Wearables are popular amongst the health-conscious as a means to access important metrics, but is continuous glucose monitoring for non diabetics necessary? Continuous Glucose Monitors (CGMs) are quickly gaining traction and for good reason. Whether you’ve spotted someone wearing one on the street or scrolled upon a social media ad, there is no doubt you will be seeing a lot more of them in years to come.

The advent of CGMs is an invaluable and life-saving tool for diabetics and blood sugar testing. As their popularity and prevalence has grown, non-diabetics have taken notice. While many tout them as a preventative measure to gain insight and track data, others deem them unnecessary for those with normal glucose tolerance, perhaps even harmful.

Before we explore both sides of the fence, let’s first get an understanding of what a CGM is, how it works, and why blood sugar monitoring is important.

What Is a Continuous Glucose Monitoring Device?

Historically, the industry standard for testing glucose levels at home has been via a blood glucose meter that pricks your finger and takes blood sugar readings. Then along came the CGM which follows a very similar premise but is worn on your body around the clock, delivering its data to you in the same manner.

CGMs provide data by measuring the level of blood glucose in your interstitial tissue fluid via a thin, wire sensor typically inserted into your upper arm. The glucose data is sent wirelessly to an app on your smartphone that is updated every few minutes. The app provides readings in real time as well as graphed average glucose levels, glucose fluctuations, blood glucose patterns, and a blood glucose range over time.

Don’t let the idea of a sensor inserted into your skin scare you. Users generally experience a slight sting that quickly subsides. Wearing a plastic disc on your arm does take some getting used to, but once accustomed to the physical device, users often become more interested in experimenting with the data.

Is a Continuous Glucose Monitoring Device for Non Diabetics Beneficiary?

A normal fasting glucose blood test is essentially just a snapshot in time for people without diabetes and highly dependent on other factors such as dinner the night before and how well one slept. The HbA1c blood test offers more insight with a three month average, but again, just three months. Peter Attia, M.D. collected data with patients over three years in his practice and found that at least 33 percent of the time, the HbA1c was conflicting with the average glucose levels collected from a CGM. 

This begs the question, wouldn’t real time data of your glucose patterns benefit just about everyone? How is one to know whether or not they have glucose dysregulation issues to begin with if not for such data?

Pros of Continuous Glucose Monitoring for Non Diabetics

1. A Preventative Tool

   Glucose tracking is a preventative health measure. A CGM will tell you how well your body is handling glucose peaks and lows. With standard testing procedures such as fasting glucose and HbA1c, your numbers typically aren’t flagged until they are extreme and you’re in the range of prediabetes and beyond.

   A CGM collects real time data that may otherwise be missed in an annual physical. A recent study found those considered non diabetic by traditional measurement standards demonstrated high glucose fluctuations via a CGM, with some reaching a prediabetic range.

2. Personalized Data

   No two people are alike and neither are their glycemic profiles. Insulin sensitivity is dependent on a multitude of factors. In addition to food, lifestyle factors (e.g. sleep, stress, and exercise) can impact your blood sugar. Wearing a CGM allows you to see how certain foods and variables affect you, personally.

3. More Awareness and Behavior Modification

   The awareness around food and the correlating blood sugar responses a CGM can provide is obvious. A recent study found that 87% of users felt that they modified their food choices based on their CGM metrics. But blood sugar and exercise go hand-in-hand as well.

   Physical activity has a direct effect on blood sugar and certain types may increase insulin sensitivity more than others. A review found that a combination of aerobic exercise with strength training was particularly effective for people with and without diabetes.

   Separate studies discovered that exercise increases the uptake of blood sugar by up to 50 fold, and a single bout of continuous aerobic exercise significantly decreased glucose concentrations when performed in the postprandial state.

   Collectively, findings show that moderate activity for 20-30 minutes beginning 30 minutes after a meal can inhibit glucose spikes. A post-meal brisk walk is effective in improving the glycemic response. Wearing a CGM provides personalized insight into how to time your meals and snacks with your workout.

   In addition to mitigating blood sugar spikes with activity, a CGM just might motivate you to squeeze in more workouts per week. A study done in a diabetic population wearing CGMs showed a significant increase in total exercise time per week. Perhaps wearing a CGM while exercising may offer insight on par with activity trackers.

Cons of Continuous Glucose Monitoring for Non Diabetics

While the pros of continuous glucose monitoring are extensive and strong, not all medical professionals are onboard with the continuous glucose monitoring for non diabetics trend. Some believe the cons outweigh the pros. What are their objections?

1. Unnecessary

   Those opposed to the use of continuous glucose monitoring for non diabetics simply feel they are unnecessary and a waste of time and money. Perhaps just another gadget to add to your repertoire of tracking tools. The use of CGMs by those with normal glucose tolerance is a relatively new phenomenon, so studies backing their benefit to this group are lacking.

2. Inaccuracy

   Another factor considered by those opposed is the possibility of inaccuracy. A study published in 2013 reported that your sleeping position may affect the data from your CGM. Due to low blood flow to your tissue from compression (think sleeping on your side on the arm with your CGM sensor), the readings can be more than 25 mg/dl off. This variation has the potential to affect your mean average glucose.

3. Lag in Data

   Unlike with the use of a glucometer that pricks your finger and measures your blood, CGMs like Freestyle Libre 2 and Levels Health rely on your interstitial tissue fluid to measure glucose levels. A study published in 2021 found that this results in a lag in the data collection. The lag of time for the glucose to move from the blood to the tissue takes about 15-20 minutes. This discrepancy should be taken into account if the levels of glucose greatly fluctuate.

4. Hyper-Focusing

   Some medical professionals feel people without diabetes with normal glucose variability may start to focus too much on the temporary glucose spikes and deem them undesirable. This runs the risk of people possibly cutting out healthy foods that are part of a well-rounded diet in pursuit of a flat line on their graph.

Summary

More than 120 million Americans have diabetes or prediabetes. Current methods for diagnosing both diabetes and prediabetes rely on a single blood test and cannot detail the nuances of glycemic patterns.

According to the CDC, 1 in 10 Americans have diabetes and 1 in 5 don’t know they have it. More than 1 in 3 have prediabetes and more than 8 in 10 don’t know they have it. Given these statistics, continually monitoring blood glucose has its benefits. While you can now access CGMs directly through companies without your physician, it is always best to speak with your healthcare provider about incorporating one into your lifestyle to achieve your health goals.

A myPrimalCoach can help you work on incorporating dietary changes, increasing activity levels, and other lifestyle factors to achieve overall health as you interpret your CGM data with your physician.