Review: Abbott Lingo Continuous Blood Glucose Monitor

My husband loved it when I had gestational diabetes while pregnant. That is to say, he didn’t love that I had a dangerous medical condition, but eating like a diabetic is ideal if your goals are to keep your weight down and stay strong. Meal plans will vary, because bodies process food so differently—I worked with a nutritionist—but the gist is that to keep your blood sugar steady, you should eat a diet high in protein and fiber, and relatively low in sugar and carbs. For example, breakfast was often scrambled eggs and blueberries. This is great. It’s also a lot of work.

The Abbott Lingo lets you eat like a diabetic. Rather than pricking yourself with a needle after every meal to test your blood sugar, as I did, you simply slap the Lingo, a small continuous glucose monitor, on your arm. A filament slides under your skin, and the sensor reads your blood glucose and lets you check it throughout the day. It works extremely well. But I should also point out that meals serve many different purposes besides trying to aim for physical perfection, and I’m probably not going to replace the sensor when it falls off.

Scaredy-Cat

First off, I have to apologize to Dexcom, because I initially chickened out when that company sent me the Stelo, which, in all fairness, did launch before the Lingo. Both Dexcom and Abbott are long-time manufacturers of diabetes equipment; my mom, who is diabetic, wears an Abbott FreeStyle Libre. (The Lingo is cleared for people without diabetes; the FreeStyle Libre is prescription-only.)

Courtesy of Lingo

Without having tested the Stelo (I will, now that I have gotten over my initial squeamishness), I can say that I like Dexcom's marketing slightly more. The Stelo is aimed toward Type 2 diabetics who manage their condition without insulin, which is common, versus just any old person who wants to monitor their blood sugar continuously. Dexcom’s partnerships also seem a bit more extensive. Dexcom has an Apple Watch app, which is insanely convenient, and it has a partnership with Oura. However, workouts logged in Apple Health show up in your Lingo app, and Abbott is a very reliable company as well.

It’s worth noting here that I am currently prediabetic, not actually diabetic. However, when I was pregnant and did have gestational diabetes that I needed to monitor hour by hour, I was so scared of having to wear a continuous glucose monitor that I pricked my own finger several times a day for months. It seemed insane to me that anyone would wear this who didn't have to. Now that I have finally put it on, I can say that choice was a little bit ridiculous. It doesn't hurt at all.

Photograph: Tristan deBrauwere

To put on the Lingo, you unwrap it and place the carton in the dispenser. Clicking the dispenser on your arm, which sends the filament under your skin, stings only faintly. It feels like getting flicked with a finger. It is way less painful than pricking your finger with a needle until you bleed, many times a day, and I was an idiot and should have done this before.

The sensor itself is fine. I don’t feel it most of the time, unless I change my clothes with much vigor and abandon, in which case I do have to be careful. You can pick where you put the sensor; most people pick their non-dominant arm. It’s water-resistant, so you can swim and shower with it, and you don’t have to charge it.

Once I had the sensor on, I opened the Lingo app, registered, and waved my phone next to it. Done! I was ready to start monitoring.

Sugar Rush

If you’ve never monitored your blood glucose continuously, you’re probably in for a few surprises. Eating in a way that makes sense to a glucose monitor does not always mean eating healthier, objectively. For example, consider a typical lunch for me, which is a bowl of homemade pureed carrot soup and whole wheat bread. Because carrots and bread are carbs, this spikes my blood sugar to an alarming extent. An ultra-processed protein peanut butter bar, however, barely moves my blood sugar at all, even though if you’re healthy, one is not necessarily better than the other.

If you reduce the number of carbs you consume, you will reach ketosis, which is when your body starts burning your body fat instead of your readily available blood glucose for energy, because you have none. This is different, and less dangerous, than getting ketosis as a diabetes complication, but I still hate it.

I put the Lingo on during CES, where I did make one alarming discovery—I was walking around way too much for the amount of food that I was eating, and I was going hypoglycemic during the night. I thought my sleep disturbances were just due to work, stress, and being away from my family, but no, I was totally bottoming out.

The app comes with several different tabs—Today, which is your blood glucose; Challenges, to develop different eating habits; Discover, which has little lessons on things to learn; and You, which is your profile and long-term stats. Lingo also has a proprietary metric, called your Lingo Count. Lingo looks at your glucose spikes and assigns them a number to quantify the stress that each spike puts on your body; a lower Lingo count is better.

The app also prompts you to tag events for your glucose spikes. For example, drinking a cup of coffee with sugar can spike my blood sugar all to hell, but so can discovering that my son is having a coughing fit. I also experienced a few connection issues, such as when I was wearing multiple coats (I’m sorry, I’m a perpetually cold person) or when I tried to check my blood glucose on a crowded bus in the middle of a hundred Bluetooth-enabled devices, but these were few and far between once I left CES.

Surprise Surprise

If you’re observant, you will probably start detecting your body’s own little weird quirks right away, which is neat. For example, if I have a little spoonful of ice cream before I go to bed, my blood sugar stays stable at night, and it’s even lower in the morning than if I had no food at all. A walk that's as gentle as getting up and putting the dishes away after eating is enough to keep my blood sugar from spiking.

If you have Type 2 diabetes or are prediabetic, you've probably been waiting for the Lingo, or for some other form of noninvasive continuous blood glucose monitoring, for a long time. Diabetes is a long-term health condition that has to be managed constantly and runs in families, like mine. It was a relief to finally put on the Lingo and realize that I'm still producing insulin and managing my blood sugar spikes effectively.

A photo of a representative from Abbott at CES in Las Vegas, Nevada.Photograph: Tristan deBrauwere

This information should be available to anyone who wants it, and it's crazy that you had to get insurance to cover a continuous blood glucose monitor for so long. A 2018 Stanford study also showed that many people have prolonged blood sugar spikes and don't know it, which can lead to insulin resistance or an increased risk of cardiovascular disease down the road. I can't imagine wanting this information and not being able to get it, especially when unmanaged blood sugar spikes can lead to so many long-term health conditions.

But personally, I do not do so well, mentally or emotionally, when I monitor my food intake this closely. I'm getting older, and I'm already having a hard time managing all the different demands on my diet, what with the fiber and protein supplements and avoiding ultra-processed food. If you're of an obsessive bent, it's really easy to become paralyzed or preoccupied, or to start denying yourself small pleasures just so you can eat only cans of sardines.

I'm not a doctor, but living longer and well includes things like getting drinks with friends, eating birthday cake with my kids, and getting hot pot with my parents. If monitoring your blood sugar will prevent you from doing these things, it's worth reconsidering.

Then there's the cost. It's $89 a month for two sensors, since they fall off every two weeks. If you don't have a reason to be concerned about blood sugar spikes, you might want to consider if there are other ways to improve it before getting a blood glucose monitor, like a gym membership, or taking your bestie out ice-skating for the afternoon.

So many things that are healthy, or even just fun, are also, maybe, just a little bit bad for you when considered vis-a-vis one metric versus another. I'm just not the kind of person who needs to be reminded constantly that it's technically healthier to eat a salad alone than it is to sneak out on a lunch date for pho with your spouse. If you’re lucky enough to have a body that produces insulin, I think you should be able to do something as wild and licentious as dabbing a little sugar in your coffee if you want. If you're not diabetic, I give you permission to do that now.