Get answers to common questions about Continuous Glucose Monitoring, the CGM diet, and how it works.

Is CGM safe?

CGM has been used by patients with diabetes for over 15 years. It is estimated up to 35% of patients with Type I Diabetes now wear a CGM, and close to 15% of all diabetic patients are currently utilizing a CGM. There are essentially no complications of CGM use.

How do I lose weight with CGM?

It is well known in the weight loss and metabolic health physician, nutritionist and dietician communities that patients can’t lose weight without burning fat. Any diet not having the goal of replacing blood glucose with fatty acids as the body’s fuel source is likely to fail. Fat stores, especially those in the truncal area of the body, are reduced when fatty acids (instead of glucose) become the body’s primary energy fuel source. The constant feedback of a CGM sensor provides the user the knowledge and power to keep blood glucose at a level necessary to burn fat and lose weight.

Even with a CGM, how will I know what foods to eat, when I can eat them, and how much I can eat?

Lowering blood glucose to burn fat is best approached with a low carbohydrate diet. There are many types of low carbohydrate diets which our patients can select. Their selected diet is then personalized to a patient’s particular dietary and metabolic needs. The MetabolicMD program provides physician and nutritionist review of your baseline blood glucose data as well as review of other pertinent initial laboratory data (a variety of tests including triglycerides, HDL, liver enzymes and especially insulin levels). Based on this data, a diet plan is provided with the goal of achieving optimal blood glucose management through appropriate low carb dietary choices. Ongoing physician and nutritionist guidance are accompanied by near real-time monitoring of blood glucose levels. Your personal nutritionist will also provide unlimited education and specific direction regarding your selected diet. Additional periodic physician ordered laboratory studies will determine if you are optimizing your diet and fat-burning capability.

What other medical conditions will a MetabolicMD CGM diet treat?

A CGM diet provides both active treatment and a preventative care for many common health issues.

For patients whose overweight status may already be causing health issues, the MetabolicMD approach is effective at reducing or eliminating many chronic conditions. We work in concert with our patients’ primary care physician to address these chronic conditions. A diet facilitated by CGM can reverse mild and even moderate diabetic states, pre-diabetes, and metabolic syndrome. It will lower insulin resistance and, by achieving weight loss, can reduce or eliminate sleep apnea and joint pain. The program is effective at lowering cholesterol and triglycerides, reducing GERD symptoms, and eliminating fatty liver disease. With dietary management of blood glucose spikes and plunges (hypoglycemia) this program will improve energy, decreases fatigue, improve mental sharpness, and improve sleep patterns. Because hormonal balance is greatly impacted by fat stores (especially estrogen and testosterone levels) the MetabolicMD CGM approach also helps to re-establish optimal hormonal balance.

For those individuals who are likely destined to heave serious health issues as they age (due to genetic issues, lifestyle issues, or because they are currently overweight) a CGM low carb diet has great preventative (protective) value. The MetabolicMD program is not only effective at achieving weight loss, but also addresses potential hidden long-term health risks including such issues as pre-diabetes, hypertension, and metabolic syndrome. In doing so the eventual complications of these pathological states can be avoided (including heart disease, peripheral vascular disease, kidney failure, stroke, etc.).

Will the MetabolicMD CGM program help my energy level?

Food choices can affect blood glucose variability (blood glucose spikes and plunges) causing fatigue and affecting energy levels. These blood glucose peaks and valleys also impact mental sharpness and even disturb sleep patterns. CGM provides the user and his/her providers data on blood glucose patterns to help decrease blood glucose variability and improve energy levels. Patients with fewer unnecessary elevations of blood glucose and fewer drops in blood glucose (reactive hypoglycemia) experience improved mental clarity.

How is the MetabolicMD program structured?

The initial six-month program begins with a one-hour physician consultation, the ordering of appropriate laboratory tests, and the prescribing of a Continuous Glucose Monitor. Program goals are collaboratively set by the patient and the physician. The patient is also provided a scale with which he/she will remotely share weights with the physician and nutritionist. Two weeks after the initial visit a second meeting with the physician takes place to review the patient’s remotely provided initial CGM and weight data as well as the laboratory results. At this time the patient also meets with their personal nutritionist. The patient, the physician and the nutritionist collaborate on the best low carb diet option for the patient. This diet is implemented, and then the nutritionist monitors the patients ongoing blood glucose data and communicates at least weekly with the patient regarding blood glucose patterns and suggested dietary adjustments. (The physician also monitors blood glucose data and patient weight at least weekly.) Frequent nutritionist – patient communication continues for the duration of the program. Also provided by the nutritionist is unlimited dietary education. The nutritionist will also contact the patient as frequently as needed (even daily if patient permission is provided) to discuss blood glucose patterns (elevations, spikes, plunges) requiring immediate dietary attention.

At week four and monthly thereafter the patient meets with the physician to discuss program progress and CGM data patterns. Repeat laboratory data will be obtained again at 12 weeks and at 22 weeks, and the physician will meet with the patient to discuss these results. At six months, the patient may choose to enter the program’s metabolic health maintenance phase. This phase includes the ongoing prescribing of a CGM and continued unlimited nutritionist support. Physician visits during this phase are less frequent, and are personalized to the patient’s individual needs.

Our physician services are not meant to replace the care provided by a patient’s primary care provider. However, with patient permission we collaborate and communicate closely with each of our patients’ physician, nurse practitioner, or physician assistant.

The cost of the six-month MetabolicMD CGM program is structured as a subscription, divided into two components. A payment is made for the initial physician consultation, and a second fee is paid for the remaining first six months of program services. As outlined above services include monthly appointments with the physician, and continuous nutritionist blood glucose monitoring, education and support. MetabolicMD does not currently participate with insurers, but we do provide itemized statements for medical services provided to patients who may then submit these receipts to their insurer. The cost of the prescribed CGM varies dependent on insurance coverage, but is usually about $60 per month. Laboratory costs are dependent on the patient’s insurance coverage. The scale used for remote monitoring is about $60 (one-time purchase).

Maintenance phase services after the first six months of the program are provided at a lower subscription rate. Patients are prescribed a CGM on an ongoing basis. This maintenance phase service also includes uninterrupted nutritionist data monitoring, unlimited ongoing nutritionist education services, and approximately quarterly appointments with the physician. Additional lab work is ordered as needed, with subsequent review of results with the physician.