Established in 2005, Dexcom Inc have consistently been producing continuous glucose monitors (CGMs) that in many ways set the industry standard. Now with the news this week (14 March 2022) that Dexcom G7 has been awarded a CE mark, the San Diego (US) medtech company look set to launch their new-generation CGM in Europe and the UK.
In January, Dexcom's CEO revealed that they would first target the larger European countries including Germany and the UK and although it's not yet available, it is probably a matter of only a few weeks.
In addition, the company stated that it "is also working closely with its insulin pump partners to integrate Dexcom G7 into current and future automated insulin delivery systems as quickly as possible." However, as yet there are no details of a US release and it has yet to receive FDA approval.
THE NEW CGM FEATURES OF DEXCOM G7
Ahead of its launch in the UK and EU, we look at the features of this new-generation CGM.
SIZE AND SHAPE
The new form of the G7 is not just a upgrade from the G6, but a completely new model. The size of the sensor and transmitter is 60% smaller than the G6, and yes, the sensor and transmitter for the G7 is one piece combined so there's no separate transmitter, eliminating the need to replace these separately. A good move in terms of being more eco-friendly.
The new shape is a shift away from the previous lozenge-shaped Dexcom sensors and although not exactly circular, it is much more similar to a FreeStyle Libre which may encourage Libre users to switch as there is some familiarity to the appearance of the Dexcom G7.
As you can see the sensor is smaller and slimmer - smaller than a quarter but a little larger than a nickel if you can relate to US currency. The slimmer profile means that it should sit well on the skin with less likelihood of knocks, although underlay is still needed to ensure it adheres to the skin.
It's not yet known if the adhesive has been changed or modified.
A huge plus to the new-generation CGM is that Dexcom have reduced the warm-up time before the sensor starts generating readings of glucose levels and such data. For the G7 it is just 30 minutes, down from 2 hours for the G6.
Dexcom are marketing this as the fastest cgm warm-up time on the market and it certainly compares favourably to FreeStyle Libre, currently its main rival for T1Ds using a sensor.
The application process for the G7 has been much simplified and as there isn't a separate transmitter. It is attached in a very similar way to a Libre, with a one-piece applicator making it much more user-friendly. And it can now be worn on the upper arm as well as abdomen.
There is also a 12-hour grace period to replace finished sensors for a more seamless transition between sensors.
Dexcom state that they have learned a lot from user's experience and feedback and one way this has fed back into the software development for G7 is the redesigned mobile App. The app has been simplified and has Dexcom Clarity integration.
Information on trends over a longer period of time will be available in the app, with the ability for users to see their time in range for some period of time, as well as other data.Other improvements include changes to alert settings.
Overall, it should feel fresh, with more useful data and be more intuitive to use.
Dexcom, unlike FreeStyle Libre, has the option for 3rd party developers to connect to its data and integrate it into their digital health apps and devices. This is done through the Dexcom Partner Web Application Programming Interfaces (API) and enables users to see their health data in one place.
This data used to have a 3 hour time-lag, however, with the new G7 app all data will be available to 3rd parties in real-time.
Garmin are one such 3rd party that use Dexcom data to integrate with their own app. And others are set to follow. It's highly likely that this part of Dexcom's business will see huge growth as many business look to make use of CGM data. Watch this space!
Dexcom have also taken the opportunity to review their bluetooth connectivity which has been upgraded and the G7 has enhanced cybersecurity.
The most recent trial carried out by Dexcom involving 308 participlants, over 80% with Type 1 diabetes, found that the G7’s mean absolute relative difference (MARD) was 8.2% for adults and 8.1% for paediatric patients. This is an improvement on G6 and there's an improvement in day 1 readings too, so better accuracy can be expected.
Dexcom G6 is currently at the higher end of the CGM market in terms of price, costing around a third more than FreeStyle Libre 1 and 2. [Libre 3 is also expected to remain at the same cost as its predecessors.]
The price for self-funding is not yet published on the website or been publicised.
The most desirable and so eagerly awaited feature that Dexcom data is directly sent to a watch (in particular Apple smartwatches ) - without a phone being nearby - is still a little way off, but has been confirmed by Dexcom's CEO as a feature coming. Dexcom state that this capability is an 'anticipated future software release' so it sounds as if an update will become available at some point for this to happen.
Another point to note is that the sensor is approved for ages 2 years old and older and there is a redesigned optional receiver that is smaller, with a more vibrant, easier to read display.
COMPARISON WITH FREESTYLE LIBRE
The obvious comparison of a Dexcom G7 is with a FreeStyle Libre and Abbott are currently in the process of rolling out Libre 3 in Europe. So, when it comes to a choice of CGM this is likely to be where users will be looking at the key differences between the two.
The stand-out features for the Dexcom G7 seem to be:
1. A quick warm-up of 30 minutes
2. The App with user-focussed data and flexibility
3. The potential use of APIs for integration with other apps
4. The potential for glucose reading direct to Apple Watch. This is a very sought after feature and will be very popular with T1s.
Although it's too early to speculate about any developments for a G8, its worth mentioning that the G7 is still only has a 10 day lifespan. Whether this is changed remains to be seen, but market pressure may play a part as other CGMs move to longer durations, for example, Sensonics have a new 6 month implantable sensor coming out soon. Eversense, and if this is well-received it could pave the way for the likes of Dexcom to review their strategy in this regard.
Business Analysts have commented that the features of the G7, such as improved accuracy and a smaller footprint, will "allow Dexcom to compete more effectively, especially in the Type 2 market."
But, the real future for CGM isn't necessarily diabetes-related at all. CGMs are already being worn by athletes and sports enthusiasts and as health data becomes more of a commodity, their use and popularity is almost certain to grow. Health wearables will be seen everywhere and Dexcom G7 is perhaps only another stage in this evolution.
Information and data contained in this blog is based on details available in the UK at the time of publication. If you are based in another country you should check the specific information and data available in your country.
Content here and on our website www.lovemylibre.com does not constitute medical advice or replace the relationship between you and healthcare professionals nor the advice you receive from them.
The author of this blog has type 1 diabetes and uses the FreeStyle Libre 2 which is provided on NHS prescription. We do not have any affiliate relationship with Abbott FreeStyle Libre, Dexcom Inc. or Garmin. All trademarks are the intellectual property of their respective owners.