Blood sugar monitoring is becoming increasingly important: Dexom’s over-the-counter sensor is now available for purchase

Blood sugar monitoring just got a little closer to becoming mainstream wellness territory. Diabetes tech company Dexcom announced Monday that its over-the-counter, no-prescription continuous glucose monitor called Stelo is available for purchase.

Stelo was cleaned up by the Food and Drug Administration for people with diabetes who do not need insulin and for any other adult who wants to better understand how the foods they eat affect their glucose levels. costs $99 for a two-pack of sensorswhat a month’s supply is. You can use your FSA and HSA dollars to buy it.

While people with diabetes need to monitor their blood sugar levels to make sure their bodies have the right amount to stay safe, blood sugar is everyone’s primary form of energy. How well the body uses blood sugar is also a measure of metabolic health — a term the medical community is still working on to describe how the body uses energy and how much risk someone has for health problems such as heart disease.

But accurately tracking blood sugar levels, or even accurately defining what it means to be “metabolically healthy,” is tricky. What we eat, the type of exercise we’ve recently done, and even the stress we experience can all affect glucose levels. And consumer wearables like smartwatches and smart rings can’t measure blood glucose, despite the existence of a few counterfeit devices on the market that aren’t FDA-approved.

This means that the world of blood sugar monitoring is the domain of diabetes tech companies, which already have sensors and technology — continuous glucose monitors — that many people with diabetes use every day. And the companies leading the way in diabetes tech have also laid the groundwork for making metabolic health more mainstream. Earlier this summer, the Food and Drug Administration has approved two new CGMs from Abbott for over-the-counter use: One for people with type 2 diabetes who don’t need insulin, the Libre Rio, and the other an easy-to-use patch for the general public, the Lingo, which made its debut at CES 2022. Both of Abbott’s over-the-counter CGMSs are based on the popular FreeStyle Libre sensor technology, while Dexcom’s prescription Stelo follows the popular G6 and G7 CGM technology for people who use insulin.

Here’s what we know about the new over-the-counter CGMs, plus insights from a company working on a new, noninvasive way to measure blood sugar levels.

Read more: The FDA wants to remind you that your smartwatch cannot yet measure blood sugar levels

Over-the-counter CGMs are officially here. Who needs one anyway?

The Stelo from Dexcom is now available. It is designed for people with type 2 diabetes and prediabetes, so they can see how different foods, sleep habits, stressful events and more affect glucose levels. It is also cleaned up by the FDA for any adult who wants to “better understand how diet and exercise can affect blood sugar levels.”

Like other wearable sensors used by people with diabetes, Stelo attaches to your upper arm. A small sensor that goes slightly under your skin then reads blood glucose data and sends it to a paired app, so you can track your blood sugar levels throughout the day and note any trends.

Abbott also has a consumer biosensor, the Lingo, and the Libre Rio, which is aimed at people with type 2 diabetes. Lingo launched in the UK earlier this year and is expected to be available in the US soon.

Some CGMs are already used for “biohacking” of glucose levels by people who want to know how their body reacts to food or what affects their glucose levels. Companies such as Nutrisense are marketed more as a consumer product, but require a prescription, which can be requested through the websites of the respective companies.

The question of “who actually needs this?” remains, however. As Dr.Robert H. Shmerling wrote in a article for Harvard Health PublishingCGMs can cost thousands of dollars a year, and companies that market their use to the general public could make big profits in an area of ​​health care that is currently unexplored. has no research to support it outside of diabetes management. In its press release, Abbott pointed to the study findings that only 12% of American adults considered “metabolically healthy”, But glucose measurements are only one of a few factors used to qualify metabolic health.

On the other hand, 1 in 3 Americans has prediabetes — a step for Type 2 diabetes that may be reversible. Providing actionable information about higher-than-average blood sugar trends could give many people the information they need to make health choices — if they can afford it, that is. Neither Dexcom nor Abbott have provided exact prices for their consumer CGMs at this time, but CGM costs for people with diabetes who don’t have health insurance remains a barrier to access to health care.

Because consumer CGMs don’t require a prescription and many cases likely wouldn’t be considered medically necessary, someone at higher risk for developing type 2 diabetes would still likely pay top dollar for an over-the-counter CGM. The high cost of biosensors is one reason there’s interest in noninvasive, even more consumer-friendly measures to monitor blood sugar.

Read more: An AI-built ‘digital twin’ can improve your health, says this startup

Noninvasive blood sugar monitoring featured at American Diabetes Association conference

There’s no way to accurately measure blood sugar levels without getting under someone’s skin at least a little bit. Even CGMs require a tiny sensor on the wearable patch, even though it’s arguably less invasive than a fingerstick.

One company, Knowledge Labsis working to change that. The company was on the American Diabetes Association Scientific Sessions in Orlando earlier this summer and promising results presented about the ability of its wearable device, the KnowU, to get stable blood sugar readings without penetrating the skin. The company is still a long way from a market-ready device, and it’s still collecting data to submit to the FDA — the prototype is still bulkier than a CGM, potentially making it a harder sell even if it’s less invasive. But the company is expanding on the idea and use of photonics and sensors that are already integrated (for various purposes) into smartwatches and used to measure factors like blood oxygen.

Because LEDs can’t accurately track glucose information, Know Labs had to go “further out on the electromagnetic spectrum,” the company’s CEO Ron Erickson told CNET. He said that while a medical device is likely the first step for the company, he’s not opposed to opening up the patented technology to consumer wearables.

Erickson calls Know Labs’ technology “form-factor agnostic” and wants glucose readings to show health trends. That’s exactly the point of wearables that show health trends.

“My longer-term vision, beyond glucose, is focused on predicting health,” he said.