Continuous Glucose Monitors (CGMs) have emerged as a powerful tool for monitoring and improving metabolic health and healthspan.
Originally designed for people with diabetes to track their glucose, CGMs have found a new audience – one who isn’t looking to avoid or manage a health condition, but rather gather information to build and maintain a robust health profile.
Peter Attia, author of “Outlive: The Science and Art of Longevity” asserts that “higher glucose variability, and higher (and more) peak glucose levels are each independently associated with accelerated onset of disease and death, even in nondiabetics”.
This is just one reason why Jabe Brown, founder of Melbourne Functional Medicine, encourages the aggregation of data, even in those who seem healthy. He says “I see optimal health in my patients who proactively manage their physiology, and we rely on data to guide their path to success”.
In this article, we’ll explore how using a CGM can be helpful for those who have that laser-focus on health.
What is a CGM?
A CGM is a small wearable device that continuously monitors your blood glucose (blood sugar) levels. This is achieved through a tiny sensor inserted under the skin, usually on the abdomen or back of the arm, which transmits data to a mobile app or receiver.
It provides real-time data and trends in blood sugar levels, offering valuable insights into how the body responds to various factors such as food, exercise, stress, and sleep.
From a data collection and analysis perspective, the most meaningful difference between CGMs and traditional glucose monitoring is the long-term ongoing data collection in real-time, versus a finger prick test that offers a snapshot of glucose levels at a single moment in time.
The benefits of using a CGM for health optimisation and longevity
A CGM offers numerous advantages, but its true value lies in empowering you to take control of your health journey. By harnessing technology to access vital health information, personal responsibility shifts from external factors to internal awareness.
In the realm of health, assessment always surpasses guesswork. The benefits outlined below predominantly stem from the behavioural decisions you can make based on tangible insights gained from your device.
Precision nutrition
One of the primary advantages of using a CGM is the ability to gain deep insights into how your body responds to different foods. By tracking how your glucose levels spike and dip after meals, you can make informed choices about your diet.
This precision approach can help you identify which foods are best for your individual metabolism and overall health. While you might be aware that eating carbohydrate-rich foods will lead to raised blood sugar levels, you might be surprised at the types of foods, and combinations of foods, that will cause your blood sugar levels to spike. A CGM helps you determine what foods spike your blood sugar – and that may be completely different to someone else’s.
While many foods have a classification of high or low glycaemic index or load (how likely they are to raise your blood glucose), the value of testing YOUR body is that you may well have a completely unique response.
Practitioner Jabe Brown recently worked with a patient whose blood sugar spiked very high for rice, but not potatoes. Even though a potato is considered a complex “healthy” carb, your body digests these carbs faster than other kinds of complex carbs. These broken-down carbs flood your blood with sugar, which can make your blood sugar spike quickly. It would be expected, after eating potatoes, to see an elevation in blood sugars. For this person not to experience a spike was a helpful piece of their data and certainly informed their dietary choices.
Improved fitness and exercise optimisation
Many people are training better by using Heart Rate Variability (HRV) data and real-time heart rate information. These tools allow for personalised training by tailoring workouts to the body’s readiness and recovery status, optimising performance, and reducing the risk of overtraining. HRV helps gauge recovery levels, manage stress, and prevent injuries, while real-time heart rate monitoring ensures optimal training intensity for improved cardiovascular fitness and overall performance. Training has never been so precise.
CGMs track real-time glucose changes before, during, and after exercise, which can help you understand your blood sugar responses to exercise. This data allows for personalised adjustments to workouts and nutrition, optimising performance and preventing glucose spikes or drops, ultimately enhancing your metabolic health.
This information can help you determine the best times to exercise, the optimal duration and intensity of workouts, and whether you need to adjust your pre-workout nutrition for better performance and recovery.
When we exercise, our muscles need a constant supply of energy, and they achieve this by having a large store of glycogen that they release during exercise. This can initially cause glucose levels to rise, especially with short duration or low intensity exercise, whereas longer duration, higher intensity exercise will cause glucose levels to lower.
By understanding the relationship between the type of exercise you do and the glucose response, we can gain insights into your unique metabolic flexibility (the ability of the body to utilise available glucose efficiently and then swap to using fat for energy). We can also better understand the relationship between food intake, glucose levels, and exercise.
Better glucose regulation reduces oxidative stress and lactate levels, which in turn helps to improve exercise performance and recovery. Using a CGM during exercise means we can track this data in real time for the most precise information on how exercise improves your glucose control.
Stress management
Stress can influence blood sugar levels, and CGMs can reveal how stressors affect your glucose levels. When stressed, the body is activated in the sympathetic nervous state of flight, fight, freeze or fawn, and must ensure it has enough energy to function appropriately. In turn, insulin levels fall, glucagon levels rise to tell the liver to make more glucose, and cortisol and adrenaline are also released. This response is to ensure the body has the fuel to get through the threat – even though modern threats like overwhelm, rushing, deadlines and timelines don’t actually require that fuel injection. This is why when in that activated stress state (aka busy, pumped, driven), you can feel ‘buzzy’ and later collapse with exhaustion, as that depletion cost emerges.
When you wear a device that feeds you real-time data, you’re more able to link the ‘stress event’ with the data so you have greater awareness of the impact of stress.
Longevity is not only about lifespan, but also healthspan, and being fully aware of your physiology in response to stress is key for long-term health. It empowers you to implement stress management techniques more effectively, such as mindfulness, meditation, or relaxation exercises, like breath work that help to mitigate the stress and blood sugar roller coaster AKA increased glucose variability, that’s been shown to impact health.
Being able to discuss these observations with a health coach will help you to plan which mindful practices are most beneficial for you.
Better quality sleep
As a pillar of health, and as it relates to lifespan and thriving, sleep belongs right near the top of the list. Poor sleep can disrupt blood sugar regulation, an often under-appreciated element of health.
A systematic review of the link between sleeping and type 2 diabetes speaks to the impact that both short sleep (less than 6 hours per night) and long sleep (more than 9 hours) might have on insulin sensitivity and type 2 diabetes risk.
The study states:
“Sleep is essential for controlling a number of hormones, including several that are directly connected to glucose metabolism. For instance, lack of sleep can increase cortisol levels, which can induce insulin resistance and raise blood sugar levels. Additionally, growth hormones and other hormones that regulate glucose regulation are released during sleep.”
CGMs can track how sleep patterns affect glucose levels, allowing you to optimise your sleep routine for better metabolic health. Improving sleep quality can have far-reaching benefits, including improved mood and cognitive function.
Sleep also has a direct impact on your hormonal relationship to food – namely through the hormones ghrelin and leptin. Poor sleep (less than 6 hours) can see you more hungry than normal because of a rise in ghrelin (one of the hormones that drives hunger) and reduced leptin (the satiety hormone), leading you to search for carbs, typically of the sweet, simple kind.
Early detection of health issues
CGMs can serve as an early warning system for potential health problems. Sudden or prolonged spikes or reporting of frequent high or low levels in blood sugar levels may indicate underlying health issues like insulin resistance or prediabetes. Early detection allows for timely interventions and preventive measures.
Motivation and accountability
Because we’re humans and sticking with any new habit can feel difficult, seeing real-time data and trends can be a powerful motivator. CGMs provide a level of accountability that can encourage you to make healthier choices and stick to your health and wellness goals.
How to get started with CGMs
If you’re intrigued by the potential benefits of CGMs as part of your data collection strategy, here are some steps to get started:
1. Consult a healthcare professional
At Melbourne Functional Medicine, our practitioners value data and encourage you to be as informed as possible about your body and health picture. This is also a great time to establish your health goals and discuss a strategy for this path of investigation.
Your practitioner might encourage you to use it for a week without making any changes, then follow that with a week of either increased or decreased amounts of specific foods (typically carbohydrate sources).
Most CGMs will record two weeks’ worth of data. You typically use a subscription model and have a new monitor every 3 months to assess and review changes.
2. Choose a CGM device
While many of the CGMs on the market are accessible exclusively for people with diagnosed diabetes, the Australian company Vively makes them available to health-centric folk like you and me.
Other devices like Freestyle Libre2 and Dexcom G6 require a letter from your doctor or nurse stating your medical need for the device.
3. Report back to your team
Tracking your glucose levels is the first step to managing your metabolic health. But measurement alone won’t provide you with the guidance needed to take action.
Sharing the data generated by the CGM with your healthcare team will enable appropriate and meaningful actions on the back of that data.
They will help you identify patterns and trends in your glucose levels, helping you to interpret the data effectively, and tailor your diet and lifestyle to balance your blood sugar levels where needed.
4. Regularly review and adjust
Continuous glucose monitoring is an ongoing process of monitoring, tracking, and refining your health protocol to make sure your strategies are still working for you.
Our patients tend to assess every 3-6 months to make sure they’re on track, and often use it as motivation to implement new health habits, or replace unhealthy habits, using the data as a catalyst for change.
CGMs: A tool for health optimisation
Imagine having a conversation in the 1980’s and explaining that we’ll be able to have a device sit under our skin and it will deliver real-time data on our biology. It would have seemed very futuristic – and here we are, in the future.
CGMs and other insight tools like Oura Rings, Whoop and Apple devices are part of what the future of health optimisation looks like. I expect implanted devices will become the next trend.
The sovereignty this approach to health offers each of us is profound. We get to learn about our own bodies. We get to make adjustments, making the connection between how we feel, with what the data reports. Importantly, we don’t set and forget – we’re able to change with our changing bodies.
