“This isn’t about treating a disease,” An Yu emphasized.
Her glucose control experiment started at a small health workshop. The speaker had warned attendees not to take their health for granted, before explaining the various effects of blood sugar imbalances on the body: fatigue, sugar cravings, weight gain, and hormonal disruptions.
An, who is obsessed with efficiency and self-improvement, couldn’t bear the idea of post-meal blood sugar spikes disrupting her focus at work or stress-induced binges affecting her mental clarity.
So she bought a glucose monitor. Tracking how specific foods impacted her blood sugar became her go-to method for maintaining energy. After spending a few weeks under the bombardment of reminder app notifications, she managed to quit coffee and ice cream, fell in love with plain water, and said she found herself feeling much more focused during the day.
On Xiaohongshu, posts about managing weight and glucose with continuous glucose monitors (CGMs) have sparked immense engagement. Comment sections buzz with debates about whether carrots or oat milk are more sugary, how to choose fruits with lower sugar content, and personal reports of blood sugar spikes following specific meals.
Much like middle-aged adults who take daily anti-aging supplements or dieters turning to GLP-1 agonist drugs for weight loss, young people now consider CGMs an essential health tool, pushing them into a broader consumer market.
CGMs were originally designed for diabetics needing regular glucose tracking. While diabetics remain the main users, people like An have piqued the interest of manufacturers. Recently, Abbott and Decans, the two largest global CGM brands, launched non-prescription glucose monitors aimed at consumers who want to track their glucose levels, sleep patterns, and emotional states in real time to optimize their metabolic health.
In China, CGMs have become a mainstay of major shopping festivals. During this year’s Singles’ Day, glucose monitors topped many “must-buy” lists. JD.com reported a fivefold increase in orders for health-related products in live stream sales, with CGMs seeing revenue double compared to last year.
The health anxieties of young people is arguably driving the growth of this market. But when did a small device like a CGM begin catching the attention of young consumers?
Unlike traditional finger-prick glucose tests, CGMs consist of three components: a sensor, transmitter, and receiver. Inserted beneath the skin, the sensor continuously monitors glucose levels and transmits the data to an app or receiver. CGMs offer round-the-clock tracking, data storage, low infection risk, and painless usage.
If traditional glucose tests are like taking a snapshot, CGMs are more like recording a video. Users simply attach a coin-sized device to the fat layer of their arm or abdomen, allowing it to monitor glucose levels continuously for up to two weeks. It’s easy to use—and more importantly—nearly painless.
This rise in user-friendly CGMs coincides with the growing prevalence of diabetes, particularly among younger demographics.
Xie Yun, an endocrinologist at Zhu Xianyi Memorial Hospital of Tianjin Medical University, has spent decades treating diabetics. For most of her career, her patients were predominantly middle-aged or elderly. But in recent years, more young people have been appearing in her clinic. “The youngest Type 2 diabetic patient I’ve treated was only nine years old,” she said.
China has long grappled with high rates of diabetes, with 150 million diabetics and 350 million prediabetics reported by 2021. The latter group, at a transitional stage before progressing to full diabetes, has significantly contributed to the growing prevalence. A particularly concerning trend is the rising incidence of Type 2 diabetes, driven by lifestyle factors, among younger populations.
Zhao Weigang, director of endocrinology at Peking Union Medical College Hospital, said that high-performing individuals are more prone to developing diabetes. Stress, poor habits, overeating, and lack of exercise are key contributors. While advances in treatment and monitoring have been remarkable, patient numbers continue to rise.
Interestingly, many young CGM users are neither diabetic nor prediabetic. Xie noted that healthy individuals may still experience short-term blood sugar fluctuations due to factors like exercise, diet, or stress. While CGMs are technically acceptable for non-diabetic use, she doesn’t generally recommend them, citing low cost-effectiveness and the potential for unnecessary anxiety due to varying accuracy between devices.
Still, young people, driven by the fear that “a diagnosis could last a lifetime,” are doing everything they can to investigate whether their fluctuating glucose levels might signify deeper health risks.
At 35 years old, Chen Chen has lived with diabetes for 23 years. Before CGMs became widely available in China, he started using them by purchasing them through agents in Hong Kong. Over the years, he has witnessed an increasing number of young prediabetics wondering why they suddenly developed abnormal glucose levels.
“You wouldn’t believe how fast they scroll through social media,” he said. “Weibo, Douyin, Xiaohongshu—the information they are exposed to is all over the place. It’s chaotic, and they might not even know how to filter it. But when they first encounter glucose issues, their primary goal is to figure out how to quickly control their blood sugar.”
Interestingly, people using GLP-1 agonist drugs for weight loss have also become dedicated CGM users. According to medical professionals, GLP-1 medications typically stabilize blood sugar, theoretically reducing the need for CGMs. Yet, trials have shown that GLP-1 users are more likely to adhere to CGM usage. The rising popularity of GLP-1 drugs may, in fact, further drive CGM adoption.
“The overlap in users of these two products isn’t surprising,” An said. “Understanding your health is always a good thing.”
During this year’s Singles’ Day festival, Chinese CGM brand Sinocare sold over 400,000 units—a 400% year-on-year growth rate. Meanwhile, Sibionics achieved RMB 100 million (USD 14 million) in sales, with a 176% increase in orders on its self-operated e-commerce platforms.
The development of China’s CGM market began in 2017 with the entry of global brands like Abbott and Decans. However, the market’s true expansion took off in 2020. Yang Tian, a CGM component supplier, reported that the market grew from RMB 150 million (USD 21 million) in 2020 to an impressive RMB 4 billion (USD 560 million) by 2023.
Improving product performance has been a critical factor in increasing CGM market penetration. In the evaluation framework for CGMs, the mean absolute relative difference (MARD) is the most widely used indicator of monitoring accuracy.
MARD measures the average error between each reading and its reference value. The smaller the MARD, the higher the accuracy. Although a MARD below 15% is sufficient for regulatory approval, the industry consensus is that products with a MARD below 10% are required to gain mainstream market acceptance. Currently, major CGM brands offer products with MARD values generally between 7.5–9.5%.
As a product that requires frequent repurchases, factors like comfort during use and the intuitive nature of data presentation also significantly influence consumer purchasing decisions. Yang said that, in earlier years, some devices had overly powerful spring-loaded applicators that could cause bleeding, or accompanying software interfaces that were cumbersome to use—both of which led to user dropoffs. “These user experience issues could only be resolved through continuous market feedback and iteration,” he added.
The nearly 25-fold market growth in just three years has been driven by another undeniable factor: the approval and entry of multiple Chinese CGM products during this period, triggering a “price war.”.
Chen still remembers when he was diagnosed with diabetes around the year 2000. The first question the doctor asked his father was about the family’s financial situation. At the time, finger-prick glucose testing was the standard, and test strips cost RMB 5 (USD 0.7) each, with a recommended frequency of eight tests per day. This could result in an annual cost of up to RMB 15,000 (USD 2,100) for test strips alone. When CGMs first emerged, their sensors also cost several hundred RMB.
In the past two years, however, the entry of domestic brands has driven down CGM prices by more than 50%. Particularly after last year’s Singles’ Day festival, sensor prices dropped to the RMB 100–200 (USD 14–28) range. This price drop has significantly increased the penetration of domestic brands, whose market share now stands at around 20%.
For younger consumers, the calculation is straightforward: monitoring their blood sugar for the cost of a few cups of coffee per month is a deal that’s hard to pass up.
Yang said, “From our observations, certain domestic listed companies are the most aggressive in this price war.” He welcomed this trend to a certain extent, stating it could motivate downstream manufacturers to lower costs and increase efficiency. Chips, which historically accounted for a substantial portion of CGM manufacturing costs, have naturally become one of the main targets for optimization.
Around 2020, anticipating the wave of domestic CGM approvals, Yang’s company became one of the early adopters to transition into medical chip R&D. He believes that CGMs are a rare segment in the healthcare industry that straddles both B2B and B2C markets while offering significant growth potential. This year, with the mass rollout of products, his company’s CGM-related revenue is expected to exceed RMB 10 million (USD 1.4 million).
However, price wars won’t last forever. Influenced by factors like costs, branding, and distribution channels, CGM prices in the Chinese market have begun to stabilize. During this year’s Singles’ Day festival, CGMs from brands like Sinocare, Yuwell, MicroTech Medical, and Sibionics were consistently priced around RMB 150 (USD 21) on e-commerce platforms. Meanwhile, international brands like Abbott offered CGMs priced between RMB 250–300 (USD 35–42), without the dramatic price cuts seen last year.
An unspoken consensus seems to have emerged among companies: while market expansion is important, profitability is essential. And as this equilibrium takes shape, a new question arises: after competing on price, what’s next for CGMs?
Today’s consumers have largely come to associate glucose monitors with round devices that adhere to the arm and require biweekly replacements. While not particularly inconvenient, reducing invasiveness remains the ultimate goal for CGM manufacturers worldwide.
At the end of October this year, Lepu Medical gained regulatory approval for a non-invasive glucose monitor. As the name suggests, non-invasive glucose monitors eliminate the need to pierce the skin, typically using a fingertip clip instead.
Technologically, these devices often rely on light as a medium to extract changes in physiological signals related to blood glucose concentration, indirectly calculating glucose levels. Alternatively, some utilize thermal methods to measure internal body heat or glucose phase data, which can then be used to deduce blood glucose concentration. With advantages like convenience, rich data insights, and true non-invasiveness, these methods have become a research hotspot in recent years.
In addition to Lepu Medical, Chinese companies like GHA and Jing Ce Medical have also received approvals for non-invasive glucose monitors. Internationally, tech giants such as Apple, Google, and Samsung are exploring similar technologies, with products ranging from glasses and watches to rings—aiming to produce a solution that can integrate seamlessly into everyday life.
Despite their promise, non-invasive monitors face two persistent issues: delayed results and lower accuracy. Regardless of whether companies pursue optical, thermal, or fluid-based sampling methods (like tears or sweat), none have been able to fully overcome these limitations.
According to a doctor familiar with currently available non-invasive glucose monitors, achieving reliable data without embedding sensors in interstitial fluid has consistently been the goal, but it’s an inherently less accurate approach. In research conditions, MARD values can be controlled below 15%, but the tightly controlled environment of trials doesn’t reflect real-world performance. “I rarely recommend these products to patients because they are hard to obtain and not very reliable,” the doctor told 36Kr.
For example, Jing Ce Medical disclosed clinical data for its non-invasive CGM, showing a MARD of 10.69%. Similarly, Lepu Medical’s regulatory approval noted that its device requires finger-prick calibration every 30 days and is only intended as a supplement to existing glucose monitoring methods—not a replacement.
The US Food and Drug Administration (FDA) recently issued a warning that no wearable devices, including smartwatches, are currently approved for self-measuring blood glucose levels. The agency noted that glucose readings from such devices are likely to be inaccurate.
“Currently, no non-invasive devices have achieved MARD values below 10%. Until there’s a fundamental breakthrough in accuracy, these products are more like toys. They’re unlikely to disrupt the CGM-dominated market anytime soon,” said an investor closely tracking the technology.
KrASIA Connection features translated and adapted content that was originally published by 36Kr. This article was written by Hu Xiangyun for 36Kr.