Lessons Learned From 90 Days with a CGM

After learning I am borderline diabetic last summer I decided to take a deep dive on ways to halt the progression of the disease or even reverse it. With my history of heart disease and a family tree full of diabetics, I simply had to put my foot down and proactively nip this thing in the bud. One thing is clear though: the Internet is awash with miracle cures, nonscientific diets, and plain old bull puckity.

Diabetes is a fairly simple thing to diagnose. A fasting blood sugar level of 126 mg/dL or higher or an A1C of 6.5% or more indicates you have diabetes. My fasting glucose levels had been creeping up for years, and my A1C finally reached close to 6.5% last summer. I was no longer pre-diabetic— according to my physician, I had the disease.

So I did the research. I read articles, and books, and watched podcasts. I tried to separate the wheat from the chaff. What was causing the rise in my glucose levels and what could I do to bring them down?

A few things I read made the case that I should try wearing a continuous glucose monitor for a few months to see what foods raised my sugars. Everyone is different, so it made sense to give it a try. My doctor agreed and she wrote me a prescription for a Freestyle Libre 3 and while it was not covered by insurance as I had not yet been formally diagnosed as diabetic it was only $80 or so for a one-month supply. I picked it up, popped it onto the back of my arm, and downloaded the app to my phone. What happened next has changed my life.

The very first meal I ate after attaching it was an eye-opener. I was out doing some shopping at the mall and I stopped into a Mediterranean place and ordered what I thought was a healthy dinner. It was a vegan wrap, with hummus, lemon-herb tahini, green pepper, tomato, cucumber, roasted corn, pickled onions, crispy garbanzos, romaine, cabbage, and falafel. Within an hour, my glucose levels spiked off the charts to more than 200 mg/dL.

What did I do wrong? After I got home I looked up the nutrition of the wrap and it turned out it had more than 119 grams of carbohydrates! Carbs are broken down into sugars, and if you are insulin resistant like me your blood glucose will most definitely spike. The carbs in the wrap came from the wrap itself, the garbanzos, and the falafel.

Over the next few weeks and months, I adjusted what I ate to contain much fewer carbs, but I also experimented a bit with my system to see what spiked my sugars. If I had an apple, my sugars spiked. If I had an apple with peanut butter, it spiked less. If I had a basic beer, like a lager, no movement. When I had a wheat beer, my sugars went through the roof. Bread of any kind — from Ezekiel to “low net carb” Hero bread spiked my sugars. Seed crackers, no spike.

The bottom line is the fewer carbs I ate, the better my glucose levels. It’s not rocket science, but I still learned a ton. Not all carbs are alike, and not all carbs spike your sugars. But what I learned is that even a small amount of “bad” carbs raises my glucose levels too much so there’s no workaround. I need to stay away from bread and pasta and rice and potatoes. I’d read sweet potatoes are better than russet potatoes, but both spiked my sugars. The ONLY rice that didn’t spike my sugars was riced cauliflower. No bread, not even the so-called low-net carbs bread, worked for me.

I will say that I also learned that not eating enough carbs has a downside. I tend to be a black or white person, so for a while, I just didn’t eat any carbs at all. That caused hypoglycemia, which drained me of energy and ultimately can kill a person. You have to eat carbs — you just have to choose the right ones.

These carbs, especially along with protein and fat, did not spike my sugars: asparagus; broccoli; cauliflower; Brussels sprouts; berries; lentils and beans in small portions; green beans; leafy greens; tofu; nuts. Of course, veggies veggies, and more veggies. But I can and now do eat lots of protein and fat. In fact, I sort of have a new appreciation for meat. I no longer shy away from a little beef or pork, and I eat plenty of fish and poultry. I eat lactose-free cheese (because I’m lactose intolerant) and nut butter like they’re going out of style. Lactose-free dairy yogurt has become a new standard. A word about yogurt — most of it is loaded with sugar and the dairy-free ones have a lot of carbs. Chobani Zero is my go-to.

A few other powerful learnings from the CGM experiment:

• Aerobic exercise, even a moderate amount (20 minutes) of walking after a meal immediately brings my glucose level down. Exercise has such a dramatic effect on glucose I now ensure I eat some almond butter or a cheese stick before I go for a walk so my glucose doesn’t go too low.

• Quinoa is not a low-carb food. I thought it wouldn’t do anything to my glucose but it spikes it.

• Sugar of any kind raises your glucose (sugar, honey, agave). I have found some products made with monk fruit that I like. Stevia is OK in moderation but I find it bitter. Allulose is the new natural sugar substitute that is popping up all over and it tastes great and doesn’t affect my sugars.

• Not all alcohol is the same. For me, a couple of beers or glasses of wine don’t spike my sugars (except for the aforementioned wheat beer). Hard alcohol without sugary mixers is fine. So much for my favorite, the margarita. But ranch water (Top Chico and Tequila) is fine.

• Jessie Inchauspé, aka the Glucose Goddess, is brilliant. Her hacks to keep your glucose from spiking work, though she doesn’t have diabetes or pre-diabetes so while she can down a little vinegar before eating a slice of cake I’ll probably just not eat cake.

I go back to my doctor in a few weeks to get new bloodwork. I fully expect my A1C to be below pre-diabetes levels now after clicking up into the diabetic range. I also have noticed my fasting glucose levels going lower — I can see this on the CGM when I wake up. They were creeping up into the 120s but over the past few weeks, I’ve seen them mostly in the 100-109 range or even lower. I have also lost weight as a result of eating this way. Losing weight was not a major reason for working on my sugars, but I have lost about 10-12 pounds in these first few months and my pants are now very loose. It’s a nice side effect and I would ultimately like to get down to a good weight for my body shape which would mean a total loss of around 20-25 pounds so I’m on my way.

The thing is, I’m eating plenty of food now I just eat different foods. An omelet for breakfast is great and keeps me full until lunch. I will eat a salad with protein for lunch, or lunch meat wraps (no bread, just ham or turkey rolled up around cheese). Dinner is a low-carb meal, maybe fish with veggies or tofu stir fry. Snacks now are carrots with peanut butter or hummus, a cheese stick, a hard-boiled egg, or a serving of cashews. Popcorn, my old standby, spiked my sugar. I carry low-carb protein bars with me now, or jerky. Or little packets of nut butter.

Will all this help me live longer? I hope so, but even more than that I do not want to live as a diabetic. I’ve seen people suffer from this disease, including my father, and it’s no way to live let alone die.

Last summer’s diabetes scare was a turning point for me. I even started exercising (just walking) pretty much every day. I have lots of plans for the next 25 years of my life and I want to not only be alive to enjoy those plans but also be healthy enough to enjoy them.

Even if you don’t have diabetes or pre-diabetes, consider trying out a CGM for a few months. It will change the way you think about food.