Can I Get a CGM if I Don't Have Diabetes?
(Updated 9/12/2024)
As of September 2024, there are NEW Over-The-Counter CGM Options - read all about it!
Continuous glucose monitors… or CGMs for short… have been popularized by biohackers in recent years. But can YOU get one?
In my nutrition practice, I’ve been using them with my clients and in groups to help all sorts of people improve their health.
It’s helped people with diabetes get their glucose better controlled (lower A1c and fewer medications).
It helps people with insulin resistance reverse it.
The data helps my collaborating physicians make more informed decisions about blood sugar medication for our patients (when to put them on meds and when to take them off).
It’s helped people reduce inflammation and pain, lose some belly fat, sleep better, improve energy and regulate mood.
This is because elevated blood sugar and insulin levels have far-reaching effects on the body. The standard American diet is basically a recipe for diabetes and inflammation. Sometimes, it takes a tool like a CGM to give my patients the clarity and insight they need to make strategic changes in their diet and lifestyle that give them the results they want.
How do I buy a cgm
Get a prescription from your doctor (elaborated on below)
Take your prescription to a pharmacy to purchase.
Who qualifies for a CGM?
This depends entirely on your doctor. But in my experience, most doctors are happy to write a prescription for their patients for a limited time. Remember that most doctors are only familiar with their use in managing diabetes, not for disease prevention. But when they learn the benefits and the price, they typically support their patients in taking a more active role in their health.
Nearly every provider I have sent a letter to for my clients has written a prescription for at least 3 months. This includes healthy 40-year-old individuals who want to optimize their health and prevent future disease.
Can you get a continuous glucose monitor if you’re not diabetic?
The short answer is “yes”.
The key thing to remember is that you DO need a prescription to obtain a continuous glucose monitor in the U.S. (but not in Canada or Mexico). But you DON’T need insurance to pay for it.
Edit: This is about to change, as the first over-the-counter continuous glucose monitor was just approved by the FDA and is set to hit stores in the summer of 2024!
To get insurance coverage, knowing which diagnosis codes your doctor uses is important. If you do have diabetes and use insulin, your doctor will code for that and your insurance might probably cover the cost. Fine. But if you don’t have diabetes, they can write an “off-label” prescription for you and insurance is unlikely to cover your equipment. This means you CAN buy it from the pharmacy but insurance might not cover the cost. In my experience, a FreeStyle Libre CGM (which lasts 14-days) will cost between $40-70 without insurance. Learn more about the cost of using a CGM here.
How do I ask my doctor for a prescription for a continuous glucose monitor?
There seem to be 2 categories of providers when it comes to CGMs. Those who know the benefits and are happy to write a script for it, and those who only know about it for use with diabetes but aren’t experienced in using it for prevention.
Remember that your doctor is a busy person and while they know a heck of a lot, they don’t have time to know everything. When bringing new information to their attention, it is helpful to keep it concise and from a trusted source. When I say “trusted”, I mean from a peer-reviewed source that your provider trusts. Their medical license is on the line and they need to be able to justify the decisions they make. Another good source is a letter from another licensed healthcare professional. I typically write a note on behalf of my patients and group participants explaining my reasoning for recommending a CGM, the estimated price, the support I will be providing, and specific prescription codes for the device I’m requesting (to save them time).
What would sway a doctor on the fence?
Heart disease is still the #1 killer.
Type 2 diabetes (and pre-diabetes) are the leading causes of CVD.
Type 2 diabetes (T2D) is decades in the making. A person will typically have insulin resistance for years before developing T2D.
A person can have pre-diabetes for years and this alone contributes to the development of obesity, cardiovascular disease, hormone dysregulation, fatty liver, inflammation, pain and brain fog. 1 in 3 adults in the US has pre-diabetes and most don’t know it.
Using a CGM can:
Help assess insulin resistance and prediabetes.
Provide the user with IMMEDIATE feedback about their food choices.
Show the user a clear cause and effect between their blood sugar and what they eat/drink in a way finger sticks and conventional labs never could.
Help the user lose weight, lower blood pressure, triglycerides and A1c in just 3 months.
Tight regulation of glucose and insulin levels can prevent certain cases of obesity, diabetes, heart disease and other chronic diseases.
How much does a continuous glucose monitor cost?
I cover this topic in detail in this post. But the base cost of a FreeStyle Libre system is $40/sensor or $80/month. For people looking to use it for 1-3 months for education and prevention, this is a very reasonable expense.
Insurance does sometimes cover use, but this depends on:
Your insurance coverage
Your diagnosis codes
How persistent you and your doctor are in advocating for coverage
I’ve seen private insurance cover 50% of the cost for clients who are coded for prediabetes, metabolic syndrome and obesity. I’ve seen some medicare plans cover 100% for a person with type 2 diabetes NOT taking insulin. But most of my clients pay cash. My advice if you want to get your insurance to cover it is to:
Be sure your doctor is using all the suitable diagnosis codes that apply to you including prediabetes, metabolic syndrome and obesity.
If your provider does not feel you have any of these conditions, but you do, then be open to paying cash for a month or 2. Sometimes, my clients have shared their data with their doctors and a clear diagnosis of prediabetes was given. This is because fasting blood sugar and A1c are not always good measures of disease progression. I’ve also seen patients use a CGM for 1-3 months cash-pay, get rapid improvements in their A1c, blood pressure, lipids and weight loss… only to have their doc go to bat for them and get insurance to cover it from here on out.
How I help my clients get a CGM
First, I give them a letter to share with their provider. It has a little bit of information about why we are using it and clear instructions on what to order to save them time. I find doctors like to know that you will have support interpreting the data because they know you’ll have greater success using a CGM with help. Indeed, I’ve had people join my group CGM program and have huge success after not moving the needle using a CGM on their own. A little support goes a long way.
Second: Sometimes, it helps to see how powerful of an educational tool it can be.
I might share this kind of image with them (and their doctor) to show them HOW we will use it. The power of using continuous glucose monitors for a defined time period for educational purposes and even as a diagnosis tool is clear and there is research to back this up.
Often a new client will call saying their doctor wants to start them on medication for their blood sugar, lipids or blood pressure and they don’t want to. Their doctor often gives them 3 months to see if they can move the needle first. In this case, we can find a good compromise. Even if medications ARE necessary, a CGM can help us minimize them, choose the most effective ones and know when to stop/start. It gives the prescribing physician better information and gives the patient more control.
How do I learn how to use a continuous glucose monitor?
The first step is to decide which brand of CGM is best for you.
If you have type 1 diabetes and or type 2 and take insulin multiple times per day, you will likely qualify for insurance coverage and might consider a Dexcom G6. The Dexcom integrates with an insulin pump.
If you are non-diabetic, have pre-diabetes, type-2 diabetes without insulin or just use a small amount of insulin, then the Libre FreeStyle systems might be a good choice.
You have a few different ways to jump into a FreeStyle Libre system:
One is to log onto the FreeStyle Libre website and work it out for yourself. It takes time, but most of the information is there and the customer service is good. For example, when I first started using it, it took me about 2 months to work it all out, coordinate it with my doctor and figure out how to use it. This was part of my job, so it was fine. You might not have the time or interest in re-inventing this wheel.
A few online companies have sprung up offering to sell you a CGM with a month of online dietician support. They have an in-house prescriber to handle the prescription for you. This is the most expensive option by far as they all involve a monthly subscription. It can also be difficult to share your data with other providers. But they can be a great option if you can’t get a prescription from your doctor, are faily tech-savvy, know a thing or 2 about blood sugar already, and don’t need to share your data with anyone else.
In my experience, people can flounder without some support and education on the front end. I offer regular 4-week group programs teaching people how to obtain and use their continuous glucose monitors AND how to interpret the data and hack their blood sugar. In fact, some of the people in my program had already been using a CGM for months without much improvement until they took my program. Learning how their blood sugar works and getting another set of eyes on their data to help them troubleshoot their diet and exercise strategy with some simple, targeted ideas were needed to turn the ship around and start healing their metabolism finally.
That 4-week program is what launches them. Every week, I get emails from clients who took part in my 4-week program telling me that since then (with no more input from me) they have continued to improve glucose control, lose weight, improve their labs and reduce medications. Some aren’t even using a CGM anymore, but are simply using the personalized strategies it helped them develop while in the program. What’s more, their family members usually benefit too. There is a growing group of lurking spouses who have made dramatic turnarounds in their health by just doing what their partner (my client) does. It’s like a two-fer!
Join My “Hack Your Blood Sugar” Program!
If you are the DIY sort, you might be able to do this on your own with a little bit of help. On the other hand, you might appreciate taking part in a 4-week group program to get a great jumpstart. We offer a wide range of supports to suit your needs with the goal of making YOU the expert.
Biohacker’s guide to using CGM
“Just give me the instructions and I’ll be on my way, thank you.”
Some of my clients don’t need as much support. I like to call you my “Biohackers on a Budget”. That’s why I also offer an inexpensive downloadable e-book for $27 that guides you through the process and a DIY online class as well that outlines all the steps, provides instruction, videos, a standard letter for your doctor and much more.
These options are also great if you already HAVE a provider helping you with your nutrition, but don’t know how to use a CGM. You can learn this together and not have to hire a totally new provider.