REVIEW – I’m a pre-diabetic and you might be one too and not even know it. Diabetes is a disease where a high level of sugar/glucose is circulating through your bloodstream. The problem is that you may not notice any major symptoms until damage to your heart, kidneys, eyes, nerves, etc has already started happening. That’s why it’s important to know what your A1C is (average blood glucose reading for the last 3 months) and know how certain foods and activities affect your daily blood sugar levels. You can ask your doctor for an A1C test and even buy at-home A1C tests from Amazon. But knowing how specific foods and activities affect your glucose levels is like having the world’s best multi-tool in your pocket and that’s where the LEVELS metabolic health tracker system comes in. Let’s take a look.
What is it?
LEVELS is an application for iOS that works in tandem with FreeStyle Libre 14-day continuous glucose monitor sensors to provide deep insight into your metabolism and how certain foods and exercise affect your blood sugar levels throughout the day.
What’s in the box?
- 2 FreeStyle Libre 14-day sensors
A little background about me and diabetes
I’m not going into this review without any knowledge of diabetes. I know how brutal the disease is because I grew up with a mother who was a “brittle” diabetic with wild swings in blood sugar levels. My mom died way too young at age 58 after multiple amputations and strokes. When I found out that I was a diabetic in 2004, I immediately changed my eating and exercise habits to combat it.
At a routine yearly physical, my fasting blood sugar was 101, which is 1 point over what is considered the high end of a normal fasting glucose reading. So I had an A1C test and the result was 6.7 which meant that I was a diabetic. I didn’t want to take insulin so I opted to try diet and exercise first as means to lower my A1C level. I successfully brought it down to 6.0 in just 6 months and in the years that have followed, I’ve stayed around 5.7 which has kept me in the pre-diabetes range.
Last fall I started testing my blood with a regular glucose meter which uses a drop of blood and noticed that my fasting glucose was elevated higher than I’d noticed before. I wasn’t really surprised at the readings because working from home due to COVID had enabled me to slip into bad habits of eating empty high-carb foods and snacks. I went to the doctor and asked for an A1C and my result was 5.9 which was higher than the previous year. I knew it was time to get serious again and started researching Keto-friendly foods, low-carb foods, and continuous glucose monitors.
My doctor prescribed me the Freestyle Libre 14-day sensor which has helped me a LOT, but the Freestyle app is very basic because it only shows a graph of your glucose readings and doesn’t provide much else in the way of useful info. Then I stumbled upon the awesome Serious Keto YouTube channel and in one of the videos, he mentioned that he was beta testing the LEVELS CGM. I immediately went to the LEVELS site and signed up so I could try it too.
Design and features
The LEVELS system has two parts. The CGM and the app. The system ships with 2 Freestyle Libre 14-day sensors. I’m not going to focus much on that part of the system because I’ve already reviewed the Freestyle CGM sensor which you can read by clicking the link above. The other half of the LEVELS system is their LEVELS app and this is where the real magic is.
The way it works is that you scan the Freestyle sensor using the Freestyle app on your phone to see your current blood glucose reading and then you launch the LEVELS app which syncs/imports the data from the Freestyle app.
Like the Freestyle app, the LEVELS app will display a graph of your glucose readings throughout the day. But where the LEVELS app is so much better than the Freestyle app is that it will let you take a picture of your meals/foods and it will sync Apple Health info like your workouts. When you take a picture of a meal that you’re about to eat and/or log a workout, the app will track your blood glucose spike or drop related to the food or workout.
Using your meal and workouts will put points on the glucose graph and will track how your blood sugar spikes or how it drops based on food and exercise.
You can even compare how your blood sugar reacts to two foods. Or in the example screenshots above, I am comparing how my blood sugar levels react to eating the same protein bar but with one of them, I walked 20 mins before eating it. The app also has a challenge section that gives you ideas of certain foods that you can eat as a test to see how your body reacts to them.
The LEVELS app assigns a metabolic score to each food to let you know how it affects your blood sugar. The app will also assign a score for each day which lets you look back to see trends. You can see that I tend to eat worse starting Friday through Sundays. That’s because I allow myself to eat pretty much whatever I want on Saturdays, but sometimes the junk fest starts on Friday night and spreads into Sundays… I need to work on that.
Another feature of the LEVELS app is a selection of great articles on managing diabetes. The app will also send daily, weekly, and monthly email reports about your time in the target blood glucose range, etc.
My questions for the LEVELS team
1. Will you ever offer the app to be used by existing Freestyle Libre 14 day sensor users?
It is possible that if CGM hardware becomes over-the-counter in the US that we would offer an app-only version of our product. For the time being, given that the sensors are prescription only and will be for the foreseeable future, our product will remain a package complete with a physician consultation, fulfillment of the sensors from our partner pharmacy, and access to the Levels app.
2. Can anyone sign up to buy the 1 month trial system now, and what is the price?
Anyone can sign up to join the waitlist at the moment. Currently we’re still in our beta testing phase so only a limited group have been able to purchase so far. We have had 6,000 people go through our beta program, and there are 100,000 people on the waitlist. Anyone can sign up and join the waitlist at https://www.levelshealth.com/signup
3. After the 1 month trial ends, how much does it cost to continue using the app and receiving sensors?
Levels starts off with a 28 day program helping members identify how their nutrition, exercise, sleep and stress decisions impact their metabolic fitness and understand how to develop a truly personalized lifestyle. For those who would like to continue using Levels past the first month, we offer ongoing sensor subscriptions for $199/mo to continue the journey. Our goal is to get the price down to $99/mo within two years. You can find out more in our Secret Master Plan.
4. Will health insurance cover the cost of the sensors?
Many insurance companies already reimburse for sensors for individuals who have Type 1 or Type 2 diabetes, which are the conditions for which the sensors are FDA approved. The sensors are not currently covered for individuals without diabetes who are using CGM to help personalize their diet and lifestyles. However, as use of CGM in a non-diabetic population grows and as the value emerges showing that this tool can potentially keep people healthy and reduce rates of future disease, I think we will see a movement towards coverage by insurance companies. There is much research that still needs to be done to show that utility and potential cost savings from non-diabetic individuals using this device. Additionally, as the market for these devices grows and expands into the price-sensitive mainstream consumer space for health, wellness, and fitness, costs of the hardware will come down.
What I like
- So much useful info!
- Lets you clearly see how certain foods and activities affect your blood sugar levels
- Gives foods a grade
What I’d change
- Allow existing Freestyle Libre users to download and use the Levels app without requiring them to buy sensors from Levels
Final thoughts
Having diabetes can be a scary thing and I’m VERY fortunate that I’ve found ways to manage my own condition without taking drugs. The LEVELS continuous glucose monitor and metabolic health tracker system is an awesome addition to my health toolbox because it lets me see exactly how eating a greasy (but delicious) fish and chips meal spikes my blood sugar by over 100 points vs eating the same meal and then immediately going for a 30 minute walk. LEVELS makes me think twice about eating something that I already know is going to cause a huge spike in my blood sugar. I feel that software and hardware combos like LEVELS is the future of health care and can help millions of people work with their metabolism to stay healthy and free of diabetes.
Update 8/12/22
It’s been over a year since I posted my review of the Levels metabolic health tracker system which at the time of that review, it was still in beta testing. I’m happy to announce that Levels is now out of the beta testing phase and they have made some additions and changes worth mentioning.
The biggest change is that now Levels supports not only the FreeStyle Libre CGM, but they are now supporting the Dexcom G6 CGM. Why does this matter? Well, there’s the convenience factor. The FreeStyle Libre CGM sensor has to be manually scanned with your phone to take a blood glucose reading at least once every 8hrs. If you don’t do that, you’ll lose data as the sensor itself can only hold up to 8hrs of readings.
The Dexcom G6 doesn’t have that limitation because it’s constantly taking readings automatically and sending the info to your phone. You can even add a widget on your phone or smartwatch to see your current blood glucose reading. The downside of the Dexcom is that the sensor only lasts for 10 days instead of 14 days like the FreeStyle. There are also two parts to the Dexcom. The sensor and the transmitter. See my Dexcom G6 review and my FreeStyle Libre 14 day CGM review which explains everything in considerably better detail.
Another new service from Levels is a blood panel that gives you the following info:
A1C – Average glucose levels in the last 3 months
HOMA-IR – Indicates how well your body’s insulin deals with glucose
Fasting glucose – Measure of blood sugar levels unaffected by a recent meal
Fasting Insulin – Measure of insulin levels unaffected by a recent meal
Cholesterol – LDL, HDL, and Triglyceries, levels
hsCRP – It’s an indicator of how much inflammation you have in your body
The only thing I wish was that Levels offered a way to talk with a human healthcare expert where you could ask questions about your blood panel results.
And the really great thing is that you don’t have to even leave your house to have this blood work. They come to your house! Levels let me try this service. It was an easy process where I gave them my information, scheduled my desired date and time, and then waited for the health tech to show up at my home.
The tech arrived at my house with her medical gear and drew my blood. Then a day or so later, I received a notification that my results were available. I was able to view them through the Levels app. I liked that this blood panel provided tests that I’ve not had in the past (HOMA-IR and hsCRP).
Other changes include updates to the Levels app to simplify the user interface.
To use Levels, you must pay $199 per year which does not include the price of the blood glucose sensors (FreeStyle or Dexcom) which ends up being an additional $199 a month. The price of the blood panel is $179.00. Note that most people will just use this service for a month or two to get an idea of how foods and activity affect their blood sugar levels.
Price: $398 for the 28-day program and $199/mo if you wish to continue (does not include the price of additional sensors)
Where to buy: LEVELS
Source: The sample for this review was provided by LEVELS.
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“ Allow existing Freestyle Libre users to download and use the Levels app without requiring them to buy sensors from Levels”. BINGO, that was my first question. I don’t understand why they limit this today. Charge a reasonable price for the app and they have an instant user base.