Should People Without Diabetes Use a Continuous Glucose Monitor? What 4 Doctors Say
Key takeaways:
Using a glucose tracking device (continuous glucose monitor, or CGM) without diabetes is a personal choice.
Dexcom’s FDA-cleared Stelo CGM will be available in summer 2024. It’ll be the first over-the-counter (OTC) option in the U.S., making CGMs more accessible.
It’s thought CGMs may help people shape lifestyle choices to improve their health. But, so far, there’s little scientific evidence to support its use in people who don’t have diabetes.
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Table of contents
In recent years, continuous glucose monitoring (CGM) use has surged in people without diabetes. And with Dexcom Stelo on the horizon, it’s set to become even more popular. That’s because it will be the first over-the-counter (OTC) CGM available in the U.S. — without a prescription.
While the Stelo CGM may sound like a great addition to your health toolbox, take caution. Despite proven benefits of CGMs in Type 1 and Type 2 diabetes, there’s no solid evidence for benefits in people without diabetes.
Minisha Sood, MD, is an endocrinologist. That’s a specialist in hormones and metabolic diseases, including diabetes. Dr. Sood told GoodRx, “In general, in people without diabetes who feel well and have no metabolic disease, using a CGM doesn’t add clinical value.”
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She’s not the only healthcare professional to be concerned by the rise in popularity and availability of these devices. In fact, of the four doctors interviewed for this article, not a single one supported the use of a CGM in people without diabetes. Let’s understand why these newly available OTC devices are just not ready for regular use yet in the general population.
What is a continuous glucose monitor (CGM)?
A CGM is a wearable medical device or “biosensor.” It measures, shares, and records glucose (sugar) levels. The data lags slightly behind true levels. But other than that, a CGM provides “real-time” glucose values day and night.
Its main purpose is to identify patterns and alert for high or low glucose levels in people with diabetes. However, it’s also being used as a lifestyle tool for people without diabetes.
What to know about over-the-counter continuous glucose monitors: What are the differences between over-the-counter and prescription continuous glucose monitors (CGMs)? And can anyone use them? Get expert answers to these questions and more.
How much does a CGM cost? Find out how much you can expect to pay for a CGM — and whether insurance will cover the cost.
Balance your blood sugar: Following a prediabetes meal plan can help you decrease your blood glucose levels and your risk of Type 2 diabetes. Learn more about nutrition recommendations for people with prediabetes.
For most people, a CGM isn’t necessary. Their body can regulate glucose levels after meals and maintain energy needs between them. For others, “seeing” their real-time glucose can create more awareness of the impact of lifestyle and behaviors on glucose levels. In other words, using a CGM may help encourage healthier habits like regular physical activity, nutritious eating, and optimized sleep.
How does a CGM work?
CGMs have three components:
A sensor that measures glucose levels under the skin
A transmitter that sends real-time glucose readings to an approved device
A receiving device that stores and displays glucose data
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Here’s how it works:
Once inserted into the skin with an “auto-applicator,” a tiny sensor measures glucose levels in the tissues.
The attached transmitter then shares real-time glucose data with a compatible smartphone.
With Dexcom’s Stelo, the sensor provides results every 15 minutes.
You need to change the sensor every 15 days.
Each CGM brand is different in terms of where it’s inserted and the devices it shares data with. In the case of Dexcom’s Stelo, it’ll be worn on the arm, and the data is sent to a smartphone.
What are the limitations of a CGM
It’s important to know what a CGM can’t do. A CGM does not offer medical advice. It provides data about your glucose levels over time. But to know what that data means for you, you’ll need to share your Dexcom results with a healthcare professional. They can review your glucose trends for any concerns and, if needed, recommend next steps for your health.
How is a CGM different from a glucose meter?
A CGM is different from a glucose meter (glucometer). CGMs offer glucose trends over time. But a glucometer only measures your blood glucose at the moment you prick your finger for a glucose reading. This means glucometers provide a limited amount of information. Glucometers are more accurate, though, especially when glucose levels are changing rapidly.
Can you get a CGM over the counter if you don’t have diabetes
Right now, CGMs are only available with a prescription from your medical care team. Even then, having a CGM prescription doesn’t necessarily mean your insurance company will pay for it.
Coverage and costs can vary from one company to another. Most plans generally cover CGMs for people with Type 1 diabetes — and those with Type 2 diabetes taking insulin. Call your insurance provider to learn more about your CGM coverage.
Soon, CGMs will be available OTC for anybody. Put another way, you won’t need a prescription. The Dexcom Stelo has been FDA-cleared for use in people 18 years or older as long as they are not taking insulin or at severe risk of low blood glucose (hypoglycemia).
It hasn’t been cleared for use in anyone taking insulin or at risk for hypoglycemia. That’s because Dexcom’s Stelo CGM updates glucose results on a smartphone every 15 minutes. It does not alert for dangerously high or low glucose levels. For these individuals, Dexcom G6 and G7 are the preferred devices.
When will the new Dexcom Stelo integrated continuous glucose monitor (iCGM) be available OTC?
Dexcom expects to have Stelo on pharmacy shelves by summer 2024 for OTC purchase.
While Dexcom has not revealed Stelo’s cost, the company says pricing will be “competitive.” As GoodRx learns more, we’ll update you on pricing and possible ways to save.
Can a CGM improve your health if you don’t have diabetes?
CGMs have become increasingly popular among athletes and others seeking to optimize their health. The hope is that CGM devices may help people better understand the impact of lifestyle changes on their glucose health, which in turn would shape healthier choices.
But is there any evidence for this? And do doctors recommend the use of CGMs once they become available without a prescription?
For Farah Khan, MD, also an endocrinologist, the answer is a clear no: “People who do not have diabetes don’t need to use a CGM,” she said.
And that’s because if you’re healthy, there’s no good evidence that wearing a CGM has any additional health benefits at all, said Sanjai Sinha, MD.
“There are no trials that have tested the benefits of CGMs in people who don’t have diabetes,” Dr. Sinha said. This includes people who are trying to lose weight or taking diabetes medications to lose weight.
So, if you’re not on treatment for diabetes, then using a CGM won’t affect your weight, food choices, or other aspects of your health, he said.
In fact, there are some potential risks to having too much data about your glucose levels if you don’t have diabetes. If you’re healthy and your glucose levels are in a good range, “more information is not always a good thing,” said Dr. Khan.
That’s echoed by a third endocrinologist, Sonal Chaudhry, MD. She points to a risk of “information overload and potential anxiety” in healthy people who use CGMs. “To a user, the fluctuations in glucose levels can look significant,” she said. “But so long as glucose levels are within range, it’s expected to have glucose fluctuations after meals.”
Dr. Chaudhry added: “CGMs are also not very accurate when glucose levels are low or low-normal. This risks causing people unnecessary alarm about falsely low glucose levels, also called hypoglycemia.”
Much more research is needed to understand how CGM data in healthy people affects anxiety levels, their relationship with food, and other aspects of wellness.
The bottom line
CGM has become popular among those without diabetes. With the arrival of Dexcom’s FDA-cleared Stelo, CGMs will be available to all people without a prescription.
The theory is that CGMs may help people without diabetes shape healthier lifestyle choices, but there is simply not enough evidence to support this.
Why trust our experts?
References
Browne, G., et al. (2023). Personalized nutrition programs are making people feel weird about food. WIRED.
Ehrhardt, N., et al. (2020). Continuous glucose monitoring as a behavior modification tool. Clinical Diabetes.
Klonoff, D. C., et al. (2023). Use of continuous glucose monitors by people without diabetes: An idea whose time has come? Journal of Diabetes Science and Technology.
Klupa, T., et al. (2023). Expanding the role of continuous glucose monitoring in modern diabetes care beyond type 1 disease. Diabetes Therapy.
Schraer, R. (2024). Doctors question science behind blood sugar diet trend. BBC.
