Continuous glucose monitors or CGMs are a hot new trend in the health and wellness world. More people living with all types of diabetes are getting access to these devices as insurance coverage for them is continuing to expand. In addition, private companies such as Levels and Nutrisense have come one onto the scene to market CGMs to people without diabetes in the hopes of making CGMs as common place as pedometers.
While CGMs provide clear benefits to people living with Type 1, as well as most (but not all) people living Type 2 diabetes. The big question is whether or people with normal glucose control should be using these devices. This question has become controversial. Many wellness influencers and biohacking gurus insist that having a flat line CGM trend is something we should all be striving for, while many health professionals and institutions warn that there may be risks associated with chasing the lowest blood sugars possible.
That said, a CGM can be a wonderful and life-changing tool for many people. So to tease out whether or not a CGM would be a good fit for you specifically, lets dive into the pros and cons of CGM use and some things to consider before you hop on board:
Should you use a CGM if you are living with Type 1 Diabetes?
If you are living with Type 1, Type 1.5 or insulin-dependent Type 2 diabetes you will likely benefit the most from using a CGM. Having access to real-time blood sugar data can allow you to predict and prevent high and low blood sugars before they become a safety concern. Having access to your complete blood sugar trends can also help you to optimize your insulin regimen so that you can achieve the more stable and predictable blood sugar results. If you are unsure how to use your data to do this, click here!
Having access to that much information all the time can cause burnout for some, so it may be beneficial to take CGM breaks and opt for finger-sticks periodically if this is a challenge you experience.
Should you use a CGM if you are living with Type 2 diabetes or pre-diabetes?
Most folks living with non-insulin dependent Type 2 diabetes would benefit from using a CGM, at least for a period of time. That said, I have seen first-hand that a CGM can be harmful and counterproductive for some. Here are some of the pros and cons to be aware of:
Pros:
- Can help you learn your daily patterns
- Can teach you how your body reacts to different foods and habits, which can guide positive lifestyle change
- Seeing real-time improvement in numbers can be motivating
Cons
- Can become a source of stress and obsession
- Can guide some to a reactive eating pattern that may not support longterm health or BG stability
- Can cause confusion or frustration as it can be challenging to know what to do with the info you are seeing
When considering using a CGM, I encourage people to weigh these pros and cons and use a “know thyself” approach. You can get good information from traditional finger-stick monitoring, so reflect on how having access to more information 24/7 will impact your overall wellbeing. Remember that a tool is only a tool if it is useful! If using a CGM becomes a report card or a source of stress, then it may be counterproductive.
Should you use a CGM if do not have any form of diabetes?
This is where things get more murky! Overall, most people will likely not benefit from CGM use and the potential risks start to outweigh the benefits:
Pros:
- If you have existing insulin resistance and you don’t know it, using a CGM can give you an early warning
- It could bring greater awareness to your eating patterns and increase motivation for exercise and prioritizing good sleep
Cons
- Eating for the lowest BG possible may lead to an eating pattern that could increase chronic disease risk
- Can become a source of stress or obsession
- Can make eating and exercise become transactional and increase the risk of disordered eating tendencies
- Can lead to social isolation
Something to keep in mind when it comes to the health claims put out by CGM companies who market to people without diabetes is that most of the benefits touted (ie. weight loss, less brain fog) have not been thoroughly vetted by research. They are theoretical benefits. At this point, there is also no evidence that using a CGM in people with normal glucose control reduces the risk of chronic disease development including the development of diabetes. Additionally, none of the proposed “optimal guidelines” put out by CGM companies such as Levels or Nutrisense are backed by research. There is currently no evidence that maintaining stringently low BG reduces the risk of any chronic disease. If you would like to learn more about this, I have linked a video essay on this topic at the bottom.
Questions to ask yourself if you are considering a CGM:
- What am I hoping to gain by using a CGM?
- How will I use the data?
- Am I someone who will become stressed or obsessive if I have access to this information?
- How much am I willing to change about my lifestyle based on what I learn?
- Are there certain things that are important to my quality of life that I am not willing to change?
