Podcast

Levels – Metabolism is Life

Episode introduction

In America, democracy is prized. But Josh Clemente realized that one important element of our lives is lacking in democratic access – control over our own health. Our modern medical system prioritizes focusing on sick patients over healthy ones, which means that often when you reach a doctor and discover a problem, things have gone too far. By making health data more available to individuals on a daily basis, we can change that. That’s why Josh founded Levels, a company that’s pioneering a new application for biowearables that measure blood sugar and let users understand the granular workings of their own bodies. On this episode of The Story of a Brand, Josh talks with host Ramon Vela about the problem with diet culture, advances in technology, and why starting Levels was a true test in teamwork.

Show Notes

Show Links

Key Takeaways

08:02 – Using health data to personalize your life

For many aspects of our lives, like finance, we have tools that give us data that we base our decisions on. Levels is trying to give you the same access to information about your body so you can make better health decisions.

“We have an increasing amount of information in our lives. Whether that’s financial information, information about our heart rate from our Apple Watch, information about what every celebrity is doing on the internet at any given time – there are tons of data out there. But as we use more and more of this in our daily lives, the one massive gap is how we feed our bodies and how we nurture holistic health. So it’s very uncommon for people to make decisions based on their own health information. So what Levels is, is we provide you with real-time data from your own body related to your nutrition, helping you understand specifically how a certain food is affecting your health in real-time. You can imagine a wearable device and a software system that allows you to log off food as you’re eating it and see how your body is responding in terms of your blood sugar. Blood sugar is essentially the by-product of broken-down carbohydrates. We’re eating all the time. We have carbohydrates in our food. When those break down, they release into the bloodstream. And over time, if hormonal systems get out of whack, these blood sugar elevations can be really detrimental and damaging and ultimately they induce a whole host of chronic illnesses that have really negative consequences. And so Levels allows you to see, as control of your daily choices, the positive and negative effects of different decisions, and you can navigate around them to build an extremely personalized lifestyle, just you and your own body.”

11:04 – Stop flying blind: harnessing the power of medical devices

The technology for continuous glucose monitoring already exists. Levels is making that technology more accessible and available so that it can be used to preventively stave off diabetes.

“Technology has trickled down into the medical device world. There has been a really fascinating development where we now have sensors that can be used to help manage conditions. The condition specifically that this technology was developed for was diabetes. People with diabetes have lost control of their blood sugar and it gets very out of range and it starts to cause a lot of negative consequences, like heart attacks, stroke, blindness, amputation, and a lot of bad stuff when things get really bad. And so it’s important for people with diabetes to have a really good awareness of their blood sugar and to be making decisions for medication and nutrition that help them manage those. The microelectronics revolution led to this tech being developed so that these people who are managing their condition can be always in the know. As that has happened, the supply for these devices has increased, but the accessibility has not. Importantly, many of the chronic illnesses in the United States and globally that we’re concerned about, specifically type two diabetes, stroke, Alzheimer’s disease, PCLs, and fertility – many of these have chronic lifestyle roots, meaning that they develop over a long period of time without side effects, without symptoms. They’re very quiet. It is the result of choices that are made without feedback. So essentially we are almost flying blind in a sense and we don’t know that something is going wrong until it’s already happened. And part of what Levels is doing is reapplying technology that’s been developed for a post-diagnosis use case to the world of wellness and information.”

12:48 – Levels is democratizing health data

We can’t wait until we fall sick before we start caring about our health. The most elegant solution is to get access to your body’s own data.

“Democratizing access to one’s own health data, that is part of the core mission of Levels. Not only increase access to continuous glucose monitors that can measure your blood sugar in real-time, but to all important health data that can help us make better choices in the moment that we need to. It’s really important that we not leave our preventative health and wellness to the medical system, in the sense that that’s not the most effective way to fix things. We can’t wait until the sickness has set in before we start caring about or managing a certain part of our health. And we also can’t fix this by passing some sweeping legislation that has a one size fits all diet for everyone. The reason for that is that everyone is different and unique, and we can get into some of those individual factors in a few minutes. But I think that the most elegant and the most effective solution is to inform the individual with their own body data at the moment that they need it. That’s the best way that we can do it. Level’s tactics are focused directly at increasing that access.”

15:42 – The problem with contradictory diet advice

In today’s world there are too many experts and too many choices. This has led to a tremendous amount of contradiction and frustration for the average person who just wants to be healthier.

“As we get more and more data about individuals, rather than looking at the average of a population, but instead looking at how a specific person responds, you start to see the reason that this is so important, so necessary. Physicians and nutritionists and dieticians give a  lot of really well-meaning advice we’ve all heard. Eat healthier and work out more – well that that’s a very abstract concept. What is healthier? What should I eat specifically? And then you get into specific dietary philosophies. Some people say you should eat eggs. Some people say no eggs, eggs are bad for you, you should eat an entirely plant-based diet. You have keto diets, you have carnivore diets. All of them are essentially trying to say that every person should eat this one way and there’s no other way that’s healthy. And what this has led to is a tremendous amount of contradiction and frustration for the average person who just wants to be healthier. They don’t want to subscribe to a dietary philosophy. They want to eat healthier. So that’s the first problem, there’s all this contradicting coverage.”

17:56 – What am I going to eat and why?

Even though experts agree on what a good diet is for an average person, every individual still struggles with this question. That’s because the average diet might be working against them. With technology we have the capability to answer this question once and for all.

“A really dramatic kind of underpinning of what we’re doing here is recognizing that even though you can average everyone in the world together and say, this is the average diet that people eat, that’s not interesting. Because each of those people, as an individual, each of them has to sit down for lunch and say, what am I going to eat and why? And if they eat like the average, they may be eating in a way that is actually working against their goals and against their health. So it’s important that with the technological capability that we have, this isn’t a pipe dream or a miracle that we’re hoping for. We have it now. And so we should increase accessibility and then each person can try things, learn from those things and improve. And that’s called a closed loop feedback system. So you try something, you receive data based on how that worked for you, and then you can make an even better decision next time around. Right now, we’re all operating on what’s called an open loop system, which is that we make choices and we never get feedback on them. Or if we do, it’s years or decades in the future, when we get a diagnosis of an illness or when we gain a lot of weight that we didn’t expect. And so we can now close those loops in minutes instead of decades. And people can develop that truly personalized approach.”

29:08 – A new kind of organization

Levels is a startup that combines many unique verticals under one umbrella. Josh described how it has taken a long time and a lot of trial and error to find a cohesive path forward.

“I had been a part of startups, but I had never started one myself. And so that’s an extremely disorienting process. You don’t know where to start. I filed an LLC and I started doing research on what was necessary to be able to distribute continuous glucose monitors. And what I came across was a massive absence of information. It just felt like I could not find the answers I was looking for because it seemed to me no one had done anything like this. And the reality is that Levels is now an organization that has prescription products that are prescribed by a partner, a telehealth network of physicians. We have pharmacies that deliver the products to the Levels member at the end. We have a data science vertical that is bringing in patient health information, encrypting it, performing analysis on it, and delivering insights to the users. And each of those is typically a unique industry approach. To combine all of them together has taken a very, very long time and a lot of challenges and trial and error to figure out what we need to do.”

30:28 – The power of synergy

Josh struggled with the sheer amount of work to be done when he first formed an LLC. Once he brought on a co-founder, he realized that things accelerated quickly and they were able to onboard additional co-founders and figure out the legal and regulatory tasks.

“Once I had formed an LLC, I did a lot more research on the state of things. What devices were out there, whether or not I should focus on building a continuous glucose monitor or focus on data science or the software, which is not in my expertise. I concluded that the software was really where the value proposition is. That’s where people will take this raw data from the hardware and then learn how to use it. And then, so it seemed, that’s where the focus needed to be. So after about a year of coming to that conclusion, I then started to realize that I needed more people. I needed to partner with a team that could bring that software expertise and could bring the business intelligence that I would need in this new industry I’d never been in. That led to reaching out to my now co-founder, Sam. He was a friend at the time. I knew he was a multi-time founder and a software engineer. Over the course of showing him what I had learned and getting him to try a CGM himself, we then joined forces because he very quickly saw the potential. That was really a force-multiplying moment.”

Episode Transcript

Ramon Vela: [00:00]                            Recorded at Attention Agency Studios. This is not your average entrepreneur or e-commerce podcast, and he’s not your average host. This is the Story of a Brand with your host, Ramon Vela.

Josh Clemente: [00:22]       So Levels allows you to see as control of your daily choices. You can see the positive and negative effects, different decisions, and you can navigate around them to build an extremely personalized lifestyle, just you and your own body.

Ramon Vela : [00:37]                            Have you built an online brand that consumers love? Do you sell in consumer categories that are essential to everyday life? Do the majority of your sales go through Amazon FBA? If this sounds like you, you should get to know Forum Brands. Forum is a team of expert investors, operators, and many ex Amazonians who provide entrepreneurs and owners with the most efficient and lucrative way to sell their e-commerce businesses. If you’re interested in exploring a sale and cashing out years of your profits in one day, visit us at forumbrands.com to schedule a call.

Hey everyone. This is Ramon Vela, and this is another episode of The Story of a Brand. I, like always, I have an amazing founder and brand that we’re going to feature today and that we’re going to learn all about. But before I do, I’ve actually been thinking about something and that something is gratefulness. So let me ask you, Josh. Do you remember a time when someone provided you with just an amazing amount of support, whether it was maybe just time or might’ve been financial or it might’ve been some other resource, but it was just amazing because what it meant to you was that that person believed in you? And it could have been a teacher or an investor or whoever it is, but somebody who just put their support behind you and just made you feel like, “Wow, this person believes in me,” and just gave you that confidence. Do you remember a time like that?

Josh Clemente: [02:11]       Yeah. You know, Ramon, I actually have. I’m lucky enough to have many people in my life who come to mind when I’m asked that question. But since this is a conversation about, you know, parts of my career and trajectory to get to where I am and all of the experiences I’ve had, one particularly comes to mind, which is my uncle Jim, who early on, before I had started my career, I had just finished up university. He put his support behind me to help me find my first position. And he reached into his extensive network and was able to get in touch directly with the CEO of SpaceX, Elon Musk, and put in a strong word in my favor. And I was, you know, kind of an untested recent grad engineer. And so, you know, putting reputation on the line like that was a really big vote of confidence in me. And it led to six amazing years at SpaceX, kind of proving myself and learning. And one of the greatest experiences I think of my life and it was the beginning of my career.

Ramon Vela: [03:15]                            Wow. That is amazing. And you know, the thing about when someone does that for you, they’re staking their reputation for you. So it’s, there’s so much on the line and you just feel it’s, you just feel like, “Wow!” It’s like, when you think about it, like they’re putting such a vote of confidence in you and they really believe in you. That kind of support is just amazing. So wow, great for your uncle.

Josh Clemente: [03:43]       Yeah.

Ramon Vela: [03:44]                            Well, you know, in that kind of, you know, the reason I was thinking about that is I’m really big on gratefulness. You know, being grateful allows you to- You know, it’s hard to be stressful, first of all, when you’re grateful. And I think it just, it helps to fuel you in those times where time are tough and so forth. And I’m feeling really grateful right now because I have a new sponsor and they are just amazing because not only are they providing me with time and energy and their knowledge and their financial help to help sponsor the show, but I feel like it’s really a, it’s a belief in me and what I’m doing with the show. And that’s, to me that’s so important because I’ve been pretty much funding this endeavor by myself. For the most part it’s self-funded. Of course I have advertisers and that definitely helps, but I mean, this has been such a lot of time and resource for me. So, let me introduce you to them. They’re a company called Attention Agency, and they’re a full funnel growth and performance digital marketing company. They’ve got proven strategies, they’ve scaled and optimized a lot of direct to consumer brands through things like media buying and data-driven analysis and creative services. And just so everyone knows, whenever you hear me talk about an advertiser or a sponsor like Attention Agency, I always do my due diligence. I always want to make sure that whoever it is I’m referring is, you know, as good. And so that I can honestly tell you, “Definitely use these people.” So I actually interviewed several of the attention agency clients and based on their feedback and my observation, they are one of the best in the business. And they handle so many fast growing direct to consumer brands. So you definitely know that they have the proven experience to do what they’re doing. Now, if you’re looking back on this year and wondering what went wrong or what could have been better, or you’re starting to plan for 2021. Do me a favor, and this is my piece of advice: Talk to the folks at Attention Agency. And they actually have something for my listeners. They’re doing a comprehensive, no obligation, 14 point audit of your social search, shopping, email, and SMS channels. Again, this is, it’s comprehensive and insightful, but there’s no obligation. You don’t actually have to work with them, but I think you’ll get a lot out of this 14 point audit. It’ll show you the weaknesses and show you the strengths, things like that, and where you need to improve. So visit attnagency.com/storyofabrand. That’s attention. Spelled A T T N. Agency.com forward slash story of a brand and go get your 14 point audit. And even if you don’t want to do that, if you happen to run into them, you see them on social, say hello and thank them for their support of the show, because I really love doing the show and I think it’s important. And so I appreciate their belief in me. So now, without further ado, let me introduce you to my partner here who just helped me with this announcement. Let me introduce you to Josh Clemente, who is the founder and president of Levels. Welcome to the show.

Josh Clemente: [07:03]       Thanks so much for having me Ramon.

Ramon Vela: [07:06]                            Well, Josh, I appreciate it. And thank you for your feedback and your input. I bet you didn’t realize I was going to wrangle you into an announcement, but I appreciate it.

Josh Clemente: [07:14]       Of course. Yeah. I like the approach.

Ramon Vela: [07:17]                            Well, you know, I have so many thoughts. You and I have already done sort of like a little pre-call before this interview. And so I’m really excited because I think what you’re doing is really, it’s, I don’t want to give out too much, but it’s exciting. And it has to do with health, which I think is just, it’s not only just, has always been important, but I think so many people are thinking about their health nowadays. I think this is really a great time for what you’re doing. So, but why don’t we kind of let people know what we’re talking about a little bit? Why don’t you give us a 100 foot overview of the brand?

Josh Clemente: [07:54]       Sure. So Levels is the metabolic fitness. And so to break that down a little further, you know we have an increasing amount of information in our lives, whether that’s financial information, information about our heart rate from our Apple watch, information about what every celebrity is doing on the internet at any given time, tons of data out there. But as we use more and more of this in our daily lives, the one massive gap is how we feed our bodies and how we nurture holistic health. So it’s very uncommon for people to make decisions based on their own health information. So what Levels is, is we provide you with real-time data from your own body, related to your nutrition. So helping you understand specifically how a certain food is affecting your health in real time. So you can imagine a wearable device and a software system that allows you to log a food as you’re eating it and see how your body is responding in terms of your blood sugar. And blood sugar is essentially the, it’s the by-product of broken down carbohydrates. So, we’re eating all the time. We have carbohydrates in our food. When those breakdown, they release into the bloodstream. And when, over time, if hormonal systems get out of whack, these blood sugar elevations can be really detrimental and they can be damaging and ultimately induce a whole host of chronic illnesses that have really negative consequences. And so Levels allows you to see as control of your daily choices. You can see the positive and negative effects of different decisions, and you can navigate around them to build an extremely personalized lifestyle, just you and your own body.

Ramon Vela: [09:41]                            Well, and just writing a note down there. You know, when I’m, when I was thinking about your platform, your service, what I was thinking of is that it’s in many ways you’re liberating data. And, or maybe, you know, maybe a more dramatic way of saying it, you’re democratizing this health data because it, you know, and we’ll get into this, I’m sure, but a lot of the information, some of the information that you’re providing is available, but it’s not available to the everyday person and it’s not available unless you meet certain criteria or conditions and so forth. So I kind of feel like what you’re doing is you’re liberating a lot of data that it can be available, but not available to everyone, but making it available for everyday use or, and for the everyday person to able to see those positive or negative effects of their decisions. Would that be a good way to describe what you’re doing?

Josh Clemente: [10:46]       Absolutely. I think that’s, you know, sort of the other side of the coin for Levels. Right now there’s been an amazing technology development kind of wave with the micro electronics revolution that led to smartphones and faster and smaller laptops and so on and so forth. And that technology has trickled down into the medical device world. And so there has been a really fascinating development where we now have the sensors that can be used to help manage conditions. The condition specifically that this technology was developed for was diabetes. So people with diabetes have lost control of their blood sugar and it gets very out of range and it starts to cause a lot of very negative consequences. Heart attacks, stroke, can be blindness, amputation, a lot of bad stuff when things get really bad. And so it’s important for people with diabetes to have a really good awareness of their blood sugar and to be making decisions for medication and nutrition that help them manage those. So that microelectronics revolution led to this tech being developed so that these people with, who are managing their condition, can be always in the know. Now as that has happened, the supply for these devices has increased, but the accessibility has not. So importantly, many of the chronic illnesses in the United States and globally that we’re concerned about, specifically type two diabetes, stroke, Alzheimer’s disease, PCOS, infertility, many of these have chronic lifestyle roots, meaning that they develop over a long period of time without side effects, without symptoms. They’re very quiet. It is the result of choices that are made without feedback. So essentially we’re almost flying blind in a sense. And we don’t know that something is going wrong until it’s already happened. And part of what Levels is doing is re, I think reapplying technology that’s been developed for a post-diagnosis use case to the world of wellness and information. So as you mentioned, democratizing access to one’s own health data. That is part of the core mission of Levels, is to not only increase access to continuous glucose monitors that can measure your blood sugar in real time, but to all important health data that can help us make better choices in the moment that we need to. It’s really important that we not leave our preventative health and wellness to the medical system, in the sense that that’s not the most effective way to fix things. You know, we can’t wait until a sickness has set in before we start caring about or managing a certain part of our health. And we also can’t fix this by passing some sweeping legislation that has a one size fits all diet for everyone. The reason for that is that everyone is different and unique, and we can get into some of those individual factors in a few minutes. But I think that the most elegant and the most effective solution is to inform the individual with their own bodies data in the moment that they need it. And that’s the best way that we can do it. So I think, you know, Levels’ tactics are focused directly at increasing that access.

Ramon Vela: [13:52]                            Well, and, you know, it seems to me that we have been told for a long time now, and I know this is, I mean, this isn’t just a current trend, but you know, we’ve been told a long time about take control of your health, right? I mean, you go to the doctor and wherever your provider is, I’m sure they send you emails about, you know, “Make sure you’re, you know, you’re eating well or make sure you’re exercising or make sure that you’re doing this or that.” And I think to a certain, I mean, I don’t want to discourage people from doing that of course, but to a certain degree, we, like you said, are blind to much of the data that would be great for us to have. And so we don’t, we can’t really take control over our health in the ways that I think, you know, a lot of people have envisioned in the past until now, right? Until I think, you know, the trends in the technology and then companies like yours. And that’s why I’m really excited because I almost kind of feel like in some ways, and I also feel that this is just the beginning, but I feel in some ways that with the companies, with a company like yours, that vision is going to be fulfilled or is being fulfilled, where it’s not just about, “Hey, you know what? You should exercise. You should eat better.” I mean, all those things are great. Like they’re activities that you needed doing, but we’re missing that data, we’re missing that personal health information to make those, as you say, you know, make either the positive, see either whether the decisions we make are either positive or negative and then be able to like make, you know, changes based on that. So I think you guys are, in some ways, you’re fulfilling that vision.

Josh Clemente: [15:37]       Yeah. You know, it’s pretty amazing because the, as we get more and more data about individuals, so rather than looking at the average of a population, but instead looking at how a specific person responds, you start to see the reason that this is so important, so necessary. You know, physicians and nutritionists and dietician, there’s a lot of really well-meaning advice and not advice we’ve all heard. You know, “Eat healthier and work out more.” Well that’s a very abstract concept, you know, “What is healthier? What should, what do you, what should I eat specifically?” And then you get into specific dietary philosophies. Some people say, you know, “You should eat eggs.” Some people say no eggs or eggs are bad for you. “You should eat an entirely plant-based diet.” You know, you have keto diets, you have carnivore diets, you have almost every sort of philosophy and all of them are essentially trying to say that every person should eat this one way and there’s no other way that’s healthy. And what this has led to is a tremendous amount of contradiction and frustration for the average person who just wants to be healthier. They don’t want necessarily to subscribe to a dietary philosophy, they want to eat healthier. And so that’s the first problem, is there’s all this contradicting, all this contradictory coverage. The second thing is that there is no such thing as a one size fits all diet. And we’ve, we know this in part because of the technology that Levels is using, the continuous glucose monitor. So in 2015, a study was performed on 800 people without diabetes. And that study showed that two people could eat the exact same two foods and have equal and opposite blood sugar responses to those foods. And the reason that’s really important is that not only is the blood sugar response different, but the hormones that respond to blood sugar to control it, hormones like insulin, will also be different. And those hormones control where that blood sugar goes, whether or not you gain weight, whether or not you burn that glucose off. So there’s a whole host of downstream effects that are basically different for these two individuals because their bodies don’t process those foods at the same way. And the example was those two people eating a banana and a cookie made with wheat. And so that’s kind of like a fruit sugar and a grain. So that’s a really dramatic kind of underpinning of what we’re doing here, is recognizing that even though you can average everyone in the world together and say, “This is the average diet that people eat.” Well, that’s not interesting because each of those people is an individual and each of them has to sit down for lunch and say, “What am I going to eat and why?” And if they eat like the average, they may be eating in a way that is actually working against their goals and against their health. So it’s important that with the technological capability that we have, you know, we have this technology, now this isn’t a pipe dream or a miracle that we’re hoping for. We have it now. And so we should increase accessibility and then each person can try things, learn from those things and improve. And that’s called a closed loop feedback system. So, you try something, you receive data based on how that worked for you, and then you can make an even better decision next time around. Right now, we’re all operating on what’s called an open loop system, which is that we make choices and we never get feedback on them. Or if we do it’s years or decades in the future, when we get a diagnosis of an illness or when we gain a lot of weight that we didn’t expect. And so we can close those loops in minutes instead of decades. And people can develop that truly personalized approach.

Ramon Vela: [19:10]                            Yeah. And what you’re saying is so powerful. I mean, it just underscores what I said, it’s just going to go, just really, really powerful and empowering to have that type of information, that data, and that ability to do that. So this is really exciting. So tell me, how did you get into this? Because you have this really interesting background and, you know, you have, you know you were talking earlier about your uncle and you’re talking about SpaceX. So tell us a little bit about how you got into this. What were the driving factors?

Josh Clemente: [19:44]       Yeah. So I kind of think of myself as patient zero for Levels. And what I mean by that is that I was working at SpaceX. I was actually working on life support systems. And so these are the equipment and mechanisms that keep astronauts alive in the spacecraft during orbital flights. And so these are, you know, breathing systems and fire suppression systems and pressure management systems, all these different things that humans interact with to be able to basically flying the spaceship. And during my time there, I experienced a sort of a transition from, I think being at my peak in my early and mid twenties to suddenly feeling like something had changed. I felt like I had sort of a terminal illness, in a sense, because I would go through these really unexpected waves of just complete fatigue, mental and physical, where I would get shaky, I would get this kind of cold sweat sensation. I would just, my eyes would be drooping. My mood would shift very quickly to irritability and frustration. I just felt like I was kind of always on edge and didn’t have the energy I needed to perform. And this is when I needed to perform at my peak. You know, I was leading a team. This was the most important project of my life. And so I actually went to my doctor. I asked for blood tests, we looked through the blood tests, nothing was out of the ordinary. And I kind of left there on, you know, without any hope, really, and continued going about my day, you know. I was also at the time and still am a CrossFit instructor. So I take fitness very seriously. I played sports my whole life and I’ve always been a physically fit person. I’ve always been, I’ve taken pride in, kind of putting in the work at the gym, no matter what’s happening in my life and getting stronger and thinking that that’s the best way to stay healthy. So this was a very strange situation to be in where I felt physically unhealthy. And even despite, you know, looking and being on the outside quite healthy. So I started to read more and more about the energy system of the body. And so, the energy system, the way that our cells produce energy is called our metabolism. And we can produce energy from two sources, either fat or sugar. And most people in the world who are not in a ketogenic state, they’re not on a keto diet are, they’re getting their energy from sugar. So this is called glucose when it’s in the blood. So I decided, “You know what, I’m going to start tracking my own blood sugar, just using these device you can get at CVS called a glucometer.” So I would prick my finger, you know, many, many times every single day. And I would plot those in my computer and try to see if something was going out of the ordinary. That went on for several months. I didn’t really see anything interesting. I wasn’t very educated on what I was looking at. And one day I read a book called Wired To Eat, which said, basically talked about this new technology called a continuous glucose monitor. And this allowed you to just wear a simple patch on your arm and you would get full time glucose information. You never had to prick your finger. It would stream to your smartphone. And I was immediately interested. You know, this is fascinating. It’s, my fingers are black and blue from picking them. And it’ll let me see information while I’m sleeping and while I’m working out and while I’m in those stressful meetings. So I asked my doctor for one. He said no, because I’m not diabetic, and only people with diabetes need to measure blood sugar. So, I didn’t lose hope. I continued to look. Eventually I got one actually from a friend who was able to secure somewhere else. And when I put this device on, over the next two weeks I learned that, without knowing it, I was either borderline pre-diabetic or full-blown pre-diabetic, depending on who you talk to. And this was based on the way my body was responding to the meals I was eating and the choices I was making around caffeine and stress and sleep that were putting me into a constant state of elevated sort of fight or flight mode. So I was sleeping very poorly. I was working out really hard. I was eating whenever I could, whatever I could because I didn’t really know what nutrition meant for health. And my blood sugar was extremely erratic. It was, I was spending a lot of time outside the normal range both during the day and while I was trying to sleep. And it had produced a scenario where I was seeing these massive elevations and crashes, which were leading directly to this sensation of fatigue that would come over me, that cold sweat feeling, that shakiness, that need for a nap and more coffee. And by seeing that in the moment, it completely transformed my understanding of my own health. And I started to make different changes with my, the meals I was eating. I started to experiment with getting more sleep with trying to, you know, maybe practice a little mindfulness and breathing exercises in the middle of the day, if I’m feeling very stressed. And I started to just very quickly see my blood sugar equalize and normalize. And instead of having these sort of jagged peaks and canyons, deep canyons, I started to see these rolling hills, and you know, my glucose started to smooth out and come lower and lower, and I started to feel much better. And that was literally a transformative experience for me because I could see in the moment the effect of every choice I was trying, every experiment I was making. So, you know, once I had kind of practiced this self-empowerment using this device, I realized, you know, this has potential to change many lives. Looking at the numbers, there are about 88 million people in the United States alone that have pre-diabetes and according to the CDC, 90% of them don’t know they have it. So I’m not just, you know, one example, you know, one in a million. I’m one of many, I’m one of about 30% of the United States. And the fact that everyone is flying blind is leading to this consequence. I felt. I certainly did not want to be unhealthy. I was trying actively to be healthy and yet all these decisions were compounding in a negative way. And it wasn’t until seeing that data that I could make better choices. So I just decided, you know, it was, this was something I wanted to do. I wanted to increase the accessibility of this technology and make the data actionable. So take away the requirement for people to kind of do thousands of hours of research as I had, and learn biomechanics and physiology. But instead just take this amazing tech and build a behavior change user experience on top of it. And so that’s what Levels is.

Ramon Vela: [26:15]                            Well, and that was such a comprehensive explanation. So thank you. You really touched on a lot of different points there. And again, you know, like it’s just so amazing the fact that, you know, some of those data and information and I guess sort of devices are not available to some folks because you have to already be diabetic in order to get it. So to me that’s really, I mean, I don’t know what the reasons are for that, but it just seems amazing that if the medical community and health professionals want us to be healthy, we need the tools. We need the kind of things that you’re talking about here. So to me, this is so exciting. I feel like I want to run out and go and go get one. And we’ll talk about that because I think you’re still in the, you’re still not available, right?

Josh Clemente: [27:06]       Yeah. We’re still in beta mode, we’re calling it. So, not fully available yet, but expanding access monthly.

Ramon Vela: [27:14]                            Yeah. And so, yeah, so it’s like so exciting, but you know, I can see how so many people want, have already tested this out. And then anyone wanting to take a look at the website, you can go to levelshealth.com. And that’s levels with an s, the word health.com. So go ahead and take a look at that. So you got to start it. And now I would imagine a little bit different than what other, maybe brands and startups face, you know. And we cover a lot of types of DTC type of companies, direct to consumer and so forth. But what I would imagine for you, you probably had some additional challenges given that you’re dealing with health data. I don’t know of any of the regulations apply to you, but I mean, have there been the usual sort of startup challenges that people face in different companies or have you been, you know, faced with some like really different ones? And if you could share some of those challenges, that would be great.

Josh Clemente: [28:18]       Yeah. I think we’ve kind of had a combination of the standard and an additional kind of set of challenges that are related to being in the healthcare space and specifically working with health data. You know, initially when I started the company, I kind of had this shower Eureka moment where I was like, this is, you know, I just realized this is what I want to do. There’s this opportunity to improve the usability of continuous glucose monitors and get access to them. And I was like, you know, I had this idea and I was just going to do it right away and drop my other projects and just move on to it. And from that time until today, it’s going on three years now. And so, over the ensuing two years before we started Levels, you know, I went on kind of a personal exploration of trying to figure out how to start a company. You know, I had been a part of startups, but I had never started one myself. And so that’s an extremely disorienting process. You don’t know what, where to start, you know. So I filed an LLC and I started doing research on what was necessary to be able to distribute continuous glucose monitors. And what I came across was a massive absence of information. It just felt like I could not find the answers I was looking for because it seemed to me no one had done anything like this. And the reality is that you know, Levels is now an organization that has prescription products that are prescribed by a partner tele-health network of physicians. We have pharmacies that deliver the products to the end, the member, the Levels member at the end. We have a data science vertical that is bringing in patient health information, encrypting it, performing analysis on it and delivering insights to the users. And each of those in and of themselves is kind of a unique, typically a unique industry approach. And so to combine all of them together has taken a very, very long time and a lot of, really a lot of challenges, and almost trial and error to figure out what we need to do. You know, we spent- Well, I’ll kind of return back to the beginning. Once I had formed an LLC, I did a lot more research on the state of things. You know, what devices were out there, whether or not I should focus on building a continuous glucose monitor or focus on the data science or the software, which is not in my expertise. I kind of concluded that the software was really where the value proposition is. That’s where people will take this raw data from the hardware and then learn how to use it. And then, so it seemed, that’s where the focus needed to be. So, after about a year kind of putting that, coming to that conclusion almost, I then started to realize that I needed more people. I needed to partner with a team that could bring that software expertise and could bring the business intelligence that I would need in this new industry I’d never been in. And so that kind of led to reaching out to my now co-founder Sam. He was a friend at the time. I knew he was a multi-time founder and a software engineer. And basically over the course of showing him what I had learned and getting him to try a CGM himself, we then joined forces because he very quickly saw the potential. And that was really a force multiplying moment. You know, there was a lot of struggle prior to that. And then when you have two people with complimentary skill sets on the team, things started to accelerate quickly. And then we had to spend a lot of time from there, bringing on additional co-founders and then also figuring out the legal and regulatory environment that we were facing, which took us again at least six months before we had even the ability to start working with our very first customer.

Ramon Vela: [32:14]                            You know, I’ve always been curious about something in- You know, in many startups, you can get things going right away. You can create like, you know, MVP type products and get people trying them right away. You can get feedback, and that kind of feedback, and that whole process is, there’s an energy source in many ways, to take one of your terms, you know, it kind of feeds you and it kind of gets juices you up and so forth. Like how does it, how do you get through six months of kind of like waiting for regulations and waiting for this kind of stuff? I’m just kind of curious. I mean, was it, were you going bad crazy? You know, like trying to, you know, wanting- Because it feels like you get really excited. Like I just, just to note that when we started to, went to right now, your voice inflection is going up. And when you start talking about, you know, there’s the, you know, this discovery made and the story of how you got challenged and going forward, I can hear your inflection of your voice is sounding more and more passionate. So, how do you get through when you’re waiting for so long? I mean, are you just like pulling your hair out, getting frustrated with all of this?

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