Health Conditions / Metabolic Health / Type 1 Diabetes

However, that’s not the messaging or target audience of the aforementioned CGM ads that popped up in my feed, which suggest that pretty much anybody who wants to lose weight or feel better or improve their health would benefit from a CGM. Plus, it’s important to note that people with lower incomes are at a greater risk for prediabetes and type 2 diabetes—not those who can afford to buy CGMs out of pocket.But when it comes to the general public, experts aren’t convinced that CGMs are necessary.Currently, there is “no compelling evidence” to say that people without diabetes or prediabetes would benefit from a CGM, Christine Byrne, MPH, RD, a Raleigh-based dietitian who specializes in eating disorders, tells SELF. In fact, one 2019 study published in the Journal of Clinical Endocrinology and Metabolism, in which researchers analyzed CGM data from 153 people without diabetes, found that 96% of the readings were in the normal range.The non-diabetic CGM market thrives on an assumption underlying a lot of wellness and biohacker culture today: More data about our bodies is inherently better. But that’s not necessarily true, Byrne points out. For starters, CGMs aren’t always accurate, because there’s often a time lag of 10 to 15 minutes and a 10- or 20-point difference between what your CGM says and your actual blood glucose level. And they tend to over-read lows, in particular, Dr. McGill says, which some people may find “disconcerting.”Blood sugar is also a complex, multifactorial phenomenon. To make sense of your CGM data, you’d ideally be tracking “food, exercise, sleep, stress levels and how your energy fluctuates throughout the day, in order to better understand how these different components affect blood sugar,” Yasi Ansari, RDN, a spokesperson for the Academy of Nutrition and Dietetics, tells SELF. In other words, just because your blood sugar rises 20 points after you eat a mango doesn’t mean mangoes are bad for your health (or even that a mango would have that same exact effect on your blood sugar on a different day).There are also potential mental-health downsides.Even if there was enough research supporting the idea that CGMs have a positive effect on your blood sugar, in reality they may also have unintended negative consequences beyond your physical health. For one, fixating on your blood sugar “could cause you to pathologize completely normal glucose responses and fluctuations,” Byrne says. “If you eat carbs, your blood glucose will go up, and that’s totally normal and fine.”And hyper-focusing on your blood sugar in order to inform your eating choices could also result in greater rigidity around food—especially in people with a history of restrictive dieting or disordered eating behaviors. “Similar to the effect that activity trackers or calorie counting apps can have, using this device may take away from the joy and pleasure of eating, as well as listening to your body when it comes to making food and exercise choices,” Ansari explains. You want to be able to eat and “not always be worried about the impact it might have on blood sugars,” as she puts it.And there are often easier (more affordable) ways to address many of the issues you hope to resolve with a CGM.If you’re concerned about or at risk for prediabetes or diabetes, talk to your doctor about getting screened, Byrne says. You can also start with basic, evidence-based measures for stabilizing blood sugar levels, like more physical activity.

Another interesting development is how I’ve started connecting the subtlest initial physical sensations of impending low or high sugar to my readings. Those earliest symptoms (like feeling a teeny bit faint or having a quickened heartbeat with low blood sugar, and a slight tinge of nausea or dehydration with high blood sugar) can mimic some of the effects of exercising, so it’s trickier for me to discern what is blood sugar-related or not during a workout. Checking that real-time data point against how my body is feeling more frequently has been helpful for learning more about what these sensations are indicating.The Venu 2S has really come in handy during workouts outside the house, too.While I mostly exercise at home, I’ve also used the Venu 2S while hiking in the mountains or at fitness studios in the city. It makes checking my blood sugar less of a hassle and more subtle—I can do it while in downward dog or on a Pilates reformer, for instance.Before the Garmin, I’d generally leave my phone in my bag during classes and look at my blood sugar on my pump. While I usually give the instructor a heads up that my insulin pump may beep during class, I still get side-eye from people (who perhaps think I’m checking my phone), and sometimes the instructor forgets and says something, too. That’s not on me—and no one should ever feel like they should conceal their medical technology—but I do like having a more discreet option that’s there if I want it.The Venu 2S is also a great diabetes management tool outside of exercise.My biggest surprise is how the Dexcom-Garmin integration has become a useful component of my diabetes care outside of working out, too. There are so many times during the day where glancing down at my wrist is simply more quick and seamless than consulting my phone or insulin pump. (Wearing my Garmin nearly around the clock is easy given the impressive battery life—as someone with a habit of letting my devices die, I love that a full charge lasts a good four to five days.)I’ve found the watch useful while driving, walking, showering, booking it through the airport, and even getting a massage. It’s also been clutch in certain social situations—while out to dinner with a friend, at a movie, or on a date, for instance. (My phone is often in my bag and my pump tucked in my back pocket or bra, making it a little awkward to fish out.). Plus, I like not having to take out my phone mid-conversation.Something else I appreciate is how the customizability of the Venu 2S lets me take what I need from a smartwatch and leave the rest behind. I can turn off a lot of the notifications that feel excessive and pare down the data visible on the screens so I’m not overwhelmed by metrics. I’ve only scratched the surface of this watch’s tracking capabilities, but the reality is that I’m already required to quantify and monitor so much when it comes to my health for the sake of diabetes management, that adding more of that to the mix is just not a priority.And overall, it’s a good general fitness tracker—though there are a few drawbacks.Outside of the CGM functionality, I really like this watch as a general fitness tracker. The touch screen, side buttons, and accompanying app are all simple and intuitive to use. While I haven’t utilized some of the Venu 2S’s more advanced fitness tracking capabilities, I still find the most basic metrics valuable. I love seeing my heart rate get up there when I’m really pushing myself, as well as my heart rate range breakdown after my workout—it enhances my sense of accomplishment more than I thought a number would. I’m a big walker, so I like the step count function too. And the distance tracker was helpful while hiking.

That’s the first traumatic memory that I ever recovered and worked through with my current therapist, four years ago now. Processing Penny’s death and the way it affected me—how it seeded deep in me fears of my own body and fate—was the breakthrough I needed to recognize the tremendous trauma that had been slowly unfolding within me over many years.Chronic illness is an under-recognized and misunderstood source of trauma. “Oftentimes in our society and our culture, we think about trauma as something that’s associated with combat or a very violent, terrifying event,” Ashwini Nadkarni, MD, a Harvard Medical School instructor and psychiatrist at Brigham and Women’s Hospital who specializes in working with people living with a chronic illness, told me. “What’s not well understood is that the burden of having a chronic medical condition very much meets those criteria for a trauma experience.”The trauma of my diabetes diagnosis began to manifest in the perfect storm of adolescence. I was experiencing new stressors: my mom’s mental health struggles, and, having managed my own care for a couple years now, diabetes burnout—a term used to describe feeling emotionally fried by the around-the-clock management. Never-processed traumas billowed up into waves of anger, terror, self-loathing, and, though I couldn’t name it then, grief—for the body, the health, the easy relationship with food, the self-trust, and the potential future I had lost. At 13, for the first time, I grappled with the magnitude and permanence of my disease.I blamed myself for getting diabetes. I believed my existence was a burden on everyone, a feeling I can trace back to a specific memory from a few years earlier. On a family vacation in Utah one summer, we were trying to figure out who was going on a hike with my parents and who was staying back, and I volunteered to join. Once my parents were out of earshot, my sister hissed at me, “Don’t you think Mom and Dad want to get away from worrying about you and your diabetes for once?” The guilt crushed me, and I didn’t feel like going after all.Paralyzing fear and morbid assumptions clouded my visions of the future. These core beliefs have been the hardest for me to recognize as traumatic residue, because for many years they were simply the lens through which I saw myself and the world. Beliefs like: I will probably experience complications like going blind and kidney failure by the time I’m 30. I shouldn’t have children because they will be sick and hate me. I will die young.I was besieged not by traumatic flashbacks, but traumatic flash-forwards into a coffin of sickness and suffering. Depression and anxiety consumed me. Intrusive thoughts and a sense of impending doom kept me up at night as I googled phrases like “average life expectancy female type 1 diabetic.”I eventually started attending therapy and taking antidepressants. With a body I saw as fundamentally, irreversibly broken, I readily accepted that my brain was broken too. I started to numb out with sugar, an exceptionally self-destructive impulse for a person with type 1 diabetes. I developed a binge eating disorder—which wreaked havoc on my blood sugar—that I hid from everyone.

If you have type 1 diabetes, you’ve probably fielded a lot of questions about what the condition is and isn’t—and what actually causes it. Are you simply just born with it? Is type 1 diabetes genetic?The thing is, when most people think about diabetes, they’re largely referring to type 2 diabetes. And it makes sense, since of the 34.2 million Americans with diabetes, 90% have type 2, and only about 1.6 million have type 1, according to the American Diabetes Association (ADA).While type 1 only accounts for about 5 to 10% of people living with diabetes—folks like singer Nick Jonas and Justice of the U.S. Supreme Court Sonia Sotomayor have it—there has been a recent uptick in cases. According to a 2020 report from the Centers for Disease Control and Prevention, there has been about a 30% increase in type 1 diagnoses in the United States, with numbers jumping from 1.25 million to 1.6 million. And rates among Black and Hispanic communities seem to have the sharpest increase.1We’ll get into what causes type 1 in a minute (yes, genes are a factor), but first, let’s talk about how type 1 and type 2 diabetes are different.What’s the difference between type 1 and type 2 diabetes?While both type 1 and type 2 diabetes occur when the pancreas can’t make enough insulin for what the body needs, this lack of insulin happens for very different reasons.“Insulin is a hormone that acts on many different organs in the body, helping them to use nutrients like glucose, fats, and proteins,” Laura C. Alonso, M.D., distinguished professor of medicine, chief of the Division of Endocrinology, Diabetes, and Metabolism, and director of the Weill Center for Metabolic Health, tells SELF.Type 1, which usually starts in childhood and is seen more often in those of European ancestry, is an autoimmune disease. “The body’s immune system kills the insulin-producing beta cells in the pancreas,” Siripoom McKay, M.D., an assistant professor of pediatrics-diabetes and endocrinology at Baylor College of Medicine and medical director of inpatient diabetes at Texas Children’s Hospital, tells SELF. “Losing the majority of beta cells requires insulin therapy to lower glucose levels.”Simply put, people with type 1 diabetes have to take insulin every day to stay alive. (Which is why having access to affordable insulin is so important).Type 2 diabetes, on the other hand, results from changes in the body that make it difficult for your pancreas to produce enough insulin, along with your body not using insulin efficiently (that’s called insulin resistance). As the disease progresses, people with type 2 diabetes may also have to take insulin, but there are a number of other medications and lifestyle changes that can help, too, according to the ADA.In both cases, the lack of insulin getting into the cells in the body is the hallmark of the disease. “When your body doesn’t make enough insulin, sugar builds up in the bloodstream, and over time that can damage your body,” says Dr. Alonso. If high blood sugar is untreated for months or years, it increases the risk of serious health problems like heart attack, stroke, kidney disease, blindness, and even amputations in severe cases.Is type 1 diabetes genetic?The short answer is yes, a family history of diabetes matters. In fact, more than 40 genetic regions (where genes are located on a chromosome) have been identified that are related to immune function and beta cells (i.e. the insulin gene), Aaron Cox, Ph.D., an instructor of medicine – diabetes, endocrinology, and metabolism at Baylor College of Medicine, tells SELF. This genetic predisposition is coupled with impaired function of the immune system and what’s called a “precipitating event”—anything that could cause beta cell stress like environmental factors (things like a typically “Western diet” and antibiotic use could contribute)2 or even an infection. “Ultimately, the immune system recognizes the body’s own proteins as foreign and proceeds to destroy the beta cells from which these ‘foreign’ proteins originate.”

People of certain races, including African Americans, Latinx, Native Americans, Pacific Islanders, and Asian Americans are also more likely to develop type 2 diabetes, although experts don’t fully understand all the reasons for this elevated risk.What are the signs of type 2 diabetes?Some signs of type 2 diabetes can be subtle, because the condition tends to develop slowly over time compared to type 1 diabetes, per the NIDDK. In fact, it may take several years for symptoms to pop up, so you may not realize you have the disease until it causes certain complications, like heart issues or blurry vision.While having just one on this list isn’t a surefire indicator of the condition, pay attention to whether you’re experiencing several of these, Hien Tran, M.D., an endocrinologist with Texas Diabetes and Endocrinology, tells SELF. Simply having a dry mouth on its own may not be enough to prompt a doctor’s appointment, for example, but if that sign is paired with other symptoms on this list and you also have any of the risk factors mentioned above, it may be worth getting checked out.Now, here are the type 2 diabetes symptoms to keep on your radar:1. You’re drinking a lot of water… and need to pee all the time.Having too much sugar in the blood is tough on the kidneys since those organs are responsible for processing that excess glucose, according to the Mayo Clinic. As a result, they work overtime to eliminate it from the body. As your body loses fluids, you may feel the signs of dehydration creeping in. So, you drink more fluids to make up for it, and the cycle of constantly peeing continues. That’s why frequent urination and increased thirst tend to be the two most common type 2 diabetes symptoms, particularly in the early stages.2. And you need to pee, like, right now.Despite peeing more often, you may also experience the strong need to go but very little—if any—comes out when you do, which is known as “urgency incontinence,” per the NIDDK. Although this is also a big head’s up that you might have a urinary tract infection, especially for people with vaginas, it’s also common with type 2 diabetes.3. Your mouth feels super dry.As we mentioned, when you pee more often, your chances of getting dehydrated go up, which will often kickstart your thirst response. With type 2 diabetes, the excess glucose in your system also takes fluid out of your tissues, making that thirst more ferocious. That can be exacerbated by having a dry mouth, and the feeling that you simply can’t drink enough water or other fluids to switch off that thirsty feeling.Dry mouth is characterized by feeling a lack of saliva often or most of the time, a dry, rough tongue, pain in the mouth, cracked lips, mouth sores or infections, and problems with chewing, swallowing, or even talking, per the NIDDK. Because of this, dry mouth can raise your risk for certain dental problems, like tooth decay and gum disease.4. You have weird changes in your vision.People with diabetes can also develop diabetic retinopathy, which is a condition that can cause damage to the retina (the thin, light-sensitive tissue that lines the inside surface of the back of your eyes) over time, according to the American Optometric Association. That’s because excess blood glucose damages all of the tiny blood vessels in your body, including those in your eyes. This is a problem because the eyes’ blood vessels will then break and leak fluids, resulting in complications like cloudy or blurry vision or difficulty focusing.If type 2 diabetes goes untreated, new blood vessels may form in your retina as a response—but because they’re so fresh, they’re more prone to leaking as well, causing the eye tissue to swell. Over time, if type 2 diabetes continues to go untreated, your risk of vision loss goes up.5. You can’t satisfy your hunger.Even if you have a big meal, you might walk away feeling hungry, the Mayo Clinic says. That’s because insulin resistance is preventing glucose from reaching your cells to give you the much-needed energy boost that food provides—so your brain and muscles keep sending hunger signals as a result.6. You feel tired (and cranky!) all the time.The blood sugar spike you experience after eating can cause major fatigue because the glucose isn’t being processed effectively in your body. Dehydration can also make you feel tired, the Mayo Clinic says, and so can trouble sleeping if your symptoms (like dry mouth or constantly needing to pee) are causing discomfort.