Coming up in our program today is continuous glucose monitoring useful for runners.
We’ll answer that question and also have Dr. Lyons joining us to give us his insights on the topic.
Next, we’ll finally settle the debate: is sparkling water as hydrating as plain water?
And last, we’ll discuss the risks of children using lotions.
Welcome to Health Channel News.
So starting off, we’re reporting on an article in Runner’s World, written by Renee McGregor, a leading sports dietician. The article explores whether continuous glucose monitoring, or CGM, is necessary for runners. CGM devices are gaining popularity among athletes. These devices provide real-time data on blood glucose levels, which some believe can help optimize performance. But according to McGregor, most runners may not need to monitor their glucose levels this closely.
She explains that the body has its own built-in system for regulating glucose levels using hormones like insulin and glucagon. When we consume carbohydrates, our body stores them as glycogen. This is released as energy during exercise, and fluctuations in glucose levels are a natural part of that process.
McGregor points out that healthy individuals can experience normal glucose fluctuations throughout the day, even outside the typical range, without any negative effects. The article highlights that while some individuals, like those with type two diabetes, may face issues like insulin resistance, this is rare in active runners. It also notes that glucose spikes aren’t always food-related. Exercise, stress, and even dehydration can impact glucose levels.
Says McGregor, for runners, carbohydrates remain essential. McGregor explains in the article that during high-intensity exercise, the body prefers simple carbohydrates for quick energy and recovery. Finally, the article suggests that for most healthy runners, using CGM may not be necessary and could even cause anxiety. Athletes are encouraged to consider simply trusting their body’s natural glucose regulation.
However, CGM has applications beyond athletic performance. Many individuals use it to manage their weight and monitor blood sugar fluctuations. To explore this topic further, we’re joined now by Dr. Michael R. Lyon, a certified specialist in obesity medicine.
Dr. Lyon, welcome to the studio.
Very glad to be here. Thanks.
Dr. Lyon, CGM is becoming more common among individuals looking to manage their weight. Is this approach helpful for those without diabetes?
Well, I can say there are perils to being an early adopter, and this is something that I was, uh, many years ago when CGM was first introduced by a company called Medtronics. We got a grant from Medtronics to use CGM in our clinic in a non-diabetic population. And people were struggling with their weight, who had high BMI and had physical evidence that obesity was creating serious problems, but they were non-diabetic.
And we were one of the first clinics to, in a fairly large scale, look at continuous blood glucose monitoring and its usefulness in, in, um, not just for someone, for instance, who’s on insulin, where they have to be very careful with big highs and big lows, but in individuals who’ve never been on insulin and aren’t on any blood sugar-affecting medications at all, typically. And it was a real eye-opener because we used the continuous glucose monitoring data to look at when signals for appetite occurred in these people.
That is when a person is struggling with their weight, they often struggle with hunger pangs throughout the day. Often, you can say kind of inappropriately or maybe extremes of hunger where they end up eating without full restraint. And that ends up, uh, curiously, if you can abolish that kind of blood sugar roller coaster, you can see a person’s appetite really calm down. And that was the first observation that we had made.
So yeah, I think it has great usefulness, but it’s a little bit premature to say, you know, it’s kind of ready for the mainstream. We don’t know exactly what it all means yet. I think there’s a lot of things locked up in the variability of blood sugar. Yes, for sure.
Okay, so in your experience, are there any downsides to using CGM for weight loss?
Well, like any test, there are always some downsides. Too many tests lead to a lot of anxiety and often no difference in clinical approach. From a physician’s point of view, we should only do a test if it could lead to a different clinical decision, and that’s true in a person’s life as well. Like, it’s great that you can monitor all these different parameters in your body, but does it really translate into healthier behaviors?
And that may or may not be true when it comes to something like monitoring blood sugar. It could lead to quite a bit of anxiety, almost like an obsessing about blood sugar. In some cases, we see this already in people with diabetes that, uh, use finger sticks to measure their blood sugar. Sometimes people start to obsess about it and try to micromanage it.
When it comes to blood sugar, you kind of have to have the bigger picture in mind. And so, that’s part of the peril, just leading to more anxiety. Some of it’s related to the fact that we don’t really know what normal is for people without diabetes in terms of the highs and the lows completely. We know relatively speaking, you know, like if your blood sugar is over a certain number, say 10, that suggests that you may have diabetes.
But on the other hand, we don’t know how many times people have sort of the lower end of the diabetes level of blood sugar without any diabetes at all, or even pre-diabetes. We’re not certain. Suffice it to say that in the future, we’re probably all going to be looking at blood sugar a lot more than we do, like we do with blood pressure.
There’s really good home monitors for blood pressure. So a lot of people, if they have an issue with blood pressure, they use it and ideally use it from time to time to sort of see if you’re on track.
When it comes to CGM in people without diabetes, my impression is this: most people will use it and really learn from it. They’ll learn that there are certain ways of living that don’t really work that well in terms of their desire to have healthier blood sugar. They may see really big surges after meals that leave them feeling not so great, and it explains why they don’t feel great after certain meals.
Or they may find that, for instance, if they eat a certain kind of meal, like maybe a meal high in carbohydrates that are higher in glycemic index, they may find that their blood sugar goes quite high initially, but then it starts rapidly dropping later within an hour or two, and they feel hungry and maybe shaky and weak. They’re starting to get those hypoglycemic symptoms often before they’re even in the hypoglycemic zone because the blood sugar’s dropping very quickly.
So it can be very useful to give you feedback. Then you can say, well, what does it look like if I eat a little differently or if I exercise a bit differently, or if I watch my caloric intake, or if I eat more of certain kinds of foods earlier in the day? You can start doing that and getting real-time feedback, and it is quite useful.
I use it myself periodically, maybe three times a year to kind of see where I am, see if I’m on track or not, because of a very strong family history of diabetes, and I’m 65, so I have to think about these things. I think it has some perils, but for the most part, unless you are a very anxious person who tends to obsess about your health, it probably is of net value for most people.
So for individuals struggling with obesity, how does blood sugar regulation play a role in weight management?
Again, there are a lot of unanswered questions, but I was one of the earliest adopters of this technology in my clinical work back probably 15 years ago now. I don’t remember when we first started using CGM, but a big company that developed the CGM technology initially called Medtronic offered to provide my clinic with equipment for free to be able to use CGM in my practice in a very busy government-funded obesity treatment center.
So these were bigger people. Many had diabetes, but many had pre-diabetes or no sign of diabetes yet. And we were using it in all our populations, and we found that it had some very interesting information. We usually would do the study at baseline and see what their blood sugar looked like and then repeat it after we made some dietary changes or they lost weight and we saw what happened. And it was often visually quite striking.
