Hello, everyone, and thank you for tuning to
the Becker's Health Care podcast. I'm Molly Gamble
with Becker's and thrilled today to be joined
by Scott Odgers, senior director of key accounts
and health system innovation with Dexcom.
Scott, thank you so much for joining me
today. Hi, Molly. Thank you for having me.
Well, we've got a lot to dig into,
Scott. 1st, can you just introduce yourself a
bit more, provide an overview of your work
with Dexcom? What do you do? Absolutely. Thank
you for asking. So I've been with Dexcom
nearly 11 years. And so when I started
with Dexcom, that was very much in the
beginning of CGM development. In fact, it wasn't
even approved for pediatric use yet.
So so that's that's where I work. And
then I've,
I started there working more in the payer
insurance side because there really wasn't much reimbursement
for it.
So we worked through commercial insurers, through Medicaid
and Medicare, and now all of the above
cover it. And there's even cash options. So
it has really, really, expanded in terms of
the access for CGM, as well as the
technology itself has has evolved quite a bit
over time. Well, more evolution we're gonna touch
on in just a moment. Yes. CGM and
listeners, continuous glucose monitoring.
For those, Scott, who might be less familiar
with CGM,
can you give an overview of it? And
then also
talk a little bit, if you will, about
how it works, these devices, and then who
benefits from them? Yeah. So it's it's I'm
from Wisconsin.
And ironically, it was invented in Wisconsin at
the University of Wisconsin
in 1983.
So kind of a neat connection, and that's
right where I work.
But fast forward a little, and Dexcom was
founded in 1999,
and has been the leader in CGM advancement
ever since.
In terms of how continuous glucose monitoring technology
works, there's a sensor that resides just under
the skin in the interstitial fluid.
So think of, like, a fish line and
maybe an eighth of an inch long. That's
that's what it looks like that resides under
the skin. And then there's an algorithm that
converts the data into a glucose value that
is displayed on a smartphone or a receiver.
So there's both options.
And it shows the current glucose level as
well as where it is going and how
fast.
And I would be remissed recently we got
approved for smartwatches. So now you can see
it on like Apple Watch, things like that
too. And so a little bit more about
the technology though, but so what it does
show is your current glucose level, but it
also shows where it's going. So I think
of GPS. So not only do you see
where you are presently, you get to see
where you're going, what turns, and what's happening
if there's construction and things you have to
account for. It monitors glucose in much a
similar way in terms of
whether you're stressed, whether you just ate, exercise.
It shows where you are currently, but then
there's an arrow that is either up, down,
straight across, or somewhere in between, and that
tells you how fast you're going in a
certain direction. So for people that, especially people
that are on insulin, that's incredibly important so
that they can manage their diabetes in a
healthy way.
Who benefits? Is it primarily children? Is it
adults? Is there one patient population that has
the best or, like, the most use of
this device? Yeah. It's evolved. So yes. Another
great question. So it was first developed for
people with type 1 diabetes taking insulin.
And while insulin is one of the most
beneficial drugs that there that exist today, it
can also be life or death situation in
terms of how it's used, how it's dosed
for people that are dependent on it.
And this is where CGM has made a
profound difference in helping people at risk of
hypoglycemia,
which is low blood sugar, or hyperglycemia,
which is high blood sugar, and everywhere in
between. It's really a guide for how to
manage their insulin, their food intake,
exercise, stress, illness,
and overall lifestyle. It's it really does relate
to every aspect of their life and how
it affects their blood glucose.
I guess what impresses me from what you
shared so far, Scott, is that you mentioned
this was developed in the 19 seventies at
University of Wisconsin. This was almost like a
wearable before I,
my concept of wearables was a thing. Right?
Is that accurate? So it wasn't a wearable
then. In 1983, the technology
was developed where you could monitor it. And
I believe it was, actually had to be
inserted under the skin and left there. But
since then, it's now it's like a little
patch that resides on the skin with that
little interstitial
little filament, if you will, and that's where
it's evolved to. So, yeah, initially and it
was kinda clunky. It wasn't very accurate.
And that's something else that Dexcom has really
pushed the boundaries for is to increase the
accuracy.
So now it applies and that's that was
critical for the pediatric indication, which happened shortly
after I joined Dexcom. So it used to
be 25 and older.
And we got the first indication for pediatrics,
and it went down to 2 years old.
So that was tremendous for those kiddos out
there living with diabetes that and then think
about the parents in schools and everywhere else
in terms of now they had access to
this technology in a reliable and accurate way.
So that was a tremendous breakthrough.
But it really has evolved beyond people, with
just type 1 diabetes, but to people with
type 2 diabetes that may or may not
be on rapid acting insulin, but, basal insulin
and really any drug or treatment that would
cause hypoglycemia.
So it's it's it's really Medicare covers for
anyone on basal insulin
or any type of insulin, whether you're type
1 or type 2 have type 1 or
type 2 by diabetes.
Can you talk about that with the evolution
in mind, listeners? Can you talk about, Scott,
how these CGM devices are meeting patients'
expectations now for just more streamlined,
more digitally attuned,
and health care experiences and also information? Yeah.
Excited to answer that question because that's where
the innovation is really cool to see what's
happening. But,
in CGM's first iteration, it was required to
use a receiver.
And going back to g 5 mobile, which
would have been around 2016, 2017,
that was the first CGM that could go
to a smartphone,
which was
which really a game changer for people. So
they didn't have to look like this medical
device and now could look like a consumer
product.
So people didn't have to feel self conscious
because they're looking at their phone all the
time anyway, but now they can see their
glucose level there. So that that was a
big, change.
And then we we, are very active in
our partnerships. So we look at data integration.
We do have public APIs where we have
100 of partners that
ingest our data and then use it whether
it's a chronic condition management program, maybe a
post acute care program, diabetes management,
program,
and a number of others. But they take
our data and use it towards all kinds
of means. So we have partnered with automatic
insulin delivery systems, like, think of a insulin
pump or a, like, a patch pump or
smart pens, that have the ability to dose
based on the Bluetooth connectivity with our product.
And then we're even doing it with, lifestyle,
like, apps and things like that. So people
that are are using it for, you know,
reminders of different sorts, but how it works
into their life. So, again, hundreds of apps
that can ingest our data,
and then, again, provide that person or that
patient data in a way that's meaningful and
helpful to them.
That's terrific. And I know too in March
this year, so not that long ago from
when you and I are sitting down now,
Scott, the FDA approved
the first over the counter CGM device that
does not require a prescription.
That was big news at the time. I
wanted to touch on that. Can you expand
on how you see that
move helping to enable greater access for patients?
Yes. That actually at the conference here has
been one of the key questions we've been
getting, like, day in and day out. So
it's really exciting. Yes. The name of the
product is Stello, s t e l o,
and it's the first glucose biosensor
approved back in March and became available to
consumers online,
through consumer purchase this past August. And it
is available without a prescription because it is
intended for anyone 18 and older not on
insulin or at risk of hypoglycemia.
So think anyone with type 2 diabetes not
on insulin or hypoglycemic
risk,
or people newly diagnosed with type 2 diabetes,
you know, that may be just on lifestyle
management protocols.
People with prediabetes
and even health and wellness, is everyone is
becoming more aware of glucose, carb counting, and
all those things, you know, that you you
read about on every different health app or
news article around, glucose and diabetes, that we
see out in the public.
Scott, we've really had a vibrant discussion about
CGM. Is there anything that you didn't share
or I didn't ask you that we'd be
remiss to not touch on for our listeners?
Yes. Thank you for asking. A few things.
So one is, especially thinking about health systems
that may be involved with Becker's.
Recently, NCQA
when I say recently, January 1st, they adopted
GMI, which is glucose management
indicator,
which can be used instead of an a
one c for for basically how people are
doing with managing their diabetes. And it requires
CGM to be worn with that. So that
is significant because we're working with a number
of health systems in terms of not only
explaining what that means,
and how they can use it, but also
how they can take that data in across
for not just an individual patient, but for
population health management.
So this can raise the quality scores for
any health system that's looking at doing this
because
a one c, while it's a 3 month
average, you don't know what's happening. Over 3
months, your blood glucose can go all over
the place. The GMI indicator is a much
tighter, much closer measurement that gives a a
provider and then a health system much better
access to information, again, across an individual patient
and even across populations.
Couple other things I think are are I
really wanna make sure I mention, and and
that is that, I mentioned Dexcom's first. So
just I'll mention a couple of those and
how Dexcom is trailblazing in the CGM,
category.
I mentioned the 1st pediatric indication. We're also
the 1st CGM indicated for pregnancy.
The 1st direct to phone as we had
talked about, 1st direct to watch, 1st to
gain reimbursement from Medicare.
And then we also had the 1st share
follow, which is one I forgot to mention
earlier. And that's where an individual living with
IVs or using a Dexcom can share their
data with a loved one, a friend, a
teacher,
up to 10 people that they want to
see their data. And we've heard literally stories,
say, a college student maybe,
went low some night. A parent can see
that, call them, or call their roommate and
have them woke up to see if there's
something wrong with that person, or even call
91 if needed from, you know, from distance.
So it's really neat to see where that's
gone. And I'd be remiss, of course, if
I didn't mention again, STELLO, the first OTC
glucose biosensor. So those are just naming a
few. But what's really exciting is that I
know there's more to come, just in a
in a short, short amount of time coming
up here.
Scott, I wanna thank you for your time
and your insights today. This has been a
really interesting discussion about CGM, where it's been,
and where it's going. If listeners wanna learn
more, where where should they find you? No.
Yes. Thank you for asking, Molly.
So a couple different ways they can reach
out to us. Probably the main way is
key accounts, so key
accounts at dexcom.com.
That will reach me and my team. And
then what we do is evaluate what the
requests are. And some some some areas health
systems may wanna reach out to us for
is we have some programs. For example, we
have an adult hospital discharge program where we
provide both education and actual Dexcom product that
they can then provide to their patients that
are being discharged. Maybe they're newly diagnosed or
had a hypoglycemic
event.
We have a pediatric discharge program, so thinking
of pediatric hospitals.
We have well developed education and resources for
them, so they can help, put patients on
CGM that need it. And then 3rd is
a little bit broader category, but we can
help with data integration, whether that's direct into
an EHR integration
or it's even like a chronic condition management
program or post acute care management program. And,
again, they can reach us at key accounts
at dexcom.com,
and we can help them with any kind
of requests or needs that they might have.
Thank you, Scott. And my thanks too to
Dexcom for sponsoring today's content. To our listeners,
thank you for joining us today, and please
be sure to check out other Becker's podcasts.
Have a wonderful rest of your day.