Prediabetes in 2026: Should You Use a CGM, a GLP-1 — or Neither?

By Samuel Mota‑Martinez, MDFeatured on DoctoLoop

In 2026, prediabetes has become one of the most over-discussed — and misunderstood — diagnoses in American healthcare.

Scroll through social media and you’ll see continuous glucose monitors (CGMs) worn by non-diabetics, glucose curves shared like fitness stats, and GLP-1 medications framed as a near-universal solution to metabolic health. For many patients, the underlying question is simple:

If I’ve been told I have prediabetes… what am I actually supposed to do?

The honest answer, according to Dr. Samuel Mota-Martinez, is that for many patients, the right approach may be far less aggressive — and far more individualized — than the internet suggests.

The biggest misconception about prediabetes

“One of the most common misconceptions I see,” Dr. Mota-Martinez explains, “is that a diagnosis of prediabetes automatically means you need medication.”

In reality, the long-term benefits of starting medications early — before someone has diabetes and without other major risk factors — are still unclear. Research continues to evolve, but current evidence does not support a one-size-fits-all pharmaceutical response.

“The decision to use medication should always be informed by the full medical picture,” he says. “Not just an A1C number, but a patient’s weight, family history, lifestyle, and overall risk profile — and always in discussion with their physician.”

CGMs: powerful tools, limited use cases

Continuous glucose monitors have become one of the most visible symbols of modern metabolic care. But visibility doesn’t always equal necessity.

CGMs are unquestionably valuable for patients who use insulin. Because insulin dosing changes day to day, real-time glucose feedback can help prevent both under- and over-treatment.

For patients with prediabetes — especially those not using insulin — the value is far less clear.

“In theory,” Dr. Mota-Martinez says, “a CGM can show how your body responds to different foods and encourage healthier choices.”

In practice, however, studies have not shown durable long-term benefits for most non-insulin-dependent patients. What has been observed is increased anxiety — patients worrying about every post-meal fluctuation, even when those variations are not clinically meaningful.

“More data isn’t always better care,” he notes. “Sometimes it just creates stress without improving outcomes.”

When GLP-1s actually make sense

GLP-1 medications have transformed the treatment of diabetes and obesity — but they are not a first step for everyone with prediabetes.

Dr. Mota-Martinez typically considers GLP-1 support only after lifestyle interventions have been genuinely tried — usually for at least three months — and when meaningful improvement hasn’t occurred.

The clearest scenario? Patients with prediabetes and a body mass index over 30 who are struggling to lose weight despite appropriate nutrition and physical activity.

“In those cases,” he says, “a GLP-1 can be a helpful tool — not a shortcut — to reduce risk factors and prevent progression to diabetes.”

Looking beyond A1C

Another common issue in prediabetes care is an overreliance on a single lab value.

“A1C is useful,” Dr. Mota-Martinez explains, “but it doesn’t tell the whole story.”

To understand true metabolic health, he looks at a broader panel that may include:

A full lipid profile
Fasting blood glucose
Kidney function
Thyroid markers (such as TSH)
Periodic complete blood counts, since certain types of anemia can falsely affect A1C readings

This wider lens often reveals why two patients with the same A1C may need very different care plans.

What success can actually look like

Before GLP-1s were available, many patients with diabetes required three or four daily medications, often with uncomfortable side effects — and still saw only slow improvements.

Today, Dr. Mota-Martinez has seen patients dramatically improve their A1C, reduce medication burden, and feel better overall — sometimes transitioning to a once-weekly GLP-1 and a single oral medication.

“The labs improve,” he says. “But more importantly, patients feel better. They lose weight, their risk factors decline, and their long-term outlook improves. That’s the goal of preventive medicine.”

So… CGM, GLP-1, or neither?

For many patients with prediabetes, the most effective first steps remain the least flashy: nutrition, physical activity, sleep, stress management, and individualized medical guidance.

Some patients benefit from advanced tools. Many don’t need them at all.

The key is not chasing trends — it’s choosing the right intervention for your body, your risk factors, and your life.

Ready to talk about your metabolic health?

If you’ve been diagnosed with prediabetes — or told you’re “borderline” — and you’re unsure whether lifestyle changes, a CGM, GLP-1 support, or none of the above is right for you, a personalized conversation can make all the difference.

👉 Book a first consultation with Dr. Samuel Mota-Martinez A focused, one-on-one visit to order your labs, risk factors, and options — without pressure, hype, or one-size-fits-all answers. $50 introductory consultation
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Want to learn more about Prediabetes in 2026 from Samuel Mota-Martinez? RSVP to our Webinar on March 26th 1:30 Pm ET here.