I want to share my experience using CGMs with you. My telling is unique because I’m not selling anything – which also means that I don’t have discount codes for you either.
Also this is just part one! Part two will be published later this year when I have finished using my prescribed CGMs. This brings me to an obvious point – continuous glucose monitors are prescription-only medical devices. You will need a prescription to get one, and it may not be easy if you’re not full diabetic (which is ridiculous). I appealed to my regular doctor, but services are available that can prescribe and guide you – those are quickly mentioned, but I don’t have any relationship with any such company.
Hopefully CGMs will be available over the counter like other diabetes-related items like traditional glucose monitors, testing strips, and glucose tablets. It’s just a device that gives valuable real-time information, and I believe that so many people would change their habits if they could easily see the impacts of daily food choices.
Disclosure: This site contains a few non-Amazon affiliate links, but not this post 😉
So I bought…Several CGMs (Part One)
I was prescribed (and will be buying several) continuous glucose monitors. Instead of writing one big mega-post about them all, I wanted to break it up, so here we are at Part One.
Basic Definition of CGMs
“CGM” is an initialism for continuous glucose monitor. The object is classified as a medical device, and they are prescription-only at the time of writing (2023).
I am using Abbott’s FreeStyle Libre II CGMs. Each sensor is a round white disk that I wear on the back of my right arm (either arm is fine, I just prefer my right side). It has a filament that measures the glucose in my interstitial fluid (not blood like a skin-prick, but a useable body fluid regardless), and it transmits glucose readings to my iPhone on demand…but not automatically.
A needle is involved, but it’s in the applicator; it’s not loose. The CGM is very easy to apply, and I confidently apply my own CGMs wherever I am (usually at home, but not always). Each sensor works for 14 days. I can’t say if the data becomes unusable, because the app simply doesn’t work after 14 days. There is more than one CGM manufacturer and each product is a little different, but I’m just focusing on the ones that I am using.
I use sensor covers that I bought online -mine are plain black- these are optional and only to protect the sensor from any accidental actions or frictions that could loosen the sensor from my arm. The sensor has plenty of adhesive, but I’ve pinched it (uncovered) when reaching into the backseat, or just toweling off after a shower. Sensor covers let me live my life normally without needing to be particularly gentle with the back of my arm.
>> My very first CGM! 👆
What Sparked the Purchase
This was just the next step in my journey to understand and improve my metabolic health.
I’ve been working to improve my body and mind. I didn’t suspect any problems, I just didn’t think that I was my optimal self. A lot of it had to do with pregnancy weight that wouldn’t budge. It was uncomfortable and I didn’t think that was right.
I started with intermittent fasting, which I absolutely love (it makes my complicated life simpler, it’s nice). But then March 2020 brought normal life to a screeching halt. I am a “control freak” as they say, and when I am not in control of things, my stress levels skyrocket. I learned that chronic high cortisol can legitimately damage insulin sensitivity…and I suspect that is exactly what happened to me. Regularly eating bread and pasta was not helping.
☞ Related: Intermittent Fasting, Month Forty📍
Luckily, I like my annual medical checkups (especially when fasted lab work is included), and my January 2022 visit came with a red flag – I was prediabetic. Specifically my fasting glucose was high when it was tested; over 110mg/dL. Upon closer inspection, my previous fasting glucose numbers were all triple digit values and they were slowly increasing. At that time I was 37, and little heavy for my preference. This was also when I realized that my previous weight loss stalled, and I was plateaued for two entire years. Dang stress.
At this point I already had a copy of the Obesity Code (Dr. Jason Fung) – but now I re-read it with the sudden knowledge that the contents were relevant to MY BODY RIGHT NOW.
Urgency has entered the chat.
I tried to get a CGM with my old doctor, she said no. So I took berberine and experienced positive affects. She retired and I saw a different doctor. He and I were on the same page about the real issue being insulin – and he agreed to prescribe me some CGMs…but with the express knowledge that I would pay out of pocket – my health insurance won’t touch them because I’m not diabetic yet.
< Deleted rant about the American healthcare system’s reliance on an unhealthy population, and how industrial interests have historically been prioritized over health. >
You know what’s a fun read? A charming book called The Hacking of the American Mind by Robert H. Lustig, MD. It’s on Audible too, wink wink. Remember – no links because I’m only sharing, and not selling.
Whew. So there it is. My purchase was sparked by experiencing a problem and needing to fight for a device that delivered the data I need.
Funny story – Mister Jupiter offered to buy me everything for finger sticks, because those glucose monitors don’t require a prescription – I declined because I had a hunch that part of my problem was the overnight glucose actions that happen when I’m asleep (and therefore unable to prick my finger).
Turns out that I was right, but not how I expected.
Nothing significant actually. I was a little worried that I would flick off a CGM after a shower, so I was very careful with my arm until my sensor covers arrived. Besides a physical loss, I’m always a little afraid that my CGM is a lemon and is giving me inaccurate data – but that’s just a risk that I am taking because I don’t feel like buying a traditional glucose monitor to double check readings. If data is fully bonkers, I am ready to ask Abbott Labs for a replacement.
First Use Reactions
My first uses were very interesting.
I wore my first two CGMs back-to-back (28 consecutive days) for a normal-ish baseline. It was right at the New Year so there was more afternoon champagne than usual, but we didn’t change our food intake.
The first hypothesis I was excited to test was “is bread a problem for my body?”
The answer? YES. BIG PROBLEM.
My suspicion was accurate. But I also got crazy high glucose spikes with beer, rice, and potatoes. I also learned that those days with the high highs tended to give me very low lows in the night. That was my nocturnal surprise data!
My second hypothesis was “do I have a strong Dawn Effect that takes a long time to come down?”
The answer? NOPE. I experience the opposite.
It’s the early mornings (usually around three am) that my glucose dips under 60mg/dL and triggers the low glucose alert. No wonder why I am so tired in the morning – I have very little circulating energy. Luckily, the glucose dip is rarely sustained; it just goes down for a minute and bobs back up to my previous average.
Changes After First Use?
I definitely changed a few things, but only my food intake.
I didn’t switch arms, or angle for a different kind of CGM.
I was already cutting back on refined carbohydrates because I generally felt better without them -but after seeing how high my glucose goes after ingesting bread, beer, rice, or potatoes- I have aggressively cut back on those non-plant carbs and starchy starches.
Now I’m only having simple carbs or starches about once a month, instead of several times a week. I am not dogmatic about it, and some weeks are more disciplined than others. It’s fine.
It may sound impossible, but it’s really easy. I nibble on meat and cheese when I want. I can make and eat all of the chili -or- leek soup that I want. Regular wine has no affect, and neither do my daily medications. It’s easy for me to buy sushi at lunch (if sashimi is unavailable) and know that I’ll need to avoid starches for the next several days. If I have beer with dinner – it’s fine! I just won’t have any beer for the next several days – and so on.
It’s not a life of deprivation, it’s just applied knowledge of what my body handles well (or not). When my options are “feel like crap” or “feel well”…I choose to feel well. It’s easy.
I mentioned chili or leek soup earlier. I learned that I can eat those all day every day and have very stable glucose. I feel great and nourished, my glucose remains steady. Other great foods for my body include steamed broccoli, shrimp soup, and bacon. I have a lot of delicious options. The low carb life is the one for me, and thanks to keto’s visibility, I can usually eat low carb in public with little effort.
My personal goal is to keep my postprandial glucose under 120mg/dL. I call this a “Perfect Glucose Day” and it’s just a goal that I set for myself. Each “Perfect Glucose Day” takes effort, but it’s usually not difficult.
I’ve learned (by taking notes and looking for patterns) that when my glucose doesn’t go over 140mg/dL, it’s less likely to go under 60mg/dL when I’m asleep. Knowing that avoiding high highs prevents low lows makes is SO EASY to avoid the foods that don’t work for me.
⫸ If you’re interested in easy changes that provide big positives, grab a copy of Glucose Revolution by Jesse Inchauspé. It’s also on Audible (I listen to more books than I read).
When faced with food that I wouldn’t make for myself, I am happy to fast (instead of eating low quality food just because everyone else is). It’s not unusual for me to look at a menu, and just have coffee and water for lunch.
For the record, I love beer. I love pizza. BUT! Knowing what they actually do to my glucose is all the motivation I need to drop the frequency. I’m not giving anything up. Even potatoes; a starchy vegetable that I mostly avoid. Even though I don’t eat potatoes often, I still love chili-cheese tater tots, and therefore will never swear off potatoes.
Summary: After seeing what happens after I eat bread, rice, potatoes, or drink beer I have dramatically reduced my intake of those foods. Size loss remains slow and steady; my clothes are fitting so much better! No word yet on weight – I don’t own a scale because my clothes tell me exactly what I need to know. Gravity is irrelevant in my closet.
How I Use it in Our Environment
My environment in this case is just normal life. CGMs are designed to be lived in, so I do.
How I Use it in Our Life
Our life is normal, thankfully! I simply apply one CGM each month, and get moving.
CGM #2 flew with me to Honolulu; I was curious about mai-tais and long flights, so I traveled with it and applied it in my hotel room. No big deal. Also I only had one mai-tai because any amount of orange juice is not awesome for me.
CGMs don’t affect my traveling, or sleeping. I eat and drink as I please. I shower and swim normally. The only thing I cannot do while wearing a CGM is exfoliate my entire right arm. That’s it, so I give it a good scrub before and after each CGM.
Overall Impression [including accessories and current use]
It’s a legitimate shame that non-diabetics have to even fight for these devices at all. The real-time insight on how our foods affect our glucose is so valuable. Well, valuable if you’re willing to make changes to improve outcomes.
My current prescription covers nine or ten total CGMs, and I am mostly wearing one each month. This one prescription covers most of 2023, and I’ll probably take a break for a few years…or not.
If I’m doing “everything right” and my size starts creeping up again, I’ll probably try to get a few more CGMs. If I can’t get more in the future, I’ll request several lab tests at least – not because I’m trying to be a certain size, but because I know that my healthy body is a small one.
Overall I wanted a CGM for the raw data; I didn’t go through a program like Levels because I don’t need or want dietician support. I didn’t go through Zoe because I’m moving to another country soon and expecting my microbiome to change as a reflection of my new location.
I just needed to know what happens when I eat X or Y. Or drink A or B.
Basic information. Freestyle Libre II is great – it gives me what I want when I want it.
Usage Details That I Learned First Hand
Pricing- I was afraid of huge prices (especially after the big disclosure that my insurance won’t touch it)…but I pay about $35 for each CGM at Kroger. That’s it; they are not cost prohibitive at all. I prefer to buy mine in pairs, so I buy two CGMs every two months. It’s very manageable. I haven’t tried to fill that prescription anywhere else, so I can’t provide any comparisons.
Alerts- This was a surprise. The app has mandatory alerts…but they are disabled when the app is closed. Turns out that I only get hypoglycemic when I’m sleeping (nocturnal hypoglycemia!), and the alerts wake up Mister Jupiter…not me. So I close the app before bed to get around those mandatory alerts.
(If you’re Abbott or my doctor – sorry! I don’t want to sleep on the couch.)
Oh! You may have already seen this photo – but this was a big win when I was wearing my fourth CGM. I learned that chili keeps my glucose steady…and I love chili. I easily lost a little size in one week, enough to measure with my birthday skirt. I’m hoping to zip it all the way up soon.
Thoughts for Future Use or Modifications
As far as I am aware, my future use will be the same as current use.
- aim to wear a CGM each month on certain menstrual cycle days (I’ll expand on that in Part Two)
- continue wearing CGMs only on my right arm
- continue tracking my meals to see what spikes my glucose
- continue limiting my bread, beer, rice, and potato intake
- continue general experimentation to learn how my body handles certain foods.
So that’s it for the first half of my adventure wearing CGMs. I’ll be back for Part Two later this year when I have used all of the continuous glucose monitors that I was prescribed.