June 2024 - Continuous Glucose Monitors
Welcome to Picasso Health & Nutrition’s first newsletter!
I’m so glad you’re here.
Each month I will include an article regarding a relevant nutrition and/or health related topic, share news and updates regarding Picasso Health & Nutrition as well as a pertinent recipe I’ve been enjoying. There may also be a sprinkling of other items here and there. I would love to hear what you think. You can do this by emailing me at therese@picassohealthandnutrition.com, popping onto my website picassohealthandnutrition.com and sending a message on the contact page, or giving me a call at (406) 545-5888.
Featured Article
What is a Continuous Glucose Monitor? Could Its Use Benefit Those Without Diabetes?
Wearable health devices are currently common place for many who are taking steps to improve their health. Could wearing a continuous glucose monitor for those without diabetes be beneficial?
A continuous glucose monitor or CGM was developed primarily for people to manage their diabetes. The CGM consists of a sensor between the size of a quarter and a 50 cent piece. It’s typically attached to the back of the arm with an applicator and adhesive. The sensor measures glucose levels in the interstitial fluid just under the skin (see illustration). These continuous measurements sync to the corresponding app downloaded on the users phone providing real-time readings of blood glucose 24/7. Each sensor lasts about 14 days.
Advantages
CGMs are increasingly being used by those without diabetes. Even if a person may not be diagnosed with diabetes, blood glucose control and variability can play a strong role in long term health. Typically, our blood glucose (BG) rises after we eat. Our aim is to have a subtle rise and fall post meals and stable BG overnight. Certain meals may result in spikes in blood glucose. These spikes and their corresponding dips may cause food cravings, hunger, stress, and decreased insulin sensitivity over time. In addition to diabetes, blood glucose and insulin disregulation is linked to obesity, high triglycerides, PCOS, heart disease, inflammation, cognitive decline, metabolic syndrome and cancer. In addition to food, other lifestyle factors like sleep, fluid intake, activity, and stress are also influential when it comes to blood glucose levels. CGMs helps users to discover in real time how food and lifestyle factors impact blood glucose. This information can become a powerful motivator for positive lifestyle change in the long run.
Possible Challenges
Although there are several benefits, there are challenges to consider. Data available 24/7 can be overwhelming, especially if the user is new to the information and does not understand how to interpret it. The cost of obtaining a CGM could be prohibitive to some. Insurance typically does not cover CGMs without a diagnosis of diabetes.
At this time, a prescription is necessary to receive a continuous glucose monitor.
Potential Solutions
The information received from a CGM is quite valuable, but can be daunting if one doesn’t know where to start. Healthcare professionals who are trained in the use and interpretation of CGM data can act as a guide to co-create a plan for diet and lifestyle adjustments. This puts the CGM user at ease and increases the likelihood of lasting behavior change. An additional value of a CGM is to note trends. Using the continuous glucose monitor for a month can shed light on key findings that can be used to improve BG levels.
Upon research of the self pay cost of CGMs, the range found was $38-$74 per 14 day sensor. Some companies offer a free sensor and some pharmacies offer coupons to reduce the cost. Again, the assistance of a knowledgable practitioner could be quite helpful.
At the current time, a prescription is needed to receive a continuous glucose monitor. However, in March of this year, the FDA granted clearance for the first over-the-counter continuous monitor. This is intended “for anyone 18 years and older who does not use insulin, such as individuals with diabetes treating their condition with oral medications, or those without diabetes who want to better understand how diet and exercise may impact blood sugar levels.“ The over-the-counter CGMs is slated for release this summer.
A provider is a partner in a patient’s healthcare. Although a prescription will not always be needed for those without diabetes to obtain a CGM, it’s encouraged to communicate interest in this device with your doctor, explaining your reasons why it could be beneficial for overall health and quality of life.
The use of CGMs for those without diabetes is emerging. Although there are some challenges to consider, it provides compelling insights into how diet, stress, activity and sleep can impact metabolic health. It’s a unique opportunity to use this data to drive individualized care and improve quality of life.
Article References
Continuous Glucose Monitoring as a Behavior Modification Tool https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7164990/
Continuous Glucose Monitoring in Healthy Adults—Possible Applications in Health Care, Wellness, and Sports https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8915088/
Glucotypes Reveal New Patterns of Glucose Dysregulation https://journals.plos.org/plosbiology/article?id=10.1371/journal.pbio.2005143
Glucose Levels and Risk of Dementia https://pubmed.ncbi.nlm.nih.gov/23924004/
Use of Continuous Glucose Monitoring in Obesity Research: A Scoping Review https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8502209/
Association of hemoglobin A1c with cardiovascular disease and mortality in adults: the European prospective investigation into cancer in Norfolk https://pubmed.ncbi.nlm.nih.gov/15381514/
Insulin Resistance in Polycystic Ovarian Syndrome https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9665922/
FDA Clears First Over-the-Counter Continuous Glucose Monitor https://www.fda.gov/news-events/press-announcements/fda-clears-first-over-counter-
continuous-glucose-monitor Insulin Resistance: The Increased Risk of Cancers https://www.mdpi.com/1718-7729/31/2/75
News and Updates
Insurance Updates
I’m currently an in-network provider for Blue Cross Blue Shield of Montana, PacificSource Health, Medicare, Medicaid Healthy Montana Kids Plus with others pending. If you are out of network or you do not have insurance, you may self pay, receive a Superbill or use your FSA/HSA. I’ll continue to keep you updated.
Program Updates
I am excited to introduce a new group: Using a CGM to Optimize Your Health
Details:
Five, one hour group sessions plus one individual 30 minute session with me
Learn how to obtain and use a continuous glucose monitor
Discover in real time how your food and lifestyle impact your blood glucose
Learn how glucose variability and insulin sensitivity can impact your health
Receive information weekly to guide and inform your choices
Use this data to see metabolic trends to help make lasting lifestyle changes unique to you
My plan is to offer both an in-person group in Red Lodge and a virtual group.
Cost: $250 plus the price of the sensors x 2 (ranging from $38-$70 per sensor)
If you gather four additional friends and family members for a group (five people total), you would each receive a 20% discount.
Interested? Want to learn more? Contact me here
Featured Recipe
Seed Crackers
I’m a sucker for a good cracker, but when wearing a continuous glucose monitor for a couple of weeks I learned the crackers I’m choosing spike my glucose. That’s when I began searching for alternatives. I came across a variation of this recipe, did some improvising and came up with a cracker I really enjoyed. It’s seed-based, rich in fiber and healthy fats. It’s surprisingly easy to make. Make it your own by experimenting with different spices, herbs and seeds. I may add hemp seeds to vary the flavor and texture next time. Serve these crackers alongside your favorite hummus, dip, nut butter, soup, salad or by themselves. I found myself crumbling them up to top soup or salad for extra crunch. Try them. I’d love to know what you think and how you enjoy them.
Makes 6-8 cups of approximately 3 inch crackers
1/2 cup pumpkin seeds
1/3 cup ground flax seeds
1/3 cup whole flax or hemp seeds
1/2 cup raw sesame seeds
1/3 cup chia seeds
1/2 to 1 teaspoon salt
1 cup water
1. Heat oven to 200 degrees
2. In a large bowl add all of the ingredients and stir together for one minute, until the seeds start to stick together. Let sit for a few minutes to allow seeds to absorb the water.
3. Lay a large piece of parchment paper on the counter. Place half of the mixture on top of the parchment paper. Place another piece of paper on top and roll to your desired thickness (3-4 mm thick) using a rolling pin, drinking glass or your hands. Repeat with the other half.
4. Transfer the crackers and parchment onto the two baking sheets, leaving the top piece of parchment on, and cook for about 2 1/2 hours until dehydrated and starting to crisp up. Remove the top layer of parchment for the final 30 minutes.
5. Let cool completely before breaking into cracker pieces of your desired size. I found it helpful to slide the crackers onto a drying rack, removing the bottom parchment sheet if you can.
Thank you for receiving my inaugural newsletter! What did you think?
Can you think of others who may like to receive it? Share your comments, questions or lead potential new folks here. I look forward to hearing from you.
Look for my next newsletter in early July.
Thanks again, and take care,
Therese