The Future of CGMs and Sensors
What’s on the Horizon for Type 1’s in Aotearoa New Zealand?
Continuous glucose monitors (CGMs) have already transformed the way many people live with Type 1 diabetes. What was once managed through intermittent fingerpick checks can now be guided by continuous, real-time data.
And this is just the beginning when it comes to this technology space. Recent months have seen a surge in new sensor announcements globally, and it feels like we are entering a new phase in diabetes care – one where CGMs and hybrid systems are evolving into more intelligent, integrated metabolic systems.
So what does this mean in practice? And what does it mean for us here in Aotearoa New Zealand?
A Growing Range of Sensors
For many years, people choosing a CGM had limited options. The potential options are changing rapidly. New sensors such as the Dexcom G8, FreeStyle Libre 3 Plus, Simplera Sync, and the implantable Eversense 365 reflect a shift toward smaller, more comfortable, and longer-lasting devices.
This increase in competition is important. It drives innovation, improves user experience, and – over time – has the potential to improve access.
What Is Available in Aotearoa?
In Aotearoa New Zealand, access to CGMs is largely determined through Pharmac. CGMs are now funded for many people living with Type 1 diabetes who meet specific clinical criteria, and access continues to improve…
But many of the newest technologies described globally – including some next-generation sensors and more advanced automated systems – are not yet available, and largely not know about. Of course, as with many areas of healthcare, there can be a gap between what is technically possible and what is practically accessible. So it still pays to be ahead when it comes to advocacy!
Beyond Glucose: A Major Shift
It’s important to be clear: the continuous glucose monitors currently available here in Aotearoa measure glucose only.
However, a new generation of sensors is being developed that can measure additional signals alongside glucose – most notably, ketones.
This is increasingly important as more and more people living with Type 1 diabetes are using insulin pumps. Rising ketone levels can signal insulin deficiency and may indicate an increased risk of diabetic ketoacidosis (DKA), a serious and potentially life-threatening complication.
The ability to continuously monitor ketones would provide earlier warning signs of DKA, particularly useful for people using insulin pumps, where interruptions in insulin delivery have an immediate effect, but are not always picked up on.
In the future, this kind of data may also be integrated into automated insulin delivery systems, allowing them to respond not just to glucose levels, but also to other significant metabolic changes.
Since the production of ketones does not directly correlate with blood glucose levels (as patients have previously been advised) and with the increased uptake of off-label SGLT2-inhibitor use in Type 1’s, continuous monitoring of ketones could increasingly become a valuable and potentially life-saving tool.
Towards More Automation
Many people are already using hybrid closed-loop systems, where insulin delivery is partially automated but still requires user input—particularly around meals.
The next generation of systems aims to go further. Researchers and companies are working towards:
- More automated correction dosing
- Reduced need for carbohydrate counting
- Systems that can better respond to real-world variability
While fully “hands-off” diabetes management is not here yet, the direction of travel is clear.
Less Burden, More Freedom
Another important trend is longer sensor wear.
We are already moving from sensors that last 7–10 days, to ones that last 14–15 days, and soon to implantable sensors that can potentially last for up to a year. For many people, this means fewer insertions, less disruption, and in general a reduced daily burden.
Measuring Other Signals: Promise and Potential
Alongside ketones, researchers are exploring additional markers such as lactate, hydration, and physiological stress signals. These are not yet part of routine diabetes care, and their role is still emerging—but they point to an important shift in how we understand glucose.
For example, lactate is a marker associated with exercise intensity. During high-intensity activity, rising lactate levels can signal that the body is switching to anaerobic metabolism—often accompanied by hormonal changes that can cause glucose levels to rise rather than fall. This may help explain why some people experience unexpected hyperglycaemia after certain types of exercise.
Hydration is another factor that is often overlooked. Dehydration can affect glucose levels, circulation, and even sensor performance. A sensor that provides insight into hydration status could help people better interpret fluctuations during illness, hot weather, or periods of reduced fluid intake.
Researchers are also exploring ways to detect physiological stress signals—reflecting changes in hormones such as cortisol or adrenaline. These signals could help explain rises in glucose that occur in the absence of food, for example during illness, emotional stress, or poor sleep.
Importantly, these markers are unlikely to replace glucose monitoring. Instead, they may provide context.
Rather than simply seeing that glucose is rising, future systems may help answer a more useful question: why?
Over time, this could support more personalised and intuitive diabetes management—where patterns are better understood, and responses are more tailored to the individual.
Interoperability and Choice
Another important shift underway is greater interoperability between devices.
Historically, insulin pumps, glucose sensors, and algorithms were often designed to work within closed systems. This meant that once you chose a particular device, you were often locked into that ecosystem.
Increasingly, companies are moving towards more flexible approaches. Sensors, pumps, and software platforms are beginning to work together across different brands, allowing people to mix and match components based on their preferences and needs.
This has important implications. It may allow individuals to choose the sensor they find most comfortable, the pump that best suits their lifestyle, and the algorithm that provides the level of automation they prefer.
Over time, this could lead to more personalised systems—and reduce the need to compromise based on limited compatibility.
Looking Ahead
The pace of innovation in diabetes technology is accelerating.
New sensors, algorithms, and approaches to automation are emerging rapidly. But technology alone is not enough — how these advances translate into everyday life will depend on how quickly they become available, how easy they are to use, and whether they are accessible to everyone who could benefit.
One important shift is greater interoperability between devices.
Historically, insulin pumps, glucose sensors, and algorithms were designed to operate within closed systems, often locking users into a single ecosystem. Increasingly, companies are moving toward more flexible approaches, with devices beginning to work across different platforms.
This could allow people to choose the sensor they find most comfortable, the pump that best suits their lifestyle, and the algorithm that offers their preferred level of automation — reducing the need to compromise based on limited compatibility and enabling more personalised systems over time.
For those of us living with Type 1 diabetes, the direction of travel is clear. Technology is evolving toward safer, more responsive systems that can detect risk earlier and provide richer data to support simpler, more automated decision-making — ultimately reducing daily burden.
This also raises important questions about equity and access. Ensuring that new technologies reach the people who need them most will be just as important as the innovations themselves.
The challenge now is not just advancing the technology, but making that future a reality for everyone living with Type 1 diabetes here in Aotearoa New Zealand.
Further reading:
https://diabetotech.com/
https://www.drugdeliverybusiness.com/
Published 15th June 2026
| LEGAL DISCLAIMER: The information on this website is provided for general educational purposes only and is intended for a New Zealand audience. It is not a substitute for professional medical advice, diagnosis, or treatment. While I strive to ensure accuracy and relevance, please always seek guidance from your healthcare provider for personal medical decisions. Use of the content is at your own risk. Links to other sites are for convenience and do not imply endorsement. |
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