Should you be wearing a continuous glucose monitor?
If you weren’t already aware, there’s a new trend: healthy people wearing continuous glucose monitors. I was one of them. Continuous glucose monitors like Dexcom G6 or Freestyle Libre are two brands of monitors that were originally designed for people with diabetes to more effectively manage their blood glucose levels. Instead of finger sticks at random checks, continuous glucose monitors (abbreviated CGM) work by the user wearing a patch on the back of the arm. The patch contains a small needle that continuously senses blood glucose levels. Why would a healthy person want to wear a medical device that provides instant feedback on blood glucose levels? Well, why not.
As Americans, we are suffering from a number of lifestyle-related diseases such as diabetes. For many individuals, a diabetes or pre-diabetes diagnosis comes unexpectedly after a set of routine labs are drawn by their physician. In our current healthcare model, a person is either diabetic or they’re not. But in reality glucose and hormonal dysregulation occurs on a continuum, and most doctors are not catching the trends soon enough. Continuous glucose monitors can be an effective tool for providing individuals with real-time information on how factors like food, stress, sleep and exercise impact their blood glucose levels.
My experience with the Freestyle Libre was ultimately a great learning experience. Since the patch attaches to the back of the arm, I received many curious questions from fellow yogi’s, as well as from strangers wanting to know what was on my arm! For many people, the idea of monitoring glucose patterns is a relatively new one. Some of the more savvy health seekers are familiar with tracking sleep, steps, and even lunar patterns, but even these folks weren’t quite sure why someone like myself would want to wear a CGM. I did my best to explain in layman’s terms.
Promising Future for CGM’s
As a dietitian, I wish more of my clients had access to a CGM. There is some concern of the accuracy of the data of the Freestyle Libre, but in general this quantitative feedback could bring much-needed awareness to how their eating impacts their glucose levels. This insta-feedback could allow for greater modifications in behaviors. Just like activity trackers are not 100% reliable, the numbers do provide me with some valuable information about how active or inactive a person is. Otherwise, I must rely only on subjective information from the patient.
The current challenges around CGM’s for non-diabetic persons is that they are not covered by insurance and therefore the cost is paid out of pocket. This can run about $130 for a 14 day sensor and reader. In addition, you’ll need a MD order for one.
What I Learned from Wearing the Freestyle Libre
Not surprisingly, I enjoyed having numbers and instant feedback regarding my blood glucose levels. My whole journey into nutrition started with my curiosity about high-glycemic foods and the impact they had on my energy levels. I grew up on donuts and fast food, and flushed it down with copious amounts of mountain dew—true story—so when someone gave me a book about the glycemic index I was beyond excited to change my diet, even if I fumbled my way through it over the next few years. Even though my current diet could rival that of a Buddhist monk, I still suspected I was dealing with blood glucose “issues.”
My diet remained mostly consistent over the 2 week period, and I was pleasantly surprised to see that my blood glucose ranges also remained consistent. My average blood glucose over 14 days averaged about 75 with my fasting levels hovering around 69. Even after meals, my blood glucose ranges never climbed over 100. Interestingly enough, morning fasts and lack of sleep seemed to negatively impact my blood glucose levels later in the day. I wasn’t exactly surprised by this because from research I knew that sleep and stress had a tremendous impact on blood sugar regulation and appetite, but it was pretty cool to see it confirmed with numbers. The greatest lessons I learned from wearing a CGM was to continue to practice of the dietary changes I had implemented through trial and error over the years. From a blood glucose standpoint, my diet and lifestyle seemed to be working well for me. My only regret is that I would have liked to have had a minimum of 30 days with the CGM. If cost would allow, I would invest in a Dexcom G6 CGM and monitor for a minimum of 3 months, if not indefinitely.
Considering the availability of personal tracking devices on the market, I would not be surprised if consumers will soon have the option to purchase their own CGM. When this happens, patients will have more data, but unfortunately I’m skeptical that this will translate into changed behaviors. Still, I welcome the day when I can use fancy tools to encourage behavior modification.