Casey Means, a Stanford-trained physician and wellness influencer nominated by President Donald Trump for surgeon general, is convinced the U.S. is experiencing an epidemic of metabolic dysfunction — a crisis silently unfolding inside the cells of millions of Americans.
One solution, she says, is giving people a close-up view of that crisis. Coincidentally, Levels, a company she co-founded, sells a system that allows people to continuously track their blood glucose levels in real time. She claims this information can help people home in on food and lifestyle choices that will improve their metabolic health.
It’s a philosophy that other Make America Healthy Again movement members have pushed. Health and Human Services Secretary Robert F. Kennedy Jr. extolled glucose monitoring devices as only costing “$80 a month, and they’ve been shown to be extraordinarily effective in helping people lose weight and avoid diabetes.” Meanwhile, Food and Drug Administration Commissioner Marty Makary told senators at his confirmation hearing that glucose monitors shouldn’t require a prescription. He similarly talked up their promise to address obesity and prevent diabetes.
There’s just one problem: These claims aren’t backed by science. They promise to lead Americans down a path to wellness but, without more evidence, could amount to a waste of our health care dollars.
“What is the utility there? The answer is zero,” says David Nathan, a Harvard Medical School professor who has led some of the most important studies on diabetes prevention. “This, to me, is a scam.”
In an information-rich age where our smartwatches can tell us the quality of our sleep, the number of steps we’ve taken, oxygen levels in our blood, heart rate and more, you might ask: Why not track blood sugar?
More data is not always better. It doesn’t always tell us something meaningful and, worse, could even cause harm by creating unnecessary anxiety or leading us to draw the wrong conclusions about our health.
Continuous glucose monitoring (CGM) has allowed people with Type 1 diabetes to better manage their blood sugar, which, in turn, can lead to fewer serious health complications like blindness, kidney failure and even death. People with Type 2 diabetes have also used CGM to prevent dangerous fluctuations in blood sugar, but the data are mixed on the long-term benefits.
And then there’s CGM in people who don’t have diabetes. Levels is one of several companies that charge anywhere from $199 to more than $400 per month for CGM, which is often paired with diet coaching. “I believe CGM is the most powerful technology for generating the data and awareness to rectify our Bad Energy crisis in the Western world,” Means wrote in a blog post on her company’s website.”
In reality, the data supporting constantly monitoring blood sugar in people who don’t have diabetes, and even in those with prediabetes, is virtually nonexistent, Nathan says. One 2024 review of the literature on CGM in healthy people found scant evidence of its utility.
There’s little evidence that blood sugar tracking can prompt people to make long-term changes in their habits, which is the foundational tenet of companies like Levels. Studies of evidence-backed lifestyle interventions show that many can elicit short-term benefits. It’s the long haul that people struggle with.
The MAHA movement likes to say it’s about following “gold-standard science.” For people with diabetes, blood sugar tracking is part of gold-standard care. But for everyone else? So far, there’s nothing to suggest this would be a wise way to spend our money.