Dexcom has been working on a variation of their CGMs for Type 2 Diabetics that do not use insulin and the personal improvement market. The new product is called Dexcom Stelo. The FDA completed the device review 3/5/2024 and Dexcom expects to have the product on store shelves this summer.
Highlights from the FDA review:
Available Over the Counter
15.5 day device lifetime
Same hardware as the G7
G7
Stelo
Sends data to multiple devices
Device restricted to connecting to smartphone only at this time
Updates every 5 minutes, displays data every 5 minutes
Updates every 5 minutes, displays data every 15 minutes
Measures glucose values within the 40- 400 mg/dL range, displays data in the same range
Measures glucose values within the 40- 400 mg/dL range, displays data between 70-250 mg/dL
Alerts and alarms: Urgent Low Alarm, Urgent Low Soon, Low, High, Rising Fast, and Falling Fast Alerts
No alerts and alarms
Can be calibrated
Cannot be calibrated
Dexcom also notes changes to the algorithm to support the longer wear time and to reduce trend line jitter for the Stelo.
Doing less is an excuse for charging less. They have the algorithm already and it’s the same hardware. They did something similar in the UK, called the Dexcom ONE. But the Dexcom ONE gives alerts, but can’t be calibrated, and it doesn’t have the trappings like share etc. It had to compete with the widely used Libre there. Interesting that a lot of Brits don’t like the Dexcom One better than the Libre, without calibration the Dexcom accuracy is similar, and maybe even not quite as good, but the graphs Libre has and supplies is much more detailed than the Dexcom One.
But I am really glad that a sensor will finally be available without a prescription. It also allows better shopping around for a better price. It seems like it makes sense when you can get a BG meter, why not a CGM to know what your blood sugars are doing.
I wear a Dexcom G6 supplied by my insurance, but I pay for a Libre to use while I swim. The Libre just is used for swimming and the reader goes back in my purse after. Because I can calibrate the Dexcom to be within 5 points most of the time, I like it a lot better. But if I couldn’t calibrate it? The no script could be a game changer for some and really beneficial for people not diagnosed but suspicious and wondering what their BG level is doing. Even if it’s just for sports, because if you want to, why not?
I told someone who is into youtube videos of non-diabetics wearing CGMs and they were excited to the point that I think a Stelo would make a fun birthday present.
If you are T2D does the Stelo sound like a helpful product?
My husband is/was a T2D. He’s maintained around a 6.2 A1c with the use of Metformin, exercise and watching what he eats. But he likes his junk food sometimes and knows he isn’t always paying attention. He will wear a Libre off and on to see how his numbers are doing. He does BG test off and on, but it doesn’t give a full picture like a Libre does. It’s invaluable to remind him of what he needs to consistently do.
It really has helped him a lot to know that exercise really helps, and to know he needs to portion the junk food he eats. There is nothing like seeing your numbers play out in front of you. But he wouldn’t want to wear it all the time, nor does he want to ask the doctor for a script and have the doctor oversee it. Similar to my husband, I’m sure there’s other people that don’t qualify for insurance coverage, or they don’t want to ask for one, or even go to the doctor to ask about it, or maybe they just try one to see.
You can buy blood pressure machines, BG meters and A1c kits, you can buy needles. Why can’t you buy a CGM? And a little competition on a non script route would do wonders on costs of these items.
Yes although not for me. I have a friend who will use it for ice hockey. He is Type 2 and has worn Dexcom occasionally during games to see what is happening. He has been spiking up over 200 but his GP tells him that is no big deal. I am hoping he gets back to using a CGM and Stelo will probably work well for him.
I think CGM for personal improvement is a solution looking for a problem. The only reason for someone who doesn’t have diabetes to use CGM is if they have another condition or are on a medication that affects BG. Other than that, CGM will not impact one’s health or athletic performance. 1) One cannot change their BG and 2) if one could, the body would do a much better job. Even with the latest tech it’s a chore at best.
OTOH, if DexCom doesn’t pursue this market, their competition will out spend them.
Well as it’s already mentioned this new cgm is meant for type 2. Type 1 requires more accurate and frequent readings for insulin closed loop pump operations.
However if I was a type 2 (I’m type 1), I would still prefer the most accurate of anything that’s meant for my health. There are many type 2 on insulin pumps after many years also. My personal opinion is keep the BG as close as a normal healthy person to avoid any complications in the future. Whether you’re type 1 or type 2 shouldn’t distract you from the main goal, the target BG. Treatment can vary depending on your condition obviously. I don’t have a choice so I must use insulin
Oh, I agree. For type 2, it’s great. My wife is on the Libre 2. For people who are not using BG to make immediate treatment decisions, the accuracy is not necessary. OTOH, if they cost the same to make, give them the better CGM. They may well be the same product, but T2s can wear it long without effecting the outcome. I think anyone on a pump should have the T1 product.
For non-diabetics, they are marketing them like heart rate monitors. The difference is that HRMs provide useful data that can effect one’s performance. CGM doesn’t.
The only real reason I can imagine for a T2 not on insulin is as a learning tool not as a management tool. Most type 2 diabetics have no idea what happens with their blood glucose throughout the day. This will give them more than just snapshots in time provided by finger sticks.
Very few T2’s are motivated enough to do the multiple daily sticks to get the true picture of their diabetes. One stick in the morning is not enough to educate them about how their diet and exercise affects them. They never learn that pancakes for breakfast will cause a big BG rise or that bacon and eggs have little affect at all.
Heck, as a Type 1 I’m not motivated enough to do fingerstick. CGMs that don’t require a calibration have made an amazing improvement for me.
An estimated 34.5 million people in the US have T2. ~25% of them are are on insulin so the T2 market for Stelo is about 25.8 million. I saw an estimate that only half of people with T2 test according to doctors orders so there is lots of opportunity for improvement. There are also lots of studies that show that clinicians can improve their T2 patents outcomes when handed an AGP report versus a BGM log.
I’m a lot more hesitant when it comes to the personal improvement market. I see more market pressure coming from social media than doctors and it makes me wonder how much of that market pressure is funded by Dexcom. Weight Watchers partnered with Abbott to show Libra data in their app. There are also fitness apps that display Libre or Dexcom data.
I keep struggling with the fact that I find this whole personal-improvement, fitness-app CGM thing really annoying. Rationally, I try to reject this feeling. There’s nothing wrong with people wanting to have more information about their health, whatever the reason, and CGM exists, so if you can afford one why not? Plus the proliferation of manufacturers will help reduce prices and drive innovation, so that’s good too.
But I struggle to shake off the part of me that feels a bit of a cringy George-Costanza vibe around the whole thing too. I totally acknowledge that I shouldn’t feel that way, but there it is. For a long time seeing a CGM on someone’s arm was a sign of another T1 and I’ve had a lot of brief but supportive interactions with other Members of the Tribe on that basis. I’m not pushy about it but it’s a rare enough condition that I find most of us respond pretty positively to that kind of thing. But suddenly I’m seeing all kinds of apps for non-D people to track their glucose with these things, so that’s probably going away. There’s also the flip side of having this thing on my arm mistaken for just another health-fad gadget when actually it’s a lot more serious than that, a feeling that’s also obscurely annoying and unjustified and faintly cringe but, well, real.
I know this isn’t rational, but I wanted to surface it b/c it’s probably not unique to me. And OTOH it did bring to mind one of the peak moments in the history of cringe-comedy, so there’s that.
I get this. We as diabetics are a minority in society. Type 1 diabetics are even a smaller slice. Now that physical fitness buffs and health advocates are taking an interest in “our” hardware, it would be nice if that meant more people would understand our struggle but we know that’s not happening.
We still must interact and hopefully educate the rest of society but we realistically know that people are most interested in the health aspects that directly impact their lives. They rarely take more than a passing interest in health issues that don’t affect them or their loved ones. It’s just a reality of human nature.
I’ve even felt this isolation among people with diabetes. Trying to live with normal BGs using therapeutic carbohydrate reduction has put me into a small slice of a small slice. I know that many people often see my comments and posts as written by that “fanatical low-carb guy” who eats an insanely difficult diet that sucks the joy out of life!
I’m being facetious, of course. I love the nutritious food I eat and greatly enjoy the normal blood sugar levels that follow. I don’t think that there’s anything special about my personality and think that people could reproduce what I do if they wanted to.
I suppose that I could migrate to another online community, like Type 1 Grit, but I’ve been here a long time and this place feels familiar to me.
Being T2 and have worked to keep a log of my BG, food intake and activity for the last 20 years, you are so correct. Other T2’s usually say “I take a pill for that” or “it’s not that bad” and “I’m OK”. I ask them when is the last time they had a blood draw or checking with a doctor I hear that they don’t much or ever. Or they just don’t understand the concept of the treatment and continue with the high carb and fat diet I used to have.
My niece died from high BS at age 34. One day she felt like hell and she tested and poke test and could not get any blood in her fingers, and she figured she was low and she thought the meter was wrong so she treated it with “healthy” fruit juice. She seldom checked her BS, “it’s all so confusing” and a CGM is such as hassle. She was convinced normal BS was between 300 and 400. I had many arguments with her about that, but in her head if she got down to 200 she panicked as that was too low. Those around her did not understand how diabetic treatment and life style needs to change so a diabetic can live life through eating carefully, exercise and proper use of medications. But as everyone reading this knows that it’s a lot of work, but it can be done! I’ve heard too many times that it all seems sooo easy for me to handle as an example. But they don’t really know how diabetes works and I don;t think they want to. Then after her death her dad and husband had/have this guilt that they didn’t do enough to help and then asking me what went wrong. It was a perfect diabetic storm for her when she passed.
That is such a sad story! What you describe is a perfect example of why I’ve always said T1 is in some ways easier than T2, in that you don’t have any choice about taking it seriously right from the start. Typically you’re already in crisis, and the moment you start taking insulin everything changes. With T2 it’s typically just a bad number that showed up in your bloodwork, you don’t necessarily feel bad or anything, so it’s easier to minimize what you’re dealing with, which is a totally human thing to do. Diet and exercise, sure, everyone could do better with that, and Metformin is pretty benign. Most people don’t want to reorder their whole lifestyle without some kind of gun to their head, which is kinda what T1 is. I totally sympathize with people who try to minimize the impact of T2 on their lives because I’m sure that’s exactly how I would have reacted if it were me.
The population is getting older so I see this often when friends and families reach into their late 70’s and develop T2. It is just one more medical issue to deal with amongst many others so they take the why bother attitude. I gave my uncle a glucose monitoring kit many years ago and I think he used it twice, and felt T2 was just part of his aging process. We are so used to having to take care of our diabetes, it is heart wrenching to see and understand friends and family ignore diabetes unnecessarily shortening their lives.
I think all who read a thread like this one realize that readers, commenters, and lurkers make up a small slice of the much larger real-world diabetes demographic. We also realize that people generally don’t learn anything until they are ready. This drastically cuts down the opportunities we each have to help people with their diabetes.
It doesn’t matter that we have all the pertinent experience and have already made all mistakes. Spending your time and effort with someone who isn’t interested is worse than saying nothing at all. It may destroy any future opportunities when that person is ready to learn.
As you say, many people will never be ready to improve their health, no matter their age. I, for one, believe it is always worth the effort to feel better, age notwithstanding.
People get very touchy about any proposed changes to the way they eat. They accept the outcomes of poor diet as “just part of the aging process.” Eating an appropriate nutrition dense whole food diet can positively alter health in both the short and long term. It also can leave you satiated between meals and eliminate the need for willpower to resist snacking – a definite bonus for living effectively with any form of diabetes.
Constructing and executing a plan to do this is the easy part. Only a person ready to do this has a chance of success and it’s only when they choose to take on this project. Until then, it’s better to quietly stand by.
I feel that way too and recognize its irrationality. It’s the same feeling I got with the Ozempic craze, wondering what was going to happen with the supply chain for diabetics who need the drug for glucose control.
I talked to my PCP about Stelo’s upcoming release. He was interested and made the comment that at $30/month it would be useful but if its $100/month his patients won’t use it.
