I Tracked My Blood Sugar for a Month. It Burst My Wellness Bubble

Once you may have the app and an account, you possibly can connect your sensor by following the app’s directions.

The biosensor attaches to the again of the arm, ideally to an space with much less muscle. After selecting the fleshiest a part of my higher arm and disinfecting it with an alcohol wipe, per the directions, I unscrewed the applicator’s cap and pushed the button to eject the sensor into my arm. It was just about painless, undoubtedly a “lower than one” on a 1 to 10 ache scale, however the sound it makes upon ejection is surprisingly loud. 

The Stelo monitor is bought in a two-pack field with two sensors in separate applicators. Each sensor lasts as much as 15 days and a month’s provide prices $99. If you desire a renewing subscription, it prices $89 monthly. Insurance firms will not cowl CGMs for individuals who do not want insulin generally, however you need to use your FSA/HSA {dollars}.

While it is undoubtedly not low-cost at $99 for a month’s provide of sensors, the Stelo is extra reasonably priced than different client CGM firms that use a workaround for the prescription requirement. These firms achieve this by getting their very own docs to put in writing the prescriptions and utilizing Dexcom and Abbott’s sensors for diabetics. Levels, for instance, prices $199 for a month’s provide of sensors plus a separate $199 yearly price for the app. Nutrisense prices $225 to $299 a month. 

Abbott’s common wellness glucose monitor, Lingo, prices $89 for a month’s provide.

Hopefully, extra availability of glucose monitoring within the wellness house will drive down costs and even affect insurance coverage protection so individuals with higher-than-normal blood sugar ranges, or these with Type 2 diabetes who do not want insulin, can afford to maintain sporting a CGM just like the Stelo. 

Day 1: Getting snug with the depressing job of meals monitoring

I began utilizing the Stelo monitor in the midst of a piece day and was rapidly met with my first head-scratcher blood sugar occasion: consuming a vegan bowl of brown rice, grilled greens and vegan dressing shot my blood sugar up fairly excessive. I used to be made to know precisely what I ate as a result of the Stelo app has an “occasions” tab the place you possibly can log meal descriptions (with carb counts in grams, if you wish to), train or different actions and notes. 

Stress, sickness, arduous train and even lack of sleep may also have an effect on blood sugar and lift your ranges. 

At threat of sounding dramatic, I discover the concept of logging the carbs in a salad dressing preposterous. I knew I could not final a month doing it, so I did not. I as a substitute logged my meals with the primary elements. For instance, one “meal” within the Stelo app is logged as a “black bean, cheese and vegetable empanada with a facet salad of arugula and ranch.” Other “meals” are literally extra like snacks (“popcorn with butter, parmesan and dietary yeast,” “banana,” “carrots and hummus”) or drinks (“espresso with half and half and agave).”

I’ll notice right here that I finally stop logging meals altogether as a result of as I obtained extra used to checking the app periodically all through the day, narrowing down a “perpetrator” meals or stressor inflicting somewhat bump or spike in my glucose graph turned simpler.

This is not to say you should not log any of your meals within the Stelo app — doing so within the early days actually helped me get within the behavior of associating sure meals with greater or decrease glucose ranges so I might ultimately go “off e book.” Making certain you notice your meal is particularly useful in case you get a “spike detected” immediate as a result of the app will solely notify you of great blood sugar jumps. There does appear to be a slight delay in these notifications, although.

A salad assessments my persistence 

It was the tip of a piece week and I used to be hurrying to complete an article that had a deadline whereas additionally consuming a late lunch I thought was fairly wholesome: a salad made from a mattress of arugula, sauteed peppers and onions, seasoned black beans, cheddar cheese and croutons. I additionally had a small black bean empanada and put salad dressing on the salad. And I do know croutons are principally carbs and little substance however I like including crunch to salads and nonetheless take into account the meal general to be pretty nutrient-dense and colourful.

I used to be shocked, then, to verify the Stelo app and see a excessive spike in glucose. It was undoubtedly above 140 and looking out down on the graph doubled my stress. It turned a chicken-or-the-egg state of affairs — was my glucose spiking as a result of I used to be confused and drained after which ate a carb-y salad? Or was I feeling further drained and confused as a result of I went a very long time with out consuming after which ate a carb-y salad and my blood sugar is now crashing down? 

Either method, life went on, I had plans with a pal to see a film later that night time and was then hit with a special curveball: The two glasses of crimson wine and buttered popcorn that I consumed virtually in spite, assuming my biosensor was going to scream at me, did not increase my blood sugar in a noticeable method.

I later discovered that alcohol really lowers blood sugar and that not consuming sufficient protein, even when there are many vegatables and fruits concerned, causes my glucose ranges to go up. Still, the primary few days of monitoring my blood sugar served to inform me that meals which are stuffed with vitamins and in any other case good for me may trigger greater spikes in glucose than meals that I really feel assured aren’t doing me any well being favors (wine or alcohol).

Bagels and blood sugar 

There’s bagel store down the road from the place I stay in Brooklyn. One Saturday after a Pilates exercise, I ordered a veggie omelet on a salt bagel with a beet, carrot and ginger juice. 

In different phrases, it was a carb-heavy meal. And whereas it was scrumptious, I knew Big Daddy Blood Sugar was going to have one thing to say about it. And oh, did it. This stays my greatest glucose spike since I started monitoring my blood sugar, and it was fairly surprising to see how excessive it obtained, despite the fact that it fell again down quick. 

This one wasn’t shocking — I do know bagels have a variety of carbs, and whereas the juice was freshly blended and stuffed with nutritional vitamins, it was processed juice and a variety of pure sugar. But it was round this level that I began to get genuinely involved that I could also be one of many 1 in 3 US adults who’ve prediabetes however do not but realize it. 

The Stelo begins to mellow out 

A pair weeks into testing the Stelo, my glucose charts began changing into rather less spikey and my common glucose stage is trending down. I’m in a position to do that within the glucose abstract within the Stelo app, in addition to a extra complete view in Dexcom Clarity, an app individuals can use to share their glucose info with a well being care supplier. My glucose ranges have additionally been decrease within the mornings after I get up, suggesting a barely decrease fasting glucose stage (or morning glucose stage). 

I believe just a few elements contributed to this. One is that I’ve been making an attempt so as to add extra protein to extra snacks and meals, particularly as the primary meals selection of the day after I are inclined to not be very hungry. Protein doesn’t have the identical glucose-spiking impact as carbs. I’ve additionally been making an attempt to take a seat round much less after consuming, as strolling or transferring following a meal is a quick approach to decrease glucose. 

But I have not been making an attempt that arduous to decrease my glucose ranges as I needed to get a extra correct snapshot based mostly on what my norm is. This leads me to different potential influences which are extra speculative. One is that I believe I used to be getting over some kind of virus after I first began sporting the monitor. I felt fatigued sufficient to check for COVID a few occasions (detrimental), however my tiredness endured for a number of days after a fast sore throat, suggesting my physique was combating one thing and (doubtlessly) elevating my glucose ranges. At first, I did not assume a lot of this as a result of the data I’d seen advised that extra extreme sicknesses raised blood sugar, not minor bouts of fatigue.

The different issue which will have lowered my fasting glucose stage is that I used to be a bit much less confused and should’ve been getting extra restful sleep. For an enormous chunk of my Stelo evaluation, I used to be spending time with household in Wisconsin. During this time, I really anticipated my blood sugar ranges to spike a bit greater than regular contemplating I used to be consuming desserts extra typically than I often do and in addition exercising a bit much less. But popping out of a worrying couple of weeks in New York City stuffed with journey and poor sleep, might working within the peace and quiet and spending time with household improved my stress ranges in ways in which could have inadvertently lowered my blood sugar?

What the docs and analysis say 

Much of my concern and confusion all through this complete course of involves how typically my glucose ranges ought to exceed 140 mg/dL, which is the goal restrict for individuals with out Type 2 diabetes. While the previous couple of weeks I’ve been extra aligned with the advised objective of spending 96% of time within the “inexperienced,” I undoubtedly cannot say it has been that method from the soar. 

Basically, I’ve been looking for out whether or not I needs to be apprehensive about insulin resistance, which is when the physique does not reply as effectively to the blood sugar regulating hormone. If left unchecked, insulin resistance results in Type 2 diabetes, which is related to different well being issues. 

Dexcom says that they chose their underneath 140 mg/dL based mostly on analysis exhibiting that most individuals with out diabetes ought to keep beneath 140 mg/dL the overwhelming majority of the day. The US Centers for Disease Control and Prevention says individuals with out Type 2 diabetes needs to be underneath 140 mg/dL 2 hours after the glucose tolerance check. 

There’s additionally newer, doubtlessly extra speculative analysis moving into the nitty-gritty of what glucose spikes and dips ought to appear like in non-diabetic individuals as a approach to optimize well being. One small examine from 2018, for instance, discovered there are variations in the best way individuals with out diagnosable diabetes course of blood sugar, suggesting there could also be completely different “glucotypes” with greater threat of well being issues. 

But in accordance with Dr. Scott Isaacs, a board-certified endocrinologist and president-elect of the American Association of Clinical Endocrinology (endocrinologists are specialists in hormone-related bodily features comparable to diabetes and blood sugar management), the proof for a particular “goal vary” in these with out diabetes is probably not stable but. Hearing my stress about going above 140 mg/dL, he pushed again on the concept it isn’t wholesome for individuals with out diabetes or prediabetes to rise above 140, and even as much as 200.

“When it spikes up like that, that may be utterly regular.” He advised a narrative about being at a convention with different endocrinologists a few years in the past when CGMs had been nonetheless new and plenty of docs had been testing one out. 

“Everybody was sporting one, and everyone was freaking out,” he stated, significantly when blood sugar spiked after lunch. 

“It occurs,” Isaacs stated. “If you eat a sure meal, it is gonna go as much as 200.” While these spikes ought to come down rapidly, it is one metric that could be “deceptive” about sporting a CGM, Isaacs stated. 

“You can eat one thing and get a spike that goes actually excessive in your CGM, after which it comes proper again down,” he defined. At the identical time, one other particular person might eat a higher-fat meals that is not essentially more healthy, “however the sugar by no means spiked.”

Dr. Thomas Grace, head of medical advocacy and outcomes at Dexcom, took a have a look at my Stelo graphs by the Dexcom Clarity app (which anybody with a Dexcom CGM can obtain and use to share their info with a physician) and advised me my swings did not elicit any fear. But he acknowledged there is a analysis hole in CGMs being worn extra typically, and that these spikes can be utilized as a studying expertise. 

“There’s nonetheless some work being completed on this area,” Grace stated. “Before the arrival of getting steady glucose readings, we had a variety of assumptions that numbers ought to run in sure areas, and so we’re very early into this house, and there is work presently being completed to outline that.”

Grace additionally known as my consideration again to Stelo’s actual objective: It’s aiming to assist individuals with Type 2 diabetes handle and have company over their very own blood sugar ranges in order that they really feel higher, or doubtlessly reverse their want for medicine or extra medical interventions.

“That’s what we’re seeking to do, is form of give individuals light nudges to assist them with what we all know is likely one of the most impactful issues on their diabetes, which is their meals selections,” Grace stated. 

“Even although individuals have been advised to do these issues for years, it is actually eye opening to see which you could see the direct causation of issues taking place,” Grace stated. “And I believe that there is such an enormous profit there for individuals to have the ability to see this stuff.”

A1C vs. CGM: Is another correct than the opposite? 

One of the advantages to sporting a CGM, in accordance with Isaacs, is that it could be extra telling than an A1C check drawn in a physician’s workplace. An A1C is a mean of your blood glucose ranges during the last three months. It’s used for diagnosing diabetes and prediabetes, however it could be affected by small variabilities or abnormalities in crimson blood cells. 

And it may’t observe blood sugar in actual time like sporting a CGM can, so individuals who have important lows and important highs could have a deceptive A1C as a result of it is simply averaging out, in accordance with Isaacs. 

“The CGM helps you determine type of extra exactly what is going on on in comparison with the A1C,” Isaacs defined, particularly by a metric known as a GMI. I might see mine as soon as I downloaded Dexcom Clarity, which was straightforward to do and one thing I like to recommend as a result of it stuffed out a few of the long-term information lacking from the Stelo app. 

But studying this was regarding to me, as I used to be leaning on my final couple of years’ price of A1C numbers to really feel assured I used to be firmly beneath a cut-off that may recommend diabetes, prediabetes or insulin resistance. But my GMI estimate from Dexcom is certainly greater than my previous two A1Cs. (My GMI has decreased a bit over time since I began utilizing the sensor, as my common glucose ranges have been decrease, however nonetheless.) 

I’ve nothing to do with this info now apart from speculatively sift by different blood work findings. I did discover out I had a vitamin B12 deficiency in 2023 — might this have an effect on my blood outcomes or be an element? I’ve zero thought. But I completely plan to convey it up at my subsequent physician appointment.

What are the advantages and dangers of monitoring your blood sugar?

Continuous glucose monitoring offers individuals direct perception into their blood sugar ranges, which may point out diabetes, a preventable illness that may result in nerve injury, imaginative and prescient issues, coronary heart issues and extra. 

Without glucose monitoring, detection of diabetes depends on individuals getting common blood work or having diabetes progress sufficient to the place individuals really develop signs. These can embody elevated thirst and tingling within the palms and ft.

In addition to being a real-time different to conventional bloodwork, Isaacs says glucose monitoring is helpful for individuals who need extra details about how their food regimen and different way of life elements have an effect on blood glucose. So lengthy as they perceive the constraints of sporting a CGM, which incorporates not overreacting to what could possibly be “probably regular.” (Guilty.)

“On the opposite hand, I’m certain there are people who have diabetes that do not realize it, they usually put out a sensor and it exhibits their diabetes,” Isaacs stated. “It can go each methods,” he stated, however CGMs do are inclined to encourage individuals to take well being into their very own palms.

From a public well being standpoint, extra individuals sporting glucose screens will encourage extra analysis and assist inform what it means to be “metabolically wholesome” — a objective publish I nonetheless do not feel assured is sturdy sufficient on the finish of penning this evaluation.

What monitoring my blood sugar with the Stelo taught me 

I discovered there are nonetheless a variety of questions we do not have solutions for when monitoring glucose within the common inhabitants. For instance, how significant are the variations when it comes to long-term well being or general wellness between individuals with various glucose ranges or spikes? Health steering round blood sugar appears to revolve round “illness” vs. “no illness.” 

On the opposite hand, will glucoses monitoring monitoring give individuals a false sense of well being safety? What if their blood sugar stays low, however their food regimen is usually missing in vitamins that are inclined to result in optimistic long-term well being outcomes? 

On a private stage, and regardless of my early frustrations with the ups and downs, I did study lots from a month spent monitoring my glucose. (I did miss just a few days when switching sensors.) Mostly, I discovered that making very small adjustments like prioritizing consuming just a bit bit extra protein every day, and taking a brief little stroll after a meal does appear to maintain my glucose from rising excessive. 

Importantly, none of those adjustments required me to tackle habits I discover unsustainable and even dangerous in the long term — comparable to calorie counting, making use of ethical values to meals as “unhealthy” as a way to prohibit them or over-exercising. 

It additionally highlighted unhealthy habits of mine I’ve been sweeping underneath the rug. For instance, I’m a chronically poor sleeper who will keep up very late or rise up very early within the title of getting issues completed, often extra inventive or enjoyable issues I haven’t got time for within the common weekday. But as a result of my poor sleep hygiene hasn’t been affecting my well being in apparent methods, and I really feel rested sufficient most days, I’ve been treating it extra because the ghost of Christmas future that may solely hang-out a future model of myself. And by then, I’ll have a more healthy sleep sample, proper? This is even with the data that analysis has instantly pointed to quick sleeping as a possible reason behind insulin resistance in ladies. 

On a follow-up query about stress, Isaacs advised me that stress could make blood sugar greater, however there are elements that have an effect on how a lot. He added that the impression is extra pronounced in individuals with diabetes. Whether or not my poor sleep and perceived excessive stress in my Stelo testing was an actual cause for the delicate optimistic glucose shift from begin to end, I’ve determined it does not matter a lot. Because if there are two patterns that do appear to solidify time and time once more within the wellness world, it is that wholesome habits encourage different ones, and that you just really feel a higher sense of well-being when you may have company and selection over them.