CGMs Part 2 - My observations and takeaways
In a previous post, I spoke a bit about why you (even if you do not have diabetes or a known blood sugar issue) might consider wearing a CGM. If you are not clear on what CGMs are, you can read the original post here.
In this article, I will share my observations and takeaways from wearing a continuous glucose monitor for two weeks.
Sleep matters.
Sleep is vitally important for so many aspects of our health and well-being. Blood sugar regulation is not different. Sleep disruption (even for brief periods) is associated with insulin resistance.
I found that following a night of short or disrupted sleep, my blood sugars would fluctuate more, and the glucose spikes seen with carbohydrates were much higher.
For instance, the steel-cut oats that I had on a night following short sleep resulted in a glucose spike of more than 60 points - blood sugar spikes following a meal in the range of 30 points are often considered optimal.
The same breakfast after a solid night’s sleep led to much more modest spikes.
Foods that are low in calories can still spike your blood sugar.
One of the foods that I found spiked my blood sugar the most was a very thin rice cake that I had gotten into the habit of eating as a snack. They are made from brown rice and organic. Each cake only contains 30 calories. I often eat 5 with almond butter, avocado mash, or a little goat cheese for a snack.
I was surprised to find that almost more than anything else I ate (including some sweets), these little cakes regularly resulted in blood sugar spikes of 40 points or more.
Eating vegetables first led to fewer blood sugar spikes
I often have had a practice of eating a big plate of steamed broccoli or some other vegetable before going to a party or going out to eat. I did this because having a pleasant sense of fullness from the vegetables allowed me to be more measured in my choices than if I had arrived at the party or dinner ravenous.
This is a trick that Jessie Inchauspé (aka the Glucose Goddess), a biochemist and author who has written and blogged extensively about the use of CGMs, recommends to help prevent glucose spikes. I, too, found that when I began my meal with a high fiber, low carb vegetable, my blood sugar spiked less than eating the same food, but in a different order (for instance, eating the carbs first).
Eating dessert (even a large one) after a meal did not spike my blood sugar.
Again, I got the idea to try this approach from the strategies that Inchauspé recommends. I appreciate these strategies because they are not about food restriction but rather about being aware of the order in which certain foods are eaten to manage blood sugar spikes better.
During my trial, I found that when I ate sweets immediately following a meal, I did not notice any sharp spikes in my blood sugar.
Below is a picture below of one of these meals. I will make a couple of caveats that the sweets I eat tend to be free of gluten and white sugar. They are often made with nut butter or almond flour, so there is a good deal more fiber and fat than one might find in other confections. Except for some dark chocolate, I did not eat any conventional sweets during this trial, so I cannot comment on their impact. But here are links to the recipes for a couple of my favorite gluten-free cookies. The first is for a delicious chocolate cookie made with almond butter, and the second is for vegan ginger cookies (<< everyone loves these, and they are super easy to make.
CGM Report showing continuous glocuse readings at various points in the day. The table at the bottom shows maximal and minimal blood sugar within each 1-hour increment of time. The first red arrow shows time I ate mid-day meal followed by a large desert of 2 cookies (2nd red arrow). Over the next 3 hours blood sugars spoked less than 30 points from their pre-meal baseline.
Eating protein and carbs for breakfast - think eggs and veggies etc, really do keep your blood sugar stable. This sets the stage for fewer cravings during the day as those blood sugar spikes usually drive that urge to snack. If you eat meat and eggs, it can be pretty easy to compose a low-carb breakfast, if you are plant-based, it is also an option. Here is a link to some high protein, low carb plant-based breakfasts.
If I paid attention, I had some awareness of when my sugars were spiking even though they were still firmly in the normal range. The sensations were subtle: a slight sense of increased thirst, a subtle sense of lightness and expansion in my head, when the blood sugars were trending up towards their spike - which could be in the range of the 130s or 160s - still considered well within the normal territory for after-meal blood sugar. When my blood sugar started to head down again, this might signal a vague sense of wanting to snack on something. Again, my blood sugar was still firmly in the normal range.
I should note that these subtle cues were less or non-existent when my blood sugar spikes were minimized with some of the abovementioned strategies.
This was interesting and underscores one of the potential benefits of wearing a CGM - using it as a tool to increase your awareness of these subtle cues. This is information that, when you learn to tune into it you can use to guide choices even when you are not wearing a CGM.
So, in summary, my big takeaways were:
Sleep is foundational. Prioritize getting enough sleep, which will increase your body’s ability to manage your blood sugar and everything else.
Calories are not a key indicator of how food impacts blood sugar control (or even weight management if that is one of your goals). The science on this is more and more clear. But it was nice to see it so concretely displayed.
Eat a high-protein breakfast when you can. It sets the tone for the rest of the day.
Have a general approach to guide your choices, e.g., get those veggies in first if you can, try to avoid eating deserts as snacks. But also leave room for fun, spontaneity, and special occasions.
Let me know if you have questions!
To your health🌿 Dr. Nicole
