Diabetes is incredibly common. According to the American Diabetes Association, around 7 million people in the United States are undiagnosed, with 1 in 3 Americans at risk for developing type 2 diabetes. If you do not go on medication, you can manage the condition—a chronic metabolic disease that’s characterized by elevated blood sugar levels—by exercising and watching what you eat (very, very closely).
In the past few years, the tools that diabetics use to help manage their condition have become more widely available. Continuous glucose monitors (CGMs) like the Abbott Lingo and the Dexcom Stelo used to be available only by prescription. Now that you can buy them on Amazon, more and more people are realizing that eating like a diabetic isn’t a bad idea. It’s not revolutionary to say that prioritizing lean protein and fiber-rich vegetables and developing an exercise habit helps you get leaner.
You can buy a Stelo or Lingo sensor a la carte, so to speak. Each comes with their own proprietary apps, and both also partner with a wide variety of fitness trackers to let you easily track your glucose. Signos is a separate service that partners with Dexcom to use the Stelo sensors. A Signos monthly subscription includes two sensors (you have to replace the sensor every two weeks) and access to the AI-enabled weight loss management platform that offers insights, and plans, in addition to 24/7 glucose tracking.
Full disclosure: I am not actively trying to lose weight, but I am aware that my eating habits could be healthier. I was expecting to be more skeptical about this, given that when I’ve tried CGMs in the past, I have absolutely lost my mind. But speaking with a dietitian while testing Signos gave me a different perspective.
How to Use
Photograph: Adrienne So
First, you install the Signos app on your phone (iOS, Android). Then you put the CGM in your skin. CGMs work by using a dispenser to put a tiny needle just in your subcutaneous tissue to measure glucose in your interstitial fluid (ISF). (Every company calls this a filament to make it less scary, but yes, it's a needle.)
CGMs are a bit tricker to use than the traditional finger-prick blood tests. (The gold standard is the venous blood draw, but I have had quite enough of those for the time being.) It takes time for glucose to diffuse into your ISF, and the readings can vary a lot.
According to Diane Stadler, a registered dietitian and professor at Oregon Health & Science University, there are a few general rules of thumb when it comes to placement:
- Put it in your nondominant arm.
- Put it in a place where it’s not going to get compressed at night.
- Put it in a place where it’s not going to get bumped a lot.
For example, I know you’re supposed to put it in your nondominant arm, but I am also leery of sticking too many more needles into my tattoo. This time, I placed the Stelo in my dominant (tattoo-less) right arm and got readings that were, alarmingly, 10 to 25 percent higher than they were with my left arm. I just used my readings as a baseline to note spikes.
In general, as someone without diabetes, you want your fasting blood sugar (when you haven’t eaten for at least eight hours) to be below 100 mg/dL. You want your spikes to be below 180 mg/dL, to lower the number of spikes per day, and for them to return to your baseline within two hours.
Thousands of Peanuts
Courtesy of Signos
Signos (Promo Code WIRED)
When you log in to Signos, it shows you your continuous glucose readings and prompts you to log everything from your meals, exercise, weight, sleep, water, and other tags. (It also connects to other third-party apps so you don't have to log everything by hand.) These features are not anything that you can’t get from the Abbott or Lingo apps, which also offer similar AI-enabled food logging, where you take a picture of what you’re eating and it estimates what and how much you ate, and what the impact will be on your glucose levels.
What Signos offers is very personalized insights and activities. As you log your behaviors, it begins to spot patterns and nudge you to change them—for example, certain meals that regularly produce big glucose spikes. It also starts unlocking little challenges. I got really stuck on one early challenge to take 30 minutes to eat a meal. It’s one thing to sit around a table with your family for an hour during dinner, but I’m not eating that whole time. I skipped this one.
As someone who is not accustomed to tracking what I eat so closely, using Signos felt like it added an overwhelming amount of mental labor to my day. Signos’ AI is smart, but not that smart. During one dinner, both my daughter and husband yelled at me for tapping away on my phone correcting Signos’ AI-enabled meal summary (I was eating a cheddar biscuit, not eggs; green onions on slices of chicken, not asparagus) instead of talking to them.
I also occasionally had trouble correcting amounts. Signos absolutely refused to believe that I would have eaten less than 35 peanuts a serving. To be fair, my family has trouble believing this about me, too.
ScreenshotSignos via Adrienne So
ScreenshotSignos via Adrienne So
As someone who regularly exercises and is a normal weight, I am not the target audience. For more perspective, I reached out to Stadler. To my surprise, she and many other dietitians are very much in favor of CGMs to manage weight loss. Stadler pointed out that about 90 percent of her grad school students approve of their patients getting this data.
“I am a strong proponent of using technology to increase the amount of information that people can handle to make better lifestyle changes,” Stadler said in a phone call.
Of course it’s possible that using a CGM could push you into unhealthy habits, but so can any health tech. So can smart scales or fitness trackers. “People with disordered eating have a disorder,” Stadler gently reminded me; they’re not the general population. A diabetic diet closely resembles a DASH diet or a Mediterranean diet, both generally recognized as healthy diets that help you lose weight.
“I really, hope this technology will be widely used and with support, either through this app or through dietitians or primary care providers,” she said.
Every time I wear a CGM, I learn so many things about my personal metabolism. For example, stress—including the stress of having to log your food all the time!—can make your glucose measurements skyrocket. Your glucose measurements also rise when you’re PMSing (that’s why you crave salty, sugary things and want to sleep all the time!).
Unlike following a standardized diet or exercise plan that's not made for you personally, a real-time biosensor like a CGM can give you very personalized tips. In the past two weeks, I bought cottage cheese for breakfast to replace my glucose-spiking Raisin Bran. I started walking up and down the stairs or around the block after every meal to lower and shorten spikes. Eating smaller meals also makes spikes shorten in duration. These are all easy habits that don't require lifelong medication.
As the Reviews health and fitness editor, I cover a lot of products of dubious veracity and utility, but both clinicians and consumers emphasize the fact that a glucose monitor really can improve quality of life for many people. It's really rare to speak to an expert who is so enthusiastic about a technology. If you need to lose weight and need guidance, a CGM is a more promising technology to try.
Abbott
Lingo Continuous Glucose Monitor
Dexcom
Stelo
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