Most of us are aware that lifestyle modifications are one of the important aspects of diabetes management. But are the same kind of changes suggested for everyone? Does one size fit all? Not really. Both diet and exercise must be periodically reviewed for sustained and optimal diabetes management. CGM or Continuous Glucose Monitoring is the latest buzz promising assistance in personalising lifestyle modifications for people with diabetes or prediabetes with the help of technology. The technology has been here since 1999 but is recently available in the markets for personal use. But will CGM live up to the expectations and help optimise diet and exercise in people with diabetes?
About 34 million are affected by diabetes in the US, about 77 million in India, and 141 million in China. To give you a perspective, about 10.5% of the world’s population suffers from diabetes. Further, the economic costs of diabetes have increased by 26% from 2012 to 2017.
So, it is important to know how to prevent diabetes and, if already affected, manage the condition well.
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Lifestyle modifications are inherent to achieving better blood sugar control. However, one size will not fit all, nor do the lifestyle modifications. Lifestyle changes may give varied benefits to persons, and optimising the changes prescribed according to an individual’s need remains challenging.
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The three pillars of diabetes management are food, exercise and medication. However, there are two challenges when planning your diet and exercise.
- The changes may not give the intended benefits.
- The patient may not feel motivated to follow the prescribed lifestyle.
While technologies have continued to assist and improve treatments and their outcomes, will real-time CGM be useful to optimise diet and exercise and encourage patients to follow them? It looks like it can, in the case of people with Type 1 diabetes and those with type 2 diabetes who are on insulin therapy.
What is CGM and how can it help personalise lifestyle choices?
We know there are lab tests to check fasting blood sugar, random blood sugar, and HbA1c. And there are DIY home test kits involving a small prick on your finger to check your blood sugar levels at that time.
CGM or Continuous Glucose Monitoring for diabetes is a technology where a tiny sensor is inserted under your skin, usually on your upper arm or belly, to monitor your blood sugar levels day and night. The transmitter of the device sends the readings to a mobile app, which you can monitor anytime.
A section of nutritionists and lifestyle coaches argue that CGM can hugely help monitor blood sugar variations after physical activity or eating a certain food. This, in turn, can help the individual resort to better and improved lifestyle habits and choices. They believe CGM aids your doctor in optimising lifestyle changes for you. It also helps you stay motivated to follow a healthy lifestyle.
CGM may aid in optimising diet and exercise
You know that it is a widely accepted norm that high-quality (high-fibre, low GI) foods considerably improve blood sugar control. However, there is a mixed response to the low-GI diets prevalently prescribed by doctors.
Not everyone achieves the same kind of results with a certain diet plan. For example, there is no blood sugar spike for one, while for another, there is.
This is because how your body reacts to certain food may not be the same as that of another person. In other words, the glycemic response to a specific food varies from person to person.
Similarly, another popular belief is that moderate-intensity exercise for 150 minutes/week significantly improves blood sugar control. But will it give similar results to all? No.
The same set of exercises reduces your waist by 0.5 inches while your friend’s waist may decrease by 1 inch. And the same amount of calories and diet gives a fair controlled HbA1c in you, but not in your colleague.
Why?
Because several factors, such as metabolism, insulin resistance, responsiveness, muscle mass, etc., are at play and can cause significant variations in the benefits.
How can real-time CGM help?
With real-time CGM, you can monitor your blood sugar levels pre-and post-workout. You can also see how your average 24-hours blood sugar levels are with and without a workout.
CGM may help stay motivated to adopt a healthy lifestyle
When your doctor asks you to consume complex carbs instead of simple carbs, you may do it unenthusiastically.
For example, he may ask you to ditch breakfast cereals and instead take quinoa or oats. Naturally, you may not be happy about it.
How can CGM help?
With real-time CGM, you will see your blood sugar does not spike with an intake of quinoa, while with breakfast cereals, it spikes immediately. So, you feel more inclined to avoid simple carbs.
With exercise too you can notice how your blood sugar levels stay optimal.
Research on the use of CGM in diabetes patients
I.
Ninety percent of continuous glucose monitoring (CGM) users with diabetes felt its use contributed to a healthier lifestyle.
- 47% of CGM users reported being more likely to go for a walk or do physical activity if they saw an increase in their blood glucose.
- 87% of CGM users felt they modified their food choices based on CGM use.
II.
Further, a study on 40 participants found that,
- 87% made better diet choices after using CGM
- 15% limited or stopped sugar beverages
- 87.5% noticed how different food choices affected their blood glucose
- 42.5% felt CGM influenced them to increase physical activity
III.
Another study with CGM found walking after a meal was more beneficial for average 24-hour sugar control than 45-min of daily walking. Yet another study noted that brown rice is a better choice than white rice, with glutinous brown rice even more beneficial.
Self-control and self-regulation are essential factors in complying with prescribed lifestyle changes. With real-time CGM, you can continually monitor your blood glucose levels and see how a certain food or physical activity affects your blood sugar. This positively impacts your behaviour towards a healthy diet and regular exercise.
The bottom line
CGM technology continues to improve. The increased accuracy and calibration-free options make it more appealing for public use. There is significant evidence that CGM certainly helps people with type 1 diabetes and those with type 2 diabetes with insulin therapy. Some studies did suggest the benefits of CGM as a helping tool in diabetes management for people with prediabetes and diabetes without insulin use. However, more research is needed into CGM as a behaviour modification tool for diet and exercise in individuals with diabetes or prediabetes.
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