People without diabetes are using glucose monitors
Q Why are healthy people who don't have diabetes using continuous glucose monitors? Should I get one?
A Continuous glucose monitoring is a health fad among those who don't have diabetes but want to use the data to inform their lifestyle choices. Everyday factors like diet, exercise and stress affect blood sugar levels.
The monitors, which are usually worn on the upper arm or stomach, contain a specialized enzyme that reacts with glucose molecules in your body, generating a tiny electric current. Its voltage is proportional to your blood glucose concentration, which the device calculates several times per hour.
People are often fascinated by the results because everyone reacts somewhat differently to eating. In one study that tracked more than 45,000 meals from 800 people, researchers found a high variability in glucose levels even after eating the same foods, such as bread with butter.
I don't normally recommend continuous glucose monitors to healthy patients. But I appreciate that some people — especially those who feel they've already tried hard to get a handle on their blood sugar — will find seeing that data play out in real-time informative and motivational.
If you decide to use a monitor, you may find that eating a high-carbohydrate meal, like a big bowl of pasta, or a sugary drink leads to a surge of insulin and then a low blood sugar level. This can lead to fatigue and brain fog — a “crash.” If you balance your meal with foods containing whole grains and protein (which are slower to digest and therefore result in a more steady release of insulin), you may find your blood glucose levels become more steady. High-fibre foods like beans and green vegetables are also helpful — and with them, you feel fuller longer.
Other factors including exercise, stress and sleep also can impact your glucose levels: Exercise: One study found that taking a brisk walk 15 minutes after each meal helped control glucose spikes in diabetes patients better than walking 45 minutes before breakfast. In a study of 153 healthy adults without diabetes, aerobic or resistance exercise resulted in lower blood overnight glucose levels than nights without exercising.
Stress: Periods of stress can increase your blood glucose levels, in part because hormones like adrenalin and cortisol impact insulin secretion. Techniques to calm the body can help.
Illness: Other kinds of stress on our bodies, such as an infection, also modulate our blood glucose. In a small study of people without diabetes wearing continuous glucose monitors, one study noted that those who had COVID-19 had higher blood glucose levels than those who did not.
Sleep: Several studies have shown that irregular sleep, waking up often at night or insufficient sleep can promote glucose intolerance. People who don't get enough sleep are about 40 per cent more likely to develop diabetes than those who get seven to eight hours of sleep.
WHAT I WANT MY PATIENTS TO KNOW
A short trial of a glucose monitor is low risk — the monitors aren't inserted directly into your bloodstream, but rather into the subcutaneous tissue beneath your skin. Rarely, people experience discomfort around the site of the patch, often from the adhesive pulling on body hair.
But if you want to wear one for a longer period, ask yourself it will give you new, usable information. To me, there are rapidly diminishing returns. Many broad lessons you'll probably learn from an expensive continuous glucose monitor are ones that you could glean just from studying healthy lifestyle patterns.