BONUS Episode: Dexcom Updates & News from ADA with CEO Jake Leach

[00:00:00]Jake Leach, thanks for joining me from ADA. Um, how is the conference going?

[00:00:05]Let's just start with what Dexcom is presenting and talking about there.

[00:00:08]>> Yeah, certainly. Um, well, first off, Stacy, great to see you. Great to be here. Um, uh, I I always love our time together.

[00:00:14]So, yeah, we're at ADA, just got started, um, uh, a couple days ago and at this conference we have some really exciting, um, news. Um, first off, we have our connect study that we'll be presenting the results later this afternoon. Uh, that is a study in, um, people with type 2 diabetes that use, um, other glucose-lowering medications, not using, you know, not insulin. So, GLP-1s, SGLT2s, and then a a portion of the folks in this study don't use anything, um, uh, no medications. They're they're all using diet and exercise lifestyle to manage diabetes. And so, it's a study, large randomized control trial. They had the the goal is to show the impact of CGM in this population, which that hasn't been done in a randomized control trial of this size. It's been done through real-world evidence. We have lots of evidence that shows how CGM impacts this group, um, and the improvements that are driven by using CGM, but this study, I think, is going to be the cornerstone, um, to further advancing access for people to CGM around the world. So, at this point, we now have a complete data set spanning all the way from type 1 diabetes through the different stages of type 2, um, uh, the evidence needed to show the impact this product can have. So, now, at this point, all people with diabetes, we have the evidence that proves what CGM can do, um, and the benefits. So, very excited to to release that later this afternoon. Um, we also, um, had new news where we acquired a company called Nutrisense, uh, which is, uh, a company that is based on, um, nutritional coaching, uh, guided by CGM, um, for users. And that we've been working as a partnership together for quite a while. Um, I've been really excited about what they've been able to drive in terms of, um, outcomes and better metabolic health.

[00:01:56]And so, I wanted them to be part of the Dexcom team. So, we're just uh looking to close that acquisition here um in the coming weeks uh and very excited about that.

[00:02:06]And we've also got a whole new version of Stello uh that we're launching here at the show. We've got new people getting access to it. It's a whole new um uh mobile app experience. We've talked about it before, but we're actually starting uh to have people use it um outside of Dexcom.

[00:02:22]>> What is different about the Stello?

[00:02:24]>> About the hardware is the same.

[00:02:26]Software's different.

[00:02:27]>> Yeah, software's very different. So, this um design is um you notice from the moment you open the app, it's a very design forward uh looking app. It looks very, very different. It looks it's more uh akin to some of the you know, most loved mobile tech apps out there. Um you know, our partner Aura has done a really nice job in that, you know, kind of user interface. Um so, ours uh while not copying them, has a lot of um similarities in terms of just the way we use colors and the design. So, we kind of took a fresh look at the just design aesthetics, but the other thing we did was um we we've put insights that are generated from the the mobile app experience up front in the way that we display, cuz a lot of our users who are using Stello, the number one piece of feedback is, "I'm really I love this real-time data, but what else can it what what what does this mean? How does this, you know, we're trying to connect the dots for them." And we found that sometimes the insights get a little hidden, and so we put them right up front. It also has an AI coach built into it, so you can ask it all kinds of questions, like, "How am I doing today?

[00:03:31]How does this glucose look? What should I have for like you can ask it all kinds. How do I lower my glucose right now? Like what can I do?" Like I get that question actually all the time.

[00:03:38]People are like, "My glucose is running kind of high, what should I do?" And I'm like, "Well, go take a walk." Like there's a lot of things you can do. And then it learns the individual and what works for them. So, it's it's a really um exciting experience. We're pulling in more of the um activity data, sleep data from partners, uh, and using that in the coach as well.

[00:03:56]So, it it's a great experience. Looking forward to getting it in people's hands.

[00:04:02]>> For clarification, um, and I think most of my listeners know this, Stelo is a product that is over-the-counter. It is for people who do not use insulin. Um, any plans to export that kind of software, those, you know, it it's got, and I've used Stelo, it has it it already had, when I used it last year, a really great, uh, knowledge base in there. You could ask it a lot of questions. It had a lot of really basic stuff about type 2 diabetes that I think people found very helpful. Any plans to give that to the type 1 or LADA community?

[00:04:31]>> Absolutely. We're our our goal is, um, to transition, um, all of that, you know, new design and uh, new design thinking, um, as well as, uh, features.

[00:04:42]We know there's a lot of, um, overlap, um, particularly when it comes to nutrition, um, anything about like carb counting, and right now the Stelo, the new version of Stelo, you can take a picture or enter the, um, food, meal information into the app, and it'll not only analyze it, um, but it'll also give you the macronutrients associated with it. So, carbs, protein, fat, um, and it also gives it a meal score in terms of what uh, we anticipate it'll do your glucose. That could be really helpful for all of our users, right? And so, that's where, uh, we want to transition this same technology across the whole portfolio of products. Um, Stelo is kind of our, you know, our ground where we do introduction, we do some experimenting, um, and so, we've we really like what we've we're seeing here, so we want to move it over to the whole portfolio.

[00:05:30]>> Okay, tons of questions for you, focusing mostly on things you're not presenting at ADA, um, but really first on my calendar is, uh, you know, July 1st, G6 ceases production.

[00:05:43]>> Yes.

[00:05:44]>> For uh, can you talk about why? It seems very soon. I know it's probably not if you look at the timeline of Dexcom, but nuts and bolts and why you're doing this for a product that you know, Jake is beloved.

[00:05:56]>> Yes, you know, G6 has been an amazing product um that that we launched um uh 8 years ago.

[00:06:04]Um and so it was it has been a fantastic product um and we basically are at the point now where one uh we've already done lifetime buys on number of materials that are in that product. So don't have any more raw materials to build G6s. That's part of it. Uh the other part too is that I need to transition those manufacturing lines over to G7 so we can make enough sensors. The G7 manufacturing lines are much more efficient than G6 in terms of like I can build more sensors in the same amount of space and so we we need to be able to transition so we can serve the growing number of users. We're also really proud of where uh G7 is in terms of product performance, reliability, and um it's it's ability to meet users' needs. Um and so we're real stable with that at this point in time. So we are uh it's the right time to do this transition. So it's kind of like a combination of all those things. Um we um you know, still have some G6 out there in the market. Uh and we're basically most of our users have already moved over to G7. Um uh particularly most of our pediatrics uh have already moved over. Um but we still have some folks using G6 that we want to to transition over to G7. So we've got a number of folks they can contact us. We can help them um get an educational sample of G7 so they can give it a try um uh before they switch over. I think that's always That's been my most helpful um when when folks they love their G6, right? But you know, we need to move to G7. So give one a try. Um and so that I think that's a great way to help to to get the educational um experience before they moved over.

[00:07:33]>> If I remember in the past too cuz we've we've done this I mean since the podcast in 2015, we've done this a few times with G4, G5. Um in the past there have been a few devices and partnerships that have lagged. Are there any devices, are there any pump systems that only operate on G6 internationally or in the United States? There aren't, right?

[00:07:52]>> No, we just there was one internationally, um, but we just we just moved over to G7. They just announced that. So, we're we're good across all systems, um, and in the United States all of our pump partners are also compatible with the 15-day uh, sensor as well. So, both G7 10-day and 15-day are compatible with all all pumps.

[00:08:11]>> Okay. And on um, and forgive me, you know, we do this a lot rapid fire with my limited time I have with you. [laughter] But, with with the with the uh, G7 15-day, um, not approved yet for pediatrics?

[00:08:25]>> No, it's not. It's it's uh, it's only approved for adults uh, and that was really around um, as we designed the products, we want to make sure that uh, a really significant number of sensors last all the way to the end to 15 days.

[00:08:40]Right? And and we know when you know, you put a sensor in, um, what what really dictates how long it lasts isn't necessarily the physical sensor itself.

[00:08:49]It's the um, the biology of where the sensor uh, when it was inserted that we call the wound site, but basically where that sensor is in the body is um, you know, interacting with the sensor on the first day and throughout the whole wear time. And the in pediatrics, we tend to see that um, the sensors don't last as long on average um, out of out of 15 days. So, we really have said right now based on where the technology is at, 10 days is the right product for pediatrics because we want to make sure that people always have the sensors they need and we don't want to be replacing their sensors all the time um, if they're trying to use a 15-day out out.

[00:09:27]Majority of pediatrics could get a sensor to go 15 days, but the experience for >> kid. [laughter] >> Yeah, exactly, right? There are there's totally I mean, it's like that you so, you have that experience, right?

[00:09:37]You know, like 10 days the right is the right technology for pediatrics at this point in time.

[00:09:42]I do there will be G8 will be 15-day for everybody, but we're also going to do unique things about making sure that people have the sensors they need even even if it doesn't last about the 15 days, which usually it's either tape falls off or the sensor probe is no longer able to sense glucose in in the wound site.

[00:10:01]The thing that actually what's been really we did this customer advisory council which has been a really important part of listening to our customers. One of the things that really has resonated with the that group has been our kind of explanation of the other things that are going on that have impact sensor beyond just the sensor itself. And a lot of it has to do with the interaction with the body and biology. And that has really landed quite well. And so we we cover some of that in the report that we just published for everyone to see towards the output of that council. But that's a big part of sensor survival.

[00:10:35]>> I do want to talk about the council.

[00:10:37]Let's put that aside just for a moment though.

[00:10:40]A quick question about the 15-day. Why does it have a 60-minute warm-up?

[00:10:45]>> So basically in in that 15-day algorithm for the extended survival the to make it work right it needed an hour of warm-up time. But we are working on 15 30-minute warm-up for all sensors in the portfolio.

[00:10:59]So the goal would be to get back to a 30-minute warm-up for that product. But one of the things that's really unique about Dexcom is you can put your sensor in an hour before you plan to change away from your old one. So you can overlap them like that. And it is a really powerful feature that you basically have no no downtime.

[00:11:19]And so that's one of the things that many It's sometimes a takes a little bit of time for folks to understand that. I'd like people to understand that right up front. You can basically put that sensor in a little bit early and avoid any downtime.

[00:11:31]Just got to remember the pairing code.

[00:11:34]>> You got to remember which one. I mean, you can.

[00:11:37]I just remember giving Benny a bath years ago and having two pump sites.

[00:11:41]And like, "Oh, no. You know, he's 4 years old. Which is the old pump site?"

[00:11:44]Which is the old >> [laughter] >> one? You make an X on it.

[00:11:47]Um you've got a couple of things coming out that I haven't heard discussed um two in too much detail. I'd like to ask you about. Um I understand a hospital product is coming pretty soon. What is that? What does that mean?

[00:12:00]>> So, it's a uh it's a it's it'll Our goal is to have the first continuous uh glucose monitor approved for use in the inpatient setting. I don't know if if that's surprising to some listeners, but there is actually no sensor continuous sensor that's been approved uh for use in the hospital um for subcutaneous use in the United States. So, our goal There's such a need there. If you look at how many um dysglycemia events happen in the hospital, it's you know, a lot of people with diabetes, but also people without diabetes that have stress-induced dysglycemia, usually hyperglycemia, from you know, major surgeries. Um that glucose control um you know, there's a lot of people who actually are put on insulin in the hospital that don't have diabetes, but they're trying to help the body uh the the physicians are trying to help the body manage that glucose level.

[00:12:48]They use finger sticks and lab tests.

[00:12:50]They don't use continuous glucose monitors. And so, uh there's been this significant demand coming from that environment from the anesthesiologists, from all of the the the physicians in the hospital for a better tool. Uh and so, we feel like our technology is really well suited uh for hospital use.

[00:13:06]And so, we're working on getting a product approved uh that will be used in the inpatient setting. Uh and the idea there is to basically guide the glucose management in the hospital, whether you have diabetes or not, guide it with CGM instead of intermittent finger sticks, which are we all know the challenges with doing that.

[00:13:24]>> Yeah. Is this product basically a G7 or a G8 that you just have to test in a hospital setting or is it something completely new?

[00:13:32]>> It's a it's No, it's it's a it's a G7 type of product. There's some different features that are designed around the hospital.

[00:13:39]But the hardware and we'll we'll move to G8 quickly. One of the things that for the hospital that be important just like for else's this idea of multiple analytes being able to be sensed subcutaneously. There's quite a few that could be helpful. I mentioned one recently around a potassium sensor managing potassium levels. Is Obviously, it's easier in the hospital because you have access to large you know, volume you can draw blood from the patient and run it on an analyzer, but it sure would be easier to have continuous measurement particularly for people with kidney disease or cardiac disease cardiovascular disease. So there's other ones too that I think lactate would be another great one. And so that G8 platform will be important for the hospital product in the long run.

[00:14:21]>> Yeah, this is the my very next question is why potassium.

[00:14:24]And I you've led right into it, but it seemed to me that when Dexcom announced that the first analyte it might focus on an analyte you know, I got to tell you Jake that was a word I had to look up. But as you listen, it is just the thing being measured.

[00:14:40]So some companies Abbott is going to be just got their ketone measurement is ketone CGM approved in Europe. They're going to work on United States approval.

[00:14:49]But you're working on potassium. And this is a little bit more clear now as we're looking at hospitals. But you mentioned lactate as the second one not ketones. Talk to me about the analyte issue that's now in front of CGM companies.

[00:15:04]>> Well, just so I'm clear, when you say analyte issue, you mean you know, choosing another analyte to sense is that a really different >> looks like the next frontier. So how do you decide what you're going to measure?

[00:15:15]How do you decide what you're going to promote that you can measure? Cuz my assumption is that once you figure out how to measure period, you can do all these things. You just to figure out how to get the readout to be accurate to the user or the doctor.

[00:15:28]>> Yeah, I think the number one thing that we're focused on is making sure we're meeting customer needs and enhancing and improving on that. And one of the things we recognize is there is still plenty of opportunity to make glucose sensing more reliable and more accurate. And I think we all have have experiences where majority of the [clears throat] time sensors are fantastic, but sometimes they need to be calibrated, sometimes they're not as accurate as you want, sometimes they're not as reliable as you want. So G8 has a lot of technology built into it that's brand new that really focuses in on glucose reliability.

[00:16:02]But then the next So that's why I want to make sure we don't forget about glucose. There's still a lot to do there. But when But when we talk about additional analytes, again it's around this making sure that you have a clinical outcome for the user that you're trying to drive. Potassium is a very clear example of there is no at-home test for potassium. You cannot do a finger stick and test potassium. You need a larger sample of blood.

[00:16:25]And I can go into like the details around hemolysis and why, but the main thing is there is no way to monitor this at home. And so patients have to go to a lab or a hospital to get it measured.

[00:16:34]And it can be deadly when it gets out of range. And a lot of people with type 2 diabetes suffer from other chronic diseases where potassium monitoring is very important. And they need to It's kind of life life and death situation.

[00:16:45]So we feel like that is a very clear unmet need that we want to do. Lactate is another. Ketone is one where I think there is value in ketone sensing, but I think there's a lot of work which we're doing to determine the right way to introduce it clinically. Like what are the right levels to alert at, how do you alert, and what is the guidance given to the user? There's no actual you know kind of clinical data at this point in time that talks about here's you know what you would do with a continuous ketone monitor. So, I think it's not you know when we think about priorities and what we're working on getting you know further enhancing our capabilities in glucose is priority number one for us. Then as we look at the analytics where we have multiple ones in development well beyond just ketones.

[00:17:32]>> Interesting. I will tell you Jake and I know like you said clinical stuff is different. But when you find yourself squeezing urine soaked cotton balls that have been in your son's diaper to figure out if there are ketones, a ketone monitor sounds handy.

[00:17:45]>> It would be helpful.

[00:17:46]>> One of those things. I know a small population of people with diabetes. But man, those were the days.

[00:17:53]You've mentioned G8 a couple times.

[00:17:54]Let's talk about that.

[00:17:56]What is going to be different here? Can you give us the high spots?

[00:18:00]>> Sure. Sure. So, start off with it's a brand new wearable.

[00:18:04]So, it's in a familiar architecture right as a sensor probe and a and a patch and then a a little kind of sensing unit that's attached to it. But it's half the size of the G7. So, it is much smaller. It's thinner. It everything about it is smaller and it has to to enable that we have a whole new design of the electronics that are inside the G8 platform. So, it's a smaller battery. It's a smaller electronics. It's more advanced electronics.

[00:18:33]And so, it's going to improve on all the aspects, the the size, the connectivity, the glucose sensing in particular. And in the glucose sensing side there's something really exciting technology that we've been working on for many many years is basically we put another capability into the system to measure another signal from the sensor that allows us to adjust the sensor over time while you're wearing it. So, the way that I describe it is it's like every so often you have a sensor that you feel maybe you use your you know use our calibration feature. You know, and particularly those that are you know really after accuracy and they they use that finger sticks to calibrate, but it you know, it's it's it's not easy. It's you know, not particularly convenient to to have a finger stick meter measure for for calibration.

[00:19:22]So, this system actually self-adapts it from that other signal where you can measure the health of the sensor and over time and that is one of the things that leads to this significant advancement in accuracy and a big part of it is just pulling the outliers in cuz the G7 is the most accurate and with the 15-day longest sensor out there, but there's still opportunities to improve it and so we we see that particularly the outlier sensors, this G8 system is going to help pull that pull that in and make it even more >> I don't want to put words in your mouth, but let me let me then ask it this way.

[00:19:56]So, if if you're not doing a finger stick calibration and again, I don't think Benny has done a finger stick in years, but you know, a finger stick blood is incredibly accurate.

[00:20:07]If you're not doing that and then you're you're relying on another substance that the Dexcom is measuring, how accurate is that other I don't know, I'm not really understanding in other words, like why would that be more accurate or just as accurate as a finger stick?

[00:20:23]>> One thing I'd say is the finger sticks are not that accurate.

[00:20:27]Like they're they're within a range, but you know, sometimes the sensor will be off and a finger stick is more accurate than the sensor, right? This in this situation the G8 will be proven in clinical studies where we use reference blood analyzers to you know, to show the performance.

[00:20:45]So, the performance of this product is really incredible. It makes good sensors better is really the way I think about it. It's just it it is it is a going to be a step change experience in terms of glucose.

[00:20:56]>> We'll both see those clinical trials, too. I mean, it'll be really fascinating.

[00:21:00]>> be and to see you know, when I think about AID user I mean, it's important for all of our users, even our Stelo users.

[00:21:05]You know, the the number one reason people stop using a CGM today, whether it's Dexcom or a competitor's product, is because they don't feel that the glucose data is reliable on.

[00:21:15]That's the number one reason. And so, that's why we're like, the number one thing to do is to go after that.

[00:21:21]>> All right, let's talk about this advisory council.

[00:21:23]>> Yeah.

[00:21:24]>> Um, and I guess my top question from it is this this release and the reporting I've seen around it seems like it's a real um mea culpa in a way from Dexcom.

[00:21:34]Like, we heard you had complaints, we're listening, um here's what we're going to do. So, rather than go through much of the report in the remaining time I have left, can you focus on the the issues they identified? Uh uh goosenecking, adhesive. Let's start with those two.

[00:21:50]What improvements is Dexcom going to make here?

[00:21:52]>> So, I think what around the um deployment sensor deployment issues that we kind of really ran into uh at the beginning of last year, that one was one that we we identified clearly ourselves uh cuz we can see sensor performance. We saw that failure mode creeping up uh and we went and attacked it uh and uh you know, learned a lot and really brought the reliability product uh improved it.

[00:22:14]And now at this point in time, um we're just below our historic levels for that failure mode, which is very very low. And we actually out of the work that we did there, we we're uh going to drive it down to I mean, the goal is to get to zero out of box out of box deployment failures.

[00:22:29]Uh and you know, it it's a it's a pretty sophisticated system of deploying that sensor under the skin. And one of the challenges was one that we did run into was they didn't always get deployed in the skin, so you had this like loop on the sensor, which is why it was called a gooseneck.

[00:22:42]Uh and uh that was a creative name. But uh you know, we didn't want to see that.

[00:22:45]We don't we never want to see that. So, um we we attacked that and that's one of the things that obviously everybody um uh you know, has talked about and it was brought up. But some of the things I think that were important learnings in there um from from the patients was really just around friction points. That was really where we were after understanding where we adding burden to someone's life with diabetes. Our goal is always to reduce the burden. And you know, we always have the best intent. Uh we always put the customers, you know, intentions first. But we don't sometimes when we actually implement it, particularly at scale now with the the number of patients we serve, you know, we serve over 3 1/2 million people uh and that number continues to grow quite rapidly and it's a very diverse group of people.

[00:23:28]We have systems that at this point in time would we're adding friction um things around, you know, customer support um replacement sensors when needed. All of those things uh we learned quite a bit from the council around there. Even just how um messages were being interpreted. And some things [clears throat] were like our intent was not being interpreted properly and so it's on us to correct that level of communication. Um we're also making um enhancements to the devices. Um connectivity is a big focus. We've made a lot of enhancements to connectivity.

[00:23:57]Patch adhesion. So we've got a new patch that we're launching. So um some of this was reaffirmed by the the advisory council in terms of things we are already working on and some of it is new work that was spawned based on our um feedback from that council which the important part of the council for me was I you know, I worked with the team to kick that off uh earlier this year as I became the CEO was I really wanted I didn't want to just hear everyone tell us how great we were. I wanted to find out really where the friction points were. And and to get open and honest feedback around what we needed to do better. And so that was a big part of the council. So we and you know, uh that that was a very diverse group of people on that council. And some of them um were some of our more vocal critics which was something I wanted to hear. I wanted to hear from everybody. And that was um helpful >> [clears throat] >> uh for for all of us.

[00:24:45]>> Okay. I don't know if anybody else is going to ask you about this, so I will.

[00:24:48]Um of the 17 people on that council, um I know four of them who who take money from Dexcom. Kind of like how I take money from Dexcom, right? We're very up front about that. You guys have ads that run on the podcast. I always talk about disclosures. You and I did not talk about these questions ahead of time. You know, you're not editing what I say. Um but I also do uh take money in the form of sponsorship for Moms' Night Out. And there are at least four people on that list. I can look at that and say, "Yep, yep, yep." And while the report looks great, right? The concerns seem to be the concern of the community, it's not disclosed anywhere.

[00:25:22]Um so first, can you disclose that at the next report? I think that's really important for credibility, not just for Dexcom, but for those people who should have disclosed it themselves.

[00:25:32]And don't just Why? Why do you let people on the council are taking money?

[00:25:36]>> I think >> I was disappointed in that, Jake.

[00:25:39]>> Interesting. Okay, well, that's that's good feedback. That's good to understand. I think the reason why we you know, as we look at the makeup of that >> even apply. Like, why? What Okay, go ahead. I'm sorry.

[00:25:49]>> Well, I think I think I I what I what I what I what I what I what I would say is the feedback that we got from them, I could guarantee you was not influenced by our support of their programs. They are all actual users or family members of users, have a lot of experience, and have an outlet for them to talk about their experience. And I think if you look at the folks particularly even the ones on the council that we sponsor [clears throat] some of their work, they're they don't hold back punches.

[00:26:16]They tell it like it is. If you watch any of their content, they're not they're definitely giving us raw feedback. And I think through the council, we even you know, we got even a little deeper into things.

[00:26:26]And so, I think disclosure is a great point. Like, we'll make sure that that's very, very clear.

[00:26:31]But, I I can guarantee you that did not impact We Like I said, I didn't want people to tell us how great we are. I wanted to hear about what we needed to do better.

[00:26:39]>> Now you're thinking, "Why did I let these people punch me in the face, and I paid them?"

[00:26:43]>> [laughter] >> No, it's it's I mean, in the end, we're all doing this for the same reason, which is to drive better care for people with diabetes.

[00:26:51]>> Well, I appreciate you answering that, because I was I was just surprised to see that. Um I I know we don't have a ton of time left. One thing I did forget to ask you about though was the Dexcom Flex.

[00:27:01]>> Yeah.

[00:27:01]>> What is that? I know it's only in Germany, right? But what is it?

[00:27:04]>> So, basically, um outside the United States, as well as inside the United States, there's you know, we have different a portfolio of products. In the US, we have G7 and Stelo. They kind of covers this huge um opportunity for helping people manage better manage their glucose different patients. When you go outside the US, we have a portfolio, too.

[00:27:21]We have a product called Dexcom One Plus. It's not available here in the US.

[00:27:24]It's available outside the US. It's really for people who um use insulin but don't use AID. And that's the majority of people that are on multiple daily injections.

[00:27:33]Um I think the stat's actually 94% of people on in the world that are on MDI are using injections, not closed-loop AID systems.

[00:27:41]So, uh Dexcom One Plus is a product for that um segment in Germany.

[00:27:47]So, there's G7 for um all intensive insulin users, whether you're a type one or type two. Uh and we're starting to see access um open up for basal insulin users. And so, those with type two using single injections per day, long-acting insulin. And that it's Flex product is specifically designed for that population. Uh and so, you the like our feature like smart basal and some of the things that we're introducing here in the US on G7, that'll be built in um uh to the the Flex product. So, it's really a product that's specifically for that population. And we find that different healthcare systems work differently. So, that's why we have this portfolio outside the US in terms of um making sure we've got the right product for the different um uh profiles of patients.

[00:28:29]>> And then final question here, I it it leads me to think, do you see a time where or really where kind of sounds like with the Connect study and other things we're already getting there, where a Dexcom product you might flip a switch within the software and say, "I'm a type one insulin, you know, I use insulin in this way. I'm on an automated system or I'm a person who uses a once-weekly shot of basal insulin and then I'm on MDI or I take a once-weekly shot of basal, but I use a GLP-1 the rest of the time and I don't take fast-acting insulin. I mean, all of these things are it's fascinating to see how much it's changed and developed.

[00:29:03]Could we see Dexcom be that flexible?

[00:29:07]>> Yeah. Yeah, that I mean, ultimately over time that's what we want to get to.

[00:29:10]You know, we're always trying to be the easiest to use, least amount of friction, and really drive meaningful value. And I think your point around this, you know, there's all these different options, it speaks to the power of CGM across such a large population. It It can really drive a lot of benefit for a lot of people and the different use cases, uh we want features that really speak to those users and we want to innovate for everybody, including, I want to make sure this is extremely clear, our type 1 community is still extremely important to us and we're going to continue to innovate um on our products for for them. When I think about G8 and the accuracy and reliability and size of that sensor, it is the absolute um best sensor for that for our type 1 community as well as our others because, you know, what you when you're driving an AID system, you want the most accurate reliable sensor possible. Uh and so that's why we think that's a really important feature. We're also doing some stuff with the follow app here coming up soon that's going to be um a really exciting. Uh it's a long uh requested feature around acknowledging alerts um and make sure that the followers know that the um action was [clears throat] taken on the glucose alert that they received by the users.

[00:30:15]So, there's a a bunch more coming, but we're really >> Always.

[00:30:20]Always. Well, there's always more to talk about, but I really appreciate your time, Jake, especially at ADA. I know how busy everything is there. So, we'll talk again soon, um but thanks for your time and I hope the rest of the conference goes well.

[00:30:33]>> Thanks, Stacey. Great to catch up.