Continuous Glucose Monitoring Q&A with Dr. Lisa Bryant

Mar 26

**Continuous glucose monitors (CGMs)** have been gaining traction in the medical community and are commonly used by the doctors at Vancouver Wellness Studio.
Here are some common questions I receive and feel free to comment below with any other questions you may have!

What are CGMs used for?

All types of patients and medical issues! Traditionally, CGMs were used only in patients with diabetes. They are still such a great tool for managing glucose in diabetics and much more pleasant than using a finger stick 5+ times per day (ouch!). We now use CGMs in other populations as well, including patients presenting with:

Prediabetes (Hemoglobin A1c between 5.6-6.4%)
Fatigue
Insomnia
Trouble losing weight
Anxiety or other mood disturbances
Hot flashes
Trouble focusing or hyperactivity
Skin issues (acne, fungal infections)
Feeling “hangry”
Preventatively as a screening tool

Why is blood sugar regulation important?

Persistently elevated blood sugar levels cause damage to our blood vessels, leading to inflammation and, in some cases, serious health consequences. While blood sugar dysregulation may not have any symptoms in some cases, others can experience low blood sugar symptoms (hypoglycemia) which can trigger anxiety and even panic attacks, racing heart, sleep disruptions, feeling shaky and tired. We can use a CGM to determine which foods may be causing blood sugar spikes, drops and general dysregulation.

Does it hurt?

Nope! If placed properly on the back of the arm, a CGM sensor is painless and is a great way to collect glucose data over an extended period. You can place it yourself or a VWS physician can happily place it for you. You can exercise, shower and do all of your normal activities while wearing it.

**This is what the sensor looks like for glucose monitoring.**

You can also watch a video showing the ease of placing the sensor here

How long do I wear it?

Each sensor is active for 14 days. Your app will give you a countdown so you know exactly when to remove your sensor.

How does my doctor view my data?

I use a program called LibreView to connect our accounts. You will receive an email link that easily allows me to view your data and generate a comprehensive glucose report. This even allows us to approximate your Hemoglobin A1c (diabetes screening tool) over the 14 day period. I can track this over time to make sure we are working toward your health goals.

Check out this sample report. The entire report is 14 pages, but here is a sample of the type of data we receive.

Are you going to tell me I have to completely change my diet?

No way! Getting a personalized CGM report allows me to give you individual nutrition recommendations. We see a lot of variety in how patients respond to carbohydrates and a lot of it has to do with food pairing. I’ve found that combining a higher glycemic index food with healthy fats, fiber and protein slows the absorption of that carbohydrate, having less of an impact on blood sugar levels. As a naturopathic doctor, I’m also looking at other factors that have an impact on blood sugar levels. How is your stress level? Are your adrenal glands functioning well? What is your family history? Can we take a look at your other hormones that directly affect blood sugar, such as insulin? This is easy to test and gives us great information!

I review all glucose reports with my patients individually so they really understand how their body responds to certain foods. I find that an educated patient is an empowered one.

Can blood sugar dysregulation disrupt my sleep?

Absolutely. I often have patients tell me they wake up in the night between 2-5am. If someone tends toward low blood sugar (aka hypoglycemia), this is a common time frame where blood sugar drops. We can easily see this in a glucose report since data transmits 24/7 - cool stuff! And even better - we can use food as medicine to prevent nighttime hypoglycemia.

What foods and activities will help improve my blood sugar regulation?

While this is individual to some degree, we know that all people benefit from a well balanced meal or snack that contains a good amount of protein, healthy fat and fiber. Examples are turkey, fish, tofu, beans, avocados, nuts, olive oil, berries greens and other non-starchy vegetables.

Keeping sweets in moderation is very important. This includes cake, candy, pies, desserts. If you are going to have a sweet treat, try to pair it with some of the foods listed above and have your treat with a meal rather than on an empty stomach. Alcohol can also spike blood sugar. This should be consumed in moderation as well, and always paired with food. Also watch the sugary drinks - these can really throw blood sugar levels for a loop!

We also know that our bodies need to USE the glucose that we take in. The best way to utilize glucose is to exercise! Going for a walk or lifting weights after a meal helps to lower blood glucose levels.

What if my insurance doesn’t cover a CGM? Are they expensive?

There are 2 components to monitoring - the monitor and sensor. If you have a smartphone, the monitor is through a free app. The retail price on each 14-day sensor varies by pharmacy but in my experience it’s around $70-85. Luckily there are some great coupons through GoodRx and many patients qualify for a free sensor through the manufacturer. We’ve got some tricks up our sleeve!

Ok, how do I get started with a CGM to learn more about my glucose level?

Hop on our website and schedule a new patient visit with me and we will hit the ground running. Your new patient visit includes a 60 minute intake where we cover past medical history, what’s worked / hasn’t worked for you in the past, nutrition details and a complete review of systems and symptoms. You will leave with a clear plan, lab orders as needed and a prescription for your glucose sensors.

For ongoing care, I recommend our comprehensive Naturopathic Care Plan which includes all follow up visits, concierge level service with access to your physician for questions and access to discounted lab work. Our providers are skilled in preventative medicine and can order recommended screenings such as mammograms, PAP smears, diabetes and cholesterol screenings, medication prescribing and management and more.

I can’t wait to see you in the office!

Dr. Lisa Bryant, ND

Dr. Lisa Bryant, a Licensed Naturopathic Physician, provides an extensive list of services including acute care for common ailments, chronic disease treatment and management, screening and functional lab work, hormone testing and more. She believes that every person deserves to be well, and helps her patients achieve this by using a combination of biomedical tools and traditional naturopathic treatments.

Dr. Lisa’s model is fully integrative, combining the best of naturopathic and conventional medicine, including herbal medicine, dietary counseling, exercise plans, supplements and pharmaceuticals when necessary. She is a general family medicine practitioner and performs the duties of a primary care provider. She treats every patient with sincerity and respect, and loves helping her patients achieve a higher level of health.

Dr. Bryant completed her residency in naturopathic family medicine at National College of Natural Medicine in Portland, Oregon. Her clinical education included a six-month rotation in cardiovascular and pulmonary medicine and extensive experience in naturopathic primary care. Before her formal education at NCNM, Dr. Bryant attained a bachelor’s degree in Biocultural Anthropology from Western Washington University, and also studied traditional medicine in Dehra Dun, India.

Outside of work Dr. Bryant is usually found playing with her 2 kids, biking around her neighborhood, and hiking in the beautiful Columbia River Gorge. She is a Vancouver, Washington native.

Dr. Bryant specializes in chronic illness, anxiety, depression, digestive issues, hormone imbalance, blood sugar dysregulation, disrupted sleep and general family medicine.