An Ayurveda Doctor’s perspective on CGM – Is a CGM Really Necessary for Diabetics?

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A future version of the Apple Watch may be able to measure blood sugar without requiring a finger prick. While this is wonderful news for diabetics who must test their blood sugar on a daily basis, it is also a response to the growing trend of people monitoring their blood glucose levels.

 Blood sugar monitoring has long been used in diabetes care, but it’s also been linked to weight loss and high-level athletics. In fact, whether they need it or not, many people are adopting this type of blood glucose monitoring gadget.

 Our Bodies’ Glucose Utilization

Our bodies normally regulate our blood glucose levels. When we eat, insulin is released by our pancreas, which transports blood sugar into our cells. Once within, glucose fuels cell functions. People with type 1 diabetes have a pancreas that generates little or no insulin, therefore they must take insulin to operate normally. The pancreas produces insulin in type 2 diabetes, but the cells in the body do not respond to it and have difficulty absorbing glucose.

Diabetes patients must be aware of their blood sugar levels in order to manage them. High blood sugar levels can make you feel ill and lead to major health problems. Chronically elevated blood sugar levels can harm the kidneys, cardiovascular system, and eyes.

 What Is the Function of a Continuous Glucose Monitor?

While there are several brands of CGMs available, they all work in the same way. A small sensor is usually implanted beneath the skin, usually in the abdomen or on the back of a thigh or upper arm. The sensor or probe makes contact with the interstitial fluid beneath the skin and detects blood glucose levels there. Based on the sugar in your interstitial fluids, it can predict your blood glucose levels.

 A transmitter is connected to the sensor and wirelessly transmits data to a smart phone, reader, or other device, such as an insulin pump.

As the name implies, the instrument measures on a regular or continuous basis, anywhere from every minute to every 15 minutes.

 CGMs are not as timely as other monitoring devices that look at blood glucose levels directly since they assess sugar levels in interstitial fluid. CGMs are precise, however they only represent your glucose levels up to 15 minutes before the test. If you have diabetes, this can impair the timeliness of your therapy.

 Whereas traditional meters monitor a single event, CGMs measure continually and can track patterns, determining if glucose levels are rising or falling and at what pace, making diabetes management easier and more predictable.

 For example, if you have type 1 diabetes and your blood sugar levels are rising, you may need to take insulin to control your blood sugar. If you have type 2 diabetes and your blood sugar levels are consistently low, your doctor may need to alter your prescriptions.

 Don’t get me wrong: I’m ecstatic about CGM technology. It’s evolved from an anxiety-inducing nuisance that continually sends false alarms to truly life-saving technology that nearly always correctly informs about impending high and low glucose levels.

Years of shooting CGMs into the back of upper arms (along with injecting insulin and inserting insulin pump and pod infusion sites), patients arms are usually scarred and bruised to the point where they are periodically asked if they are safe at home.

 And how about a nice bath in a hot tub? As someone who requires a CGM for medical reasons, that’s a no-go (or “proceed with extreme caution”). Diabetics are advised to exercise extra caution when using hot tubs since the heat can cause hypoglycemia unawareness, which suppresses the usual warning symptoms of low blood sugar levels, such as shakiness and sweating.

 You’d think CGM would notify to a low glucose episode, but as discovered from previous attempts at long, hot baths, they tend to stop reading after a time. (Usually they spend more time turning off “lost signal” alarms than they do really relaxing.)

If you rely on CGM reads, avoid spending too much time in the water—that’s one thing about wearing CGM. Here are a couple more.

1. CGMs do not assess blood sugar levels.

Yes, you read that correctly. And, yes, a lot of people are saying it incorrectly, including some so-called “pros.” Blood glucose levels are not measured by CGMs. They test glucose in interstitial fluid, which is found between tissue layers. Glucose flows from blood arteries to the tissue that surrounds them. Interstitial fluid glucose levels are comparable to blood glucose levels, however they lag by around 15 minutes. 

The latency makes no effect to a non-diabetic. It can mean a delay in alerting a diabetic to a low glucose level and, hence, treatment.

2. Food and exercise aren’t the only things that influence your blood glucose levels.

Non-diabetics are being offered CGMs as a tool that allows them to observe the impact of diets on their glucose levels. However, a variety of other things can have an impact on those levels, ranging from illness and certain drugs to stress, lack of sleep, and menstrual cycles. I once went into a heated meeting with my son’s school with a somewhat normal blood glucose level, only to leave enraged—and with a reading in the 400s. (To put it mildly, the meeting did not go well.)

 Sensors are simple to wear for a week or two, but much more difficult to wear for an extended period of time. 

 Non-diabetics are being marketed CGMs as a transitory annoyance by some companies. They claim that if you wear a sensor for two weeks, you will have data on how food affects your glucose levels for an entire year.

 However, this scenario does not apply to diabetics, particularly those with hypoglycemia unawareness.

The longer someone has diabetes, the more likely they are to acquire the condition, a type of neuropathy that necessitates the use of a CGM on a daily basis. Don’t get me wrong: I’m grateful for CGM. But my arms are visibly harmed, as was my stomach when I wore them there on a daily basis.

 (Regular CGM users are recommended to rotate “sites”—arms, legs, stomach, upper buttocks—whenever possible to conserve “real estate.” However, certain CGMs were previously only permitted for use on the abdomen or upper buttocks, the latter of which cannot be accessed without assistance. Furthermore, not all sites are suitable for all diabetics.)

4. CGMs may reduce the “cognitive burden” of diabetics, but they may have the reverse impact on non-diabetics.

 It is estimated that type 1 diabetics make approximately 180 health-related decisions per day in order to maintain healthy glucose and ketone levels. This is referred to in medicine as “cognitive burden.” 

 Wearing a CGM is similar to having a degree of assistance—but better and all the time. It permits you to shift concentration elsewhere, knowing that something is watching over things. It contributes to the cognitive load.

 CGMs, on the other hand, may have the opposite impact in non-diabetics. Unless you have hypoglycemia, pre-diabetes, or another health condition that puts you at risk for high or low blood glucose levels, you may experience a stressful state of information overload when using a sensor. As someone who has no trouble maintaining healthy oxygen saturation or blood pressure levels, I can’t imagine being bombarded with such data (and attempting to analyse and interpret quite minor differences). To be honest, such a “tool” would certainly increase my anxiety—and I have to question if CGMs do the same for at least some non-diabetics.

 From Doctors Desk – An Ayurveda Doctor’s perspective on CGM

CGMs may be beneficial for some patients at risk of diabetes.

A CGM, in particular, could help persons with prediabetes and those with a history of gestational diabetes understand how diet and movement affect their blood sugar. According to Dr. Soumya, Lead Ayurveda Endocrinology Specialist, EliteAyurveda Clinics has confirmed that some of her prediabetes clients utilize CGMs for this purpose.

 However, when it comes to the general public, experts are divided on whether CGMs are necessary.

There is currently “no compelling evidence” that those without diabetes or prediabetes would benefit from a CGM. In fact, a 2019 study published in the Journal of Clinical Endocrinology and Metabolism reported that 96% of CGM readings from 153 patients without diabetes were within the normal range.

 The non-diabetic CGM market feeds on a premise that underpins much of today’s health and biohacker culture: more data about our bodies is always better. But, as Dr. Soumya points out, this isn’t always the case. For starters, CGMs aren’t always accurate because there’s a 10- to 15-minute time lag and a 10- to 20-point variation between what your CGM indicates and your real blood glucose level. And, according to Dr. Soumya, they have a tendency to over-read lows, which some people may find “disconcerting.”

 Blood sugar is a complex, multivariate issue as well. To make sense of your CGM data, you should track “food, exercise, sleep, stress levels, and how your energy fluctuates throughout the day, in order to better understand how these different components affect blood sugar,” according to Dr. Soumya. In other words, just because your blood sugar rises 20 points after eating a mango does not imply that mangoes are hazardous for your health (or that a mango would have the same precise effect on your blood sugar on another day).

 There may also be mental-health consequences.

Even if there is sufficient research to support the assumption that CGMs improve blood sugar control, they may have unanticipated negative repercussions that go beyond your physical health. For one thing, obsessing about your blood sugar levels “could cause you to get anxious around completely normal glucose responses and fluctuations,” according to Dr. Soumya. “If you eat carbs, your blood glucose will go up, and that’s totally normal and fine.”

 Furthermore, hyper-focusing on your blood sugar to inform your eating decisions may result in increased rigidity around food, particularly in persons with a history of restrictive dieting or disordered eating behaviors. “Similar to the effect that activity trackers or calorie counting apps can have, using this device may take away from the joy and pleasure of eating, as well as listening to your body when it comes to making food and exercise choices,” . You want to be able to eat and “not always be worried about the impact it might have on blood sugars,” as she puts it.

 And there are frequently simpler (and less expensive) ways to handle many of the difficulties you expect to fix with a CGM.

You should get screened if you are concerned about or at risk for prediabetes or diabetes. You can also begin with simple, evidence-based measures to stabilise blood sugar levels, such as increased physical exercise.

 Perhaps you’re not concerned about diabetes, but you’re experiencing a problem you suspect is related to blood sugar (such as a noon energy slump), or you’re simply trying to feel your best. In that situation, you can attempt paying more attention to your body and/or troubleshooting with some nutrition principles. “Your body is actually pretty decent at telling you what’s going on with your blood sugar,” Dr. Soumya said.

 If you feel unsteady after not eating for five hours, it could be an indication of low blood sugar and your body telling you that you need to eat more frequently. If you’re feeling sleepy after eating a lot of dessert, it could be because your blood sugar is rising. Learning to recognise your body’s subtle hunger and fullness cues (such as little weariness or stomach gnawing an hour before you’re ravenous) can help you control your blood sugar levels. Combining carbohydrates with protein, fibre, and/or fat when eating can also aid decrease the breakdown of carbs into your circulation, according to Dr. Soumya.

So, what is it about this tendency that bothers me?

“Most of us in the Ayurveda diabetes community don’t really care what the CGM companies do or who buys the devices—as long as they’re accessible to the people who really need them,” says Dr. Soumya. “Until the technology is fully accessible for the people who need it to survive, I don’t think it’s ethically okay to market it to people who don’t.”

Many diabetes reversal companies concentrate on symptoms through diets, diabetes meds, and sugar monitoring with gadgets such as CGM. This symptom-focused technique, however, typically overlooks root-cause treatment, and medicating the symptoms does not result in remission. It is crucial to recognise that this approach to diabetic treatment does not constitute actual diabetes reversal. 

True diabetes reversal involves restoring equilibrium to the body’s basic processes rather than merely symptom control.

As a result, practitioners are more concerned with diabetes control than with complete reversal of the condition. The medications utilised have high side effects, and the practitioner’s responsibility is now to cycle or alter their treatment to new classes of medicines available as the patients’ adverse effects plateau or begin to increase.

Long-term side effects of the pharmaceuticals involved can result in a significant deterioration in quality of life and are known to induce issues such as neurological, cardiovascular, and vision-related degeneration.

However, allopathic diabetes management practises are far from obsolete. DRC does not entirely transfer any patient to ayurveda meds, but rather attempts to gradually lower allopathic prescriptions in favour of herbal medications. Furthermore, in times of emergency, the allopathic system is unrivalled. We are not here to disparage any medical system, but rather to assist individuals in making an informed decision towards a comprehensive care system that works best for them.

Diabetes Can Be Reversed

 Diabetes reversal entails more than just lowering blood sugar levels.

It denotes a situation in which the body can naturally manage blood sugar without the need for external assistance. Unfortunately, as the medication benefits wear off, blood sugar levels tend to rise again, emphasizing the necessity for continual medication.

Our Approach: Rediscovering Ayurvedic Diabetes Reversal

At the Diabetes Reversal Clinic, we use a different approach, one based on Ayurveda, an old holistic medical practice. Our approach begins with a knowledge of each individual’s unique constitution and imbalances, recognising that diabetes therapy is not a one-size-fits-all issue.

Addressing the Root Cause: Our Ayurvedic treatment looks deeply into the underlying causes of diabetes, which can differ greatly across individuals. Diet, lifestyle, stress, heredity, prakriti and dosha (constitution) imbalances are all issues to consider. We can create a thorough plan by recognising these fundamental concerns.

Personalized Vedic Diet: Nutrition programmes that are tailored to promote general balance and blood sugar management.

Ayurvedic herbs and supplements that address specific imbalances and promote metabolic health are known as proprietary herbal remedies.

Recommendations for Stress Reduction, Physical Activity, and Mindful Practises such as Yoga and Meditation

Ongoing revisions to the treatment plan as the client develops on their path to reversal.

Distinguishing Factors: At DRC, our Ayurvedic diabetes reversal approach is built on personalized treatments that probe into fundamental causes for remission rather than simple symptom relief. Individualized treatments based on “prakruti” are essential.Our proprietary Ayurvedic herbal preparations are personalized to each individual. All of our medications are freshly made to preserve the efficacy of the herbs used. As a result, we are able to show better and more consistent results.

Start your Diabetes Reversal journey & Treat your Diabetes Safely

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