants receive unique and interesting information.

Upon registration to clinical study:

Access to our personalized nutrition logging application
Our Personalized Nutrition logging application allows you to record your daily activities and food intake. Our logger has a unique database with thousands of food items along with their full nutritional values that can help you follow your dietary goals.
At the end of the connection week:
  • Detailed analysis of your glucose response to the food you ate
You will receive a score of each of the meals that you ate during the week, representing the effect of that meal on your glucose levels. Your personal meal scores can help you in determining which food choices are best for you.
You will receive an hour-by-hour view of your glucose during the connection week, allowing you to see how your glucose levels respond to food, exercise, and sleep. You will also be able to see how glucose levels and responses compare to those of the other participants.
As the study advances:
  • Detailed analysis of your gut microbe composition
You will receive a detailed analysis of your gut microbe composition, along with the information presently known about the positive and negative roles that each microbe plays in your gut.
  • Access to our personalized diet planner
Our personalized diet planner allows you to enter your food preferences, and construct personal diets based on various vitamin and mineral nutritional requirements, while adhering to your dietary preferences and constraints. As more people join the study and our ability to predict personal glucose level responses to food improves, the planner will also allow you to construct a diet that maintains your predicted glucose levels at normal levels.
Where will the study take place?
This study intends to measure your blood glucose response during your normal everyday routine, and it is therefore not confined to any specific place. After connecting to a glucometer in Sourasky Medical Center in Tel-Aviv (Ichilov) or at the Weizmann Institute of Science in Rehovot. you will be free to go about your regular daily routine.
What change is required in my daily routine?
We require only a small change in your daily routine: in each of the 7 mornings of the study, we will ask you to eat a single test food. After eating the test food, you can go about your daily routine, but refrain from eating and from strenuous physical activity during the following two hours. Those tests will assist us in finding groups of people whose sugar level respond similarly to food.
Can I choose my own test food?
In order to understand which responses are shared between people and which responses are different, we will ask you to measure your response to a number of designated food items. However, since you will wear the glucometer for the duration of the study, you are welcome to test your response to types of food of your choice and liking in times when you are not testing a designated test food. You are encouraged to log those private tests using our web logging application. The more types of food you test and meals you log, the better we will be able to predict your blood sugar response to foods you have not tested.
Where can I log what I eat?
Our website has an online logging application for study participants. We invite you to start using this tool to record your daily activities and food consumption independent of participating in our study. If you do so, we recommend that you also measure and record your body weight from time to time, as in the future we plan to develop analyses for finding associations between weight and logged activities.
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Measuring blood glucose
What is a glucometer?
How do I connect to a glucometer? Is it painful?
A glucometer measures blood sugar using a sensor with a thin flexible probe that is inserted under the skin using a designated insertion kit. In the process of inserting the probe you may feel a prick, similar to that of a tiny needle. After the probe is inserted, the sensor remains taped to the skin until it is removed. In our study, the connection to glucometers will be performed by our trained and experienced personnel. To learn more about how a glucometer is inserted, check out this video:
Can I exercise, shower and go about my daily routine with a glucometer?
Yes.
How is the glucometer sensor removed?
Removing the glucometer is easy and non-painful. After completing the study (7 days), you will be asked to return to the glucometer connection station for removing the glucometer. You will also be instructed on how to remove the sensor in the glucometer connection session. Should some discomfort occur, you will be free to remove the sensor yourself or refer to one of our trained personnel.
Do I need to draw blood in order to participate in the study?
The continuous glucometer requires daily calibrations that can only be performed by measuring blood glucose by finger prick. This requires drawing a small amount (around one microliter) of blood by pricking your finger with a lancet.
To learn more about how to measuring glucose by fingerprick, check out this video:
What other maintenance needs to be done on the glucometer?
To avoid painful fingerpricking, the tiny lancet used in the fingerpricking instrument should be replaced daily.
To learn how to replace the needle, check out this video:
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Participation in the study
What is considered "healthy" for participation in the study?
Since controlling glucose levels is important for everyone, we will try and accept as many people as possible to the study, regardless of their medical status. However, to avoid any harm to you, you will be asked to fill out a medical questionnaire that will be reviewed by trained experts. Should they decide that this study may be harmful to you, you will not participate.
I am afraid of needles. Can I participate in the study?
This study requires the use of a glucometer that has a small flexible needle-like probe which is inserted under the skin. It also requires drawing small amounts of blood from your finger four times a day, using a lancet with an invisible point. If you are fine with that, you'll probably do OK.
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The microbiome
What is a microbiome?
Our microbiome is the collection of all microbes (such as germs) that are associated with our body. In our gut alone we have around 100 trillion microbes, which is 10 times more cells than we have in our entire body. These microbes have 150 times more genes than we do and weigh around 2 kilograms - more than our brain. Our microbes influence our health, weight and well-being. Unlike genetic factors that influence the same things, but are constant and cannot be changed, we can change and manipulate our microbiome.
How can my microbiome affect my health?
Our microbiome is tightly associated with our health. Here are just several examples:
  • Microbes help us digest. It is assumed that we get 10-20% of our energy with the help of our gut bacteria.
  • Microbes train our immune system, and teach it to identify friends and foes among bacteria. Germ free animals, for instance, possess a largely underdeveloped immune system.
  • Microbe diversity is important. Obese individuals have a different microbiome. It is usually less diverse than that of lean people. In an experiment in mice, scientists observed that after transferring the microbiome of obese mice to lean mice, the lean mice become obese without changing the amount of food they eat..
How can my microbiome affect blood glucose?
Insulin resistance is a state in which the cells of our body do not respond to insulin produced by the pancreas. As a result, our body cannot lower the level of glucose in our blood. A recent study (Koren et al. 2012, Cell) showed that insulin resistance is associated with certain communities of gut microbes in humans. Transferring these communities to healthy mice caused them to develop insulin resistance as well.

Another study (Qin et al. 2012, Nature) showed a strong association between type 2 diabetes and a certain "fingerprint" of gut microbes. Type 2 diabetes is a disease in which the pancreas is exhausted by trying to supply more and more insulin to an insulin resistant body. Currently, about 300 million people worldwide have type 2 diabetes, and experts predict that this number will double over the next 15 years.
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