How fear boosts CGM (Continuous Glucose Monitoring) sales
CGM is a continuous glucose monitoring device that has become incredibly popular among healthy lifestyle enthusiasts, athletes and anyone who is afraid of sugar in their food.
This is a small sensor that is attached to the body (usually on the shoulder) and sends data about your sugar level in the intercellular fluid to the application every 5 minutes.
This year, at the JP Morgan Healthcare conference, the market size for these devices was estimated at 20 billion dollars.
They scare us with scary food from all the cracks, and the only lifeline is the CGM, without which it is impossible to survive in a dangerous world. Hundreds of bloggers on Instagram, Tiktok and Youtube show data from their sensors after eating food, and demonize entire food groups for change. Fear is great at selling new tools and devices.
Is CGM really necessary for the average person or is it just marketing?
Spoiler alert: CGM is not for everyone, and in the hands of an alarmist, it can do more harm than good.
I have type 1 diabetes and I have been using CGM for the past year. In this article, I will share my observations about blood sugar fluctuations and tell you when it really makes sense to wear a CGM.
How and for whom did CGM appear?
CGM was originally developed as a device to help people with diabetes. It has revolutionized sugar control, saving and improving the quality of life for countless people.
Diabetes – silent epidemic There are already 500+ million of us around the world and this number is only growing. 90-95% of this number are people with type 2 diabetes, or “acquired”, the reason for which is often poor nutrition, overeating, lack of physical activity and, as a consequence, obesity, which brings with it all the delights of a tired metabolism. The remaining 5-10% of this number drew “lucky” insulin syringe type 1 diabetes ticket.
Precisely on the fear of getting sick type 2 diabetes and get insulin resistance Now many companies are manipulating.
1. What affects the rise in blood sugar.
Regular sharp spikes in sugar – a big problem for small vessels, and bloggers usually scare people with this, drawing scary pictures of kidneys and eyes falling off.
Many biohackers and adherents of a healthy lifestyle, when wearing a CGM, try to make lists of foods to which their body reacts especially quickly, and then confidently exclude them from their diet.
I hasten to disappoint you, sugar spikes happen even without the participation of food. More precisely, there is 42 (!) factorswhich can affect both growth and decline.
Did you sleep poorly or went to bed at 3 am?
Are you a girl and currently in the luteal phase of your cycle?
Are you not drinking enough water, taking any medications, or have a cold?
Did your boss yell at you or are you speaking in front of the team?
Or maybe all this happened to you at the same time?
Here's an example of my schedule on a day when I had a 4-hour public speaking engagement. From the food I ate, my sugar should have increased by 2-3 mmol/l and after 2 hours returned back to 5-6 mmol/l. In my case, due to stress, my blood sugar only went down when the event was over.
Green Zone – this is the range from 4 to 10 mmol/L, in which I need to stay 70%+ of the time to reduce the risks of complications from diabetes.
A person who does not understand the details may attribute these spikes to carbohydrates eaten for breakfast and may be wrong.
It's fucking hard to understand these details. For example, in order to adjust the doses of insulin in the luteal phase*, it took me several months, and my calculations do not always work, because the body is damn complex.
Every 3-6 months I have meetings with an endocrinologist and together we analyze all the indicators, including data from CGM. I suspect that most people without diabetes, but with CGM, do not even bother to see doctors and self-diagnose. But they don’t need a doctor, just like the CGM itself.
*Phase of the cycle when progesterone rises and inhibits insulin-stimulated glucose uptake
2. Sugar increases after eating – and this is normal.
When we eat carbohydrates, our blood glucose levels tend to rise. The most important thing is to stay within the recommended range. For healthy people this is the glucose level <7.8 2-3 hours after eating.
Moreover, even if sugar is higher for some reason, this is not always due to a “bad” product or potential “diabetes”. Perhaps this is due to the speed of evacuation of food from the stomach and you do not need to exclude foods, but go to an endocrinologist and gastroenterologist.
Sugar can rise in 2-3 hours not at all because of the banana you ate, but because for lunch you ate a large fatty piece of steak, which slowed down the absorption of carbohydrates, and they began to “shoot” later.
And also, any aerobic physical activity ↓ reduces sugar level in blood. Therefore, if after a hearty lunch you went for a good bike ride one day, and watched a TV series on another, your indicators for the same food will most likely be different.
By the way, here's intense strength training can do the opposite ↑ cause a sugar rush. Does this mean that they should be abandoned?
This is how my body reacts to a 40-minute moderate-intensity cycling session. Sugar dropped by 1.5-2 mmol/l:
The table contains indicators of sugar levels that you can focus on. If you have suspicions that something is going wrong in your body, it’s better to go to the doctor.
3. How can CGM harm you?
Additional monitoring increases unnecessary anxiety and stress.
When a measure becomes a goal, it ceases to be a good measure.
Goodhart's Law
Background anxiety can negatively impact psychological well-being and food decision-making.
At the same time, the error in CGM indicators is about 10-15%. Did you lie on the sensor? Is your hand numb? Did you install your device unsuccessfully? – all this can affect the numbers you see on the graphs.
It happens that I install the sensor unsuccessfully and it can lie within the range of 1.5-2 mmol/l, either up or down – this is a lot. If the CGM was installed on a part of the body where there is little fat or blood was dried inside the sensor during installation, the data will be incorrect. In addition, during the first 48 hours the device is calibrated and the indicators can “jump” a lot.
Here's my example.
Plus you need to remember that CGM measures not blood glucose leveland the glucose level in intercellular fluid, these are also lagged indicators, you usually see the glucose level that was 15-20 minutes ago. Therefore, people with diabetes recheck their blood sugar levels on a glucometer throughout the day.
You can eliminate entire food groups that don't really need to be eliminated.
Yes, some fruits and whole grains can temporarily raise your blood sugar levels and there is nothing fatal about it. This does not mean that they are harmful to the body, but by excluding them from your diet, you can deprive yourself of wonderful and necessary microelements and fiber.
Even I with diabetes eat mango and watermelon. Yes, not 1 kg at a time, but my body copes well with small amounts and eaten according to certain rules.
Sausage and frankfurters will not increase your sugar levels, but what will give you more profit: fruit or sausage?
There is a high risk of overdiagnosis.
A friend once told me that her sugar started to rise from aspartame (a sweetener) in cola zero. This is actually impossible because this particular sweetener contains 0 carbohydrates. But panic has been sown and widespread.
She also banned all sweet fruits and some grains, because they increased the sugar level up to 8 mmol/l (we remember the sign above, this is the norm). She does not have diagnosed diabetes; she never took her fears about sugar spikes to the endocrinologist, “because doctors don’t know anything” (c).
Ultimately, such exceptions and panic can lead to eating disordersissues that will need to be resolved with psychologists and psychiatrists. The woman did not know grief, the woman bought a pig.
4. How to eat while minimizing sugar spikes.
After a year of wearing a CGM and testing my body's reaction to different types of foods, I came to the conclusion that you just need to eat adequately and variedly. And even without strict fanaticism with ultra “clean” products. Everything goes clearly according to the guides of the ADA (American Diabetes Association), AHA (American Heart Association), Harvard Medical School and other heart and diabetes organizations – Eat several servings of vegetables daily, whole grains, beans, lean proteins and reduce ultra-processed foods in your diet. I didn’t discover America, I was surprised myself.
And in the end, even with some small restrictions due to diabetes, my food looks like this:
And yes, such dishes do not require long cooking and powerful culinary skills.
I show and tell in my channelHow can you collect the same plates? Subscribeif you are wondering how to improve your diet without complicated planning and restrictions.
How I still eat carbohydrates to reduce the likelihood of sugar spikes
I try to eat low to medium carbs. glycemic index.
Yes, not all fruits belong to the average GI, but I simply eat such fruits after a portion of vegetables and no more than 100-200 grams at a time. I have a broken metabolism, this may not be relevant for you.
I eat starchy foods after cooling them for a long time.
Cooked potatoes, rice, sweet potatoes, grains – I keep them in the refrigerator/freezer for several hours/night beforehand, helping them to form resistant starch.
I try not to eat “naked” carbohydrates.
Whenever possible, I eat carbohydrates with fiber, proteins or fats. Moreover, in the correct sequence: first fiber (vegetables), then proteins-fat (chicken) and only then finish with carbohydrates (brown rice/quinoa/rye/bread). It is fiber that works best + this way you are less likely to eat extra calories in an attempt to “cut down” the sugar spike.
Second Meal Effect
Incredibly, foods with a low glycemic index eaten at dinner improve subsequent glycemic response to breakfast (this also works with lunches and dinners). Therefore, it is good not to take long carbohydrate breaks, and not to eat a huge portion at a time.
After a hearty lunch you should
sleeptake a walkThe more carbohydrates I ate and the more simple carbohydrates there were in the dish, the longer my walk should be. Sport in general helps a lot with sugar control, but even a short 15-minute walk is already very will reduce the effect of a portion of carbohydrates. On a bike tour in Japan, I calmly ate curry and ramen, and my sugar levels were ideal precisely because of the high physical activity.
Who makes sense to wear a CGM?
If you remove people with already diagnosed diabetes from the equation, then:
Athletes. CGM can help optimize diet and exercise patterns, reduce the risk of low energy levels, and improve overall metabolic efficiency.
If you have prediabetes or suspect your body does not respond well to carbohydrates. But after the measurements, be sure to go to the doctor, take the necessary tests and analyze the results with him. Don't self-diagnose.
If you are worried about developing diabetes, you can read more from the ADA (American Diabetes Association) about tests and analyzes that can identify it – Understanding Diabetes Diagnosis.
In other cases, if you are afraid of high sugar levels, then:
Stick to the basic rules of proper nutrition: eat several servings of vegetables and fruits daily, whole grains, beans, lean proteins and try to eat less ultra-processed foods. I talk a lot in my channel HOW to implement these rules in life and share my recipes.
Be physically active. Any regular exercise will greatly improve blood sugar control.
Watch your weight and especially if you are a woman with polycystic ovary syndromebecause your risk of developing T2DM increases greatly.
Go through your annual checkup. By the way, this is exactly how I caught my type 1 diabetes.
Approach your health consciously, but without panic and hyper-anxiety, and do not forget to periodically visit doctors who love dokmed.
