HealthMatters
Dec. 12, 2023 — Wearable expertise has been a game-changer for customers. From rings and watches to wristbands, patches, and clothes, data that when required a bunch of complicated calculations is now obtainable anytime, anyplace with a flick of the wrist or a look at a smartphone.
Steady glucose displays – gadgets that assist folks with diabetes keep away from harmful and excessive adjustments in blood sugar ranges – are among the many most up-to-date wearables to seize consideration. Accredited by the FDA to be used in diabetes, hundreds of thousands of customers 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 part of the plenty and buy one in every of these gadgets, know that diabetes consultants are unified of their considerations that CGMs should not fairly prepared for the patron 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 recognition, Oser mentioned “we must be conscious 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 standard 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 Middle in Baltimore. “In somebody with diabetes, the quantity might go increased, last more, and take longer to return right down to regular; that’s why we use these displays: so we are able to see what and when it’s taking place.”
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 firms that promote CGMs and the apps are taking information from their clients and making generalizations, and that’s simply inappropriate,” says Danielle Omar, a registered dietitian and diet advisor based mostly in Northern Virginia. An instance is consuming oatmeal, which one social media influencer compares to being “chased by a Siberian tiger.”
Some folks had been seeing information 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 that may have been the true cause why their blood sugar spiked.”
Omar’s considerations should not 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 in all probability inform folks what their baseline is perhaps and provides optimistic reinforcement to cut 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 had been first developed within the Nineties to assist sufferers with kind 1 diabetes and are actually utilized in sure kind 2 diabetes sufferers as properly. Researchers are additionally trying into the advantages for different teams, together with folks with prediabetes and elite athletes. Nonetheless, these gadgets should not 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 therapy choice,” he says. “Simply because the expertise exists and is FDA-approved for particular medical situations, it doesn’t imply that everybody could be on them. Once I prescribe a CGM for my sufferers, it’s all the time with a dialogue about what it could supply, what it does, what its limitations are, and the way I feel it may assist with their care.”
So what particularly do these gadgets do?
“CGMs present an estimation of somebody’s blood glucose in that second,” Lam mentioned, noting that the measurement might help an individual keep away from harmful and infrequently life-threatening declines in blood sugar, or persistent and equally harmful highs. That is totally 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 inclined to last more and take longer to return to regular. Figuring out this data, which is known as “time in vary,” might help form conduct (e.g., avoiding sure desserts) and information therapies or adjustments in weight-reduction plan and way of life.
What You Have to Know
There’s little doubt that there’s in all probability 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 Scientific Analysis Unit, mentioned at the least a fourth of the inhabitants is in danger for growing diabetes, 20% of whom could also be slowly growing it over their lifetime. “The query is, what number of of these folks are you able to assist keep away from or delay it, or if not keep away from it, at the 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.”
A minimum of for now, the expertise wants to enhance. Oser mentioned not solely do readings differ between CGM gadgets, 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 received 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 additionally affect accuracy.
One other essential consideration is that meals just isn’t the one issue that may impression blood sugar ranges. “Glucose can be a window into physiology,” Lam mentioned. “Outdoors of the apparent, train, totally different stressors (together with sickness), hormones that assist our bodies battle an infection, sleep, drugs, all of this stuff can enhance insulin resistance and glucose ranges.”
One of many potential pitfalls of a wholesome individual utilizing a steady glucose monitor is data overload, Kai mentioned.
“Blood sugar varies from individual to individual, so people are going to search for numbers and fear when in reality, for his or her physiology, their private physique, their very own private metabolism, the response is completely regular,” he mentioned.
In case you are nonetheless occupied with attempting a steady glucose monitor, on the very least, contact your physician or a dietitian who might help you perceive what the numbers are telling you and how one can harness them in a manner that is sensible to your private well being.
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