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Technology Tales – the Continuous Glucose Monitor

By Tammi Kaeberlein November 27, 2023 Health and Fitness

In the realm of health and wellness, new tech is always emerging to provide insight into our inner workings. One such innovation that has gained popularity, and some controversy, is the continuous glucose monitor (CGM).

CGMs measure glucose levels in the interstitial fluid, providing real-time data about blood sugar fluctuations. Designed for those with diabetes to manage their blood sugar levels, CGMs are now being embraced, though not necessarily encouraged, by a broader audience.

Why? Wearing a continuous glucose monitor can offer valuable insights into our metabolic health, helping us make informed choices for overall well-being.

Insulin Sensitivity

Insulin sensitivity refers to how well the body’s cells respond to insulin, a hormone that regulates blood sugar levels. Higher insulin sensitivity is generally considered good because it means cells efficiently take in glucose, helping to maintain stable blood sugar levels.

I’m participating in a comprehensive, long-term health program at Optispan. The purpose of this new company is to embrace preventive health care and ultimately, to make it more available to the average person.

My doctor recommended I wear a CGM because I’m borderline pre-diabetic, based on A1C levels, which came as a huge shock to me because I consider myself very healthy. There are many reasons however, that you can have poor insulin sensitivity*, including a genetic pre-disposition, chronic stress, sleep patterns, and low muscle mass, to name a few.

In addition, some seemingly healthy foods may contain hidden sugars or carbohydrates that can affect blood sugar levels. Some low-fat or fat-free products replace the fat with sugar to enhance flavor. This can include certain yogurts, snacks, and desserts.

Many packaged snacks like energy bars, even those marketed as healthy, can contain hidden sugars and carbohydrates. Some “whole wheat” or “multigrain” products may still have a significant amount of refined carbohydrates. This is why checking the ingredient list for all your foods is so important.

Insulin Resistance

On the other hand, low insulin sensitivity, known as insulin resistance, can lead to elevated blood sugar levels and an increased risk of conditions like type 2 diabetes.

Approximately 1/3 of U.S. citizens are diabetic or prediabetic, and so I know I’m not alone. My doctor asked me to wear the monitor for two weeks, to see if I learned anything. And I did; really quite a lot. I’m sharing it with you now, because it made such a huge impact on my daily habits.

Lessons Learned from Continuous Glucose Monitoring

I Have to Rest When Sick

Being sick and on antibiotics drastically changes your body’s glucose response. It’s always important to take care of yourself, right? But when you’re sick, your body needs it even more. Don’t power through unless you have no other choice. Eat, rest, repeat.

Movement Helps Me

Moving, even a little, after meals is a good idea. Washing dishes, household chores or a brisk walk after meals helps regulate blood sugar levels more effectively than sedentary behavior.

This awareness has changed the order in which I do things during the day. Whereas before I would eat, get some computer work done, then get up and move, I’ve switched to eat, move, computer work.

Always Transition to Exercise

Warming up before and cooling down after exercise significantly helps your body maintain better glucose levels. My glucose drops significantly when I work out, so transitioning into and out of it gradually gives my body the time to adjust without dramatic changes.

Monitoring My Triggers

Even a salad and whole grain bread causes a spike in blood sugar for me, but not for my husband. It’s the bread, every single time. Everyone is different. His is pretzels.

Knowing What I Eat

Read the labels and avoid foods high in added sugar. We hear this so many times that we tend to stop listening. It matters. A lot. Even chewable vitamins can influence your body’s insulin response.

I Listen to My Body

While traditional advice often emphasizes the importance of regular meal schedules, the reality is that optimal meal timing can vary among individuals. For instance, I found that I maintained more consistent blood sugar levels with many small, balanced meals throughout the day and my body’s response to glucose is better in the afternoon than it is in the morning. I knew this going in, just never thought much about it. The days I listen to my body are always better than the days I don’t.

Beyond diet, lifestyle factors play a significant role in blood sugar regulation. Exercise, stress, and sleep patterns all influence glucose levels, and wearing a continuous glucose monitor can unveil these connections.

Observing how your body responds to different stress levels or varying exercise routines can empower you to tailor your lifestyle to promote stable blood sugar. It certainly did for me.

Ways to Improve Insulin Sensitivity

Improving insulin sensitivity is important for nearly everyone’s overall health. Here are some more things you can do.

  1. Engage in regular physical activity, including both aerobic exercises and resistance training.
  2. Achieve and maintain a healthy weight to positively impact glucose homeostasis.
  3. Focus on a well-balanced diet that includes a variety of nutrient-dense foods and sources of omega-3 fatty acids in your diet, such as fatty fish (salmon, mackerel, sardines), flaxseeds, and walnuts.
  4. Avoid excessive consumption of refined carbohydrates, sugars, and processed foods.
  5. Foods high in fiber, such as fruits, vegetables, and whole grains, can help regulate blood sugar levels, among many other positive benefits.
  6. Stay adequately hydrated as dehydration can affect blood sugar levels.
  7. Ensure you get enough quality sleep each night, as inadequate sleep can negatively impact insulin sensitivity.
  8. Practice stress-reducing techniques such as meditation, yoga, deep breathing, or mindfulness.

These are some of the key steps in our journey to health, ones that we often forget in our busy lives.

My Glucose Tolerance Test Results

Recently, I underwent a Glucose Tolerance Test while wearing a Continuous Glucose Monitor (CGM) to gain a better understanding of my glucose metabolism. Surprisingly, the results revealed a fascinating discrepancy between my A1C levels (indicating borderline pre-diabetes) and the findings of the GTT, suggesting no significant glucose metabolism issues.

The GTT is a diagnostic test that involves fasting, followed by the consumption of a standard amount of glucose, with subsequent blood draws to measure how the body processes the sugar.

To my surprise, the GTT results indicated good glucose tolerance!

This contradicted the borderline pre-diabetes diagnosis suggested by the A1C levels, raising questions about the accuracy of either one as the sole diagnostic tool.

What Does This Mean?

Good question and there are a few possible answers:

  • My new diet, since my original blood draw and AC1 results, has made a positive difference for me.
  • It’s important to use multiple diagnostic tools to assess glucose metabolism comprehensively.
  • Another overnight fasting blood draw will be necessary to obtain a new AC1. It captures an image of overall blood glucose levels over a 3-month period, so I’ll wait 3 months from the first one in order to re-assess.

Should You Use a CGM?

As mentioned previously, CGMs are primarily designed and marketed for individuals with diabetes to help them manage and monitor their blood glucose levels effectively. The controversy over where people without diabetes should use them is based on a few undeniable facts.

Invasiveness

CGMs involve the insertion of a small sensor under the skin, which continuously measures glucose levels. This process can be perceived as invasive for individuals without diabetes.

Cost

The cost of CGM systems, including the sensors and the monitoring device, may be a deterrent for those who don’t have a medical necessity for continuous glucose monitoring.

Psychological Impact

The psychological impact of seeing fluctuating glucose levels, even within the normal range, could potentially lead to unwarranted concerns and behaviors.

Medical Professional Supervision

Non-diabetic individuals may not have the necessary guidance to interpret and act on the CGM data appropriately.

Misinformation

Certain “influencers” and marketers promote questionable advice, like the belief that all glucose spikes are harmful or that individuals should strive for extremely low blood glucose levels.

However, glucose spikes are a natural response to various foods, and the advantages of maintaining very low average glucose levels over normal range levels remain unclear. Recent research indicates that insulin sensitivity is a more reliable predictor of overall metabolic health than average blood glucose or spike frequency.

If you are considering using a CGM as a non-diabetic, it’s crucial to consult with your healthcare provider to discuss potential benefits and risks in your specific case. They are only available by prescription in the U.S., so discussing this with your doctor is inevitable. And a good thing.

Let’s Have a Conversation:

Have you ever noticed how certain foods impact your energy levels or mood? How do you currently structure your meals, and do you think it aligns with your body’s natural rhythms? Do you currently use any health monitoring tools or devices? Are you open to incorporating technology like continuous glucose monitors into your health routine? Why or why not?

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Linda

There is a Professor at Queen Mary University London who does extensive research into Type 2 diabetes. In his opinion, pre diabetes is an unhelpful term and it doesn’t exist – quite simply you are either Type 2 or you are not. Research is now showing there is a third type of diabetes.

A number of years ago the WHO adjusted the blood sugar levels for Type 2 down and this is why so many more people have been given a Type 2 diagnosis. In the case of women it’s also known the problem may not be Type 2 but thyroid related. Elevated sugar levels are a known side effect of certain medications and also steroids given with cancer treatment (Dexamethasone).

I am sure wearing a monitor would make some people a bit paranoid and take them down the route of hypochondria, so unless you are confirmed as a diabetic I do not see the point in wearing one.

Tammi

Thank you for sharing your perspective Linda! Do you happen to know what the third type you are referring to is called? Is it adult onset or the type that affects people with Alzheimer’s, whose link has yet to be established?

Shirley

I was shockingly diagnosed with type 1 (insulin dependent) diabetes several years ago (at age 60) and use a CGM for diabetes management. I’m not sure why anyone would want to delve into CGM usage given cost and, as mentioned, the psychological effects of viewing your glucose levels every 5 minutes (can be very stressful esp for a diabetic) unless one has diabetes or it is recommended by a doctor for health related issues. But then… that’s just me. I am extremely grateful for CGM technology that has made diabetes management easier but wouldn’t wear one if I didn’t have a health issue that warranted it.

Tammi

I’m glad you’re finding it helpful Shirley! I wonder why you view your levels every 5 minutes. Does your monitor link to your phone and notify you if there’s a problem? Perhaps you use a different brand. The Libre 3 lets you set levels for warnings and links to an app.

TerriJ

I will have type 1 diabetes for 53 yrs. on 1/11/24. The Dexcom CGM has been a game changer for me. I think type 1 and type 2 diabetics can benefit greatly from this technology. Over the last 53 yrs. I have had, conservatively, 96,725 insulin injections. Inserting a CGM sensor every 10 days is minor and not painful when done properly. I’m trying to encourage my brother who has type 2 diabetes to use one. If you have diabetes please consider it. Reach out to your healthcare provider and do your best to be proactive about how to keep your blood glucose in line. Your life can be extended and you may avoid the serious complications.

Tammi

It really does make a huge difference doesn’t it? I hope your brother can be persuaded. An ounce of prevention is worth a pound of cure… : )

Deb

Working as a caregiver and getting through the losses of loved ones is my current life experience. Grieving and stress combined, weight gain for me. I have been researching CGMS to better monitor my health.

For me at 64:

  • I’m curious how my body reacts to food, workouts, and stress to help me positively change my overall health. I want to see what spikes my insulin levels.
  • I want to know which foods cause my blood sugar to spike, I’ve switched to a higher protein-based diet the last few months with a heavier emphasis on weight training and want to see if that is best for me.
  • I am all over the place with trying new things in the exercise world; I want to see how a CGM would help determine what is best for me. Currently UB, LB, and full bodyweight days, barre, Pilates, stretch, dance, and walking. Going to make a better effort with warm-ups and cool-downs after reading your article.

This was a good article and very informative.

Tammi

I’m so glad you found it helpful Deb! I too have moved towards more protein and weight training and I’m loving the results so far. I’m reading a great book you might be interested in – Next Level by Stacy Sims and Selene Yeager. Let us know how it goes if you can. I would love to know!

Mikki

I always want to know which foods affect me, and my glucose levels. I’ve had issues with low blood sugars since I was 14! My body produces too much insulin when I eat carbs, thus low glucose levels. I cut out carbs five years ago and have not had one low glucose episode or headache!!! I’d love a CGM, but they’re too expensive. Even test strips are outrageously expensive, as my dr ordered me some last week. Upon picking them up, they were to be $127 – after insurance!!! I said “no thank you” and will go by how I feel for the time being. I feel SO much better avoiding carbs, may not be for everyone, but it works for me.

Tammi

The Libre3 CGMs are $75 for two on Amazon Pharmacy, with insurance. You do need a prescription. But it sounds like listening to your body is working well for you and that I think is the ultimate goal anyway!

Kim

I trust the A1c blood test to give me a picture over 3 months. If you are not a diabetic, I don’t see the need for a CGM personally.

Tammi

Thanks for your response Kim! I didn’t quite see the need for it either, until I wore one for a while.

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The Author

Dr. Tammi Kaeberlein is a scientist, working in the field of aging biology. She’s also the owner and author of Wander Healthy, a travel and lifestyle blog that provides practical tips, inspiration, and motivation to move more, so that you can adventure as far and as long as you want to.

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