Podcast Summary

Podcast: Diabetes Connections | Type 1 Diabetes
Host: Stacey Simms
Guest: Sam Glassenberg, Founder of Level X
Episode: "The Worst Game Ever" – Sam Glassenberg Wants to Change How We Learn About T1D
Date: May 20, 2025

Overview of the Episode

This episode focuses on the intersection of type 1 diabetes (T1D) education and innovative video game learning. Host Stacey Simms interviews Sam Glassenberg, a veteran video game developer and founder of Level X, whose latest project is “Level 1”—a new mobile game designed to teach patients, caregivers, and families how to manage type 1 diabetes. The episode delves into the shortcomings of traditional T1D education, Glassenberg’s personal experience as a parent of a child with T1D, and why his approach to “gamifying” education is different from previous attempts. Sam shares the philosophy, design, and hopeful impact behind Level 1 while challenging industry assumptions about learning and games in the healthcare sector.

Key Discussion Points & Insights

1. The Motivation: Turning Frustration into Innovation

• The Onboarding Nightmare:
  Sam’s daughter was diagnosed at age 5, and he describes the onboarding process as “the worst game ever,” marked by stress, confusion, and a single sheet of confusing, critical instructions.

  “They gave us this one page. I call it the guide to not killing your own kid.” (07:54, Sam)

• Personal and Professional Convergence:
  Sam’s background as a Stanford-trained engineer and his wife’s role as a pediatrician didn’t make the learning curve much easier.

  “It took me and my wife a year to actually understand what this means and how to manage this disease… And I was like, this is horrible.” (08:20, Sam)

• Insight:
  Even highly educated parents struggled with T1D onboarding, making the case for better learning tools.

2. Level 1: The Game and Its Design

• What is Level 1?

  “Level one is a casual, captivating mobile video game that trains your brain how to manage type 1 diabetes.” (06:38, Sam)

• Game Mechanics and Visuals:

  • Inspired by popular touch-friendly, casual games (Candy Crush, particle puzzle, rhythm games).
  • Designed for easy play with one thumb and low reading level—appropriate for kids, teens, adults, caregivers, and even school staff.
  • Sixty 2-minute levels, introducing basics to more complex diabetes management skills over time.

  “At the end of it, you know everything about MDI and how to manage type 1 diabetes, at least for the first six months.” (09:22, Sam)

  • Playful design covers serious subjects, such as managing lows, highs, carb ratios, and ketones.

• Flexibility and Real-Life Reflection:

  “There isn’t really one way to do this… There are messages throughout that say, hey, we’re going to play the game this way. Dr. may do this another way. This is the basic of this. Your range may be set differently.” (12:51, Stacey)

  • The game deliberately avoids the idea of “perfection” in blood glucose control and rewards reasonable, not perfect, management.

3. Distinguishing from Past “Gamification” Failures

• Why Gamification Hasn’t Worked:
  • Old approaches focused on badges and points for routine T1D tasks, resulting in more “work” and lack of engagement.

  “Almost 100% of the examples of gamification that we can all think of are terrible… Quizzes were not fun in the second grade and they're not fun now… and badges, we didn't even invent badges in the games industry. We stole that crap from the Girl Scouts.” (17:47, Sam)

• Sam’s Philosophy:

  “I do not want people playing this game every day. The purpose… is to sit down and take what took me a year to learn and compress that to a few hours.” (20:41, Sam)

  • Level 1 is about building a mental model, not adding a chore.
  • Designed for quick onboarding and targeted refreshers, not chronic engagement.

4. Broadening Access and Transforming Health Education

• Primary Audience:
  • New patients, parents, caregivers, teens, school nurses, babysitters, and even primary care docs.
  • Designed for those with different literacy levels and health backgrounds.
• Impact on Underserved and Rural Communities:

  “In certain communities, type 1 diabetes is a death sentence… My hope is that this game can in some small part alleviate that education and training problem.” (28:23, Sam)

• Beyond Patients:
  • Sam notes that over a million professionals use Level X’s other games for continuing medical education, literally playing through simulated surgeries or rare presentations to build skill outside of the clinic.
  • He hopes to “democratize” the mental models of T1D management already mastered by “super-user” families.

5. Notable Features, Fun, and Family Life

• Easter Eggs and Relatable Moments:
  • “Sneaky Snack” levels teach recovery from forgotten insulin doses.

  “There’s a sequence of levels where all of a sudden, just randomly, a portal opens above the stomach and the food just drops in. And the second my daughter saw that, she goes, ha, I snuck that cookie.” (24:49, Sam)

• Daughter’s Experience:
  • Sam’s daughter, five years post-diagnosis, is thriving on DIY Loop; he hopes today’s technologies—and games—change the equation for others.

6. Partnerships & The Road Ahead

• Community Partners:
  • Beyond Type 1 and Breakthrough T1D are supporting the game’s launch and its mission to smooth the diagnosis journey.
  • Breakthrough T1D Play unites video game industry leaders touched by type 1, both for awareness and fundraising.
• Future Projects:
  • Sam hints at AI-driven tools brewing in his basement—automated carb counting from lunch photos, AI to optimize dosing parameters, and more.

  “The biggest thing we argue about here is what should the parameters be… so I’m working on using AI algorithms to settle the arguments…” (30:09, Sam)

Notable Quotes & Memorable Moments

• On the “worst game ever”:

  “It literally takes all the principles of how to make a fun and rewarding game and flips them all on their head to make the most punishing and unforgiving experience ever.” (18:40, Sam)

• On the role of learning and play:

  “Humans have evolved to learn through play. And so with level one, that's what we're doing. We learn about how to manage type 1 diabetes through play…You should learn all that by playing it in a game and then not on live human beings.” (24:11, Sam)

• On mission and impact:

  “The more we disseminate it, the more we can help achieve the mission of at least making the onboarding experience a little better.” (31:53, Sam)

Timestamps for Important Segments

| Timestamp | Segment | |--------------------|--------------------------------------------------| | 00:05–05:57 | Stacey’s introduction, gaming background, context| | 05:57–06:38 | Sam: Launch day & overview of Level 1 | | 06:38–09:56 | What is Level 1 and why it was created | | 11:21–13:59 | Intended audience, design principles | | 14:18–15:36 | Feedback, testing, and learning through play | | 15:57–21:33 | Difference from failed “gamification”; goals | | 21:33–24:46 | Sam’s background; learning complex systems by play| | 24:46–26:13 | Daughter’s favorite parts; relatable gameplay | | 26:13–28:23 | Life update, technology, partnerships | | 28:23–31:53 | Hopes for impact, underserved communities, AI ideas| | 31:53–32:41 | How to find the game, closing remarks |

Resources & Links

• Level 1 game: playlevel1.com
• Level 1 in the App Store: Search “Level1 Diabetes Game”
• Sam’s blog: worstgameever.org
• Partnerships:
  • Beyond Type 1
  • Breakthrough T1D Play (formerly JDRF Game to Give)
• Diabetes Connections: diabetes-connections.com

Tone & Takeaways

The conversation is lively, relatable, and infused with hope, humor, and candor from both Sam and Stacey. The episode is a must-listen for anyone grappling with the early stages of type 1 diabetes care—or anyone interested in novel intersections of patient education and game design. Sam’s approach is distinctly anti-“gamification,” instead using authentic game design to compress hard-earned knowledge into rapid, engaging learning, with meaningful implications for equity and access across the diabetes community.

Final Note:
“Go to playlevel1.com, download it, play it, share it with your friends, anyone you know who's been touched by type 1 diabetes... The more we disseminate it, the more we can help achieve the mission of at least making the onboarding experience a little better.” (31:53, Sam)