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Continuous Glucose Monitoring (CGM) has emerged as a recent trend among health gurus and influencers. Initially designed to monitor glucose levels continuously in diabetics, its appeal has extended beyond diabetic populations, finding its place among health-conscious individuals. Yet, the question remains: is it recommended for non-diabetics? The answer is more complex than one might think.

In our previous article, we showed how CGM affects blood sugar management for diabetic patients. Now, we are looking closer at how CGM could be used as an additional tool in the longevity kit to gain new insights into our health and lifestyle choices. 

To fulfill our vision and create a world where all people live longer without age-related diseases, we utilize preventative care and intervention strategies to add more healthy years to life. Join us as we explore the broader potential of CGM technology for proactive health management for everyone.

If you missed our introduction to CGM, follow the link 

Advantages of using CGM in a healthy population 

In addition to assisting patients with diabetes, some people without diabetes use CGMs for various health-related purposes, such as improving dietary choices and understanding how different lifestyle factors affect blood glucose levels.

CGM offers two significant advantages for non-diabetic individuals (1): 

1. Early detection of abnormal glucose regulation

CGM can help in the early detection of abnormal glucose control and diabetes, potentially aiding in the prevention of oxidative stress, chronic inflammation, and associated diseases (1). Moreover, a recent study suggests that glycemic variability is associated with measures of atherosclerosis development, and it may predict cardiovascular events and type 2 diabetes (2).

If you missed our articles on cardiovascular health you can find the introduction here 

It is normal for glucose levels to rise after a meal, and this increase can vary depending on the type of food eaten, often linked to the food’s glycemic index (GI). The GI rates carbohydrates based on how quickly they raise blood glucose levels (3). Foods and drinks high in refined sugars and carbohydrates, which have a high GI, tend to raise blood glucose more compared to foods with a low GI. Typically, glucose levels should return to fasting levels within 2 hours after a meal. While the glycemic index is helpful for assessing which foods are generally causing spikes in blood glucose, some evidence suggests that individuals may respond differently to the same food (see below) (1). This variation in response is not fully captured by the glycemic index, as it does not account for individual biology, food pairing, timing, cooking methods, and other factors.

One significant advantage of using CGM is its power to potentially detect individuals at risk of diabetes – a medical condition characterized by abnormal blood glucose regulation (1). Presently, diabetes diagnostics rely on single-time or average measurements of blood glucose, neglecting its fluctuation over time. A recent study utilized CGM technology to assess the dynamic fluctuations of blood glucose in individuals (1).

The study discovered that some people can “spike” from their food, while others do not “spike” from the same food. That means people can react differently to food regarding their blood sugar levels. Also, many people with “normal” blood sugar experienced frequent high blood sugar levels (1). The research revealed that different individuals can have unique patterns of blood sugar regulation, even if they appear “normal” by standard tests. This variability in blood sugar patterns may indicate different underlying health issues and risks for developing diabetes and cardiovascular disease. The study also developed a new system to classify these different patterns, called “glucotypes”, providing insights into personalized dietary interventions and early risk identification.

CGM can be particularly helpful for people at higher risk for diabetes due to family history or other factors and people taking medicines that can raise blood sugar (4).  

2. Lifestyle optimization

CGM data can provide insights into the effects of food intake, physical activity, and stress on glucose dynamics, providing a data-driven approach to improve our lifestyle choices (1).

  • Nutritional Behavior: CGM systems can detect differences in total glucose after meals with high versus low glycemic loads. This feature can be instrumental in creating awareness of foods and their glycemic loads, potentially leading to changes in individuals’ nutritional behavior. 
  •  Physical Activity: CGM systems can offer real-time feedback, enabling users to visualize the effects of physical activity on glucose dynamics. Such feedback can be motivating and assist in increasing regular physical activity, thus contributing to healthier lifestyle choices. 
  • Athletic performance optimization: CGM can provide information on glucose values and dynamics that may help optimize nutritional strategies pre-, during, and post-exercise, contributing to improved physical performance and regeneration.
  •  Stress management: CGM can make stress-induced glucose responses visible, allowing individuals to take practical stress-reducing actions, such as relaxation practices, to prevent chronic stress. 

Considerations for CGM Use in Non-Diabetic Individuals

While CGMs offer clear benefits for people with diabetes, deciding whether they suit healthy individuals is more complex. We want to tackle the common arguments against using CGMs in healthy individuals, which seem valid when you are on this journey alone. However, with the support of a trained, healthy longevity physician, these concerns can be effectively addressed. Let’s investigate these arguments and see how our team at NEM can offer valuable guidance and support.

Some of the most common concerns of using CGMs in non-diabetics include:

  • It can lead to data overload
    With over 200 measurements daily, it is easy to get overwhelmed and feel overloaded (4). Plus, adding other devices like fitness and sleep trackers leaves you with even more data. What do you do with all this information, and how do you make sense of it?

    Yes, we agree with that sentiment. One can get easily overwhelmed with data from CGM, especially when combined with other devices such as fitness and sleep trackers. With all this data, it is essential to have a plan for interpreting and utilizing it effectively. This is where we can help you. We assist with data interpretation and making sense of all this data to help you make better informed decisions about your health and well-being.
  • It may be hard to interpret the data
    It is very common to see glucose levels increase after a sugary meal, which is no surprise to anyone. But it is also common for glucose to go up with exercising. One may take that as a sign to avoid exercise to keep the glucose levels in check (4).

    We also acknowledge the validity of this perspective. CGM data can be confusing and might require the expertise of a healthcare professional for interpretation. As emphasized by others, although CGM offers immediate glucose data, the practical understanding and clinical decision-making derived from this data could be enhanced by the guidance of healthcare providers (5). 

    Our team of healthy longevity physicians is here to assist you in comprehending and making informed adjustments to your treatment plans based on CGM data. 

    In addition to analyzing CGM data, other clinical biomarkers and tests for detecting insulin resistance, prediabetes, and type 2 diabetes might be indicated and should be followed up on and ordered by a trained physician. CGM might not be for everybody, and it is crucial to assess risks and give recommendations at an individual level.
  • The illusion of control
    More data about your body may lead to a false sense of control over your health even if you are not immediately taking action to improve your health (4). 

    It is common for people to think they are in charge of their health when they measure a biomarker. Recognizing this need for health improvement is an excellent first step. However, just checking glucose levels without doing anything won’t help. We work with our clients, set goals, and give them step-by-step plans tailored to their needs. It’s up to the clients to do the work with our continued guidance.
  • Some research suggests that there is actually very low variation in healthy individuals but nonetheless see the potential of using CGM for monitoring of glucose levels in this population (6).
    Research aimed to study glucose levels in healthy individuals using CGMs (6). The study involved 74 participants, including children and adults, and found that most sensor glucose concentrations were within the normal range (3.9 mmol/L – 6.7 mmol/L)) for 91% of the day. The study also highlighted that extreme glucose values (below 3.3 mmol/L and above 7.8 mmol/L) were rare (only 0.2%) in healthy individuals. These findings suggest low variation in glucose levels and minimal spikes in healthy, nondiabetic individuals. Despite these results, the researchers concluded that CGM could be useful in evaluating glucose tolerance in nondiabetic individuals over time.

    Many healthy people typically have good metabolic profiles. However, we find value in examining CGM data as it provides an additional piece of the puzzle and another reference point for overall health. Metabolic health can be continually optimized, and CGM is one tool that provides us with objective data. 

As NEM focuses on prevention, we advocate for the use of CGMs for healthy individuals for two main reasons:

  1. CGM is a powerful prevention tool that can uncover potential metabolic health issues that may go unnoticed. Even individuals with normal weight can be metabolically unhealthy, and conditions like insulin resistance may not present obvious symptoms. By providing data-driven insights into lifestyle choices, CGM allows individuals to make informed decisions and take proactive steps towards improving their well-being.  
  2. The conventional way to determine metabolic health is set up for people who are already sick. 

There are two commonly used tests for measuring blood glucose – fasting glucose and HbA1c. They are considered the “gold standard” for detecting diabetes but suffer from the drawback that they provide information at a single point in time. Although HbA1c is a good snapshot of the blood sugar levels over a preceding period of three months, it still provides no information on the individual fluctuations of glucose. 

In Sweden, preventive metabolic health care is currently limited. Typically, metabolic health is assessed through a blood panel that includes cholesterol, triglycerides, blood pressure, fasting glucose, and other relevant biomarkers. Once you receive the results, you will still be categorized as either “healthy” or “unhealthy.” If you fall into the “healthy” range, no further support is usually available through the public healthcare system. As we have discussed previously, “healthy” might not be anywhere near optimal or as good as you think (7).  

The key advantage for our clients lies in the support of our licensed physicians, who work closely with our clients to ensure that their results are optimal rather than normal. This includes their glucose metabolism and all aspects of health equally. Understanding and contextualizing clinical data can be challenging, and we are experienced in considering different nuances during data analysis combining information from various sources, e.g., health questionnaires, blood work, genetic testing, biological age, and additional advanced biomarkers and detailed diagnostics where indicated. This data-driven holistic approach informs our clients on optimizing their health.

In conclusion, by utilizing CGMs, individuals can gain valuable insights into their metabolic health and take proactive steps to optimize their well-being, filling the gap left by traditional testing methods and enabling a more personalized approach to preventive care. Furthermore, by working with a licensed physician, you receive continuous support with interpreting your data and guidance on interventions that can bring you to your optimal state.

Silviya Demerzhan, Ph.D.

Chief Scientific Officer, Nordic Executive Medicine
Medical review by: Dr. Mahir Vazda MD

  1. Holzer R, Bloch W, Brinkmann C. Continuous Glucose Monitoring in Healthy Adults—Possible Applications in Health Care, Wellness, and Sports. Sensors. 2022 Jan;22(5):2030. 
  2. Hjort A, Iggman D, Rosqvist F. Glycemic variability assessed using continuous glucose monitoring in individuals without diabetes and associations with cardiometabolic risk markers: A systematic review and meta-analysis. Clin Nutr. 2024 Apr 1;43(4):915–25. 
  3. Harvard Health [Internet]. 2013 [cited 2024 Mar 4]. A good guide to good carbs: The glycemic index. Available from: https://www.health.harvard.edu/healthbeat/a-good-guide-to-good-carbs-the-glycemic-index
  4. MD RHS. Harvard Health. 2021 [cited 2024 Jan 25]. Is blood sugar monitoring without diabetes worthwhile? Available from: https://www.health.harvard.edu/blog/is-blood-sugar-monitoring-without-diabetes-worthwhile-202106112473
  5. Janapala RN, Jayaraj JS, Fathima N, Kashif T, Usman N, Dasari A, et al. Continuous Glucose Monitoring Versus Self-monitoring of Blood Glucose in Type 2 Diabetes Mellitus: A Systematic Review with Meta-analysis. Cureus. 11(9):e5634. 
  6. Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Study Group. Variation of Interstitial Glucose Measurements Assessed by Continuous Glucose Monitors in Healthy, Nondiabetic Individuals. Diabetes Care. 2010 Mar 9;33(6):1297–9. 
  7. Mean fasting blood glucose [Internet]. [cited 2024 Mar 4]. Available from: https://www.who.int/data/gho/indicator-metadata-registry/imr-details/2380