What Can You Learn From a Continuous Glucose Monitor?

One of the big new trends in wellness is people using continuous glucose monitors (or CGMs) as a tool for weight loss, athletic performance, or general health optimization (aka bio-hacking).

These devices, which provide a continuous, real-time read on your glucose levels, were originally developed to help people with diabetes manage their blood sugar.  And in fact, this is still the only purpose for which these medical devices have been approved by the FDA. 

CGMs still require a prescription in the US, but doctors have the discretion to prescribe drugs and devices “off-label,” for uses other than their FDA-approved ones. Companies that are marketing these devices to the general public generally have an “affiliated MD” to supply the necessary prescription. 

How do CGMs work?

To use them, you insert a short filament that’s not much wider than a human hair just under the skin (usually on the arm or torso). This sensor transmits glucose readings to a reader or app on your phone. The sensors themselves usually need to be replaced every two weeks. 

I recently sat down with Dr. B. Gabriel Smolarz, a board-certified endocrinologist and specialist in obesity medicine, to chat about CGMs and how they are currently being marketed and used. You may remember Dr. Smolarz from my episode on why weight loss is more difficult for some people than others and how pharmaceutical weight loss drugs can play an important role in their treatment. (Dr. Smolarz also serves as a Senior Medical Director for Novo Nordisk, a company that produces drugs to treat diabetes and obesity.)

In Dr. Smolarz’ practice, CGMs are used almost exclusively by patients who need insulin to manage their blood sugar. For example, your blood sugar level before a meal helps determine how much insulin to administer. A CGM spares patients from having to prick their finger six or more times per day to test their blood sugar. But it’s more than just convenience.

CGMs also help the doctor see patterns and trends throughout the day, at times when a patient would not normally be checking with a fingerstick. For example, are blood glucose levels consistently high after dinner? If so, the mealtime dose of insulin at dinner might need to be increased. Are they dipping too low over night? If so, the amount of long-acting insulin taken in the evening might need to be decreased.

Hacking your blood sugar with CGMs

CGMs are definitely making life a bit easier for people with diabetes and their doctors. But now, a lot of people without diabetes have gotten interested in this technology.  After all, for a couple of decades now, we’ve all been...

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