This essay is written by a member of the CIHAS team, Jennifer Nash.
So porridge makes my blood sugars go high in the morning. How high is ok? It’s a pretty steep spike, shouldn’t it be a flatter curve? Maybe I should swap cow’s milk for oat milk? And add nut butter, and fruit. Fruit has fibre, is that good for blood sugars? But fruit’s also full of sugar. Ok, no porridge, I’ll have eggs tomorrow. But can I have bread with them?
I was diagnosed with type one diabetes when I was 20, two days before I returned to university to start my final year of an undergraduate degree. I’ve tracked my blood sugar, testing at least five times a day, for 15 years. About nine years ago, when I started thinking about trying to conceive, I began wearing a continuous glucose monitor (CGM) on the advice of my diabetes team. They suggested a CGM could help me better understand my blood sugar patterns and lower my HbA1c (a blood test that gives an idea of your average blood sugar levels over the past three months), since women with type one diabetes are advised to have ‘as close to normal’ blood sugars as possible both pre- and during pregnancy. I’ve had a CGM ever since - through three pregnancies and now into the chaos of life with young kids - a little white disc attached to the back of my arm by a tiny sensor filament, which graciously sends my blood sugar readings to an app on my phone.
Without a doubt it’s changed my life. Before my little white disc, I was pricking my fingers at least 4 or 5 times a day, carefully squeezing a tiny drop of blood onto a test strip to get a singular blood glucose (BG) reading. Admittedly, this method was quicker and less laborious than than the urine testing of the pre-1980s, but still a pain-in-the-finger to do multiple times a day, sometimes in the middle of the night, and once when wearing a pristine white wedding dress, desperately trying not to drip blood onto it.
CGMs have been around since 1999, with the first CGM system released by Medtronic, one which read BG levels over a three day period. CGMs nowadays are even smarter and have revolutionised BG monitoring for diabetics. Not only do they mean no more finger pricks, but these small, pain-free devices can track BG levels in real time, accompanied with a trend arrow to show whether your BG is moving up or down, and how quickly. They also alert you (or a caregiver) to high and low BGs. In the UK, CGMs are available on the NHS for those with type one diabetes, and for those with type two diabetes who meet a certain criteria. A serious game changer for those of us trying to rein in those pesky BGs.
Sweet Life for Unsplash+
The ‘missing link’ in your metabolic health
The same Freestyle Libre disc (manufactured by Abbott) that I’ve been wearing on my arm for the past near-decade now forms part of personalised nutrition company ZOE’s at-home test kit. Abbott sells the same CGM under the name Lingo, marketed to non-diabetics as a tool for ‘metabolic awareness’. The company Supersapiens offers CGMs for performance-focused athletes to ‘master your metabolism’. Levels Health, NutriSense, Veri, Signos, the list goes on. They market their devices with similar approaches: founded on science, this cutting-edge technology is designed to help you understand how your blood sugar levels respond to your lifestyle - the food you eat, how much sleep you’re getting, the exercise you’re doing, your stress management (or lack thereof). In return for your BG data, these platforms give you glucose trend analysis, exercise insights and scores for your food choices. No longer a medical device to help those with a diagnosed condition, this is an integrated lifestyle tool designed to seamlessly fit your wellness routine and help you meet your health goals. Lingo promises to fix the ‘glucose gap’ - bridging the gap between how Britons feel and what their bodies are telling them.
Most of the CIHAS community might recognise the marketing of these CGMs as another iteration of a neoliberal healthist narrative, which turns health into a moral imperative and individual responsibility within capitalist societies. If you could simply understand what your blood glucose is doing, then you can do something about it and be healthy! Give us your BG readings, and we’ll give you ‘data-driven nutrition insights’ - the missing link in your metabolic health.
Having spent the last 15 years trying to make sense of all the data that diabetes throws at me - not only daily BG readings but HbA1c, cholesterol levels etc etc - I don’t want any more health data. I purposely avoid smart watches and sleep tracking (I dread to think with three young children). But it appears that ‘healthy’, non-diabetic individuals do want more data. 20% of global CGM sales are now to those without diabetes. With subscriptions costing around $100-$500 per month, the wellness CGM market was valued in 2024 at $329 million. According to this paper (CW: stigmatising language), people without diabetes using CGMs express their goals to be: 1) improved glucose patterns to avoid (pre)diabetes 2) peak mental or physical performance via optimal BG levels and 3) access to personal data to motivate healthy behavioural changes for nutrition and exercise.
