What to expect for CGM in 2018

Thankfully we now see more CGM options!!!

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sounds interesting…it will be interesting to see what does actually come out next year

Thanks for sharing this, Mila.

Why do I feel like the G6 has been on the horizon for forever? It’s unusual to be waiting for a Dexcom device - I’ve grown accustom to their accelerated FDA approvals.

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Initial plan from Dexcom was to launch the G5x (with the new insertion device) which actually appeared more similar to the G6 then the G5. (Until the manual for the G6 is available it is conjecture as to just HOW close the G5x is to the G6.) However it is clear the G5x is quite different from the G5. So I think this made it seem like the next generation device from Dexcom has been “right around the corner” for quite some time now.

The 2017 Dexcom/Medicare rollout ended up occupying a good deal of Dexcom’s capacity and they decided it would not be a good idea to also have a G5x rollout (particularly with the G6 being relatively soon behind) and so pulled the G5x back from the FDA before it was approved and have stated the G5x will not be launched at all.

The G6 was submitted to the FCC for approval in June of 2017 and submitted to the FDA for approval in September of 2017. Dexcom is now working with the FDA to decide the best approach to launch the G6 in terms of either once per day calibration or no calibration. Dex has publicly committed to having a no calibration G6 launch before the end of 2018. However if it would be late in the year to get this then Dex may choose to have an earlier launch of the G6 with once per day calibration and then follow-up later in the year with an additional launch of the G6 with no calibration.

Dexcom is still dealing with a huge volume of Medicare which continues to play into the overall strategy for the company.

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Interesting stuff. We can only hope that the advancements will keep coming and that we won’t hit a lull where there is no progress for some period of time. Unfortunately, as with any technological advancements, there are always the slow periods…

That being said… I don’t think I’ll ever be able to consider the Senseonics Eversense implantable CGM. Even considering it’s good for 90 days at a time, there is still the external component and the insertion procedure cannot be good for building up scar tissue! For those that dare, I found this insertion procedure video on YouTube: Senseonics Eversense CGM Insertion Procedure

** BE WARNED, IF YOU’RE SQUEAMISH ABOUT MEDICAL PROCEDURES THE VIDEO IS A BIT GRAPHIC **

With Animas backing out of the industry and encouraging everyone over to Medtronic, I’ll be following the Medtronic sensors a bit closer given the tight integration with their pumps. I can’t see myself continuing to use Dexcom sensors if I plan to use the 630g/670g with CGM capabilities, even with as much as I prefer them.

I watched the video. I can’t imagine myself wanting to go through that every 90 days. I am required to see my doctor every 90 days due to Medicare requirements and it seems like it comes around way too fast. I’m not squeamish, nor do I wimp out during medical procedures of various types, but for glucose monitoring, I think I’ll “stick” with dexcom and a traditional finger stick meter!

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There are some great products waiting in the wings. The M&M CGM from Google is lined up behind the G6. What I am really excited about is the CGM IWatch will not be marketed as a medical device but rather a fitness device.

The feedback I have heard on the IWatch is its pretty darn good but will be held for a few years for marketing reasons. While it may not be the best fit for T1s, for the general public its a game changer, IMO.

There is lots of talk now about time in range vs A1C. When some of us talked of this 5 years ago we were often seen as a bit crazy. Treating T2s as early as possibly is key and getting them as “prediabetics” is huge. Few T2s have any idea what their TIR is let alone post meal spikes. If the IWatch can provide that visibility IMO it will be a game changer.

There was also a CGM company out of China San Meditech. They were bought a few months back. They had some really interesting technology and were making the CGMs for pennies on the $$$ compared to Dexcom. I am hoping they re-emerge soon.

I’m sorry but ick. I wouldnt go through that for my diabetes for anything. That looks just awful and the fact that you have to do it every 90 days??? NO WAY!

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The latest I’ve read about Minimed’s latest creation (I currently use Minimed as my pump & sensor) says that it has a feature called Auto that allows the sensor to automatically adjust the basal based on sensor readings. I have dreamed about a feature like this since I first had CGM, but CGM was never reliable enough that I would feel safe letting it adjust my basal. Things like laying on the sensor/transmitter in bed, for example, causes it to give unexpected and obviously incorrect low numbers, which would, of course, cause it to lower the basal, making my real numbers very high. If the new sensor really is reliable enough for a feature like this, I would love it, but it would require at least a few months of using it before I was convinced that it was safe & appropriate enough to let it automatically adjust my basal. Is it more reliable? I always look forward to upgrades in my medical technology, but my doctors tend to wait a while before letting me know about it or prescribing the upgrade.

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Interesting. Let me just say, I’d rather gnaw off my own left foot than to undergo that procedure every 90 days. I really can’t imagine this product taking hold in the D marketplace…

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For people paying out of pocket it’s unfortunate that the two main changes after introducing Share years ago have been (1) automatic time-out of transmitters, and coming soon (2) automatic time-out of sensors. Are the new sensors the same construction/chemistry as g4/5?

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@truenorth
At this point, there is no restriction on restarting a Dexcom sensor and no expectation of any such restriction being put into place for the G6. In fact, the Dexcom CEO has spoken publicly about this and given every indication that the G6 sensors will be able to be restarted.
Certainly until the G6 product is actually released, there can be changes from what is expected.

The G6 sensor is definitely incompatible with the G4/G5 systems.

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It would be very cool (sorry for stating the obvious!) to need just one calibration per day. I like where they are going with this tech.

What strikes me as a little bit odd - they recently came out with a new receiver. But if G5 and G6 are incompatible, the new receiver won’t be usable with the G6.

Since the G5 is old tech and they are moving toward the G6, why would they make a new receiver for the G5 now? The expense with design and ramping up manufacturing for the new G5 receiver which will have a very short lifespan of usability as G5 is phased out makes no sense.

Why not just encourage people to move toward the G6, and continue to support the old G5 receiver until end-of-life?

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Excellent point.

The new Touchscreen Receiver was intended for the Dexcom G5x and G6. (The G5x and G6 are extremely similar - really only minor version difference more or less between them.) However the G5x ended up getting pulled back by Dexcom in terms of FDA approval as Dexcom felt they were already at full capacity with the ramp-up and roll-out for Medicare which was both unexpectedly early as well as not going through distributors as originally intended.
Rather than yet another product launch which Dexcom simply did not have the capacity for, they focused on Medicare and pulled the Dexcom G5x.
As Dexcom was continuing to have warranty issues with the old Touchscreen Receiver, so they decided to release the Touchscreen with the G5.

As of right now, the thought is the (new) Dexcom Touchscreen Receiver will be able to be remotely updated so as to be compatible with the G6 (when launched).

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So the old-style (and smaller :+1: ) G5 receiver…compatible or not compatible with the new G6 sensor?


Side rant:
Why is everyone making things bigger now? Don’t people want smaller gadgets to carry around, not bigger? It used to be, a smaller diabetes device was preferred.

The new iPhone:
image

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I have heard nary a whisper on that.

There might be an update for the old receiver. It is possible. I wouldn’t hold my breath waiting on it.

I have heard bad things about the more recent Dexcom mobile app, so I haven’t updated that either. Better the devil you know…

I’m hanging back with the G4 + Share system. I like the dark screen at night and fewer data dropouts than when I tried the G5. I also don’t want to get mixed up with Medicare’s silly rules about using the Dex phone app.

It would be wonderful if the G6 were backward compatible the current G4/G5 sensors but I don’t think that will happen.

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Definitely not. That part is a done deal.
The sensors for the G4/G5 will not work with the G6 transmitter nor vice-versa.
Aside from the electronic differences, the physical configurations are different.