Continuous glucose monitoring · a global census
How many CGM products exist in the world?
There is no official global registry of continuous glucose monitors, so the honest answer is a range that depends on what you count. This page counts them properly: roughly 45 distinct CGM systems, sold by about 20 manufacturers, are on the market somewhere in the world as of September 2026 — but only five companies' sensors are authorised and sold in the United States.
Research snapshot · 8 September 2026 · every claim sourced below
The count, five ways
"How many CGMs are there" has five defensible answers, because the question hides a definition. Pick the row that matches what you actually mean.
- 5Companies selling a CGM in the United States. Abbott, Dexcom, Medtronic, Senseonics and Biolinq. That is the entire US field — and Medtronic's newest sensor is manufactured by Abbott.
- ~13Sensor platforms that matter commercially. Distinct sensor technologies with meaningful market share: Libre, Dexcom G-series, Guardian/Simplera, Eversense, Accu-Chek SmartGuide, Biolinq Shine, iCan, Sibionics GS, AiDEX, Medtrum, CareSens Air, Yuwell Anytime, iFree.
- ~45Distinct CGM systems on sale somewhere in the world. The number this page catalogues: separate, currently-marketed products, counting a 14-day and a 15-day version of the same sensor family as two, because they are sold and reimbursed as two.
- ~70+If you count re-badged hardware. Chinese sensors are widely white-labelled — one MicroTech sensor is sold as AiDEX, GlucoRx Aidex and GlucoRx Vixxa; Sinocare's iCan i3 is GlucoMen iCan in Europe; Abbott's Instinct is Medtronic-branded. Same silicon, different box.
- 100+If you count consumer "CGM programmes". Levels, Signos, Nutrisense, Zoe, Sugarfit, Vively, Ultrahuman and dozens of regional copies are subscription apps wrapped around somebody else's sensor. They are not CGM products; they are software over Dexcom or Abbott hardware.
The concentration is the real story. Roughly 45 systems exist, but five companies — Abbott, Ascensia/Senseonics, Medtronic, Roche and Dexcom — held about 99% of global CGM revenue in 2025, with Abbott alone above 58%. Everything else in this catalogue is competing for the remaining slice, mostly on price, mostly in China, and increasingly in Europe.
What actually counts as a CGM
Almost every device below works the same way, and the differences that marketing emphasises are rarely the ones that matter.
The shared mechanism
- A filament sits in interstitial fluid a few millimetres under the skin — not in blood.
- Glucose oxidase on the filament produces a tiny current proportional to glucose concentration.
- A transmitter converts that to a reading every 1–5 minutes and sends it over Bluetooth.
- Interstitial glucose lags blood glucose by roughly 5–15 minutes, which is why CGMs disagree with fingersticks when glucose is moving fast.
- Accuracy is reported as MARD — mean absolute relative difference from a lab reference. Under 10% is considered good enough for insulin dosing.
The categories worth distinguishing
- rtCGM — real-time, pushes readings and alarms automatically. Everything modern.
- isCGM / "flash" — required scanning the sensor. Effectively extinct; Libre 3 and later are real-time.
- Professional / blinded — clinician applies it, patient sees nothing, data read at the next visit. Libre Pro is the big one.
- OTC / consumer — no prescription, for people not on insulin. Stelo, Lingo, Libre Rio.
- Implantable — a sensor placed under the skin by a clinician for 6–12 months. Only Eversense.
- Intradermal / needle-free — a microsensor array in the outer skin layers. Only Biolinq Shine.
Two things are commonly miscounted as CGMs and are not. First, smartwatches and rings claiming non-invasive glucose — the FDA has authorised none, anywhere, ever, and issued a safety communication in February 2024 warning that they can cause dangerous insulin-dosing errors. Second, metabolic-health subscriptions like Levels, Signos or Nutrisense, which resell Dexcom or Abbott sensors with their own app on top.
The catalogue
Every CGM system I could verify as currently marketed somewhere in the world, September 2026. Filter by region, category or wear time; search matches product, maker and description.
Specifications marked with a tilde are the manufacturer's own published figures and have not been independently verified; several Chinese and Taiwanese systems publish little in English, and their entries are deliberately thin rather than guessed at.
The systems most people actually choose
Nine products cover the overwhelming majority of CGM use outside China. MARD figures are manufacturer-reported from pivotal trials and are not directly comparable across studies — treat differences under about one percentage point as noise.
| System | Maker | Wear | MARD | Prescription | What it is for |
|---|---|---|---|---|---|
| FreeStyle Libre 3 Plus | Abbott | 15 d | ~8.2% | Yes | The global default. Smallest mainstream sensor, age 2+, widest reimbursement of any CGM. |
| Dexcom G7 15 Day | Dexcom | 15.5 d | ~8.0% | Yes | Dexcom's flagship since January 2026. Longest wear of any mainstream filament sensor. |
| Dexcom G7 | Dexcom | 10 d | ~8.2% | Yes | The 10-day version, still the one most pumps and apps integrate with. |
| Libre Duo 10 Day | Abbott | 10 d | n/p | Yes | First sensor to read glucose and ketones. Aimed squarely at DKA risk in type 1. |
| Eversense 365 | Senseonics | 365 d | ~8.8% | Yes | Implanted once a year. For people who cannot tolerate or keep adhesive sensors on. |
| Simplera Sync | Medtronic | 7 d | n/p | Yes | All-in-one disposable that drives the MiniMed 780G closed loop. Half the size of Guardian 4. |
| Accu-Chek SmartGuide | Roche | 14 d | n/p | Yes | The AI play: predicts a low two hours ahead and flags overnight hypo risk. Europe, LatAm, APAC, Middle East — not the US. |
| Stelo | Dexcom | 15 d | n/p | No | OTC biosensor for people not on insulin. Cleared down to age 2 in 2026. |
| Biolinq Shine | Biolinq | n/p | n/p | No | Needle-free microsensor array with an LED on the patch — works with no phone at all. |
n/p = not published in a form comparable to the others. Wear times include manufacturer grace periods where offered.
Where each maker is strong
| Maker | Position | Strategy |
|---|---|---|
| Abbott | >58% global share, 2025 | Volume and price. Libre is the cheapest mainstream sensor to make, and Abbott now also manufactures Medtronic's Instinct sensor — supplying its own competitor. Targeting $10bn Libre revenue by 2028. |
| Dexcom | Accuracy leader | Premium accuracy plus the deepest ecosystem of pump and app integrations. Moving the whole line to 15-day wear, with G8 targeted at late 2027/early 2028. |
| Medtronic | Pump-tethered | Sensors exist to feed the MiniMed 780G loop. After years of accuracy criticism it now buys Abbott's sensor rather than only building its own. |
| Senseonics | Niche, defensible | The only implantable. Small volumes, no direct competitor, and took back its own US commercial operations from Ascensia in January 2026. |
| Roche | Late but funded | Entered in 2024 with an AI-first pitch — prediction rather than measurement. Rolled out across 30+ countries; no US filing yet. |
| Chinese makers | 35–45% of China | Undercut Abbott by 30–40% domestically, then follow with CE marks into Europe and Latin America. Six-plus domestic firms launched 14-day sensors since 2024. |
The map is not the same everywhere
A CGM census only makes sense per market. The same question — "what can I buy?" — has very different answers depending on where you are standing.
United States
- Five suppliers only: Abbott, Dexcom, Medtronic, Senseonics, Biolinq.
- Three products need no prescription: Stelo, Lingo, Libre Rio — plus Biolinq Shine.
- No Chinese sensor has FDA clearance. Roche's SmartGuide is not sold here either.
- Medicare covers CGM for anyone on insulin or with a history of problematic hypoglycaemia; commercial coverage is broad but pharmacy-benefit dependent.
Europe & UK
- The widest catalogue in the world: everything the US has except Stelo and Libre Rio, plus Roche, Sinocare/Menarini, Sibionics, MicroTech, Medtrum, i-SENS, Bionime, Hippo.
- CE marking under EU MDR is slower than an FDA 510(k) but does not require a US-style reimbursement fight, which is why Asian makers arrive here first.
- Patent litigation shapes availability: Sibionics' GS1 has been restricted in Germany, France, the Netherlands and Ireland following a dispute with Abbott.
- Reimbursement is national and uneven — a device on sale is not a device you can get funded.
China
- The most crowded CGM market on earth and the source of most new entrants.
- Abbott holds roughly 30–35% of sensor units; domestic makers together hold 35–45%, up from under 15% in 2020.
- Price is the battleground — a sub-$20 sensor band that Western makers do not compete in.
- Active domestic names: Sinocare, Sibionics, MicroTech, Medtrum, Yuwell, POCTech, Glunovo, Syai, Ottai, Meiqi.
India, LatAm, Middle East, Africa
- India runs on three: GlucoRx Vixxa 2 (a re-badged Chinese sensor, ~₹3,100/sensor), Libre 3 (~₹4,670) and Dexcom G7 (~₹12,000). Price, not features, decides.
- Abbott's blinded Libre Pro is heavily used clinic-side across India and China where patients cannot afford continuous personal wear.
- Roche launched SmartGuide in the Middle East from Kuwait, Qatar and Saudi Arabia in late 2025.
- Most of sub-Saharan Africa has no routine CGM access at any price; this is the largest gap in the global picture and no manufacturer is meaningfully addressing it.
Accuracy, and the year it went wrong
A census that only lists products would be misleading. The single most consequential CGM event of the last year was a failure, not a launch.
The FreeStyle Libre 3 recall. On 24 November 2025 Abbott began a voluntary recall of select lots of FreeStyle Libre 3 and Libre 3 Plus sensors after internal testing found some could report incorrect low glucose readings. Roughly 3 million sensors in the US were affected. The FDA classified it Class I — its most serious category. As of 7 January 2026 Abbott had reported 860 serious injuries and seven deaths associated with the issue.
Readers, apps and every other Libre product — Libre 14 day, Libre 2, Libre 2 Plus, Libre Pro — were unaffected. Anyone holding Libre 3 stock should check lot numbers with Abbott before use.
Two things follow from this, and both belong in any honest comparison of CGM products.
A low MARD is not the same as safety. MARD is an average. What harms people is the tail — a sensor that reads plausibly but wrongly in the direction that causes an insulin decision. Libre 3's published MARD is among the best in the industry, and the recall happened anyway.
Confirm with a fingerstick when the reading and the symptoms disagree. Every manufacturer says this and almost nobody does it. It remains the correct advice, and it is the reason blood glucose meters have not disappeared.
What is coming
The next three years are about three shifts: longer wear, more analytes than glucose, and sensors that do not use a needle at all.
- Late 2025Biolinq Shine receives FDA de novo authorisation (September 2025) — the first glucose sensor with no needle or filament, using a microsensor array in the outer skin layers. Medtronic Instinct, made by Abbott, launches in the US for MiniMed 780G users.
- Jan 2026Dexcom G7 15 Day reaches pharmacies. Eversense 365 gains its CE mark and Senseonics takes over its own US commercialisation from Ascensia. Medtronic's MiniMed Go smart-pen system is cleared, pairing InPen with the Instinct sensor.
- Mid 2026Dexcom G8 unveiled at Investor Day: 50% smaller than G7, 15-day wear as the new baseline, a new silicon chip reading signals beyond glucose, and at least 10% cheaper to manufacture. Submission targeted for 2027.
- Aug 2026Abbott Libre Duo 10 Day receives FDA de novo authorisation — the world's first dual glucose-and-ketone sensor, and the first device to meet both the iCGM and the new integrated glucose-and-ketone monitoring standards. CE mark came in May. US launch expected later in 2026.
- Late 2026Eversense Gemini — a self-powered implant with on-board storage, read by scanning with a phone — targeted for commercial launch in Q4. Libre Duo integration with Beta Bionics iLet and Sequel twiist expected by year end.
- 2027Libre Duo integration with Insulet and Tandem pumps. Dexcom submits G8. Eversense Freedom, an implant with embedded Bluetooth and no external transmitter at all, in development.
- 2028 and beyondDexcom adds multi-analyte sensing to the G8 platform — potassium first, then ketones. Glucotrack targets a 2028 launch for a three-year implant that sits in the subclavian vein and measures glucose directly in blood, sidestepping the interstitial lag entirely.
The pattern worth noticing: nobody is competing on accuracy any more. Every mainstream sensor is now under 10% MARD and the differences are clinically invisible. Competition has moved to wear time, size, cost per day, what else the sensor can measure, and which pump it talks to.
The non-invasive question
Asked more than any other question about CGM, and the answer has not changed in twenty years.
No non-invasive glucose monitor is approved by any major regulator, for anyone, anywhere. Not a watch, not a ring, not a cuff, not a laser, not a patch that reads through unbroken skin. In February 2024 the FDA issued a safety communication stating explicitly that it has never authorised a smartwatch or smart ring that measures blood glucose without piercing the skin, and warning that inaccurate readings can lead to insulin-dosing errors causing confusion, coma or death.
Devices sold online that claim otherwise are either measuring something else entirely and inferring glucose from it, or they are fraudulent. Both are dangerous for anyone dosing insulin.
Who is genuinely trying
In development, credible
- Know Labs (KnowU) — radiofrequency spectroscopy; reported MARD 6.7–8.8% but only in small, fasting or stable-glucose studies.
- Afon Technology (Glucowear) — microwave sensing; recent testing during normal activity showed roughly 75% accuracy separating normal from elevated glucose, well short of medical-grade.
- Occuity Indigo — optical measurement through the eye; CE pilot stage.
- DiaMonTech — photothermal handheld; CE pilot stage.
- Apple — silicon-photonics interstitial sensing, reportedly in development for over a decade, still at prototype scale.
Why it stays hard
- Glucose is a weak optical absorber at physiological concentrations, and skin, water, temperature, blood flow and sweat all move the signal more than glucose does.
- Personal calibration models tend to learn the individual rather than the analyte, producing beautiful results that collapse in a new subject.
- Regulators require accuracy across the full range, including hypoglycaemia — where non-invasive approaches perform worst and where errors kill.
- Biolinq's Shine is the closest thing to a breakthrough here, and note what it actually is: needle-free, not skin-free. It still penetrates the outer skin layers, just twenty times less deeply.
How this was counted
So you can disagree with the number on the merits.
Counted as one product
- A sensor sold under its own name with its own regulatory authorisation.
- A wear-time revision sold alongside its predecessor (Libre 3 and Libre 3 Plus count as two — both are on the market, both are separately reimbursed).
- A blinded professional version of a consumer sensor (Libre Pro).
- An OTC variant of a prescription sensor (Stelo is separate from G7; Libre Rio separate from Libre 3).
Not counted separately
- Re-badged identical hardware under a distributor's brand — noted in the entry instead.
- Readers, apps, transmitters and receivers sold as accessories.
- Subscription "metabolic health" programmes built on another company's sensor.
- Devices announced, in trial, or awaiting first authorisation — those are in the pipeline section.
- Anything claiming non-invasive glucose measurement, since none is approved.
The soft edges are real: Chinese domestic-only products are under-counted because their regulatory filings and product pages are not published in English, and legacy sensors lingering in distribution are hard to date. A defensible range for "distinct CGM systems marketed worldwide in September 2026" is 40 to 55. This page settles on ~45 and shows its work.
Sources
Everything above traces to one of these. Regulatory dates come from the agency or the manufacturer's own announcement wherever possible.
- FDA — FreeStyle Libre 3 / 3 Plus sensor recall (Class I)
- Abbott — Medical device correction, FreeStyle Libre 3 and 3 Plus
- Abbott — FDA authorisation for Libre Duo dual glucose-ketone sensor, 25 Aug 2026
- Abbott — FDA clearance for Lingo and Libre Rio OTC systems
- MedTech Dive — Abbott receives FDA nod for dual-analyte sensor
- Dexcom — G7 15 Day and Stelo OTC clearance
- Drug Delivery Business — Dexcom to launch G7 15 Day · Dexcom unveils next-gen G8 · 2026 roadmap
- Dexcom — Product roadmap at ATTD 2026
- Medtronic — Simplera Sync FDA approval · MiniMed Go with Instinct sensor
- Beyond Type 1 — Medtronic launches Instinct CGM · Biolinq FDA authorisation
- MedTech Dive — Biolinq de novo for intradermal glucose sensor · Senseonics 365-day CGM cleared
- Senseonics — Eversense 365 CE mark submission and FY2025 10-K
- diaTribe — Eversense 365 explained · Medtronic Simplera · Non-invasive glucose monitoring: hope or hype
- Roche — CE mark for Accu-Chek SmartGuide · Middle East launch
- MedTech Dive — Roche CGM European rollout
- Sibionics — CE mark for the GS1 system
- Menarini Diagnostics — Exclusive European distribution agreement with Sinocare
- i-SENS — Global launch of the CareSens Air receiver
- Bionime — Rightest iFree CGM
- Diabetotech — The coming wave of continuous glucose monitors (the most complete public survey of smaller manufacturers)
- Diabetech — Next-gen CGMs in development
- MedTech Dive — Diabetes tech executives on multi-analyte sensors
- FDA — Safety communication on smartwatches claiming non-invasive glucose measurement
- GM Insights — CGM market size and vendor share · OTC CGM market
- Mordor Intelligence — China CGM devices market and China diabetes devices market
- GlucoRx India — CGM sensors available in India, compared