CGM Patent Wars: Who Is Building the Next Generation of Continuous Glucose Monitoring?

Continuous glucose monitoring (CGM) is entering a new phase.

The first generation of CGM technology focused on a basic but important problem: measuring glucose continuously without requiring repeated finger-stick tests. Today, the leading companies are trying to solve a much broader set of problems.

Can a sensor last for weeks or even a year? Can it monitor more than glucose? Can it work with an automated insulin-delivery system? Can people buy it without a prescription? And can the data predict what happens next?

Those questions are shaping the next wave of CGM development.

The commercial stakes are already substantial. Abbott reported $7.6 billion in CGM sales in 2025, up from $6.4 billion in 2024. Dexcom reported $4.662 billion in total revenue in 2025, up 16% year over year.

At this scale, incremental improvements in sensor life, accuracy, connectivity or functionality can have major commercial implications. They can also create new areas of intellectual property.

The result is a CGM race that is increasingly moving from glucose monitoring to continuous metabolic monitoring.

The Old CGM Race Was About Accuracy. The New One Is About Capability.

Today’s CGMs already provide continuous glucose readings and trend information. The American Diabetes Association’s 2026 Standards of Care now treats CGM as a core part of diabetes technology and recommends CGM for people with diabetes in a range of treatment settings. The guidelines also describe automated insulin delivery (AID) systems as combinations of an insulin pump, CGM and an algorithm that uses CGM information to adjust insulin delivery.

That means the sensor is no longer an isolated device.

It is increasingly the data engine of a larger system.

Technology direction	What companies are developing	Problem it addresses
Longer-wear sensors	Dexcom G7 15 Day	Fewer sensor replacements
Implantable CGM	Eversense 365	Long-term monitoring
OTC CGM	Dexcom Stelo, Abbott Lingo	Wider access
Automated insulin delivery	CGM + pump + algorithm	More automated glucose control
Multi-analyte sensing	Abbott Libre Duo	Monitoring glucose and ketones
AI forecasting	Emerging CGM models	Predicting future glucose patterns

These developments are not independent. Together, they point toward a different kind of medical-device platform.

Dexcom Is Pushing Sensor Life Further

Sensor replacement remains one of the practical limitations of conventional CGMs.

Dexcom’s G7 15 Day is designed to extend sensor wear to 15 days. The FDA cleared the device in April 2025 as an integrated, factory-calibrated CGM.

The improvement sounds simple, but maintaining sensor performance for longer periods requires the sensing system to remain stable despite prolonged exposure to the body and repeated movement.

That puts greater importance on:

sensor materials,
electrochemical stability,
calibration,
insertion design,
signal processing,
adhesion and wearability.

The competitive advantage is also practical. A longer-lasting sensor means fewer replacement events, potentially less disruption for users and fewer disposable components over time.

The next question is how far sensor life can be extended without compromising performance.

Senseonics is pursuing a much more radical answer.

Eversense 365 Takes CGM Under the Skin for a Year

Senseonics’ Eversense 365 uses an implantable sensor designed for long-term monitoring.

The FDA cleared Eversense 365 in September 2024. The device is classified as an integrated CGM with a sensor containing dexamethasone acetate.

Unlike a conventional wearable sensor that is replaced every few days or weeks, Eversense uses an implanted sensor together with an external transmitter.

That creates a different engineering problem.

A sensor designed to remain in the body for a year has to address long-term biocompatibility, signal stability, sensor performance and communication with the external device.

The technology therefore shifts the focus from:

“How can we make a disposable sensor last longer?”

to:

“How can we make an implanted sensor remain reliable for an entire year?”

This distinction is important for the patent landscape because the underlying architectures are different.

Two different approaches to longer CGM wear

Approach	Example	Wear period
Extended disposable sensor	Dexcom G7 15 Day	Up to 15 days
Implantable sensor	Eversense 365	Up to 1 year

Longer wear could reduce replacement burden, but it also raises the technical bar for sensor stability and safety.

That makes sensor longevity itself a competitive technology frontier.

Abbott Is Moving Beyond Glucose

Perhaps the most significant technological change in 2026 is not longer wear.

It is the addition of another biomarker.

In August 2026, the U.S. Food and Drug Administration authorized Abbott’s Libre Duo 10 Day Continuous Dual Glucose Ketone Monitoring System for people aged two years and older with diabetes.

The FDA described it as the first wearable device in the United States to continuously monitor ketone levels and the first in the world to continuously monitor glucose and ketones together in a single device.

The FDA said real-time information about rising ketone levels could enable earlier intervention before a potentially life-threatening emergency.

FDA Center for Devices and Radiological Health Director Michelle Tarver called the authorization “a breakthrough for the safety of children and adults living with diabetes.”

This is important because conventional glucose monitoring and ketone testing have traditionally been separate.

The new system brings the two measurements together.

Why ketone monitoring matters

Ketones can rise when the body does not have enough insulin to use glucose effectively. High ketone levels can contribute to diabetic ketoacidosis (DKA), a potentially life-threatening complication.

Traditional ketone testing generally provides a measurement at a particular moment.

Continuous sensing changes the model.

Instead of asking:

“What are my ketone levels now?”

the technology can ask:

“Are my ketone levels starting to rise?”

That could provide additional time for intervention.

The technical significance goes beyond ketones, however.

If one wearable can continuously measure two biomarkers, the long-term opportunity is multi-analyte sensing.

Future CGM platforms could potentially incorporate additional biomarkers, provided the sensing chemistry, device architecture and clinical evidence support them.

This creates new potential IP around:

multiple sensing elements,
electrode architecture,
analyte-specific chemistry,
interference management,
signal processing,
calibration,
algorithms and alerts.

The CGM is beginning to evolve into a metabolic sensor platform.

The Sensor Is Also Becoming Part of an Automated Treatment System

Another major development is the integration of CGMs with automated insulin delivery.

The ADA’s 2026 Standards of Care describes AID systems as having three main components:

CGM + insulin pump + algorithm.

The algorithm uses CGM information to adjust insulin delivery, with current systems making automated adjustments as frequently as every five minutes. The ADA reports that pivotal trials of current AID systems have consistently shown improvements in A1C and time in range, together with reductions in hypoglycemia in relevant populations.

This changes what companies need from a CGM.

Accuracy remains essential, but the sensor also needs:

reliable real-time communication,
predictable data transmission,
low latency,
interoperability,
stable performance,
software integration.

A sensor used simply to display glucose and a sensor used to influence automated insulin delivery have different system-level requirements.

The CGM therefore becomes one component of a closed-loop therapeutic platform.

That makes interoperability and data-processing technology increasingly important areas for development.

OTC CGMs Are Expanding the Technology Beyond Traditional Diabetes Care

CGM is also becoming more accessible outside the traditional prescription market.

In March 2024, the FDA cleared Dexcom’s Stelo, the first over-the-counter CGM in the United States. It was initially cleared for adults aged 18 and older who do not use insulin.

In June 2026, the FDA cleared Stelo for children aged two years and older who do not use insulin, making it the first OTC CGM cleared for children.

The ADA’s 2026 technology standards now list Dexcom Stelo and Abbott Lingo alongside prescription CGMs including Dexcom G7, FreeStyle Libre systems, Eversense 365 and Medtronic’s Simplera.

This creates a different product philosophy.

A traditional CGM is primarily a clinical-management tool.

An OTC CGM can become a consumer-facing data platform.

That places more emphasis on:

smartphone applications,
data visualization,
simplified alerts,
user experience,
digital coaching,
interpretation of trends.

The competition therefore extends beyond the physical sensor.

Why the Commercial Stakes Are So High

The size of the existing CGM business explains why companies are investing heavily in these technologies.

Abbott’s CGM sales reached $7.6 billion in 2025, representing a 17.4% increase excluding foreign exchange.

Dexcom generated $4.662 billion in revenue in 2025, up 16%. Its revenue has grown from $402 million in 2015 to $4.662 billion in 2025, equivalent to a roughly 28% compound annual growth rate over the decade.

These numbers also explain why intellectual property matters.

Abbott and Dexcom were involved in global patent litigation from 2021 through 2024. Their December 2024 settlement created a worldwide, royalty-free cross-license covering certain analyte-sensing patents and applications, along with a covenant not to sue that runs through December 20, 2034.

That settlement removed a major source of uncertainty between the two largest players.

But it did not stop innovation or competition.

Instead, the technology race is expanding into new areas.

New Entrants Are Also Pushing the Technology Frontier

Abbott has faced patent disputes with newer CGM manufacturers including Sibionics and Sinocare in Europe.

These disputes matter less for the technology story because of the litigation itself and more because they show how quickly the CGM field is becoming crowded.

New manufacturers are developing alternative sensor platforms and entering markets where established companies have built large patent portfolios.

For the industry, this means technological differentiation and freedom to operate increasingly go together.

A new CGM manufacturer has to answer two questions:

Can we build a technically competitive sensor?

and

Can we commercialize it without infringing the existing technology landscape?

The Abbott-Dexcom settlement illustrates the importance of the second question. The companies disclosed that their disputes involved multiple jurisdictions, patent infringement and validity claims, including proceedings in the United States, Germany, the United Kingdom, Spain and the UPC.

The Next Layer Could Be AI

The final frontier may not be the sensor at all.

It may be what companies do with the data.

CGMs generate high-frequency glucose measurements over long periods, creating datasets that can be used for forecasting and personalized analysis.

A September 2026 study evaluated time-series foundation models across eight public CGM datasets covering people with Type 1 diabetes, Type 2 diabetes and people without diabetes. The researchers found that zero-shot foundation models did not consistently outperform strong task-specific models, while lightweight fine-tuning substantially improved forecasting performance.

That finding is important because it tempers the AI narrative.

The opportunity is real, but better results will depend on the quality of the data, model design and adaptation to the specific glucose-prediction task.

If these systems become clinically reliable, however, CGM data could eventually support predictions about:

impending glucose excursions,
hypoglycemia,
post-meal responses,
insulin requirements,
individual glucose patterns.

This could create another layer of technology and intellectual property between the sensor and the clinical decision.

Where the CGM Technology Race Is Heading

The most important developments can now be viewed as one connected progression:

Stage	Technology	What it could change
1	Continuous glucose sensing	Replaces intermittent snapshots with continuous data
2	Longer sensor wear	Reduces replacement burden
3	Implantable sensing	Enables months-to-year monitoring
4	OTC CGM	Expands access beyond traditional prescription users
5	CGM + AID	Turns glucose data into automated treatment decisions
6	Multi-analyte sensing	Expands monitoring beyond glucose
7	AI forecasting	Turns monitoring data into predictions

The important point is that these developments are converging.

A future platform could potentially combine long sensor life, multiple biomarkers, continuous connectivity, automated therapy and predictive analytics.

That would be a very different device from the first generation of CGMs.

What the Next CGM Patent Race Could Protect

The industry’s next IP battles may therefore focus on several technology layers at once.

Sensor architecture: How the sensing element is constructed and remains stable.
Materials and chemistry: How the sensor detects biomarkers accurately over longer periods.
Multi-analyte sensing: How several biomarkers can be measured simultaneously without interference.
Connectivity: How sensor data move securely and reliably between the device, phone and therapy system.
Algorithms: How raw measurements are converted into useful glucose or metabolic information.
Interoperability: How CGMs communicate with insulin pumps and other medical devices.
AI and prediction: How longitudinal data can be converted into individualized forecasts.

The Abbott-Dexcom patent war was largely about protecting the technology that made modern CGM possible. The next generation could be about something broader:

Who controls the technology that turns a CGM from a glucose sensor into a continuous metabolic platform?

Conclusion

CGM technology is no longer advancing along a single path.

Dexcom is extending sensor wear and expanding OTC access. Abbott is moving into dual glucose-ketone monitoring and a broader consumer ecosystem. Senseonics is pursuing year-long implantable sensing. Medtronic is integrating CGM into automated insulin delivery. Researchers are testing AI systems that could transform continuous measurements into predictions.

Each development addresses a different limitation of today’s technology:

short sensor life, limited biomarkers, manual intervention, restricted access and data that still require interpretation.

The next generation of CGM could address several of these problems simultaneously.

That is why the industry’s patent race is becoming more interesting.

The most valuable IP may no longer be the patent covering a glucose sensor alone. It may be the combination of sensing, longevity, multi-analyte detection, connectivity, algorithms and automated action.

The CGM market began by asking a simple question:

“What is the glucose level right now?”

The next generation is trying to answer a much bigger one:

“What is happening inside the body, what is likely to happen next, and what can be done about it?”

That shift could define the next decade of continuous glucose monitoring.

Sources:

Author

Surbhi Ashri

CGM Patent Wars: Who Is Building the Next Generation of Continuous Glucose Monitoring?