Over the Counter CGMs: Expanding CGM Access Beyond Insulin Users

Over-the-counter (OTC) continuous glucose monitors (CGMs) are a game-changer for individuals with Type 2 diabetes, prediabetes, and health-conscious users interested in metabolic health, fitness, and longevity. Unlike prescription CGMs, OTC models do not include glucose alerts but still provide real-time glucose monitoring without needing a prescription.

Who Are OTC CGMs For?

OTC CGMs primarily serve a broader population than people diagnosed with diabetes. Key groups include:

People with Prediabetes or High Risk for Diabetes

Individuals with prediabetes who want to track glucose patterns.
Those with a family history of diabetes who wish to monitor early metabolic changes.
People looking to prevent or delay Type 2 diabetes through lifestyle changes.

Health & Wellness Enthusiasts

Athletes and fitness enthusiasts tracking glucose for performance optimization.
Biohackers and longevity seekers interested in metabolic health and personalized nutrition.
People following low-carb, ketogenic, or intermittent fasting diets, using glucose data to fine-tune their approach.

Individuals with Insulin Resistance or Metabolic Syndrome

People with conditions like PCOS, obesity, or metabolic syndrome, where glucose fluctuations play a role.
Those managing reactive hypoglycemia and looking for better glucose stability.

General Consumers Curious About Their Metabolic Health

Individuals who may not qualify for a prescription CGM but are curious about how foods, sleep, and stress affect their glucose.
People who experience energy crashes, cravings, or mood swings and want data to understand why.

Who OTC CGMs Are NOT Ideal For

People with Type 1 Diabetes or insulin-dependent Type 2 Diabetes, since OTC CGMs may lack critical alarms for low blood sugar.
Those who need CGM data to integrate with an insulin pump.
Individuals who rely on insurance coverage, as OTC CGMs are typically out-of-pocket expenses.

Regular CGMs vs. OTC CGMs

Regular (Prescription) CGMs

Require a prescription from a healthcare provider.
It is designed for people with diabetes, particularly those on insulin therapy.
Often integrated with insulin pumps for automated insulin delivery.
Provide alarms and alerts for highs and lows.
Offer detailed trend analysis for diabetes management.
Typically covered by insurance for people with Type 1 or insulin-dependent Type 2 diabetes.
Examples: Dexcom G6/G7, Freestyle Libre 2/3, Medtronic Guardian 4, Eversense E3.

Over-the-counter (OTC) CGMs

No prescription is required, making them more accessible.
Intended for a broader audience, including people without diabetes (e.g., fitness enthusiasts, biohackers, prediabetes patients).
It may have fewer medical-grade features, such as no hypoglycemia/hyperglycemia alarms.
Often self-pay only, meaning they aren’t typically covered by insurance.
Still use similar sensor technology but may have shorter wear times or simplified apps.
Examples: Dexcom Stelo (Upcoming in 2024-2025), Libre Rio, Freestyle Lingo

Available OTC CGMs in 2025

Dexcom Stelo

FDA Clearance: March 2024 (First OTC CGM in the U.S.)
Hardware: Uses Dexcom G7 sensor but with limited software functionality tailored for non-insulin users.
Intended Users: Type 2 diabetes not on insulin, prediabetes, and health-conscious consumers.
Wear Time: 15 days per sensor.
Glucose Range: 70–250 mg/dL.
Cost: $99 for a 30-day supply (two sensors) or $89/month with a subscription.
Placement: Back of the upper arm.
Purchase: Available directly from Dexcom Stelo Website.

Abbott FreeStyle Lingo

FDA Approval: June 2024.
Market: Individuals without diabetes, aiming to track glucose trends for fitness, metabolism, and longevity.
Wear Time: 14 days.
Glucose Range: 55–200 mg/dL (wider range than Dexcom Stelo).
Cost: $89 per 28 days or $249 for 84 days.
Placement: Back of the upper arm, abdomen, or upper buttocks.
Key Feature: Provides personalized real-time insights and habit coaching.
Purchase: Available on the Freestyle Lingo site

Abbott FreeStyle Libre Rio

FDA Clearance: June 2024.
Intended Users: People with Type 2 diabetes not on insulin and prediabetes.
Wear Time: 15 days per sensor.
Glucose Range: 40–400 mg/dL (wider range than Dexcom Stelo).
Cost: Estimated $89 per 30 days.
Placement: Back of the upper arm.
Software: Provides basic glucose trend data but lacks advanced coaching features.
Purchase: Expected OTC launch in summer 2025.

Comparing OTC CGM Specifications

Feature	Dexcom Stelo	Freestyle Lingo	FreeStyle Libre Rio
Wear Duration	15.5 days	14 days	15 days
Sensor Size	24mm x 27.3mm x 4.6mm	21mm x 2.9mm	21mm x 2.9mm
Warm-Up Time	30 minutes	1 hour	1 hour
Glucose Range	70–250 mg/dL	55–200 mg/dL	40–400 mg/dL
Alerts & Alarms	❌ No	❌ No	❌ No
Calibration	❌ No	❌ No	❌ No
Market Focus	Type 2, not on insulin & prediabetes	Health & longevity	Type 2, not on insulin & prediabetes

Why OTC CGMs Matter

These devices offer an accessible and affordable way to monitor glucose trends without insurance barriers. Dexcom Stelo and FreeStyle Libre Rio are expected to expand access for individuals managing their metabolic health, providing valuable insights into glucose patterns, diet, and exercise effects.

Final Thoughts

OTC CGMs are set to revolutionize how people engage with their metabolic health, offering real-time insights without needing a prescription. Whether for individuals with prediabetes, fitness enthusiasts, or those simply curious about their glucose trends, these devices provide a new level of accessibility and convenience. While they may not replace traditional prescription CGMs for those needing alerts and integration with insulin therapy, they are a powerful tool for proactive health management. As OTC CGMs are more widely available, they can empower millions to make more informed lifestyle choices and improve their overall well-being.