‘We love this fairly low-risk intervention’: Over-the-counter device is helping people gain insight into their health

Haley Hernandez, Health Reporter

HOUSTON, Texas – As of this summer, continuous glucose monitors (CGM) are now available over-the-counter for the first time.

The devices are used to monitor blood sugar in people with diabetes, but now, more people are using them who don’t have diabetes.

Owais Durrani is a Houston area doctor who stays up-to-date on health news, but why he chose to start wearing a continuous glucose monitor might surprise you.

“We have to measure everything, right? Our steps, our heart rate, we wear our fancy watches to exercise. So I think data is good if you know what to do with it,” Durrani said.

Understanding the data is key, according to Dr. Arti Thangudu, an endocrinologist who regularly prescribes CGM.

“It helps track patterns. In the past, we used to have just capillary blood glucose, right? People were checking their blood sugars once a day in the morning or a couple of times a day. Or maybe they weren’t at all, because that’s really annoying, right? It’s annoying to prick your fingers. It’s painful. So, now these devices that people don’t even have to do anything for, they’re just there and they stay there for several days. They don’t have to change it every day, just giving them that blood sugar information all the time and they can share that with their clinician to assess patterns,” Thangudu explained.

Unless you’re working closely with a provider who can help you interpret the patterns in glucose spikes, Thangudu worries this could drive people to make the wrong nutrition choices.

“You know, you can’t eat it thinking that it’s healthy because your blood sugar doesn’t move,” she said, using bacon as an example. “You have to look at blood sugar with the whole person and the whole clinical picture to make an assessment of their nutrition and their diet.”

However, she thinks some patients could seriously benefit from wearing a continuous glucose monitor, particularly those with metabolic complications like pre-diabetes or polycystic ovary syndrome (PCOS), especially since she thinks some people may have diabetes and don’t realize it.

“Alerting people that they might have a metabolic disease if their average blood sugar is like 150 and they had no idea, then it might be very useful for that person to get a further evaluation. There are some risks to having a continuous glucose monitoring system. If you don’t have diabetes or any sort of metabolic disease the devices are not measuring a direct blood sugar, right? They’re measuring interstitial fluid, which at times can be inaccurate, and very low blood sugars and very high blood sugars. We recommend that our patients check with a fingerstick blood sugar to make sure that what is being read off of the CGM is actually accurate,” Thangudu said.

Durrani said the device helped motivate him to make consistent healthy choices.

“Nothing groundbreaking, but I’ve learned that you know, when maybe I do have that unhealthy meal and if I workout after that, my blood glucose levels come back to a much normal level, much quicker than if I just sat on the couch and watched some TV. So, it’s not that this is any new information. We’ve known this for decades, but I think when you see it happening within yourself it’s like, ‘Wow, my glucose is like 180 right now. I don’t want it to be 180. Maybe I’ll go for a walk and make it lower.’ I think that if it’s enforcing good patterns and good behavior if you wear this once or twice, you enforce those behaviors, and hopefully, live a longer, healthier life,” Durrani said. “I know carbs are going to raise your blood glucose level. I just didn’t realize how much more times it raised your glucose level compared to like a less carby meal, like, say, a plate of rice compared to salmon and some vegetables.

“We see patients say, my gosh, when I walk, my blood sugar is much lower. I’m going to keep doing that. And we love that. We love this fairly low-risk intervention, helping patients make lifestyle changes. That’s that’s a truly beautiful tool,” Thangudu said.

The Dexcom device called Stelo is the first over-the-counter CGM and costs $99. They’re typically made to be replaced after a couple of weeks.

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