One day in September, I stood in front of my open refrigerator, ravenous but unable to figure out what I should eat. <\/p>\n
I was worried that whatever I chose to eat would cause the new app on my phone to record a spike in my glucose levels that would count against the number I was allowed that day \u2013 and I was determined to conquer this algorithm. <\/p>\n
I\u2019d just put on a continuous glucose monitor, a device that sticks to your arm and uses a tiny needle to provide near-real-time information about how much sugar is circulating in your blood \u2013 not because I have diabetes, the main use for what are called CGMs, but because these devices are starting to be marketed as wellness tools for everybody, and I wanted to see how they work. <\/p>\n
Apple? Too sugary. Granola bar? Hello, glucose spike. Cheese \u2013 that\u2019s the ticket. A few days of wearing this monitor had taught me that cheese would not cause my glucose to go up. <\/p>\n
\u201cIs this thing just inadvertently putting you on the keto diet?\u201d my husband \u2013 who\u2019d witnessed a few episodes of hanger while I was trying to figure out how to please my CGM \u2013 finally asked. <\/p>\n
Pretty much. Avoiding carbohydrates and prioritizing protein and fat, often together, didn\u2019t lead to spikes in glucose that my CGM and app, Lingo from the health company Abbott, would count against me. <\/p>\n
But because I wasn\u2019t aiming to switch to a very low-carb, ketogenic diet, I initially struggled to figure out what to eat; in the first week or so of wearing the CGM, my scale read my weight at 3 pounds lower than usual \u2013 a blip, I presume, because I was too nervous to eat normally. <\/p>\n
This is not, unsurprisingly, how experts say CGMs should be used, whether you have diabetes or not. <\/p>\n
Continuous glucose monitors have been revolutionary for people with type 1 diabetes, for whom glucose levels are life and death, providing information about how much insulin they need to inject to keep their blood sugar stable. The alternative is finger-stick testing, pricking fingertips to draw drops of blood to check glucose levels, often multiple times a day. <\/p>\n
\u201cCGMs are life-changing for insulin-dependent diabetics,\u201d said Laura Marston, an attorney and advocate for lower insulin prices who was diagnosed with type 1 diabetes as a teenager. Before she got a CGM, she said, she\u2019d go long periods without checking her glucose levels through finger-stick tests, instead adjusting her insulin doses based on how she was feeling, leading to hospitalizations with a dangerous condition known as diabetic ketoacidosis. <\/p>\n
Now, Marston said, she knows her glucose level every five minutes with a CGM, and her A1C, another measure of glucose in the blood, is steadily at a much better level \u2013 something she attributes both to the CGM and to focusing more on dealing with diabetes and having steadier health insurance. <\/p>\n
In that context, CGMs are medical devices, requiring prescriptions and \u2013 usually, but not always \u2013 receiving coverage through health insurance. CGMs can be covered for people with type 2 diabetes who use insulin, as well. <\/p>\n
But this year, Dexcom and Abbott, the two major makers of CGMs, introduced biosensors for people who don\u2019t use insulin, available without a prescription and for about $89 a month out of pocket. <\/p>\n
Dexcom\u2019s offering, called Stelo, was cleared by the US Food and Drug Administration in March, based on data from a clinical study showing that the device performed similarly to other CGMs. <\/p>\n
In an FDA release, Dr. Jeff Shuren, then director of the agency\u2019s Center for Devices and Radiological Health, said that \u201cCGMs can be a powerful tool to help monitor blood glucose\u201d and that \u201cgiving more individuals valuable information about their health, regardless of their access to a doctor or health insurance, is an important step forward in advancing health equity for US patients.\u201d <\/p>\n
Abbott\u2019s Lingo was cleared in June and is targeted specifically for \u201cconsumers who want to better understand and improve their health and wellness,\u201d the company said in a news release. <\/p>\n
The idea is that seeing near-instantaneous feedback to the glucose effects of food, exercise, sleep and stress might give people insights about unique ways their bodies react to different inputs and help them make changes to improve their health. <\/p>\n
I was excited to try it. Putting the device on was surprisingly painless, and an hour after the little disc was secured to my arm, I started seeing my glucose levels on the accompanying app on my phone. <\/p>\n
\u201c117,\u201d I messaged Dr. Jody Dushay, a physician at Beth Israel Deaconess Medical Center who works with people with obesity and diabetes and who\u2019d offered to review my CGM findings with me. <\/p>\n
The Lingo app told me that was within what it called a \u201ctypical healthy glucose range\u201d of 70 to 140 milligrams per deciliter, noting that \u201coccasionally, you may find yourself over 140 mg\/dL or under 70 mg\/dL, which is expected.\u201d <\/p>\n
Dushay had warned me before I put on the CGM that blood sugar could range from the high 50s when fasting to the 150s after eating in a generally healthy young woman. She also emphasized that continuous glucose monitoring shouldn\u2019t be used to diagnose prediabetes or diabetes. <\/p>\n
Her caution about how I might react to seeing my data turned out to be warranted. <\/p>\n
In the first week I wore the monitor, I was glued to the app, watching my glucose rise shortly after eating. The app accumulates metrics that <\/strong>it calls Lingo Counts to try to help users make sense of the data, with a higher number associated with a bigger or longer elevation of glucose. <\/p>\n