Should you follow your blood sugar with a continuous glucose instructor? : NPR

The apparatus itself is small, but the media threw around is large.

Continuous glucose monitors have only the size of a District, but the companies that sell them make huge complaints on their health benefits: you can “revolutionize your health“Said a business.

President Trump’s candidate for general surgeon, Dr. Casey meansis a leading supporter of continuous glucose surveillance. She Co -founded a business Who distributes the devices and sells an application to help people use them.

The monitor is an painless patch that sticks to your skin. Every about a few minutes, it sends a signal to an application on your phone with an estimate of your blood sugar. (It measures the concentration of sugar between your skin cells, which is almost correlated with your blood sugar level.) The application also helps you keep a journal of everything you eat, so that you can follow the impact of different foods.

Studies have shown that this technology has transformed care for people with diabetes. “He has revolutionized their lives and their family,” said Elizabeth SelvinWho is researching diabetes at Johns Hopkins University.

But in March 2024, the Food and Drug Administration approved the first Glucose monitors continues for people without diabetes. Currently, two companies make them: Dexcom And Abbott. Each patch lasts about two weeks and costs around $ 50, so following your blood sugar for a long period costs around $ 100 per month.

The critical question is: do they really help people without Diabetes or prediabetes improve their health?

Theory

After eating a meal that contains carbohydrates, the blood sugar of a healthy person increases, culminates and slowly falls on the basic line.

“These peaks and hollows are the normal physiological response to the consumption of carbohydrates, in people without diabetes”, explains Nutritioniste Sarah BerryNutrition teacher at King’s College in London. Berry is also Chief scientist of ZoeA company that distributes continuous glucose monitors (CGM) and an application to interpret the data. “We don’t need to flatten these curves,” she said.

But problems can arise when these peaks become too frequent and too high, says Berry. This could put you at a higher risk of obesity,, cancer,, cardiovascular disease And Type 2 diabetesshow studies. It can also make meals between meals, says Berry, so you will eat more during the next meal.

The idea behind glucose monitoring is that it could help you identify specific meals or sizes that produce extreme peaks. Then, if you change the meal, this change could help you lose weight, reduce your risk of diabetes or just help you feel better.

The results

Two major studies have tested this theory with randomized control trials. In studies, people wore a glucose surveillance patch for a while while they followed what they ate on an application. The researchers used data to design a personalized diet aimed at reducing blood sugar. Then, scientists tested in the way this CGM -based diet was based against a standard fat or Mediterranean diet.

At the population level, the The results were mixed. In a study by the Weizmann Institute of Sciences, the diet based on the CGM did not help people lose more weight than simply to follow the Mediterranean diet. However, this helped them lower their blood sugar, Scientists reported in the newspaper Diabetes care.

The second study compared the diet based on CGM to a low fat diet and high grain content. On average, the two regimes led to the same amount of weight loss and small improvements in blood sugar, researchers at New York University reported in the newspaper Jama Network Open And The American Journal of Clinical Nutrition. But Collin Popp, Who helped direct this study, said the overall results do not tell the whole story. These conclusions only show the average response in the entire population, says Popp.

“When you look at the individual level, it’s very different,” he says. For some people, the glucose monitoring approach has helped enormously. Some people have lost a large amount of weight. “We have brought individuals back and say:” You have changed my life. I lost 30 pounds and I feel good. “Other people in the study have weight.”

So now scientists try to understand who benefits from this technology.

When glucose monitors can be useful

1. If you are very sensitive to carbohydrates

Nutritionist Karen Kennedy Help people interpret and understand their data on glucose surveillance for five years. According to his experience, these devices help some people discover increased sensitivity to carbohydrates, even healthy versions, such as whole grains.

“They eat brown rice, quinoa, beans, rice or oatmeal, and their blood sugar is still very high,” she said.

The monitor helps them to realize that they will better manage their blood sugar on a low carbohydrate diet. “Not zero carbohydrates, but weaker carbohydrates,” says Kennedy.

“They change regime, then their blood sugar drops considerably,” said Kennedy. “If they can follow this new diet, they feel better and lose visceral fat. “”

2. If you need additional motivation to eat healthier foods

Many people already know what they have to do to improve their metabolic health. But putting this advice into practice – it’s difficult, say the popp of Kennedy and Nyu.

The rapid feedback of a continuous glucose instructor can give them a boost to implement nutritional advice. “It’s a motivator,” said Popp.

For example, one of Kennedy’s customers clearly needed to add more protein and fat to their breakfast.

“They were like,” sorry, but it’s my breakfast, and it has worked for me for 30 years. “”

Then the customer wore a patch for a week and saw how this breakfast fired on blood sugar. They immediately changed their breakfast, says Kennedy. Immediately, the customer was able to see how this new breakfast improved his blood sugar.

“They didn’t have to wait a few months and go to the doctor to see him work,” she said. “This agency can be motivating.”

3. If you need more awareness of your diet

In the NYU study, some people have greatly benefited from the diet based on CGM. When Popp and his colleague deepened their data, they found a key factor for this success: if the person has constantly recorded their meals in the appliance application on the six -month experience.

For some people, the simple fact of documenting what they ate helped them improve their diet and their blood sugar, says Popp. “I say to people all the time,” monitor what you do can play a huge role in your health. “”

“And you don’t need to record food with precision,” he adds. “It is the simple fact of documenting it that is important for most people.”

“We know that awareness helps people lose weight,” adds Selvin de Johns Hopkins. “And that should not be with an application. I have a colleague who uses a small pocket notebook. He adds responsibility” – and it is cheaper than monitoring glucose.

Before deciding to buy the device, say the experts, know:

Many people find the confusing and useless data.

“Many people come to see me and say to me:” I have been using the device for three or even 12 months, and I have all these data, but I don’t know what it means. I don’t know how to reduce my blood sugar or improve it “,” explains Kennedy.

People must really be educated on what data means, Popp agrees. But this education will only go so far because at this stage, certain data is always mysterious for scientists and doctors.

If you stay in a normal range, let’s say about 70 mg / dl at 140 mg / dl, scientists still do not understand what peaks and hollows mean.

“There are no real standard guidelines on what is a good peak or a bad peak in non-diabetics,” explains Popp.

The data can be misleading.

First of all, the devices are not super precise or precise, and our body does not always respond in the same way to the same food. A recent study In The American Journal of Clinical Nutrition found that the same meal over two different days gave very different readings. Another small studyIn the same newspaper, noted that the continuous glucose instructor overestimated people’s blood sugar levels compared to the direct measurement in the blood.

Second, data can encourage people to worry – or even stop – eat healthy foods that cause normal blood sugar fluctuations. For example, Popp has a friend who began to worry about blueberries because they increased her blood sugar and then refuse.

“You don’t want to start to label food as” unhealthy “just because it led to what I perceived as a tiny pic of blood sugar.”

Third, some people may have what looks like normal blood sugar but always has resistance to insulin, Kennedy explains. In this case, their body compensates by overproducing insulin. To understand this, you will have to see a doctor and have your insulin levels checked.

“Continuous glucose is a practical metric,” she says. “But it is only a metric, and you should use it in the context of laboratory results and other signs and symptoms.”

Published by Jane Greenhalgh