Dec. 12, 2023 — Wearable expertise has been a game-changer for shoppers. From rings and watches to wristbands, patches, and clothes, data that after required a bunch of complicated calculations is now obtainable anytime, wherever with a flick of the wrist or a look at a smartphone.
Steady glucose displays – units that assist individuals with diabetes keep away from harmful and excessive modifications in blood sugar ranges – are among the many most up-to-date wearables to seize consideration. Accepted by the FDA to be used in diabetes, hundreds of thousands of shoppers are leaping on the CGM bandwagon with encouragement from social media influencers and guarantees of improved athletic efficiency, weight reduction, and metabolic well being.
Earlier than you be a part of the lots and buy one among these units, know that diabetes specialists are unified of their issues that CGMs aren’t fairly prepared for the buyer marketplace for individuals who don’t have diabetes however need to attempt to monitor their blood sugar anyway.
“For those who look throughout historical past, there’s been many cases the place massive volumes of individuals have adopted one thing that ended up not being appropriate,” mentioned Tamara Oser, MD, director of the first care diabetes lab on the College of Colorado Anschutz Faculty of Drugs in Aurora.
Regardless of their rising reputation, Oser mentioned “we have to be aware that we don’t have actually sturdy proof but that they will trigger a change in outcomes,” she mentioned.
Highs and Lows
Blood sugar spikes after meals are a traditional phenomenon.
“They go up, your physique responds inside 15 to half-hour, after which it step by step goes down. That could be a regular course of,” mentioned Marc Kai, MD, an internist at Mercy Medical Heart in Baltimore. “In somebody with diabetes, the quantity could go increased, last more, and take longer to return all the way down to regular; that’s why we use these displays: so we will see what and when it’s occurring.”
The problem comes when an individual who doesn’t have diabetes takes this data and reinterprets it to suit what is usually an incomplete narrative.
“Many corporations that promote CGMs and the apps are taking knowledge from their clients and making generalizations, and that’s simply inappropriate,” says Danielle Omar, a registered dietitian and diet guide primarily based in Northern Virginia. An instance is consuming oatmeal, which one social media influencer compares to being “chased by a Siberian tiger.”
Some individuals have been seeing knowledge that confirmed their blood sugar spiked after consuming oatmeal. “However that’s simply the best way your physique works; you simply ate a carbohydrate,” she mentioned.
“There’s so many elements,” Omar mentioned. “What was within the oatmeal, what sort of oatmeal was it? “Was it fast oats, metal lower, or in a single day oats? What was in it? Was it sugar or jelly? A banana? Oat milk? You realize, there are such a lot of issues which may have been the true cause why their blood sugar spiked.”
Omar’s issues aren’t unfounded. David Lam, MD, an endocrinologist and affiliate professor at Icahn Faculty of Drugs at Mount Sinai in New York Metropolis, mentioned “it’s pure to have a glucose tour. Though CGMs can most likely inform individuals what their baseline could be and provides optimistic reinforcement to scale back caloric consumption, I don’t know in the event that they convey any benefit in comparison with a registered dietitian’s recommendation.”
What CGMs Do and Don’t
Steady glucose displays have been first developed within the Nineteen Nineties to assist sufferers with kind 1 diabetes and at the moment are utilized in sure kind 2 diabetes sufferers as properly. Researchers are additionally wanting into the advantages for different teams, together with individuals with prediabetes and elite athletes. Nonetheless, these units aren’t with out limitations, nor are they appropriate for everybody.
Lam says that he makes use of the displays in his sufferers with diabetes however not broadly.
“It’s an individualized remedy choice,” he says. “Simply because the expertise exists and is FDA-approved for particular medical circumstances, it doesn’t imply that everybody might be on them. After I prescribe a CGM for my sufferers, it’s all the time with a dialogue about what it could possibly provide, what it does, what its limitations are, and the way I believe it may assist with their care.”
So what particularly do these units do?
“CGMs present an estimation of somebody’s blood glucose in that second,” Lam mentioned, noting that the measurement may help an individual keep away from harmful and infrequently life-threatening declines in blood sugar, or persistent and equally harmful highs. That is completely different to extra conventional measurements just like the A1c blood take a look at, which measures common blood sugar ranges over a 3-month interval.
In contrast to a finger prick, which measures the sugar focus in blood, “CGMs measure the sugar focus within the tissues simply outdoors the bloodstream – the ‘interstitial’ fluid and state that exists within the tissues,” Kai mentioned. “Fundamental science dictates that it’s going to be about the identical.”
He mentioned that when somebody has diabetes or insulin points, spikes in blood sugar that usually happen after consuming are likely to last more and take longer to return to regular. Realizing this data, which is named “time in vary,” may help form habits (e.g., avoiding sure desserts) and information therapies or modifications in weight-reduction plan and life-style.
What You Have to Know
There’s little doubt that there’s most likely a spot for steady glucose displays within the non-diabetes shopper market within the foreseeable future. Fernando Ovalle, MD, an endocrinologist, professor, and director of the College of Alabama-Birmingham’s Diabetes & Endocrine Medical Analysis Unit, mentioned at the very least a fourth of the inhabitants is in danger for creating diabetes, 20% of whom could also be slowly creating it over their lifetime. “The query is, what number of of these individuals are you able to assist keep away from or delay it, or if not keep away from it, at the very least enhance it?”
Ovalle mentioned extra analysis is required so “we’ll be capable to know what’s really regular and really irregular past the glucose tolerance take a look at.”
Not less than for now, the expertise wants to enhance. Oser mentioned not solely do readings differ between CGM units, however that they’re much less correct on the decrease versus regular or excessive ranges.
There’s additionally the hazard of “false lows.”
“I’ve a affected person with out diabetes or prediabetes whose CGM flashed a low blood sugar studying. She obtained so alarmed, she went to the emergency room and it was a false low,” Osler mentioned. Issues like incorrect placement on the physique, dehydration, and even pores and skin trauma the place you place it could possibly additionally affect accuracy.
One other essential consideration is that meals just isn’t the one issue that may affect blood sugar ranges. “Glucose is known as a window into physiology,” Lam mentioned. “Outdoors of the plain, train, completely different stressors (together with sickness), hormones that assist our bodies battle an infection, sleep, medicines, all of these items can improve insulin resistance and glucose ranges.”
One of many potential pitfalls of a wholesome particular person utilizing a steady glucose monitor is data overload, Kai mentioned.
“Blood sugar varies from individual to individual, so of us are going to search for numbers and fear when the truth is, for his or her physiology, their private physique, their very own private metabolism, the response is completely regular,” he mentioned.
If you’re nonetheless desirous about attempting a steady glucose monitor, on the very least, contact your physician or a dietitian who may help you perceive what the numbers are telling you and how one can harness them in a manner that is smart to your private well being.