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Hello, everyone, and thank you for tuning to

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the Becker's Health Care podcast. I'm Molly Gamble

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with Becker's and thrilled today to be joined

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by Scott Odgers, senior director of key accounts

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and health system innovation with Dexcom.

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Scott, thank you so much for joining me

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today. Hi, Molly. Thank you for having me.

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Well, we've got a lot to dig into,

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Scott. 1st, can you just introduce yourself a

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bit more, provide an overview of your work

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with Dexcom? What do you do? Absolutely. Thank

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you for asking. So I've been with Dexcom

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nearly 11 years. And so when I started

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with Dexcom, that was very much in the

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beginning of CGM development. In fact, it wasn't

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even approved for pediatric use yet.

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So so that's that's where I work. And

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then I've,

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I started there working more in the payer

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insurance side because there really wasn't much reimbursement

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for it.

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So we worked through commercial insurers, through Medicaid

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and Medicare, and now all of the above

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cover it. And there's even cash options. So

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it has really, really, expanded in terms of

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the access for CGM, as well as the

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technology itself has has evolved quite a bit

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over time. Well, more evolution we're gonna touch

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on in just a moment. Yes. CGM and

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listeners, continuous glucose monitoring.

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For those, Scott, who might be less familiar

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with CGM,

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can you give an overview of it? And

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then also

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talk a little bit, if you will, about

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how it works, these devices, and then who

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benefits from them? Yeah. So it's it's I'm

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from Wisconsin.

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And ironically, it was invented in Wisconsin at

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the University of Wisconsin

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in 1983.

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So kind of a neat connection, and that's

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right where I work.

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But fast forward a little, and Dexcom was

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founded in 1999,

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and has been the leader in CGM advancement

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ever since.

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In terms of how continuous glucose monitoring technology

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works, there's a sensor that resides just under

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the skin in the interstitial fluid.

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So think of, like, a fish line and

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maybe an eighth of an inch long. That's

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that's what it looks like that resides under

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the skin. And then there's an algorithm that

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converts the data into a glucose value that

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is displayed on a smartphone or a receiver.

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So there's both options.

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And it shows the current glucose level as

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well as where it is going and how

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fast.

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And I would be remissed recently we got

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approved for smartwatches. So now you can see

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it on like Apple Watch, things like that

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too. And so a little bit more about

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the technology though, but so what it does

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show is your current glucose level, but it

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also shows where it's going. So I think

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of GPS. So not only do you see

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where you are presently, you get to see

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where you're going, what turns, and what's happening

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if there's construction and things you have to

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account for. It monitors glucose in much a

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similar way in terms of

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whether you're stressed, whether you just ate, exercise.

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It shows where you are currently, but then

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there's an arrow that is either up, down,

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straight across, or somewhere in between, and that

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tells you how fast you're going in a

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certain direction. So for people that, especially people

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that are on insulin, that's incredibly important so

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that they can manage their diabetes in a

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healthy way.

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Who benefits? Is it primarily children? Is it

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adults? Is there one patient population that has

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the best or, like, the most use of

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this device? Yeah. It's evolved. So yes. Another

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great question. So it was first developed for

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people with type 1 diabetes taking insulin.

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And while insulin is one of the most

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beneficial drugs that there that exist today, it

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can also be life or death situation in

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terms of how it's used, how it's dosed

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for people that are dependent on it.

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And this is where CGM has made a

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profound difference in helping people at risk of

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hypoglycemia,

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which is low blood sugar, or hyperglycemia,

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which is high blood sugar, and everywhere in

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between. It's really a guide for how to

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manage their insulin, their food intake,

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exercise, stress, illness,

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and overall lifestyle. It's it really does relate

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to every aspect of their life and how

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it affects their blood glucose.

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I guess what impresses me from what you

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shared so far, Scott, is that you mentioned

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this was developed in the 19 seventies at

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University of Wisconsin. This was almost like a

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wearable before I,

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my concept of wearables was a thing. Right?

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Is that accurate? So it wasn't a wearable

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then. In 1983, the technology

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was developed where you could monitor it. And

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I believe it was, actually had to be

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inserted under the skin and left there. But

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since then, it's now it's like a little

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patch that resides on the skin with that

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little interstitial

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little filament, if you will, and that's where

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it's evolved to. So, yeah, initially and it

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was kinda clunky. It wasn't very accurate.

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And that's something else that Dexcom has really

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pushed the boundaries for is to increase the

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accuracy.

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So now it applies and that's that was

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critical for the pediatric indication, which happened shortly

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after I joined Dexcom. So it used to

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be 25 and older.

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And we got the first indication for pediatrics,

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and it went down to 2 years old.

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So that was tremendous for those kiddos out

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there living with diabetes that and then think

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about the parents in schools and everywhere else

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in terms of now they had access to

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this technology in a reliable and accurate way.

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So that was a tremendous breakthrough.

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But it really has evolved beyond people, with

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just type 1 diabetes, but to people with

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type 2 diabetes that may or may not

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be on rapid acting insulin, but, basal insulin

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and really any drug or treatment that would

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cause hypoglycemia.

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So it's it's it's really Medicare covers for

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anyone on basal insulin

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or any type of insulin, whether you're type

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1 or type 2 have type 1 or

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type 2 by diabetes.

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Can you talk about that with the evolution

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in mind, listeners? Can you talk about, Scott,

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how these CGM devices are meeting patients'

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expectations now for just more streamlined,

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more digitally attuned,

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and health care experiences and also information? Yeah.

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Excited to answer that question because that's where

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the innovation is really cool to see what's

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happening. But,

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in CGM's first iteration, it was required to

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use a receiver.

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And going back to g 5 mobile, which

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would have been around 2016, 2017,

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that was the first CGM that could go

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to a smartphone,

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which was

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which really a game changer for people. So

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they didn't have to look like this medical

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device and now could look like a consumer

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product.

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So people didn't have to feel self conscious

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because they're looking at their phone all the

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time anyway, but now they can see their

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glucose level there. So that that was a

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big, change.

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And then we we, are very active in

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our partnerships. So we look at data integration.

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We do have public APIs where we have

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100 of partners that

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ingest our data and then use it whether

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it's a chronic condition management program, maybe a

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post acute care program, diabetes management,

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program,

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and a number of others. But they take

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our data and use it towards all kinds

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of means. So we have partnered with automatic

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insulin delivery systems, like, think of a insulin

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pump or a, like, a patch pump or

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smart pens, that have the ability to dose

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based on the Bluetooth connectivity with our product.

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And then we're even doing it with, lifestyle,

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like, apps and things like that. So people

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that are are using it for, you know,

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reminders of different sorts, but how it works

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into their life. So, again, hundreds of apps

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that can ingest our data,

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and then, again, provide that person or that

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patient data in a way that's meaningful and

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helpful to them.

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That's terrific. And I know too in March

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this year, so not that long ago from

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when you and I are sitting down now,

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Scott, the FDA approved

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the first over the counter CGM device that

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does not require a prescription.

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That was big news at the time. I

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wanted to touch on that. Can you expand

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on how you see that

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move helping to enable greater access for patients?

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Yes. That actually at the conference here has

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been one of the key questions we've been

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getting, like, day in and day out. So

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it's really exciting. Yes. The name of the

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product is Stello, s t e l o,

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and it's the first glucose biosensor

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approved back in March and became available to

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consumers online,

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through consumer purchase this past August. And it

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is available without a prescription because it is

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intended for anyone 18 and older not on

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insulin or at risk of hypoglycemia.

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So think anyone with type 2 diabetes not

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on insulin or hypoglycemic

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risk,

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or people newly diagnosed with type 2 diabetes,

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you know, that may be just on lifestyle

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management protocols.

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People with prediabetes

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and even health and wellness, is everyone is

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becoming more aware of glucose, carb counting, and

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all those things, you know, that you you

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read about on every different health app or

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news article around, glucose and diabetes, that we

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see out in the public.

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Scott, we've really had a vibrant discussion about

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CGM. Is there anything that you didn't share

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or I didn't ask you that we'd be

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remiss to not touch on for our listeners?

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Yes. Thank you for asking. A few things.

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So one is, especially thinking about health systems

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that may be involved with Becker's.

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Recently, NCQA

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when I say recently, January 1st, they adopted

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GMI, which is glucose management

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indicator,

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which can be used instead of an a

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one c for for basically how people are

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doing with managing their diabetes. And it requires

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CGM to be worn with that. So that

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is significant because we're working with a number

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of health systems in terms of not only

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explaining what that means,

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and how they can use it, but also

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how they can take that data in across

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for not just an individual patient, but for

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population health management.

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So this can raise the quality scores for

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any health system that's looking at doing this

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because

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a one c, while it's a 3 month

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average, you don't know what's happening. Over 3

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months, your blood glucose can go all over

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the place. The GMI indicator is a much

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tighter, much closer measurement that gives a a

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provider and then a health system much better

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access to information, again, across an individual patient

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and even across populations.

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Couple other things I think are are I

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really wanna make sure I mention, and and

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that is that, I mentioned Dexcom's first. So

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just I'll mention a couple of those and

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how Dexcom is trailblazing in the CGM,

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category.

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I mentioned the 1st pediatric indication. We're also

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the 1st CGM indicated for pregnancy.

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The 1st direct to phone as we had

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talked about, 1st direct to watch, 1st to

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gain reimbursement from Medicare.

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And then we also had the 1st share

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follow, which is one I forgot to mention

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earlier. And that's where an individual living with

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IVs or using a Dexcom can share their

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data with a loved one, a friend, a

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teacher,

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up to 10 people that they want to

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see their data. And we've heard literally stories,

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say, a college student maybe,

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went low some night. A parent can see

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that, call them, or call their roommate and

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have them woke up to see if there's

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something wrong with that person, or even call

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91 if needed from, you know, from distance.

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So it's really neat to see where that's

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gone. And I'd be remiss, of course, if

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I didn't mention again, STELLO, the first OTC

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glucose biosensor. So those are just naming a

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few. But what's really exciting is that I

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know there's more to come, just in a

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in a short, short amount of time coming

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up here.

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Scott, I wanna thank you for your time

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and your insights today. This has been a

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really interesting discussion about CGM, where it's been,

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and where it's going. If listeners wanna learn

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more, where where should they find you? No.

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Yes. Thank you for asking, Molly.

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So a couple different ways they can reach

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out to us. Probably the main way is

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key accounts, so key

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accounts at dexcom.com.

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That will reach me and my team. And

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then what we do is evaluate what the

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requests are. And some some some areas health

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systems may wanna reach out to us for

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is we have some programs. For example, we

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have an adult hospital discharge program where we

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provide both education and actual Dexcom product that

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they can then provide to their patients that

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are being discharged. Maybe they're newly diagnosed or

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had a hypoglycemic

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event.

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We have a pediatric discharge program, so thinking

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of pediatric hospitals.

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We have well developed education and resources for

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them, so they can help, put patients on

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CGM that need it. And then 3rd is

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a little bit broader category, but we can

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help with data integration, whether that's direct into

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an EHR integration

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or it's even like a chronic condition management

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program or post acute care management program. And,

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again, they can reach us at key accounts

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at dexcom.com,

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and we can help them with any kind

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of requests or needs that they might have.

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Thank you, Scott. And my thanks too to

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Dexcom for sponsoring today's content. To our listeners,

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thank you for joining us today, and please

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be sure to check out other Becker's podcasts.

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Have a wonderful rest of your day.