Comparing the Top Over-the-Counter Continuous Glucose Monitors

Checking your blood sugar levels with a glucometer is a great way to determine what is working for your diabetes management plan. However, until now, glucometers were the only over-the-counter (OTC) option for monitoring your levels accurately.

Let's face it, some other OTC products, like glucose monitoring watches, aren't up to snuff. But everything changed in 2024. As of June 2024, the FDA has approved not 1, not 2, but 3 OTC continuous glucose monitors (CGMs). Let's break down what a CGM is and then explore the new over-the-counter options.^1-3

Understanding continuous glucose monitors

These glucose monitors are small, wearable devices that continuously measure your levels. They do this using a tiny wearable sensor that sits under your skin to measure the amount of glucose in your interstitial fluid. A transmitter connects to the sensor and sits on top of your skin. It transmits your data to a receiver, which is usually a smartphone.

With a CGM, you can see what your blood sugar is doing at any time of the day or night. Is it stable, rising, or falling? You wear these monitors for 10 to 14 days before replacing them with a new one. Until 2024, all CGMs required a prescription in the United States. For people with type 2 diabetes, insurance coverage has often been a significant barrier to getting one.

Top over-the-counter CGM options

Over-the-counter means you do not need a prescription from your doctor to get a device. Currently, there are 2 OTC options from Abbott and 1 from Dexcom. Both companies are the leaders in prescription CGMs.

Dexcom Stelo

The first CGM approved by the FDA, Stelo, is for people over 18 years old with diabetes who are not on insulin. However, it is not the right fit for someone who struggles with severe low blood sugar levels. It's worn for 15 days and is linked to an app on your smartphone.¹

Abbott Libre Rio

Approved in June 2024, the Libre Rio is also for people with diabetes over 18 years old who are not on insulin. It has a wide range for detecting blood sugar patterns: 40 to 400 mg/dl. It is worn for 14 days and is linked to an app on your smartphone.²

Abbott Lingo

Also approved in June 2024, Lingo is for people WITHOUT diabetes. It is meant to be used as a tool to improve general health and wellness. This makes it a good fit for those with prediabetes. It's worn for 14 days, and data is linked to a health coaching app on your smartphone.³

The Stelo was set to be released to pharmacies in summer 2024, but it's unknown when the Abbott options will be available. At the time of this writing, the pricing of these devices had not been announced.¹

Prescription vs. OTC glucose monitors: Key differences

These OTC options open a lot of doors for people with diabetes. Glucose monitors provide valuable insight into trends in real time and over time.

However, they only offer some of the features a prescription CGM does. Here are some key differences.

Alert features

Prescription CGMs have alerts to notify users if they have high or low blood sugar. It appears that this is not available in OTC options. Also, prescription CGMs update data every 1 to 5 minutes. In contrast, some OTC options, like Stelo, update only every 15 minutes.^1-3

Data sharing capabilities

It's unlikely that OTC CGMs will offer share app features like prescription CGMs do. Share apps allow the person with diabetes to connect their CGM data to a friend or family member's phone. This means a loved one can get real-time information if needed.

Device flexibility

Prescription CGMs, such as the Dexcom G7, can be used by children as young as 2 years old. Dexcom's CGMs can also connect to smartwatches and insulin pumps. These options give more flexibility and variety to users than OTC monitors.⁴

Is an over-the-counter CGM right for you?

As with any diabetes tool or treatment option, nothing is the right fit for everybody. Exploring new possibilities to find out whether they work for you will help you make a final decision.

To further support you in trying new technologies, ask for a referral to a certified diabetes care and education specialist (CDCES). Often, they can help you understand the data you're gathering and how to use it for successful diabetes management.