How to Get a CGM With or Without a Prescription

Continuous glucose monitors became available without a prescription for the first time in 2024, when over-the-counter wearable glucose biosensors hit the U.S. market for people who don’t use insulin or simply want to track their metabolic health.¹ Before that, every CGM required a doctor’s prescription. Now you have two distinct paths, and which one makes sense depends on your health situation, your budget, and whether you need insurance to cover the cost.

The Over-the-Counter Path

The FDA cleared the first OTC continuous glucose biosensors in 2024, opening a category that previously didn’t exist. These devices are designed for adults with type 2 diabetes who don’t take insulin and for people without diabetes who want glucose data as part of a general wellness routine. You buy them directly from a retailer or the manufacturer’s website, no prescription needed and no doctor visit required. They work the same way prescription CGMs do: a tiny filament sits under the skin and measures glucose in the fluid between your cells, transmitting readings to a smartphone app.

There are practical trade-offs. OTC sensors tend to be marketed at a higher per-unit price than prescription devices covered by insurance, since insurance generally doesn’t reimburse products bought without a prescription. If you’re paying entirely out of pocket and plan to wear a sensor continuously, the costs add up to several hundred dollars a month. For someone curious about how their body responds to meals and exercise over a few weeks, though, the convenience of skipping the healthcare system entirely can be worth it.

Getting a Prescription From Your Doctor

If you have diabetes, especially if you use insulin, the prescription route is almost always the better deal. Your primary care doctor or endocrinologist writes a prescription, and you fill it at a pharmacy or through the manufacturer’s mail-order program. The American Diabetes Association recommends glucose monitoring for most patients on intensive insulin regimens, whether they have type 1 or type 2 diabetes, and that recommendation doesn’t require a history of frequent fingerstick testing first.² In practice, though, insurance coverage often imposes its own rules. Medicare, for example, has historically required documentation that you test your blood sugar multiple times a day before it will cover a CGM, a requirement that clinicians have criticized as outdated and counterproductive.

If your doctor is unfamiliar with CGM prescribing or you hit resistance, it helps to know what insurers typically look for. Most private plans and Medicare now cover CGMs for people with type 1 or type 2 diabetes who use insulin, but coverage for non-insulin-treated type 2 diabetes is less consistent. You’ll generally need a diabetes diagnosis on file, a treatment plan that includes glucose monitoring, and sometimes prior authorization paperwork from your doctor’s office. The process can take a few days or a few weeks depending on the insurer.

The Telehealth Shortcut

If getting to a doctor’s office is the main barrier, telehealth platforms have made CGM access substantially easier. Several companies now operate virtual diabetes clinics where you consult with an endocrinologist or nurse practitioner by video, get a prescription, and have the device mailed directly to your home. Research on this model has been encouraging. In one study of nearly 600 adults with type 2 diabetes who were remotely prescribed a real-time CGM, about 95% reported they were comfortable inserting the sensor at home without any in-person training, and their average A1c dropped from 7.7% to 7.1% over roughly ten months.³

A separate study looking at people with both type 1 and type 2 diabetes found that participants who started CGM remotely gained about 2.7 extra hours per day with glucose in the target range, with low rates of dangerous low blood sugar events.⁴ The takeaway is that you don’t need a hands-on clinic appointment to start using a CGM safely. A video visit and a shipped device work well for most people.

Beyond traditional telehealth, a growing number of direct-to-consumer wellness companies will pair you with a prescribing clinician who evaluates whether a CGM is appropriate, writes the prescription, and bundles the sensor with a coaching app. These subscriptions typically run anywhere from $150 to $400 a month depending on the service and how many sensors are included. Insurance usually doesn’t apply to these programs, so you’re paying a premium for the convenience and the software layer on top.

Does a CGM Help If You Don’t Use Insulin?

This is one of the most debated questions in diabetes technology. Historically, CGMs were considered tools for people on insulin, where real-time glucose data helps prevent dangerous highs and lows. But the evidence for non-insulin-treated type 2 diabetes has been growing steadily. A meta-analysis of randomized controlled trials specifically in people with type 2 diabetes who don’t use insulin found that CGM lowered A1c by about 0.37 percentage points compared to traditional fingerstick monitoring, with more time spent in the target glucose range and less time running high.⁵ An earlier meta-analysis found a similar direction, with a 0.31 percentage point A1c reduction and improvements in glucose variability.⁶

A primary care study found an even larger effect: CGM users saw a 0.62 percentage point greater A1c reduction compared to non-users, and their time in the target glucose range jumped from about 40% to 62% once they could actually see their data in real time.⁷ The improvements held over three months of wear. These aren’t dramatic numbers in isolation, but for context, many oral diabetes medications deliver A1c reductions in a similar range. The mechanism is behavioral: when people see what a particular meal or a skipped walk does to their glucose in real time, they tend to make different choices.

What About Using a CGM Without Diabetes?

A growing number of people without a diabetes diagnosis are wearing CGMs as part of a wellness or biohacking routine. The OTC devices now on the market are specifically marketed to this group, and several subscription services cater to it. The question is whether the data is actually useful if your blood sugar regulation is normal.

There’s some evidence that it can be. In one study that included self-reported non-diabetic participants wearing a CGM paired with a digital tracker, about 15% of healthy participants and 36% of those with prediabetes showed glucose excursions into the diabetic range during monitoring.⁸ Among those who had room to improve, time in range went up by roughly 23 percentage points. Separately, research on CGM-based glucose variability indices has shown that these metrics can distinguish between healthy individuals, people with prediabetes, and people with diabetes, suggesting CGM data captures meaningful metabolic information even in non-diabetic ranges.⁹

That said, there’s a real risk of over-interpreting normal glucose fluctuations. Everyone’s blood sugar rises after eating and dips during sleep. A healthy person seeing a spike to 160 mg/dL after a big bowl of rice might feel alarmed when that reading is actually well within the range of normal physiology. If you don’t have a clinical frame of reference, the constant data stream can create anxiety rather than actionable insight. The sweet spot for most non-diabetic users seems to be wearing a sensor for a few weeks to learn personal patterns, then taking a break rather than monitoring indefinitely.

What CGMs Actually Measure and Where the Numbers Can Mislead

Every CGM measures glucose in interstitial fluid, the liquid surrounding your cells just beneath the skin, not glucose in your blood. The two track closely, but there’s a built-in time lag. In healthy adults at rest, the physiological delay for glucose to move from the bloodstream into the interstitial space is about five to six minutes.¹⁰ The sensor’s own processing adds a bit more delay on top of that. During rapid changes, like right after eating or during intense exercise, the lag can mean your CGM reads lower than your actual blood sugar on the way up and higher than your actual blood sugar on the way down. This matters most for insulin-dependent users making dosing decisions, but it’s worth understanding regardless.

Certain medications and substances can also interfere with CGM readings. A pilot study found that commonly prescribed medications including lisinopril (a blood pressure drug), albuterol (an inhaler medication), and acetaminophen (the active ingredient in Tylenol), as well as wine, appeared to alter CGM readings compared to actual blood glucose levels.¹¹ Newer sensor generations have reduced the acetaminophen problem, but it hasn’t been eliminated entirely across all devices. If you take any of these regularly, talk to your provider about how it might affect your readings.

Skin Reactions Are More Common Than You’d Expect

One under-discussed downside of CGM wear is skin irritation. Over the past several years, reports of allergic contact dermatitis from glucose sensors have become increasingly common in both children and adults. The adhesives that hold the sensor in place contain chemicals that some people’s skin reacts to. One chemical in particular, isobornyl acrylate, which was used in a widely sold sensor, sensitized hundreds of published cases of allergic reactions.¹² A five-year study at a dermatology clinic found that about three-quarters of patients who came in with sensor-related skin problems were diagnosed with allergic contact dermatitis, most often from the adhesive tapes rather than the sensor housing itself.¹³

If you develop redness, itching, or a rash at the sensor site that persists after removal, it’s worth seeing a dermatologist to identify the specific allergen. Barrier films and skin-prep wipes that create a protective layer between the adhesive and your skin help for many people. Switching sensor brands may also solve the problem, since different manufacturers use different adhesive chemistry. For most users, mild irritation that fades quickly is normal and not a sign of allergy. Persistent or worsening reactions that spread beyond the adhesive footprint are the red flag.

Third-Party Apps and Predictive Features

The raw glucose data from a CGM is useful on its own, but a growing ecosystem of third-party apps aims to add layers of interpretation. Some integrate CGM data with diet logs, heart-rate data from a fitness tracker, and activity information to generate personalized recommendations about which foods spike your glucose and which don’t.¹⁴ Others have developed predictive models that forecast where your glucose is heading. One such app achieved roughly 99% clinical accuracy for 30-minute glucose predictions and could detect upcoming low glucose events with a mean lead time of about 16 minutes.¹⁵

These tools are appealing, but they come with caveats. Most consumer-facing CGM apps, particularly those tied to wellness subscriptions rather than medical devices, generate proprietary “metabolic scores” based on undisclosed algorithms. One study in non-diabetic and pre-diabetic users validated such a score against clinical markers of insulin resistance and found a strong correlation, but that was for one specific platform’s scoring system.¹⁶ There’s no standardization across the industry, so a “metabolic score” of 85 from one app may not mean the same thing as 85 from another. Treat these numbers as directional guidance, not clinical diagnoses.

Who Owns Your Glucose Data

Every CGM generates a continuous stream of health data, and the question of who controls that data is murkier than most users realize. When your CGM syncs with a manufacturer’s app or a third-party platform, your glucose readings are typically stored on the company’s cloud servers. In the U.S., traditional healthcare data is protected by HIPAA, but consumer-grade devices and direct-to-consumer wellness apps often fall outside HIPAA’s scope entirely. A review of CGM and mobile health data governance found significant regulatory gaps, especially for devices sold over the counter, where data ownership remains legally ambiguous and patients, providers, manufacturers, and app developers may all hold competing claims to the information.¹⁷

An earlier analysis warned that patients’ ability to control how their CGM information is collected, stored, and used is “virtually nonexistent,” and that inadequate cybersecurity measures create physical security risks as well as privacy ones.¹⁸ A review of privacy policies from internet-connected medical devices found that some manufacturers’ policies explicitly stated they didn’t even apply to the device itself, only to the company’s website.¹⁹ Before signing up for any CGM service, it’s worth reading the data-sharing terms. Some companies anonymize and sell aggregated data to researchers or pharma companies. If that bothers you, look for platforms that offer local-only data storage options or that explicitly commit to not sharing data with third parties.

The Environmental Cost of Disposable Sensors

Every CGM sensor is a single-use device containing a plastic case, an electronic circuit board, and a small battery, all of which get thrown away after a wear period of one to two weeks. With an estimated 230 million glucose sensors used worldwide each year, the waste adds up. A study that weighed and categorized the components of three popular sensor models found that packaging, applicators, and instructions made up the bulk of waste per sensor, ranging from about 58 to 108 grams depending on the brand. The sensors themselves weighed only a few grams each, but at global scale, that still translates to roughly 580 tons of discarded sensors annually, including about 130 tons of circuit boards and 110 tons of batteries.²⁰

None of the major CGM manufacturers currently offer recycling programs for used sensors or applicators. The batteries are too small for standard battery recycling streams in most municipalities, and the electronics are fused into the plastic housing in a way that makes separation impractical. As OTC availability pushes the user base well beyond the diabetic population, the waste volume is set to grow. Some researchers have called for manufacturers to explore rechargeable or refillable sensor designs, but nothing has reached the market yet.

CGMs at the Veterinarian’s Office

If you have a diabetic pet, the same technology has made its way into veterinary medicine. The most commonly used CGM in dogs and cats is the Abbott FreeStyle Libre, which has adequate clinical accuracy in both species, though its reliability drops somewhat in the low blood sugar range.²¹ For pet owners managing a diabetic animal, a CGM can reveal glucose swings that spot-check blood draws at the vet’s office would miss, giving the clinician a much fuller picture when adjusting insulin doses. Veterinary CGMs are applied during a clinic visit and typically worn for up to two weeks, with the pet’s fur shaved at the application site. The sensors are the same human-market devices repurposed for veterinary use, and they still require a veterinary prescription.

Differences in Access Across Countries

Access to CGMs varies dramatically depending on where you live. The U.S. and European markets have followed different regulatory timelines, with Europe’s more decentralized approval system historically bringing new diabetes devices to market faster than the FDA’s process, though both systems have been criticized for struggling to balance rapid access with adequate safety evidence.²² In many European countries, national health services cover CGMs for most insulin-dependent patients, though coverage for non-insulin-treated type 2 diabetes remains inconsistent. In some lower-income countries, CGMs are simply unavailable or prohibitively expensive, and fingerstick meters remain the standard of care. The arrival of OTC options may eventually push prices down through competition, but for now, the gap in global access is wide.