Continuous Glucose Monitors - Should You Use One?

Recently, it’s been getting harder and harder to keep up with all of the nutrition and “wellness” trends all over social media. In this post, we dive into the topic of continuous glucose monitors and why people who don’t have diabetes have decided to start wearing them to monitor their blood sugar. This may seem innocent at the surface level, but take a read to find out why it does more harm than good to wear one when it’s not medically necessary. Plus find out what we at HSH recommend you do instead.

         For individuals with diabetes, it is crucial that they have a strong awareness of their blood sugar levels throughout the day. In diabetes, depending on the type, an individual’s pancreas either does not produce adequate insulin, or the cells in the body have become resistant to insulin. In either case, insulin cannot do its job properly, meaning that the sugar in the blood cannot enter the cells to be used for energy. This can lead to dangerously high blood sugar levels (hyperglycemia) that can have incredibly damaging health effects if not addressed. For individuals who take insulin to help manage their diabetes, there is also a risk of low blood sugar levels (hypoglycemia), which can also be dangerous. Continuous glucose monitors (CGMs) are inserted under the skin, usually on the stomach or arm, and contain sensors which measure the amount of glucose in the blood. The information can be sent directly to a smartphone or another monitor. CGMs are particularly appealing for people living with diabetes because it means they don’t have to stick their fingers every few hours to test their blood. When used consistently, and paired with adequate education on diet and lifestyle habits by experts such as Registered Dietitians or Certified Diabetes Care and Education Specialists, CGMs can make life easier for those living with diabetes while helping to prevent life-long health complications.

It is becoming increasingly popular for individuals who don’t have diabetes to begin purchasing and using CGMs to keep track of their own blood sugar levels throughout the day. This  is giving more money to CGM companies and may have some negative impacts on the individuals who choose to use them. There are big creators on Tiktok that are “testing food for fun” and showing the impact on their blood sugars, ya know again for *fun,* so we thought we would break this one down. 

First, let’s look at some potential benefits that may seem appealing:

·       Genuine curiosity. For those of us who are particularly interested in food, such as Registered Dietitians, dietetic students and interns, and those of us who want to optimize athletic performance, we may have genuine increased curiosity in how our eating habits impact our blood sugar. Any self-proclaimed science or nutrition nerd could certainly see the appeal in analyzing the way our body metabolizes and reacts to the foods we eat. Wearing a CGM would help to quench that curiosity.

·       Monitor for prediabetes. A diagnosis of prediabetes indicates that blood sugar levels are consistently elevated, but not high enough to be diagnosed as diabetes. In 2019, the number of Americans aged 18 and older with prediabetes was 96 million. Individuals with prediabetes do not need to monitor their blood sugar as often as those with diabetes, and the usual recommendations are diet and lifestyle changes. Use of CGMs in non-diabetic individuals who may know they are at increased risk of developing prediabetes could provide them with information that may help them lower their blood sugar levels away from the prediabetic range.

Negative Impacts:

While these reasons may certainly seem appealing for non-medical use of CGMs, it is important to consider the possible negative impacts, and weigh the pros vs. the cons to decide if it’s truly worth it. One of the biggest concerns with consistent use of CGMs by individuals without diabetes can be seen in looking at fitness trackers as an example. The wide-spread use of fitness trackers, such as Fitbits, Apple Watches and Garmin watches, while certainly proving instrumental in getting people up and moving, are also proving to be a source of stress and anxiety for many. For example, the rings feature of Apple Watches encourages individuals to close their rings through fitness each day, and certain individuals report walking circles around their home at the end of the day just for the sake of closing their rings. Exercise and movement, which do provide significant benefits for cardiovascular health and muscle mass, should also be intuitive in order to be truly healthy. Fitness trackers have begun to dictate when and how much we should move, which is not always healthy. In a similar fashion, use of CGMs for those who are not diabetic could contribute to excess stress and obsession around numbers and food, particularly for those who may identify more with a type A personality. Some individuals may truly feel neutral about that type of data, which is all the more reason for them to use CGM if they are truly just curious. However, those prone to disordered eating habits or perfectionism may want to tread lightly when considering use of CGM, as it truly could do more harm than good.

In addition, it cannot be ignored that there is a significant population of individuals with diabetes who have unequal access to CGMs, making it even less appropriate for those who don’t require them for medical reasons to also have access to them. Specifically, a study titled Health Equity and Diabetes Technology: A Study of Access to Continuous Glucose Monitors by Payer and Race, found that poorer, older, and Black Americans have less access to CGMs compared to others. Regardless of age or health insurance coverage, black individuals with diabetes get GMCs less often. The study also noted that Americans on Medicaid are the least likely to have access to a CGM. This significant discrepancy in access to CGMs among the population of people who require them for medical reasons certainly needs to be addressed first before they become a mainstream priority for individuals without diabetes. OUR RECOMMENDATION: Talk to a dietitian and learn how to manage YOUR blood sugars best, and skip the CGMs for *fun*

Sources:

https://www.health.harvard.edu/blog/is-blood-sugar-monitoring-without-diabetes-worthwhile-202106112473

https://www-uptodate-com.proxy.libraries.rutgers.edu/contents/measurements-of-glycemic-control-in-diabetes-mellitus?search=continuous%20glucose%20monitoring&source=search_result&selectedTitle=2~135&usage_type=default&display_rank=2

https://www.diabetes.org/healthy-living/medication-treatments/blood-glucose-testing-and-control/checking-your-blood-sugar

https://www.niddk.nih.gov/health-information/diabetes/overview/managing-diabetes/continuous-glucose-monitoring

https://www.diabetes.org/about-us/statistics/about-diabetes#:~:text=New%20cases%3A%201.4%20million%20Americans,18%20and%20older%20had%20prediabetes.

https://www.diabetes.org/newsroom/press-releases/2021/american-diabetes-association-releases-study-access-barriers-to-continuous-glucose-monitors-at-cost-care-summit

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Written by Sarah Davis

Hey there, I’m Sarah! I am a current dietetic intern and graduate student in the Rutgers School of Graduate Studies, pursuing a Masters in Nutritional Sciences. I’m passionate about food and nutrition and so excited to explore my options as a RD!

Learn more about me and the HSH offerings here.