I Wore a Continuous Glucose Monitor for Months. This Is What I Learned.
Just part of a year-long process to work on my blood sugar levels. NBD.
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This whole thing started the exact same way my recurring nightmare always does—with a test I was unprepared for. However, unlike in my anxiety dreams, I wasn’t staring slack-jawed at an incomplete high school AP calculus pop quiz. (Why is it always that class?) This time, I was on a Zoom with my new functional medicine doctor from Parsley Health, who was going over the results of a battery of blood tests I’d recently taken.
The issue at hand was one I’d literally never thought about once in my life: my blood sugar levels.
As part of Parsley’s standard intake process, I did a fasted A1C test—which measures your average blood sugar over the previous three months—and my results were high. According to the American Diabetes Association, if your levels are above 6.5%, you are considered diabetic, and if your levels are between 5.7% and 6.5% you are prediabetic.
Mine came in at 5.6%, which is right on the border, information I found shocking considering I’d never had an elevated result before, I don’t have a family history of diabetes, and I never had gestational diabetes. In addition to all of that, I was well into my daily exercise journey and had lost a lot of the weight I’d gained while pregnant with my second kid.
Because I had made so many positive lifestyle changes in the previous year, I was pretty concerned, a feeling that only grew as I started digging into research about diabetes. According to the CDC, about 10% of Americans—approximately 37 million people—have diabetes, and the vast majority of those who are diagnosed, like 90% to 95%, have type 2. Even scarier: Almost 100 million people—we’re talking one in three adults in this country—are prediabetc, but 80% of them don’t know it.
Considering that high insulin costs are forcing people to ration their insulin, which is horrifying, the fact that any COVID-19 infection raises your chance of developing diabetes by 40%, and that folks who have diabetes already are at a higher risk for severe illness and death if they contract COVID-19, I felt even more determined to get a handle on my blood sugar.
Because this is the amazing thing about the human body: In many cases, it’s possible to change those numbers and prevent or delay type 2 diabetes through lifestyle changes. (And it goes without saying, but I’m going to anyway: The fact that I have access to medical care and proactive practitioners is an absolute privilege. Though, it shouldn’t be.)
Step 1: @glucosegoddess + Glucose Revolution
Over the next year, I learned as much as I could about controlling one’s blood sugar and started eating more leafy greens, fiber, and lean protein, while trying to reduce the amount of processed food and sugar in my diet. (It’s worth noting that Kelly Leveque of @bewellbykelly has been talking about balancing your blood sugar in this exact way for ages, and her Fab Four smoothie was the first step in my journey, which I started on years ago.)
One of my best finds during this research period was Jessie Inchauspé, @glucosegoddess on Instagram, who makes all of the science around blood sugar make sense to a civilian like me. Earlier this year, she published her first book, Glucose Revolution, and I very much recommend it. There’s a lot to appreciate about Jessie’s take on how to balance your blood sugar, but the thing I appreciate most is the fact that it’s a realistic, adaptable framework.
She also opened my eyes to the fact that you can have a steadier blood sugar response simply by thinking about the order in which you eat food. That simply by eating your green salad or vegetables first, followed by protein, followed by carbs, you can significantly control any blood sugar spike you might get from the rest of your meal. And that moving your body after you eat is another way to hack your blood sugar levels and blunt a post-meal glucose spike.
And while I felt like I was understanding the science more and forming better habits to reduce my blood sugar levels, I still was really curious about how my specific body reacts to food. I’d heard about continuous glucose monitors from a few different people and started looking into them and another data point in my health journey.
Step 2: 14-Day Continuous Glucose Monitor
Originally developed for diabetics to monitor their glucose levels at home, a CGM is a small sensor that you attach to the back of your arm that measures interstitial glucose levels, which is the glucose in the fluid between your cells. It’s not as accurate as a finger-stick blood test or a blood draw, but it does give you a ballpark of what’s going on with your blood sugar. You link the sensor to an app on your phone, and the sensor transmits data wirelessly to the app.
These days, CGMs are becoming popular with non-diabetics who are either concerned about their blood sugar levels, like I am, or simply interested in how the food they consume impacts their bodies. And unsurprisingly, a slew of startups are getting into this space, creating apps that take the CGM data and translate it for the user in the form of helpful graphs, charts, and scores. Levels, which is the program I tried, is one of the best known companies in this space. (It has a good story, one of the co-founders came from SpaceX, so far it’s raised $50 million from high-profile investors, and it’s gotten tons of major press from places such as The New York Times and Fast Company.)
So back to Parsley Health and my functional medicine doctor. When I told her that I’d like to try a CGM, she was open to it and prescribed one for me. I used the FreeStyle Libre, which was $75 with my insurance and covers two weeks’ worth of the sensor. I downloaded the free LibreLink app, attached the sensor to the back of my left arm, and started monitoring. Per my health team at Parsley, I changed the settings to 70 to 140 mg/dL. Though, the actual goal is not just staying in that range but keeping your blood sugar pretty steady, meaning not having a ton of spikes and crashes throughout the day.
As I mentioned earlier, I had a number of good habits in place already, which was encouraging. I usually have a Be Well by Kelly Fab Four smoothie for breakfast, which is one of my most stabilizing meals. I’m not a huge fan of salad dressing—often a place where blood-spiking sugar lurks—so any meal that involved a salad (which is a common lunch for me) with some form of protein was usually pretty good. And if I had a green salad with oil and vinegar before eating veggie-and-sausage pizza, I spiked a little, but way less than I imagined.
That said, I was also shocked by some of my other results. An almond-milk flat white I picked up while running errands? Spike. I realize that most coffee shops don’t use unsweetened almond milk, so I tried whole milk for my flat white another day. Huge spike! Two other factors that heavily impacted my blood sugar: work stress and quality/amount of sleep I was getting. At one point, while going through some particularly intense negotiations at work, I hung up the phone and took my reading. You guessed it: BIG spike.
My reaction to alcohol and sweets was also interesting. I don’t drink very often, but one night I went out to dinner with my husband and had a glass of wine with dinner. No spike. Another night I went out with friends and had one of the restaurant’s signature mezcal cocktails and registered a super spike. The culprit: simple syrup, of course. As for anything sweet, ice cream at the end of a meal resulted in a small spike (which makes sense because it has eggs and milk in it, which stabilizes the sugar somewhat), but eating a very small piece of dark chocolate on an empty stomach in the middle of a stressful work afternoon? Blood sugar to the moon, as you might imagine. (This all lines up with @glucosegoddess’s teachings, which is that it’s better to have dessert as a part of your meal than a random sweet treat.)
Step 3: Levels App
A few weeks into my experiment, a friend got me into the Levels program/app, which pulls in the data from your CGM and presents it in a very user-friendly way. Each meal gets a score on a scale of one to 10, depending on how steady your blood sugar response is to it, and there are tons of interesting articles in the app itself.
The other biggest difference between the free app and the fancy one from Levels is that the “ideal” range on Levels is set to 70 to 110 mg/dL, which is significantly tighter. Since the CGM is not a perfect reflection—the devices have to be within 15% of the true number 95% of the time, which is why my functional medicine health team said not to hyperfocus on the number but to look for the spikes and drops—I would get frustrated sometimes if I started the day with a higher initial number because it made staying in the under-110 mg/dL range tricky.
The other challenging thing about Levels is the upfront price. The first month is $400, which breaks down into $199 for the two monitors/sensors you need (versus the $150 I paid with insurance) and then $199 for the annual membership. If you continue after the first month, it’s $199 per month for the two CGM sensors. So if you were to do Levels for a year, it would be almost $2600 versus $900 to get the CGM sensors through insurance and only have access to the aforementioned app LibreLink, which is less flashy but free. Again, this still feels really high to me.
So what did I learn?
After several months of research, following and absorbing all of Jessie Inchauspé’s excellent insights from her @glucosegoddess IG account and her book, and then monitoring my blood sugar through a CGM and two different apps, I mostly feel angry that the American healthcare system makes monitoring and treating diabetes so expensive. According to NPR, one in four insulin-dependent diabetics have to ration their insulin because of cost, which has more than doubled over the last 10 years, and folks are dying because of it. I know that’s not the answer you want, but honestly, that’s my biggest takeaway.
On a more personal level, I also feel really lucky that I was able to turn my A1C levels around. I retested recently, and my number had dropped from 5.6% to a very healthy 5.1%, which delighted my functional med doctor. Again, the fact that I have access to this sort of medical care and work with a team that is proactive rather than simply reactive is a huge privilege, and I wish that it was an option for everyone.
It’s been a few months since I went through this process. Did anything stick?
Absolutely.
I am much more aware of the order in which I eat my food and how it impacts my blood sugar and mood. While I still have sugar from time to time, I’m much more likely to eat it as dessert than on an empty stomach, as I know it impacts my body in such a different way. The trick I have stuck to the most is starting with veggies or a green salad before eating the rest of my meal.
My other big change is the fact that I “clothe my carbs,” per @glucosegoddess, which basically means if I’m eating something that is more carb-forward, I make sure I pair it with fat and protein. So if I’m having an apple as an afternoon snack, I eat it with a little unsweetened peanut butter or a small chunk of cheese.
I also realized that most salad dressings are sneaky sources of sugar, so that’s something I pay attention to now. Because if I’m having sugar, I want it to really count, like in the form of high-quality ice cream or really lovely dark chocolate, not in salad dressing, you know?
Though I’m a little less religious about it these days, I also really felt the benefits of moving my body after I eat, which helps to bring down your post-meal blood sugar levels. So going for an after-dinner stroll or having a dance party in my living room with my kids is definitely a new aspect of my routine that’s sticking.
So that’s my story. If you have any questions about it, please feel free to ask.
As always, thank you for being here, and thank you for sticking around. If you have any questions or concerns, or want me to touch on any topics in particular, I’m all ears. Leave a comment on Hi Everyone’s Bulletin or DM me on Instagram—I’m @hillarykerr—my inbox is always open!