Are protein shakes and CGM useful for better sugar control?

Question

Hi doctor,

I was diagnosed with type 2 diabetes last year. My latest HbA1c is 7.4%, and fasting sugar is 145 mg/dL. I am on Metformin 1000 mg twice daily, but still see mild fluctuations. My concerns are:

Should I be considering adding another medicine, or can a stricter diet and exercise control it better?
I sometimes skip dinner due to work. Could that cause sugar swings?
Is it safe to take occasional protein shakes while managing diabetes?
I have heard that continuous glucose monitoring helps understand food effects. Is that worth trying long-term?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Your numbers show that your diabetes is not well-controlled, but there is still room for improvement.

An HbA1c (glycated hemoglobin) of 7.4 percent and fasting sugars around 145 milligrams per deciliter on Metformin 1000 mg twice daily means you are already close to the usual goal of about 7 percent.

Whether you need a second medication depends on how consistent your lifestyle is.

If meal timings, diet, and exercise are still irregular, it is reasonable to focus on these first and repeat your tests in a few months.
If your routine is already steady and your numbers have remained unchanged, then adding a second medicine may help improve control.
Skipping dinner can definitely lead to glucose fluctuations.
Long gaps followed by heavier meals tend to cause later spikes. If you cannot have a full dinner, try at least a small, balanced snack instead of skipping completely.
Protein shakes are acceptable occasionally if they are low in sugar, fit your calorie needs, and your kidney function is normal.
Avoid high-sugar or mass gainer shakes.

A short trial of continuous glucose monitoring (CGM) can provide very useful insight. Wearing a sensor for even 10 to 14 days can help you understand how food, sleep, and activity affect your readings and guide more precise adjustments. This is optional but often helpful.

Overall, you are close to the target. You are not failing treatment. With consistent meal timings, regular exercise, and your doctor’s guidance on whether to continue lifestyle changes or add another medicine, you can achieve even better control.

Please reach out if you have any further questions.

Thank you.