Use of Continuous Glucose Monitors by People Without Diabetes: An Idea Whose Time Has Come?

Abstract

Background: Continuous glucose monitor (CGM) systems were originally intended only for people with diabetes. Recently, there has been interest in monitoring glucose concentrations in a variety of other situations. As data accumulate to support the use of CGM systems in additional states unrelated to diabetes, the use of CGM systems is likely to increase accordingly. Methods: PubMed and Google Scholar were searched for articles about the use of CGM in individuals without diabetes. Relevant articles that included sufficient details were queried to identify what cohorts of individuals were adopting CGM use and to define trends of use. Results: Four clinical user cases were identified: (1) metabolic diseases related to diabetes with a primary dysregulation of the insulin-glucose axis, (2) metabolic diseases without a primary pathophysiologic derangement of the insulin-glucose axis, (3) health and wellness, and (4) elite athletics. Seven trends in the use of CGM systems in people without diabetes were idenfitied which pertained to both FDA-cleared medical grade products as well as anticipated future products, which may be regulated differently based on intended populations and indications for use. Conclusions: Wearing a CGM has been used not only for diabetes, but with a goal of improving glucose patterns to avoid diabetes, improving mental or physical performance, and promoting motivate healthy behavioral changes. We expect that clinicians will become increasingly aware of (1) glycemic patterns from CGM tracings that predict an increased risk of diabetes, (2) specific metabolic glucotypes from CGM tracings that predict an increased risk of diabetes, and (3) new genetic and genomic biomarkers in the future.

Continuous Glucose Monitoring in Enterally Fed Children with Severe Central Nervous System Impairment

“…Originally, the system was developed to improve glycaemic control in patients with diabetes, and also, the standards for interpreting the CGM readings are dedicated to this group of subjects [ 26 ]. Subsequently, the method was deployed in other clinical situations related and not related to disordered glucose metabolism (e.g., hypoglycaemia in neonates, patients in critical conditions, sport medicine, and healthy individuals) [ 27 ]. We have shown that for patients with chronic CNS damage who are tube-fed, hypoglycaemia can be a significant clinical problem.…”

Technology Roadmap for Flexible Sensors

“…Patient adoption of CGM devices has been rapidly expanding, as evidenced by a 237% revenue increase of Dexcom between 2018−2021 and a forecasted global CGM market of $15 billion by 2032. 925 The success of CGMs has also led to the idea of assigning glucotypes in non-diabetic individuals, 926 in which people can track their glycemic responses to get more precise ideas of their predisposition to diabetes. Companies such as Levels Health and Nutrisense now sell CGMs with related software and information to those interested in monitoring their glucose responses in the context of weight loss, athletic performance, and improved general wellbeing.…”

Continuous Glucose Monitoring in a Healthy Population: Understanding the Post-Prandial Glycemic Response in Individuals without Diabetes Mellitus

“…[1] Increased visibility of glucose data has resulted in a recent trend of individuals without DM using CGM as a means of monitoring their health. [2] One area of interest is the effect of post-prandial hyperglycemia (PPHG) upon the health of individuals with and without DM. Through dietary and lifestyle changes, individuals attempt to minimize PPHG to aid weight loss, optimize mental health, suppress hunger and food cravings, improve sleep, as well as avoid glycemic fluctuations which could lead to chronic disease including cardiovascular disease.…”