Monitoring your blood sugar levels

Because of my research and publications on magnesium, I was contacted by Nutrisense. This company helps people without diabetes improve their diet and “metabolic health”. They are interested in educating people about the role of magnesium, a very underappreciated mineral. The company offered me a free 2-week trial of their continuous glucose monitor (CGM). I have a healthy diet and normal weight so I was not sure that I could get any useful information. But I thought that some of my patients could benefit and wanted to see what they would experience.

CGM did provide some interesting observations. After exercise, I gulped down 12 oz of unsweetened coconut water. My glucose went up to 150, the upper limit of what is considered normal. I ate a golden delicious apple for a snack one afternoon. Healthy, isn’t it? My glucose level shot up to 165. The next day, I went to a birthday party for a 3-year-old and ate two slices of pizza, without toppings. The glucose level went up to 164. Another night, I had some sushi. The level was 169 (sushi rice is always cooked with sugar). Then, after dinner out with my family, we decided to have ice cream. I had two scoops with the good excuse of wanting to see how high my glucose would go. Surprisingly, it went up only to 151.

It is well known that eating protein and fat first will slow down the absorption of carbohydrates. This is why an apple, eaten between meals gave me a higher spike in sugar than two scoops of ice cream I ate after dinner. Any liquid form of sugar gets absorbed fast. So, you may want to avoid sweet drinks, including fruit juices. I found that getting feedback from the CGM helped modify my eating habits, mostly for the better. I may be less inclined to avoid desserts after dinner. However, additional calories do make me gain weight, so I will try to control myself.

A few caveats. Whenever I slept on the side where my CGM was attached, the glucose level appeared to drop to dangerous levels. This incorrect reading happens when compression restricts blood flow to the monitor. Occasionally, when exercising, I felt a poke from the needle of the CGM. And, after two weeks, my skin became a bit irritated by the sticky bandage that covered the CGM.

I may recommend CGM to my patients who get migraines when they are hungry and to those who are looking for additional help in losing weight. In addition to getting direct feedback about the impact of food on their sugar levels and those levels on their migraines, some patients may benefit from a consultation with a dietitian. Nutrisense can connect you with a dietitian.

My reactions to various foods were normal. Hunger is not one of my migraine triggers. However, many people with migraines have reactive hypoglycemia – an exaggerated response to carbohydrates. This means that when the blood glucose level spikes after a carbohydrate-rich meal, too much insulin is produced, and the glucose level drops below normal. This can be a migraine trigger. Even if migraine is not triggered, this can also make you sluggish and less productive. Skipping meals is also a known migraine trigger and the mechanism is similar – your blood glucose drops too low. There is also a strong correlation between weight and migraines – the heavier you are the more migraines you get. Women with polycystic ovarian syndrome (PCOS) are at a higher risk of having insulin resistance and developing diabetes.

The ideal diet is low in carbohydrates and high in protein. Three or four meals a day is the frequency that works best for most people. In general, the last meal should be at least two hours before bedtime. But there are exceptions.  For some, having a snack in the evening prevents morning or middle-of-the-night migraine.