The FDA has approved the Dexcom Stelo Glucose Biosensor System, the first over-the-counter (OTC) continuous glucose monitor (CGM) system. This device is intended for adults 18+ who manage diabetes with oral medications, or do not use insulin, as well as individuals without diabetes who wish to monitor how diet and exercise affect blood sugar levels.
Some see this as a win for increased healthcare accessibility and another way for individuals to be empowered with knowledge about their health, while others worry about a new wave of health anxiety and health misinformation. Could both be true? Here are our tips for addressing nutrition-related questions from patients about OTC CGMs, and whether they are helpful or harmful.
Benefits to OTC CGMs
- More accessible: OTC CGMs don’t require prescriptions, so they are more accessible, especially for non-insulin dependent Type 2 Diabetes and pre-diabetes patients.
- Enhanced patient empowerment: CGMs allow patients to monitor blood sugar more regularly, empowering them to make informed decisions about diet and lifestyle, potentially improving glycemic control and outcomes.
- Improved health outcomes: Studies show CGMs can reduce HbA1c levels in both Type 1 and Type 2 diabetes patients.
Potential Drawbacks to OTC CGMs
- Overuse & misuse: Not everyone needs continuous glucose monitoring. Constant health data access can be detrimental to those with eating disorders and/or health-related anxiety.
- Inaccuracy & lack of guidance: There may be discrepancies between sensor glucose levels and blood glucose. Using CGMs without professional guidance can lead to misinterpretation of data.
- Cost concerns: OTC CGMs are expensive, and there are concerns that OTC access may limit insurance coverage for those who need it in the future.
Nutrition Basics for OTC CGM Monitoring
Nutrition education plays a crucial role in the effective use of CGMs, particularly in helping patients understand how dietary choices impact their blood sugar levels. Here’s how registered dietitians can support patients using CGMs:
- Understanding Glycemic Impact: Educate patients on the concept of glycemic index (GI) and glycemic load (GL) of foods to promote more stable glucose.
- Meal Timing and Composition: Talk to patients about the importance of meal timing and composition. Encourage regular, balanced meals that include lean proteins, healthy fats, and complex carbohydrates to minimize glucose spikes and support sustained energy levels. Personalize meal timing and composition based on CGM data.
- Effect of Fiber: Emphasize the role of dietary fiber in slowing down glucose absorption and promoting satiety. Educate patients on nutrient-dense choices that provide essential vitamins and minerals without causing rapid spikes in blood sugar.
- Monitoring Patterns: Teach patients to analyze CGM patterns related to meals, identifying how specific foods impact their glucose levels. This awareness helps them make informed adjustments to their diet to achieve better overall glycemic control.
- Behavioral Strategies: Address behavioral strategies such as mindful eating, stress management, and regular physical activity. These practices can complement dietary changes and contribute to more stable blood sugar levels observed through CGM data.
- Goal Setting and Monitoring: Collaborate with patients to set realistic nutrition goals based on CGM feedback. Regularly review progress and adjust recommendations as needed to optimize nutritional support and achieve desired health outcomes.
By integrating comprehensive nutrition education into CGM management, healthcare providers can empower patients to make informed dietary decisions, improve glucose control, and enhance overall health and well-being. This approach fosters a proactive partnership between patients and healthcare teams, leveraging CGM technology to its fullest potential.
Refer Your Patients to a Registered Dietitian
Culina Health is proud to be trusted by over 1,000 referring physicians nationwide. We are in-network with most major insurance plans, and our diverse team of registered dietitians provides patient-centered and evidence-based care that supports patients and builds upon the work they’re doing with primary care providers and specialists. Learn more about how we make referrals seamless here and email us at partners@culinahealth.com to learn more about referring a patient.
