Continuous Glucose Monitoring—Is it Right for Me?
GCM and Functional Medicine
You may have read recently about Continuous Glucose Monitoring (CGM). There are many companies popping up (Levels, Nutrisense) who are providing CGM devices to consumers for tracking their blood sugar in real time. Many functional medicine patients at Tendwell in Denver, CO and New York, have used these devices to explore how their body reacts to different foods, movement and meal spacing. One Tendwell patient in particular is quite a success story--finally getting to a place of comfort after years of feeling inexplicably ravenous or fatigued at various moments in her day and not knowing exactly which foods to eat that would satiate her and set her up well for the next day. She had seen numerous doctors and endocrinologists. She had been put on metformin (a common blood sugar and diabetes medication) without any results. With no change in her hemoglobin A1C levels, weight or symptoms, she was left frustrated--until using a continuous glucose monitor for a couple months. Just two months of real time information was eye opening and life-changing for her. She was able to drop the extra weight and figure out exactly which foods worsened her symptoms.
Many type 1 diabetics have been using CGM technology for years, as a necessity. Type 1 diabetics must administer the right amount of insulin to address the level of glucose (sugar made from food) they are eating to make sure this fuel is getting into their cells and not just sitting in their bloodstream wreaking havoc.
This CGM technology can help the average person as well. Perhaps you have noticed a slump in energy that hits in the afternoon—post lunch. Many patients, tell me that there are moments in the day when they “can’t keep their eyes open”. They need a quick nap or a cup of coffee or caffeinated tea to power through the rest of their day. Maybe you’ve had trouble losing weight? Or sleeping through the night? Or maybe you have a family history of diabetes (type 2) or Alzheimer’s disease (sometimes called diabetes type 3)? Or perhaps you have had a rising or stagnant Hemoglobin A1C? Or maybe you are just the type who loves data and want to make informed choices about what you eat, when you eat and what combinations of foods make you feel best. Many functional medicine doctors and functional medicine nurse practitioners, including myself, are using these tools—the continuous glucose monitor—to help clients address all of the above.
One of my favorite books written in the last year is called Glucose Revolution, written by Ms. Jessie Inchauspe. She has a variety of fun and educational Instagram posts on the topic. Her handle—Glucose Goddess—is no accident. She used herself as a test subject and conducted the interesting experiment of eating foods in differing combinations and even eating the same foods in a different order, then comparing blood sugar results. Hot tip: reordering food intake produces different elevations in blood sugar. Eating green veggies (fiber) first is an easy hack to reduce spiking glucose levels. Adding a teaspoon or 2 of apple cider vinegar before eating also can help. Her work is fascinating. You can also do this experiment for yourself. I am happy to be your functional medicine guide through the process here in Denver, New York City or wherever you may be.
How does CGM work?
Continuous glucose monitoring automatically tracks blood sugar levels, throughout the day and night. You can see your glucose level anytime usually by way of an app on your smartphone. You can also review how your glucose changes over a few hours or days to note trends. Observing your glucose levels in real time can help you make more informed decisions throughout the day about how to balance your food, physical activity, supplements and medicines. A CGM works through a tiny sensor inserted under your skin, usually on your abdomen or back of the arm. The sensor measures your interstitial glucose level, which is the glucose found in the fluid between the cells. The sensor tests glucose every few minutes. A transmitter wirelessly sends the information to a monitor. Sometimes, the app will alarm when blood sugar spikes or falls to low. Associating how you are feeling at this time and what foods have been eaten are key to your success. The sensor typically lasts for about 2 weeks and then needs to be replaced.
Will insurance cover this product for me?
The answer, as always, is “maybe!” It depends on the diagnosis codes and what your particular insurance plan thinks is necessary. The good news is that there are affordable options that exist which you can purchase independent from insurance coverage.
Finally, we are living in exciting times! It’s so wonderful that we are able to have more data at our fingertips to put to use in creating more effective plans for optimizing our health. No longer do we need to wait to develop diabetes before intervening. Knowledge leads to small changes that lead to prevention. This is the mantra of the functional medicine practitioner. We are always digging deeper to find the root cause and mediators of dysfunction.
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