Most people do not give much thought to their blood sugar, until they get the sad news from their doctor that they are prediabetic or have full blown diabetes. Part of the problem is that most individuals do not do a set of yearly comprehensive bloodwork, therefore, it is not possible to address imbalances before they become full blown problems. This is why I do comprehensive labs with all my clients. The goal is prevention. 

For example, if I see that a client’s blood sugar is trending high, even though it is in lab range, we will address that marker with diet and lifestyle changes to prevent the trend from continuing in an unhealthy direction. It is important to understand that blood sugar or glucose is the body’s primary fuel at the cellular level, providing the energy needed for various bodily functions. Think of blood sugar as your bodies “check engine light” for the health of your metabolism overall. 

How does blood sugar work?

Glucose or blood sugar enters the bloodstream after the body breaks down carbohydrates from food. It is important to understand that eventually all carbohydrates break down into sugar in the body. Whole food carbohydrates from vegetables, fruit, beans and legumes, and whole grains will break down slower than processed food carbohydrates like cake, chips, and candy. The hormone insulin, produced by the pancreas, helps glucose enter the cells for energy, and when blood sugar rises, the pancreas releases more insulin to lower it and will also release glucagon if needed to bring up low blood sugar. This is what happens when all is working as it should.

However, over time dysregulated blood sugar can result in hyperglycemia or high blood sugar, which predisposes a person to nerve damage, kidney issues, and cardiovascular issues over the long term. On the other hand, hypoglycemia or low blood sugar can result in dizziness, confusion and even seizures if it is a longer-term issue. So, once again maintaining stable blood sugar is key to metabolic health. 

Enter the CGM:

A CGM or continuous glucose monitor measures glucose levels in the interstitial fluid between cells, so it will differ slightly from finger prick tests that draw from blood. The advantage to a CGM is that it is minimally invasive, not painful to use, and data is transferred to your smart phone in real time. Some sensors like the Libre 3 are very small, the size of two stacked pennies, you can “set and forget” for two weeks, it is FDA approved and waterproof. It is a wonderful way to gain self-knowledge and support informed diet and lifestyle choices. “Always on data” with a CGM will capture trends and fluctuations that a fingerstick or bloodwork will not. 

My CGM journey:

I never ask my clients to do anything that I have not tried myself, so for the last two weeks, I have been wearing a CGM, and it has been very enlightening. I collaborate with a company that looks at optimal or functional lab ranges instead of the broader lab ranges, and this is because I am working to optimize my health not to manage a condition. 

CGM Metrics:

• Activity Score: An activity is food, exercise, a beverage, sleep, meditation, stress level, or anything else you want to track that may impact your glucose levels. It reflects your metabolic response within a three-hour period post activity, within a glucose range of 72-140, factoring in your glucose levels when you started the activity. It also looks at peaks and dips in glucose readings over that period and how long it takes you to get back to baseline. You will receive a score from 0-100, coded by color, and just like a traffic light, green means great, yellow means exercise caution, and red means STOP!
• Daily Metabolic Score: This is a daily “check engine light” for the body. It is based on average glucose readings between 72 and 110, as well as time in this range, spikes and dips, how long to normalize, and stability/variability. 
• Time in range: This is simply the percentage of time that you are in range and keeping your glucose between 72 and110 over the course of a day. 
• Reports: After the two weeks is over with your CGM, you can run metabolic reports that allow you to compare how you did week one versus week two, and this gives you clues about what variables you could change to optimize your score. You can also do keyword searches if you feel a particular food may be the culprit. 
• Other: If your activity scores are rating high, but your daily scores are not, then you need to look at other inputs like food intolerances, over or undereating, exercising too much or not enough, stress and emotions, hormones, and environment as all of these variables can affect your blood sugar. 

What I learned:

1. My occasional Chai that I have just a few times a month spiked my blood sugar up to 172 and dropped it down to 71 in a 45-minute period. This is not what I expected. I thought the fat in the cream would moderate the amount of sugar in this drink. This was not the case for me. Ooops!
2. I learned that undereating could promote high blood sugar levels. Say what? Yes, it means the body is overcompensating as there is not enough energy to support all systems. So, the body, in its innate wisdom raises blood sugar to compensate. This happened to me one day when I was busy with work and did not eat for 7 hours. Another ooops!
3. I also learned that some glucose spikes are healthy. For example, sauna, cold plunges, and HIIT workouts are all examples of “healthy spikes” that are not problematic overall. 
4. Meditation brought my morning blood sugar down ten points. This is a notable example of how reducing stress can positively impact blood sugar. 

In summary, even as someone who is not pre diabetic or diabetic, I would give the CGM a thumbs up. 

Here is the reason! I learned a great deal about what meals were most optimal for my blood sugar, what lifestyle factors influence my glucose, and I have made some minor tweaks to optimize my glucose and subsequently my metabolism. Given the fact that we all become more insulin resistant as we age, I will continue to use CGMs with my clients and myself to optimize blood sugar, metabolic health, manage weight, and prevent problems down the road.