Latest Opinion on CGMs (Continuous Glucose Monitors)

I first wrote about my own experience of a CGM in 2022, but I thought the topic was worth revisiting now we’re all a bit more familiar with them, or maybe even more reluctant to use them in the light of recent opinions in the nutrition world about certain “Projects”.

Given that as a nation we are more metabolically unhealthy and overweight than ever before, and yet we are so much more advanced with the tracking of bodily functions than ever before, we have to ask whether devices such as CGMs are worth it. And as with anything health-related the answer is extremely nuanced with no straight definitive answer. Sorry, that’s probably not what you want to hear, but bear with me as I lay out some of the facts and my opinion for you to decide whether it’s right for you.

• Firstly, what is it? A CGM is a device that’s worn on the arm to track blood glucose handling. A small filament sits below the skin and tracks glucose in the tissues (rather than the bloodstream and therefore lags a little behind it). So we’re looking at trends, not real-time blood glucose levels.

• What does it do? It tracks average glucose levels over the day, morning fasting glucose and glucose variability, all of which can give insight into this important part of our metabolic health. You can track your response to the food you are eating and your activities, with the aim of reducing your average glucose levels, reducing your glucose ‘spikes’ which if regular and sustained can lead to poor health, and to achieve a faster recovery from spikes.

• Why would we want to wear one if we’re otherwise ‘healthy’? It’s clear why we would wear one if we are Type 2 Diabetic or have been diagnosed as Insulin Resistant, but why are seemingly healthy people using them? The answer is usually to manage weight, or to prevent future health issues. It can be empowering to know what’s happening in our bodies, before we tip into ill health.

So What Are The Positives To Wearing One?

• We know that restrictive diets don’t work and lead to additional weight gain, so getting more in tune with your blood glucose levels can empower you to make long term sustained changes by making healthier choices

• We are all different, so knowing your own trends can give you personalised data

• Research has shown that people who wear CGMs are more motivated to make changes to diet and exercise habits.

• One study showed that on one diet challenge, the participants who wore a CGM lost more body weight and fat mass than those who didn't wear one, and they achieved reduced fasting glucose and total cholesterol.

• The secret however is in getting support to interpret the data for your unique circumstances.

And What Are Some Of The Less Positive Aspects?

• Data without interpretation is just additional ‘noise’. Many people wear a monitor and don’t know what to do with the results. Or, they may be getting advice from an App, but just can’t get motivated to make the changes they need. They may have blind spots when it comes to nutrition habits and the impact they have. And they may not understand all of the factors that influence blood glucose levels. This is why I feel that anyone wearing a CGM should get one-to-one support and coaching for interpreting their data and carrying out changes. Why?

• It can create health anxiety and could lead to disordered eating. Some people end up eliminating foods and food groups because of spikes. However, it’s important to zoom out and look at the bigger picture. Our body is designed to deal with blood glucose spikes. The issue is only if there are too many, or we don’t recover quickly from them, or if there are signs that our average blood glucose is raised. I’ve seen this, especially with porridge oats! You don't have to quit ladies! And what happens if you can’t digest pulses and high fibre? You are not doomed!

• There are so many factors that influence our blood glucose levels - these include not just diet, but vitamin and mineral deficiencies, exercise, sleep, time of day, stress, menstruation, menopause, hydration, certain illnesses eg PCOS, genetics. Alcohol can temporarily suppress blood glucose. High intensity exercise can spike glucose. Sleeping on your glucose monitor can mean you have blood glucose dips at night, so maybe you don’t have a ‘hypo’ in the night after all! So, to reiterate, by getting one-to-one support, you can navigate all of this and get the right advice, support and motivation to make the most of your data.

So What’s The Aim If We Do Decide To Give One A Go?

• Use the data to make changes to your diet that help you flatten out the spikes of your blood glucose, so you get rolling hills and not too many regular jagged mountain ranges.

• Don’t panic about occasional spikes, if you are otherwise healthy, this is normal and your body has the brilliant, innate capacity to handle it.

• Get some one-to-one support - it will save you time, reduce your anxiety and overwhelm, possibly save money, and help you make the personalised changes that suit your unique body and life challenges.

• Don’t become obsessed! This is hard, especially when you first have a device fitted as it’s tempting to keep checking it, but my suggestion would be to check a couple of times a day. Look for trends, not blips!

I hope you found this article useful. If you'd like to know more, or you’re curious about how I can help you make the most of your device, then please do get in touch by emailing alexis@alexispriornutrition.com

With very best wishes