Direct to consumer CGM's one year on
Continuous glucose monitors or CGM’s, have been used to help people living with Type 1 Diabetes manage their condition. As their accuracy improved and the prevalence of Type 2 Diabetes started skyrocketing, CGM’s started to be prescribed for people living with Type 2 Diabetes who were on insulin. However, the opportunity to track glucose levels, in this case interstitial glucose, was not missed by the biohacking community who saw it as a way to track responses to training schedules, sleep and dietary interventions for optimal performance. As awareness and interest in CGM’s grew in groups outside of the diabetes population, the device makers Abbott & Dexcom saw the opportunity, both launching direct to consumer CGM sensors (Stelo & Lingo) over the summer in 2024. Essentially, opening the floodgates to glucose tracking for all consumers looking to understand and track their responses without needing a prescription at a reasonably affordable price.
We wrote a deep-dive article on this topic recently which you can read here as a primer on the topic, but a lot can happen in 1 year! This article provides a bird’s-eye view for more context about what has happened over the last year with regards to CGM’s, and what we can expect in the next few years ahead.
So what has happened since the launch of the DTC glucose sensors in summer of ‘24?
Government
There has been a greater focus on prevention and and self- management from governments especially in the US and the UK. For example the NHS has launched their National health & prevention strategy which highlighted the need for individuals to take charge of their own health by understanding how their choices influence their healthspan. The recommendations included:
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Regular screening
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Promoting healthy behaviors and
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Tackling issues like obesity, alcohol and tobacco dependency
In the US, a similar shift towards prevention (think MAHA) is occurring where the health secretary RFK has created an ecosystem of industry partners to improve the nation’s health through digital health. The focus again here is on self- tracking and self-monitoring with CGM’s clearly taking a seat at the table.
Industry
Finding solid numbers of how sales have been impacted the two major shareholders in the market is difficult, however the last numbers were that Dexcom expected $4.03 billion in revenue in 2024 (a gain of 11%) growing to $4.60 billion at 14%. Dexcom reported that it saw growth of their user base by about 25% to 2.8 million (December 2024) according to Fierce Biotech
However, Stelo racked up more than 140 000 users and $22 million in revenue up until December 2024 with most signing up for subscriptions. Dexcom expects Stelo sales to rise 2-3% in 2025.
At the end of 2024, Dexcom announced a partnership with Oura (famous for it sleep ring wearable) which would allow users to track how their sleep data correlates with their glucose levels. Dexcom also added a meal tracking feature and AI summary to make it easier to track blood sugar response to food and understand what drove the variability.
According to Abbott CGM sales brought in more than $1.6 billion in sales, growing 21% year over year, but it was not split out by sensor type ie wellness vs medical (Medtech dive)
In the startup world, the activity is also heating up:
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Levels one of the initial companies in the Metabolic health space, went nationwide with their personalised health program.
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Biolinq raised $100M for their patch uses small electrochemical sensors to measure glucose levels from the intradermal space just beneath the skin's surface.
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Hello Inside raised $1.65 million for their women’s health solution
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Signos just announced that it received FDA approval for the CGM-enabled weight loss program- an industry first
In Science
There have been many criticism of the use of CGM’s in healthy individuals by scientists in the field and for very good reasons. Mostly because much of the variability in glucose levels is impacted by so many factors and of course glucose levels are narrowly controlled in healthy individuals.
In short, there are two schools of thought:
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CGM’s are only useful for individuals with Type 1 Diabetes and the clinical practice or recommendations do not fundamentally change in Type 2 Diabetes or Prediabetes therefore CGM’s should not be recommended in routine clinical practice.
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CGM’s have the potential to be used as a behaviour modification tool.
Let’s look a little at what research had dished up over the past year on this topic
Weight loss
In one recent study of 6197 users, preprandial glucose readings were analyzed over their first 30 days of an app use. App engagement, changes in body weight and fasting glucose levels by baseline weight and diabetes status were examined. Users rated their preprandial hunger subjectively on a 5-point scale. Researchers found that Glucose-guided eating via the app led to consistent weight loss across all weight categories and significant improvements in fasting glucose levels for users with prediabetes and diabetes (Jospe et al 2025)
Digital AI coaches
In another retrospective study researchers evaluated the impact of an AI-supported continuous glucose monitoring (CGM) mobile app (“January V2”) on glycemic control and weight management in 944 users, including healthy individuals and those with prediabetes or type 2 diabetes (T2D). The January AI app, leverages AI to personalize feedback, tracked users’ food intake, activity, and glucose responses over 14 days. Significant improvements in time in range (TIR) were observed, particularly in users with lower baseline TIR. Healthy users’ TIR increased from 74.7% to 85.5% (p < 0.0001), while T2D users’ TIR improved from 49.7% to 57.4% (p < 0.0004).
Higher app engagement correlated with greater TIR improvements. Users also experienced an average weight reduction of 3.3 lbs over 33 days. These findings suggest that AI-enhanced digital health interventions can improve glycemic control and promote weight loss, particularly when users are actively engaged (Veluvali et al 2025).
Women’s health
FLO Living is leading a groundbreaking study launched in April this year to evaluate the impact of the Cycle Syncing® Method on menstrual cycle symptom burden (total number of symptoms) and symptom severity (intensity of those symptoms). Backed by Mira, Hello Inside, and Citruslabs, this research is a major step toward validating a dietary and lifestyle-based approach to hormonal health. The approach will involve the use of a CGM to track blood glucose and how these tracks with hormonal fluctuations.
Concerns over Accuracy of CGM’s - Overestimation of Post prandial glucose levels
In one study published in the American Journal of Clinical Nutrition, researchers aimed to study the effects of food on glucose response using a CGM. The researchers found that CGM’s overestimated glycemic responses in numerous contexts. In addition, there is interindividual heterogeneity in the accuracy of CGM in estimating fasting glucose concentrations. Correction for this difference reduces, but does not eliminate, postprandial overestimation of glycemia by CGM. Researchers cautioned about inferring absolute or relative glycemic responses to foods using CGM, and advised capillary sampling for accurate quantification of glycemic response (Hutchins 2025).
Flatlined support- Lack of standardized ranges for healthy individuals
In a recent survey study conducted among healthcare professionals, findings pointed to the need for future work to develop CGM criteria for identifying potentially high-risk individuals who may progress to prediabetes or type 2 diabetes (Spartano et al 2025).
In another recent Systematic review, researchers noted no direct evidence supporting routine non-diabetic CGM to prevent cardiometabolic disease, and stressed the lack of outcome data (Wilczek et al 2025)
What does this all mean?
CGM’s are not going anywhere yet…
Despite a lack of support from academia on the use of CGM’s in healthy individuals, consumer interest and demand for CGM’s in health, wellness and prevention is soaring but not quite flooding the market. The increased accessibility of CGM’s, consumer willingess to pay, and now integration of CGM’s with other wearable data such as sleep wearables (Oura) is providing a holistic insight into consumers’ unique biology, and the growing sales numbers speak for themselves. Consumers are buying up subscriptions to the tune of $22 million, and yet only a tiny percentage of the population have used a CGM, meaning that we are only at the start of market penetration.
Self-tracking and prevention move to the main stage
Governments across the globe are seeing the potential of self-tracking through wearables and sensors and we will see more movement in the direction of incentivising the use of CGM’s and step counters. Prevention is solidly on the health agenda by hook or by crook while consumer interest is high and healthcare expenses are through the roof.
GLP-1 is speeding up the shift in consumer awareness and understanding of the role of blood sugar in overall health
Increasing use of GLP-1 is further driving interest and adoption to improve health by managing blood sugar levels AKA Metabolic health. Consumers understand the connection between food and blood sugar and ultimately the goal is not weight loss, it’s health. As more GLP-1 users aim for health, the lifestyle changes and behaviours they adopt span beyond weight loss. For example GLP-1 users purchase smartwatches at higher rate than non-users in the first year of treatment (Circana, 2025) and gut health is a key concern for GLP-1 users.
Insatiable appetite for solutions that are multifunctional
Now that a lot of the hype has moved on from glucose spikes and flattening the curve, consumers understand that context is important, and only with longer tracking and religiously noting down food, sleep, stress and physical activity will they get a true and full picture. The conversation has shifted towards holistic health, blood glucose as only one data point and the connection between glucose management and ultimately improving healthspan. This means that food, ingredient and snack brands need to create solutions that satisfy the need for these consumers looking at macronutrients, micronutrients, formats and functionality And low sugar please.
Is non-invasive glucose monitoring next?
January AI has already made their app available which provides insight into how a food or ingredient may impact blood sugar levels without the need for a CGM. While the promise of smartwatches and rings detecting blood sugar in real-time have not come to fruition yet, we expect machine learning and predictive modeling to do the heavy lifting without the need for continuous monitoring but rather intermittent monitoring as in a few times during the year for 11-15 days each stretch.
In a recent study, researchers aimed to predict glucose levels based on non-invasive sensor data using machine learning and investigated their correlation with standardized meal intakes by identifying physiological factors in healthy individuals. They found that skin temperature (STEMP), body temperature (BTEMP), blood volume pulse (BVP), electrodermal activity (EDA), and heart rate (HR) have the strongest correlations with Interstitial Glucose alterations. Their machine learning algorithm showed minimal errors during meal interventions across 32 participants, promising the potential for wearable technology in glucose monitoring. Could this be the future of blood glucose monitoring?, only time will tell.
In summary,
Reflecting on all the events just one year on, we can say we are at the beginning of a new era where food, health and tech intersect. It could be CGM’s today and watches or Digital twins tomorrow, but the trajectory is certainly hinting at a data driven one where real time tracking could influences short term food and lifestyle choices. There is a clear shift towards understanding longitudinal data and contextual data in order to act or change behaviour.
There are major valid concerns about who we are leaving behind, as even at a cost of $99 for 2 sensors, this can be a high price to pay. Who will be able to afford the foods that are recommended?. It is up to us to ensure that these tools and technologies benefit all, but especially those who need it the most. Furthermore urgent research needs to be done to better determine the optimal interstitial glucose range in healthy individuals from different backgrounds and ethnicities. The food system is bound to be changed forever.
We certainly live in interesting times, and while it is tempting to select a single perspective, my creative and curious side always wants to deeper understand why there is a discrepancy between what happens in academia and the Real-world context.
Interested in keeping up with industry developments at the intersection of Food, Health and Tech and keeping it real? follow me.
My name is Mariette Abrahams, CEO & Founder of Qina, a Personalised Health & Nutrition consultancy and platform that helps companies innovate, conduct research and get clear on the industry. We combine our domain expertise, digital tools, global network and proprietary data to clarify strategy, identify white spaces and stay relevant.
Learn more about me here
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