Home PC News Dexcom makes controlling blood sugar far simpler for diabetes patients — and...

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

If you’ve ever puzzled if the info we’re amassing will likely 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 stay. But I can’t say that the info I’ve collected up to now, from step counters to sleep screens, has actually taught me something actually helpful — till I attempted out Dexcom’s newest monitor. It turned out not solely to be a great well being care story but in addition an important knowledge story.

The Dexcom G6 Pro 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 tutorial fascination. But for Ric Peralta, for instance, a 47-year-old man who has been residing 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 type of perception that we each obtained from knowledge is one thing I might anticipate to be taught from a Star Trek Tricorder. But it’s out there right this moment, and it’s why Dexcom has a inventory market worth of $40 billion and gross sales near $1.5 billion a yr.

Glucose screens measure the extent of sugar in your blood. For diabetic sufferers, that is important. Diabetes affects more than 34 million Americans and is the seventh main reason behind dying within the United States. The conventional normal 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 Type 1 diabetes, the pancreas can’t produce the hormone insulin, which helps the physique take up sugar and take away it out of your bloodstream. For Type 2 diabetes sufferers, their physique could not be capable to produce or course of insulin successfully. Either situation means individuals need to inject themselves with insulin to take their glucose ranges down. But they’ll solely do that if they’ll precisely measure their blood sugar ranges in actual time, one thing that hasn’t been doable or handy till not too long ago.

Above: Kevin Sayer is CEO of Dexcom.

Image Credit: Dexcom

More not too long ago, COVID-19 sufferers with poor glucose management have had unhealthy issues resulting in greater fatality charges. “We got an emergency approval from the FDA to use [glucose monitors] in hospitals,” Dexcom CEO Kevin Sayer stated in an interview with VentureBeat. “They saw the glucose problems COVID-19 patients were facing. Many of them have diabetes or have high glucose variability.”

Moore’s regulation

Above: The Dexcom Seven Plus CGM debuted in 2009.

Image Credit: Dexcom

Dexcom has been making glucose screens for years. Each one has been getting smaller and extra handy, in keeping 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 similar to much better glucose screens.

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 screens in 2009, 2012, 2015, 2017, and 2018. The newest G6 Pro debuted in 2020. People 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.

As the electronics grew to become cheaper, Dexcom was in a position to create cheaper, more practical, battery-operated screens that measured glucose ranges and transferred the info wirelessly in actual time, Sayer stated.

The smartphone period

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

Image Credit: Dexcom

Peralta, the diabetes affected person, has observed 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 robotically monitor Peralta’s sugar ranges 300 occasions a day and ship the info to his Apple Watch.

“This was mind-blowing for me. A dramatic, immediate change for me,” Peralta stated. “The fact that I no longer have to constantly calibrate is a huge game-changer for me.”

The Dexcom G6 Pro, which got here out this yr, is the primary gadget authorized for non-diabetic customers. For non-diabetics, the Dexcom G6 Pro is OK to make use of in blinded mode. That means 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 remedy choices in actual time. (With that stated, a supplier might decide that an individual may profit extra from seeing the info in actual time, so there are eventualities the place a healthcare supplier may prescribe a G6 Pro 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 Pro could possibly be authorized).

The screens are nonetheless costly at round $900. But roughly 98% of medical insurance suppliers cowl using these screens for diabetic sufferers. It’s going to take a number of extra spins of Moore’s regulation to make such units inexpensive to the lots. But the latest fashions are so much much less invasive, so sufferers usually tend to put on them on a regular basis. And in addition they have a sharing characteristic that’s important for caregivers.

Sayer relates one story a buyer instructed him. A younger lady shared her glucose monitor outcomes together with her mom, who lived in Australia. One day, the younger lady 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 known as the paramedics, they usually broke down the door of her daughter’s resort room and saved her.

“There’s nothing more powerful than a story like that for someone with Type 1 diabetes,” Sayer stated. “The game-changer for us has been the connection to the phone.”

Quantifying myself

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

Image Credit: Dexcom

Pretty quickly, this measurement know-how and real-time monitoring — the stuff of desires for quantified self practitioners — will turn into related to somebody like me, who in any other case had little interest in the units.

I don’t have diabetes, fortuitously. As I agreed to check the monitor, I noticed 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 might use this knowledge not as a affected person, however as a shopper. I might have 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 the best way to connect it to the left facet 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 somewhat 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 robotically 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 be taught that consuming an enormous pile of spaghetti was one of many issues that might push my blood sugar degree off the charts and even put me above the 180 milligrams per deciliter threshold that docs thought-about to be excessive.

At the identical time, after I went for a jog, I discovered my glucose ranges dropped a lot that it dipped beneath 70 milligrams per deciliter and triggered alerts for me, as if I have been in peril of fainting. My common glucose degree was 124 milligrams per deciliter, which was throughout the vary of regular, in line 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 observe very intently.

“The more a person stays within the range, the better quality of life they will have,” Sayer stated. “People can stay engaged with their status. You can eliminate hospitalizations and save money. Doctor visits are efficient.”

If somebody like Peralta spikes above his restrict or falls beneath the decrease threshold, he faces massive well being dangers. If his blood sugar is simply too excessive, it may well injury his blood vessels. The lows, often known as hypoglycemia, can result in starvation, trembling, coronary heart racing, nausea, and sweating. It can even improve the danger of different issues like coronary heart illness, stroke, nerve issues, and kidney illness. It is a lethal drawback, probably resulting in coma or dying. An injection of insulin can head it off, however Peralta stated that, prior to now, the quantity of insulin to inject was usually a guessing recreation.

Above: Dr. Daniel Katselnik is a diabetes specialist.

Image Credit: Dexcom

The Dexcom app shared the info with the Clarity app, one in every of Dexcom’s companions, and the physician, Katselnik, was in a position to entry my knowledge after I shared my account code with him. He obtained 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 recommended vary.

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

Sayer, who usually exams 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 through the day as a result of they have been so sugary.

“You learn about what you eat, the timing of your meals, and how everything makes a difference,” Sayer stated. “You can see here are some meals that may not have been good for you.”

Help 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.

Image Credit: Dexcom

Even after carb binges, my blood sugar returned to common as a result of my pancreas was working properly, in contrast to in a diabetes affected person. The physician stated I might stop diabetes sooner or later by controlling my food plan, like decreasing my consumption of carbs. Eating carbs with protein and fats reduces the spike. You’ll discover the influence 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 instructed me that when your blood sugar is spiking, you may deliver it down quick by exercising.

That’s a short-term answer. Over the long run, exercising so much will assist scale back the spikes in blood sugar. Katselnik famous that the Dexcom G6 Pro is an efficient 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. This is much simpler than pricking your finger hourly.

“This is clearly a leap. It’s accurate. It’s easy to use out of the box,” Katselnik stated. “You don’t have to calibrate it or do anything along those lines. So you get all the information you want. And the nice thing is you can do it remotely. This is a life-saving device for a fair amount of people, and it’s a standard part of care.”

You can substitute the transmitter and preserve utilizing it. The sensor lasts about 10 days, so you need to substitute that and pop within the current transmitter once you do this swap. Doctors use the Dexcom screens 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 big use in the future is for patients who are prediabetic or maybe at risk for diabetes, so they can get the data and change their behavior so they don’t become diabetic,” Katselnik stated.

Actionable knowledge for diabetes sufferers

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

Image Credit: Dexcom

For docs and sufferers, these Dexcom screens 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 lots of time. The new glucose screens ship this data immediately, and docs can have a look at it immediately. In reality, caregivers can have a look at somebody’s knowledge and name an ambulance in the event that they see the particular person is having an episode. Patients’ lives are being saved because of this.

“This is true continuous information,” Katselnik stated. “The only thing that is comparable is heart-rate data, and that’s super simple compared to blood sugar data. The data can be used to change medications and dosages. We’re in an exciting time. We have fully embraced it at our office.”

Peralta stated that his personal endocrinologist may be very happy with the outcomes utilizing the Dexcom G6. Peralta is doing a little fine-tuning together with his routine as he nonetheless has some occasional lows. Those occasions have been scary, as Peralta knew he needed to do one thing. One time, he misplaced his imaginative and prescient and his means to talk, however he was nonetheless aware. While he couldn’t say something, the app might ship an alert to his spouse. She might then interact 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 received’t drop too low. Since the app works with the Apple Watch, Peralta can flip his wrist over to see the place his blood sugar is at through the day, giving him reassurance or reminding him he has to train or eat or use his insulin photographs.

“As a Type 1, that’s just part of your daily routine, as you are constantly worried about your numbers,” Peralta stated. “With the old fashioned way of the fingerprick, it’s basically you’re gonna burn through more strips than the insurance will provide if you’re constantly checking. And so you’re constantly guessing. ‘How does my body feel? Am I high? Am I low? Am I going up or down? I think I feel this way.’ Instead, I can see exactly where I am now.”

The knowledge is totally different from the standard knowledge that we get from our units right this moment. It’s actionable.

“There’s no question that, moment to moment, this completely changes your life as a diabetic,” Peralta stated. “As a Type 1, we are living our lives basically, constantly on this fight to just try to keep ourselves alive. If I didn’t have this equipment, if I didn’t have insulin, I would not be here right now. It’s as simple as that. And anything that allows me to approach living a normal life is a powerful tool that is worth having. I can plan out hikes and I can plan out trips.”

The way forward for the quantified self

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

Image Credit: Dexcom

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

Back in 2012, Sayer famous an Olympics biking staff used the glucose screens and located one explicit athlete was operating out of power. They requested her what was occurring 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 food plan and instructed her that her abilities, not her physique form, was what obtained her on the staff. Once she began consuming correctly, she was in a position to carry out a lot better.

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

“As long as I have been doing this, I’m starting to notice through some of the other apps that I’m just finding new ways of micromanaging,” Peralta stated. “If I’m starting to trend in a certain direction, then I realize that if I just give myself an insulin dose I can flatten that curve a little, but not so much that I’m going to drop off like a rock and be crashing in an hour. After I do this for months, I can see exactly what I need. And I’m definitely 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. You could, as an example, look to your blood sugar for why you’re in a nasty temper. You can do one thing about it, like eat a snack. Artificial intelligence might come into the image as properly and deal with lots of the care so the affected person received’t need to be so attentive.

“If I am snippy and biting someone’s head off, I can see it,” Peralta stated. “‘Oh, this is why I’m like this. This is why I’m in a bad mood.’ And I started apologizing for what I did and saying, ‘Look, I’m sorry, but this is why.’”

He’s grateful for the know-how. “I think I can come pretty darn close to living a normal life,” Peralta stated.

At some level, the quantified-self followers will seemingly be a market alternative, as the corporate will be capable to make cheaper screens for many who are simply inquisitive about their our bodies. “What’s more important about that use case is giving them a meaningful experience, like developing analytics engines around that for somebody who is not a diabetic,” Sayer stated.

A sliver-thin Dexcom G7 gadget is concerning 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 have a look at my breakfast and inform me to not eat the bagel that’s on my plate.

“We obviously have to take the cost out of this to get it to the mass market,” Sayer stated. “This is real health care. This is life and death stuff. We have a lot to do. It makes it very easy to go to work every day.”

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