Continuous Glucose Monitors for One and All?

Advertising Poster for Moser WatchesTo each his own – because truly, one size will never fit all. We can find no better illustration for this than the idea that perfectly healthy people might want to wear a continuous glucose monitors. And yet we have a crop of new tech startups that want to put these glucose monitors on all of us to help us compulsively evaluate our lifestyles.

Casey Means is a co-founder and chief medical officer at one of these startups – Levels. She describes this as a dream come true:

“We’ve had trackers for many other things like sleep, stress and fitness. But a continuous glucose monitor measures an internal biomarker like a tiny lab on our arms. This is the first time it’s been used for a mainstream population for the specific purpose of making lifestyle decisions.”

A tour through the company’s website will give you a glimpse of obsession with metabolic fitness. Metabolism is life! Are you fueling correctly? For peak athletic performance, fueling your body is everything.

Sharply Contrasting Views of Self-Monitoring

What feels like a dream for Means, though, might be more of a nightmare for someone like Lindsay Crouse. She writes that she ditched her smartwatch and feels great about it. She did it because self-monitoring had become a kind of dependency:

“With my smart watch, sometimes I would wake up in the morning and check my app to see how I slept – instead of just taking a moment to notice that I was still tired. When I discovered that my watch could measure my stress levels, it was as if I’d started carrying around an expensive psychological pyramid scheme on my wrist. The more I used my watch to monitor my stress, the higher my stress levels rose.”

In short, it was not helping her sense of wellbeing.

Tool or Burden?

The line between a tool and a burden is sometimes very fuzzy. Self-monitoring can help with health. It’s very useful for keeping diabetes under control. It helps many people maintain a healthy body weight. But it can also become burdensome, or even harmful. Carolyn Plateau and colleagues, for example, found features of compulsive eating and exercise pathology among users of this kind of technology.

Rachael Kent found “powerful compulsions” to use these technologies when they linked up with social media. At this point, observations about the benefits and risks of self-monitoring are mostly anecdotal, but worth watching.

It is easy for our possessions to possess us. When that possession is a self-monitoring device, it might not only possess us, but also obsess us. So maybe not all of us need a continuous glucose monitor.

Click here, here, here, and here for diverse views of self-monitoring.

Advertising Poster for Moser Watches, illustration by Alexander Rodchenko / WikiArt

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February 12, 2022

3 Responses to “Continuous Glucose Monitors for One and All?”

  1. February 12, 2022 at 7:11 am, Al Lewis said:

    Choosing Wisely recommends that people with diabetes monitor less than once a day for many of the reasons above – stress and false positives.

    Neither they nor US Preventive Services Task Force have recommendations for non-diabetis monitoring, for the simple reason that it never occurred to them that anyone would want to do such a thing.

  2. February 12, 2022 at 8:40 am, Monica Reinagel said:

    Great insights here. You might also be interested in this recent conversation I had with Gabe Smolarz on the off label use of CGMs as a biohacking tool.

    After we published this interview, I received a very poignant email from someone with type 1 diabetes who has struggled to get her insurance company to cover a CGM to allow her to better manage her disease, and who felt some understandable resentment about these devices being turned into playthings.

    • February 12, 2022 at 9:55 am, Ted said:

      Very helpful perspective, Monica.