CGM for Weight Loss
Follow these steps to use a CGM to help you eat correctly.
a. Check sugars and or swipe at least every 8 hours so that we can see a 24 hour period of time as each swipe records the previous 8 hours
b. When you eat anything, google the grams of carbohydrates in the item and make a mental note. Remember to stick to the amount specified by Dr. Jogi for your individual situation
c. Swipe every 5-10 minutes after eating and you will see a real time rise in your blood sugars. You can stop swiping after the blood sugars start to go down
d. Make mental notes of the amount and type of "sinister food" you just ate if it causes your blood sugars to rise about 130. Then next time eat less of that type of food or avoid it. Goal is to remain within a range of 60 to 130 at all times
e. You can reduce the rise in the blood sugars of a known "sinister foods" by pre-eating a bowl of steamed or grilled Broccoli 30 min to 1 hour prior to the sinister food intake. This can reduce the rise in blood sugar by 30%
f. If the blood sugars alarm for low sugars, please ignore it (do not eat to bring it up) unless you are taking a medication that can lower blood sugars such asa sulfonylurea or insulin.
Insulin is the primary hormone that directs the body to store fat. The best ways to reduce insulin levels in the body are
Not eating (see fasting protocols - www.medhavijogi.com/blog/weight-loss-ideas )
From Ann Tholen, registered dietician:
Proper nutrition not only has the ability to control our blood sugars, insulin levels and risk for diabetes mellitus, but can also prevent high cholesterol, hypertension, cancer, inflammation and boost immunity. Keep this objective at the forefront when using the CGM to best promote all aspects of a healthy lifestyle including diet. For instance, if you find that the 2 packets of flavored instant oatmeal you were eating because you “thought it was healthy” for breakfast spikes you blood sugar more than grabbing a poptart running out the door, don’t instantly swap the meal for a poptart. Use the CGM as a prompt or warning siren to investigate your foods further. Instead ask these questions:
Did the food have added sugars you were not aware of? Look closer at the nutrition facts. Read for “added sugars.” Foods should ideally offer 0 grams of added sugars and ideally no more than5 grams per serving when keeping in mind the average woman needs no more than 24 grams per day and a man needs no more than 36 grams per day. This can add up fast in day since most foods now offer a surplus of added sugars. That instant oatmeal as it turns out offers 12 grams added sugar per packet.
What was the total carbohydrate per serving and did it fit into your tailored carbohydrate goals? Speak with your doctor or Registered Dietitian to have a meal plan and macros tailored for your individual needs.
Are there ways to incorporate healthier and less processed convenience versions of these foods? Often “instant” foods are made to cook and break down faster and will enter the bloodstream in a similar way. Did you know there are ways to make foods more resistant starches that will lower postprandial response?
Could perhaps a smaller portion of the food be eaten and balanced with more fiber, healthy fat and protein to have allowed for better glycemic control? Adding foods such nuts, avocado, and high fiber vegetables can lower the postprandial peak after meals.
Are there other factors at play affecting your readings such as stress, poor sleep, insulin resistance from sedentary lifestyle that also need to be addressed?
And finally, ask yourself, is this food promoting my health in some way either with phytonutrients, fiber, vitamins or minerals? If not, is it worth keeping?
This is a lot of work
In a patient with a BMI more than 24.0 this can be a lot of work since it is a change in lifestyle away from a carbohydrate-centric and excess consumption. Seeing a doctor every few months for lab work can be too long for immediate feedback and the weight loss may lag behind your efforts which can be frustrating
Realizing that blood sugar is a surrogate marker of insulin levels (in a patient not on insulin or hypoglycemic agents like sulfonylureas, we can use a continuous glucose meter as a real-time marker of your diet.)
CGM technology has been around since 2010 and has been used in diabetes. Insurance will pay for devices in diabetes patients but until recently the cost was too prohibitive for off label use in nondiabetic patients
If you have a smart phone then either a Freestyle Libre or Libre2 or Libre3 device is $75 cash every 2 weeks and can be very helpful to identify weaknesses in your diet. This sensor is prescribed by your physician to your local pharmacy. If the price is higher with your insurance or not covered then use goodrx to get a lower price instead
Freestyle libre1 (no alerts to your phone)
Freestyle libre2 (sends alerts to your iphone, requires pulling data manually)
Freestyle libre3 (automatically pushes data to your phone and gives alerts)
Then purchase the "Freesyle Libre" smart phone app to connect to your sensor via bluetooth,