Impact of Continuous Glucose Monitoring (CGM) on BGM Market Share

Impact of Continuous Glucose Monitoring (CGM) on BGM Market Share

Continuous glucose monitoring (CGM) is taking sales from blood glucose monitoring (BGM), the meter-and-test-strip method, but the shift is lopsided. At Abbott, which sells both, CGM made up more than nine-tenths of its Diabetes Care sales in the last quarter of 2025 [1]. By 2021 to 2023, most US adults and youths with type 1 diabetes in a national records database used a CGM [2], while more than four in five insulin users with type 2 diabetes in one large Medicare plan still didn't at the end of 2023 [3]. CGM users keep a meter as well: as of October 2026, the American Diabetes Association (ADA) says anyone using a CGM must have access to BGM at all times [4]. We didn't find a published US market-share figure for test strips in any primary source we could open, so this article works from what is public.

What company sales show

The clearest signal comes from Abbott's own reports. In the fourth quarter of 2025, its Diabetes Care unit had $2.13 billion in sales, and continuous glucose monitors made up $2.0 billion of that [1]. For the full year, the unit sold just under $8.0 billion, up 17.5% from 2024 [1]. Abbott doesn't break the rest of the unit out by product. Abbott Diabetes Care is the company that holds the FDA clearance for FreeStyle Lite strips [5], so its strip sales most likely sit in that remainder, which came to less than a tenth of its CGM sales that quarter.

The trend held into 2026. Abbott reported that its CGM sales grew 11.0% in the second quarter [6].

Other strip makers are harder to read from the outside. In its July 2024 half-year report, Roche, which makes Accu-Chek meters and strips, folded Diabetes Care sales into a broader "Near Patient Care" area, so strip revenue stopped appearing as its own line [7]. The same report announced a CE mark in Europe for Roche's own Accu-Chek SmartGuide CGM [7].

LifeScan, the OneTouch company, is the case we found most telling. It emerged from a Chapter 11 restructuring on December 8, 2025, having eliminated more than 75% of its debt [8]. Two months later it announced a partnership with i-SENS to sell a CGM under the OneTouch Vita brand, with launches planned in Germany, Ireland, Portugal and Belgium by early 2027 [9]. LifeScan's releases don't blame CGM for its finances, and we won't either. What they do show is a company built on strips deciding it needs a sensor of its own.

Ascensia, maker of Contour meters and strips, had been selling the implantable Eversense CGM in the US. Senseonics, the company that makes Eversense, took over that role on January 1, 2026 [10]. For background on why strips were such a steady business in the first place, see The 'Razor and Blade' Business Model in MedTech.

Who has switched, and who hasn't

Use data shows where CGM is winning. In a national database of US electronic health records, CGM use among adults with type 1 diabetes rose from 5% in 2009 to 2011 to 57% in 2021 to 2023, and among youths from 4% to 82% [2].

In type 2 diabetes, the switch is much earlier along. Among adults 65 and older with type 2 diabetes who use insulin, the yearly rate of starting a CGM in traditional Medicare rose from 107 to 5,249 per 100,000 people between 2013 and 2020 [11]. The authors concluded that CGM initiation still stayed below 10% in that group [11]. In one large Medicare Advantage plan, CGM use among members with type 2 diabetes on insulin climbed from 1.4% in January 2021 to 17.2% in December 2023 [3]. Neither study counts people with type 2 diabetes who don't take insulin.

How many strips a CGM user still buys

Switching to a CGM doesn't take a person's strip use to zero. A German study followed 1,343 adults who started an intermittently scanned CGM, a sensor read by scanning it with a reader or phone, between 2015 and 2018. Average strip use fell from 2.7 to 1.4 strips a day, and 40% of them kept using strips [12]. Here's what surprised us: that is roughly a halving, not the near-total collapse the phrase "no fingersticks" suggests.

A later German study of insurance claims from 52,296 people with insulin-requiring diabetes found that nearly all CGM users cut back. Among 2,306 long-term users, nearly one third stopped using strips altogether, while about 9% kept using them heavily [13]. Both studies cover 2015 to 2021, so they describe an earlier mix of sensors than people wear today.

One routine job strips used to do is gone from the current Dexcom and FreeStyle Libre sensors. Calibration means entering a fingerstick reading so the sensor can correct its own estimate. The Dexcom G7 is factory calibrated, with manual calibration optional [14], and the FreeStyle Libre 3 Plus and 2 Plus sensors are factory calibrated and don't require fingerstick calibration [15]. The implanted Eversense 365 is the exception. After its warm-up it asks for four fingerstick calibrations, then one a day through day 13, then one a week [16]. We trace how the meter moved from main tool to backup in Disruption by Continuous Glucose Monitoring (CGM).

What coverage rules keep in place

In the US, Medicare pays for strips whether or not a person qualifies for a CGM. Its glucose monitor policy, LCD L33822, covers a CGM for people who are insulin-treated or who have a documented history of problematic hypoglycemia [17]. People taking only oral diabetes medicines don't count as insulin-treated under that policy [17]. Strip coverage stays in place for both groups: up to 100 strips every 3 months for people not treated with insulin, and up to 300 for people who are, with more allowed when extra criteria are documented [17].

The ADA's 2026 Standards of Care lean toward CGM. They recommend it from diabetes onset for people on insulin, for people on non-insulin therapies that can cause hypoglycemia, and for people on any treatment where CGM helps [4]. The same section says people with diabetes should be provided BGM devices as their circumstances, preferences and treatment indicate [4]. Which tool fits a given person is a decision for that person and their care team.

Over-the-counter CGMs and the non-insulin market

People with type 2 diabetes who don't use insulin are the group Medicare's CGM rules leave out unless they have problematic hypoglycemia [17], and CGM makers now sell to them without a prescription. In 2024 the FDA cleared the Dexcom Stelo and Abbott's Lingo as over-the-counter CGMs, each for people 18 and older not on insulin at the time of clearance [18] [19]. We cover that market in Over-the-Counter (OTC) CGM Market.

We haven't found a primary source that measures how much strip buying these sensors replace. Until a company or payer publishes strip volumes by year, the best evidence is what's above: CGM dominating sales at Abbott, CGM use climbing among people on insulin, and average strip use per CGM user that fell by about half, not to zero, in the German data.