Medical Weight Loss Success
MedicalWeightLoss Success
3 Introduction
6 CGM benefits
6 CGM health data benefits, via its sensor and app
6 CGM Issues and Tips
7 Making sense of the CGM health data
7 Examples of people using CGMs 11 FAQs
Success with Medical Weight Loss requires commitment and a willingness to take action as you find out what works for you.
This journey is about Progress, Not Perfection. You can do it! Simply reading through this eBook and committing to using CGMs (Continuous Glucose Monitors) as part of your helpful tools for success with medical weight loss is a great first step.
Test, don’t guess about how your blood sugar reacts to all the aspects of your lifestyle. This is critical to being successful with your health goals, including releasing unwanted weight.
For example, people have bio-individual reactions to foods. There is no such thing as a “one size fits all” nutrition plan. What spikes one person’s blood sugar might not be a problem for another person.
A person's metabolism is affected by their:
hormonal balance
blood sugar reactions
insulin sensitivity
insulin resistance
PCOS
thyroid health
adrenal/stress response health
All of these factors play a role in weight gain, weight loss, and whether a person easily releases unwanted weight.
Some people might be more sensitive to the effects of stress, or poor sleep, meal timing, specific aspects of nutrition, exercise, and strength training on their blood sugar levels than others.
Please prioritize your own self-care so you regain your health, have plenty of energy and live a life you love.
We are with you every step of the way on your healing journey. Remember what matters.
Progress, not perfection. Your future self thanks you.
Best wishes,
Dr. Beverly Yates ND
CONTINUOUS GLUCOSE MONITORS ARE A GAME-CHANGER.
Being able to tell, in real time, how a person’s blood sugar is responding to their lifestyle and any medication is important.
Success with medical weight loss depends on a number of factors. Struggles with blood sugar make it harder to have sustained success with releasing unwanted weight, even if other factors are to be in the healthy range.
For a person who has challenges with weight loss, it is a win to gain insights into how the blood sugar levels are responding to:
• nutrition, including beverages
• different kinds of exercise
- walking
- strength training, resistance training, weight training
- Aerobic
- high-intensity interval training (HIIT)
- Interval training
• sleep
- Poor sleep
- Sleep apnea
- Insomnia
- Frequent awakening while sleeping
- Not enough hours spent asleep
- Erratic bedtimes
- Erratic awakening times
• stress levels
- trauma
- surgery
- loss of a loved one, grief
- financial or employment changes
- chronic stress
- other aspects of stress
• timing of eating meals
• travel and time zone changes
• unusual life events
• And other aspects of life that affect blood sugar levels.
With this health data, this info, you can become aware of what you are doing that keeps your blood sugar in a healthy range and what aspects of your lifestyle are causing blood sugar spikes, both the highs and the lows. These reactions can be the difference between success and failure with attempts at weight loss.
Sometimes people feel overwhelmed trying to make sense of the information from the CGM. Sometimes people are excited and energized to see what the CGM reveals. Looking at the CGM data and its insights holds people accountable for their lifestyle choices and it highlights what might be happening that someone had no idea was messing up their health. Hidden reactions to foods, beverages, sleep issues, stress, mental health, anxiety, depression and more can finally unlock the missing pieces to the weight lose puzzle.
The use of CGMs is growing rapidly. People who seek success with weight loss, who have diabetes, prediabetes, PCOS, or who want to improve their metabolism use CGMs for actionable insights. The CGM provides much needed insights and can guide lifestyle choices that create the outcome of healthy blood sugar levels. The CGM takes much of the mystery out of this.
Many people start out using glucometers as a way to test their blood sugar levels and keep track of these important health results. The reality of continual finger sticks to get the drops of blood for repeated testing makes the consistent use of a glucometer uncomfortable for most people; it hurts. And the ongoing costs of the test strips for the glucometer add a recurring expense too.
For these reasons and more, people prefer to use continuous glucose monitors - CGMs - to track their blood sugar results.
CGM benefits
The improvement over glucometers
• Convenience
• Reduce the need for fingersticks (& less pain), use of glucometers and their test strips
• The data can be tracked and shared with others
CGM health data benefits, via its sensor and app -
• Get the blood sugar data (without continual need for test strips, finger sticks, messiness, pain)
- Any time - Anywhere
• Store the data
• Share the data
• Review the data for trends and insights
• Gives you a more holistic, big picture view of how blood sugar affects you
• Provides insight into how your moods might be reflected in your blood sugar levels
• May result in more specific, personalized care
• Alert you to highs and lows in blood sugar levels
CGM Issues and Tips
• It can be a challenge to get the CGM to stay on the skin for the full length of time. You can buy protective “skins” or patches to place over/around it to help keep it in place longer.
• Some people have reactions on their skin at the CGM location site due to the adhesive on the back of the CGM.
• Before applying the CGM: be sure to prep the skin before application, by washing the skin, drying it, and wiping it with alcohol.
• Avoid doing sweaty things right before applying the new CGM so the skin is dry.
• Read the info that comes with the CGM and its sensor Check the manufacturer’s website and product packaging info for tips and recommendations.
• If you apply the new sensor before bedtime, be sure the warm-up time of the sensor is complete before you go to sleep.
Making sense of the CGM health data
Some things to consider as you review your CGM health data:
• If you are using insulin as part of your treatment, how does your blood sugar respond to your medication timing?
• Did a particular food spike the blood sugar result?
• Does a particular food combination spike the blood sugar result?
• Do feelings of stress cause high blood sugar levels?
• Does exercise affect your blood sugar levels?
• Does vigorous exercise cause a significant rise in your blood sugar levels?
• Does gentle exercise lower your blood sugar levels?
• Did poor sleep happen because of low blood sugar?
• If you awaken in the middle of the night, with your heart racing, and can’t get back to sleep, does this track with a blood sugar low, or a blood sugar high?
• Does the “hangry” feeling happen at the same time as low blood sugar?
• Does a late afternoon urge to snack happen at the same time as a high blood sugar reading?
• Does not drinking enough water, and being dehydrated, cause high blood sugar levels?
Take actions based on data - test don’t guess, 24/7 basis
Examples of people using CGMs
Let me share a few stories to explain why CGMs are such a game-changer for people who want to lose weight, have diabetes or blood sugar issues.
THE CGM REQUEST REFUSAL - SHIRLEY
Shirley had type 2 diabetes, needed to lose weight, and asked her doctor to prescribe a CGM for her so she could discover what she might be eating or doing that was keeping her blood sugar chronically high. To her shock and dismay, her doctor refused to prescribe a CGM.
What was the reason for this CGM prescription refusal?
In Shirley’s doctor’s opinion, her diabetes was “stable”; her A1C had stayed at 7.5 for years. To this doctor, Shirley’s diabetes was “well controlled,” and therefore, this doctor thought, she didn’t need a CGM. He also didn't think she needed to do anything else besides "eat less and move more" to lose weight. This doctor was unwilling to make more resources available to support her health goals.
Shirley did not agree with this. She wanted a better level of health for herself, and wanted to use the info from the CGM to guide her actions and the lifestyle elements that have the most influence on blood sugar, like her nutrition, meal timing, sleep, stress, and exercise.
Shirley had an A1C of 7.5 for years, and no matter what she did, her A1C didn’t budge. She tried her darnedest to get her A1C lower, with a goal of getting it back to a healthy range of under 5.6.
This refusal of a CGM prescription really upset Shirley. She felt like her doctor was not partnering with her to help her improve her health.
After all, if Shirley couldn’t find out what she might be eating or doing that was keeping her blood sugar chronically high, and making it much harder to lose weight, how was she supposed to fix it?
Good question
Shirley deserves to be healthy, and have her doctor and health team do their parts to help her reach her health goals.
We can’t change what we don’t measure. What gets measured, gets improved.
Without this life-affirming information from CGMs, diabetics and people who want to lose weight are left on their own to guess what to do to improve their health and get out of the dangerous zone of chronically high blood sugar levels. When things like this happen, I recommend that this person find another doctor or health professional who will authorize the prescription for a CGM (and any other helpful health data wearable or tool) so she can unlock the mysteries of how her body is responding to what she eats, drinks, her sleep, her exercise, her stress levels, and the timing of her meals.
Ultimately, someone who wants to lose weight, improve their metabolism, has diabetes or prediabetes is best served by working with those who will respect her wishes to be as healthy as possible.
FEELING OVERWHELMED BY CGM DATA - ROBERT
Robert has Type 1 diabetes, uses a CGM and an insulin pump. Using a CGM has overall been a big improvement in managing his diabetes, compared to a glucometer.
The CGM is a game-changer for sure. Not having to do numerous fingersticks a day was a relief.
But Robert noticed that having continuous info on his blood sugar levels at times felt overwhelming, and sometimes puzzling. Most of the time he found he understood how the CGM data matched his lifestyle and medications. And there were times when his blood sugar didn’t match what he was expecting, which was frustrating and confusing.
Robert asked his health team for help, but found that they were helpful when there was a blood sugar crisis, and not able to give him the level of support he wanted around how to interpret the CGM data that didn’t make sense to him.
Robert eventually realized he needed to seek out different health professionals who looked at him as a whole person, and could help with teasing apart what the CGM data was really trying to tell him. Naturopathic physicians (NDs, NMDs) and licensed Naturopathic Doctors address the whole person and how they live their life, addressing root causes when working with people to help them achieve their health goals.
Now he had clear guidance on what the CGM data meant, relative to his lifestyle, medication, nutrition, sleep, exercise, stress levels, and the timing of his meals. This let him better understand what the CGM data was telling him. This gave him the confidence to make adjustments as needed without feeling upset when he had a CGM reading or a series of readings that didn’t match what he expected to see. Robert came to understand more about what were normal variations, and where he needed to make immediate changes so he could stay well and avoid big health problems. This also meant he felt less stress, and this lowered level of perceived stress helped to keep his blood sugar in a healthy range more often.
CHANGING THE FAMILY HISTORY OF DIABETES, BEING OVERWEIGHT WITH A CGM - MALIKA
There are a lot of people in Malika’s family who have some kind of diabetes; type 1, type 1.5 (LADA - Latent Autoimmune Diabetes in Adults), prediabetes, type 2 diabetes, type 3 diabetes She was diagnosed with prediabetes, with an A1C of 6 2 and was worried she’d have type 2 diabetes unless she took action. She was also told she had metabolic syndrome, which includes high blood pressure, high blood sugar, an unhealthy cholesterol profile, and excess body fat around the waist.
When Malika first saw her doctor and asked for a prescription for a CGM, her doctor wouldn’t agree to write this prescription. Her doctor felt that since she didn’t have type 2 diabetes and also wasn’t on prescription insulin there was no need to monitor her blood sugar as closely as a CGM would. This doctor also didn't think it would help her lose weight, as he didn't know how it would help and was ignorant about how to interpret the CGM data and unwilling to learn how to help this patient in this way.
Malika didn’t agree with this point of view. She wanted to take control of her own health destiny.
Without the health data and insights the CGM can provide, Malika felt she would be guessing about what things to change about her lifestyle - things she had control over and needed to know, specifically, what was going on so she could respond as needed. Otherwise, she would be guessing about needed lifestyle changes.
Remember what I always say -
Test, don’t guess.
Malika made another appointment with her doctor and asked for the CGM prescription again. She painted a clear picture of the future health she wanted to enjoy, emphasizing that she wanted to live long and live well, to enjoy her later years with robust health. Malika got her doctor to understand how important it is to know what blood sugar levels are in response to nutrition, meal timing, sleep, stress, and exercise. Her doctor finally cooperated and prescribed the CGM.
Malika uses her CGM health data to make specific shifts and changes to her nutrition, meal timing, sleep, stress, and exercise with the goal of getting her blood sugar levels consistently in a healthy range and keeping them there. She’s found in her case, that her nutrition, stress and meal timing have the most impact on her blood sugar levels All things considered, losing weight was enhanced and her progress sped up as she understood her body's reactions to her lifestyle through her CGM data.
Now that the mystery around how these lifestyle elements affect Malika’s blood sugar is solved, she continues to fine-tune how she lives her life. She no longer has prediabetes and continues to keep the healthy lifestyle in place, understanding that if she returns to what she was doing before using the CGM insights, the prediabetes the unwanted weight, and metabolic syndrome most likely will return.
Malika does not have magical thinking that the prediabetes and metabolic syndrome will stay away if she returns to her prior unhealthy habits. The CGM insights helped her dial in what changes she needed to make so she could improve and restore healthy blood sugar levels.
DOES A CGM REQUIRE A PRESCRIPTION?
Yes, if you are in the US, a prescription is required for a continuous glucose monitoring device. I hope the information here is helpful to you to live a healthy life.
HOW LONG DO CGMS LAST?
For most CGM sensors, they last 7 - 14 days and you change them at home, depending on the device and the manufacturer’s guidelines. For some long-term implantable CGM devices, your healthcare provider will change the sensor in a procedure in their office a handful of times (or less) each year.
CAN I WEAR THE CGM TO THE GYM OR WHILE EXERCISING?
Yes You can wear the CGM to the gym or while exercising Just be careful not to snag the CGM on your clothes, pajamas, sweater, towel, or other materials, as this might loosen the sensor, knock it out of place or break off the filament.
ARE CGMS WATERPROOF?
CGMs are water-resistant, not waterproof. Wearing a CGM while sweating, exercising and at the gym is OK. If you are swimming please note:
• Most devices recommend that you keep the sensor underwater for less than 30 minutes
- If you want to swim longer, be sure to wear the large waterproof bandage supplied with the CGM, or purchased separately
•
• Don’t take the sensor deeper than 3 feet (approx. 1 meter) Avoid exposure to saltwater, sea water or ocean water
HOW DO I APPLY (PUT ON) A CGM? HOW DO I REMOVE A CGM?
Please follow the specific instructions that come with your CGM device.
HOW DO I GET FAMILIAR WITH MY CGM?
Carefully read all the instructions that come with the CGM, and check the manufacturer’s website. If your doctor’s office has people on staff who will help you apply your CGM, especially in the beginning when all of this might be new to you, let them help you get familiar with it. It’s OK to ask for help and use it when it is available to you Go through your normal routines so you can discover how your habits impact your blood sugar levels This lets you find out what your baseline is before you make any changes
HOW OFTEN DO I SCAN MY CGM SENSOR?
Follow the manufacturer’s information. To capture as much data as possible, most sensors recommend scanning the CGM at least every 8 hours, otherwise, there are gaps in the collected and reported data. On a practical level, scan when you go to sleep and scan when you wake up (approx. 8 hours apart), then set a timer (on your phone, watch, alarm clock, etc.) to scan again 8 hours into your day so you get as much info as possible.
CAN I GET A CGM SENSOR THAT DOESN’T REQUIRE BEING SCANNED TO GET THE BIO-DATA?
Yes. For example, the Abbott Freestyle Libre 3 does not need to be scanned. It is connected to an app via Bluetooth technology and provides continuous real-time biodata As long as the app on the smartphone stays in the range of the CGM sensor, it will pick up and report the bio-data to the app so you can see your blood sugar level in real-time.
In some cases with CGMs there may be a 10 - 15 minute lag time in the data.
Be kind to yourself.
Best wishes,
Dr. Beverly Yates ND
https://naturalhealthcare.com https://drbeverlyyates.com
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