#1555 Dexcom President and Chief Operating Officer
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Jake Leach brings Dexcom news from ADA and answers some listener questions.
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DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.
Scott Benner 0:00
We had so much good content this week, it didn't all fit between Monday and Friday. So because of that, you're getting a special episode today, ad free, with Jake leach from Dexcom.
Today's episode doesn't have any ads, but if you need something that one of the advertisers makes or supplies, please consider using one of my links. They're in the show notes of your podcast player and at Juicebox podcast.com when you use my links to get more information or to make your order, you are supporting the podcast while we're talking about that so many of you listen that aren't subscribed or following in a podcast app. And if you could do that for me, it would really help the show. Go into Apple podcasts and hit follow or go into Spotify, hit subscribe. You know these apps, they call it different things, but follow or subscribe, set yourself up to get new downloads doing just that simple task, that free thing that you can do, you will be supporting the production of the Juicebox Podcast and helping to keep it free and plentiful. Nothing you hear on the Juicebox Podcast should be considered advice medical or otherwise, always consult a physician before making any changes to your healthcare plan or becoming bold with insulin if you're looking for community around type one diabetes, check out the Juicebox Podcast. Private Facebook group. Juicebox Podcast, type one diabetes, but everybody is welcome. Type one, type two, gestational loved ones. It doesn't matter to me if you're impacted by diabetes and you're looking for support, comfort or community. Check out Juicebox Podcast, type one diabetes on Facebook. That's good to see Jake. I just hit record. Just so you know, yeah, sounds good. How's art and doing really well. I appreciate it. She's 21 she's had diabetes 19 years now. She's still in college. She had a little thing where she she woke up in her sophomore year, beginning of her sophomore year, and she's like, I don't think this is the right place, but she kept going, and then she's like, I'm gonna switch gears. And I was like, okay, so she went from Savannah and came home and changed to a psychology degree. Wow, cool. We had an issue where she had to get an injection. But she has sort of a, she's got a bit of a needle phobia, which is, I guess, an odd thing to for some people to think about with type one diabetes. But, yeah, we were, like, commuting to her to help her with stuff, and it was like, it was getting too much. So,
Jake Leach 2:34
yeah, no, it's, it's incredible. It's, actually, that's really interesting. You're talking about the needle phobia. But I could see, you know, with the more modern technologies we've all been working on, continuing to develop and innovate, it does kind of get to a point where someone with needle phobia can, or, you know, has an issue with needles, doesn't have to always face that, because the technology is
Scott Benner 2:53
so much better. Oh, for certain. I mean, you know, I didn't realize it at the time when you guys went from, I guess it was g5 that had the plunger, right? Yeah. G6 was the first auto applicator for us. It was just a button, push, yeah. And I remember the time when you made the switch, there was a segment of people who came to me and said, this is such a big deal. And I couldn't wrap my head around I was like, why does it matter? Like, that one wasn't bad. Like, you pinch it, you push the thing, you pull the collar back. It
Speaker 1 3:18
was over. It wasn't, you know, I didn't find it to be difficult. It's not till now that I realized that some people do not want to see how the sausage is made. So, oh, yes, I when we were designing the auto applicator for g6 I remember I had a video of a woman that was she had posted on the Internet, and it was, she was chasing her daughter around with a g5 trying to put it in her arm, or, you know, in her abdomen, yeah. And I showed it to the team, saying, Okay, this is what we're going to try and solve, exactly the anxiety of having to chase your, you know, four year old around to put a sensor on them. And so, yeah, it was the team got a kick out of it. They really it helped get everybody excited. I think you don't realize sometimes, till you look at it, there's a great story. Somebody at Omnipod told me that they used to have a photo of Arden up as like, a five year old in the office, and she had the pod on. And they always thought, like, oh, it's, you know, it's so, so small. It's so great. And they saw it on a little kid, and they thought, I wonder if we can make this any smaller, you know, because on her, it looked huge. And then they shrunk it down. And, you know, little stuff makes a big difference to people. I guess it's my point, absolutely. Yeah. So what have you guys been up to? What are you here to tell me about? Oh, we've been doing all kinds of stuff. You know, we've got new innovations coming on the g7 platform. We've been working on stello. We've been, you know, broadening awareness. You know, it wasn't that long ago that CGM is really kind of a tool focused on more intensive insulin users. And I think that's, you know, that's where the initial evidence for clinical outcomes, all that stuff was generated. But now, you know, as we continue to grow and conserve more customers, as we look at this type two population, you know, type two diabetes continues to increase. Around the world, and CGM is an amazing tool to help people better manage it. Lot of it in type two, as you know, you know, a lot of it's around kind of lifestyle and, you know, food and activity levels. And so, you know, CGM is a great tool to help people manage that differently and more effectively. And so we're just really out there trying to drive the messages around type two. And we have a type two report, basically a state of type two in the United States, specifically around CGM. We did this for in our European region earlier, or, I guess, late last year. And so now we're we did it again the US. We talked to over 100 healthcare providers. We talked to a lot of people. Over 300 people have diabetes, type two, and most of those folks are not taking insulin, so they're treating their type two with oral medications or other other medicine, non non insulin, and really just getting after their experience with CGM, the benefits. And really around the prescribers asking them, and you know, they very much see CGM as a as a critical tool for managing all of type two, not just those insulin users. What are they
Scott Benner 6:08
reporting back? What are people getting out of seeing the CGM data?
Jake Leach 6:11
So I think the main thing is that they all believe that 100% of these folks said CGM in combination should be used in combination with GLP ones and sglt twos all the time. You should always have CGM alongside so that you can see basically, how those, those different medications are helping, you know, helping improve blood glucose, but also the medications, again, as you know, they're not the only solution, right? A part of this is changing choices and habits and forming healthier habits to manage diabetes. And a CGM is perfect tool to show that, because it's just that instantaneous feedback of of a meal or, you know, activity level that causes glucose to be so much better controlled, they learn that very quickly, right people when they see that, you see in your own data. It's extremely quick to figure it out.
Scott Benner 7:03
So, you know, it's a lesson you hear people with type one talk about all the time. I mean, genuinely, I interviewed a person this morning, 44 years old. She was diagnosed when she was 22 and she said she kind of was able to pretend she didn't have diabetes. That was her coping mechanism. Then she got on a CGM, and then suddenly saw what was happening and realized, like, I can't, how am I going to ignore this, you know? And I even think back to, I mean, I don't know how long you guys have been coming on the podcast, but way, way back, Kevin told me I'm wearing the product, you know, like, I don't have diabetes, but I'm wearing it. And here's a list of three foods I don't think I'm going to touch anymore, just seeing what it did to my blood sugar while I was wearing it. Yeah. So I guess my point is, is that when we can talk to type ones who lived before CGM, and hear from those adults who are seasoned, and they're veterans of the fight, and they can tell you how big of a deal it is to see the feedback, it's interesting that we almost didn't, like, immediately just apply that to type two like, why did we have to, like, go talk to people to figure that out? You know what I mean? Like, it's, it's really great. I mean, it's fantastic that it's getting out there. So, but how does it get out there? Like, are you counting on an endocrinologist or a GP? Are you counting on the people who do you want to say, hey, you should try this thing if your loved one is newly diagnosed with type one diabetes and you're seeking a clear, practical perspective, check out the bold beginning series on the Juicebox Podcast. It's hosted by myself and Jenny Smith, an experienced diabetes educator with over 35 years of personal insight into type one our series cuts through the medical jargon and delivers straightforward answers to your most pressing questions, you'll gain insight from real patients and caregivers and find practical advice to help you confidently navigate life with type one. You can start your journey informed and empowered with the Juicebox Podcast, the bold beginning series, and all of the collections in the Juicebox Podcast are available in your audio app and at Juicebox podcast.com
Speaker 2 9:01
in the menu. Short answer that is, everybody right. I think it's a big focus of ours is just raising the awareness that CGM technology exists. Many people who have private insurance are start. We're starting to see coverage for all diabetes. You know, got three of the largest PBMs now have have Dexcom CGM on their lists of covered, covered devices. So we still have work to do with, you know, Medicaid and Medicare and, you know, all the pairs, like we always do, but we're starting to see lots of real world evidence being generated by people using both g7 and stello that have type two, and we're starting to see their their outcomes and how much improvements, no surprise, the improvements that they're making when they start using CGM. You can within the first month, we're seeing significant improvements in time and range. I love these studies, where we show, you know, a whole large population of folks go on CGM at this point in time, at the beginning, before they view. To CGM their their first week, they know they've low time and range, nowhere near the 70% goal for type two diabetes that the ADA has put out there. And then you know, within that 30 days, you know, you use three sensors, and before you know it, they're hitting a time and range goal that you know probably maybe felt not attainable without the right tools. And so you put CGM in their hands, and it's, it's really exciting to see, and that's while they do have a physician, I mean, a lot of that's just their own, their management themselves. They're now have data. They can do something about it. They can, they can hit their goals that have been really hard for them in the past to be able to achieve. So I love those studies. There's lots of people starting to use CGM, but it's awareness around the physicians. You know, if you have coverage, we want you to get a prescription and get it covered by your insurance company. If you don't have coverage, you've got, you've got the stello option. You know, sign up for a subscription, get it. You know, less than $100 a month, you could have CGM full time, right? Do you think those people are just seeing the impact of food and making different food decisions. Because, I mean seeing a turnaround that quickly in a few weeks, right? Like, it's not like they up their medication if they're on an oral or something like that, right? They just, they saw what was going on, and they're like, Oh, I'll make different decisions here. That's the vast majority of his different decisions. I think one of the other things I love to hear about is when users understand that, you know, modest levels of activity can have a significant impression. You know, just a walk, you know, just just a moderate walk around the block. We're not talking about running, running on a treadmill. That can also really help their glucose levels and so just a little bit activity. But I think, you know, the biggest impact is usually around diet, you know, food choices, meal compositions, all the things that we you know, may have been told before. You know, through through diabetes education, but when it's your own data on, you know, coming out in real time, and you can see that those numbers, you can see the graph. You can see the on Stella, we've got the spike detect feature that really helps try and focus in on the more impactful spikes during the day, and what helped you think through what happened there, and what could you do different? I it's an amazing education tool, and I just love hearing when folks are able to make some changes on their own, simply that improves their health.
Scott Benner 12:16
Like, what's the level of like? I guess. Where does your A, 1c, have to be if you're type two, like, before you're eligible, because insulin resistance can start way before your your a 1c, goes up, right? And if you're going to see a ton of people on glps, mostly have a lot of success, that success is going to be because they probably have insulin resistance that might not have thrown them into pre diabetes for years. Like, to me, like, that'd be a place to grab those people?
Jake Leach 12:41
Yeah, yeah. There's definitely approximately 100 million people in the US that have pre diabetes, and, you know, hundreds of millions more around the world, and the vast majority don't know they have diabetes, pre diabetes, right? They haven't been diagnosed. They're not aware. That's the group where raising awareness that the technology exists to give it a try. There's definitely people who, you know, didn't understand their their metabolic health or their glucose health until they tried stello, and then they realized, wow, okay, there's some stuff going on here. To take a closer look. Yeah, it's an amazing tool. Now that it's available over the counter, it's such a new a new thing, but raising the awareness, get it out there, by all means possible is kind of the way we're looking at it.
Scott Benner 13:22
I've shared it a lot on the podcast, but I'll fit in enough of it here that you know people will know I'm serious about this. I started taking a GLP two years ago. I just told you that I'm 62 pounds lighter than I was, but what I learned was it had very it did not have nearly as much to do with what I was eating as it did. I don't really know a way to describe that. Like, I used to be anemic all the time for no reason. My body never absorbed iron. I went on a GLP that stopped immediately. I used to my digestion didn't work well, that stopped. It fixed things about I hate to say it like that, but it changed things about me. I don't even completely understand. Yeah, my back doesn't hurt anymore. It used to be, I'm so embarrassed, but like, if we all went out to dinner and ate the same thing, I'd be four pounds heavier the next day just retaining water. Yeah, no, I don't drink, I don't smoke, I don't do drugs, I don't like, I'm active. Like, didn't matter, didn't matter what I did. And then, you know, I started using the GLP. So my point is, is, if that's true, and I believe it is. And I've just recently had an interview with a doctor who's kind of behind the scenes on helping to talk more about how diagnosis are going to go in the future. He seems to feel like it's not just going to be type one, type two, you know, but he said you're going to see dual diagnosis as soon for people with type one who also have insulin resistance, that's going to be he believes like a real diagnosis. I think that explains why some type ones go on a GLP and see great benefit, and some don't see any difference at all. That's right, I guess where I'm coming from is I wish somebody would have told me this 20 years ago. I know it didn't exist, but I can I see what my life's like now. And I. Wish I would have had this sooner. I
Speaker 2 15:01
guess it's the Yeah, the GOP, one class of drugs at all that, although they have been around for almost that long, 20 years, the new formulations, the once weekly is like all those things have really enhanced the the outcomes. And I think the outcomes are incredible. You know? I think what, what we've seen is particularly in in diabetes, the best outcomes are generated when when you're using the right medication, often on GLP, one alongside with the CGM. So understanding, you know, just even the medication adherence part, is something that we know doctors recognize when they're writing prescriptions is like, you know, if you can see how impactful the medication is to you, you're more motivated to take it, right? And so I think when you have a CGM, and it's showing you that, while also helping educate you on on, you know, meal compositions, activities and tracking things and a little bit of accountability too, right? If you learn a sensor, you know, there's a, there's an accountability component there too. So I think all that together is how it works produce, you know, fantastic outcomes for people. I can also see the impact it would have on the physicians who might not believe in it until they see it on the data, you know, because there's still plenty of people I've, I've had doctors say to me, like, well, you're gonna have to use that for the rest of your life. And I was like, no. I mean, no one says that to a thyroid person who needs thyroid replacement hormones. If this is what it needs, this is what I need. And you maybe it would stop people from having that experience where they've, you know, lost the weight, then the doctor takes the med from them, and then they're right back in that same situation again. I see a ton of benefit from it. So I wish you a lot of luck. I hope it, uh, I hope it goes well, getting it out there. Yeah, no, we're gonna keep, uh, we'll keep driving. And, you know, the job's global. There's, there's so many people around the globe that either have access to CGM and aren't using it yet, like they have coverage in some form, or that don't yet have coverage. We're out there every day, bringing the advocacy, bringing the clinical evidence. We have a very large clinical trial we're running right now in people type two who don't use insulin specifically, a randomized, controlled trial to show the outcomes that can be generated by wearing a Dexcom CGM for that population. And I think that will be an important evidence to use globally, not just here for the United States, to get more access and coverage, because CGM saves money in the first year. There's not too many therapies that, net the cost of the drug or the device are going to save you money in the beginning, but with CGM, people you know, have the information they need to better manage their diabetes. They're not going to the hospital as often. They're not showing, you know, not using as much of the healthcare system, because they are living healthier. All those things bear out pretty quickly, so you don't have to wait like, you know, months and months to get the outcomes.
Scott Benner 17:40
I have two hurdle questions. Do you have any data that says what the hurdle is? Once somebody actually has one to putting it on, and I know that we're not exactly a society of like, preemptively getting in front of something so like, because I'm thinking about like a friend of mine who whose family is still in India, and they talk about how much pre diabetes and type two is in their family, and there's a large population of people who, I mean, you would imagine that country would get a huge relief if they'd never progressed all the way to type two diabetes or pre diabetes,
Jake Leach 18:13
that's right, yeah. So I think the there has to be some level of engagement by the user to take the action, right? They got it. They have to have the interest level. They have to have the knowledge that, for example, CGM exists, and curiosity around using it, right? And so the biggest thing that we found is just making sure people know the technology exists, what it can do for them. And then also, we use our warriors, quite frequently, to talk about their experiences, to think there's nothing better than someone explaining. I mean, I can tell you how great CGM are all day long, but if you have someone who has a very personal story about how CGM changed their life, then I think that's resonates really well across users and so we are we have more and more now of our warriors are type two, in addition to all the type one warriors that we have around the world. I think we have over 30,000 warriors today that are out there telling, telling about their, you know, talking about their stories, their personal experiences with with their Dexcom CGM, and how to change their life. And that's that's worked well for us. But it's just, yeah, the job will never end in terms of making sure the technology people are aware of it. It's, you know, less than two mil, 2% of the people in the world using that have diabetes are using CGM. So there's still hundreds of millions of people that could benefit from the technology that don't have access to it. So that's, that's our focus as an industry, too. It's not just Dexcom. I think we're all focused on making sure people can get access to this technology. How would you be able to or would you be able to keep up with, like, What if everybody just woke up tomorrow?
Scott Benner 19:42
Was like, That guy's right. What would you do to ramp to ramp? But Jake would be like, I would just give I'd go home. I'd be like, I did it. I'll see you later.
Speaker 2 19:51
No, no, no in any like that. If something like that happened, I you know there isn't the capacity out there between us and all the. Folks that make CGM out there, there's not the capacity to service all those people overnight. But, you know, it never happens like that. It happens in stages of access. But, you know, I can tell you, one of the things that I'm always it's exciting, but also it's a lot of work all the time, is that ever, pretty much every quarter for us, is a record number of sensors manufactured. And it's been like that for many, many years, and we intend to keep it that way. So I think that scaling is a big part of what we do. We've learned a lot of lessons along those journeys from g5 to g6 to g7 and then to our next generation platforms as well. Big part of this is not just a feature set. Now. It's about building sensors in large scale, high reliability product for large scale. That's a big part of what we do. How much time does it take if you identify a defect in the process or something going wrong more often than it should? How long does it take to identify it and then change production so that it I'm trying to figure out what that window is, yeah, it's actually pretty quick in terms of our ability to, if we see an issue, to be able to correct it. And then for it usually takes a couple of months before users start seeing it in the field, because it goes through distribution channels and things. It can be pretty quick. But it also depends maybe on geographies. And, you know, in the United States, the largest volume is, you know, lot of stuffs running through pharmacies in the US. It's, you know, some of the highest volumes of that stuff goes, goes the fastest. But yeah, I think our goal is always to continue to come out with new, innovative features continue to enhance the reliability of the product. America. 15 day g7 is another improvement in accuracy. We've spent some time looking at all the g7 performance out there since we launched it a couple years ago, and we're able to take that and build some of those learnings into the new algorithm that's in the 15 day product. And so it's got even better, better performance.
Scott Benner 21:52
That leads me to a question that people send in, if there's people running around who are like, Look, I can't get my sensor to go past seven days. It just doesn't work for me past seven days. And they've come to grips with that, is changing to the new one that's going to last 15 days. Is that going to change their experience, or are they just going to be wearing a 15 day sensor that lasts them seven days once? What? You know? What I mean?
Jake Leach 22:10
Yeah, it's a really good question. Scott, I think it depends a lot on what their particular issue or situation is, right? Is it Are they having challenges with adhesive or are they having challenges with sensor probe remain accurately measuring glucose over that whole time. So I think it'll be a little different. We are as we've always have. We're always continually enhancing adhesives, so we've got another couple that are in the mix here in the near term that further enhance the adhesion of the product while balancing skin irritation and ensuring that we don't we don't get those. We every time we've made this adhesive change, we focused on folks that have sensitivities and making sure that we're not causing more of an issue there. Especially with g7 we actually had a significant improvement. We launched the new adhesive on the g7 product in terms of less, less reactions. So, but it's something we're always mindful of. But, yeah, I think, you know, depending on what the person's issue is, you know, they may also a 15 day. If their 10 day isn't lasting, their 15 day may also but one thing is, we replace sensors. You know, particularly if you get a sensor error, we're going to replace that sensor every time. If you have an issue, what I generally see is people, over time, learn what, what, where it was specific, where location works best for them, what adhesive combination works best for them. Frequently, a new user, if they do have an issue, they figure out over time how to resolve it as they use more and more sensors. But you know, it's part of the fact of CGM. Not all CGM sensors specifically last the full duration. It's a smaller percentage, but it does happen, and that's part of just the state of the art of the technology, and something that we're always working on, enhancing, extending. I mean, we took us a while to make sure we were ready to do 15 day because of that, we want to make sure that the vast majority of sensors make it to the full 15 days. And part of that was bringing it to stello first. We brought it Stella first. We've seen good performance with Stella 15 days, and now we're ready to continue extending it on to g7
Scott Benner 24:07
Listen, I've seen you pressured a number of times over the years. I've never thought that you guys have rushed just because you were getting pressure. I mean, I'm seriously like the Apple Watch functionality, like you could have buckled a bunch of times and just said, Look, here it is. It might work. It might not like, you know what I also wonder, I mean, you and I have talked about this before, but like, it's still like a an inanimate thing being inserted into a living person. Like it's, it's not a perfect scenario, right? Like, sometimes people get luckier and some don't. Sometimes, like you said, they find a place or a way and then it fixes their problem. I feel bad all the time when people tell me their their problems, and they say, What are you doing? I go, I have Arden wears right through the 12 hours. Like, yeah, she doesn't. She very, very, very rarely has a problem. I will tell you. We've seen a few of the insertions where the where the sensor wire ends up outside of the CGM, and you pop it off and throw away and put another one. But other. Than that. I don't know how to respond to them. She doesn't have adhesive allergies, and the thing lasts for so I just knock on wood, and I go, go, we're finally getting lucky about
Jake Leach 25:07
something. Yeah, the point when you started that was the that idea of, yeah, it's a sensor probe under the skin that, and that's in, you know, in terms of the science that's, that's what we work on the most, in terms of the way the body reacts to the sensor and different insertions. Sometimes it's, you know, works perfect, and other times, that particular just insertion has nothing to do with the physical sensor itself. It's a perfectly good sensor, but you know, your body's reaction to it in that, that state and time you know you get, maybe it doesn't last the full 10 days. So it's part of the science that we strive and work on and continue to enhance longevity. But yeah, I think anybody who does have issues, we always want them to come contact us. We want to hear about them, and we want to, you know, help them figure it out. That's, that's our number one, number one policy for customers. We're here to support you. We want to figure it out. We're not always perfect, but we strive to be, and we always strive to get better and better. Yeah, hey, I want to make sure.
Scott Benner 25:59
Do you have anything else for your announcement? Can I ask you a couple other questions?
Jake Leach 26:02
Well, I think other questions? Well, I think there's one really cool thing I wanted to tell you about. In g7 we've got a photo meal logging feature that we're launching here imminently, that allows you to take a picture of your food that you're about to eat. And so instead of having to manually log it, it does an automatic you take the picture. It uses AI to determine what the food is, gives you a description of it. It's pretty cool. I've been using it quite a bit. The demo version. It's pretty cool to be able to log your meals that way, and then it gets recorded into the into your glucose history. So you've got that capability to log those meals. And then, if you can imagine, once we have that out there, and people start using it, there's a whole host of things we can do in terms of meal recommendations, helping physicians understand meal compositions for patients and how to help them enhance things so that that feature is launching here very quickly, on g7 first, actually, we're bringing it g7 first. We're going to bring stello later this summer.
Scott Benner 26:57
Okay, are you going to sunset g6 at some point. And do you know when that is? Yeah, at
Speaker 2 27:03
some point we will. I think you know, our goal has been making sure we support customers across the whole spectrum, particularly aid users. And so Omnipod just launched their iOS app version that's compatible with g7 another lot of people waiting for that, that is going to help with the folks have been waiting to upgrade to g7 now they can. So at some point we will sunset g6 but we're not we're not ready to do that this point in time. We want to make sure everybody has a chance to get their upgrades through before we'd start talking about g6 discontinuation. So you brought up a second ago that the photo logging is AI looks at it and recognizes the food. I've been wondering what else you you might be thinking about with AI. And I'll tell you from just from my perspective, I've done some things, like built my own large language models that are just made out of the transcripts of the podcast. And all that is, is what, maybe 2000 conversations about diabetes at this point. There's almost nothing you can ask it that it doesn't know about diabetes now, and as you're talking about what you're talking about, I'm thinking, How long, I mean, we don't all eat that many different things, right? So how long is it going to be before I take a picture of the plate and it's already seen me eat this 10 times, and it goes, this is this much insulin? We're going to extend it this far? Like, is that a world we're looking for? I mean, I think there, as you know, there's enough variability in diabetes that it may not be just quite that perfect, but it will certainly be able to be Hey, when you ate this last time, here's what happened to your glucose. Good job. Great meal. Keep doing it. Or it could be, hey, here's a way you could do this differently. Maybe change a portion or something, swap something out for a protein, swap some carbs out, like, just basically switch it up a bit to really help them. It's like a great in the moment teaching tool, yeah. So I think we are, you know, AI is going to it's helping us in all kinds of different ways. As you, as you mentioned, it's a wonderful resource for information properly, kind of managed, right? We've been using it in the stello insight report, the generative AI and the AI technology that Google has their their vertex and Gemini technologies, those, it's really fun and cool to play with. We continue to come up with new use cases. You're going to see a lot, I think you're going to see a lot from from Dexcom and many other companies. Just in the way that we use AI technology for all different aspects of our lives, we're clearly very focused on applying it to diabetes and and continuous glucose monitoring, and I think it's going to make the products more engaging and going to give you better insights, ultimately, right, that are highly personalized and simple and easy to use, and really amplifies the value that we're already bringing. This is a very forward looking and if you're thinking about it, you might not be able to say it even but say it even, but you have everybody's data, if you've got their graphs, and you've got their logging of insulin and carbs. I mean, at some point that's got to be enough information to teach an A I D system with right to be predictive. Yeah, you could do absolutely. I mean, we we actually have one of the tools that we have with. And our research development team is a physiologic simulator that based on, you know, different activity levels, food levels, everything. Can predict glucose excursions, and you can, you can, basically can recommend the amount of insulin to take or a different type medication. We've used that to help develop quite a few things, including our basal optimization algorithms for insulin optimization, we've started using it for aid algorithms. We used it when we did the control IQ development. So we've been using simulators for a long time, and now the AI tools are just making them more powerful. So I absolutely think, I think that, and the real benefit here is you can really short circuit and speed up some of the innovation when you can do simulations and in silico modeling versus having to do large clinical trials, there's still often a point where you need to do some some trials to really prove safety. But, you know, the in silico stuff really gets you a long way. And so I think that's clearly one of the areas that AI is going to help us. I imagine that's how you figured out predictive low alerts. Yep, that's exactly how the predictive LOW Alert was developed. Was developed off of a lot of user data that you know. The whole goal with that was to make sure you know the urgent low soon. We didn't want to be alerting you if you're not really going to go low soon, right? And it's kind of funny, because if you wear that as someone who doesn't have diabetes, you'll you'll cut sometimes get those alerts just because the way your glucose dynamics look, but you know, those that particularly have diabetes or are dependent on insulin, it's very accurate in terms of its ability to predict without giving you too many nuisance alarms, that balance was purely driven by analyzing user data and figuring out the right time to alert. Yeah, I have a question from somebody that wants to know if you're exploring other ideas for different sensors. They brought up biomarkers, guys, they were really specific, or CCL two from subcutaneous tissue, like somebody who's listening knows more than I do. But are you? Are you looking into branching out different things? Yes, we are. We're, you know, if you think about the platform we have this wearable subcutaneous sensor probe that continuously measures an analyte. Today, it's glucose. There's quite a few others that we've been working on, both enzymatic and some that are not enzymatic. The use cases are pretty powerful. There's quite a bit of both chronic disease and other health conditions that you can better manage if you had some of these markers. And so, glucose is still our focus because of the significant need out there, but we've been for years working on a number of different programs that extend sensor sensing beyond glucose. We'll start talking more about those here soon. You definitely feel like there's an opportunity to increase the impact we can have by adding some additional analytes to the sensor.
Scott Benner 32:44
This is for me, but I'm 53 do I live to see a sensor that doesn't have to be inserted
Jake Leach 32:51
that's accurate enough to give insulin off of or is it just, do we just not possess that technology at this point? It definitely doesn't exist today, at least anything we've seen, and we've seen quite a bit, and we've evaluated a lot of non invasive so no, no sensor under the skin, and no, no sensor in contact with the actual glucose molecules. We've not seen anything that even comes close to the performance you would need to actually do the things we do today. You know, one of the things I've seen is there's some interest in, you know, them being able to categorize risk for high glucose, right? So, you know, those types of systems could potentially say, Hey, you're have a higher risk of exposure for glucose, so you might want to go wear a CGM. I mean, I think that's, that's the closest I've seen to a technology something like that. But when it comes to making food choices and better, and particularly managing diabetes with insulin. There's nothing that I've seen that's even close to being able to do that. But I love, I love all the, you know, I love the efforts. It's we stay close to the number of companies that are developing technology in this space. It just hasn't, hasn't come to fruition.
Scott Benner 33:59
I only ask because of the number of people who are duped by the fake ad of the pulse ox meter that says that it's a glucose monitor, and you don't have to get I don't know if you've seen that one, but it's been going people are taken in by that with the frequency I have a really big like, my group has like 70,000 people in it, right? Like they're active every day. And so the amount of people that I see who are taken in by that really what it makes me feel like this, but in their heart, they really wish that was true. Yeah, you know, yeah. So I was just asking the question to break their heart so they can stop
Speaker 2 34:27
thinking, yeah. I mean, I do think, I mean, it is, it's a it's been something that billions and billions of dollars have been invested in. I think it's just the science. When you get down to the physical science of it, it's just hard to you look at a pulse oximeter, it could tell, you know, blood oxygen based on the color of the blood, but you glucose, there's no color change. There's RFS been tried. So many things have been tried with great promise, but it doesn't play out when you get down to the actual physics. It shows the value of glucose sensing. And everybody who's who wants to try to get into that, that type of development, they're basically further. Validating just how important glucose is as a biomarker, just yeah, the sensing mechanism. I think we do the best at it, and we're going to keep innovating. I'm going to see if you'll tell me when g7 15 day is going to come out. But before I do, I want to know if there's any other stuff in the pipeline that you're able to talk about, smartphone, watches, pumps, any integrations that are coming. Nothing to talk about at this point. We're going to keep you know, driving new versions of our apps, new features. The photo, meal logging is a big deal. It goes across our whole platform. We got continued enhancements in identity management, right? Just making it easy, passwords and things you forget, those are linking, linking between partners, right? We've got our aura partnership with Stella, which has been very exciting to see the number of folks that are linking their stellos up with their aura apps. But there's improvements we can make in that process. There's just so many things we can do to further enhance the, you know, the experience around the products, and that's what we're focused on. Okay, awesome. Well, I appreciate it. Can you tell me when 15 day g7 is available later this year? Yeah, later this year? Yeah, definitely, yeah, it'll come out later this year. Yeah. Team's working hard right now, building inventory, getting them, getting ready for the launch. So it's coming
Scott Benner 36:08
right?
Speaker 2 36:09
Is there any connection between when people have problems with their g7 is there any connection to where it's being produced and the problem coming out of a certain place, or, like, at a certain time period or something like that? No, it definitely so the it's a really good question, because we do have multiple manufacturing sites now. For many years, we just manufactured sensors in San Diego, and then we opened a site in Arizona, and now we open a site in Malaysia as well. So we build sensors for the world in all those different locations. We have the exact same equipment in every single facility. We use the same automation equipment we use. The teams are all kind of trained in with the same technologies. Our experts are, you know, spend time in all of our factories making sure things are running so it definitely we don't have specific, you know, differences between factories. Even the way that we measure the performance the factory is exactly the same. And I can assure everyone that when I look at the performance of our product in the field, as well as what we've got coming out of the factories, very diligently, I actually spend a good amount of my time following up on that and making sure that we're always making a better sensor every day. And we do have consistent performance across factories. You know, we do have issues. They do pop up and we fix them quickly. It's part of just the scale that we operate at and continuing to build record new sensors every quarter. We're just continuing to learn and enhance and get better and better. I definitely want to make sure everyone understands that it is the same process, same performance across factories, no matter where it comes from. I mean, it just thinking about it from common sense. If you did identify a place that was making a mistake, I would assume you'd be able to fix it. You'd know what the mistake was. So, yeah, it's just the randomness of production. When something goes wrong, yeah, I think when if something, if it's, if it's something on our side, like a, say, a deployment issue, yeah, it's basically just sometimes, you know, there's a small percentage of sensors that, when you try to deploy them, they fail, and so we're always studying those. We want to hear about them from users. We want to replace them right away when that does happen, and G sevens continue to get better in terms of its its performance now which 15 day coming out in the higher accuracy and longer where. So we're continuing to invest in both future innovation, but also just continued reliability enhancements and making making the products
Scott Benner 38:21
better. Listen, I tell people the same thing all the time, but I always there are moments when I think they just think, well, yeah, Dexcom, they buy an ad on your podcast. What are you going to say? But you know, my daughter's been doing this for 20 years. We started with a meter. If I took you back then and gave you the first Dexcom, you'd be like, Thank you. I'll take you. Don't need to make it any better. This is perfect. Thank you. If you go back 40 years and find some old head who was on regular and mph, they'll tell you, if it doesn't work all the time, put another one on, because this stuff is awesome. I mean, listen, I've been watching you forever, you guys, you get better all the time. I've never seen you not working on making things better, sleeker, you know, more accurate. And listen, every time something comes up, I think if it's just like a fun thing, that's all like, the magnet thing with the g7 now, like, if you ever, like, you know, it goes on, but the magnet doesn't turn it on. You just get a magnet. You like, move it around and it pops on you. Like, hey, I figured it
Speaker 3 39:12
out that was, yeah, I saw some of that on social media too. At first, when I saw it, I was like, wow, that's interesting. And then I looked into it, I was like, oh, yeah, nope. That there was a particular failure mode we had that you could do that with, but we fixed that.
Scott Benner 39:24
Yeah, no. And, like I said, it doesn't happen anymore, but for like that couple of like, I mean, I think it happened twice, but it's interesting, though, because you watch a person online with a more of an engineering brain, who goes, like, look, there's a magnet in there. I think that the reason that battery doesn't start running until you put it on is because that magnet is doing something when it when it separates. So I would just hold the magnet up to it again and pull it away a couple times. I was like, That guy's a genius.
Jake Leach 39:47
I love the ingenuity and the passion of the community out there, and a lot of the feedback that we get from users gets put right into the product just because of that, because, you know, we're they're thinking of wonderful things for us to do. And. As well as what we're doing internally,
Scott Benner 40:01
they're the ones using it, right. So, yeah. So anyway, man, Jake, I really, I appreciate your time, and I hope you I know we're recording this ahead of time for ADA, but I don't know if you're going, but I hope you have a good experience. If you head off to the conference, yep, yep, I'll be there. Excited to be there, excited to meet with lots of our customers and physicians and, yeah, catch up. Awesome. All right, it was good to talk to you. You too. Scott, thank you.
My diabetes Pro Tip series is about cutting through the clutter of diabetes management to give you the straightforward, practical insights that truly make a difference, this series is all about mastering the fundamentals, whether it's the basics of insulin dosing adjustments or everyday management strategies that will empower you to take control. I'm joined by Jenny Smith, who is a diabetes educator with over 35 years of personal experience, and we break down complex concepts into simple, actionable tips. The Diabetes Pro Tip series runs between Episode 1001 1025 in your podcast player, where you can listen to it at Juicebox podcast.com by going up into the menu.
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