What personal Continuous Glucose Monitoring (CGM) systems, such as Dexcom (glucose monitoring system), are available over the counter for patients without diabetes?

Over-the-Counter CGM Options for Non-Diabetic Individuals

Currently, there are specific over-the-counter continuous glucose monitoring (CGM) biosensor devices available for individuals without diabetes, which are designed to provide insights rather than alarms and are indicated for people with prediabetes or those without insulin-dependent diabetes. 1

Available OTC CGM Options

The American Diabetes Association's 2025 Standards of Care specifically identifies a category of CGM devices called "over-the-counter CGM" or "biosensors" that:

• Measure glucose continuously
• Display glucose levels at various times
• Provide insights rather than alarms
• Are specifically indicated for people with prediabetes or those with diabetes not on insulin 1

Key Differences from Medical CGMs

These OTC biosensors differ from traditional medical CGMs in several important ways:

• No alarm functionality: Unlike medical CGMs used for diabetes management that provide alerts for dangerous glucose levels
• Focus on patterns: Designed to show trends and patterns rather than for acute management
• Different regulatory pathway: Not classified as integrated CGM (iCGM) systems that meet the higher FDA standards required for integration with other medical devices 1

Clinical Applications for Non-Diabetic Users

The use of CGM in non-diabetic individuals has been expanding, with four main user categories identified:

1. Metabolic diseases related to diabetes: Conditions with primary dysregulation of the insulin-glucose axis
2. Metabolic diseases without primary insulin-glucose dysregulation
3. Health and wellness: General population interested in metabolic health
4. Elite athletics: Performance optimization 2

Normative Glucose Data in Non-Diabetic Individuals

Understanding what constitutes "normal" glucose patterns is important for non-diabetic users:

• Mean average glucose in healthy individuals is typically 98-99 mg/dL (5.4-5.5 mmol/L) for most age groups, and slightly higher (104 mg/dL or 5.8 mmol/L) for those over 60 years
• Healthy individuals spend approximately 96% of time with glucose between 70-140 mg/dL (3.9-7.8 mmol/L)
• The typical coefficient of variation (measure of glucose variability) is 17±3% 3

Important Considerations and Limitations

When using OTC CGMs, non-diabetic individuals should be aware of:

• Accuracy limitations: Some CGM systems may have lower accuracy in certain conditions or with certain medications
• Interfering substances: Acetaminophen and other substances may affect readings with some sensors 1
• Environmental factors: Temperature, humidity, and altitude can alter glucose readings 1
• Skin reactions: Potential for irritation or allergic reactions to adhesives 1

Benefits for Non-Diabetic Users

The potential benefits of CGM use in non-diabetic individuals include:

• Identifying glycemic patterns that may predict increased risk of developing diabetes
• Motivating healthy behavioral changes related to diet and exercise
• Improving mental or physical performance through glucose pattern optimization 2

Practical Usage Tips

For optimal use of OTC CGM systems:

• Scan intermittently scanned CGM devices (like FreeStyle Libre) at least once every 8 hours to avoid data gaps 4
• Be aware that different CGM technologies have varying levels of accuracy
• Understand that these devices are meant for general insights rather than medical treatment decisions in non-diabetic individuals

While CGM technology continues to evolve rapidly, individuals without diabetes now have access to specific over-the-counter options designed to provide glucose insights for general health and wellness purposes rather than medical management.