Stelo, Lingo and Libre: OTC CGMs vs a Prescription

The prescription monitors — Dexcom G7, Libre 2 and 3 — are built for people whose glucose can fall dangerously, and they add the features that population needs: real-time readings without delay, configurable alerts for lows and highs, sharing to a clinician's or family member's phone, and integration with insulin pumps and delivery software. For a person with type 1 diabetes or on insulin, those features are the reason the device exists and the reason it needs a prescription and a clinician.

For a person without diabetes, on no glucose-lowering medication, they are features they will not use. The on-a-GLP-1 page covers the one exception that applies to this practice — a person on a GLP-1 alongside a sulfonylurea or insulin, whose hypoglycemia risk is real — and the ADA guidance that a CGM is recommended for people on therapies that can cause hypoglycemia, not for the general population.

Not the sensor. The main page is candid that the device you get through us is comparable to one you could buy, and the comparison table there sets out the difference: an eligibility screen before you wear it, a clinician reading the trace against your labs, medications and history, and a written interpretation at the end with a decision attached.

That is worth spelling out because it is the whole of the argument. A two-week glucose trace in a person without diabetes is mostly normal variation, and the research on the main page — the 2026 reviews finding no health benefit from CGM in people without diabetes, and the warning that over-interpreting normal fluctuation causes unnecessary restriction and anxiety — is a description of what happens when a consumer app labels a normal post-meal rise a "spike" and a person changes their diet to avoid it. The interpretation is the product. A clinician saying "this is normal, stop worrying about the oatmeal" is a service an app does not offer, and "this pattern with this A1c and this fasting insulin is prediabetes, here is what we do" is another.

When you are curious, healthy, on no glucose-affecting medication, and want to see what your glucose does — without a clinical question behind it. An over-the-counter sensor answers that at lower cost and with no eligibility process, and the vs-A1c page will help you read it. We would rather say so than sell you an interpretation of a trace that does not need one.

When you already have a clinician managing your metabolic health who will read the data. Buy the sensor; bring the trace to them.

When you have used a CGM before, know what your patterns look like, and want to check something specific — a new diet, a training block, a period of poor sleep — for yourself.

And when to come through a clinician instead: when you have prediabetes or a family history and want the trace read alongside a panel; when you are on a GLP-1, metformin or any glucose-affecting medication; when a previous consumer CGM left you anxious or restricting; or when you want the measurement to lead to a decision rather than a dashboard. That is what the CGM through ACT 2 is for, and it is a narrower group than the market would like.