Home Blood Sugar Management Is blood glucose monitoring worth it without diabetes?

Is blood glucose monitoring worth it without diabetes?

by Robert H. Shmerling, MD
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This is an ad we haven't seen yet, but it may be coming soon. A man jogs along a dirt path that winds through a peaceful countryside. He stopped at the lookout and looked down at his phone. A number flashes on his phone screen, letting him know his blood sugar is normal. He smiled and resumed his run.

Curious what's different about this ad? Jogger not diabetic. So how does his phone know his blood sugar levels? And why would he want to know his results mid-run? Read.

Do I need to monitor my blood sugar levels if I don't have diabetes?

Several companies are working hard to make this type of advertising a reality, and have begun selling implantable blood glucose monitoring devices for people without diabetes.called continuous glucose monitoring system, or CGM, is often used by diabetics. These companies could make huge profits by convincing healthy people without diabetes (or other blood sugar problems) to start monitoring their blood sugar levels.

CGM uses a small sensor wire, or filament, that penetrates the skin to frequently and easily assess blood sugar levels. The filament remains in place, usually on the upper arm or abdomen, and is protected with an adhesive patch. The results are displayed on the receiver or sent to the user's phone.

Historically, CGMs required a prescription, but the FDA's recent approval of over-the-counter CGMs may tempt healthy people to start using these systems without a specific medical reason.

Where are the health benefits in this?

Many of us already monitor our weight, heart rate, or steps per day. So why not monitor your blood sugar levels? Also, is there any evidence that continuously monitoring blood sugar levels with a CGM is beneficial for a healthy person without diabetes? There are few published studies that help answer these questions. .

of best research i found I didn't find anything particularly surprising. Of her 153 people who did not have diabetes, about 96% had normal or near-normal blood sugar levels. In fact, many of the abnormal levels were considered impossible or false. Another small study We targeted people who were not diabetic, were overweight or obese, and were sedentary. Participants completed a counseling session about the effects of physical activity on blood sugar levels and used a CGM device and an activity tracker for 10 days. Afterward, they reported feeling more motivated to exercise.Yet another analysis of her use of CGM for rare conditions low No evidence of health benefits was found for children's blood sugar levels.

However, we found no published studies suggesting that monitoring in healthy people without diabetes or other blood sugar problems leads to improved health outcomes.

Therefore, until further research proves the value of CGMs for people without diabetes, it remains to be seen whether the cost and time it takes to implant one of these systems is accomplishing anything, or whether it is simply a matter of recent health. I don't know if the monitoring fad is just a waste of effort and money.

When it comes to cost, CGM is not cheap. It can cost several thousand dollars per year. And health insurance companies are unlikely to cover CGM for people without diabetes, at least until there is convincing evidence that it actually helps.

Blood sugar monitoring for diabetics offers undeniable health benefits

For people with diabetes, the main goal of treatment is to Blood sugar levels are close to normal range. This helps prevent symptoms and complications, prolongs life, and improves quality of life.

Development of CGM equipment that can easily and frequently measure blood sugar levels without it Fingersticks have revolutionized the care of millions of people with diabetes. In addition to providing blood sugar results, some devices have alarm settings that alert you and others if your blood sugar levels become dangerously low or high. Some systems also allow results to be sent directly to the user's doctor if desired.

If knowledge is power, why not monitor your blood sugar levels?

So why does that person I don't Do you have diabetes and want to monitor your blood sugar levels? Possible reasons include:

  • Detection of prediabetes. In prediabetes, blood sugar levels are slightly elevated, but not high enough to meet the definition of diabetes. For a healthy person, it is usually recommended that he have a blood sugar test done every three years. If you have been diagnosed with prediabetes, it is recommended that you repeat the test at least once a year, but more frequently. CGM may allow for early diagnosis of prediabetes or diabetes. This may be especially helpful for people who are at higher risk for diabetes due to family history or other factors or who take medications that can raise blood sugar levels.
  • The concept of “optimizing” blood sugar levels for optimal mental or physical performance. Not surprisingly, some CGM manufacturers believe that by knowing your blood sugar levels, you can make changes to keep your blood sugar levels in the “ideal range” to perform at your best or prevent diabetes. or to improve your health in other ways. For example, you might change what you eat or when you eat it. None of these marketing concepts are proven or well researched. And even the ideal blood sugar range for people without diabetes is uncertain.
  • A sense of control. Gaining more information about your body may give you a sense of control over your health, even if you don't take immediate action.
  • Curiosity. Let's be honest: It's tempting to collect information about your body that might be of interest to you (even if you don't know what to do with it).

But the truth is that useless, redundant, or inaccurate knowledge cannot make you powerful. It can even be harmful. For example, if a biologically small drop in blood sugar levels causes you to snack more (“to avoid hypoglycemia”), you may gain weight and actually gain weight. increase Risk of developing diabetes. Surveillance systems sometimes provide inaccurate information or false alarms, which can lead to unnecessary anxiety, phone calls, doctor visits, emergency department visits, and even inappropriate treatment.

conclusion

Unfortunately, some manufacturers of CGM systems do not wait for solid research results to sell these devices to healthy people. Therefore, consumers and marketing experts, rather than researchers and doctors, may ultimately drive demand for a product.

New technology requires a scientific learning curve to determine when to use it. In my view, we are at the very beginning of the learning curve for home glucose monitoring in people without diabetes. I think we need to learn a lot more before we embrace what could be the next fad in health monitoring.

There is wisdom in the teachings of my favorite medical school professor. can Measuring something doesn't mean you should. ”

Follow us on Twitter @RobShmerling

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