How to get a CGM without diabetes and what you can learn

Since their inception around 25 years ago, continuous glucose monitors (CGMs) have traditionally been tools for people with diabetes to constantly monitor blood sugar levels, which helps them accurately dose insulin without frequent finger prick tests.

Over the past few years, however, interest has grown in the use of CGM among people without diabetes, driven by a desire to avoid prediabetes and Type 2 diabetes (conditions of high blood sugar), as well as to gain insights about how diet, sleep, and activity influence blood sugar levels.

For people without diabetes, a CGM offers real-time feedback on how foods and other lifestyle factors affect your glucose levels. This information can help you aim for more stable blood sugar to boost energy, improve focus, aid weight loss, prevent and manage chronic disease, and even foster longevity. Here, we explain what a CGM is, how it works, why people without diabetes might want one, and how you can get one.

What is a CGM?

A CGM is a wearable device about the diameter of a quarter that tracks your glucose (blood sugar) level throughout the day, taking a reading every few minutes. The CGM communicates that data to your smartphone, where you can see it in an app like Levels. (Alternatively, the data can be sent to a small reader or an insulin pump.)

How does a CGM work?

You painlessly attach the CGM sensor to your abdomen or tricep using an applicator. The applicator embeds a tiny filament just underneath the skin in your interstitial fluid, which surrounds your cells. The body of the CGM itself sits above the skin; you can leave it exposed or cover it with an adhesive patch. You can shower, swim, sleep, and work out with the device. You’ll need to replace the sensor regularly, usually every 10–14 days.

The filament, about the width of dental floss, contains glucose oxidase. This enzyme converts glucose molecules to hydrogen peroxide. The hydrogen peroxide then reacts with platinum to create an electrical current. The electrical current wirelessly transmits a signal to an app or monitor, where an algorithm converts the signal to a glucose number. Your app usually presents glucose levels as milligrams per deciliter or mg/dL.

Why do you need an app like Levels with a CGM?

While the CGM manufacturers offer apps to display the basic data, an app like Levels helps you make sense of that data.

The Levels app shows you a graph of your glucose levels throughout the day within a recommended range for people without diabetes. You’ll see the magnitude of any spikes, also expressed as mg/dL. If you have a spike, you’ll also see how long your body took to return to a more stable blood sugar level. The amount of variability in a given day translates into a Stability Score so that you can monitor trends over time.

Additionally, the Levels app helps you log the foods you eat and imports sleep and exercise data from your phone to see how daily meals and lifestyle decisions affect your glucose. Plus, Levels provides valuable feedback and insights about why something may have caused a glucose spike or dip, helping to inform your choices for improved metabolic health going forward. It even scores your meals so you can keep track of what works best for you. The Levels app also offers a library of metabolically friendly recipes and science-backed articles about metabolic health. Finally, the app shows you long-term glucose, sleep, and exercise metrics and lets you set daily goals to keep yourself on track.

How do people with diabetes use CGM?

The chronic condition diabetes falls into two main categories: Type 1 and Type 2. Type 1 is a chronic disease in which the pancreas produces little to no insulin, the hormone that helps clear glucose from your bloodstream into cells for energy or storage. Without insulin, blood sugar levels can grow dangerously high, so people with Type 1 diabetes need to give themselves insulin injections. Seeing their real-time glucose levels with a CGM helps them dose insulin appropriately (too much can cause a dangerous blood sugar crash). Without a CGM, people with Type 1 have to rely on regular finger-prick testing, which can be painful and cumbersome. CGM offers more precision when it comes to managing their health. (CGMs can even connect to a worn insulin pump to automatically dose insulin.)

Type 2 diabetes is primarily a lifestyle condition in which persistent high glucose levels mean insulin loses its ability to do its job—called insulin resistance. People with Type 2 might use a CGM to track how their diet and lifestyle factors—like sleep, physical activity, and stress—affect their glucose levels so they can work to bring them down. By maintaining tighter blood sugar control, people with Type 2 diabetes can help slow or halt disease progression and perhaps even reverse it by lowering their fasting glucose level and increasing insulin sensitivity. A lower fasting glucose level can help reduce a person’s risk for cardiovascular disease and other severe conditions.

What is the best CGM for people without diabetes?

There are three primary manufacturers of CGMs in the US: Dexcom, Abbott, and Medtronic. All CGMs work similarly, but they vary a bit in shape, size, and other factors, such as how often you need to replace them. No one currently makes CGMs explicitly for people without diabetes. Instead, people without diabetes who use a CGM wear the identical versions as people with diabetes.

What can you learn from a CGM?

Wearing a CGM is about so much more than knowing your glucose level from moment to moment. Even if you eat the same food as someone else, your glucose response will be individual to you and could be quite different from the other person. This unique response is called bio-individuality. You can even have a different glucose response to the same food if you eat it at a different time of day. For these reasons, a CGM can be beneficial for determining what foods best support your metabolic health and which ones can harm it over time.

You’ll also learn how lifestyle factors affect your glucose levels. For example, poor sleep the night before can impact your glucose levels the next day. Likewise, if you’re going through a stressful time, you’ll likely see higher glucose levels than on a day when stress is minimal.

Understanding how diet and lifestyle affect your glucose levels can help you improve your metabolic health over time. For example, maintaining tighter glucose control can support weight loss if that’s your goal. It might also help you manage or reduce symptoms of polycystic ovary syndrome (PCOS), migraine, menopause, skin conditions, sexual dysfunction, and more.

Why is monitoring glucose valuable if you don’t have diabetes?

Glucose levels can be a matter of life and death for people with diabetes, but even for those without a diagnosed metabolic condition, glucose (and its partner molecule insulin) play a central role in our health, impacting how we feel at any given moment and our susceptibility to long-term disease.

Glucose is the primary fuel source for our cells, so it impacts every part of our body. When our body’s ability to use glucose is not operating optimally, it can manifest in a wide variety of problems, from fatigue to heart disease.

More than 38 million, or 12%, of adults in the United States have Type 2 diabetes. Of those, nearly 9 million people don’t yet know they have the condition. Before people develop Type 2 diabetes, they will develop prediabetes. More than a third of adults in the United States have prediabetes, with 80% of those undiagnosed.

Well before glucose metrics indicate prediabetes, however, they can suggest that such a diagnosis is likely around the corner. In a nutshell, Type 2 diabetes is severe insulin resistance, but insulin resistance is already present if one has prediabetes. What’s more, insulin resistance may be present for more than a decade before glucose levels are high enough for a diagnosis of prediabetes.

Insulin resistance occurs when you repeatedly have blood sugar spikes, where your blood sugar jumps out of an optimal range due to meals and other lifestyle factors. In response to a blood sugar spike, your pancreatic beta cells release insulin. Insulin signals cells to let glucose in for energy or storage. However, repeated spikes will cause repeated insulin surges. Over time, cells, which can get overwhelmed by too much glucose, will become resistant, or numb, to insulin’s signaling, leaving you with consistently higher blood sugar levels and, therefore, a higher risk for many diseases, weight gain, and more. Maintaining a low glucose variability, meaning fewer dramatic changes in your blood sugar levels, increases insulin sensitivity, which is the opposite of insulin resistance.

Insulin resistance can cause cellular dysfunction. It can drive inflammation, shares a strong relationship with obesity or weight gain, and promotes chronic disease development, including cardiovascular disease, dementia, cancer, and more. Ultimately, insulin resistance can shorten your healthspan.

What are the benefits of stable glucose?

Maintaining stable glucose, or low glucose variability, can boost your health in several ways. To understand the benefits, you need to know why and how spikes and dips can affect your health.

After a glucose spike, a crash may follow. A crash in response to a spike is called reactive hypoglycemia, when your body overcorrects the high blood sugar with an insulin surge that then quickly depletes glucose from the bloodstream, leaving you with low blood sugar. Low blood sugar can leave you feeling sluggish, foggy, fatigued, shaky, nauseous, irritable, and craving carbohydrate-heavy foods and sweets that can further cause blood sugar dysregulation.

Maintain consistent energy. Crashes are less likely to occur if you keep your blood sugar in a stable range and avoid large swings up and down. If you’re metabolically flexible, your body will instead burn fat for energy when glucose in the bloodstream drops, keeping your energy more stable.

Improve focus. Reactive hypoglycemia can interrupt your focus by tanking your energy and giving you uncomfortable symptoms. Additionally, worsening metabolic health is linked to deteriorating cognition. More stable blood sugar may help you maintain and even improve your mental fitness.

Manage weight. Insulin resistance and weight gain are intricately connected in a chicken-egg scenario. Insulin resistance drives weight gain, and vice versa. Insulin promotes the storage of excess glucose as fat. And high insulin prevents fat burning. Increased body fat promotes inflammation, which can drive insulin resistance.

Reduce disease risk. Eight of the ten leading causes of death pre-COVID—including cancer, heart disease, stroke, and Alzheimer’s—are tied to high blood sugar. Maintaining stable blood sugar levels helps lower your risk of developing life-threatening diseases.

Support longevity. By reducing your disease risk through tighter blood sugar control, you might extend both your lifespan and your healthspan. Not only are you likely to live longer, you might also experience a relatively good quality of life in your latter years from staving off inflammation, maintaining healthy joints, and more.

How do you get a CGM if you don’t have diabetes?

In the United States, CGMs are available by prescription only. However, doctors increasingly prescribe them to people to improve their health. You can ask your doctor for a prescription, but insurance may not cover it. A CGM might be health savings account (HSA) eligible.

You can also access a CGM from various biotech companies, including Levels. Levels works with a network of independent telehealth physicians. These physicians can assess your eligibility for a prescription, and then the Levels pharmacy partner can fulfill it. Visit our membership cost and info page to learn more. You can also opt into the Levels study to bypass the need for a prescription.

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