Dexcom makes controlling blood sugar far easier for diabetes sufferers — and everybody else too

Dexcom makes controlling blood sugar far simpler for diabetes patients — and everyone else too

For those who’ve ever puzzled if the information we’re amassing shall be helpful, try the continual glucose monitor from the medical gadget firm Dexcom.

As a tech narcissist, I’ve been for years in how know-how can ship a “quantified self,” or knowledge about myself and the way I reside. However I can’t say that the information I’ve collected to date, from step counters to sleep displays, has actually taught me something actually helpful — till I attempted out Dexcom’s newest monitor. It turned out not solely to be an excellent well being care story but additionally an incredible knowledge story.

The Dexcom G6 Professional gave me insights into how my physique was behaving second to second, and the way I can take cost and management how I really feel. For me, this was a type of educational fascination. However for Ric Peralta, for instance, a 47-year-old man who has been dwelling with diabetes for 12 years, it makes an enormous distinction in how conveniently he can monitor glucose ranges and handle life-or-death conditions.

This sort of perception that we each received from knowledge is one thing I might anticipate to study from a Star Trek Tricorder. Nevertheless it’s accessible as we speak, and it’s why Dexcom has a inventory market worth of $40 billion and gross sales near $1.5 billion a 12 months.

Glucose displays measure the extent of sugar in your blood. For diabetic sufferers, that is essential. Diabetes impacts greater than 34 million Individuals and is the seventh main explanation for dying in the USA. The normal commonplace of look after glucose monitoring has been a fingerstick meter, which is painful as some sufferers want to check their blood by pricking their fingers as much as 12 occasions a day.

In a affected person with Sort 1 diabetes, the pancreas can’t produce the hormone insulin, which helps the physique soak up sugar and take away it out of your bloodstream. For Sort 2 diabetes sufferers, their physique might not be capable to produce or course of insulin successfully. Both situation means individuals need to inject themselves with insulin to take their glucose ranges down. However they will solely do that if they will precisely measure their blood sugar ranges in actual time, one thing that hasn’t been doable or handy till just lately.

Above: Kevin Sayer is CEO of Dexcom.

Picture Credit score: Dexcom

Extra just lately, COVID-19 sufferers with poor glucose management have had dangerous problems resulting in greater fatality charges. “We received an emergency approval from the FDA to make use of [glucose monitors] in hospitals,” Dexcom CEO Kevin Sayer stated in an interview with VentureBeat. “They noticed the glucose issues COVID-19 sufferers have been going through. Lots of them have diabetes or have excessive glucose variability.”

Moore’s regulation

Above: The Dexcom Seven Plus CGM debuted in 2009.

Picture Credit score: Dexcom

Dexcom has been making glucose displays for years. Every one has been getting smaller and extra handy, consistent with the march of Moore’s regulation — the notion that digital units get higher each couple of years. Intel chairman emeritus Gordon Moore foresaw within the 1960s that the variety of elements on a chip doubled each couple of years. That made electronics cheaper, sooner, and smaller. And the regulation has held up for many years, resulting in advances comparable to much better glucose displays.

Dexcom has ridden this wave. It was based in 1999, debuted its first short-term monitor in 2004, and went public in 2005. It launched new glucose displays in 2009, 2012, 2015, 2017, and 2018. The most recent G6 Professional debuted in 2020. Individuals can now connect the monitor to an insulin pump, and a software program algorithm will work out how a lot insulin to launch into their bloodstream to counter an increase in blood sugar.

Because the electronics turned cheaper, Dexcom was in a position to create cheaper, more practical, battery-operated displays that measured glucose ranges and transferred the information wirelessly in actual time, Sayer stated.

The smartphone period

Above: The Dexcom glucose monitor reveals you your blood sugar degree in actual time.

Picture Credit score: Dexcom

Peralta, the diabetes affected person, has seen the distinction. When he began utilizing Dexcom’s G5 monitor a number of years in the past, he needed to manually calibrate it each 12 hours. That meant he needed to prick his finger twice a day and analyze the blood to see if it matched the monitor’s outcomes. It was additionally considerably bulkier than the present mannequin. The newer G6 mannequin is far smaller, and it may well mechanically monitor Peralta’s sugar ranges 300 occasions a day and ship the information to his Apple Watch.

“This was mind-blowing for me. A dramatic, instant change for me,” Peralta stated. “The truth that I not need to consistently calibrate is a big game-changer for me.”

The Dexcom G6 Professional, which got here out this 12 months, is the primary gadget permitted for non-diabetic customers. For non-diabetics, the Dexcom G6 Professional is OK to make use of in blinded mode. Meaning real-time glucose knowledge is hidden from the affected person and reviewed retrospectively with their well being care skilled on the finish of the monitoring interval. In unblinded mode, diabetic sufferers can see their glucose knowledge all through the 10-day sensor put on to achieve insights and make therapy selections in actual time. (With that stated, a supplier may decide that an individual may profit extra from seeing the information in actual time, so there are eventualities the place a healthcare supplier may prescribe a G6 Professional off-label and allow an individual with out diabetes to put on it in unblinded mode. In that means, my utilization of the Dexcom G6 Professional could possibly be permitted).

The displays are nonetheless costly at round $900. However roughly 98% of medical health insurance suppliers cowl using these displays for diabetic sufferers. It’s going to take a number of extra spins of Moore’s regulation to make such units reasonably priced to the lots. However the latest fashions are rather a lot much less invasive, so sufferers usually tend to put on them on a regular basis. And so they even have a sharing function that’s essential for caregivers.

Sayer relates one story a buyer advised him. A younger girl shared her glucose monitor outcomes together with her mom, who lived in Australia. Someday, the younger girl went to mattress early throughout a modeling gig in New Orleans — and she or he didn’t get up. Her mom noticed the alert from the monitor on her smartphone. She referred to as the paramedics, and so they broke down the door of her daughter’s resort room and saved her.

“There’s nothing extra highly effective than a narrative like that for somebody with Sort 1 diabetes,” Sayer stated. “The sport-changer for us has been the connection to the cellphone.”

Quantifying myself

Above: Right here’s my glucose monitor take a look at outcomes after 10 days.

Picture Credit score: Dexcom

Fairly quickly, this measurement know-how and real-time monitoring — the stuff of goals for quantified self practitioners — will change into related to somebody like me, who in any other case had no real interest in the units.

I don’t have diabetes, luckily. As I agreed to check the monitor, I spotted that I used to be going to get a glimpse inside my physique that most individuals by no means get an opportunity to do. I discovered, as Sayer noticed, that I may use this knowledge not as a affected person, however as a shopper. I may take a look at what I used to be doing and what I used to be consuming and work out what the impact was on my blood sugar.

It was fairly non-invasive. A nurse confirmed me connect it to the left aspect of my stomach. There was a tiny pin prick after I activated the gadget, which poked a needle into my pores and skin. After that, I couldn’t really feel it anymore. The monitor itself was slightly over an inch lengthy and it was glued to my pores and skin. I used to be in a position to put on it for 10 days and take showers with it. It mechanically uploaded the measurements of my blood sugar in actual time to my iPhone. It by no means fell off.

I used to be astounded to study that consuming an enormous pile of spaghetti was one of many issues that would push my blood sugar degree off the charts and even put me above the 180 milligrams per deciliter threshold that docs thought of to be excessive.

On the similar time, after I went for a jog, I discovered my glucose ranges dropped a lot that it dipped under 70 milligrams per deciliter and triggered alerts for me, as if I have been at risk of fainting. My common glucose degree was 124 milligrams per deciliter, which was throughout the vary of regular, in keeping with an analysis by Dr. Daniel Katselnik, a diabetes and metabolism specialist in Texas.

The vary of numbers for sugar ranges is what diabetes sufferers need to comply with very carefully.

“The extra an individual stays throughout the vary, the higher high quality of life they are going to have,” Sayer stated. “Individuals can keep engaged with their standing. You may remove hospitalizations and get monetary savings. Physician visits are environment friendly.”

If somebody like Peralta spikes above his restrict or falls under the decrease threshold, he faces large well being dangers. If his blood sugar is just too excessive, it may well harm his blood vessels. The lows, often called hypoglycemia, can result in starvation, trembling, coronary heart racing, nausea, and sweating. It might probably additionally improve the danger of different issues like coronary heart illness, stroke, nerve issues, and kidney illness. It’s a lethal downside, probably resulting in coma or dying. An injection of insulin can head it off, however Peralta stated that, up to now, the quantity of insulin to inject was usually a guessing sport.

Above: Dr. Daniel Katselnik is a diabetes specialist.

Picture Credit score: Dexcom

The app shared the information with Dexcom’s Readability app and the physician, Katselnik, was in a position to entry my knowledge after I shared my account code with him. He received it in a matter of seconds, and we in contrast the numbers that the app recorded to my notes on what I used to be doing on the time. He famous proper off the bat that 94% of my outcomes have been throughout the prompt vary.

However 5% of the time it was excessive due to what I ate. And after I was out of the vary, I received an alert on my iPhone. I discovered a kind of nights was the massive spaghetti dinner. One other day I had a spike after a lunch. I seen after I drank a cup of orange juice, the sugar degree went as much as 145. After I had plenty of carbs to eat, I received sleepy, because the sugar degree have been beginning the spike upward.

Sayer, who usually checks new units, stated he purchased doughnut holes for his grandkids and ate a few them. He famous that his glucose degree was up 10 factors throughout the day as a result of they have been so sugary.

“You find out about what you eat, the timing of your meals, and the way all the things makes a distinction,” Sayer stated. “You may see listed below are some meals that will not have been good for you.”

Assist for prediabetics

Dexcom G6 is a continuous glucose monitor that connects to your smartphone.

Above: Dexcom G6 is a steady glucose monitor that connects to your smartphone.

Picture Credit score: Dexcom

Even after carb binges, my blood sugar returned to common as a result of my pancreas was working effectively, in contrast to in a diabetes affected person. The physician stated I may stop diabetes sooner or later by controlling my weight-reduction plan, like decreasing my consumption of carbs. Consuming carbs with protein and fats reduces the spike. You’ll discover the impression of various meals in your blood sugar. Alcohol can have a particular impact in making your blood sugar spike, although I didn’t do that.

Katselnik additionally advised me that when your blood sugar is spiking, you’ll be able to carry it down quick by exercising.

That’s a short-term resolution. Over the long run, exercising rather a lot will assist scale back the spikes in blood sugar. Katselnik famous that the Dexcom G6 Professional is an effective sensor with FDA approval, with an accuracy degree that’s inside 9% of lab testing accuracy. I used a single-use disposable gadget. There’s a model that has a transmitter that may final 90 days. That is far simpler than pricking your finger hourly.

“That is clearly a leap. It’s correct. It’s straightforward to make use of out of the field,” Katselnik stated. “You don’t need to calibrate it or do something alongside these strains. So that you get all the knowledge you need. And the good factor is you are able to do it remotely. This can be a life-saving gadget for a good quantity of individuals, and it’s a regular a part of care.”

You may exchange the transmitter and hold utilizing it. The sensor lasts about 10 days, so it’s important to exchange that and pop within the current transmitter once you do this swap. Medical doctors use the Dexcom displays on common diabetes sufferers, Katselnik stated. He makes use of it on dozens of diabetes sufferers in addition to prediabetic sufferers who’re borderline for having the illness.

“The massive use sooner or later is for sufferers who’re prediabetic or perhaps in danger for diabetes, to allow them to get the information and alter their conduct in order that they don’t change into diabetic,” Katselnik stated.

Actionable knowledge for diabetes sufferers

Above: Ric Peralta makes use of Dexcom merchandise to observe his blood sugar.

Picture Credit score: Dexcom

For docs and sufferers, these Dexcom displays are godsends in comparison with the older machines. Peralta used to need to prick his finger and draw blood and put it into an analyzer to get his sugar degree. That concerned plenty of time. The brand new glucose displays ship this info immediately, and docs can take a look at it immediately. The truth is, caregivers can take a look at somebody’s knowledge and name an ambulance in the event that they see the particular person is having an episode. Sufferers’ lives are being saved consequently.

“That is true steady info,” Katselnik stated. “The one factor that’s comparable is heart-rate knowledge, and that’s tremendous easy in comparison with blood sugar knowledge. The information can be utilized to alter drugs and dosages. We’re in an thrilling time. Now we have totally embraced it at our workplace.”

Peralta stated that his personal endocrinologist may be very happy with the outcomes utilizing the Dexcom G6. Peralta is performing some fine-tuning together with his routine as he nonetheless has some occasional lows. These occasions have been scary, as Peralta knew he needed to do one thing. One time, he misplaced his imaginative and prescient and his capacity to talk, however he was nonetheless acutely aware. Whereas he couldn’t say something, the app may ship an alert to his spouse. She may then have interaction with him and do one thing to assist him out.

Now Peralta is aware of that if he’s going to go for a strenuous stroll within the woods, he has to eat one thing forward of time to maintain his blood sugar excessive sufficient in order that his numbers gained’t drop too low. Because the app works with the Apple Watch, Peralta can flip his wrist over to see the place his blood sugar is at throughout the day, giving him reassurance or reminding him he has to train or eat or use his insulin photographs.

“As a Sort 1, that’s simply a part of your day by day routine, as you’re consistently frightened about your numbers,” Peralta stated. “With the quaint means of the fingerprick, it’s mainly you’re gonna burn by extra strips than the insurance coverage will present in case you’re consistently checking. And so that you’re consistently guessing. ‘How does my physique really feel? Am I excessive? Am I low? Am I going up or down? I feel I really feel this manner.’ As an alternative, I can see precisely the place I’m now.”

The information is totally different from the same old knowledge that we get from our units as we speak. It’s actionable.

“There’s no query that, second to second, this utterly modifications your life as a diabetic,” Peralta stated. “As a Sort 1, we live our lives mainly, consistently on this combat to simply attempt to hold ourselves alive. If I didn’t have this gear, if I didn’t have insulin, I might not be right here proper now. It’s so simple as that. And something that permits me to strategy dwelling a traditional life is a strong device that’s price having. I can plan out hikes and I can plan out journeys.”

The way forward for the quantified self

Above: The Dexcom G6 (left) is rather a lot larger than the next-generation G7 steady glucose monitor.

Picture Credit score: Dexcom

Katselnik thinks that body-hacking individuals {and professional} athletes will even eat up this knowledge and alter their conduct consequently. Athletes who face low blood sugar discover that they’re utterly out of vitality. That’s why they should monitor their vitality and drink issues like Gatorade to remain at excessive vitality ranges.

Again in 2012, Sayer famous an Olympics biking crew used the glucose displays and located one specific athlete was working out of vitality. They requested her what was taking place and she or he stated she was weight-reduction plan as a result of she felt she was larger than the opposite athletes. The trainers put a cease to the weight-reduction plan and advised her that her abilities, not her physique form, was what received her on the crew. As soon as she began consuming correctly, she was in a position to carry out significantly better.

Over the long run, Peralta stated he also can make good use of the information for his personal self-service.

“So long as I’ve been doing this, I’m beginning to discover by among the different apps that I’m simply discovering new methods of micromanaging,” Peralta stated. “If I’m beginning to pattern in a sure route, then I notice that if I simply give myself an insulin dose I can flatten that curve slightly, however not a lot that I’m going to drop off like a rock and be crashing in an hour. After I do that for months, I can see precisely what I would like. And I’m undoubtedly having far fewer peaks and valleys.”

Sayer stated future merchandise that use this core sensor know-how will be capable to assist individuals in a wide range of methods. Chances are you’ll, as an illustration, look to your blood sugar for why you’re in a nasty temper. You are able to do one thing about it, like eat a snack. Synthetic intelligence may come into the image as effectively and deal with plenty of the care so the affected person gained’t need to be so attentive.

“If I’m snippy and biting somebody’s head off, I can see it,” Peralta stated. “‘Oh, that is why I’m like this. That is why I’m in a nasty temper.’ And I began apologizing for what I did and saying, ‘Look, I’m sorry, however that is why.’”

He’s grateful for the know-how. “I feel I can come fairly darn near dwelling a traditional life,” Peralta stated.

Sooner or later, the quantified-self followers will doubtless be a market alternative, as the corporate will be capable to make cheaper displays for many who are simply interested by their our bodies. “What’s extra essential about that use case is giving them a significant expertise, like creating analytics engines round that for someone who will not be a diabetic,” Sayer stated.

A sliver-thin Dexcom G7 gadget is in regards to the measurement of a nickel, and it’ll have its personal transmitter constructed into it. It’s within the product pipeline for 2021. I’m ready for the day when a monitor will take a look at my breakfast and inform me to not eat the bagel that’s on my plate.

“We clearly need to take the fee out of this to get it to the mass market,” Sayer stated. “That is actual well being care. That is life and dying stuff. Now we have rather a lot to do. It makes it very straightforward to go to work on daily basis.”

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