Understanding CGM and Its Role in Lifestyle Changes, Pt. 1
In this podcast episode, Lisa Jones, MA, RDN, LDN, FAND, interviews Grace A. Derocha, MBA, RD, CDCES, a certified diabetes care and education specialist and health coach in Detroit, Michigan. In part one of this four-part series on diabetes technology, Lisa and Grace discuss continuous glucose monitoring (CGM), particularly how CGMs can provide insights beyond blood sugar levels for those individuals looking to make specific dietary lifestyle changes.
Listen to part two of this four-part series here.
Listen to part three of this four-part series here.
Listen to part four of this four-part series here.
Transcription
Moderator: Hello and welcome to Nutrition 411, the podcast, a special podcast series led by registered dietitian and nutritionist Lisa Jones. The views of the speakers are their own and do not reflect the views of their respective institutions for Consultant 360.
Lisa Jones, MA, RDN, LDN, FAND: Hello, and welcome to Nutrition 411, the podcast where we communicate the information that you need to know now about the science, psychology, and strategies behind the practice of dietetics. Today's podcast is part of a series of short episodes featuring Grace Derocha. First, I want to introduce Grace. Grace is a registered dietitian, certified diabetes care educator and specialist and health coach. She loves helping others learn how to live a healthier and happier lifestyle. Grace was born and raised in Michigan. She attended Michigan State University, Go Green, and she received two Bachelor of Science degrees in dietetics and psychology. She also completed her dietetic internship at MSU. Grace later received her MBA with specializations in marketing and management from Wayne State University. Grace is proud to be one of the national spokespeople for the Academy of Nutrition and Dietetics. Grace is also a wife, mommy of two, a dog mom, Spartan, and Avid Detroit sports fan. She loves music, dancing, food, cooking, shopping, reading, and smiling. I love all of that, Grace. Welcome.
Grace A. Derocha, MBA, RD, CDCES: Thank you so much for having me, Lisa. I'm excited to be here today.
Lisa Jones: So our first episode, we're going to talk about understanding a CGM and its role in lifestyle change. So my first question for you, Grace, is what is continuous glucose monitoring and how does it differ from traditional glucose monitoring methods?
Grace Derocha: This is a great question. So continuous glucose monitoring, CGMs, which I'll probably say more than saying all three of those words because it is a tongue twister. So it is technology that's used to track a person's glucose levels in real time throughout the day and night. It involves some type of small sensor that's inserted just under the skin, sometimes depending on the brand that you're using, it might be on your arm or your abdomen. And then this measures interstitial glucose levels, which is really the glucose found in the fluid between cells. So that becomes important because real -time blood glucose monitoring when people would poke their fingers for a glucometer, that actually just tests the blood and not the interstitial fluid for the blood sugar level. So it could be a little bit different as far as numbers go. So being able to use a CGM really allows someone to reduce those finger pricks and constantly see hence the name continuous glucose monitoring what their blood sugar levels are running.
Lisa Jones: Yes, it sounds like for a variety of reasons including what you mentioned about the pricks with the finger. That doesn't sound like fun. So this sounds like a more fun and more accurate way to do it.
Grace A. Derocha: Yeah. And it's nice too, because with the CGMs, you're getting 288 readings a day, as opposed to when you poke your finger, you get that one reading right at that time only, so you only know what that blood sugar is then, not kind of where the trend might be going.
Lisa Jones: Yeah, so it's important to watch the trend, but also too that I think for patients that are worried, that helps kind of reassure them because at 288 times, like by the time that you're, get to that level, you're like, okay, I'm good today. Let's talk about tomorrow. All right, great. So how can this provide insights beyond just blood sugar levels for dietitians working with clients?
Grace A. Derocha: Oh, this is such a great question. So your CGM really provides that valuable insight with the blood sugar levels and the trend that it's going in. So as a registered dietitian, being able to personalize people's nutrition and really look at their lifestyle to advocate for the best blood sugar levels is kind of a key. There's a few things that we want to think about with that CGM providing insight for dietitians to help clients in the best way possible.
First, really understanding how that food and glucose relationship works, so that CGM data can help the dietitian look at what the person's eating, what their portion sizes might be, what their different food groups and macronutrients are, and how that combination at that meal or at that snack can affect glucose levels. So that's one way.
Lisa Jones: Oh, I was just writing down some notes. All right. So that's, that's wonderful. That's really kind of a, allows them to kind of, I think, pinpoint if you will, like some causes or where there needs to be changes, right?
Grace A. Derocha: Yeah. So I always say to people, right, we have our healthy lifestyle habits that we're trying to incorporate. And then we also have the medication that we might be taking to help with certain conditions or chronic conditions. And when we can tie those things together, it can be a beautiful pairing of helping us live healthier. So that CGM data, and, you know, really honing into those food and blood sugar relationships tha might be happening can help us look at that and hopefully make effective change.
Lisa Jones: Oh, I love that. And then talking more about, is there any other key components of CGM data that dietitians should then focus on when they have to guide clients?
Grace A. Derocha: Yeah, I think, again, talking about behaviors, it's very interesting 'cause I don't think people realize with blood sugar levels, there are over 50 things that can make them go high. It's not just food or what you drink. It could be things like stress or sleep or lack of sleep or exercise. So again, kind of looking at some of those things too in someone's life can really be impactful to do better, right? When it comes to what we need to do to live healthier when it comes to what the client can focus on and how the dietitian can help drive them there.
Lisa Jones: Yes, and it's great that you said focus 'cause a lot of times patients can be overwhelmed. So I like again, and that's you're really honing in on what the focus should be and kind of giving them manageable steps of what's the next steps, how can we help you better? So that's fantastic. So how can understanding glucose patterns then help make more effective dietary recommendations?
Grace A. Derocha: Yeah, so it's funny. I was just talking to someone the other day about this meal timing. It's it's funny to think about We usually say breakfast lunch and dinner, but it doesn't always work out that way, right? Especially when we're busy and things kind of throw a wrench in our plans. So meal timing can play into this. Snack timing. Looking at what is impacting our day the most is really another key in kind of working towards using the data from the CGM to help us make us more aware and help us. I always say it's always interesting to do research on ourselves. And a CGM is one of the most powerful tools that we have right now that can allow us to really hone in and make these observations.
Lisa Jones: Yeah, so it definitely does sound powerful 'cause I'm also wondering too, a question came up when you were talking about that in terms of women that have gestational diabetes. Do you find like how often are you using it for those types of since it's kind of, I don't want to say temporary, but you know what I mean, like after they deliver the baby, they usually no longer have it because it's gestational.
Grace A. Derocha: Yeah. So, I personally had gestational diabetes with my kids. So it can be, but it wasn't as popular then. It wasn't as available or as popular. But now I am seeing people use them often with gestational diabetes and or, you know, other reasons besides gestational diabetes just to kind of see where they're at if they have a family history of diabetes and kind of seeing where are my blood sugars or why do I maybe feel off compared to how I was when I was a little bit younger. So definitely a great way to look at that.
Lisa Jones: So then that begs the question, can somebody that's not like say they're Maybe they get some blood work and they find out they're prediabetic or they just want to know kind of to your point, can they explore this or they only do it for people that have like meet certain criteria?
Grace A. Derocha: So I think it I think it would depend on a few things. There is over-the-counter options. Some brands do offer that and I think that's that's coming down the pipeline too from what I hear. That's the buzz so people would be able to then get it for themselves and buy it over the counter.
Otherwise, I think it would be a matter of looking at your insurance, talking to your doctor, and seeing even if they could recommend one short term to gain some insight. And then if you felt with your doctor that there was a need for more long-term insight, hopefully that would be able to be covered on the insurance end, But heads up, over-the-counter, CGMs are coming. I think there's someone outside right now.
Lisa Jones: I might have to go check that out, but I can imagine Dietitians are probably thinking of that question, because that's why I asked it.
Grace A. Derocha:Yeah, yeah, definitely. And I think too, when we're looking at it, because it's a lot of data, so it can be overwhelming as a person at, at it all, and like, what does it mean? So, you know, remembering to take some of it in stride, since it is all the time, every five minutes, telling you what your blood sugar is, it can be a little overwhelming.
Lisa Jones: Yeah, so true. All right. Well, thank you so much. Is there any additional takeaways that you want to say about this particular topic, understanding CGM and its role in lifestyle changes?
Grace A. Derocha: Yeah, I would say just in general, you know, remembering that the CGM is another tool that you can use to be a helpful thing to you, and not a burden something. I sometimes hear my clients or patients tell me that like, I sometimes don't want to know all the time. But to remember, you know, Remember, it is to effectively give you some insightful data to be able to make some changes that could be really important for the long haul, as opposed to feeling like something's babysitting you and telling on you regarding what your blood sugars are running based on. Just getting to eat and enjoy some of the food that you like.
Lisa Jones: Yeah, that's such great advice because it's almost like insightful data for a better tomorrow. So if they think of it like that, then they can, it just makes it more easier than having so much.
Grace A. Derocha: I love that. Lisa, you literally said that and I got goosebumps. I love, I love that. That's like so, that feels good and it gives people vision.
Lisa Jones: There you go. We all need vision, right, Grace? Thank you so much for being on episode one. I look forward to future episodes. Yes,
Grace A. Derocha: I can't wait. Thank you so much, Lisa.
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