Should you be tracking your glucose levels?
These monitors are great for diabetes management, but what about chronic disease management more broadly? Here’s an expert’s take on what you need to know.
These days you can track just about any health metric using a watch, ring or other wearable.
From heart rate and activity levels to oxygen saturation and sleep quality, your body’s data is at your fingertips.
The newest kid on the block is continuous glucose monitoring, aka 24/7 recording of your blood sugar levels.
Originally designed for diabetes management, glucose trackers are now being pitched as a game-changer in the battle against chronic disease and weight gain.
But do we need yet another health data tool in an already saturated market, and an often costly one at that?
What is continuous glucose monitoring?
You may have noticed people wearing a small round patch on the back of their arm. This is a continuous glucose monitor. It works by inserting a small sensor into the skin to measure glucose levels in the interstitial fluid – the fluid around your body’s cells. A transmitter then wirelessly sends data to a smart phone app, insulin pump or other receiver.
The sensors need to be replaced every seven to 14 days, while the transmitter can last for several months.
For people with type 1 diabetes, CGMs may be subsidised through the National Diabetes Services Scheme. But for everyone else, CGM costs can end up topping $3000 a year through monthly app fees, personalised coaching, and replacement sensors and transmitters.
Who needs CGMs and who likely doesn’t?
Continuous glucose monitors have been a game-changer for those with diabetes. They mean fewer finger pricks (the standard method for testing blood sugar). They also provide quicker, easier identification of blood sugar level changes that may need addressing.
For everyone else, CGMs are marketed as a way for generally healthy individuals to monitor how food, activity and other lifestyle factors impact their blood glucose levels.
In Australia companies such as Vively sell them as an aid for weight loss and boosting energy, saying they will help users “make smarter choices, lose weight naturally and feel more energised every day”.
While the level of detail they provide may help certain groups, such as high-performance athletes who are looking to fine-tune an already healthy routine, for the average person, it’s hard to see the benefit in knowing your levels at every moment of the day.
For most of us, all we will see is a generally consistent glucose level, punctuated by small spikes around mealtimes – a completely normal response to food.
Looking at this data might feel positive for your health, but it means nothing if we don’t have a detailed understanding of all the factors that influence changes in blood sugar level, know what to look for, and what, if anything, to do about it.
It’s even more pointless when the fundamentals are still a struggle. Is there any point tracking your blood sugar constantly when the green leafy vegetables you know you should be eating are wilting at the bottom of the fridge?
Not only can this overload of information be confusing, but it’s possible that this level of focus on fundamental biological process could lead to unnecessary anxiety and disordered eating patterns.
What to do if you are concerned about your blood sugar
Just because CGMs aren’t the silver bullet for everyone, it doesn’t mean there isn’t a health issue that needs addressing.
About two million Australians have prediabetes, a condition where blood glucose levels are higher than normal. Many with prediabetes don’t know they have it, so there is a clear need to identify blood glucose issues as early as possible.
But rather than spending thousands a year on a constant monitor, a much simpler way to identify prediabetes involves a test for blood glucose levels or HbA1c. The HbA1c test gives an indication of your average blood sugar levels over the past two to three months. These tests can be organised by your GP and are covered under Medicare. If previous results were normal, you may only need to be tested every few years.
If prediabetes is identified, lifestyle changes and regular tests of your blood sugar levels can help to monitor levels and reduce the risk of developing type 2 diabetes. The focus should be on regular exercise, eating a healthy balanced diet and weight management as required.
High blood glucose levels don’t mean that bread, rice and other carbs are completely off the table. However, meal choices should include lean sources of protein, heart-healthy fats and fibre to assist in lowering the meal’s glycaemic index for better management of blood sugar levels. An accredited practising dietitian is the best healthcare professional to provide tailored nutrition advice for your individual needs.
Professor Nigel Turner is a metabolic researcher who heads the Cellular Bioenergetics Laboratory at the Victor Chang Cardiac Research Institute.
This column is published for information purposes only. It is not intended to be used as medical advice and should not be relied on as a substitute for independent professional advice about your personal health or a medical condition from your doctor or other qualified health professional.
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