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Continuous Glucose Monitors Without Diabetes: What a Brand-New JAMA Review Found (2026)

For most of the past decade, a continuous glucose monitor was something you got from an endocrinologist, not a wellness startup. That changed fast. Dexcom’s Stelo launched over the counter in August 2024, Abbott’s Lingo followed within days, and “glucose spikes” went from an obscure clinical concept to a fixture of health influencer content — one keyword search on TikTok reportedly surfaced more than 2 billion views before Stelo had even shipped its first sensor. Longevity clinics started bundling continuous glucose monitoring into premium membership tiers alongside full-body MRI and biological age panels. A single French biochemist-turned-author built an Instagram following in the millions around glucose-spike advice.

None of that tells you whether wearing one does anything for your health if you don’t have diabetes. As of the first week of August 2026 — just weeks before this article was published — that question finally got a serious answer from the people whose job is to grade the evidence rather than sell the device. JAMA Internal Medicine published a full review and a companion clinical piece, led by researchers including physician-scientist Minna Johansson of the University of Gothenburg, that did for continuous glucose monitors what a 2019 JAMA study did for hospital executive physicals: it actually checked.

Key takeaways

  • A JAMA Internal Medicine review published August 3–4, 2026, found no good evidence that CGM improves health or prevents disease in people without diabetes — even though the same review confirms real, guideline-backed benefit in several diabetic populations.
  • The reviewers’ specific worry isn’t that glucose data is meaningless — it’s that normal, harmless fluctuations get misread as danger signals, prompting unnecessary anxiety and needless restriction of otherwise healthy food.
  • Over-the-counter CGMs (Dexcom Stelo, Abbott Lingo) launched in 2024 without a prescription requirement, fueling a consumer wellness market layered on top of a technology built and validated for people managing insulin-treated diabetes.
  • There is currently no validated “time in range” standard for people without diabetes — the guidelines that make CGM data interpretable exist only for people who already have the disease.
  • Neither OTC device includes real-time high/low glucose alerts, the core safety feature of a prescription CGM.
  • A year of continuous wear, once you add an app subscription on top of sensors, commonly runs $1,400 to $2,600 — a real cost for a use case the newest evidence doesn’t support.

Quick Answer: Does the Evidence Support CGM Use, by Population?

Who’s wearing it What the evidence actually shows Where CGM sits
Type 1 diabetes Strong, established benefit — reduces severe hypoglycemia and improves glycemic control versus fingersticks Standard of care
Type 2 diabetes on insulin Strong benefit, especially for people on multiple daily injections or at high hypoglycemia risk Guideline-recommended
Type 2 diabetes, not on insulin Helps people see how food, meds, and activity affect glucose; a modest average HbA1c benefit in some trials, but no proof it independently prevents complications Reasonable, individualized use
Prediabetes Plausible, actively studied use for short-term behavior change under clinical guidance Reasonable in specific cases, not a blanket recommendation
No diabetes, no prediabetes, general “wellness” use No good evidence of health benefit; risk of misinterpreting normal fluctuations, per the 2026 JAMA review Unproven, currently marketing-driven

Not sure whether a CGM — or any preventive test — actually fits your risk profile? Answer a few quick, non-identifying questions and get personalized eligibility guidance across all 6 categories ScanGlean covers. Take the Fit Check →

How We Got Here: From Hospital Prescription to Wellness Accessory

Continuous glucose monitoring was originally built for a narrow, high-stakes job: helping people with type 1 diabetes avoid dangerous swings in blood sugar without constant finger-pricking. For years, getting one meant a diabetes diagnosis and a prescription.

That gate came down in 2024. The FDA cleared Dexcom’s Stelo Glucose Biosensor System in March 2024 as the first continuous glucose monitor available without a prescription, cleared for adults with or without diabetes who don’t use insulin. Dexcom launched it commercially that August, pricing a one-month, two-sensor supply at $99, or $89/month on subscription. Abbott followed within days of Dexcom’s launch with Lingo, cleared by the FDA in June 2024 specifically as a general wellness product for adults without diabetes — a deliberately different regulatory lane than a medical device meant to manage a diagnosed condition.

The consumer response was immediate, and it plugged directly into an existing cultural moment. “Glucose spikes” had already become a social media fixture, driven heavily by French biochemist-turned-author Jessie Inchauspé, who built an audience in the millions around rules for flattening blood sugar curves. Fact-checkers at Agence France-Presse, working with the Central European Digital Media Observatory, found the CGM-adjacent hashtag universe on TikTok had racked up billions of views, alongside physicians and dietitians publicly pushing back on the more alarmist claims. Longevity clinics moved fast to capture the trend: Superpower’s higher membership tier, for example, now bundles continuous glucose monitoring alongside coronary CT angiography and multi-cancer blood testing, as we cover in our longevity clinics comparison. Consumer platforms like Levels built an entire subscription business around interpreting CGM data for people who were never candidates for a diabetes diagnosis in the first place.

By the time this article was published, the sensor itself had gone from a clinical tool to a wellness category — while the specific question of whether that category does anything for a healthy person had never been put through a rigorous, independent review. That changed a few weeks before this article went live.

What the Brand-New JAMA Review Actually Found

On August 3 and 4, 2026, JAMA Internal Medicine published two connected pieces as part of its “Less Is More” series — a full narrative review, “Continuous Glucose Monitoring in Type 2 Diabetes and Beyond,” and a companion clinical review, “Continuous Glucose Monitoring for Persons With and Without Diabetes,” led by Minna Johansson, an associate professor at the University of Gothenburg’s Sahlgrenska Academy, alongside co-authors Justin A. Dower and Kasia J. Lipska. The framing itself is notable: it’s the first major, independent evidence review to look at CGM across the full spectrum of who’s actually wearing one now — not just people with diagnosed diabetes.

The review’s core finding, stated without much hedging: there is no good evidence that CGM improves health or prevents diabetes in people who don’t already have it. That’s a direct quote from the companion piece, and it’s aimed squarely at the fastest-growing segment of CGM’s current user base.

Johansson was direct about the concern in the University of Gothenburg’s announcement of the findings: “This technology is tremendously valuable for certain groups. But it is increasingly being used by groups where we do not know if it provides benefit — or if it could even be harmful.” She went on to describe the practical downstream effect: “Continuous glucose monitors generate enormous amounts of data that are difficult to interpret… it risks drawing time and resources away from patients with greater healthcare needs” — healthy people showing up to primary care visits asking a clinician to help them make sense of readings that were never validated as meaningful in the first place.

The review didn’t argue CGM technology is flawed or that the sensors are inaccurate — it argued something more specific and, honestly, more useful: that a medical technology validated for one population was expanding into new ones faster than the evidence was being generated to support that expansion, and that healthy users seeing normal glucose fluctuations were being nudged toward unnecessary dietary restriction and anxiety as a direct result. The authors’ recommendation wasn’t “ban CGM for healthy people” — it was that companies selling these devices should be transparent about the actual state of the evidence in non-diabetic use, and that the technology should be deployed where it’s proven to help, not simply because the data now exists to collect.

Where CGMs Are Genuinely Proven to Help

This is the part that gets lost in both directions of the CGM debate — dismissed entirely by skeptics, glossed over by wellness marketing. The JAMA review is explicit that CGM is a real, guideline-backed advance for several specific groups, and none of what follows is in question:

  • Type 1 diabetes. CGM is standard of care. It reduces dangerous low-blood-sugar events and improves overall glycemic control compared to fingerstick testing, and few endocrinologists would recommend managing type 1 diabetes without one today.
  • Type 2 diabetes on insulin, especially multiple daily injections. A randomized clinical trial published in JAMA found CGM meaningfully improved glycemic control in people with type 2 diabetes on basal insulin, and it’s now a guideline-recommended tool for this group, particularly anyone at elevated risk of hypoglycemia.
  • Type 2 diabetes not on insulin. The evidence here is real but more modest: a 2025 systematic review and meta-analysis published by the American Diabetes Association’s Clinical Diabetes concluded CGM helps people see, in concrete terms, how specific foods, medications, and activity affect their own glucose — a genuinely useful behavior-change tool — though it hasn’t been shown on its own to prevent long-term diabetes complications the way it has for insulin-treated patients.
  • Anyone at high risk of hypoglycemia, regardless of exact diabetes type or treatment regimen, where continuous alerting has clear, direct safety value that fingerstick testing structurally can’t match.

The common thread: every one of these groups has an existing abnormality in glucose regulation that CGM is measuring against an established clinical reference point, with a defined goal (avoid dangerous lows, hit a target HbA1c, adjust a specific medication dose). That reference point is exactly what’s missing for the next group.

Where the Evidence Runs Out: Life Without Diabetes

Strip away the established use cases above, and what’s left is a rapidly growing population wearing CGMs with no diabetes diagnosis at all — precisely the group the 2026 JAMA review found no supporting evidence for. That’s not because nobody’s looked. A 2025 systematic review in Cureus, examining seven studies and roughly 1,127 non-diabetic participants, found CGM shows genuine promise as a tool for personalizing lifestyle interventions — one study in the review found that a 20-minute walk timed before a post-meal glucose peak measurably reduced the size of that spike — but concluded that direct evidence of impact on actual cardiovascular risk factors remained limited, and that its effect on hard outcomes like heart attacks or strokes “remains unclear” given how sparse the data still is. A separate systematic review of CGM in non-diabetic populations for cardiovascular prevention reached essentially the same conclusion: plausible mechanism, thin outcomes data.

There’s a deeper wrinkle underneath all of this, one that predates the wellness boom by several years: healthy people’s glucose isn’t actually as uniform as the “just eat clean and it’ll be fine” framing implies. In a widely cited 2018 study from Stanford researcher Michael Snyder’s lab, published in PLOS Biology, researchers put CGMs on people who tested as having entirely normal glucose tolerance by standard clinical tests (oral glucose tolerance test, HbA1c) — and found that while most had low or moderate glucose variability as expected, a meaningful subset showed unexpectedly large swings, with glucose regularly climbing above 180 mg/dL despite passing every standard diagnostic test for normal glucose regulation. The researchers coined the term “glucotypes” to describe these hidden patterns. That finding is genuinely interesting science, and it’s part of why researchers remain actively curious about CGM’s future role outside diabetes — but a single lab’s exploratory finding about hidden variability is a research lead, not a validated reason for a healthy 32-year-old to spend $1,000 a year finding out which glucotype they are, with no established action to take based on the result.

The Interpretation Problem Nobody Has Solved

Even setting aside outcomes, there’s a more basic problem: nobody has published a validated answer for what a “normal” or “concerning” CGM pattern even looks like in someone without diabetes.

For people with diabetes, this problem is solved. “Time in range” — the percentage of the day spent within a specific glucose window — is a formally defined, consensus clinical metric with clear targets. Liao Yue, an assistant professor of kinesiology at the University of Texas at Arlington, laid out the gap plainly in an April 2026 piece for The Conversation: those same frameworks simply don’t exist for people who don’t have diabetes. There’s no consensus threshold for how many spikes above a given level are fine versus worth acting on, and — with an estimated 115.2 million American adults already living with prediabetes, a population where this data might eventually matter most — the research needed to build that threshold hasn’t caught up to the number of people generating the data.

Layered on top of that gap is a fact that gets lost in a lot of glucose-spike content: a temporary rise in blood sugar after eating is the expected, healthy response, not a warning sign by itself. University of Wisconsin endocrinologist Dawn Davis put it bluntly in AFP/CEDMO fact-checking coverage of viral glucose-spike claims: “Everyone’s glucose will ‘spike’ after they eat, particularly a food that has a high glycemic index. This is normal. In patients without diabetes, the body will secrete insulin to help clear this glucose load and the blood glucose will return to normal baseline levels within about 2 hours.” Registered dietitians Christine Byrne and Abby Langer, along with cardiologist Rohin Francis, made similar points in the same reporting, pushing back specifically on social content that treats an ordinary, self-correcting spike as evidence of metabolic damage. UCLA Health senior dietitian Christine Goukasian offers the honest middle ground: frequent, very large glucose swings over years may plausibly matter for long-term inflammation and vascular health, but the goal for someone without diabetes “is not to avoid carbohydrates altogether — it’s about the type of carbs and about finding balance,” not panic over a single post-meal number a sensor happens to display.

Put those two facts together — no validated threshold, and normal spikes look alarming without one — and you get a predictable outcome: someone without diabetes straps on a sensor, watches a completely ordinary glucose response to a banana or a bowl of rice, and has no reliable way to know if what they’re looking at is nothing or something.

The Psychological Cost Nobody Advertises

This is the part of the JAMA review that got the least marketing attention and arguably matters the most: the reviewers explicitly flagged that pushing CGM into low-risk, healthy populations carries a real downside, not just a null result. Researchers and clinicians working in this space have specifically raised the risk of CGM use feeding orthorexia-like patterns — an escalating need to keep glucose numbers “perfect,” a growing fear of otherwise healthy, carbohydrate-containing foods, and rising anxiety generated by fluctuations a person would never have known about, or worried about, without a device constantly reporting them back in real time. For someone who already has a difficult relationship with food, that risk is amplified considerably; but the JAMA authors’ point was broader than that — this is a plausible, documented cost of routine non-diabetic use in general, not a rare edge case limited to people with a prior eating disorder history.

That’s a genuinely uncomfortable thing to sit with if you’ve bought into the wellness framing: a device marketed on the promise of giving you more control over your health can, in the specific population the newest evidence examined, produce more anxiety and more restrictive eating behavior without any offsetting proof of a health benefit to show for it.

Stelo vs. Lingo vs. Levels vs. a Prescription CGM: What You’re Actually Buying

Dexcom Stelo Abbott Lingo Levels (app + sensor) Prescription CGM (Dexcom G7 / Libre 3)
FDA status Cleared March 2024, OTC Cleared June 2024, OTC, general wellness Uses OTC or prescription sensors depending on plan Prescription-only, iCGM-cleared
Intended for diabetes? Adults with or without diabetes, not on insulin Not intended for anyone with diagnosed diabetes Depends on sensor used Yes, including insulin users
Real-time high/low alerts No No No (uses underlying sensor’s limits) Yes
Published accuracy (MARD) ~8–10% ~8–11% Same as underlying sensor (Dexcom or Abbott) ~7.8–8.2%
Wear time per sensor Up to 15 days Up to 14 days Varies by sensor 10–15 days
Approx. monthly cost $89–$99 $49 (1 sensor) to $249 (6 sensors, ~$89–$100/mo) $199/year app + $150–$200/mo sensors Often insurance-covered for eligible patients; high self-pay cost otherwise

Pricing reflects publicly listed rates as of mid-2026 and changes with promotions and subscription terms; confirm current pricing directly before buying.

The practical gap that matters most isn’t raw sensor accuracy — all of these devices are reasonably close to each other and to prescription-grade CGMs on that metric. It’s the missing safety layer: neither Stelo nor Lingo includes real-time alerts for dangerously high or low glucose, which is precisely the feature that makes CGM most valuable for the diabetic populations the evidence actually supports.

What This Actually Costs

  • A single month of OTC sensor wear runs roughly $89–$100 regardless of brand, whether bought directly from Dexcom or Abbott.
  • Consumer platforms add a subscription on top of hardware. Levels charges around $199/year for its app and coaching layer, separate from whatever you pay for sensors — meaning the software itself is a recurring cost even before a single sensor ships.
  • Continuous, year-round wear is expensive. Between sensors and app fees, a full year of uninterrupted CGM use commonly lands between $1,400 and $2,600, depending on brand and plan — a genuine sum of money for a use case the newest independent evidence review found no proven health benefit for.
  • Insurance generally won’t help. Coverage for CGM is built around diagnosed diabetes and specific treatment regimens; a healthy person buying one as a wellness product is paying entirely out of pocket, though the purchase is typically HSA/FSA-eligible.
  • The real comparison point isn’t a competitor’s CGM — it’s a $0 alternative. A standard fasting glucose and HbA1c test, already part of routine bloodwork for most adults, remains the guideline-based way to check for prediabetes and diabetes risk, at a fraction of the cost and with an interpretation framework that’s actually been validated.

Who Might Reasonably Use One Anyway

None of this means a CGM is worthless for every non-diabetic person — it means the reasonable use cases are narrower and more specific than the marketing suggests, and they look different from “wear it indefinitely as a wellness habit”:

  • Prediabetes. With glucose regulation already measurably abnormal, short-term CGM use under a clinician’s or dietitian’s guidance to identify specific problem foods or timing patterns is a plausible, actively studied application — closer to the diabetic use cases with real evidence than to general wellness use.
  • Strong family history of type 2 diabetes, especially alongside other risk factors, where a defined, time-limited period of monitoring paired with a specific behavior-change goal is a more coherent use than open-ended data collection.
  • A specific, answerable question — “does eating dinner earlier change my overnight glucose,” tested for a couple of weeks with a clinician or dietitian actually reviewing the data — is a fundamentally different use case than passive, indefinite wear with no defined endpoint.
  • People already established on one for a legitimate diabetic indication should keep using it exactly as their care team recommends; nothing in this new evidence review changes anything for that group.

What the 2026 JAMA review argues against isn’t glucose data itself — it’s indefinite, ungoaled wellness monitoring in someone with no diabetes risk markers and no clinician involved in interpreting what the numbers mean, sold on the implicit promise that more physiological data automatically equals better health.

The Bottom Line

Continuous glucose monitoring is a real, valuable, guideline-backed technology — for the specific populations it was built and validated for. Type 1 diabetes, insulin-treated type 2 diabetes, and anyone at meaningful hypoglycemia risk have genuine, well-evidenced reasons to wear one. What changed in the first week of August 2026 is that the fastest-growing part of the CGM market — healthy people with no diabetes diagnosis, buying Stelo, Lingo, or a Levels subscription as a general wellness habit — finally got a rigorous, independent look from JAMA Internal Medicine, and the finding was blunt: there’s no good evidence it improves health or prevents disease in that group, and there’s a real, documented risk that normal glucose fluctuations get misread as danger, feeding unnecessary anxiety and food restriction in people who were never at elevated risk to begin with.

That doesn’t make the sensor technology fraudulent, and it doesn’t mean nobody without diabetes should ever use one. It means the honest starting point is the same one this site applies to every scan and test it reviews: know exactly what a device has been proven to do, for whom, before assuming that “more data about your body” is automatically the same thing as “better health.”

Frequently Asked Questions

Do continuous glucose monitors actually work for people without diabetes?

They work as intended — they accurately track glucose in real time. What’s unproven is whether wearing one improves health or prevents disease in someone who doesn’t have diabetes. A JAMA Internal Medicine review published August 3–4, 2026, by researchers including Minna Johansson of the University of Gothenburg, states plainly that there is no good evidence CGM improves health or prevents diabetes in people who don’t already have it, even though the underlying sensor technology is accurate and well-validated for the populations it was originally built for.

What did the 2026 JAMA Internal Medicine review actually find about CGMs?

Two companion pieces published together found genuine, evidence-backed benefit for people with type 1 diabetes, people with type 2 diabetes on insulin, and people at high risk of dangerously low blood sugar. For people with type 2 diabetes not on insulin, CGM helps people see how food and activity affect their glucose, but hasn’t been shown to prevent complications on its own. For people without diabetes, the authors found no good evidence of any health benefit, and warned that constant glucose data can prompt unnecessary anxiety and needless restriction of healthy foods in people who were never at risk to begin with.

What’s the difference between Dexcom Stelo and Abbott Lingo?

Both are over-the-counter, prescription-free CGMs cleared by the FDA in 2024, worn on the back of the arm for up to 15 days. Stelo is FDA-cleared for adults with or without diabetes who don’t use insulin, while Lingo is cleared as a general wellness product for adults without diabetes and isn’t intended for anyone managing diagnosed diabetes. Neither device includes real-time high/low glucose alerts, which is the main functional gap versus a prescription CGM like Dexcom G7 or Abbott’s Libre 3.

Is it normal to have blood sugar spikes if I don’t have diabetes?

Yes. Nearly everyone’s glucose rises after eating, especially after refined carbohydrates, and in someone without diabetes, insulin brings it back down within about two hours. University of Wisconsin endocrinologist Dawn Davis and other physicians have publicly pushed back on social media content that frames these ordinary, self-correcting spikes as dangerous. The genuine open question — one researchers say current guidelines don’t answer — is whether unusually large or frequent spikes matter over a lifetime for someone who is otherwise healthy, and no consumer CGM comes with a validated threshold to tell you where that line is.

Can wearing a CGM cause anxiety or disordered eating?

It’s a documented concern, not a hypothetical one. Clinicians and researchers have specifically flagged the risk of orthorexia-like patterns — an escalating need to keep glucose numbers “perfect,” fear of otherwise healthy carbohydrate-containing foods, and anxiety driven by normal, harmless fluctuations that a person would never have noticed without a sensor constantly reporting them. The risk is highest for people who already have a difficult relationship with food, but the JAMA reviewers noted it as a real cost of routine use in healthy people generally, not an edge case.

How much does an over-the-counter CGM cost?

Dexcom Stelo runs about $89–$99 for a one-month, two-sensor supply. Abbott Lingo is priced from about $49 for a single 14-day sensor up to $249 for six sensors (roughly $89–$100/month for continuous wear). Consumer platforms like Levels layer an app subscription (around $199/year) on top of sensor costs, pushing a full year of continuous wear north of $1,400–$2,600 depending on the sensor brand and how many months you actually wear one.

Who should actually consider using a CGM without having diabetes?

The clearer cases are people with prediabetes, a strong family history of type 2 diabetes, or a specific reason (working with a physician or dietitian) to understand how their own body responds to particular foods or exercise timing over a short, defined period. Using one indefinitely as a general wellness habit, with no plan for what a given number should change, is exactly the use case the 2026 JAMA review found no evidence for — and flagged as a real opportunity cost when it crowds out care for people who need CGM more.

Are Stelo and Lingo readings as accurate as a prescription CGM like Dexcom G7?

Close, but not identical. Published accuracy data puts Stelo’s mean absolute relative difference (MARD) in roughly the same 8–10% range as prescription iCGM devices like Dexcom G7 (about 8.2% MARD) and Abbott’s Libre 3 (about 7.8–7.9% MARD), with Lingo landing in a similar band. The bigger practical gap isn’t raw accuracy — it’s that neither OTC device provides real-time alerts for dangerously high or low glucose, a safety feature prescription CGMs are built around.


This article is for general educational and informational purposes only. It is not medical advice, and it is not a substitute for diagnosis, treatment, or guidance from a licensed physician, endocrinologist, or registered dietitian. Whether continuous glucose monitoring is appropriate for you depends on your individual health history, risk factors, and goals — always consult a clinician before starting or stopping any glucose monitoring, medication, or dietary change. Pricing referenced in this article reflects our research as of mid-2026 and is subject to change; see our Methodology page for how we research and grade the evidence behind claims like these.

Disclosure

ScanGlean does not sell continuous glucose monitors, sensors, or app subscriptions, and we currently have no paid, affiliate, or referral relationship with Dexcom, Abbott, Levels, or any other company named in this article. If that changes for any provider we cover, it will be disclosed here and on our Methodology page, and it will never influence how we grade the evidence.

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