For those of you that have someone with Type 1 or Type 2 diabetes in your life, you’re probably familiar with a continuous glucose monitor, or “CGM”. Compared with the finger-prick system, the CGM is an incredible feat of technology: It’s a wearable biosensor that streams real-time blood glucose levels to an app on a patient’s phone, alerting them to life-threatening spikes or dips in blood sugar in real time. Not to mention that it’s so much less invasive: It lives in your arm for two weeks at a time, it’s easy to apply and remove, and there are no finger pricks or blood drops involved.
But here’s the thing: We can all benefit from understanding what spikes our blood sugar— even if we don’t have diabetes. And wearing a CGM can provide a fascinating window into how your dietary and lifestyle decisions impact your health. A small handful of companies have been re-branding the CGM for those interested in improving their metabolic health, and I started becoming really interested in trying one. So I reached out to a company called Levels that I had heard great things about. They offered to send me a month’s worth of CGMs so I could see it in action, and it proved to be fascinating— it has completely changed the way I think about food, exercise, and my own health.
Why would I want to wear a CGM?
It turns out, how long our blood sugar is elevated, and how many spikes we have throughout the day, can lead to a range of short- and long-term health effects. We’re talking fatigue, brain fog, depression, all the way up to cardiovascular disease, stroke, and cancer. In fact, Alzheimer’s has recently been dubbed “Type 3 diabetes”, because insulin resistance in the brain is being linked with cognitive decline. So knowing about your blood sugar levels throughout the day, and seeing how dietary and lifestyle changes can impact them, is a powerful thing that can help you avoid numerous diseases well beyond concerns about diabetes.
For me, I was especially interested in how blood glucose might affect my mood and some post-pandemic weight loss I was after. I think we all have a keen sense of how blood sugar drops affect mood (that lovely “hangry” feeling is blood sugar at play), but sometimes seeing the data plotted out on a graph while experiencing the effects is enough to inspire me to change habits. And because blood sugar spikes can make it difficult to burn fat, and I had some weight to lose, it was the perfect time to see if I could lean into habits that would help me stabilize my blood sugar… and see if that helped me on the scale.
Did it hurt to install?
That was my first and most pressing question and the thing I was most nervous about. I watched about a million videos of people punching them into their arms, along with the instruction video that Levels sent, which was really easy to follow. The whole process took just a couple of minutes (most of which was me psyching myself up to push the button!) but when I finally did, I barely felt it. There is a small needle in the applicator that guides the sensor into your arm, but it quickly retreats and leaves you with an adhesive plastic disk with a small, horse-hair-like sensor inside your arm. Once you add the sticker on top, it’s waterproof and protected from bumps, clothes and regular life. (and, turns out, a great conversation starter… everyone who saw it wanted to talk about it, which was kind of fun).
Once attached, the sensor syncs to the Levels app and sends your blood glucose data to it throughout the day. For those with Type 1 diabetes, a CGM is typically also connected to an insulin pump that automatically delivers (and regulates) insulin if their blood sugar gets too high. But for Levels users, it’s all about presenting your data to you and showing you how to improve it without any medical intervention.
How much does it cost?
The pricing for Levels is a bit confusing and hard to find on the website, but here’s how it breaks down: When you first sign up for Levels, the total cost is $398. This includes the first month of continuous glucose monitors for $199 + the annual membership fee of $199. After that, monthly CGMs are $199 each.
What did I learn?
The name of the game with the Levels app is stable blood sugar: The fewer spikes and elevations, the better your “metabolic score” is at the end of each day. And just like with any other fitness tracker or biohacking device, the gamification is key— it’s all about keeping your streak going and keeping your score as close to 100 as possible.
In the month I wore my CGMs, I did a deep dive on the literature and “blood sugar hacks” that are abundant online, both on the Levels blog and in other medical blogs online (my absolute favorite is @glucosegoddess on Instagram). I was able to see data on all my meals, and then tweak things about those same meals and compare the results. Here are some of the most valuable things I learned:
Refined carbohydrates and sugars send your blood sugar through the roof.
I knew this going in, but to see it on the app— just how long your blood sugar stays elevated after that glass of orange juice, cookie, or rice bowl is, is sobering. Eating mostly healthy fats, fiber-rich greens and proteins helped me keep my blood sugar like a chill ripple and not like a treacherous rollercoaster.
My breakfast completely changed.
There are healthy cereals, alternative milks, and gluten-free pastries that I used to feel good about starting my day with. But now, I look at all of those things and KNOW they will start me off on a blood sugar rollercoaster. Studies show a savory breakfast (that has the same calories as a sweet breakfast) has a lesser impact on glucose levels, and I found this to be true. Turkey sausage, eggs, greens, and healthy fats like avocados or nuts became my go-to. I go longer after breakfast without being hungry now (like 4-5 hours, whereas before I used to be prowling for lunch after 2-3 hours), and feel so much calmer.
Exercising after a meal helps level out your spikes.
If you are going to go for it and have pasta for dinner, it helps to take a walk afterward. I was able to compare a few meals with the same meal plus exercise afterward, and it made a big difference. This was empowering, because it meant that I could enjoy the foods I wanted (ie. pizza night), I just needed to walk the dogs afterward and my blood sugar would take less of a hit.
The order in which I ate foods mattered a lot.
Let’s say you’ve got a plate with grilled chicken, broccoli and mashed potatoes. If you eat the foods in the right order, you can reduce a glucose spike by 75 percent. (Mindblowing, right?) Here’s the recipe: Eat your veggies first, protein and fats second, starches and sugars last. As you digest those vegetables, the wall of your upper intestine is coated so that starches and sugars are absorbed with a lesser impact on your glucose, but you get to eat the same foods.
One magical ingredient before meals changes everything.
Apple cider vinegar, white wine vinegar, rice vinegar—the choice is yours. Adding one tablespoon to a tall glass of water before you eat helps break down starches and slow their impact on your glucose levels. In other words, you’re less prone to blood sugar spikes and crashes and are better equipped to ward off cravings. This one was remarkable to observe: The same meals in the same quantities eaten the same way had wildly different results if vinegar was my appetizer.
Sushi just didn’t work.
I ended up eating a fortune’s worth of sashimi (raw fish, no rice) on the night I went out with my family to a sushi restaurant. And even though I had some rice at the end of my meal, after greens and protein, it STILL caused a spike. I would imagine that it’s different for everyone, but it has changed my view of sushi as a healthy meal in general. I will definitely have more sushi in my future (I live in Los Angeles, after all!) but I think I’ll be seeing it more as a seldom-eaten treat than a weekly occurrence.
Same with kombucha.
Even though there’s technically no added sugar in a kombucha drink, I found that it spiked my blood sugar like crazy. I went on some message boards and found that people’s reaction to kombucha is mixed… some people spike more and some don’t. Another reason why wearing a CGM is so helpful— it gives you specific information about your own body, so you don’t have to use generalized wisdom to make decisions. So whereas I used to think it was healthy for me, I think I’ll be skipping it from now on.
How did I do with weight loss?
This was the craziest thing. Because I wasn’t restricting any calories, weighing anything, or following any program or diet. I definitely was greatly limiting my carbohydrate and sugar intake, but still had dessert once a week, and bread/starches 2-3 times per week, and using my hacks to level their effects (vs. having them at every meal like I used to). I made room for the foods/meals that were important to me, but on the days I wasn’t having starches, I was loading up on steak and arugula, avocados and scrambled eggs, sweet potatoes and broccoli, chicken club lettuce wraps, and huge salads with salmon on top. I didn’t feel deprived ever and I wasn’t restricting my calories in any way. Most importantly, I felt calm, energetic and less hungry than usual.
I wore the CGM for 4 of the 6 weeks I ate this way, and lost 10lbs.
If you’re coming from the “a calorie is a calorie” frame of mind and are used to leveraging 100 calorie packs of processed cookies or fat free ice cream on a diet, this way of life and way of eating will probably be tough for you to adjust to. The truth is, all calories are NOT the same— some will help your body thrive while others can negatively impact your health over time. I’m 48 years old. I’m not a dieter and I don’t come from diet culture. But I do like taking control of my own health, and unlocking ways I can be more comfortable at the dinner table, less plagued by what would be “good” for me and what would be “bad”, and more confident that I’m doing right by my health for the future. My experience with Levels and their CGM puts me in the driver’s seat on all of those fronts, and even if I don’t continue to wear one, I’ve learned so much that I’ll use to help me make decisions around food for the rest of my life.