The CGM Craze: Data-driven Dysfunction or Glucose Godsend?

So, what’s the deal with Continuous Glucose Monitors (CGMs)? Let’s break it down! These little gadgets are like the trendy accessory everyone’s wearing, but they’re not just for the diabetes crowd anymore. Originally, they were lifesavers for folks with diabetes, helping them more swiftly and accurately target insulin dosing in response to blood sugar spikes. But now? They’ve become the latest wellness flex for CEOs and influencers who think they’re biohacking their way to immortality.

In this episode, Aimee busts some influencer BS and advises on when CGMs can be useful, while also providing practical strategies for metabolic health without tech dependency. If you’re tempted to jump on the CGM bandwagon, are already riding it and wondering if it is worth it, or want to explore a more nuanced take on the matter, this episode is for you!

Find Research Citations and Transcript at Blasphemous Nutrition on Substack

Work with Aimee

Photography by: Dai Ross Photography

Podcast Cover Art: Lilly Kate Creative

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Transcript

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If you've been wondering whether a CGM could be your holy grail or if it's just another health cult initiation, buckle up. We are about to separate the data-driven insights from the digital distractions. Let's go. Hey Rebels. Welcome to Blasphemous Nutrition. Consider this podcast your pantry full of clarity, perspective, and the nuance needed to counter the superficial health advice so freely given on the internet. I am Amy, the unapologetically candid host of Blasphemous Nutrition and a double degreed nutritionist with 20 years experience. I'm here to share a more nuanced take. On living and eating well to sustain and recover your health. If you found most health advice to be so generic is to be meaningless or so extreme that it's unrealistic. And you don't mind the occasional F-bomb, you've come to the right place. From dissecting the latest nutrition trends to breaking down published research and sharing my own clinical experiences, I'm on a mission to foster clarity amidst all the confusion and empower you to have the health you need to live a life you love. Now, let's get started. Welcome back to Blasphemous Nutrition, the podcast where we burn diet dogma at the altar and build real health from its wreckage. My name is Aimee. I'm a double degreed functional nutritionist who doesn't need a Bluetooth enad arm patch to know that skipping lunch and rage snacking at 4:00 PM might not be optimal. Yes, that's a clue. Today we're digging into one of the trendiest new rituals of the wellness world, continuous glucose monitors or CGMs. CGMs have been used in clinical practice with diabetic patients for many years now, but with the FDA approving direct to consumer use in September, 2024. Now it seems like everyone is supporting them like they're some kind of fashion trend. Maybe you've seen them on your favorite influencers. Maybe your cousin is wearing one. Maybe you are wearing one right now and trying to decide if your oat milk latte was a metabolic sin. Here's the deal. I am definitely not anti CGM, but I am against unquestioned obsession, really shitty science interpretation and the slow spiral from awareness into anxiety. All right, so what the fuck is the CGM? Why is everyone using one? Let's go back to the basics because not everybody listening is deep in the church of biohacking. And even if you are, you still might be confused about what the hell you're actually wearing on your arm and what it's telling you and what that all means. A CGM is a small device, usually stuck on the back of your upper arm, and it uses a tiny, tiny filament inserted just under the skin to measure the glucose levels in your interstitial fluid, not your blood. In interstitial fluid every few minutes. Hence, the continuous part of continuous glucose monitor. It does not measure your bloodstream directly, but rather the surrounding fluid. So there's a little bit of a lag. There's a little bit of nuance there. It's not the same number that you will find if you're using a traditional glucose monitor where you have to prick your finger. CGMs were originally designed for people with type one diabetes or insulin dependent type two, so they could more closely monitor dangerous highs and lows in their glucose and adjust their insulin accordingly, you know, basic medical necessity. But over the last few years, CGMs have gone from a really important clinical tool to what my Gen Alpha child would call Wellness Flex. You've got CEOs, influencers, and self-proclaimed longevity experts slapping'em on like they're the new. Fitbit and there are startup companies pushing these$200 a month subscriptions to tell you that your glucose spiked after you ate a banana. No shit Sherlock. So how did we get here? I think it's safe to say that CGMs are a consequence of the rise of precision nutrition. I mean, don't get me wrong. Individualized nutrition is 100% the future and absolutely the right direction to head when it comes to health and disease prevention. And disease treatment for that matter. But what I'm seeing with CGMs right now is less about personalization and more about perfectionism in disguise. We've turned blood sugar, which is a normal fluctuating context dependent marker into some kind of metabolic morality test. Oh no, I spiked. Or, oh look, I'm so flat today. I only do zone two cardio because it doesn't spike my blood sugar. So let's, let's be clear here. Some of the stuff getting shared on social media is total garbage, like what I just mentioned above, or people demonizing potatoes or bragging that their post meal glucose stayed perfectly flat because they had no carbs and no protein. That's not blood sugar balance. It's fear mongering dressed up as discipline. If you've been curious or attempted, or maybe you're already logging your numbers and low key spiraling, I want you to stay with me. At the end of the day. If your health strategy has you afraid of fruit, it's no longer a strategy. It's a disorder with a data dashboard. And this is actually what happens often when you start tracking every blip and every bump in your blood sugar like it's a stock ticker. It quickly turns your awareness into an obsession. Now, here's the thing. I am a hundred percent for information Science is my friend. And I love, I love, I love that we have a decent alternative to pricking one's finger. Data is the bomb, but only when it's interpreted through a lens of context and critical thinking. And this is where CGMs can go sideways really fast because when you start looking at that little blood sugar graph every couple minutes. It stops being a tool and starts being a judge or a fricking priest. And then you gotta step into the metabolic confession booth and beg for forgiveness. Forgive me, father, for I have spiked. No, no, no. Like there's three primary dangers of metabolic micromanagement that I tend to see in CGM users. The first is hyper vigilance in food fear. And you know it, it starts innocent enough. You're curious. You wanna know what your body's doing. There's nothing wrong with this. And then. You have a spike and it looks bad, and suddenly you're second guessing the health attributes of quinoa. You start avoiding certain foods, not because they actually make you feel bad, but because they make the graph look bad. You're checking your phone mid meal, like it's some kind of glucose horror crux, and suddenly you stop eating out because you're worried that the numbers will go up and you don't know what's hidden in the. Sauces and how that's gonna affect your glucose at that stage. It's no longer healthy. You are in a slow slide into Orthorexia that just happens to have a tech upgrade. The second thing that I see is false equivalents because a blood sugar rise. Isn't inherently bad, and that is counter to what you will see some influencers brag about on the internet. So let me say this again. A post-meal glucose spike is normal, it's expected, it's physiological. It is not a sign of metabolic doom, but CGMs and bro science don't be explaining that. They just show you a line going up and then. Suddenly people are thinking, oh my God, I'm, I'm doing something wrong, or My body is completely broken, and then they think I need to cut out carbs even more wrong, wrong and possibly wrong. A spike after a balanced meal that includes carbohydrate normal, a spike after a donut on an empty stomach. Still not a crisis, it's just context. Your blood sugar is a dynamic system. It is not supposed to be flat. Flatlining is not how human biology works. So trying to force your glucose to stay perfectly level at all times. It's like trying to keep a campfire at exactly the same flame height, no matter how much fuel or what kind of fuel you throw into it. It is completely unreasonable to expect that, and it's also unnecessary to do this to achieve metabolic health. Your blood sugar is dynamic. It is supposed to respond. If you eat something, it rises. You move your body, it drops, or sometimes it spikes really high. This causes so much panic. In my clients just starting A CGM, when they go out for a run or they go to a fitness class and their blood sugar pops up, they're like, oh my God, what's going on? Sometimes simply being stressed or sleeping like trash can elevate your blood sugar level. It doesn't mean you're in a state of dysfunction. It is your body adjusting. It's your body doing its job. Your blood sugar responds to what's on your plate, how fast you ate it, how long you slept the night before, how much muscle mass you have, whether or not you're ovulating. Whether or not you are stressed, it responds to you being stuck in shitty meetings all day long. There is about a dozen other things that your blood sugar responds to that isn't accurately reflected on your CGM. It's not a closed system with a single dial. Now if you're spiking like crazy, if you're crashing hard after a meal or you're walking around in some kind of brain fogged rage every day, then yeah, we should have a conversation. But a post-lunch bump in your graft does not mean your metabolism is failing. It means your body is alive. And responding. So you gotta stop chasing flat lines like it's some kind of prize. Metabolic health is not achieved through rigid control. It happens through creating adaptability. You don't want your blood sugar to be still. You need it to be responsive and adaptable and responsive. Adaptable systems aren't flat lines. They're flexible, they're messy. They're actually rather brilliant just like the rest of your body when it is supported instead of micromanaged. The last thing that I often see is this level of reductionism, A one number fallacy. Some people think that as long as their blood sugar levels stay flat, they're doing everything right, you know, even if they're undereating over caffeinating, skipping sleek and hanging on by a very thin thread emotionally just to get there. If the line is flat, they think they're winning. And that's kind of like saying your house is fine because the thermostat looks stable, but the roof is leaking and the basement's on fire. Flat glucose is not equal to thriving. Sometimes it means you're not eating enough or you're afraid to. Okay, so I probably sound like some kind of anti-tech profit with a vendetta against wearable glucose devices. So let's like roll it back a little bit. Let me reiterate. CGMs are not evil. I actually use them in my practice often. However, the way that they are being referenced in pop culture and health culture and these wellness cults is overhyped, grossly under explained. And often misused in the right context with the right mindset. CGMs can be a really powerful tool for insight and health, and it is awesome in those situations. So let's see when it makes sense to use A CGM and how to do it without losing your mind. Okay, use case one. If you have been told you have insulin resistance, pre-diabetes, or PCOS, this is the first and most valuable use case scenario for CGM use. It's the original purpose of CGM for clinical support. If you've got legit blood sugar dysregulation, and it's not just curiosity dressed up as biohacking, CGMs can be incredible tools to help you improve your glucose regulation and even pull yourself out of pre-diabetes or reduce medication dosage if you already have diabetes. If you are in this camp. A CGM can help you see how your body responds to specific meals, how to track true highs and lows and make targeted meaningful shifts that can improve your health significantly without guessing. But even then, I recommend doing this alongside a practitioner because interpreting this data solo can sometimes feel like doing your own taxes blindfolded with Latin instructions. And then knowing what to do with the data, how to adjust your meals in a way that brings glucose levels back into more ideal ranges, and that's another task altogether best and most often effectively done with guidance. Use case two, you suspect you have reactive hypoglycemia or you have really intense. Mood and energy swings after meals. CGMs can be extremely useful in helping you connect the dots between how you feel and what your blood sugar is actually doing. So if you're getting shaky and irritable or brain foggy within a couple hours after eating, if you crash really hard in the afternoon. Or if you feel like a completely different person, depending on when or what you eat. A CGM can give you some important clues and insights into whether or not your blood sugar may be at play here. And this is one of the rare times when real time data can offer you something that your journal or your calendar can't. That data gathered from A CGM will either confirm that it is a blood sugar issue. Or deny it, in which case you can start looking elsewhere. But if it is a blood sugar issue, then you can take that data and use it to adjust your meals and find your personalized target macro ratios to prevent those spikes and crashes that leave you feeling completely useless after 2:00 PM. Use case three is when you want a short term experiment to build awareness. When used briefly, A CGM can be a fantastic learning tool. It's a two week snapshot. It's a metabolic audit. Use it as a peek behind the curtain. But not this lifelong confession booth. And this is crucial. If you do this, you have got to go in with guardrails. No cutting out entire food groups because of a spike. No excessive fasting just to bring the glucose down lower. No judging your worth based upon a fucking graph. If you're someone who's triggered by tracking or you tend toward all or nothing thinking, a CGM may not be your friend right now, and that's okay. There are so many other resources to draw upon, and you're much better off getting to your goals without jumping on the CGM bandwagon. So big picture, CGMs can be a great tool, but it, it's not your savior. And it goes without saying that A CGM is not a moral compass. It's also not a diagnostic tool, and it's definitely not a substitute for intuition or knowing what you already know about your body to make good decisions. Rather than thinking that spikes are bad, think of your blood sugar levels like packages in a delivery truck. So you eat a meal, especially one with carbs, and your body sends glucose into the bloodstream attached to insulin, like a truck heading out with a fresh load of Amazon packages. The rise that you see on your CGM is the truck leaving the warehouse. Okay? It's not a problem. It's part of the process. The goal's not to stop the truck. The goal is to make sure the truck delivers those packages to where they need to go. Efficiently and in a timely manner. Where do they need to go To your brain, to your muscles, to your organs. If the roads are clear, for example, you don't have insulin resistance. You move regularly, you get solid sleep, right? Delivery is smooth. It's all good. But if there's a traffic jam from stress, sleep deprivation, or metabolic disease, well then, yeah, deliveries get backed up. But that's something that we can work on and improve with supportive strategies. While A CGM can offer insight, chasing flat glucose lines while ignoring your fatigue, your hunger, or your central nervous system is not optimization. It's metabolic micromanagement dressed up as healthy living. Okay. I wanna kind of segue into addressing the unspoken elephant in the room. What is driving the obsession with CGMs? While it is very true, I. That there is an outrageous rise in metabolic dysfunction and diabetes across the world, and it is true that this is a crippling and devastating problem that must be addressed. The rise of CGMs as we are seeing them, especially in the United States and in pop culture, is not just about curiosity or even science. I think it is ultimately about control. We live in a culture that conditions us to believe our bodies are a problem to be solved, like being born in a human body is some kind of original sin that we have to strive to fix and perfect. Be it our weight, the lines on our face, or achieving those perfect little glucose curves. We're sold an idea that if we try harder, we track better, we biohack more precisely and get up at 5:00 AM like huberin and do 27,000 things before noon. We would finally feel okay in our own skin we could be redeemed. Enter the CGM, and here we have the latest shiny tool, promising clarity, certainty, and salvation in a world full of hormonal chaos and health. Gaslighting. And I get it, like when your body feels unpredictable, the numbers on a graph feel like power. They feel like certainty. And you get that graph without the hassle of dealing with the healthcare system. Holy shit, that's pretty damn cool. Right? But here's the truth. Wellness culture has turned self quantification into a substitute for self-acceptance. So let's break down the drivers behind this. Okay. When we look at what's fueling the obsession with CGMs, I see four primary things. First is the promise of control. These websites, and you know, some influencers too, they sell this fantasy that if you just manage this one marker closely enough, you're gonna unlock the body you want. Health doesn't work that way. Like you're not a spreadsheet. You are a complex, dynamic organism that cannot be simply quantified. Having the perfect glucose curves doesn't mean weight is automatically gonna come off, or that you're gonna feel younger than you have in years, but some of the ads that I see make it look otherwise. The second thing is diet culture rebranded as data. I mean, thank God we are not tracking calories anymore, but we're tracking glucose curves and the anxiety, the restriction that results from that, the perfectionism. Still the same. I see this in clinical practice all the time. CGMs can quickly become a moral compass. Did I spike? Did I fail? Like when those thoughts take over, you've started moralizing your biology and sliding into legitimate disordered eating behavior. Number three is wellness consumerism. Okay? Let's not forget, CGMs is a big business. CGM wearables are predicted to be a$5 billion market this year. That's billion with a B, and it's expected to double in less than a decade. You've got startups monetizing fear and turning normal physiology into a subscription service. They're selling you this idea that glucose stability is the ultimate pinnacle of health, but you gotta step out from that. And remember, it's just one piece of a much, much bigger picture. The ultimate reality is that health still comes down to the unsexy, boring shit. Getting enough sleep, getting enough fiber, getting enough protein, moving your body, which ironically is going to do more for your glucose management without even knowing the numbers. And then the last one is optimization addiction. My God, we are just trying to optimize the fuck out of everything. And you know, I think the base of that is that we're all being told that being good enough isn't enough. You gotta optimize, you gotta track, you gotta perfect. We're turning our bodies and our health and our wellness into some kind of pathological stock market expectation of ever increasing benefit. CGMs tap right into that belief of optimizing and tracking and making things perfect by giving you a new number to chase. It is a new way to fix yourself. But what if you're not broken? What if your blood sugar isn't actually the problem? What if the problem is that you're exhausted? You are under fed, you are undermuscled, and you're totally disconnected from your body. And your heart and what you want from life. But here's the sneaky part, right? For, for some people, the more they track, the less they trust themselves. The more we chase perfection, the more we struggle with simply being human. CGMs, of course, did not create this obsession with fixing and perfecting, and. Uh, trying to make ourselves something different than we are has been going on for a very long time. But CGMs do pour some gasoline on that situation. So what do you do instead? I mean, whether you're wearing a CGM right now, or you're just kind of feeling stuck in the cycle of overthinking every damn bite that you put in your mouth. If you're second guessing every meal and the graphs, the numbers, the constant analysis, and it's leaving you confused or worried rather than empowered, like take a deep breath. Here's the thing. You do not need to control every bite you put into your mouth to support your blood sugar. What you need is clear structure, consistent habits, and the patience. To track patterns over time. That's where we see trends and that's where we get valuable information. So what supports metabolic health in the real world? Guys, I'm gonna give you the unsexy, boring shit, and it starts with two questions at every meal. One, where is my produce? Two, where is my protein? These aren't gimmicks, right? These are grounding principles. Focusing on these two questions puts the most metabolically supportive foods on your plate. At every meal, they become the foundation of a blood sugar supportive plate. Protein slows digestion and it blunts glucose spikes by triggering the release of gut hormones like GLP one. Yeah, I said it that GLP one and it also helps regulate your appetite protein gives your metabolism a solid anchor to work with and then produce especially colorful fiber rich vegetables. Feed beneficial gut bacteria. Many of them play a direct role in blood sugar regulation, inflammation control, and even insulin sensitivity. Did you know your veggies could do that I'll be talking more about that in a later episode. And then we have fats. Fats slow. The rate at which food leaves your stomach and it helps regulate post-meal blood sugar levels. Fats are also super important for hormonal stability, especially in midlife when for some of us, those symptoms are already in flux. You don't need any fancy gadgets, just the basics done consistently. Another thing that is really helpful for glucose control is to move your body after meals. Even a short walk after lunch or dinner can improve glucose uptake by your muscles. I'm talking 10 minutes here. Don't mistake this as a need to earn your food. A walk after a meal simply supports your physiology. Movement is one of the fastest ways to put those post meal nutrients to use. Think about it. When you move your body, you increase your blood flow, and that shuttles nutrients in the blood into the cells. But here's a bonus, A good post-meal walk is also fantastic for improving your digestion. In fact, there's been a meme going on right now about fart walks. It's totally legit. Like fart walks are legit. I also wanna say that you do not need to skip meals to support your metabolic health. If you're using fasting as a tool, it really needs to come with structure, not just coffee and willpower. Skipping meals randomly increases stress hormones and makes your blood sugar harder to manage later. So if you're trying intermittent fasting, do it with intention. Throw out the idea that more is better because it is not, and make sure that you get enough protein in the meals that you eat. You want to understand how intermittent fasting fits within your life, within your body's needs, and not just blindly follow somebody else's protocol. As with everything else, more or longer is not better in this regard. One thing that rarely gets talked about that's super, super important for metabolic health is protecting your sleep. One bad night of sleep can temporarily raise your blood sugar levels and reduce your insulin sensitivity. So many, many bad nights of sleep. Can produce metabolic dysfunction over several years. If you're waking up tired, you're relying too heavily on caffeine, you're skipping rest days, right? You're brewing a blood sugar issue with that coffee. Even if your CGM says otherwise, it just might not show up immediately. Finally to support metabolic health, you want to build and maintain muscle mass. Muscle tissue is your body's biggest glucose fan. After the brain. The more lean mass that you carry, the more efficiently you can use glucose and store glucose, especially after meals. Resistance training doesn't have to be complicated. It doesn't have to be crazy. Weightlifting at the gym, grunting and sweating with the dudes, but it does need to be present. You need to lift heavy things that challenge you on a consistent basis. Be that inside the gym or outside the gym, and you need to eat enough protein to make sure that you have the essential tools on hand to build that muscle in the first place and to keep it on your frame once you have it. So while none of those is nearly as sexy as sporting A CGM this summer, it will have you accomplishing more and feeling better than obsessing over your data. If your current approach has you constantly guessing, chasing symptoms or. Stuck in cycles of overcorrection, you have got to pause and reassess whether or not this is ultimately worthwhile. You don't need perfect data. Ultimately, like you need to find a strategy that fits within your life and evolves with your body because your body is not a static organism. It is changing and evolving moment to moment, day to day, year to year. And your needs will change along with it. So whether you're wearing a glucose monitor or not supporting blood sugar starts with how you build your meals, how well you sleep, how often you move. And how consistently you show up for these basics. And remember, at the end of the day, blood sugar is just one piece of the metabolic picture. So if something still feels off, don't ignore it, but don't automatically assume that the problem is you. Alright folks, that's it for today. If you've enjoyed this episode, please like and subscribe to Blasphemous Nutrition. If it made you think about somebody who's kind of getting stuck in the CGM Crazy forward this episode to them. Maybe I'll develop a new hater or maybe I'll find a new fan, who knows. Thanks again for listening. Stay salty, stay curious, and I will see you next time. Any and all information shared here is for educational and entertainment purposes only, and is not to be misconstrued as offering medical advice. Listening to this podcast does not constitute a provider client relationship. Note, I'm not a doctor nor a nurse, and it is imperative that you utilize your brain and your medical team to make the best decisions for your own health. The use of information on this podcast or materials linked to this podcast. Are at the user's own risk. No information nor resources provided are intended to be a substitute for professional medical advice, diagnosis, or treatment. Be a smart human and do not disregard or postpone obtaining medical advice for any medical condition you may have. Seek the assistance of your healthcare team for any such conditions and always do so before making any changes to your medical, nutrition or health plan.