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Frequently asked questions about the program
What phones do you support?
iOS 12.1 or later, on the following devices: iPhone 7 iPhone 7 Plus iPhone 8 iPhone 8 Plus iPhone X iPhone XS iPhone XS Max iPhone XR iPhone 11 iPhone 11 Pro iPhone 11 Pro Max Android: version 5.0 or higher (with NFC capabilities) on: Samsung Galaxy S6 Samsung Galaxy S7 Edge Samsung Galaxy S8 Samsung Galaxy S8+ Samsung Galaxy S9 Google Pixel Google Pixel 2 Google Pixel 2 XL LG Nexus 5X Wileyfox Swift
How much does it cost?
The program, containing the blood glucose monitor, kick-off session, guidance and report with conclusion and advice costs 199 Euros.
What is the dawn phenomenon?
The dawn phenomenon, sometimes called the dawn effect, is an early-morning (usually between 2 a.m. and 8 a.m.) increase in blood sugar (glucose) which occurs to some extent in all humans, more relevant to people with diabetes. It is thought to occur due to temporal elevation in serum cortisol, epinephrine and norepinephrine associated with transition from sleeping to wakefulness
Which sensor do you use?
At the moment, we make use of the Abbott FreeStyle Libre sensor which works for 14 days.
Does applying the sensor hurt?
In short, no it does not. The sensor is being applied by a spring needle, and this needle does not stay in your arm. The spring needle applies a filament (flexible needle) in your arm for the blood glucose measurement.
How long will the sensor work?
The sensor will last for 14 days. Keep the sensor on during this period, and do not try to reapply it in case it came off. After the 14 days period, you can simply peel off the sensor and throw it away.
How do you calculate which foods are good and which ones are bad?
Based upon your blood glucose levels, we determine which foods are good for you, and which ones bad. The ‘worst’ foods on the list have the highest likelihood for gaining weight and getting fatigued (like the infamous after dinner dip). We calculate the score of the foods with our own proprietary algorithm, which is based on an Incremental Area Under the Curve method (iAUC). In short, this means the larger the area you can fill below the blood sugar line, the worse the food item in fact is.
Do you accept health insurance?
At the moment, unfortunately, we are not able to accept health insurance this program. In case this changes in the future, we will inform you via this Knowledge Base and our newsletters
What is a hypo (hypoglycemia)?
Hypoglycemia, also known as a 'hypo' or low blood sugar, is a fall in blood sugar to levels below normal. This may result in a variety of symptoms including a feeling of hunger, fatigue, sweating, shakiness and weakness. In patients diagnosed with diabetes, these symptoms can be life threatening. The glucose level that defines hypoglycemia is variable. In people with diabetes, levels below 3.9 mmol/L is diagnostic. In adults without diabetes, symptoms related to low blood sugar, low blood s
How to calculate net carbs?
Carbohydrates are being (to a certain extent) metabolized in your body as glucose, one of the fuel sources in your body. Looking on the nutritional table of packages, there are three main types of carbs: Carbohydrates Sugars Fibers Fibers are carbohydrates, but won't raise your blood sugar levels and will not trigger insulin. Basically, the fibers will buffer the effects of the carbohydrates turning into sugars (releasing them more slowly). You can calculate the net carbs as follo
Glucose, insulin and weight loss
If we do not eat (eg between meals, during sleep or fasting), the absence of new glucose supply (from food) causes insulin levels to drop. This is a signal for the body to burn stored energy. This starts with glycogen. Only when the stocks of glycogen are used up, do we start to burn fat. The goal of weight loss is to burn excess stored fat by mobilizing it and bringing it to areas of the body that can use it as fuel. It is important to note that the "storage" signal from insulin prevents the bo
Am I eligible for the program?
To be eligible for the program you: Need to be curious about your health! Should not have serious health conditions. Check with your doctor first Should not plan intense contact sports or water based activities during the program (swimming is fine) (just to be sure you don’t lose the glucose monitor) Need a smart phone with NFC capabilities Should be on the Dutch, Belgium, UK, Spanish or Italian App Store / Play Store. We’ll take care of the rest.
How to make sure, the sensor stays sticky
The sensor is designed to stick to your skin for 14 days. To increase the likelihood it stays on your skin, please follow these tips: Shave your arm in case of hair Choose the correct spot: on the backside of your arm, in the fluffy/fatty/least muscled part of your arm Clean your arm with the alcohol swab Let your arm dry for 1 minute After applying, wait 2 seconds before removing the applier spring Check if the sticker is glued on all around Use the protective patch
How much time will the program cost?
We know you have a busy life, and we design around it. The logging part of the program takes two weeks, though only one evening kickoff requires you to be physically present in Amsterdam. During the program, the continuous glucose monitoring happens automatically, no need for you to do anything other than place it on your arm at the start and have it synced with your phone. Every meal you take a picture of your food to record it. Throughout the program you can optionally chat with others in the
Can I join the program during the Corona (COVID-19) virus situation?
Yes, this is possible. During the period of social distancing, we offer a remote option: we send the sensor to you by mail, and you will receive all instructions via email. We also offer a weekly webinar where we tell you more about the program. We provide this service currently in the Netherlands and Belgium only. Group starting dates can be found here: [https://www.theclearhealthprogram.com/product/clear-nutrition-program](https://www.theclearhealthprogram.com/product/clear-nutrition-progra
Should I space out my meals to observe its sole effects?
When you eat a dinner, drink a glass of wine, and eat dessert in the same time frame, your body will not distinguish these foods. When you see something happening to your blood sugar levels after such an event, we advice you to test them 'spaced out' with approximately 2 hours, so you can observe the sole effects.
What happens when my glucose levels are going (too) low?
When your glucose is going down, the app will show an arrow in the downward direction. A low glucose is not necessarily a problem: some (healthy, young) people have a lower glucose baseline and feel fine. Also time of day shows an effect: at night, your body prepares for its sleep, and often in that time period, your glucose levels are dropping (there is no need for energy in your body anymore). In case of health conditions (most noteworthy diabetes), an event of low glucose can be dangerous.
How often should I scan my sensor?
At least once every 8 hours, since the sensor's memory chip can only store data up to this amount of time. By scanning, you transfer the data to your own account. It is possible to set a scan reminder in the app. Scanning more often is not a problem: we advice you to scan upon waking up, before going to bed, after every meal and whenever you are curious!
Is it worth it?
For a fraction of the price of a dietitian or lifestyle coach, you get a truly personalized food recommendation plan that’s evidence based and designed to keep you energized, manage weight and have long term health. You decide if that’s worth it.
Can I do sports with the sensor?
Yes you can. Feel free to go to the gym, swimming is also possible, just make sure to avoid high contact sports like kick-boxing (in case there is a chance, your sparring partner kicks against your sensor).
Why does my glucose level go up after/during exercise without food intake?
Your blood glucose levels go up because your liver breaks down it’s energy stores (called glycogen) which essentially releases glucose into the bloodstream, so your muscles can do their work.
Can I do an MRI scan while using the sensor?
Doing an MRI scan will cause the sensor to malfunction. You are also instructed to take off materials such as our sensor, prior to doing an MRI scan. It is best to start the program, after doing such a scan.
What factors make your blood sugar level rise?
There are multiple factors, why your blood sugars might rise. The most common ones are: Food Drinks Some artificial sweeteners Exercise Waking up (called the 'dawn phenomenon') Stress Low sleep quality Sunburn Dehydration Caffeine Illnesses, such as the flu Medicines (they can have added components, such as maltodextrin) Birth
Should I log a glass of water?
In short, no. Your body won't react to certain drinks, such as water, black coffee and black or green tea. There is no need to log them during the program. When adding sugar, sweetener, or milk, it is important to log the drink.
Why is continuous blood glucose monitoring important?
Blood glucose responses are intimately tied to your health and well-being. Basal blood glucose levels slowly rise as you age and having higher levels than average for your age is associated to looking older. It’s more than skin deep though: high blood glucose levels are associated to higher chances of disease and all cause mortality. Knowing how you react to foods empowers you to keep your blood glucose levels in a healthy range.
How can I download my blood glucose data?
You can download your 'raw' blood glucose data and any comments you have made in the Freestyle Libre app by logging into www1.libreview.com. The login is the same as the login you use in the Freestyle Libre app. In addition to the raw data, it is also possible to download a PDF of your blood glucose data.
When is the glucose data accurate?
Upon placing the sensor, it takes 1 hour before the sensor is calibrated and registering your blood glucose levels is possible. In the first hours, however, readings may vary. Inserting the sensor is the cause of this. Our advice is, to apply the sensor in the evening, wait a little with the activation, and use your breakfast as the first meal you track.
Glucose, insulin and energy storage
When glucose goes up in the blood, more insulin is also produced. If there is more glucose in the blood than the body needs (for energy), elevated insulin levels signal the liver and muscles to store glucose in the form of glycogen. Once the liver and muscles are filled to the brim with glycogen, the remaining glucose is converted to fat (triglycerides) and sent to the fat cells. The liver and muscles are a kind of short term (limited) storage space for energy in the form of glycogen, and fat ce
I cannot scan my sensor
Depending on your make and model of your phone, scanning behavior can be a bit different. Please try the following tips: For iPhone, hold the top back part of the phone near, or against the sensor For Android, hold the middle back part of the phone near, or against the sensor Keep the phone in place for a couple of seconds Make sure, NFC is turned on Remove the cover of your phone, if applicable Try scanning with less layers of clothing Reboot your phone. Especially
Why does fruit (juice) give me a spike in blood sugar levels?
Most fruits contain quite some sugars, primarily in the form of fructose. Especially when you squeeze them into a juice, you will lose part of the fibers, that normally buffer the effects of the sugar intake. Eating a piece of fruit has therefore a lower effect on your blood sugar levels. The fibers also make sure you'll be satisfied quicker. Most people have enough when eating one orange, though a glass of orange juice typically has 4-5 squeezed oranges in them. Since part of the fibers are los
Can you shower and swim with the sensor?
Yes you can. Showering is not a problem, in case of swimming, please do not swim longer than 30 minutes. It is possible to dry the sensor after 30 minutes with a towel, and continue your exercise. You should not dive more than 1 meter with the sensor.
How come my blood sugar levels drop when consuming alcohol?
The liver acts as the body’s glucose (of fuel) storage, and helps to control the glucose levels in the blood by storing and releasing glucose depending upon the body’s need and in response to hormones insulin and glucagon. When you drink alcohol, it impacts the liver: your body tries to eradicate this toxic substance as soon as possible, through the liver, and this process interferes with the liver’s normal ability to release glucose into the blood. Alcohol can sometimes trick us. A number of
Why do I see a peak in blood glucose, when showering or taking a bath?
When you see your blood glucose rise when taking a hot bath or shower, this can be due to the following reasons: Just like a sauna, the sensor might have a misreading when it becomes too hot (the sensor readings are stable between 10 and 45 degrees Celsius) Alternatively, a hot bath or shower can be seen by the body as a small stress event, raising your blood glucose levels
Determining diabetes mellitus
For the diagnosis of diabetes mellitus, in the event of a symptom of hyperglycemia (e.g. urinating a lot, drinking a lot, dry / sticky tongue, listlessness, tiredness or sleepiness, loss of appetite, losing weight for no reason): Based on blood tests, the following values are used: Two fasting blood glucose values ≥ 7.0 mmol/L on two different days. Or with fasting blood glucose value ≥ 7.0 mmol/L or an arbitrary blood glucose value ≥ 11.0 mmol/L in combination with complaints that are app
What should your blood glucose levels be?
Normal blood glucose values should be between 3.9 - 8 mmol/L. Fasting blood glucose (> 8 hours not eating or drinking anything except water) should preferably be below 7.0 mmol/L. Peaks after eating should not exceed 8.0 mmol/L. An occasional spike isn't too bad, though. Values below 3.9 mmol/L are in general fine, in case you are not diagnosed with diabetes. Do keep track of energy during these levels.
What is an (individual) response to nutrition?
Different foods eaten at different times of the day and in different combinations can lead to completely unique hormonal responses in the body. It is these hormones - especially insulin - that determine what happens to the food molecules once they are broken down by the digestive system and how well they are processed. Genetic factors (DNA), intestinal flora (microbiome) and lifestyle factors (diet composition, exercise, sleep, stress, etc.) ensure that different individuals have very variable g
Blood glucose and pregnancy
If you are pregnant, your body produces other hormones. These hormones cause the body to temporarily react less well to insulin, the hormone that regulates blood sugar. During a normal pregnancy the body makes extra insulin to keep the blood sugar good. But with gestational diabetes this does not happen (enough). As a result, too much sugar remains in the blood. Pregnancy diabetes, or gestational diabetes is a temporary type of diabetes that immediately passes after the birth. The medical word f
Why do blood glucose levels differ between the sensor and a finger prick?
Blood glucose (pricked) does not always correspond to glucose measured by the sensor. Finger prick blood glucose readings and sensor-measured glucose will not always be the same, and are likely to differ. This is because the sensor measures glucose in the interstitial fluid (ISF), a thin layer of fluid surrounding the cells of the tissues under the skin, not in the blood. The glucose values in the ISF are 5 to 10 minutes behind changes in blood glucose. Glucose measurements based on ISF appear
What's the minimum age for joining the program?
The minimum age for joining the program is 18 years. The reason, why we don't offer the program below the age of 18 years has to do with: Privacy requirements; Under 18, the body is still growing; Metabolic processes in adolescents might not be exactly similar to that of adults, and insights and knowledge on personalized nutrition are mainly based on scientific research in adults.
How do I change my app store?
In order to change your app store, follow one of the links below: Apple (App Store): https://support.apple.com/en-us/HT201389 Google Play Store: https://support.google.com/googleplay/answer/7431675?hl=en
How long does it take until I see something happening in my blood sugar levels?
Between 15 minutes and 2 hours after eating or drinking, something can happen with your blood sugar levels. It is also possible that nothing (substantial) happens, meaning that that meal is a good meal!
Where does the program take place?
All programs currently take place online. We have two options: start individually by watching a video, or join a kick-off webinar.
What is my estimated A1c?
A1c reflects the (predicted) average blood sugar level over two to three months. Specifically, the A1c predicts what percentage of hemoglobin — a protein in red blood cells that carries oxygen — is coated with sugar (glycated). The higher the percentage, the poorer the blood sugar control and the higher the risk of developing (pre)diabetes or complications of diabetes. For someone who doesn't have diabetes, a normal A1c level is below 5.7 percent. If the A1c level is between 5.7 and 6.4 percent,
Can I also log naps during the day?
In the Clear app it is only possible to log your sleep at night. It is possible, for your own administration, to add a note in the Freestyle Libre app. It is also possible to register your energy level as 'low', when you feel you need to take a nap.
What is insulin's role?
Insulin is released in response to glucose in the blood and is the primary hormone involved in fat storage and weight gain. Insulin is the main anabolic hormone in our body, which means it promotes "building" in the body (e.g. fat storage), rather than breaking things down. Insulin tells our cells to take up glucose from the blood before use or, if there is too much, for storage. Since weight loss generally requires us to burn fat stores, we need to control our insulin so that we signal the body
Is every peak in blood sugar bad?
No, some peaks are totally fine. A flat line in blood sugar levels is only possible, when not eating at all (fasting). All foods (especially carbohydrates) increase your blood sugar levels, which is fine. Your body provides a closely regulated balance. Above 8 mmol/L (due to eating) is not so good, it means that the body has to make more insulin to compensate for that blood sugar peak. If that happens too often, the pancreas has to work too hard to make large amounts of insulin each time. A
What is a Continuous Glucose Monitor (CGM)?
This technology has emerged out of the medical diagnostics field for diabetes treatment. Essentially it consists of a wearable device that you apply on yourself, e.g. the upper inner arm, which has a small and painless flexible needle that inserts into the skin. This device records the glucose levels in your interstitial tissues.
How does continuous / Flash monitoring differ from finger pricks?
Traditional blood glucose monitoring gives the user glucose readings at specified times. Users are not provided with information about how their glucose levels have changed, nor how their glucose levels are moving. Without such information, significant glucose fluctuations - the highs and lows - can be easily missed. A continuous of flash (CGM or FGM) system is a new way of taking glucose readings. The user can obtain a current glucose reading by scanning only with the reader above the sensor. I
Can I travel by plane with the sensor?
Yes, this is possible. Please mention before you go through customs that you make use of a medical device, to prevent the sensor being ripped off in case of a frisk.