There are a few key areas to focus on when using a CGM.
These are Glucose Variability, the area under the curve (spike height + time it takes spike to return to baseline), Last Spike Hour, and Time in Range.
Glucose Variability (GV):
Refers to your spikes and dips in glucose throughout the day or how much higher or lower your glucose is compared to your average range. High glycemic variability is seen with impaired glucose tolerance (big jumps up and down over a short period of time). Signos defines a glucose “spike” as a quick rise in glucose of more than 30 mg/dL. Whether you are in your ideal range or outside of it, the change of +30 points or more is causing stress in your system. We may still notify you even when you are in your range if our algorithms detect your glucose is elevating very quickly and we have data on what you ate.
To learn more, check out this article.
Area Under the Curve:
Aim for steady rises, falls, and rounder curves—ideally, a less "noisy" graph. Your goal is to eat balanced meals that produce a spike of about +30 points rise or less most of the time and that come down back to baseline within two hours or less. It’s helpful to become aware of foods that contribute to spiking glucose more significantly and cause it to stay elevated for over two hours.
It’s critical to remember not all spikes are “bad.” Spikes are simply a way your body communicates with you about the impact of a behavior, like food, movement, sleep, or stress. You can determine how to respond to spikes more effectively as part of your weight management program, as responding to spikes and minimizing them when possible requires the same health behaviors that we know are key to weight management. Exercise, which is a positive health behavior for weight management, can cause glucose spikes, but that certainly doesn’t mean you should stop exercising!
Some foods, including complex carbohydrates like sweet potatoes or overnight oats can be part of a nutrient-dense diet. What can help with weight management is to pay close attention to processed foods in particular and what they do to your glucose, as they can contribute to weight gain.
The goal is NOT to avoid all carbs or sugars. Apples, for instance, may contribute to a spike but are packed with vitamins and minerals for a strong, healthy body. You'll notice that a whole fruit spike is generally smaller and drops quickly. So the more you can opt for whole foods compared to processed foods, the more stable your glucose will remain, which supports overall health. We rarely eat foods in complete isolation. It’s helpful to think about how to pair foods to reduce glycemic impact. For example, pairing almond butter with an apple for a snack can provide added protein and healthy fat in moderation which dampens the glucose spike that an apple by itself would have.
Last Spike Hour:
Our research thus far shows that members who have the last spike of the day about 3 hours or more before bedtime have better metabolic and weight outcomes. So plan your meals to be equal in size throughout the day or even get smaller or lower in carbs for the last meal of your day to avoid higher spikes in the evening.
Time in Range (TIR):
We see members have more success with their goals when they have a TIR of 85% or higher about 80% of the time.
As an added reference, our recommendations for glucose levels in healthy adults (people without Type 2 Diabetes):
- Fasting: <100 mg/dL (optimal is closer to 70-90 mg/dL)
- Before eating: 80-130 mg/dL
- Two hours after eating: <140 mg/dL
Our recommendations for people with Type 2 Diabetes per American Diabetes Association Guidelines:
- Before eating: 80-130 mg/dL
- Two hours after eating: <180 mg/dL (but aiming for lower is better for improving diabetes)
For more information, check out this blog post.
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