Dexcom has announced a big step in its campaign to bring continuous glucose monitoring (CGM) technology to everyone with diabetes. Next year, the business will release a new sensor designed for people with type 2 diabetes who do not require insulin.
The new Dexcom product, which does not yet have a name, will have the same physical sensor as the new Dexcom G7, but with a new streamlined app and new features. It will also lack some of the original model’s features that were designed for insulin users with type 1 and type 2 diabetes. Each sensor will have a 15-day life, and Dexcom will provide a new cash-pay option for patients who cannot access the device through their insurance.
Jake Leach, Dexcom’s executive vice president and chief operating officer, chatted with Diabetes Daily and previewed the product for us.
The new product will not be physically different — it’s the same sensor as the G7. Leach emphasized that the new product maintains the same high standards for “performance, accuracy, and reliability,” even if users that do not require intensive insulin management might seem to have a less serious need for pinpoint accuracy: “We do feel like the performance of the sensor is really important.”
The major differences will come with the redesigned app. The current G7 app has many features that are likely of little interest to patients who don’t require insulin, including alarms for low glucose levels and Follow, which lets family members or friends observe the user’s blood sugar measurements remotely.
Although Leach didn’t offer too many details, he hinted that the new app would be more engaging than the current G7 app:
“It’s really focused on giving feedback and insights around how diet, activity, sleep, and stress impact glucose. The app gives users insights so that they can make decisions that are right for them. It helps people get the most out of their CGM.”
“It’s a unique software experience,” Leach said, “uniquely designed for users that are not managing their diabetes with insulin.”
The Value of CGM Data in People Who Don’t Use Insulin
There are about 28 million Americans with diabetes who do not use insulin, and some experts have expressed doubt that they really require CGM technology. Patients that do not use insulin, generally speaking, do not need to check their blood sugar measurements all that frequently, according to authorities like the American Diabetes Association, especially if they are doing a good job of meeting the blood sugar targets set by their clinicians.
Until recently, the use of CGM technology was mostly limited to people with type 1 diabetes, who greatly benefit from one of the device’s most pivotal functions: a blaring alarm to warn users of dangerous hypoglycemia (low blood sugar). In the past several years, insurers have become more eager to cover the cost of CGMs for people with type 2 diabetes that use insulin, who also have a lesser but still substantial risk of hypoglycemia. Most recently, Medicare announced that it would cover CGMs for people with type 2 who use only basal insulin, and private insurers are rapidly following the government’s lead.
Coverage for people with type 2 diabetes that do not use insulin at all, however, remains rare.
Leach contends that CGM technology can still be incredibly valuable for such patients, due to the insights it provides:
“The No. 1 thing that they’re learning is how different factors such as medication, sleep, physical activity, and (most importantly) diet impact their glucose control.”
“The product is designed to give people the insights they need so they can make the decisions that are right for them and help them get better glucose control and better control of their diabetes.”
Scientists affiliated with Dexcom recently presented data from a real-world study of adults with type 2 who did not require insulin. Over the course of three months with the G6 CGM, study participants:
Improved their time-in-range from about 40 percent to about 56 percent
Improved their glucose management indicator (GMI), an estimate of A1C, from 8.2 percent to 7.7 percent
Improved their mean glucose level from 203 mg/dL to 182 mg/dL
Dexcom has also supported the work of Thomas Grace, MD, who found even more impressive results when he helped distribute CGMs to real patients in his community.
Insurance Coverage and the Cash-Pay Option
More robust experiments and studies, however, will be needed to convince insurers.
Leach says that CGM advocates need to prove that the technology leads to positive “clinical and economic outcomes” in people with type 2 diabetes that do not use insulin. In other words, CGMs need to make people healthier and save insurers money. Though the technology can be expensive, if CGMs can delay or even eliminate the need for more expensive medications or other costly interventions by improving blood sugar control, they might pay for themselves.
In the meantime, Dexcom will debut a cash-pay option, allowing customers to pay out of pocket without having to go through their insurance.
“We want this to be as approachable and accessible as possible,” Leach says.
It is possible to buy G7 sensors today without using health insurance — today, a 30-day supply cost $377 on Amazon’s online pharmacy — an option that it seems relatively few customers use. Leach did not offer any numbers, but suggested that the new Dexcom product for users without insulin would be less expensive.
Leach also understands that people without diabetes might be interested in purchasing the new sensors:
“We really believe in the benefits of CGM to a broad population, even beyond diabetes. Glucose control is one of the leading indicators of metabolic health and a really important aspect of overall health.”
Leach says that the new Dexcom product will be released at some point in 2024.