A reporter's descent into CGM madness | The Vergecast

ELI5/TLDR

A Verge reporter spent 18 months testing continuous glucose monitors — small needle-based devices that track your blood sugar in real time — and nearly wrecked her relationship with food in the process. The devices, originally built for diabetics, are now being marketed to everyone as “metabolism optimizers,” pushed by wellness influencers and the Trump administration alike. She did eventually discover a real health issue (fatty liver disease), but the path there involved obsessive data-tracking, skipping birthday cake, and her therapist staging an intervention. Separately, actor Ben McKenzie explains why his crypto documentary lands on “it’s gambling and crime” as the only two real use cases.

The Full Story

Crypto: A Documentary About Trust and Money

The episode opens with actor Ben McKenzie — Ryan Atwood from The O.C., now an unlikely crypto critic — discussing his documentary Everyone Is Lying to You for Money. His argument is clean and structural: money is trust. Crypto claims to be “trustless.” A trustless currency is a contradiction in terms.

“If money is trust and you’re saying it’s a trustless currency, then you’re saying it’s like a governmentless government or a religionless religion. The words you’re searching for are anarchy and cult.”

The technology doesn’t help the case. Bitcoin processes five to seven transactions per second. Visa does 24,000. Even Sam Bankman-Fried admitted in interviews that it didn’t work yet — but promised it would, eventually. McKenzie’s turning point came in El Salvador, the only country that tried to use Bitcoin as actual money. Remittances are 25% of El Salvador’s economy. If crypto-as-money was going to work anywhere, it should have worked there. It didn’t. Usage dropped below 1% of remittances. Merchants looked at him like a confused tourist when he tried to pay in Bitcoin.

The conversation lands on a sharp distinction: stock markets are positive-sum games (your investment funds companies that make things), while crypto is zero-sum at best, negative-sum in practice. McKenzie estimates $150 billion in illegal activity was facilitated by crypto in 2025 alone — from Russian oligarchs buying drones with sanctioned oil money to North Korean hackers funding half their nuclear program.

“There’s only two things that you’re interested in crypto. You’re either trying to get rich because you’re gambling, or you’re a criminal.”

The price keeps going up mostly because of political protection. Trump — who called Bitcoin a scam in 2021 — embraced it in 2024, and the price surged to $120,000 before settling back to the $60,000s. The deepest irony: the supposedly decentralized system now depends on the most powerful government figure in the world to survive.

CGMs: From Diabetes Tech to Wellness Obsession

A continuous glucose monitor is a small device with a tiny needle that you stick into your arm. It reads glucose levels in the fluid between your cells — not directly from blood — and streams that data to an app on your phone. Think of it like a Fitbit, but for your blood sugar. Until 2024, you mostly only knew about these if you were diabetic or loved someone who was.

Two things changed. The FDA cleared CGMs for over-the-counter use in 2024, opening the door to non-diabetics. Then RFK Jr. declared wearables a “fundamental pillar” of the MAHA (Make America Healthy Again) movement, with a stated vision of every American wearing one within four years. His surgeon general nominee, Casey Means, co-founded Levels — a CGM startup — and her book claims that optimizing your metabolism via glucose tracking can prevent everything from acne to cancer.

Victoria Song’s 18-Month Experiment

The Verge’s senior reviewer Victoria Song had a legitimate reason to test CGMs. She has PCOS — polycystic ovary syndrome — a hormonal condition that affects metabolism and makes her more likely to develop insulin resistance. Her father had severe type 2 diabetes. She’d gained 25 pounds doing nothing different, a hallmark of PCOS.

Her first CGM test in 2023 (before over-the-counter devices existed) came back fine — nutritionists told her everything looked great. A year later, the over-the-counter devices told a different story. She was waking up with glucose readings of 110-115 mg/dL, when the target is under 100. She panicked.

Her doctor said her blood labs were normal. She insisted on an ultrasound. They found mild fatty liver disease. Another doctor eventually told her plainly: your genetics are bad, you need medication, and no amount of lifestyle optimization is going to fix this.

The Descent

The daily experience of CGM testing is an obsessive-compulsive feedback loop. Song was wearing two monitors simultaneously (one per arm), running controlled experiments with food timing, checking three to four apps, and trying to isolate variables she couldn’t possibly control — like whether her cat sleeping on her arm was compressing the sensor.

“I started going to social events and not eating anything because I was terrified if eating a slice of pizza was going to spike my glucose.”

She bought a kitchen scale. Memorized the weight of her plates. Learned to scoop rice to a precise amount. Stopped eating cake at friends’ birthday parties. Her therapist noticed. Her friends staged interventions. She had slipped into the early patterns of disordered eating — someone who had spent decades recovering from exactly that.

“Can we consider that it’s not out of the realm of possibility that you can enjoy a single slice of cake and see a spike, and that’s okay?”

The Science Gap

Here’s the problem: nobody actually knows what CGM data means for non-diabetics. Song interviewed researchers who gave 20 CGM reports to 18 expert endocrinologists. There was no consensus on what any of it meant or what follow-up to recommend. The researchers told her it could take years before we have enough peer-reviewed studies to offer actionable advice to healthy people.

Meanwhile, the medication her doctor prescribed actually worked. Her cholesterol normalized. Liver enzymes dropped 65%. But the side effects were severe — she lost muscle mass, couldn’t run more than a mile (from someone who’d cut 16 minutes off her four-mile time), and her wearables now tell her she’s “below average” in cardio fitness. The devices that once said she was seven years younger than her age now scold her.

“Is my life optimized now? I would argue not.”

Why All Gadgets Look the Same (Hotline Bonus)

David Pierce closes with a listener question about why every laptop looks like a MacBook and every phone looks like an iPhone. Two reasons: once a design wins, changing it punishes your customers (think of how many people rely on knowing where buttons are in Microsoft Word), and manufacturing at scale demands uniformity. New gadget designs only happen when a genuinely new technology — like flat screens replacing CRTs — forces a redesign. If you want exciting new gadgets, root for a breakthrough in display tech or input methods.

Key Takeaways

CGMs measure interstitial fluid, not blood glucose. The readings are a proxy, not a direct measurement, and can be affected by sleeping position, pressure on the sensor, and other uncontrollable variables.
There is zero medical consensus on what CGM data means for non-diabetics. 18 expert endocrinologists couldn’t agree on follow-up recommendations when shown non-diabetic CGM reports. Actionable guidelines may be years away.
The “dawn phenomenon” is normal. Your liver dumps glucose when you wake up to give you energy. Elevated morning readings don’t necessarily mean anything is wrong.
CGM data can trigger or worsen disordered eating. The only concrete finding from ~10-12 studies on wearables and health anxiety: they exacerbate symptoms in people who already have eating disorders or disordered eating patterns. This population overlaps heavily with the health-optimizing audience most likely to buy CGMs.
The FDA cleared OTC CGMs in 2024. These are different devices from diabetic CGMs, designed for people with pre-diabetes, type 2 diabetes not on insulin, or general wellness tracking.
The MAHA movement has made CGMs political. RFK Jr. wants every American in a wearable within four years. His surgeon general nominee co-founded a CGM startup. This political backing shapes which features companies develop and how they market them.
Crypto processes 5-7 transactions per second; Visa does 24,000. The technology remains fundamentally unsuited to function as money at scale, even after 15+ years.
Crypto’s two real use cases are gambling and crime. An estimated $150 billion in illegal activity was facilitated by crypto in 2025, per a crypto industry report (likely an underestimate).
El Salvador tested Bitcoin-as-money and it failed. Despite being the ideal candidate (remittance-dependent economy, government mandate), Bitcoin usage fell to under 1% of remittances.
Product design converges because success breeds inertia. Once a design wins the market, changing it costs too much money and annoys too many people. New form factors only emerge when new technology forces redesigns.

Claude’s Take

This is a good episode with two genuinely distinct stories that share an unexpected thread: the gap between what technology promises and what it actually delivers. McKenzie’s crypto segment is well-trodden ground at this point, but he articulates it with unusual clarity — the trust paradox, the El Salvador reality check, the simple math of zero-sum versus positive-sum games. Worth hearing even if you’ve already made up your mind about crypto.

The CGM segment is the real draw. Victoria Song’s reporting is valuable precisely because she’s the exact person these devices are marketed to — health-conscious, data-literate, with genuine risk factors — and she still spiraled. The fact that 18 endocrinologists couldn’t agree on what non-diabetic CGM data means is the kind of detail that should make anyone pause before buying one of these things to “optimize” their metabolism.

The political framing is important and Song is right to include it, even if some listeners will find it annoying. When the person who might become surgeon general co-founded a CGM company and the health secretary is running ad campaigns for wearables, that’s not background noise — it directly shapes what gets built and how it gets sold. Score of 7: solid reporting-driven conversation, not groundbreaking, but the personal narrative gives the CGM segment real weight.