Diabetes Blog – Happy-Medium.net

I had a super conversation this week with Kevin Sayer, President and Chief Executive Officer of Dexcom, the most popular continuous glucose monitor on the planet.

This was intended to be a podcast interview, but due to technical issues on my part, we were not able to record our conversation. Too bad, because it really was a good one.

Since I’m not very good at writing down things word for word (one of the many reasons I started a podcast), I will instead give you a synopsis of the questions I asked (in bold), and the answers that were given. Just imagine us talking, and it will be almost like being there.
 
 
First, I asked Kevin about his twenty-plus years of experience in the medical technology and medical device field. What has that experience taught him about the importance of what he does, and how it affects patients living with diabetes?

He answered this by telling me about a Facebook post he read earlier in the day. It was from a parent of a child with diabetes, who was in the hospital. The child was wearing a Dexcom CGM, and had a glucose check performed by a nurse. The check came in in the 240 mg/dL range, and about an hour later, the nurse came back to perform a correction bolus based on that amount. Only the Dexcom the child was wearing had shown that his BGs were coming down, and were still trending that way. After some pleading, the parents were able to convince the nurse to check again before blousing. That check resulted in a reading in the 60s. In this instance, the Dexcom, and the parent’s trust in what they were reading, helped to avoid an emergency, and possibly saved a child’s life. Cases like that help underscore what Mr. Sayer, and Dexcom, are trying to accomplish.

Dexcom has been pretty innovative over the years. In the past year, we’ve seen the rollout of Dexcom Share, and FDA approval of the Dexcom G5. A little over a week ago, they received the CE mark of approval in Europe for the G5, so they’ll be rolling out that product to Europe in the coming weeks. Has Dexcom started shipping the G5 to users in the USA?

The answer is: Yes! Just this week, the G5 started going out to users here in the USA.

FYI: If you are currently on the G4 Platinum product, there are low cost, and in limited cases, no cost upgrades so people can more easily move to the latest and greatest Dexcom system. Go to the Dexcom website for more details.

In the news release on the G5 in Europe, I noticed language that states:

“…the new Dexcom G5 Mobile CGM system does not require confirmatory finger sticks when making treatment decisions.”

Now, we know that’s a no-no here in the USA, and the G5 has not been approved for that here. But I also know there are clinical trials ongoing to help determine the efficacy, I guess, of People With Diabetes dosing insulin based on CGM numbers rather than fingersticks. Other than being the CGM involved in the studies, is Dexcom involved in those trials in any other way?

This elicited a passionate response I wasn’t expecting. Kevin Sayer is firmly behind the idea of using a properly-functioning, properly-calibrated CGM to inform insulin dosing decisions, independent of fingerstick confirmation. Dexcom has mounds of data, from multiple studies, and they are planning to go to FDA at some point to get the, I believe the term was, adjunctive exemption that would allow Dexcom to promote their CGM (either the G5 or a future generation product) in the same way that they are promoting it in Europe. He believes that trending data gathered over hours, rather than a one-time BG meter reading, is a more accurate way to determine insulin dosing decisions.

I’m really blown away by the amount of collaboration that Dexcom has been involved in over the years, and I’m talking several years, at least back to 2007. Most recently, we’ve seen Dexcom become part of the Animas Vibe system, and part of the T:Slim G5 system. In an industry that gets a lot of criticism for not playing well with others, what’s the secret to Dexcom’s success in making these partnerships happen time after time?

Mr. Sayer gave kind of a two part answer to this. In the beginning, Dexcom was very small, and collaborating with a bigger partner was a way to grow the business and forge relationships. Today, it’s about Dexcom being the CGM of choice, and making sure that if a Person With Diabetes wants to use a Dexcom as part of their overall diabetes management, they should be able to do that. And forming relationships years ago helped Dexcom have those conversations with other companies when the time came to branch out.

I also asked: Does he see Dexcom as a leader in collaboration as well as technology? The answer is yes. It happened the way it happened over the years, but yes, Dexcom sees collaboration as essential and good for Dexcom.

Finally, I asked about CGM coverage for Medicare patients here in the USA… rather than talk about what passage of such legislation would mean to his company, I wanted to ask: How does it make you feel knowing that patients on Medicare, some of whom were your customers a year or two ago, are unable to use CGM technology at all, without paying 100 percent out of pocket for it?

This, he admitted, is the biggest thorn in his side right now. It’s the biggest complaint that Dexcom gets on a regular basis. He mentioned that his most reliable customers, in addition to children using the G4 and G5, are those in their 40s, 50s, and 60s, who might be less hypo aware, and rely on the safety of CGM technology to help keep them out of the hospital. And have been steady CGM users for a long time. To take all that away just because you reach a certain age doesn’t make sense. Dexcom is working alongside others to try to convince lawmakers to add a category to Medicare coverage, allowing seniors in my country to continue using CGMs. The patient data and the dollar data backs it up. Dexcom will continue to fight for CGM coverage for patients on Medicare.
 
 
You know, the thing about Dexcom is, you can’t even blink hardly without seeing another announcement about a new product, upgraded technology, regulatory approvals, and continued partnerships. It has to have been an exciting almost nine months as CEO for Kevin Sayer. From my standpoint, I’m looking forward to what the next nine months and beyond will bring from Dexcom.