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.
The good news is that these sources of added sugar are not the ones that most nutrition experts and health organizations are taking fire at, even though they’ve gotten swept up in the anti-sugar crusade. “There are people who are very health-conscious coming to me worried about the added sugar in tomato sauce or yogurt,” Dr. Tewksbury says. “But that’s not the source of added sugars that major organizations and dietitians are worried about.”What experts are sounding the alarm on is the foods and beverages that offer sugar (and calories) in high concentrations, and not much else. Added sugars in and of themselves are not unhealthy—in fact, they’re the same as naturally occurring sugars in terms of their chemical structure and how the body processes them. It’s the large amounts of added sugar and the nutrition-lacking foods people regularly consume them in that are an issue.“These products that are basically nothing but added sugar in high concentrations and little other nutritional value are the sources of the vast majority of the added sugar individuals consume,” Dr. Tewksbury says. According to the 2020–2025 Dietary Guidelines2, created by both the Department of Health and Human Services (HHS) and the Department of Agriculture (USDA), the top offenders by far are sugary beverages (sodas, fruit drinks that are not 100% fruit juice, sports drinks) and processed sweets (cookies, candies, pastries, ice cream). This absolutely does not mean you can never have these items or should feel guilty about enjoying the hell out of them when you do have them! Sugary foods and drinks can absolutely be part of a healthy lifestyle. Health and nutrition experts are generally most concerned about people consistently bypassing daily sugar intake recommendations in a way that can put their health at risk. What are the daily sugar intake recommendations? The 2020–2025 Dietary Guidelines advise capping your daily added sugar intake at 10% or less of your total calories. Each gram of sugar equals 4 calories, so if you eat about 2,000 calories a day (we’re using this general number just for math’s sake), the recommendation is to aim for under 200 calories worth of sugar every day, or 50 grams.Similarly, the World Health Organization (WHO) recommends keeping consumption of “free sugars” (which includes everything that falls under added sugars, plus sugars from 100% fruit juice) at 10% or less of caloric intake. But WHO takes it a step further by saying that reducing intake of free sugars even further, to 5% or less of caloric intake, would offer additional health benefits. No matter the exact number you go by, the general spirit of these recommendations is clearly that “most of us could probably stand to cut back a little bit,” as Dr. Tewksbury puts it.What are the health concerns around added sugar? These numbers may seem arbitrary, so let’s go over why these guidelines exist. Broadly speaking, these recommendations are based on the fact that (a) high added sugar intake over time is associated with negative health outcomes, and (b) most people are eating high amounts of added sugars. According to the Centers for Disease Control and Prevention (CDC), consuming too much added sugar is associated with cardiac and metabolic health issues like obesity, type 2 diabetes, and heart disease. That said, multiple studies have found that some of the strongest evidence for the relationship between sugar consumption and weight gain, diabetes, and heart disease applies to added sugar that comes from sugar-sweetened beverages only. And according to the Dietary Guidelines, sugar-sweetened drinks account for over 40% of the average American’s added sugar intake.
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.
The majority of us don’t purposefully eat plastic, but that doesn’t mean we’re not consuming it every day. Microplastics, which are tiny plastic fragments, are everywhere—including inside of our bodies, according to mounting research. For the first time, researchers found that 17 out of 22 people had microplastics originating from common products in their blood, according to a May 2021 paper published in the journal Environment International1.“This is the first study to identify plastics that we know are in containers, plastic bottles, clothing, and other products that we use, inside of people,” Andrea De Vizcaya-Ruiz, PhD, an associate professor in the department of environmental and occupational health at the University of California Irvine, tells SELF. The two most common types of plastic found in the study were polyethylene terephthalate (PET), which is used to make plastic water bottles and clothing fibers, and polystyrene, which is found in food packaging, disposable utensils, and straws.In March 2022, researchers published a paper with another original discovery: 11 out of 13 people had microplastics in their lungs, according to the study published in The Science of the Total Environment2. Numerous other studies support that we’re regularly consuming plastic, Kelly Johnson-Arbor, MD, a medical toxicologist at MedStar Health in Washington, D.C., and co-medical director at the National Capital Poison Center, tells SELF. “Microplastics have been found in human saliva, scalp hair, and feces, suggesting that we are all likely exposed to these plastic fragments on a regular basis,” she says.Researchers are still exploring what this means for human health, but SELF talked to experts about what we do know.What are microplastics?Microplastics are tiny particles of plastic, less than 5 mm long, that are created in two ways. Primary microplastics3 are manufactured to make things like microfibers4, which are found in synthetic fabrics, or plastic microbeads, which are in some cosmetics. Secondary microplastics are formed after breaking off from larger plastic products like water bottles, car parts, and product packaging.Biodegradable items such as a banana naturally break down until they finally dissolve. But many plastics never decompose completely. They get smaller and smaller over time, but the pieces remain in our environments as pollution for hundreds of years, resulting in secondary microplastics, Dr. De Vizcaya-Ruiz says.Ok, but why are microplastics inside our bodies?Microplastics can be found in our water, air, food, and soil, so they’re unavoidable.“When humans consume food, drink water, or breathe air that is contaminated with microplastics, the plastic fragments can enter the body,” Dr. Johnson-Arbor says. Some estimates show that people in the U.S. consume and breathe in between 74,000 and 121,000 microplastic fragments each year5, according to Dr. Johnson-Arbor.But how exactly do these plastics get into our blood? After consuming food or water containing microplastics, researchers suspect those tiny particles make their way to the gut, through the intestinal membrane, and into the bloodstream, Dr. De Vizcaya-Ruiz says. Something similar may happen when microplastics enter the bloodstream after being inhaled and passing through the membrane of the lungs.How are microplastics affecting human health?Plastic may be ubiquitous now, but it’s only been widely used for the past 70 years or so6, meaning there aren’t a lot of studies examining what types of plastics may affect human health and in what quantities.
Type 2 diabetes is one of the most common chronic health conditions in the U.S. (a whopping 10.5% of the population has it1)—yet it is woefully misunderstood by most people. There are all kinds of misconceptions about what causes type 2 diabetes. Because of this, you might think you did something wrong if you get a type 2 diabetes diagnosis. But the truth is, the condition is the result of a combination of factors, some of which can be outside of your control. Ultimately, type 2 diabetes occurs when your body doesn’t use insulin properly. The good news is, that there are lots of ways to change that. Keep reading to learn what really causes type 2 diabetes—and what you can do to prevent it.What is type 2 diabetes?In a nutshell, type 2 diabetes is a chronic disease that occurs when your pancreas doesn’t produce enough insulin (or doesn’t use it efficiently), which results in too much glucose (or sugar) circulating in your blood, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Over time, high blood sugar levels can cause problems with your immune, nervous, and circulatory systems. Worth noting: If your body has started having problems producing insulin and using glucose, but your blood sugar hasn’t yet risen to a concerning level, then you may be diagnosed with prediabetes.So, what’s the difference between type 1 and type 2 diabetes? Type 1 diabetes also occurs when there is too much glucose in the blood, but it’s an autoimmune condition, meaning the body attacks the insulin-producing cells in the pancreas.What causes type 2 diabetes?Experts don’t know exactly what causes type 2 diabetes, but there are several factors at play—some are within your control (think: getting enough exercise) while others are outside of your control (like genetics). Here are some possible causes:Insulin resistanceThe main culprit of type 2 diabetes, insulin resistance is when your body doesn’t use insulin efficiently, which leads to high blood sugar. Glucose is what your body uses for energy. But it has a lock on it, meaning it can’t get into your cells on its own; it needs insulin to do that (think of insulin as a key that opens the lock so glucose can enter).Insulin resistance is when your key (insulin) doesn’t work as well as it should. Sometimes it unlocks, and sometimes you have to go through a series of acrobatic hand movements to get the lock to open. Since glucose isn’t getting into your cells consistently, it means there is extra circulating in your blood, increasing your blood glucose, or blood sugar, which may lead to type 2 diabetes.There’s another thing that happens with insulin resistance. Your body can’t make enough insulin to compensate for the extra glucose. As a result, more glucose ends up circulating in your blood, which can damage your cells and lead to complications that affect your eyes, kidneys, and nerves, according to a 2019 study published in the journal Nature.2Excess body fatSo, what causes insulin resistance in the first place? The answer is complicated, and it doesn’t just happen overnight. But one of the main factors is excess body fat, which can cause inflammation throughout your body. That inflammation may then trigger a chain reaction that ultimately leads to insulin resistance and eventually type 2 diabetes, according to a 2015 study published in the journal Lipids in Health and Disease.3It’s important to note that not all people with type 2 diabetes are considered clinically overweight, and not all people who carry excess weight have type 2 diabetes.Your genes and how you grew upInheriting certain genes can increase your risk of developing type 2 diabetes. If you have one parent with type 2 diabetes, your risk increases by 40%, according to a 2015 study published in the journal Genes. If both parents have it, that risk jumps to 70%. And compared to the general population, you have a three-fold increased risk if you have a parent or sibling with type 2 diabetes.4
If you’re concerned, you can ask about any tests you might need, which can include an A1C test to measure average blood sugar over three months and a fasting plasma glucose test to look at your blood sugar at a single point in time, per the U.S. National Library of Medicine. This will also alert your health care provider to stay on top of the issue.“When a patient asks for a test like that, your doctor will be more tuned in to watching for signs of diabetes,” Dr. Wyne notes. “Also, it shows you’re being more proactive about your health, and that can lead to some good discussions about lifestyle changes that can help.”Can prediabetes be reversed?If your doctor confirms you have prediabetes, you may understandably feel a bit overwhelmed. But it is indeed possible to reverse prediabetes, depending on what you do next, says Dr. Wyne. At the very least, you may be able to significantly slow the progression toward the more serious diagnosis of type 2 diabetes, which requires taking insulin injections.“Prediabetes isn’t an official medical condition or disease,” Dr. Wyne adds. “Think of it instead as a warning sign. If you take action now, you can change where you’re headed.”With prediabetes, overhauling your lifestyle habits is nearly always the first step, says Dr. Tran. There are many factors that can lead to higher blood sugar, including poor sleep and increased stress, but the biggest switch will come down to what eat and how much you move. “Control of blood sugars is 80% dietary,” she says. “Just by cutting down portions of carbohydrates by a quarter or a half will help.”If there’s one diet change to make right away, it’s eliminating sweetened drinks, Karen Graham, R.D., certified diabetes educator and co-author of Diabetes Meals for Good Health, tells SELF. She says examples include soft drinks, sports drinks, sweetened smoothies, sweetened tea, and sweetened coffee drinks. With the exception of some types of smoothies, these drinks often don’t contain much fiber—which is needed to help slow down digestion and regulate blood sugar levels. That means you’ll be getting a blood sugar spike with every drink.Choices like fried foods or sugary desserts should be punted into the “occasional” category while your blood sugar remains elevated. You might also need to cut back on certain beneficial carbohydrates until your blood sugar levels stabilize, including some fruits and whole-grain bread, Dr. Tran says.In general, it’s helpful to track the foods you eat—there are several apps that can help you do this—to understand how many carbohydrates you’re eating, at least when you first receive a confirmation of prediabetes. Working closely with your doctor or a registered dietitian who is also a certified diabetes educator can help you figure out how to navigate these diet changes, so you’re making adjustments safely with your body and personal needs in mind.Getting more active is also important if you’re trying to reverse prediabetes, and that’s true even if you already take walks or do other activities like yoga, says Graham. That’s because consistently exercising increases your sensitivity to insulin, which can help lower and stabilize your blood sugar levels over time, according to the American Diabetes Association.
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.