Use of Continuous Glucose Monitors by People With and Without Diabetes

Continuous glucose monitors (CGMs) have emerged as a pivotal technology for people with both type 1 and type 2 diabetes that provides real-time insights into blood glucose levels.

CGMs have enabled people without type 1 and type 2 diabetes to be exposed to the world of blood glucose levels and time in range. But is that a good thing?

Our in-depth article explores the advantages and disadvantages of CGMs for people with and without diabetes and how this technology is being integrated into wider health and lifestyle management.

What are CGMs?

CGMs are devices that continuously track blood glucose levels through the body’s interstitial fluid.

This provides a dynamic, real-time view of blood sugar patterns throughout the day and night.

CGMs typically comprise a small sensor inserted under the skin and a transmitter that sends the data to a monitor or smartphone. Some CGMS have displays that show blood glucose information in real time.

Advantages of CGMs

In the evolving landscape of diabetes technology, CGMs have transformed how people with type 1 diabetes in particular manage their blood glucose levels.

Improved blood glucose control

CGMs provide real-time feedback and trends which enable individuals to manage their blood glucose levels more effectively.

Peeople are able to see the impact certain foods, exercise, stress and medications can have on their blood sugar levels.

CGMs also allow people to see how long their blood glucose levels are in range.

This can lead to significant improvements in blood glucose control and thereby reducing the risk of diabetes-related complications.

Hypo and hyperglycemia prevention

By alerting users to sudden drops or spikes in glucose levels, CGMs can help prevent severe hypoglycemia (low blood sugar) and persistent hyperglycemia (high blood sugar) which are common challenges for people with diabetes.

Alerts can be set to notify people on when they are getting close to going hypo or hyper.

Reduced need for fingerstick testing

CGMs can decrease or sometimes eliminate the need for traditional blood glucose testing via finger pricks, offering a less invasive and more convenient monitoring method.

Closed-loop insulin delivery systems

Also known as the “artificial pancreas” closed-loop insulin delivery systems continuously monitor blood glucose levels and automatically adjust insulin delivery in real time.

This significantly reduces the burden of constant monitoring and manual insulin adjustment, improving glycemic control and reducing the risk of both hypoglycemia and hyperglycemia.

Are there advantages for people without diabetes?

It has become commonplace to hear of people without diabetes using CGMs.

Athletes and sports enthusiasts are increasingly turning to CGMs as a tool to optimise performance and recovery.

For athletes, maintaining optimal blood glucose levels is crucial for sustained energy, endurance, and performance.

CGMs are used as a window into how their bodies respond to various types of training, the impact of stress, and the effect of their diet on glucose levels.

Real-time data allows athletes to fine-tune their nutrition and training regimes, ensuring that they are fueling their bodies appropriately before, during, and after exercise to maintain energy levels and accelerate recovery.

By avoiding the peaks and troughs of blood glucose levels, athletes can potentially reduce the risk of energy dips and improve their overall metabolic efficiency.

The adoption of CGMs by sports people highlights a broader trend of leveraging health technology not only for disease management but also for enhancing physical performance and wellbeing.

For people without diabetes, CGMs can provide fascinating insights into how their diet, exercise, and stress levels affect their blood sugar levels, enabling more informed lifestyle choices.

For example, feeling tired after meals, a condition often referred to as postprandial somnolence or the “food coma” can sometimes be linked to fluctuations in blood glucose levels. High blood glucose following a meal can trigger this sensation of fatigue as the body works harder to manage and utilise the excess sugar.

CGMs can be used as a useful tool in this context by offering real-time insights into how specific foods and meal compositions impact glucose levels.

CGMs can also serve as a tool for preventive health and help to avoid the onset of type 2 diabetes and other metabolic conditions.

Disadvantages of CGMs

While CGMs are innovative devices that have transformed diabetes management, there are several disadvantages that have been noted.

Cost

CGMs can be expensive.

Skin irritation

Some users may experience skin irritation from the adhesive used to hold the CGM’s sensor in place.

Additionally, having a device attached to the body continuously can be uncomfortable for some.

Accuracy

While CGM technology has improved significantly, discrepancies can still occur, especially in the case of rapid glucose changes. Users must be prepared to verify readings with fingerstick tests if needed.

Reliance on software

A number of software issues have rendered CGMs useless for people with diabetes. These issues have highlighted reliance on software and Internet-enabled technologies.

Should people without diabetes use CGMs?

CGMs offer novel insights into blood glucose management and their use in people without diabetes comes with specific challenges and considerations.

Unnecessary anxiety

While data is always useful to make better decisions, when CGMs are used by people without diabetes it can cause unnecessary anxiety or an obsession with numbers.

Continuous access to glucose data can lead some individuals to fixate on minor fluctuations in their blood sugar levels.

In the context of an individual without diabetes, these may be within a normal range and not a cause for concern. Hyper-awareness can contribute to stress and anxiety, which ironically, can themselves impact glucose levels.

Misinterpretation

The wealth of data provided by CGMs can be both a blessing and a curse.

For those without a medical background or thorough understanding of metabolism, there is a significant risk of misinterpreting the data.

Physiological responses to food, exercise, and stress can cause variations in glucose levels that are normal but might be perceived as problematic.

Misinterpretation could lead to unnecessary dietary restrictions or lifestyle changes.

Overreliance on technology

CGMs can make it easy to become over-reliant on technology for health and lifestyle decisions.

The immediate feedback loop provided by CGMs might lead some people to trust the technology more than their own bodily signals, such as hunger, fullness, and fatigue.

Over-reliance on technology can detract from developing intuitive eating practices and listening to the body’s natural cues.

As with any health technology, it’s essential for individuals to consult healthcare professionals to determine if CGMs are a suitable option for their personal health and lifestyle needs.