WH reports on the convo-sparking issue.
One woman’s health-saving device is another woman’s…lifestyle tracker? That’s the complicated question surrounding the rising interest in glucose monitoring for active, healthy people. As the main sugar found in your blood, glucose *is* a big deal. It’s what gives the cells in your body the oomph they need to function. So it’s not surprising that a number of start-ups are advocating for keeping tabs on this health marker in order to boost energy, optimize workouts, and more.
Where things get dicey: With the mainstream attention on glucose comes the promotion of continuous glucose monitor (CGM) devices, making them seem as if they’re any ol’ trendy tool. But experts and those with diabetes have thoughts about the idea of watching blood sugar fluctuations around the clock when you’re generally healthy—and doing it with tech that other patients really need to live. The questions: How important is understanding glucose as part of the bigger picture of your health, really? And when, if ever, do CGMs make sense if you don’t have some kind of diagnosis?
Meet the experts: .css-7qz8rz{-webkit-text-decoration:underline;text-decoration:underline;text-decoration-thickness:0.0625rem;text-decoration-color:#f7623b;text-underline-offset:0.25rem;color:inherit;-webkit-transition:background 0.4s;transition:background 0.4s;background:linear-gradient(#ffffff, #ffffff 50%, #feebe7 50%, #feebe7);-webkit-background-size:100% 200%;background-size:100% 200%;}.css-7qz8rz:hover{color:#000000;text-decoration-color:border-link-body-hover;-webkit-background-position:100% 100%;background-position:100% 100%;}Caroline Apovian, MD, is an internist and codirector of the Center for Weight Management and Wellness (CWMW) at Brigham and Women’s Hospital. Disha Narang, MD, is an endocrinologist at Northwestern Medicine Lake Forest Hospital.
Hey, we wouldn’t have a proper trend on our hands without a healthy dose of skepticism and a whole lotta Qs to accompany it! However much you know (or don’t) about this topic, chances are, you’ve forgotten key deets from bio class about this life-sustaining molecule. We’ve got the Spark notes for you.
When you eat or drink something that contains carbohydrates, your body breaks that thing down into basic chemical components—one of which is sugar. The sweet stuff then enters your bloodstream and gets carried to cells, where it’s used for energy. You need that sustenance to fuel your muscles and your brain.
This process is especially important if you’re an athlete. Muscles use glucose right off the bat to power movements, says Caroline Apovian, MD, an internist and codirector of the Center for Weight Management and Wellness (CWMW) at Brigham and Women’s Hospital. (That’s why “carb loading” before big races is a thing.) Consuming sugar is the only way to increase blood sugar, and expending energy (which burns glucose) lowers it, although your system does this naturally, all on its own.
More explanation: When you initially consume that carb- and sugar-containing food or drink, your blood glucose level rises pretty immediately, says Disha Narang, MD, an endocrinologist at Northwestern Medicine Lake Forest Hospital. Then your pancreas releases insulin, a hormone that transports the glucose into the cells. This transfer ultimately reduces the level of sugar in the blood, bringing it back to normal again.
Here’s the deal: If you don’t have diabetes, your body is on autopilot, processing glucose and keeping levels in check. When you have diabetes—a group of diseases that result in too much sugar in the blood—you need to bring in resources to regulate. Type 1 is caused by a deficiency of insulin and is often diagnosed in children and young adults. “The pancreas does not release insulin, so you need to take it in injectable form,” Dr. Narang says. Type 2, however, is known as a disease of insulin resistance and is typically connected to lifestyle. “The pancreas produces insulin, but your tissues don’t accept it,” she says. This leaves glucose in the blood instead of making its way into cells.
Typically, people with diabetes have to track their blood sugar. That’s done with a finger prick or with newer devices called CGMs (more on these in a minute!). This lets you know if you need to eat something (to increase low blood sugar) or inject insulin (to decrease it). As you can see, it’s an ongoing dance for those who need to monitor, which is primarily people with type 1 (when there’s no insulin production from the pancreas, they have to know glucose data to decide how much insulin to inject—unlike with type 2, in which the pancreas is able to produce it, and they need less). It’s why docs and patients have *a lot* of feelings about this issue.
Continuous glucose monitors, or CGMs, are devices that get inserted into your skin and use a tiny sensor to read your glucose levels every few minutes, around the clock. They’re a recent advancement in diabetes care. But they key phrase there is "diabetes care"—experts do not recommend healthy individuals use CGMs for a variety of reasons we’ll get into here.
For people with diabetes, they’re a total game changer. “CGMs help us determine if insulin dosing for patients is appropriate, and they help patients dose their insulin properly,” Dr. Narang says. It also shows you in real time how specific foods affect blood sugar. There’s no denying that CGMs are valuable, even lifesaving, for this group.
Despite how useful they are, though, they’re not always covered by health insurance for diabetes patients—and a higher demand for everyone can mean increased prices for those who need them most.
There’s also the issue of accuracy. Even the devices that people with diabetes rely on are not 100 percent accurate and typically show much more variance at lower (normal) blood sugars, she adds.
You’ll be hard-pressed to find a physician who deems it necessary to regularly tune in to your glucose happenings unless you have to for medical reasons. The experts we spoke with emphatically say that, if you don’t have diabetes, a risk of developing it, or the gestational type, constantly tracking is pointless at best.
The reality is that your body knows how to adjust when blood sugar goes up and down with each snack, meal, and workout. With a device, “you’re going to watch your body do what it’s supposed to do—and then you don’t need to do anything differently,” Dr. Apovian points out. In fact, when researchers analyzed data from monitors used by 153 people without diabetes, they concluded that 96 percent of the readings were in the normal range, a finding published in the Journal of Clinical Endocrinology and Metabolism. And a separate piece in JAMA addressed the rising marketing of CGMs—and concluded that there is no evidence that people with normal glucose responses benefit from this tracking. What’s more, the knowledge you may glean won’t be all that surprising: When you eat a bowl of fruit, your blood sugar will go up. When you eat a salad, it won’t spike as much. You kinda already knew that would happen, right?
Not only will measuring cost you a pretty penny (around $200 per month for CGM equipment and app access), but many medical pros also worry the casual monitoring may impact some consumers’ mental health, Dr. Apovian says. “I’ve had enough people buy them and contact me really alarmed, because they ate pasta and their blood sugar rose. But of course it did—everybody’s blood sugar rises when they eat any carb,” Dr. Narang says. This way of thinking has pushed people to unnecessarily cut back on carbs (which you need in order to survive) and embark on restrictive dieting that’s not sustainable, she adds.
Okay, time to level set. If you want to feel you’re in the driver’s seat with your glucose rises and falls, follow this advice (and you’re likely crushing these already): Eat a balanced diet with plenty of fruits and veggies. Think about pairing lean protein with whole grains at each meal and snack, which helps slow down the release of sugar into the bloodstream. Cut back on overly processed sweets. Exercise regularly (at least 30 minutes, five times per week!), and sleep at least seven hours a night.
What’s Normal? So glad you asked. When you’re fasted (say, you just woke up), below 99 mg/dL is considered healthy. If you’re one to two hours post-meal, a normal number is less than 140 mg/dL. If your blood sugar is outside these ranges, that’s a sign of prediabetes. FYI: You wouldn’t know your exact blood sugar number unless you tested. For the average person, it’s safe to assume everything is working as it should unless you experience symptoms, which include excessive thirst, frequent urination, unintended weight loss, fatigue, and constant hunger. If that’s the case, talk to your doc stat.
When you notice a swing in mood or energy after you haven’t eaten for a while, that’s likely low blood sugar nudging you to have a snack. There’s no need to know your exact glucose reading, though; simply eating anything will give your body what it needs to self-regulate.
The bottom line? You know yourself best—like whether you enjoy body and health data, can maintain a healthy relationship with wearables and stats, and have the means to invest in new tools and tech. But know that if you focus on a dietary plan low in processed foods and refined carbs, your body is structured to manage these hormones on its own, Dr. Narang says. Trust, your body’s got this on lock.
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