Continuous Glucose Monitoring
The ability to measure blood sugar in real-time is important in patients with diabetes, but can be a valuable diagnostic tool for non-diabetic individuals, too. Continuous glucose monitors (CGMs) are small sensors that attach to the back of your arm and insert a thin filament as wide as strand of hair just under the skin - this can continuously measure and report your blood sugar directly to your smartphone, as well as share data with your healthcare provider. Many individuals wonder if a CGM is really necessary or whether it will only confirm what they know about their eating habits. Below, we highlight some of the key ways a CGM can be used for individuals without diabetes.
Insights: The first thing CGM users comment on is learning about their unique blood sugar response to various foods, exercise, sleep, and stress. Complex signaling occurs between the pancreas, liver, adrenal glands, and skeletal muscles which regulate glucose metabolism - these fine-tuned endocrine feedback loops can be disrupted - for example, when excessive calories are turned into visceral fat tissue which deposits in internal organs or stress hormones spike during times of sleep deprivation causing glucose elevation. CGMs can help identify these patterns while they are still early, subtle findings, and before the onset of more significant metabolic illness. For those who already have some insulin resistance or early metabolic syndrome, the CGM insights may not be as subtle, but are nonetheless helpful to quantify the scope of the problem.
Nudging: Insights from the CGM data can be translated into deliberate decisions about what to eat, as well as encouraging better exercise and sleep habits. For many, seeing the data is enough to change behavior - knowing your unique glucose reaction to rice versus pasta, for example, may nudge you towards different food choices, or seeing how quality sleep and exercise buffer against glucose spikes may motivate you to make incremental lifestyle changes.
Caloric Restriction: In our modern world, calories are abundant, and many people do not adequately regulate how they consume calorie-rich foods. Data suggests that caloric restriction (CR), generally, is associated with improved health and lifespan. CR can take many forms - it can be time-based (i.e., intermittent fasting) or food-based (e.g., ketogenic diet), for example. For those who do not want restrictive diets or fasting, a CGM can help to identify opportunities to cut excessive calories by learning which foods cause glucose spikes and adhering to a diet that generally lowers average daily glucose levels.
Early Warning: Correlating your average glucose levels and daily glucose patterns with other health markers such as fasting insulin levels, liver function tests, and DEXA results can identify insulin resistance before metabolic syndrome or pre-diabetes are present. Data from a CGM is likely more sensitive than hemoglobin A1c in understanding blood sugar levels, and when considered together, with the other biomarkers, paints a much more detailed metabolic health picture than any single test alone.
Screenshot from Freestyle Libre 2 app that wirelessly collects and displays your glucose levels onto your phone.
For most patients, using a CGM is a simple 3-step process:
1. Attach
Setting up a CGM is easy - simply use the kit to apply the coin-sized monitor to the back of your arm where it sticks with an adhesive. A mobile app connects your sensor to your device where you can check and track your blood glucose levels.
2. Monitor
Your CGM app will log your glucose and provide you with graphical trends - you can add info like your exercise and food intake to learn your body’s reaction. You can easily link your data to an experienced provider who can remotely monitor your levels, generate comprehensive reports, and help you gain unique insights.
3. Optimize
Armed with insights from your CGM, you and your provider can guide your nutrition, exercise, and sleep to optimize energy balance. Maintaining steady and low glucose throughout the day will avoid unnecessary calories and insulin spikes, improving your metabolic health.
