We use cookies to understand how our site is used so we can improve it. Necessary cookies are always on. You can accept all, reject all, or choose what to allow. Learn more
Glucose MonitoringThe blade moved from a strip you touch to a sensor you wear.
Glucose Monitoring
The blade moved from a strip you touch to a sensor you wear.
The defining fact of the glucose-monitoring market is a crossover: a real-time wearable sensor (CGM) is overtaking the fingerstick blood-strip market (SMBG) it grew out of. The same razor-and-blade economics persist on both sides — a durable reader plus a high-margin recurring consumable — but the consumable has migrated from a strip you touch to a sensor you wear. Eight research houses size the 2025 CGM market anywhere between US$4.75bn and US$13.38bn, a two-and-a-half-fold spread that is genuine disagreement, not measurement error. This is a study of that market through one participant astride the transition — Korea's i-SENS, where 81% of revenue sits on exactly the crossover line.
A continuous glucose-monitoring sensor worn on the upper arm. The recurring consumable — replaced every 10–15 days — is the economic center of gravity in CGM, the "blade" of a razor-and-blade model whose blade migrated from a fingerstick strip to a wearable patch. That single substitution, not any company's product cycle, is the spine of this market.
The defining structural fact of the glucose-monitoring market is a crossover: a real-time wearable sensor — continuous glucose monitoring, or CGM — is overtaking the fingerstick blood-strip market — self-monitoring blood glucose, or SMBG — that it grew out of. The same razor-and-blade economics persist on both sides: a durable reader plus a high-margin recurring consumable. But the consumable has migrated from a strip you touch to a sensor you wear. CGM compounds at roughly 15% on the broad reading; the legacy strip core plateaus at 6–9%. That single substitution, not any company's product cycle, is the spine of this study.
Begin with the question every market study must answer first and most honestly: how big is it? For glucose monitoring the honest answer is a range, and the range is not measurement error — it is a genuine disagreement about what the market is. Eight research houses size the 2025 CGM market between US$4.75bn and US$13.38bn, and that two-and-a-half-fold spread resolves into two coherent camps. This is a study of that market — its sizing, its structure, its reimbursement-gated demand and its near-duopoly competitive shape — read through one participant whose income statement renders it cleanly: i-SENS (KOSDAQ 099190), where 81% of revenue sits on exactly the SMBG→CGM crossover line.
CGM 2025 base — a range, not a point
$12–13.4bn
The whole-system camp — Grand View (US$13.38bn), Mordor (US$13.28bn), GM Insights (US$12.4bn) — counts the recurring consumable sensor and reads ~US$12–13.4bn at ~15–16% CAGR. The device-only camp — Towards Healthcare (US$4.97bn), Intel (US$11.35bn), Cognitive (US$4.75bn) — scopes narrowly and reads ~US$5–11bn at ~7–9%. The split is a scope/methodology disagreement, not noise. Sources: eight research houses; ranges preserved, never averaged into false precision.
How the market earns: the consumable, not the device
The economic center of gravity in CGM is the recurring consumable sensor. Replaced every 10–15 days, it is the "blade" of the razor-and-blade model. Houses disagree on exactly how large the sensor slice is because they treat integrated all-in-one patches differently: Grand View puts sensors at 62.8% of 2025, Mordor at 84.35% — we preserve both rather than average them. Transmitters are a smaller, longer-lived layer; receivers are shrinking as the smartphone displaces dedicated readers. The legacy half of the market has the identical architecture, one generation back: a durable, low-margin meter (the razor) plus a consumable, high-margin strip (the blade) and a lancet. The strip is the economic engine.
Reading the value chain through the lens company's own disclosures surfaces a structural feature of the whole category: the cost is not in the bill of materials. The largest input is the IR sensor at 28.2% of purchases, then packaging (22.3%), outsourced processing (18.6%), frames/instruments (15.5%) and carbon paste (15.4%). Raw materials are a low share of cost of goods — the value sits in the electrochemical biosensor process and its IP, not the commodities. This is why a small maker can compete on quality without a giant's raw-material scale, and why strip-compatibility lock-in lets a single contract maker run multiple retail brands off one production line. OEM/ODM is a structural channel feature of this market, not a quirk: brand owners — ReliOn/Walmart, BGStar/Sanofi, Barozen — source private-label strips and meters from contract makers.
Biosensor input
Share of purchases
Cost character
IR sensor
28.2%
process / IP-heavy
Packaging
22.3%
commodity-light
Outsourced processing
18.6%
service
Frames / instruments
15.5%
commodity-light
Carbon paste
15.4%
commodity-light
The market reaches patients through structural routes — export via overseas buyer or local distributor, then domestic distribution — over which payer coverage sits as the true valve. The input mix shows where the cost actually is: no single input exceeds ~28% of purchases, so the value is in process and IP, not materials. Figures are i-SENS DART FY2025 (rcept 20260318001657), cited as illustrative of the category's input economics, not as a company value argument.
The legacy half of the market, one generation back. A fingerstick blood-glucose meter and its consumable test strip — a durable, low-margin razor metering a high-margin recurring blade. The strip is the economic engine, and strip-compatibility lock-in is the structural reason an OEM/ODM contract-manufacturing channel exists in this market at all.
What is pulling demand — a floor and an accelerant
Demand for glucose monitoring has two layers: a structural floor set by the diabetes epidemic, and a mix-shift accelerant set by reimbursement and the OTC frontier. The floor is brutal in scale. The IDF Diabetes Atlas (11th ed., 2025) counts 589 million adults aged 20–79 with diabetes in 2024 — an 11.1% prevalence — projected to reach 852.5 million by 2050, a 45% rise. 252 million remain undiagnosed, a latent demand reservoir; over US$1 trillion was spent on diabetes in 2024 (~12% of global health expenditure); and 81% of cases sit in low- and middle-income countries, the long-run geographic expansion vector. The floor explains why the market grows at all.
The accelerant explains why CGM decouples from SMBG. On top of the floor sits the substitution that drives this study: wearable real-time sensors displacing fingerstick strips. It is a mix shift within the same patient, not only new-patient growth — the single biggest reason the CGM curve (~15%, broad camp) separates from the SMBG curve (6–9%). The newest vector is the over-the-counter / Type-2 frontier: Dexcom's Stelo, the first FDA-cleared OTC glucose biosensor (March 2024, US$99/2-pack), and Abbott's Lingo and Libre Rio (FDA-cleared June 2024). The addressable pool is large — roughly 25m US Type-2 patients not on insulin, ~15m diagnosed and ~85m undiagnosed pre-diabetics. A GLP-1 / metabolic-health tailwind is real but unquantified; we assert no number for it.
The structural demand floor — adults with diabetes (20–79)
589m → 852m
589 million adults with diabetes in 2024 (11.1% prevalence), projected to 852.5 million by 2050 — a 45% rise. 252 million remain undiagnosed, the latent reservoir that reimbursement converts into demand; over US$1 trillion was spent on diabetes in 2024. A market-demand floor, not a company metric. Source: IDF Diabetes Atlas, 11th ed. (2025).
Above the floor and the accelerant sits the true demand valve: payer coverage. Medicare/CMS in the US and the NHIS in Korea gate adoption — coverage scope, not clinical need, decides volume. That is why the 2023–2026 reimbursement environment is the most demand-material chronology in this market, the strongest stretch of coverage expansion in years, and why a reimbursement calendar matters more here than any single product launch. In Korea specifically, the Korean Diabetes Association now recommends real-time CGM for all Type-1 adults plus selected Type-2 patients, NHIS coverage is broadening, and i-SENS has secured reimbursement in six countries including Korea. Reimbursement, here as everywhere in this market, is the difference between a clinically-indicated patient and a paying one.
The five-year past, read through the lens
The cleanest available read on how this demand has actually converted to volume is the lens company's own trajectory, because 81% of its revenue sits on the crossover line. i-SENS' consolidated revenue grew from ₩265.1bn (FY2023) to ₩291.1bn (FY2024) to ₩315.4bn (FY2025) — a steady 9–10% climb. But the revenue line understates the story inside it: the growth is a mix shift, a plateauing legacy strip line offset by a step-change in CGM volume. The unit series is the spine because it is the hard, DART-grounded figure — CGM production tripled from 183,570 units (2024) to 563,598 units (2025), against capacity raised from 150,000 to 2.0 million units. A plateauing legacy line offset by a step-change in the new consumable — the market's own shape, rendered at company scale.
The mix shift inside the revenue — consolidated revenue vs CGM unit rampSource: i-SENS DART Annual Report FY2025 (rcept 20260318001657). Revenue bars are consolidated (CFS, ₩bn); the line is CGM production units (thousands), the hard DART series. Cited as evidence of the market's mix shift — CGM units tripled (183,570→563,598) in one year while revenue climbed a steady 9–10% — not as a company value argument.
The other half of the mix-shift story is price, and here the lens shows textbook commodity dynamics on the legacy line. Over three years the export strip ASP eroded from US$3.1 to US$3.0 to US$2.9, and the export meter ASP fell harder, from US$10.2 to US$9.1 to US$7.2. Domestic strip pricing held firmer (₩7,012→₩7,277). The read is unambiguous: the legacy export strip is in commodity price erosion, and the market's growth has to come from CGM mix, not strip ASP. FY2025 revenue split ₩247.0bn export (78.3%) against ₩68.4bn domestic (21.7%) — confirming that this market, even read through a Korean maker, is a globally distributed one. The latest print (Q1-2026) showed revenue of ₩75.1bn (−1.5% YoY) with operating profit of ₩0.94bn, down from ₩3.2bn a year earlier; we flag it strictly as a margin/mix observation on the crossover — the cost of scaling a new consumable line while the legacy line's ASP erodes — not as a forward signal of any kind.
The new consumable, scaling. i-SENS' CGM production tripled from 183,570 units in 2024 to 563,598 in 2025, against capacity raised from 150,000 to 2.0 million units. The unit ramp — not a discrete revenue line, which DART does not break out — is the hard evidence of the market's mix shift from a strip you touch to a sensor you wear.
The competitive structure: a near-duopoly atop a legacy oligopoly
After sizing, the competitive structure is the strongest single piece of evidence about this market: global CGM is one of the most concentrated categories in all of medtech — a near-perfect duopoly — sitting atop a separate, more fragmented legacy SMBG oligopoly. Three players hold roughly 98% of the global CGM market: Abbott at ~56.5%, Dexcom at ~35.1% and Medtronic at ~6.9%. Abbott and Dexcom alone are ~91–92%; an alternative framing puts the top five (adding Ascensia and Roche) at ~99%. In the US specifically, Dexcom holds ~74% of CGM (2024). This is the structural fact a market study must foreground: any new entrant, i-SENS included, is attempting a jump into a market the duopoly already owns.
Share understates how large the gap is in absolute revenue. The CGM revenue pools of the leaders dwarf the challenger field. Dexcom reported FY2025 revenue of US$4.662bn (+16%); Abbott's CGM (FreeStyle Libre) booked US$2.0bn in Q4-2025 alone (+12.2% organic), implying a run-rate of ~US$7.5–8bn — though Abbott does not disclose a full-year CGM total in the fetched release. Senseonics, the long-duration implantable niche, did US$35.3m (+57%). Beneath the CGM duopoly sits a different competitive structure: on the lens company's own 2022 disclosure, the legacy SMBG market is a more fragmented oligopoly — Roche and LifeScan each ~22%, Ascensia ~9%, Abbott ~5% — and i-SENS competes there not only with its own CareSens brand but as a top-tier strip OEM/ODM, supplying the very oligopoly that fronts the brands at retail.
Player
Ticker
CGM-relevant scale
Role in the structure
Abbott
NYSE: ABT
~$7.5–8bn*
global #1 CGM by revenue
Dexcom
NASDAQ: DXCM
$4.662bn
US leader (~74%), G7 flagship
Medtronic
NYSE: MDT
~6.9% share
diabetes a sub-segment of medtech
Senseonics
NYSE-A: SENS
$0.035bn
implantable Eversense niche
i-SENS (the lens)
KOSDAQ 099190
sub-1% global
only Korean CGM maker; SMBG OEM/ODM
The competitive set — named listed peers and the lens, by scale and role. Share understates the gap: the leaders' CGM revenue pools dwarf the challenger field. *Abbott FY CGM total not disclosed in the fetched release — run-rate estimated from Q4 US$2.0bn. i-SENS CGM is company/press-reported. The market's revenue concentration, not a company ranking. Sources: SEC/EDGAR & company releases (Dexcom, Abbott, Senseonics); i-SENS DART. All figures FY2025 unless noted.
The lens company occupies the most analytically useful seat in this market precisely because it is asymmetric: strong where the market is slowing (a top-tier global SMBG OEM/ODM with real scale on the legacy side), tiny where the market is growing (sub-1% of global CGM), and dominant in one fast domestic lane (the only Korean-made CGM, in the 14.9%-CAGR Korea CGM market). Read as a sequence, its moves trace the exact path the crossover demands of any incumbent attempting the jump: it built global scale first as a strip OEM/ODM; crossed the CGM frontier with CareSens Air, the first Korean-made CGM (MFDS Jul-2023) at MARD 9%, accuracy competitive with Dexcom and Abbott; is now scaling the new consumable; and through its 2023 AgaMatrix acquisition opened US distribution into CVS, Sanofi and Alliance Healthcare — the rails for a US/EU CGM push.
Where the value actually sits. Raw materials are a low share of cost of goods in this market — the worth is in the electrochemical biosensor process and its IP. That input economics is why a sub-1% maker can compete on accuracy (CareSens Air at MARD 9%) without a giant's raw-material scale, and why the legacy strip line defends margin on process cost as its ASP erodes.
Where the market goes — a contested forward, anchored to houses
The forward picture is two-speed and genuinely contested. For the CGM growth core, the disagreement is the same two-camp split that governs the present size, projected forward. The whole-system camp carries ~US$13bn (2025) to roughly US$28–31bn by 2030/31 at ~15–16% — Mordor reaches US$31.38bn by 2031, Grand View US$41.41bn by 2033, GM Insights US$55.5bn by 2035. The conservative camp carries device-only scope to ~US$19bn by 2034 (Intel, 7.7%) or US$9.93bn (Towards Healthcare, 7.22%). The legacy SMBG/BGM base carries forward from ~US$16–24bn (2025) to ~US$25–36bn by 2030–32 at 6–9%. And the specific lane the lens sits in is among the faster domestic vectors: Korea CGM at US$233.98m (2026) to US$468.17m (2031), a 14.88% CAGR — roughly a double in five years.
Market ring
2025 base
Forecast
CAGR
Reading
Global CGM — broad
$12–13.4bn
$31–55bn
15–16%
whole-system core
Global CGM — device-only
$5–11bn
$10–19bn
7–9%
narrow scope, low band
Global SMBG / BGM
$15–25bn
$25–36bn
6–9%
larger but plateauing
Korea CGM (the SAM)
$0.23bn
$0.47bn
14.9%
fast domestic lane
The market in nested bands — each tied to a named house, never collapsed to one point. The CGM high band runs to $31–55bn by 2030–35 (Mordor / Grand View / GM Insights); the low band to $10–19bn by 2034 (Intel / Towards Healthcare / Medical Device Network); the SMBG base plateaus; the Korea SAM doubles. Windows differ by house — see the CAGR column. Sources: Grand View, Mordor, GM Insights, MarketsandMarkets, Fortune Business Insights. Ranges shown where houses disagree; no NRG point forecast.
The open question that drives the CAGR spread
7% vs 16%
Strip away the detail and the ~2× CAGR disagreement reduces to one question: does the OTC / wellness / Type-2 wave (Stelo, Lingo, Libre Rio) materially enlarge the pie — or merely re-base ASPs lower? The broad camp bakes OTC/Type-2 in as net-additive volume and reaches 15–16%; the conservative camp scopes device-only and/or assumes ASP compression offsets the volume, and reaches 7–9%. A market study's job is to frame the open question, not to resolve it. Sources: eight research houses; ranges preserved.
“The market is a razor-and-blade crossover — a wearable sensor consumable overtaking a fingerstick strip consumable — throttled by reimbursement, concentrated at the top and fragmented beneath, growing somewhere between 7% and 16% depending entirely on whether the OTC frontier enlarges the pie or re-bases its price. The consumable is the market; the device is just the meter that bills it.”
— Nathan Research Group, Diabetes Care Series N°01
Strip the glucose-monitoring market to its transferable lesson and three things remain. First, the consumable is the market: in both halves the economic center of gravity is the recurring consumable, not the durable reader, and any analysis that sizes the "device" while ignoring the consumable annuity is sizing the wrong thing. Second, the throttle is reimbursement, not need: clinical need is effectively unlimited — 589m diabetics, 252m undiagnosed — and what converts need into demand is payer coverage, which makes a reimbursement calendar the right leading indicator, not a product roadmap. Third, concentration sits up top and fragmentation underneath: a near-perfect CGM duopoly atop a fragmented SMBG oligopoly, where a credible-but-small participant can hold real scale on the slowing, fragmented side while remaining sub-1% on the growing, concentrated one. i-SENS made that structure legible; the structure is the point. Our full market study — the sizing and its two-camp dispersion, the value-chain economics, the demand engine and reimbursement throttle, and the competitive map — is available to download with this article.
Working With Nathan Research Group
Partner With Nathan Research Group
Research houses establish the shape of the glucose-monitoring market — the sizing, the segmentation, the wide-band forward CAGR. What they cannot settle are the questions that decide a thesis: whether the OTC/Type-2 frontier is net-additive volume or ASP-dilutive cannibalization, the real economics of the sensor consumable behind the unit ramps, and how reimbursement is actually moving in the US, Korea and the EU. That intelligence lives with the people who build, sell, prescribe, reimburse and distribute these products — and reaching them, compliantly, is what we do.
Korea’s first dedicated expert network — Seoul, since 2013
Who we put in the room
Former executives & founders
From i-SENS and its CGM/SMBG peers — Dexcom, Abbott, Roche, LifeScan, Ascensia — on how the duopoly and the legacy oligopoly actually compete.
Biosensor & CGM engineers
Electrochemical sensor process, MARD/accuracy, sensor-wear and warm-up — the technical wall between a sub-1% challenger and the market leaders.
Endocrinologists & diabetes KOLs
Clinicians who prescribe CGM and SMBG across Type-1, Type-2 and the new OTC frontier — where the substitution actually happens, patient by patient.
Pharmacy/DME, OEM/ODM (ReliOn, BGStar) and export markets — the strip-compatibility lock-in that lets one maker run multiple retail brands.
Reimbursement specialists
CMS/Medicare, NHIS and EU payer pathways — the market's true throttle, where coverage scope and not clinical need decides volume.
Procurement & payer-side buyers
Who can speak to real consumable pull-through and coverage — the reorder and attach behavior the unit ramps only hint at.
How an engagement works
1Scope
We turn your thesis into a precise expert profile and question set, mapped to the decisions you need to close.
2Source & vet
We screen and compliance-clear each expert — relevance, recency, and the absence of conflicts — before any call.
3Convene & synthesize
We arrange interviews on your timeline and, where useful, deliver written synthesis tied back to your questions.
If your team is evaluating i-SENS, the glucose-monitoring market, or the broader Korean and Asian medtech supply chain, tell us the decision you’re trying to make.
A direct reply from a partner, not an intake form.
Based solely on public sources. Nathan Research Group does not request or facilitate material non-public information, and runs every engagement through a documented compliance protocol.
