The Oura fitness ring and the Stelo continuous glucose monitor (CGM) now connect. For the past month, I’ve been wearing the Oura Ring on a finger and the CGM on my arm. Together, they’ve given me a more complete picture of how sleep, stress, exercise — and, of course, food — affect blood sugar. I wrote about Stelo in January. What’s new is that it now integrates with the Oura Ring, which I’ve recently started using for the first time. Oura provides a variety of health and fitness data. Together, the two devices give me a much broader picture of how daily habits affect blood sugar.
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I don’t have diabetes, but my late father did, so I pay attention to my glucose. But as I’ve since learned, a single fasting glucose value is just a snapshot in time, Taken a few minutes earlier or later, the number might be different. That’s why doctors often follow up with an A1C test, which averages blood sugar over about 90 days.
Stelo
Stelo is one of Dexcom’s two CGMs. Unlike its prescription-only sibling, the G7, Stelo doesn’t require a prescription, and it’s not intended for people on insulin. It’s about the size of a quarter with tiny prongs that go just under the skin and are essentially painless. Once applied, Stelo pairs with your phone and delivers glucose readings every 15 minutes. That’s less frequent than prescription CGMs, but more than enough to show how food, activity, sleep and stress affect your glucose. Each sensor lasts 15 days. They are a bit pricey: two sensors for $99 or down to $84 a month for a three-month subscription. Amazon sells two sensors for $90.93. Some people wear them for two weeks then take a break or stop using them after learning their patterns, which saves money and, as I’ll discuss later, reduces the potential anxiety that can come with health tracking.
The Stelo app shows your current glucose reading and all prior results. It also calculates your “time in range” between the lower and upper limit you specify or your doctor recommends. Being out of range temporarily isn’t necessarily a big deal if levels return to normal in a reasonable amount of time. The app also reports your average glucose over 3, 7, 14 or 30 days, and there’s a companion app that generates detailed reports and can send data to your health provider. Those reports include a Glucose Management Indicator (GMI), which roughly corresponds to A1C. My actual lab A1C was slightly lower than Stelo’s estimate, something Dr. Thomas Grace, Dexcom’s Head of Clinical Advocacy and Outcomes, attributes to timing differences and calculation methods.
One thing I’ve learned from Stelo is that glucose fluctuates in ways that don’t always seem obvious. As Grace explained, “Little things can cause fluctuations throughout the day, including sleep and stress. It’s not only what we eat and how much we move; there are a lot of things that go into glucose.”
I’ve seen this myself. At my doctor’s office, two fasting glucose tests taken half an hour apart differed by more than 8 mg/dL. Stelo shows similar shifts, even when I haven’t eaten or exercised,
Enter Oura
Both Stelo and Oura let you log meals by typing or photographing food. Oura users can see glucose graphed alongside exercise, stress, sleep, and (if logged) food intake. Seeing these factors together is powerful. You can watch how a poor night’s sleep or a stressful day changes your blood sugar and how a short walk after a meal helps bring it back down. Research backs this up. A 2022 New York Times article noted that “light walking after a meal, in increments of as little as two to five minutes, had a significant impact in moderating blood sugar levels.” Grace points out that the sequence of what you eat matters, too: “If you ate pasta first, then a meatball, then your salad, you would have a totally different glucose experience than if you ate the salad first, then the meatball, then the pasta.”
Oura by itself
Of course, most Oura users don’t wear a CGM. They rely on the ring’s core insights and general sleep, activity and fitness data including how long and how well they slept, how much deep and REM sleep they got and how long it took to fall asleep. Oura uses AI to offer advice such as, “Your sleep efficiency wasn’t optimal last night,” along with tips to improve. It also reports average overnight oxygen saturation (SpO₂), charts your heart rate, tracks breathing irregularities, and explains variations. During the day, Oura automatically records many workouts, counts steps and reports total and active calories burned. It also reports stress resilience, cardiovascular age versus actual age, cardiac capacity (via a six-minute brisk walk test), and a daily readiness score.
Some people find a ring more comfortable than a watch. The ring’s lack of a screen, requiring you to look at the phone app, has its obvious drawbacks but can also reduce the temptation to fixate on your results.
Dr. Winston Vaugn, an Atherton-based physician who specializes in nasal and sinus surgery, likes the Oura ring because “It’s just simple to put on,” he said. “I go to sleep and then wake up and look at my restlessness, efficiency and that kind of forced me to start going to bed a little bit earlier and changing some of the things in my environment. … I learned to sleep better with the Oura ring.”
Recently, Oura added an AI-enabled Advisor that gives personalized feedback about your sleep, activity, readiness, and resilience. You can ask it health, fitness and wellbeing questions. As I write this, my “Advisor” noted that my readiness score and sleep data were a bit off last night and suggested I “take it easy” today.
Oura also integrates with Apple Health, syncing data both ways. For the most part this is helpful, but I did run into some confusion: Oura gave me a cardiac capacity score from its own six-minute walk test, then later replaced it with Apple’s much different VO₂ Max score, which is based on a different method entirely.
The Oura ring starts at $199 for the 3rd generation or $349 for the Oura Ring 4 I tested. Both work with Stelo. Stelo integration and most other Oura features require a $5.99 a month (or $70 a year) membership.
Caveats
These tools aren’t for everyone. I find them useful, but I also recognize the downsides. If you use them, it’s best not to stress over a single result but to focus on trends. Stress itself can raise blood sugar and cause other problem, and ironically, tracking stress, or any health metric, too closely can make you more stressed. I now try to avoid obsessing over every data point and instead pay attention to overall patterns, summaries and, most important, how I feel. It’s also important to consult a doctor if you have any anxiety or concerns and to remember that nothing in life, including our health stats, is going to always be perfect.
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Larry Magid is a tech journalist and internet safety activist. Contact him at [email protected].