Continuous glucose monitoring made me continuously crazy

Daily beingness is antithetic erstwhile you’re tracking glucose. A small implicit a twelvemonth ago, I was connected my mode to a conference. My bags were packed, the Uber was connected its way, but determination was 1 past happening to bash earlier I could caput to the airport. Tearing unfastened a tiny isopropyl intoxicant wipe, I cleaned the tegument connected the backmost of my arm. After that, I applied a tiny applicator to the cleanable skin, doing my champion to disregard the disposable needle inside. I squeezed my eyes unopen and pressed a button. It made a ka-thunk. I repeated the process connected the different arm.

In my close arm, I present had a Dexcom Stelo. In the left, an Abbott Lingo. Both were over-the-counter continuous glucose monitors (CGM) that would show the emergence and autumn of my glucose levels. Opening my phone, I checked some the Dexcom and Abbott apps to marque definite the CGMs were transmitting data. I made a intelligence enactment to cheque however precocious altitudes mightiness interaction readings. It crossed my caput that, to my surprise, I’d felt zero pain.

There was nary urgent aesculapian crushed wherefore I needed to way my glucose. I’m not a diabetic. My A1C levels — the metric that measures semipermanent humor sweetener — person ever been good. But glucose tracking isn’t conscionable for diabetics anymore. On societal media, you tin spot doctors, wellness influencers, biohackers, and athletes talking astir CGM use. I conscionable hap to trial wellness tech, truthful I thought I’d springiness it a whirl for a fewer weeks and spot if determination was immoderate payment for a non-diabetic similar myself utilizing this tech.

Instead, I ended up spending implicit a twelvemonth investigating the devices, speechmaking up connected studies, speaking with researchers, and falling down rabbit holes. I bounced from doc to doc trying to fig retired if determination was really thing incorrect with maine — oregon the devices I was using.

The archetypal “professional use” CGM was cleared by the Food and Drug Administration successful 1999. Most radical deliberation these devices are utilized to way humor sugar, but that’s not wholly correct. Technically, they supply real-time glucose measurements from the interstitial fluid betwixt your cells, conscionable underneath your skin. Compared to accepted finger-stick tests, which straight measurement humor sugar, CGMs tin way glucose trends implicit an extended play of time.

Until 2024, CGMs required a medicine and were devices chiefly utilized by Type 1 diabetics — radical who nutrient small to nary insulin. Now, some Dexcom and Abbott merchantability CGMs targeted astatine non-diabetics, prediabetics, and Type 2 diabetics who don’t trust connected insulin. To differentiate, sometimes you’ll spot companies marketplace over-the-counter devices arsenic “glucose biosensors.”

The benefits of utilizing CGMs for prediabetics and Type 2 diabetics are clear. Unlike Type 1 diabetes, prediabetes and Type 2 thin to make implicit clip arsenic the assemblage becomes much resistant to insulin. If caught aboriginal enough, it tin beryllium “reversed” with manner interventions similar changes to fare and exercise. People with pre- and Type 2 diabetes besides marque up the overwhelming bulk of cases successful the US. According to the American Diabetes Association, arsenic of 2021, Type 2 diabetics marque up astir 95 percent — oregon astir 36 cardinal — of the estimated 38.4 cardinal Americans with diabetes. Meanwhile, astir 98 cardinal were estimated to person prediabetes. Put each that together, and a important fig of radical could perchance larn a batch from utilizing CGMs astir however their dietary habits interaction a morganatic metabolic condition.

Less wide is whether this exertion is utile for non-diabetics. But that hasn’t stopped the propulsion for this tech, from some the CGM makers and the government. If Health Secretary RFK Jr. has his way, successful 4 years, everyone mightiness beryllium wearing 1 of these. Underscoring this, President Donald Trump’s arguable surgeon wide nominee Casey Means is besides the cofounder of Levels, a CGM startup aimed astatine non-diabetics. In her publication Good Energy, she calls retired the exertion arsenic a utile instrumentality successful fixing metabolic dysfunction — thing she claims is astatine the basal of each imaginable chronic ailment today. However, respective aesculapian experts person publically questioned this logic, stating the grounds for non-diabetics simply isn’t there.

But we’ve present entered a caller epoch wherever wearable exertion offers a tantalizing promise. It’s not conscionable astir flagging imaginable illnesses. It’s astir optimizing your body’s biometric information to unrecorded the longest, healthiest beingness possible. In the discourse of the US’s terribly flawed healthcare system, this tech has often been positioned arsenic giving backmost a grade of power to the mean person. Wear this device, way your health, larn much astir yourself, and subsequently marque amended choices.

Optimization of metabolic wellness has been a rising inclination for years. Most commonly, this has travel successful the signifier of nutrient logging. However, CGM-related metabolism tracking has gained traction owed to the other furniture of information it provides. January AI was primitively a CGM startup that past pivoted to providing glucose spike prediction wrong a repast logging app based connected the information it collected. Meanwhile, Oura has since partnered with Dexcom to supply glucose readings, repast logging, and AI interpretations wrong its ain astute ringing app. Abbott besides precocious partnered with Withings, different wearables maker, for a akin integration. When you origin successful that GLP-1 usage is increasing, alongside the instrumentality of 2000s-era, ultra-skinny fare culture, it seems similar CGM usage is being positioned arsenic the adjacent improvement of fittingness tracking.

“It’s predicted 1 successful 2 Americans volition person obesity by the twelvemonth 2030,” says Dr. Thomas Grace, a diabetes clinician with Type 1 diabetes who consulted with Dexcom connected the Stelo CGM. “I deliberation the astir breathtaking happening for myself, for my patients, and for radical utilizing Stelo is the instant reward they get from knowing however food, activity, stress, and slumber impact their wide glucose health.”

I’m the nonstop benignant of non-diabetic that Dexcom, Abbott, and different CGM startups are targeting. I’ve got a household past of Type 2 diabetes and precocious cholesterol. I’ve been diagnosed with polycystic ovary syndrome (PCOS) — a chronic information that galore doctors person told maine means I apt either person insulin absorption oregon chronic inflammation that makes maine predisposed to diabetes. As a runner, I’ve struggled with vigor levels portion grooming for long-distance races contempt pursuing modular fueling practices and carb loading. Why not effort biohacking my nutrition to negociate my diabetes risk, summation penetration into PCOS, and beryllium a amended athlete?

Wearing a CGM 24/7 is invisible until it isn’t. I went days without remembering they were successful my arms. Then, they’d inevitably snag connected my garment sleeve, oregon I’d brushwood into a doorframe, the interaction popping the CGM retired of my arm. Now, adjacent erstwhile I don’t deterioration CGMs, I’m alert of the backmost of my arms and the chopped of each my shirts. That hypervigilance comes with being perpetually monitored — adjacent if you’re the 1 doing the monitoring.

At first, I’d reappraisal my information each morning, aft each workout, and a fewer hours aft each meal. Most of what I saw was beauteous normal. A vessel of pasta? Glucose spike. Roasted salmon and a broadside salad? Minimal increase. Carb loading earlier a agelong run? Mondo spike, followed by a crisp decrease. (I recovered CGM usage excessively cumbersome for mid-run fueling, arsenic there’s a five-minute hold betwixt readings.)

Nevertheless, reviewing my information aggregate times a time began spiking my anxiety. Both Dexcom and Abbott’s apps person acquisition articles astir what the perfect glucose scope is for steadfast nondiabetics — 70 to 140mg/dL. Fasting glucose levels — similar erstwhile you’re sleeping — ought to beryllium successful the scope of 70 to 99mg/dL. Those archetypal fewer months, I woke up good beyond 100mg/dL each day, adjacent without late-night snacks. Sometimes, I’d aftermath up to spot the Dexcom app had alerted maine to glucose spikes portion I slept. (Abbott doesn’t nonstop spike notifications for Lingo.)

A twelvemonth prior, I had tested Nutrisense — which besides makes usage of CGMs — for 2 weeks and ne'er had elevated greeting glucose levels. Clearly, diabetes had yet travel for me.

Elevated greeting glucose is simply a interest due to the fact that of the Dawn Phenomenon. To assistance hole your assemblage to aftermath up, you nutrient hormones similar cortisol and maturation hormone. That signals to your liver to merchandise glucose, giving you vigor for the day. In diabetics and insulin-resistant people, however, it leads to overly precocious humor sweetener levels during the morning. Something, perhaps, similar what I was seeing.

Cue anxiety, scheduling a flurry of doctors’ appointments, and hyperfixating connected my fare and exercise. At the doctor’s office, I got shrugs, quizzical brow raises, and a reluctant acquiescence to tally humor tests. (“Do they truly person non-diabetics wearing those?” a caregiver asked portion taking my humor pressure.) My A1C, a gauge for your mean glucose levels implicit 2 to 3 months, was perfectly normal. No diabetes here. I did, however, person elevated liver enzymes and cholesterin levels.

Out of an abundance of caution, my doc ordered an ultrasound. I had to hold respective weeks for an appointment. Later, erstwhile the goo was slathered implicit my abdomen, I watched nervously retired of the country of my oculus arsenic an ultrasound technician muttered to herself. After different fewer days, I got a telephone from the doctor. I was diagnosed with a “nothing to interest astir close now” lawsuit of non-alcoholic fatty liver — a information that commonly occurs alongside PCOS. Maybe, my doc suggested, I should chopped retired each intoxicant (I seldom drink) and suffer assemblage abdominous (I’ve been trying for 10 years). Come backmost successful astir a year, they said, and we’ll spot wherever you’re at.

Read 1 way, this could beryllium a occurrence communicative for CGMs. The devices flagged thing had changed, and though it wasn’t diabetes, I had astatine slightest 1 caller authoritative diagnosis. Glass fractional full: Control implicit my wellness had been handed backmost to me.

A much skeptical instrumentality is that elevated liver enzymes and precocious cholesterin had been contiguous successful erstwhile humor work. A erstwhile doc had besides suspected fatty liver disease, but said an ultrasound wasn’t indispensable unless my levels worsened. Were my levels worse astatine this CGM-inspired humor test? Not particularly. The proposal I’d been fixed was the aforesaid arsenic it had been successful years past. Glass fractional empty: I learned thing new.

It wasn’t until overmuch later, aft consulting with Dexcom and Abbott, that I learned broadside sleeping could pb to inaccurate overnight glucose readings. When you’re connected your side, the CGM tin get compressed. That, successful turn, could pb to readings little or higher than your existent glucose levels. I tried swapping arms for the Lingo and Stelo to trial for this, but it was intolerable to relationship for however I shifted positions each night. Either way, I continued getting precocious overnight and greeting glucose readings from some sensors for months.

The worst portion was that I couldn’t archer whether the information was inaccurate oregon my doc had missed something.

I started moving into issues aft the archetypal period of continuous wear. For starters, it tin beryllium pricey. Dexcom and Abbott some gave maine respective trial units, but for the mean person, it tin outgo astir $100 a month. A azygous sensor lasts astir 15 days if everything goes well. Sometimes, they malfunction oregon get ripped retired aft getting caught connected covering and different objects. The adhesive besides leaves stubborn residue that takes weeks of showering to afloat remove. Partly to agelong retired my supply, partially to springiness my tegument a break, I started investigating 2 weeks of each month. After six months, I pared down to erstwhile a quarter.

But careless of however often a idiosyncratic uses CGMs, each assemblage is different. Foods that origin a spike for maine whitethorn bash thing for you. The lone mode to cognize for definite is done diligent logging and experimentation. The conundrum is that this creates a upland of data, and arsenic I learned, interpreting that information without capable discourse tin pb to unnecessary anxiety.

Compounding the issue? CGM makers person differing approaches connected however to contiguous that data. The Dexcom Stelo app, for example, volition springiness you spike alerts aft astir an hr oregon two. Abbott’s Lingo CGM eschews specified alerts altogether. Instead, Abbott opts for a Lingo Score that tries to simplify earthy information into a digestible fig that signifies however good you did connected mean astatine keeping your glucose wrong a steadfast scope of 70 to 140mg/dL.

Using a CGM to enactment wrong that scope sounds comparatively elemental and easy. In reality, it’s complicated.

“The 1 survey that did look astatine follow-up outcomes recovered that radical who spent much clip supra that scope were much apt to get diabetes, but this was successful a beauteous tiny population,” says Nicole Spartano, adjunct prof astatine Boston University’s Chobanian and Avedisian School of Medicine. “They whitethorn person already had prediabetes and are benignant of connected their mode already. I deliberation we’re truly astatine a constituent wherever we don’t person a batch of accusation from a probe standpoint.”

For example, Spartano notes that there’s often a deficiency of discourse for however CGM numbers could subordinate to an individual’s health. On the 1 hand, doctors often spot a fasting humor glucose level of implicit 100mg/dL arsenic a origin for concern. CGMs, however, do not measurement humor glucose. They measurement interstitial glucose, which can, astatine times, beryllium higher than humor glucose. Spartano says much probe is needed to find what the differences betwixt humor and interstitial glucose could be, some broadly and connected an idiosyncratic level.

“We presume that they’re wholly accurate, but they’re not exactly accurate. There’s a definite level of accuracy that the FDA requires, but that inactive leaves immoderate wiggle room,” says Dr. David Klonoff, aesculapian manager astatine the Diabetes Research Institute astatine Mills-Peninsula Medical Center and editor-in-chief of the Journal of Diabetes Science and Technology.

Basically, if you deterioration 2 CGMs simultaneously, arsenic I did, it’s imaginable to get antithetic numbers and not cognize which 1 is genuinely correct. And portion astir radical would lone deterioration 1 astatine a time, determination could besides beryllium a quality betwixt 1 CGM you deterioration and the next, based connected whether they were applied correctly and respective different factors.

But accidental everything is assumed to beryllium accurate. What is the champion mode to construe CGM information for non-diabetics? To effort and find out, Spartano ran a objective survey successful which 18 endocrinologists were asked to measure information from non-diabetics.

“We gave them 20 antithetic glucose show reports and asked them, ‘If idiosyncratic came successful with this report, would you suggest they person a follow-up screening for this?’” says Spartano. She says immoderate experts viewed peaks arsenic a mean portion of physiology. Others saw elevated levels arsenic a motion idiosyncratic mightiness request further testing.

“Essentially, determination was nary consensus. Even clinicians who work CGM information each day, each time don’t cognize what to bash with this data,” says Spartano.

“One of the problems is we don’t person an perfect mode of analyzing the accusation yet. We cognize if idiosyncratic is doing truly poorly oregon wholly normally, but the radical that look to beryllium headed for trouble? We tin lone say, ‘It doesn’t look normal, but it’s not abnormal. It’s thing successful the middle,’” agrees Klonoff.

According to Klonoff and Spartano, determination isn’t a notation acceptable of information that’s been vetted and agreed upon by a radical of experts. The information that’s coming successful from antithetic subgroups of radical utilizing over-the-counter CGMs is each truthful caller that it’ll instrumentality years earlier that’s adjacent possible.

So, accidental you, a non-diabetic, needed assistance interpreting your CGM data. It’s precise imaginable that if you were to contiguous your information to 10 antithetic doctors, you mightiness get 10 antithetic recommendations.

During my research, aggregate doctors and diabetes experts told maine I was good fixed that my A1C remained optimal and my CGM information — for the astir portion — stayed wrong a steadfast range. Spikes, they assured me, are a mean portion of my metabolism functioning arsenic it should.

However, that’s technically not optimizing. Take Means. While her credentials are questionable (she thinks you tin forestall crab with “good energy” habits), successful her New York Times bestseller Good Energy, she advises, “We privation to minimize spikes due to the fact that they are associated with worse outcomes.” She advocates for stricter criteria. Post-meal glucose levels shouldn’t emergence supra 115mg/dL, nary spike should beryllium supra 30mg/dL, and “optimal” greeting fasting glucose should beryllium betwixt 75 and 80mg/dL. I’ve seen different influencers urge akin advice, albeit with somewhat antithetic numbers.

By those standards, you could beryllium successful a steadfast scope 100 percent of the clip but inactive person a “suboptimal” metabolism. Never caput that experts person said there’s not capable statement to specify what warrants “good” oregon “bad” CGM information successful non-diabetics. Many CGM apps volition springiness you scores and further metrics to purpose for. If you’re a perfectionist similar me, that tin beryllium a look for disaster.

The longer I wore CGMs, the much obsessed I became with the nutrient connected my plate. A portion of pizza astatine a gathering would marque maine interruption retired successful a acold sweat. Common consciousness says a azygous portion of pizza erstwhile successful a portion is not the extremity of the world. But the thought of a spike alert oregon a atrocious people was capable to person maine that I should forgo eating meals oregon snacks entirely, adjacent if my tummy was growling. Likewise, I began overexercising. I’d consciousness bully if my fasting glucose was beneath 85mg/dL, and stressed if it was thing implicit 100 — adjacent if determination was a logical, temporary, bully crushed for that. I began to consciousness stressed astir being stressed. At a definite point, I became incapable of enjoying societal events and started avoiding them. The worst infinitesimal came aboriginal connected successful investigating astatine a household Thanksgiving dinner. I started negotiating with myself astir what I could devour based connected however it was showing up successful a CGM app. After six months, it became atrocious capable that radical adjacent to maine felt the request to intervene. I had been excessively fixated connected successfully “optimizing my metabolism” to notice.

This is often forgotten successful the communicative to optimize metabolism. Studies person recovered that it’s hard to reason that wearables, diet, oregon fittingness apps person a definitive nexus to disordered eating oregon eating disorders — though the hazard is there, and they person been associated with exacerbating symptoms successful those who already person experienced them. For immoderate people, CGM usage won’t travel with this benignant of acheronian side. For me, it perfectly did.

I present opt to usage CGMs lone to trial caller features.

After astir a year, I decided to behaviour 1 last test. Once again, my information was wonky. Morning glucose was elevated. Post-meal spikes were prolonged. And my regular mean glucose was higher than it’d ever been. I was consistently exhausted. I kept gaining value contempt vigilantly monitoring my nutrition and exercise. I recovered a caller doc and got immoderate much humor enactment done. Still nary diabetes oregon prediabetes. But my atrocious cholesterin had worsened, and 2 liver enzymes had much than tripled from the erstwhile year. An ultrasound showed my fatty liver had progressed from mild to moderate. For the archetypal time, I had my insulin absorption tested and was recovered to beryllium connected the “high broadside of normal.”

My caller doc concluded that my non-medicated efforts to rein successful my chaotic metabolism, portion admirable, weren’t cutting it. Prescriptions were written, a program was formed, and 4 months into treatment, my CGM information and humor enactment person dramatically improved. For the archetypal clip successful a decade, my atrocious cholesterin is normal. I’ve mislaid 15 of the 25 pounds I gained, and my liver enzymes person dropped by astir 65 percent. My greeting glucose levels are nary longer elevated.

Proponents of non-diabetic CGM usage mightiness framework this arsenic an outright win. In galore ways, it is. Even so, I’m hesitant to qualify it that way. I was often stumped by my data, anxious erstwhile consulting doctors, and for a time, wrecked my hard-fought narration with nutrient and exercise. Overall, it took 13 months from starting CGM investigating to uncovering a satisfactory attraction for my metabolic issues and 17 months to yet spot improvement. Along the way, I shed galore tears of frustration, and I’m still adjusting to the broadside effects of my caller medications.

I’m grateful to spot my wellness improve. My semipermanent investigating of CGMs undeniably played a relation successful that. But arguably, medicine — not CGM usage and decidedly not “taking power of my health” done manner changes unsocial — is what’s yet helping maine consciousness better. I’m each for non-diabetics having entree to these sensors, truthful agelong arsenic they’re alert of the limitations. What I’m not for is framing CGMs arsenic a metallic slug for demystifying and optimizing your metabolism.