We have been using continuous glucose monitors (CGM) at the Eat Well Clinic for over a year and clients are truly benefiting from the results - more than we could have imagined!
If you are diabetic or have pre-diabetes (or are at risk of pre-diabetes / insulin sensitivity), then using a CGM could be an invaluable experience. Clinically, the use of CGMs are for type 1 diabetic clients, however we have been open minded about this and (when appropriate) wearing a CGM has also proven useful for many of our non-diabetic clients. Although this is a topic of great debate, we have seen people improve their energy, control sugar cravings, see improvements in training sessions and reduce risk factors that could have led to more complex illnesses.
We have worked with clients in many different health situations, and regardless of their level of "wellness", everyone learns a lot from the instant feedback the CGM provides. By wearing a CGM you can learn which meals / timings of meals your body responds well to, portion size management and what direct effects your lifestyle has on your blood glucose (i.e. stressful events, exercise and poor sleep). Our job is to translate the data you receive into a long-term healthy eating plan.
Read on to find out more about:
Blood glucose levels and insulin resistance
It is important to understand the reasons why maintaining a stable blood glucose level is beneficial to your health.
Whenever we consume foods or drinks containing carbohydrate (either simple sugars: sweets, cakes, syrups, or starchy foods: potato, rice, bread, pasta), our body works to turn this into a fast, easy to access energy source. Depending on the type of carbohydrate we eat, it affects our blood glucose level in different ways. Other factors such as stress, amount of sleep and some medications also affect our glucose levels, but for now we are going to focus on the dietary aspect.
Sweet, simple carbohydrate foods are easy to digest and can cause a fast increase in blood glucose levels, which in turn leads to a fast/large release of insulin. Insulin is a hormone, produced and released by the pancreas when glucose levels rise in the bloodstream. Insulin's job is to carry the glucose to the cells so our body can use it as energy. It can help to think of insulin as the "key" which unlocks the channel where glucose can cross from the bloodstream into a cell to be used as energy (see image below). If you don't need this energy immediately (i.e. you aren't currently doing anything physically demanding), then your body stores this as glycogen, a molecule stored in the muscles and liver as a quick energy source, for use at a later date.
Our body stores on average between 1200-1600 Kilocalories worth of glycogen in the liver and muscles. When these stores are full, any additional/unused glucose is stored in fat cells as a long term back-up energy source. If a person continues to consume a diet high in glucose (which exceeds energy requirements), it puts a large stress on this storage system. Fat cells which become overly-full will try to protect themselves by reacting less to insulin's attempts to add more glucose to the cell. This results in the body producing more and more insulin to try to control the body's blood glucose levels. If this process continues, and the fat cells stop responding to the insulin, it is known as insulin resistance, where you can see a rise in blood glucose levels. It is important to note that chronic stress and poor gut health (not just obesity) contribute to this situation. If insulin resistance isn't addressed (with lifestyle changes) and circulating levels of insulin and blood glucose remain high, then there is a change of developing pre-diabetes, type 2 diabetes and other cardiovascular risk factors (such as fatty deposits in arteries).
By monitoring your blood glucose levels, you are able to see which foods/meals/portion sizes cause high/prolonged spikes in glucose, and therefore insulin.
Learning how to manage and maintain your blood glucose within healthy levels could significantly reduce the risk of long-term metabolic health issues, improve energy levels, stabilise mood, balance hormones and improve sleep. This stability comes from maintaining a blood sugar that peaks and falls as shown in green in the graph below. When a diet is high in refined carbohydrates (white/processed bread, pasta, rice, cakes, biscuits etc.) then you will see faster peaks in your blood sugar. These high peaks are typically followed by a large fall/crash in blood sugar levels - this crash can also lead to feelings of tiredness, sweet cravings and mood imbalance.
What can I learn about my diet and lifestyle?
Each client has access to data which shows a rolling trace of your blood glucose levels over the day. You are able to look back through previous days as well as add information of interest such as: what you ate, if you did sport and you can connect to most sports watches to include sleep data. If you want, you can allow your dietitian to have remote access to your results. All of the data collected, including the impact of certain foods, how well you slept, how active you were is analysed in relation to your blood sugar results.
Our method is to have a period where you eat "normally", your dietitian can then assess your results and make practical, realistic suggestions (in line with your personal goals). The following weeks are focused on implementing and assessing the impact of those changes. If you use the sensor for 1 month it gives a good understanding of how your current lifestyle affects your blood sugar, if you continue for longer it allows more time to get a more precise plan in place.
"This has really made me think about what I am eating. It is fascinating how simple changes have improved my blood glucose control, plus I lost weight!"- Eat Well Clinic Client with pre-diabetes
What is it like wearing a CGM?
Most people's initial concern is about having something attached to their arm. The reality is that our clients are always shocked how simple and painless it is to apply, and that within an hour of wearing it they have already forgotten that it is attached. When you open the sensor, you will see the short needle which allows the sensor filament to placed under the skin, this needle does not stay in your arm. The ultra thin filament that is placed under the skin is very fine and flexible and you will have no idea that it is there, see image below.
The ultra-slim design of the Abbot Freestyle Libre 2 sensor is a huge plus. The sensor can either be worn alone (as seen in the video below) or it can be covered with a plaster, like the one shown in the image at the top of this article. Both options are fully waterproof. Some people prefer to cover the sensor with a plaster so it doesn't have any raised edges, other people prefer to just have the white disk - this is a personal preference. From experience, if you are likely to be putting on/removing your top frequently then the plaster is likely to start to peel off. This doesn't affect the waterproof status or the sensor readings, but some clients find it more practical to wear it without the plaster in this case.
Which clients benefit most from a CGM?
We see the best results with the following clients / symptoms:
Struggling to lose weight
Cravings for sweet foods
Energy crashes
Insulin resistance / Pre-diabetes
Perimenopause
Sports professionals
Eat Well Clinic CGM services
All of our clients that choose to use a CGM will receive a personal report which directly relates to their results. We cross-analyse dietary intake, activity and any other reported events with the data to give you your detailed nutrition plan.
Each report includes a detailed summary of your results, our findings and a long-term health plan. Below is a sample overview of a 1 week blood glucose analysis. From the data we can highlight possible at-risk mealtimes or meal choices where you can adopt different habits to protect or improve your health.
If you want to learn more about the different services we offer at the Eat Well Clinic, involving glucose monitoring, please click here.
We would love to hear about your experiences if you have tried a CGM!
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