Impact of GLP-1 Agonists on CGM Market

Introduction to GLP-1 Agonists and CGM

So far, GLP-1 drugs look more like a companion to continuous glucose monitors (CGMs) than a threat to them. Dexcom's revenue grew 16% in 2025, to $4.662 billion [1], and in a survey Dexcom ran in 2026, 58% of people with type 2 diabetes who take a GLP-1 said they also use a CGM [2]. The catch is where that evidence comes from. Nearly every number we found linking the two was produced or paid for by a CGM maker, so we name the source next to each one.

What GLP-1 agonists do

GLP-1 receptor agonists copy a gut hormone called glucagon-like peptide-1. They raise insulin release when glucose is high, hold back glucagon (a hormone that pushes glucose up) and slow how fast the stomach empties [3]. They are not insulin. Ozempic, the semaglutide brand for type 2 diabetes, is labeled as an add-on to diet and exercise for adults with type 2 diabetes and is injected once a week [4].

The label also warns that taking it with insulin or with a sulfonylurea (a pill that makes the pancreas release more insulin) raises the risk of hypoglycemia, or low blood glucose [4]. That is one reason a sensor enters the picture. Still, Ozempic's dosing section is a weekly step-up schedule, with further increases left to the prescriber when more glucose control is needed; nothing in it is keyed to CGM readings [4]. A CGM adds a running picture of how treatment is going, and any change to a medicine is a decision for your care team.

What the sales numbers show

As of October 2026, Dexcom's sales are still climbing. Full-year 2025 revenue was $4.662 billion, up 16% from 2024 [1]. Second-quarter 2026 revenue rose 13% to $1.308 billion, with US revenue up 11% [5].

Here's what surprised us. None of the Dexcom earnings releases we read for 2025 and 2026 mentions GLP-1 drugs, and none splits out sales to people who take them [1][5]. Revenue alone can't tell us whether GLP-1s brought Dexcom new customers, cost it some, or did both. The growth fits the companion story without proving it.

Who pairs the two

Dexcom's 2026 State of Type 2 Report surveyed more than 800 healthcare professionals and 2,500 people with type 2 diabetes in eight countries, the United States among them [2]. Among those taking a GLP-1, 58% said they pair it with a CGM, compared with 27% of people with type 2 diabetes who don't use insulin [2]. Half of the professionals expected growing GLP-1 use to raise CGM uptake [2].

Treat these as a manufacturer's survey. The press release doesn't describe how respondents were recruited or give margins of error, and Dexcom presented the results as an untapped opportunity for CGM [2].

What the outcome studies found

The case CGM makers bring to doctors and insurers rests mostly on insurance-claims and health-record studies. In each one below, people who added a CGM to a GLP-1 saw a larger drop in HbA1c (a blood test of longer-term average glucose) than people on the drug alone.

• An Abbott-authored study matched 478 adults who started a GLP-1 and a FreeStyle Libre sensor together with 2,390 who started only the drug. After six months, HbA1c fell 2.43 percentage points in the Libre group and 2.06 points in the drug-only group [6].
• A Dexcom-authored analysis of semaglutide users found a 0.55-point larger HbA1c drop among 2,759 CGM users than among 18,488 people without a CGM [7].
• A study by IQVIA staff, covering 13,221 matched people, found HbA1c fell faster and further when a CGM was added to an existing GLP-1 [8].

These are retrospective and company-authored, so they show an association, not a cause. Dexcom's CONNECT trial is different because it was randomized. It assigned 283 adults with type 2 diabetes who don't use insulin to either a Dexcom G7 or fingerstick testing for 26 weeks [9][10]. Among participants taking a GLP-1, HbA1c fell 1.4 points with the G7 and 0.2 points in the fingerstick group, according to Dexcom's announcement of results presented at the American Diabetes Association's June 2026 meeting [9]. As of October 2026, ClinicalTrials.gov lists Dexcom as the sponsor and the trial as active but not recruiting [10].

One more study points at a link between the two product lines. In a second Abbott-authored claims analysis, 68.4% of people who used a CGM steadily were still filling their GLP-1 a year after starting it, compared with 51.9% of matched people without a CGM [11]. If that pattern holds, sensor sales and drug refills rise together.

Who pays: coverage rules

Coverage is where the companion story meets a limit. Medicare's glucose monitor policy, LCD L33822 (revision effective October 1, 2024), covers a CGM only when the person is insulin-treated or has a documented history of problematic hypoglycemia, along with other conditions such as training and a prescription that follows the device's FDA indications [12]. As of October 2026, then, someone taking a GLP-1 without insulin and without that history doesn't meet Medicare's CGM criteria [12].

Commercial plans vary. In May 2025, Dexcom said two of the three largest pharmacy benefit managers (PBMs, the companies that run drug and supply benefits for insurers) now cover its CGMs for anyone with diabetes [13]. That is the company's description, and the release doesn't name the PBMs. In Dexcom's 2026 survey, 90% of US healthcare professionals cited coverage and reimbursement as barriers to CGM use [2].

Guidelines give payers mixed signals. The ADA's 2026 Standards recommend CGM for people on insulin, rated with the ADA's highest evidence grade (A), and for people on non-insulin medicines that can cause hypoglycemia or on any diabetes treatment where CGM helps, both rated grade C [14]. On cost, an Abbott-funded model estimated that adding a Libre sensor to GLP-1 therapy would cost $40,968 per quality-adjusted life year (QALY, a year of life weighted for health) from a US payer's view [15]. That is a projection, not observed spending. Our article on global market access and reimbursement models covers how payers weigh numbers like these.

Over-the-counter sensors sidestep coverage

Over-the-counter CGMs don't need a prescription, so insurance rules don't decide who can buy one. The FDA cleared Dexcom Stelo, an over-the-counter CGM for adults who don't use insulin, in March 2024 [16], and Abbott's Lingo, also for adults not on insulin, in May 2024 [17]. An adult taking a GLP-1 without insulin can fall within those labels, though each label carries its own exclusions, and the buyer pays instead of the plan. We cover these devices in our over-the-counter CGM market article.

What we still don't know

Public sales reports don't separate GLP-1 users from other customers [1][5], so nobody outside the companies can yet measure how many CGM sales the drugs drive. The outcome evidence is mostly observational and company-authored, and the CONNECT subgroup figures we could read come from Dexcom's announcement [9]. The next data point on our list is Dexcom's third-quarter 2026 report, scheduled for October 29, 2026 [18].