Our genes don’t define us, but they can certainly shape us. While some of our genes are phenomenal, others may hold us back, causing us to work harder than not fall into a ditch that our bodies are more coded for.
For me, one of those areas in my health is diabetes. Even for the fittest of my family members, my family history related to diabetes is abysmal.
In addition, I am a sugar addict. While I eat relatively healthy otherwise, I absolutely love, crave, and cope using sugar.
Due to my family history, I have been increasingly curious about continuous glucose monitors (CGMs). Somehow, I started receiving ads on Facebook related to various continuous glucose monitor programs.
Of course, this led me to be even more curious.
Recently, I signed up for and used the January.ai “Season of Me” app and continuous glucose monitor system. I also considered Levels and NutriSense, but both had waitlists that didn’t open up for me, so I went with January.
What are Continuous Glucose Monitors?
If you know anyone with diabetes, you know that they have to prick their skin a few times a day, squeeze a drop of blood out, and put it in a monitor to analyze and deliver a glucose reading. Cntinuous glucose monitors (CGM) replace this and is just what it sounds like.
CGMs continually monitor your blood sugar level throughout the day, helping you avoid the need to regularly prick your skin, and test manually.
If you have seen anyone with a little patch covering the back of their upper arm, they are probably wearing a CGM. Using an applicator that comes with the device, you insert a tiny needle into your skin and it monitors your glucose level 24 hours a day. The device lasts for 14 days.
While I was a little apprehensive about how much it would hurt to apply, I was happy to discover that it doesn’t hurt at all!
Can You Get a CGM Without a Prescription?
This was my biggest question once I decided I wanted to do a test and see how my blood sugar levels were over the course of a few weeks. The short answer is that you can’t get a continuous glucose monitor without a prescription.
But, when you sign up for one of the programs that are now available (see next section), you get a prescription through the program, and they ship the monitors to you.
What Is the Difference Between January, Levels, and NutriSense?
Currently, there are three primary programs available that come with continuous glucose monitors. All three programs seem to have similar offerings.
Not having done all of the programs, here is what I can tell you about the biggest differences between them:
- Based on the website alone, Levels seems to have the best app and supplemental information available.
- NutriSense offers the longest program offerings (up to 12 months) and comes with free access to a dietician for one month.
- January seems to be the most basic and is also the cheapest.
They are all in beta testing, so you have to join a waitlist to get access.
Right now, it appears that Levels has the longest waitlist. I signed up for the waitlist several months ago and still haven’t “gotten in.” NutriSense seems to be allowing folks in pretty quickly, and January allows you to sign up immediately.
How Much Do the Programs Cost?
Here is a pricing breakdown for each program
- January currently has a $200 off coupon, so it costs $288/month
- NutriSense costs $350/month (less if you sign up for multiple months)
- Levels is $399/month
With each program, you get continuous glucose monitors and access to the app. Each program appears to be similar and has “experiments” you can do. A couple of examples of experiments include:
- Eating white rice for breakfast after fasting overnight
- Comparing your glucose levels after eating the same meal for lunch two days in a row and then exercising
Aside from the dietician offering by NutriSense, it appears you get roughly the same offering for varied prices between the programs.
Unfortunately, none of the programs appear to take insurance, but it is possible you could get reimbursed by your FSA or HSA depending on the circumstances.
What Did I Learn After Wearing a CGM for a Month?
Ultimately, I’m extremely glad I signed up for a CGM program.
I already had a solid baseline of what good nutrition is going into the program. I know it’s important to eat protein and fiber with every meal, to try to go at least 12-14 hours for overnight fasting, and to exercise.
But, I was shocked by some “healthy” foods that spiked my blood sugar. This included oatmeal (with blueberries and pumpkin seeds), an apple with peanut butter or cheese (note to self, eat just half an apple), and sushi. White rice is notorious for spiking blood sugar.
Wearing the monitor all the time and having to track what I ate on the app brought increased awareness to how much I snack during the day. Particularly in the afternoons, I really graze. Working from home during the pandemic has been especially bad for this.
Lastly, the program brought awareness to just how much protein I need to eat to keep my glucose levels from spiking. It was more than I thought.
What Are the Downsides of a CGM?
There are a few downsides I encountered with January.ai’s CGM.
The CGM used by January is the Abbott Freestyle. It is known for not being able to track lower blood sugar very well. A few times, it had my glucose readings at levels where I should have been in a hypoglycemic coma (below 50) and somewhat regularly showed my levels in the 60s.
Because of this, I used a regular glucose monitor (where you prick yourself) for a few days. My actual blood sugar was never as low as the CGM showed (it was usually in the 90’s when it registered this low). However, this is a known challenge with the device.
You also have to sync your monitor every eight hours. This was never a major problem for me except at night. I tend to turn off my phone and leave it in the kitchen before bed, so it would normally be nine hours before I would scan. But is that a significant obstacle? Not at all.
“Seasons of Me” Program
As for the January “Seasons of Me” program, I thought it was ok. There wasn’t as much guidance as I would have liked. You couldn’t alter the days of your experiments, and the reporting/insights were not that terrific.
Hopefully they will make improvements to the program over time. But, right now, I’d rate it as pretty basic and not particularly useful. If there were a way to get a CGM without the program, I would recommend forgoing the program.
My biggest complaint was how it calculated my calories. I work out for around two hours each day (60 minutes of intense cardio and 60 minutes of strength). I’m in my late 30’s so while my metabolism has slowed down some, it’s not completely shot.
That said, January’s program frequently told me to consume 1300-1400 calories a day. If I ate this little, I would be starving all the time. I usually consume around 1800-1900 calories per day, for which I was scolded with a red bar and didn’t get as many “points” in the app. Again, not a big deal, but a bit frustrating.
I look forward to the future when a lot more data is available about glucose levels so better guidance can be given.
For example, it would be interesting to learn if I should let my blood sugars return to a certain level before eating or see data on how my glucose levels and curves compare to others.
Update: Since the initial writing of this post I used the Levels CGM. If you want to learn more, read my Levels Health Review and 20 Things I learned by wearing a CGM.
The Bottom Line
If you are interested in improving your nutrition, are worried about diabetes, or are curious about how what you eat affects your blood sugar, I would recommend signing up for a metabolic program and looking into continuous glucose monitors. You will get fantastic insights and be glad you did.
Like with money, when you track it, you will focus on it that will let you see patterns and make improvements.
Would you recommend January or another continuous glucose monitoring program?