Should you be wearing a continuous glucose monitor (CGM) in midlife?

You’ve probably heard people talking about continuous glucose monitors (CGMs). They are the latest in a line of wearable devices that promise to revolutionise your health. Maybe you know someone doing the Zoe programme, or you might have spotted people wearing a little white disk on their upper arm and wondered, what’s that all about? So, what’s the deal with CGMs and why all the hype? Are they worth investing in? I was recently given the opportunity to trial Lingo, one of the latest CGMs to hit the market. Read on to hear about my experience.

What does a CGM do?

When you see someone wearing a little disc attached to their upper arm, chances are, it’s a continuous glucose monitor (CGM). A CGM continuously tracks blood glucose levels in real-time and provides updates to the user throughout the day and night by linking with an app on their phone. This is a medical necessity for those with type 1 diabetes who need real-time information to work out how much insulin they need to dose. Since very high sugars are dangerous to the body and very low sugar levels (hypos) can be life-threatening, these monitors can mean the difference between life and death.

What are the advantages of using a CGM?

Consistently steady glucose is a sign of good metabolic health and glucose control can improve how you feel in the short term and your long-term health. Over the last couple of years, more and more people who are simply interested in their health are investing in devices such as CGMs. Many people love to get data on what their body is doing and may find it motivates them to make changes to their diet and lifestyle to improve their health. A CGM can help you learn how your body responds to food, exercise, stress and sleep. It may be useful to someone who has been told they have prediabetes and wants to reduce the risk of developing type 2 diabetes, or those who are looking for answers to why their energy or focus is lacking, why they can’t control their hunger, why they’re struggling to lose weight or why they don’t sleep well.

How much does it cost and how long should you use it for?

Lingo costs £59 for a 2-week programme, £99 for 4-weeks and £289 for 12-weeks. My clients get a 10% discount on these prices. Each biosensor is designed to last for 14 days but unfortunately, mine did stop working after 10 days. Maybe I was just unlucky but I have heard of similar complaints so it might be something to consider if you’re expecting it to last the full 2 weeks!

Lingo advises that 2 weeks is sufficient to learn how your body responds to your daily food and exercise choices, however a minimum of 8 weeks is required to gather enough data to drive healthy habit change.

What did I learn from wearing a CGM?

• I had my biggest glucose spike from mashed potato! Also, sourdough bread, rice and lentils, not hugely surprising given their carbohydrate content.

• I slept better on the nights that my blood sugar was balanced throughout the day and on the days where I had a higher protein breakfast.

• A protein powder green smoothie at breakfast balanced my blood sugars much better than sugar-free granola with yoghurt and chia seeds.

• A high protein lunch balanced my blood sugars through the afternoon and meant I was more focused and less tired.

• Exercise after eating a high carb meal brought my blood glucose spike down much faster than if I ate the same meal without moving afterwards.

• My blood sugar levels went naturally lower when my next meal was due demonstrating the importance of meal routines and regularity for metabolic health.

• A couple of alcoholic drinks in the evening caused an extended spike followed by blood sugar dips that night, affecting my sleep quality.

Why is balanced blood sugar important, especially in midlife?

Balancing blood sugars isn’t a new concept and it’s something I work on with most of my clients. It’s especially important when we head into perimenopause and menopause because oestrogen has such a protective effect on cardiovascular health. Declining oestrogen levels reduce insulin sensitivity, making us less tolerant of carbohydrates, more likely to store weight around the middle (hello menobelly) and increasing the risk of insulin resistance, heart attack and other cardiovasular diseases.

At the most basic level, the principles to follow for balanced blood sugars are:

• Eat regular meals, 4-5 hours apart

• Combine carbs, protein, fats and fibre at each meal

• Minimise refined carbs and sugars

• Go easy on the booze

• Drinks lots of water

• Get good quality sleep

Our bodies are cleverly designed to maintain steady blood sugar levels and do this by releasing hormones such as insulin and glucagon in fed and fasted states. As long as we don’t have diabetes, eat relatively healthily and don’t continuously abuse our bodies, we should be fine, shouldn’t we? So why do we need to use a CGM?

My thoughts...

I do believe CGMs can have a part to play in health and some people who like to see data may find them useful. Individual responses to foods really vary and what spikes blood sugar for one person may not do so for another. A CGM allows you to trial different foods and patterns of eating and see if they link to particular symptoms such as a mid-afternoon energy slump, fatigue after exercising or waking up at certain times in the night. It can allow you to track how you respond differently to food depending on quality of sleep, stress levels, time of day or different hormone levels during the menstrual cycle.

Women in midlife are at increased risk of insulin resistance and this often goes undiagnosed because if you’re not tracking your blood sugar levels, how would you know if they’re swinging around all over the place? Unfortunately, the signs and symptoms of insulin resistance can easily go unnoticed for a long time so a CGM could show you that your metabolic health is declining, prompting you to make changes to your diet and lifestyle.

I did find I became slightly obsessed with checking my blood sugar levels and it can be quite addictive. If you’re not diabetic, do you need to constantly know what your blood sugar is doing? I’d say probably not! There is such a thing as having too much information and your body is designed to quietly control your blood sugar without you needing to think or worry about it. CGMs may therefore not be suitable for everyone, for example people with disordered eating patters, obesseive type personalities or who experience health anxiety.

It's also important to remember that eating carbs will always cause a ‘spike’ in blood sugar and that spikes aren’t necessarily bad! It’s more about how long the spike lasts, how long it takes to come back down, how long your blood sugar is in the ‘healthy’ range and your overall percentage variability. Carbs on their own will always cause a bigger spike than if you combine the same carbs with protein but it doesn’t mean you shouldn’t eat those carbs, and using a CGM could cause you to cut out healthy foods thinking they are ‘bad’ when they’re not. The Lingo app does provide education and coaching around this so it may be a better alternative to other CGMs on the market, but I feel it's always best to work with a nutrition professional to help you make sense of the data and provide some context.

If you’d like to test your average blood sugar levels over the past few months without using a CGM, you can test your haemoglobin A1c (HbA1c), Haemoglobin is a protein found in red blood cells that carries oxygen to different parts of the body, and glucose can attach to it, forming a "glycated" haemoglobin molecule. The HbA1c test measures the percentage of glycated haemoglobin in the blood, reflecting the average blood sugar levels over the past 3 months. You can get your HbA1c done privately and relatively inexpensively, and even test it yourself at home. It’s a test I often recommend to my clients.

Link – www.hellolingo.com