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Monday, April 22, 2024

Why some people are using glucose monitors, but not for diabetes - The Washington Post

Why people without diabetes use glucose monitors to track their health

A photo illustration of someone using a continuous glucose monitor with a blue blood sugar curve illustrated on top of the photo.
(Washington Post illustration; iStock)

"Why are healthy people who don’t have diabetes using continuous glucose monitors? Should I get one?

Continuous glucose monitoring has become a major 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 your 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 my healthy patients. But I do appreciate that some people — especially those who feel they’ve already tried hard to get a better 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 rapid 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 fiber 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 adrenaline 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 percent more likely to develop diabetes than those who get seven to eight hours of sleep.

How can I get a continuous glucose monitor?

The Food and Drug Administration recently approved a continuous glucose monitor for sale over the counter, and the device is expected to be available for sale this summer.

Until then, people without diabetes will need a physician to prescribe them a monitor in this off-label way and need to pay out-of-pocket. This can reach a few hundred dollars per monthdepending on the monitor and subscription plans to the associated apps. Some companies advertise a “free” virtual medical consultation — this is a requirement for the prescription, not a favor to you.

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 our skin. Rarely, people experience discomfort around the site of the patch, often from the adhesive pulling on their body hair.

But if you decide you want to wear one for a longer period, ask yourself if doing so gives you new, actionable information. To me, there are rapidly diminishing returns. Many broad lessons you’ll probably learn from a continuous glucose monitor are ones that you could glean just from studying healthy lifestyle patterns without going down this expensive path."

Why some people are using glucose monitors, but not for diabetes - The Washington Post

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