#194 Dexcom Returns

Jake Leach is back...

Dexcom's SVP of R&D is here to talk about your favorite CGM!

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DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.

Scott Benner 0:00
Hello friends welcome to Episode 194 of the Juicebox Podcast. Today we're sponsored by Dexcom. On the pod and dancing for diabetes, there are links in your show notes, but you can always go to my omnipod.com Ford slash juicebox dancing the number four diabetes.com or dexcom.com, forward slash juicebox.

On today's show, we welcome Jake Leach back. That's right, the Dexcom, Senior VP of research and development is back on the show to tell us about new developments with Dexcom. And answer a ton of questions that were submitted by you the listeners through Facebook and Instagram. Jake was very generous with his time today. So let's not waste any more of your time getting to the show. I'm not even going to give you the tease about what's on this episode. It's all of your questions, and everything Jake was allowed to talk about. Alright, before we get to it, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, and to always consult a physician before making changes to your health care

Unknown Speaker 1:08
plan. Hello is Jake, Jake and Scott? Hey, Scott. You know, we're

Scott Benner 1:32
recording right away. So I,

Unknown Speaker 1:33
you know,

Scott Benner 1:34
besides having you on last time, you said hey, I'm gonna have stuff to talk about after I go to Germany, which I thought was great. I actually reached out into the, into the, into the world and got a few questions for you that I'm going to rapid fire through at the end if we have time, which I think we will. Awesome. Okay, so the last time you were on, I can't believe I'm saying this. I kind of forget why you came on. I think we were talking about g sex. That's right. And it arriving right. And sort of at the end of the episode I said, Is there you know anything else you can tell me about stuff? That's common? And you said after October? So it's after October?

Jake Leach 2:11
Tell me all Yeah. I'd love to tell you every I'd love to tell you everything. But I've got the we got a number of exciting things that are now becoming public that we can I can talk about and obviously have a lot of exciting stuff in the pipeline that will also be coming out but influence influence partnerships as some of our new newest announcements so we can spend some time talking about how we're integrating g six with a number of influence and delivery partners.

Scott Benner 2:40
Okay, well, I'm thrilled because this is, you know, the first time that I genuinely have no idea what we're going to talk about. So I'm excited to find out along with everybody else. I don't even know where to start. Go ahead. What's the most exciting thing it's about that?

Jake Leach 2:55
Well, one of the one of the things that we that Novo Nordisk announced that the E ASD was that we've partnered together Dexcom and Novo Nordisk have partnered to develop diabetes technology, specifically around connected insulin pens. Also, some folks call them smart pens. But what it basically is, is it's a number of insulin pens that they are, have had in development, and are planning to launch as early as next year. And what they are is their pens to keep track of insulin doses, and then communicate via a couple different technologies, some, some are NFC, and some can be Bluetooth, communicate those readings to your phone. And so you're moving forward, the Dexcom app will be able to record insulin doses for those on MDI therapy, the influence and injections can be loaded into the phone. And then you can imagine all of the exciting algorithms and decision support technology that can be developed once you have a good valid insulin data, communicate to the app. That's the whole point is that we want it to be done passively. So that the users aren't typing in or trying to track themselves or their insulin doses. It's all about the pen. They know the technology doing that for them. Okay.

Scott Benner 4:26
Yeah, because I think that's a speed bump for people really, when you have to log things. It seems good in theory, right? Until you're, you know, injecting, you know, I don't know, on a park bench, and you're think I'm not gonna put this in my app. now. I'll do it later. And you'd ever remember that kind of thing. So these pens are just going to speak to an app or they're going to speak to the Dexcom that

Jake Leach 4:49
they'll speak to the Dexcom app. There's also other partners that novo announced that they are partners like gluco that will also be able to access the data. So There's a quite a bit of work going on, on developing the kind of architecture and how the apps coexist and how the data flows. But it's exciting that we have another originally we had Lily on the pen side, we still do. And now we have the next large insulin manufacturer kind of coming on board and connecting with Dexcom. So, we're pretty excited about that. Partnerships been, we've been working on it for a while. And so it was just recently announced last month. So we're gonna, you know, head down and develop some exciting products for both the US and outside the US.

Scott Benner 5:38
I have to ask, even though you won't be able to tell me but is there a timeline for it?

Jake Leach 5:42
Well, what what Nobu announced is that it's been public is that they're expecting to launch some of these pins in early 2019. In in key key markets, so they have a number of markets inside and outside the US. So the plans will continue to firm up, but they're planning to get the technology out soon. In 2019, which obviously means it's been in development for a while. You know,

Scott Benner 6:09
it's kind of incredible, as you're saying this, it strikes me that in the world I grew up in and I'm, you know, I'm getting towards 50 now, but in the world I grew up in there be I don't want to call them monopolies. But you if you made an if you made an agreement with a pen company, it would be with that pen company, and that would be kind of your power base, like your power would be in exclusivity. But now the power is in choice. It really is. It's a paradigm shift. Really, it's it's interesting that you're working with Lilly working with novo they all have these smart pens, and you're happy to do business with with any of them that are that are doing good work. It's it's really, do you know what I mean, how that's sort of uncommon for somebody my age, at least to look back on the way the world used to work.

Jake Leach 6:55
It is, it is a, you know, kind of the always been a key focus of Dexcom. To be, you know, we're very open, we really feel that partners can really amplify the value of our CGM, as well as our CGM can amplify the value of their systems. And so early on, we made the decision to non exclusively partner. Our first two insulin partnerships were with animals and intellect, you know, many years ago is when we first started those relationships and said, you know, what, we're, we're not going to be exclusive, or we're going to work with all the different options, because you said it's got it's all about choice. And some patients choose to use an insulin pump. For continuous infusion, others, find the pens, kind of their therapy of choice. So it really, our goal is to kind of cover as many options as we can with or different partnerships, both on the pen and the insulin pump side.

Scott Benner 7:53
I think it speaks to the quality of Dexcom, too, that the pump companies and the pen companies then are willing to do don't mean like, it's to be able to say, hey, it's on the pod with Dexcom, or it's, you know, tandem with Dexcom. Like, that's kind of that's interesting, I think, I think that shows that you guys are our leaders in the in the space for sure. Okay, cool. So, smart pens coming, that that are gonna make decisions. And basically, you're going to what you're going to start getting not only decision based data back, but sort of that it'll also log so that you kind of have the, I guess the information that a pump would give you to insulin on board time left, and that sort of idea is all going to be there. We interrupt your regularly scheduled podcast to remind you to go to dancing for diabetes.com. That's dancing, the number four diabetes.com.

Jake Leach 8:45
That's right. That's right. It'll be a lot of info on board. And then you can start algorithms that give guidance on around insulin dosing. We'll start with insulin visualization. So making sure that the insulin is captured, particularly in our retrospective views. So you can imagine for the healthcare provider, when you go into the clinic, you know, up into this point, the information from a MDI user is fairly challenging because they're giving their doses as they need whether you know, eating their meals, but you're not really getting an electronic copy of that. So this one, the idea is healthcare providers not going to get high quality data from the insulin pens visualized in clarity. So there's a lot of opportunity and visualization of insulin data in follow. That's another feature that we're looking at, because Wouldn't it be great to be able to see influence, delivery as well as glucose and excursion within the follow up, both for our pump and pen partners, we think that would be a really good feature for follow that we've actually already enabled it in the cloud in the back end, and so we just have to do the visualization. When we have to have the connection to the partner data, and then we do the visualizations both in clarity and in follow, and in the G six app. So a lot of a lot of work been going on behind the scenes there and now are excited to start getting ready to bring some of it to the market. And to

Scott Benner 10:18
extrapolate even further into the future. Even though it wouldn't be exactly the same. You could have that app prompt you when to, to Bolus. So it would almost be like as close as you could get to a closed loop system. But with MDI, is that reason? That's right,

Jake Leach 10:34
that's exactly how you got to Scott. And we can even we can detect missed meal, Miss boluses. I mean, imagine, you start to see a glucose excursion with no insulin delivery, you can actually prompt the user to say, Hey, did you remember to take that take that bolus, so there's quite, there's quite a bit of advice, guidance help that a system can provide, I think the key has always been got to be easy to use. And it's got to not cause you got to get a lot of benefit from it, you know, in order to be able to, you know, in order to use the devices. So these things have to be really simple. So,

Scott Benner 11:11
can I asked you to pretend with me for a second say I'm using this system in the future. And I'm injecting, and I'm and it tells and I forget to tell it, hey, I'm having a large meal. And it it can see my blood sugar starts going up. So it says to me, Hey, did you remember the Bolus? And I think, Oh, I didn't. And then can it? Can I tell it? Well, that's the meal I ate around this time. Could it make an insulin decision, not just based on the carbs, but on what it's seeing with my blood sugar as well?

Jake Leach 11:42
Absolutely, absolutely. I think the, you know, Bolus calculator. There's lots of them in existence today. But what what doesn't exist is a is a bolus calculator that not only takes a glucose level into account, but also takes change in direction. You know, there's a number of protocols with a number of, you know, guidances out there about how to dose insulin based on you know, glucose change and to train the arrows on your on your CGM. But if you can imagine that you would be fairly simple to take that and generate an algorithm that just prompts the user with, here's a glucose change, here's how much your blood sugar is, here's how much if it's correction dose here, so much insulins on board. And then you could basically enter carbohydrates, there's a lot of exciting work going on in terms of out to help folks estimate carbohydrates and a lot of thought on pattern recognition there. I mean, if you think about it, people don't eat. Most people don't eat, you know, dramatically different meals every day. to kind of have handled the added quite a few patterns, right? So you could start to understand for a certain person, what are the different meal sizes look like? So it may not have to be am dialing in exact number of carbs. It could be more like I'm having my typical breakfast.

Scott Benner 13:03
See, you're gonna put my podcast out of business, Jake, because I talked I talked about obviously Pre-Bolus thing is just monumentally important. But if you miss on Pre-Bolus, or Pre-Bolus in time, or Pre-Bolus just isn't possible. Then I talked about over bolusing. So Bolus for the carbs, then Bolus for the spike that's going to come because you didn't Pre-Bolus and Bolus for the momentum that the food causes. And it's a guessing game right when you're doing it without an algorithm. All this talk about algorithms and the future is making me excited. It also makes me incredibly happy that Arden is an omni pod user already. Because once all of this comes together, not only is Arden going to have all of the goodness that comes from this Dexcom stuff, but she's going to have the only tubeless insulin pump to make it all happen. But even before all that integration is finalized, I believe that Arden is incredibly lucky to be using a tubeless insulin pump that allows her the freedom to live the way she wants without being connected to a device and a bunch of tubing. The best part about the Omni pod really is it small form factor that it's self contained that holds your insulin, and that when you need to talk to it. It's not connected to something that you have to keep clipped to you. There's this little device off to the side, you push a couple buttons on it, tell it you want insulin, and then there's a wireless transmission that happens between that device and the pod in the bowl is just happened. Actually a little later in this episode, you're going to hear Jake talk about something about Omni pod that's going to make you incredibly excited. I don't want to spill the beans yet, but trust me when you hear it. It's gonna make a giggle.

Unknown Speaker 14:34
Like a little gleeful he like that.

Scott Benner 14:36
That's not playful. I can't do it anyway, it'll be delay. In the meantime, if you're not already using the Omni pod Today's the day to start and it's super simple. All you need to do is go to my omnipod.com forward slash juicebox. There you can try a free no obligation demo the pod they'll actually send you one out that you can wear and try for yourself. You can absolutely not be free. You cannot beat no obligate Just go on Miami pod.com Ford slash juice box, fill in the tiniest bit of information, get the demo, see what you think and get ready for the future, you want to be ready when the future gets here, you don't want to be standing around like oh, and the futures here, I didn't know.

Jake Leach 15:17
What's next, what we've got just a quick, kind of to touch on on the insulin pump side. We one thing I think we mentioned last time, when you and I spoke was that Dexcom had recently acquired type zero technologies, which is a group in Charlottesville, Virginia to spin out of the University of Virginia. They've licensed technology from the university and have a close working relationship with the technologist at the university. And what they've developed is both closed loop algorithms for insulin pump delivery, which is what's that technology thing implemented the next generation of the tandem pump, it's called control IQ. And so tandems that clearly clearly come through study. So there's that technology on the insulin pump side that we plan to make available to, to our pump partners, and continue to evolve that technology working closely with tandem on a next generation have even passed what they're having clinical studies now. And so we have that technology. But that group also as part of our approach to the decision support algorithms that united talked about. So that group was doing it was actually even conducting studies on MDI, in a, they called it the control, or the in control advisor is actually an app that gave advice about their diabetes, in terms of insulin and how much to take. And so was actually recording a lot of information during a study. So that study is still ongoing. And we're learning quite a bit about how to implement a good decision support system from that study. And we're just basically taking a team from type zero and combining it with some of our internal efforts, you know, to really supercharge this focus on decision support. But what guidance we can help give patients now that we've got, you know, accurate CGM, reliable CGM ratings along with insulin data. So we've got to kind of both sides covered. On our pump side, we've got tandem spoke about, we've got insolate. And with their horizon system, which is they've been continuing providing updates on the progress. They're, they're planning to enter clinical studies soon with that. One of the interesting things that they recently announced that if you heard this with it, they are now partnered with Samsung to bring to market the ability to dose your influence. So from hydro boluses, or make pump adjustments from your own cell phone. So it would be an insolent app on your phone that allows you to provide dosing guidance, which is really exciting because we for a long time at Dexcom, we've always taught that cell phone is a great interface for many, not for everybody. But for many patients. That's a very convenient option. And with the insulin system, we always had this extra PDM. Yeah, to carry the programmer. And now, for those who want to use their phone, they can use that connection on their phone. So that that was an exciting announcement that came out at the Samsung developer conference last week. But both insulin index contenders.

Scott Benner 18:32
I haven't dug into that as far as I have, but just the just the overarching announcement in seven days, became the second most popular blog post on my blog this year.

Jake Leach 18:45
And Oh, nice. I'm so excited. Yeah, I'm

Scott Benner 18:47
assuming you know what the most popular one was. But yeah, it's you guys. You guys are the I think that on the pod index commerce are the two most kind of compelling technologies in diabetes, but But anyway, that's, it's amazing. It's incredible. Can I ask you a sort of related question? Do you guys do you guys see pumps with closed loop systems? Do you see glucagon ever being necessary in the closed loop? Where do you think the algorithm will make the glucagon not necessary? Would you not care?

Jake Leach 19:17
You know, it's a it's a great question. It's got because we haven't, we're partnered with beta bionics, which is a you know, founded by Ed Damiano. And his approach has always been to use glucagon. You know, by hormonal, we got insulin and glucagon. And he's, you know, he's produced some really exciting results with that system, in both adults and in pediatrics, you know, in different environments. And I think what from for me, one of the things I always struggled with early on with it with the concept of glucagon in the closed loop was that there just wasn't nobody had pumps stable glucagon. Yeah. So He had to, he had to mix it, you know, and a lot of stuff that Ed was doing was he, every day, you had to either mix a new version of the glucagon and then put it into the reservoir or the pump. So I always thought, Boy, that's a real hassle. I don't know if the benefits are worth doing that. But he can he believe in the technology. And so he's been working with a couple of different manufacturers on, you know, making pump stable glucagon available, you know, so he's made a lot of targets there, I think there's still more road to go. But I think it's much more of a possibility now that you're getting glucagon that can remain stable in a pump for multiple days. So it's interesting to see, I think there's, you know, there's, there's, it's more of a system with the two drugs in it more complex, but, you know, potentially could get better outcomes from it. So the answer really is, I don't know, I think we're, we're partnered with some folks that are working on single hormone and with add on is dual hormone. And we'll see, you know, I think what's gonna end up happening is the usability of the product. And the clinical outcomes are kind of the two keys, ease to the product, as well as cost, you know, what, how are these markets going to evolve over time, my expectation across all the markets is we're going to continue to improve the technologies reduce the cost of them.

Scott Benner 21:19
So that'll be another important aspect of the technology. There's a small company in Chicago that's getting ready to put their their stable glucagon, I think into FDA. into the process.

Unknown Speaker 21:30
Yeah. Okay.

Scott Benner 21:32
Well, yeah, I just was wondering, like, because it makes sense that if you had if you if you could bump both ways, not just make, you know, kind of your future decisions based on on algorithm data that I get, I assumed it would be easier, but you make a point about cost, and something's going to come up later while we're talking. But okay, that's, that's absolutely terrific. I'm at a loss. I don't know what they ask you about next.

Jake Leach 21:56
Well, give me some more updates. So we've, we started last month, we started launching g six outside the US. So we started with the murky markets outside the US, Germany, Switzerland, UK, and we're going to continue to roll it out over the coming months. But our plan is to roll it out as fast as possible. We already overall there's more cheese users on G six than there are on G five. So we've been very quickly upgrading all the patients that g six got and balancing our ability to manufacture the product that we you know, we've been continually increasing the scale of our manufacturing operation on G six. And we've had some We've had a few struggle jiki broke up. You are completely gone. I can't hear.

Unknown Speaker 22:50
Did I lose you?

Unknown Speaker 22:54
I definitely lost you. Oh, a second. Everybody.

Scott Benner 22:57
On Jake on a cell phone today?

Jake Leach 22:58
We don't usually do that. Sorry about that. I guess we got cut off. Don't

Scott Benner 23:11
worry about you were set. I think you were getting ready to tell me you were talking about supply chain, I think.

Jake Leach 23:17
Okay, yeah. So we are, yeah, we're ramping g six as fast as possible. And we are, you know, excited about what we're seeing in the market. There's more users on G six that are on G five now. And we will you know, our plan is to get as many people on G six as possible. We recently got approval for Medicare with G six. So we're planning to launch that as soon as we have capacity to do that. So yeah, for us all things, g six, we're working on enhancements to that platform, and also working on our next generation platform, the g7.

Scott Benner 23:55
Okay, so let me ask you a question about supply chain because I reached out into the community. And there was a couple of things that I got asked about multiple multiple times. One of them was that. So it's interesting that some people experience it. Forget what the issue is, sometimes issues are experienced by some people and not by others, which must be a phenomenon makes you mental. But because like for instance, I have Arden's had the G six since the limited market release, so we have to be up on six months now, right, if not longer, and we have not had one failed sensor, every one of those made it 10 days. But then you'll hear somebody say I can't get any of my sensors to last more than seven days or six, you know, like that kind of thing. And the same goes with supply. I hear people say all the time that customer service is slower now that they've grown, which we've seen in the past, Kevin's been on the past and talked about that, like we grew really big. We're trying to catch up with customer service, we'll get there and that there's a problem with supplies. But as an example in my life, when by the way I want everyone to understand that when I call Dexcom it's not like a like a different phone rings too. So I call the same customer service people you do my account doesn't say the guy from the podcast. And I said, Hey, you know what I mean, it's time for me to order sensors. And I waited for I was on hold and had the whole, the whole call was done in less than 10 minutes and stuff arrived Three days later. Why is it different for some people than others?

Jake Leach 25:18
It's a great, great question, the dog project comes into play. So when it comes to just product performance, one of the things we're very proud of is that as we've continued to scale g six, we've been able to keep the product quality high. And so what I would say is what from from the data that I've looked at G six, often new users to the system, whether they're particularly if they're new to CGM, or even if they're just new to the G six system, because it is different. Sometimes it takes a little while to figure out some of the tricks to make and stuff, you know, and sensors last stay on all of those, all of those things. So what we've seen is new users continue to get better experiences with the product in terms of sensor lasting, Bluetooth connectivity, all of those things, once they learn some of the tricks to getting a feel for the for the system to work. And we we've uh, we're one of the things we're focused on is how do we continue to make it so that you don't have to know the cycle your Bluetooth on and off to fix your connection, or, you know, make sure you really clean the scan and don't use, you know, like, some sort of lotion on before you put your sensors on, and how you treat the adhesive and all those things, right. But all the things you've learned over years of using a CGM product. So, but you know, some some patients, but, you know, not all sensors last, they do, they can stop before 10 days. And so we, you know, we want those people to call in, we want to be able to replace their sensors. So I think, you know, different experiences, there are lots of different experiences out there. But from everything I've seen, the quality of the product is still still very high, even though, you know, we're continuing to scale manufacturing. on the supply side, it's a very, it's a very complex story, because different people based on their insurance and how they get the product or middle determine, and of what looks to happen, I'll give you an example. Some patients get the product directly from us. Some patients get them through a distributor, the distributors make very large orders from us. And then they take those orders, and they provide them to the patient. And so depending on which distributor you have, how they do their orders, and when you know, we do run into some sort of supply issue can dictate who could run into an issue and who doesn't. Our goal is to make sure that nobody runs into a backorder situation, whether it's a direct customer or through a distributor, or through the pharmacy, because more and more patients are starting to get the product in the pharmacy.

Scott Benner 27:58
So jump in for a second. Yeah, so a distributor, a distributor can throw out like they can make a decision to throttle their shipments. But that doesn't mean that. So I think what people imagine is that there's a big Dexcom warehouse somewhere and it's empty, and there's no stuff in it. And I believe that by No, I read through this stuff, and I think oh my gosh, thank God, I don't have like a market research shop. Because as I'm reading through people's questions, you can sort of see where sometimes this they don't realize that the questions very specific to them. Or that just because they went online and saw 20 people say the same thing. That doesn't mean anything because I don't think you guys do you guys release your actual amount of users. Would you? You don't say that. Do you publicly? No, no, I

Jake Leach 28:42
don't I don't I don't believe in anything, but it's the same

Scott Benner 28:44
but but if I said that I saw 100 people saying the same thing. That would be a tiny percentage of the overall users. It absolutely and imperceivable amount almost. And so and so that's sort of the internet playing tricks on you once in a while and when it's happening to you it's as real as it could be. You don't I mean like like you said something just a second ago was amazing. But you know, you put on the new g six right? You stick it on your break off the little tab you push the button and it's on. But how many people then go back and push down on the adhesive when they're finished? I do that and they never fall off of Arden. You don't I mean, like as Arden's been moving towards her first shower, she'll come to me and say, hey, let's cover this next calm before I jump in the shower, like little stuff that that takes you from thinking, Oh, this thing doesn't work to me just understanding like, Oh, this is exactly how this works. There's this thing that is incredibly specific. It's this device that's incredibly specific. It's static, trying to be put on what I'm guessing is hundreds of thousands of different people with different skin types, different hand lotions different bla bla bla bla bla. And it's interesting because it's easy to feel like it's you and it must be this horrible problem. But I will say that we've been using on the pod forever like it got it's gotta be it's 10 years. In the first week I had on the pot, three of them must have, I took them off. And I thought, Oh my God, this thing stinks. It doesn't work. And then I realized, like two months into it, that each one of those was me. Like, I just, I didn't do something that I now know how to do. And it's just very interesting, because when you're caught in that moment is super simple to feel like, this is a huge world issue. And it has to be happening everywhere. So my point is, is I believe that when somebody says, You know, I reached out to edgepark, and edgepark said, that there's a supply issue, they are apt to then blame Dexcom, not edgepark. But is that the case? Or how does it actually and I didn't mean to use edgepark as an example, but like a distributor can throttle their own stuff? That's a supply issue. That doesn't necessarily mean you don't have it? Is that what I'm, is that right?

Jake Leach 30:44
Yeah, generally what, if a distributor is struggling to meet an order, it's generally because their shipment from Dexcom, either they didn't order enough, or we weren't able to send enough, you know, to meet their forwarder. And then we're going to send a bunch more, but because one distributor is running into an issue doesn't mean the other distributors have that same issue. And doesn't mean that Dexcom direct customers or pharmacy customers will have it's one of those, you just kind of if you're tight on supply, somebody somewhere is going to get hit by that. And then our goal is to prioritize anybody who doesn't have sensors, we got to get, you know, get them sensors as fast as possible. So it's one of those things it's not, it's kind of it can move around, based on you know, what timing, but we are continuing to ramp and we're gonna, you know, our expectation is, we'll have plenty, plenty of capacity. We're almost there now. And so we, but we got to grow, you know, demand is definitely outpacing what we thought, we just the awareness around Dexcom CGM g six, it's, we knew it was going to be high, but it's a little higher than we planned. So yeah, we, we, you know, in hindsight, for our next launch, we'll plan or plan for even more demand than we think just just to be safe.

Scott Benner 32:05
I can I can I can we extrapolate that that same statement and sentiment applies to customer service that you're you're adding to that now?

Jake Leach 32:13
Oh, absolutely. Yeah, absolutely. We're, yeah, we're continuing to add more and more folks across our different call centers, depending on what technical support or customer support for orders. Patient Care, for those that need extra extra help. So we've definitely got all all those head counts are increasing so that we can make sure we can answer get to those phones. We we keep tight metrics on all the our ability to you know, how quickly can we answer phones? How long are folks on weight, and every time I see a long wait time, I feel feel awful. It's like, Hey, we got to get you know, this person needs help. Let's get somebody on it. So we're doing everything we can to bring on more folks.

Scott Benner 32:54
It's very cool. It's so funny how cyclical this whole thing is, like, I had this conversation with Kevin two years ago. Like, like, it's the same conversation like I'm going to ask you in a little bit like to explain like how Bluetooth works again, because the people who heard that explanation, some of them are off in their lives now. And now there are new people coming on, they need these same explanations. But first, do you have any other because? Any other announcements that we haven't touched on yet?

Jake Leach 33:20
No, I think I think, Scott, I think we've hit it all.

Scott Benner 33:22
Okay, so now we're gonna know we're gonna play fast money here. All right, we're gonna we're gonna whip through and see how quickly Jay can talk.

Jake Leach 33:30
I love it.

Scott Benner 33:31
Alright, so I have some now questions and some asks. Great, yeah. So I think some of them we've hit already, there are people who think the sensor failure rate is greater with G six and G five. Does any of the data support that statement?

Jake Leach 33:47
It does not. But what I will say is that the adhesive on G six, although it's a different shape, and a little more actual piece of material on V 6000. v five is the same past material. So if you are struggling, it is answer. The stands for seven is going to be more challenging for 10 days. So I think that in that aspect. Let's see in terms of our kind of rates, the replacement and rates of relapse, we're seeing good performance. But people do have issues and you know, within the product doesn't always last a full 10 days. So we are continuing to improve it. We do have a new patch material that will be coming out soon, which is very similar, same materials, but a little bit more advanced design on the patch side. So we're excited to see how that does in the market.

Scott Benner 34:45
Some of that somebody did. Is it possible that the Dexcom rep would have handed me some of that at the jdrf event in Ohio last week. He said out

Jake Leach 34:51
that. I don't know. I don't know. I know. I know. We're close on it. So I don't know. I know we haven't cut over full production to it. Okay. But you may have gotten some early access to it. But yeah, it's a little, little state here. And from our clinical studies, we've run with it. We've seen, you know, really good performance, folks that we're having issues with, with the older patch sticking this one, let's fix the vignette stuff better for them and their sensors. So that's Yeah, so we're not seeing sensor g six different but you know, 10 days is longer. So, you know, the poles can have issues. Okay.

Scott Benner 35:30
Okay. Let's see, did that. And that leads me to the next question. A bunch of people asked me, is the adhesive any different than prior?

Jake Leach 35:39
No, no, it is not not, not on the first year at present g six out there today. But there is a new new version coming, that's going to be at least from our clinical studies, you should be sticking around to stay on longer timeline for the new season. It's going to I don't know the exact time, but it'll definitely be out. Within, if not this year, next year.

Scott Benner 36:01
This is here, this one was huge. Is my Apple Watch ever gonna be able to act as you know, as my receiver without a phone nearby?

Jake Leach 36:13
Yes, the answer is yes. The timing is still you know, we're still working through all the challenges of the complexity of the Bluetooth under the hood. So you know, we've been working on the Apple Watch project since before Apple announced it, not this summer, but the past one. And what we found through working with Apple and working with the products is that the original user experience from some of the initial implementation from Apple, it wouldn't have been what we wanted, it would have been too complex and kind of frustrating for most people. So Apple's made a lot of enhancements on the way that the watch Bluetooth functions. And so a lot of it is very beneficial to the CGM communicating directly to the watch without a phone or receiver model. And so we're deep in development on net. And we're working on out the chain, the Bluetooth protocols within the transmitter. It can't support a direct to watch connection. But we will get there. Apple is committed to it, we're committed to it, we're going to make it happen. It's just taking longer than we want and longer than we hoped. But it's a very active project. And we don't have any timing on it. But it's it's as soon as possible the new operating system from The watch has allowed us to make a lot of progress on this development. We were a little bit stalled for a bit because there there's some challenges with how the system would pair to the transmitter. And so, but we've overcome most of that there's still a few things we got to fix, or figure out how to solve.

Scott Benner 37:54
So is it a hardware issue? or salt? Like what if I have an older watchmate? My might I just not be involved in this when it finally comes to fruition? Or was it more about the operating system? If you're listening to Jake right now and thinking How is it possible? I don't have a Dexcom it's time to get moving dexcom.com forward slash juice box. There's also links in your show notes. That's where you go. That's where you get this whole process started.

Unknown Speaker 38:21
Come on. Think

Scott Benner 38:22
about it. Listen to what he's saying. No finger sticks, integration, decision making. Everything is coming like a freight train. The future is bearing down on you like a bear in the woods and you're holding the big honeypot. Here comes your go.

Unknown Speaker 38:39
Hey,

Scott Benner 38:39
it's the future coming.

Unknown Speaker 38:41
Boo.

Scott Benner 38:41
I'm almost here. Here it Here it is. It's sneaking up behind it. It's not even that it's kind of like a big heavy footsteps. And it's like it's not even sneaking. Really it's right here. It's coming. Like I don't know what comes fast. Think of something that comes fast. Rain on a summer day. Yeah, like you know, you're walking around. It's nice to have that Awesome,

Unknown Speaker 39:00
cool beard. I'm

Scott Benner 39:01
sorry. That's how fast Dexcom is coming. And the stuff they have right now is spectacular. But the future is so bright. You're gonna have to wear shades to understand what I'm saying. Do you understand what I'm saying? dexcom.com forward slash juice box. Don't even let me spend time talking about sharing follow. Don't let me spend time talking about no finger sticks. That's all there. You understand that already? The last thing to do is to get it. I don't know. I just listened to music. Listen, didn't didn't didn't go get a dex coming. This is over cuz Scott was telling me about it. It sounds really cool. Yeah, that's it. dexcom.com forward slash juicebox. It's like you're the predator. And Arnold Schwarzenegger. Isn't that movie? What's it called predator and he goes, he goes he says that a predator kill Do it. Do it. Now I'm here. Do it. Just do it. dexcom.com for slash juicebox

Jake Leach 39:53
it's mostly about the operating system. I believe the very first the series one watch does not work as well. doesn't have the hardware, but the other series watches do work. And so if you don't have to have in the latest series for, for this feature to work, it's the way that we're we see it right now you can still have some of the older versions, you just need the latest operating system for the lock, which may almost everybody upgrades right away in the same vein,

Scott Benner 40:18
do you want to do this with Fitbit ever?

Jake Leach 40:23
So we, we do and we are working with Fitbit. And we actually recently got a few approvals for some products that are for really outside the title one intensive influence space, they're more protect to one of the integrations there is with a Fitbit. It's not direct to watch, though it's through the phones, though. So the Fitbit technologies though, they'll need to make some changes to the hardware and software on the Fitbit before we could enable a direct connection. But we are working with them on site, we call it secondary display. But it's the concept of have the convenience of the readings on your wrist. But you do still have you're still tethered to your phone, but the circuit still connects to the phone. So but we are working on that. And we did get approval recently for a product in the tattoo space that utilize that. And so we're looking at how do we take that and apply it to our D six product. Okay. Okay. Let's see.

Scott Benner 41:30
Oh, here's an easy one Android, any updates to the Android app? Will there ever be a widget or notification that includes the number?

Jake Leach 41:40
Yes, yes, yes, yes. We're working on that. I'm assuming when they say that the there's the the we call widgets on the iPhone. There is a display of on when you swipe, you can see the number on Android, they may be talking about follow. I don't believe we have that functionality on the Android follow. But yeah, our we're working on all of enhancements to follow as well as G six, as well as supporting more phones on Android. And so I mean, we we continually have done a number of point releases, you know, fixing bugs improving performance on both the iOS and Android apps over the past. Since we've launched the SEC, let me

Scott Benner 42:22
let me pop in with this just real quick. It's nothing I think you probably have to answer but people want you to know that the Google pixels aren't allowing follow to override default sounds or alerts with the latest release.

Jake Leach 42:34
Okay, that's good. That's good feedback. I hadn't I hadn't heard that yet. So we'll, we'll jump. I'll jump right on it.

Scott Benner 42:40
We can we can beta test you right now. And so to the beat information right now. So you did mention g six for Medicare that happened is that going to happen?

Jake Leach 42:50
Yeah, yeah. Yeah, we're going to Yeah, we're gonna we're going to launch that as soon as we have enough supply.

Scott Benner 42:57
Great. Oh, so that's another thing that's this year. We're not this year, but in the next handful of maybe a quarter to two quarters situation.

Jake Leach 43:05
Yeah, absolutely. Yeah. I think I think Kevin may have given given some more particular guidance on our last earnings call. But just you know, it was from last week. But yeah, we're definitely, you know, full force on getting getting ready to launch that.

Scott Benner 43:17
Is there a time in the future, we can expect a, like a generational leap with the follow up, like rise and fall alerts like that are, you know, for rapid rise and fall like no data alerts, like being able to use landscape? Those sorts of things?

Jake Leach 43:32
Yes, yes. There's a there's an entire revamp of follow in progress right now. Okay.

Scott Benner 43:39
I see, you're not gonna tell me when,

Unknown Speaker 43:41
in that same.

Scott Benner 43:42
In that same vein, a couple of people wanted to know that the watch app looks a little old. So fair, I

Jake Leach 43:48
passed. I agree. I agree. I agree. We, it's one of those. You know, for a long time, we were so focused on G six, and all our resources were on G six. And so we were just making the system compatible to make it work now, we need to continue to enhance the platform. And I completely agree there's a facelift is needed.

Scott Benner 44:10
Me banks have a couple more incentives. A couple of bigger questions.

Unknown Speaker 44:13
Let's see.

Scott Benner 44:16
Here's a small one. I guess the app update that happened recently, when you add an event, the highlighted.is gone that seemed very important to somebody, and I think they would like it back.

Unknown Speaker 44:27
So I know you will

Unknown Speaker 44:28
take a look.

Scott Benner 44:29
When will we be able to see a number on my watch complication? So not just the Dexcom icon, but as a follower, when can I look down on that complication and see a number without having to open it up?

Jake Leach 44:42
So that's, that's a very good question. And that's just one of those features that it's on our way called the backlog. We have a long list of features that we continually work to prioritize implementation, but that is something we do want to it's on our list to implement. So it will happen likely with a with a new release of five Have a will usually what we do is we will release features, you know, kind of one at a time, you know, or a few groups together. One of the exciting things is the new 510 k status of the texts come to the class to a little bit faster our ability to get releases out. So now that we have that, from the FDA, we're looking at how do we take advantage of it, and it's likely going to be a number of releases, with new features being able to get in more frequently than you've seen in the past, due to the faster approval times,

Scott Benner 45:38
I wanted to mention that I got a new Apple Watch. And there's the new face that, you know, is the one that I want to use, except the complications are sort of like a slightly different shape on some of the watch faces, and it doesn't allow for third party complications in some of them. Is that something you're aware of? And is that being blocked by Apple? Or? Or is your complication just not designed to fit in it?

Jake Leach 46:00
No, it's it's a certain certain complications work in those spaces, and other ones don't enter the apple really controls. That's, that's one of the unique things they control that watch face. And I think that is, you know, that they're all there's quite a if you get into the details, there's quite a few rules around the complications and how often you can update them. Most of it is driven by battery consumption on the watch, right? The more your activity you're doing, the more you're updating the complications, the number of complications, all those things have an impact on the battery life of the launch. And so they've got some tight restrictions that they've worked to loosen as a, you know, I get feedback from users and developers, they get feedback and they make changes, but they tightly control it so that you get a repeatable experience on the watch battery life.

Scott Benner 46:49
Okay. Yeah, that sounds like something they don't they don't want to make a claim about the watch battery life and then have your complication, drag that down. And then that's not something they can answer to. It's sort of like the trend, it's sort of like your problem with Bluetooth. Like it's trying to involve somebody else? And how do you address something with a different company? Hey, a lot of people a lot, a lot of people want to know, when there, you'll be able to increase the number of followers. Is that something that's being thought about? Because apparently, there's a lot of I have to drop somebody and then re add people and do a lot of this stuff. with smaller kids, it seems to be more prevalent there with their parents is that on the horizon by any chance?

Jake Leach 47:27
It is, it is it's one of the key features of our next generation follow is to be able to follow more, have more followers. And so it's all empty, able to follow more people. So both of those are on our list, because we recognize when we originally developed it five was like kind of a number that we optimized around. But there's no technical reason why we can't do more, it was just kind of that's where we landed in the original share. And so it's high time we we updated.

Scott Benner 47:58
Somebody wanted me to ask you if you can make it possible to log in the follow app and have that link to the main account.

Jake Leach 48:05
So Oh, that's a good, that's interesting, sort of had the follower. Enter events,

Scott Benner 48:11
right. And their events to meld seamlessly with what's being entered on the other on the on the person with diabetes phone two.

Jake Leach 48:20
So yeah, that's good. That's good. Good to be back. Okay.

Scott Benner 48:23
g six for iPad coming.

Jake Leach 48:27
But I do not be lose that.

Scott Benner 48:29
I don't know. I don't use my iPad for Dexcom stuff.

Jake Leach 48:32
So I was gonna Yeah, the Yeah, the iPad support. For the G six is no, is not on the roadmap right now, most, most of our experiences with the iPad, was that, you know, the use case, there weren't very many people using it and the amount of work for us to support it was quite, quite substantial. Because every time a new version comes out, we every time there's a new version of iOS or the phones, we actually have to do a tremendous amount of testing on the inside. Nobody sees that. But that's how we ensure everything works properly. And so the itI was just not not supported. For that reason, if if we didn't have to test it as rigorously, it could be But at this point, right now, that's where we're at. We do a lot of testing for each, each model of phones, whether it's iOS or Android. So

Unknown Speaker 49:22
let's see.

Scott Benner 49:24
Is there in in Actually, I'm gonna ask that one. One last one. Let me jump to that. Sorry about that. Alert sounds being more user definable. We talk about this a lot. I remember the last time I spoke to you, I talked about a person who was telling me that children like boys of a certain age can only hear certain pitches and like that voices work better. And so people really do overwhelmingly want more options because I think they get alarm fatigue, but someone made a specific asked me the specific question that I like so not only do they want more sound But they want to know if they can define if you guys can define better the alerts. So the example that was given to me was basically this. Say My target is 110. But my blood sugar's 120. And but the dex knows, I'm going to be, say 105, in in five minutes or something like that, Is it really necessary for me to be alerted that I'm 120? If I'm going to be 105, and stable five minutes from now? And are smart alerts like that possible? And so there are two different questions in there a Will we be able to make user defined sounds? If we can't, is that the FDA? Or is it? Is it just a limitation of the software? Something you guys haven't implemented? And can you make it so that it's smart enough not to alert us when it doesn't need to, even though the number might indicate that it should, dancing for diabetes just had their huge blowout show, it just happened. If you missed it, it's not too late to find out more about it, check them out on Facebook, Instagram, and dancing for diabetes.com. That's dancing, the number four diabetes.com?

Jake Leach 51:04
Two great questions. So the on the on the user defined sound is not it's just something that we haven't implemented. But we have talked about it quite a bit, because we do get the requests. And so I don't see any reason. Regulatory wise, as long as you know, we have a default sound. And then the if the user chooses to select a different sound, that they should be able to do that. So I think that's a good enhancement for the app as we move forward. And then on the smart alerts, yeah, we have a lot of discussion about this internally, we kind of we basically did implement the urgent low soon alert, which is kind of the concept of a of a smart alert, where the goal is to give the user more time have an alert sooner in time than they normally would get. If they're going to be urgently low in the next 20 minutes to 30 minutes. So I think there's a lot of opportunities for smart alerts I, I know I've heard many times about, you know, someone has a particular meal, and they know their glucose is going to be high. And they don't want to continually be alerted. They want to be able to say, Okay, I get it, I eat some cake and my glucose can be high, don't keep reminding me ideas. Remind me and, you know, way out in the future if something hasn't been corrected, but I think that it could a great idea about that concept of if you're about you're going above on 20, but we know are going to be 105. Particularly if we've got insulin information and kind of some patterns, I think there's a lot opportunity for making alerts and alarms more convenient. I think we've had threshold alerts for a long time, we're starting to introduce some predictive nature. And I think convenience is a big aspect. For us. For the alerts, it's always about, we got to make sure that our instructions about how they work are very clear. And that's where the FAA comes in. They we do you know, the way that you validate as you do a lot of human factors, testing with actual users to ensure they understand how the alert works, because the last thing you'd want is to implement an alert where the users, some users may understand it, but others may not understand exactly how it works and have a different view of the wrong interpretation. So that's where, you know, gotta be obvious. Yeah. Which is, sometimes I've always been surprised at how hard sometimes it is to make things obvious, because everyone has, you know, different assumptions. And they approach things differently. And so that's a that's an exciting part of developing user interfaces is, you know, how can you take lots of different people and have them all have the same assumptions about something? So Jeff, it's good, good to be back.

Scott Benner 53:48
Okay. Have you ever used Photoshop Elements? There's, I have not personally 13 minutes. So there's, it's an interesting in it in that you can choose to use elements as a beginner as a, as an intermediate, or as an expert. And as you click on tabs at the top of it, it changes what the app does. It's pretty, it's fascinating. I know, it's not something you could ever do. But it's it made me think of it while you were ready. We're talking about that. So in the in the end, what you guys make has to work for everybody. And just because some of us might be more expert users than the other doesn't mean we can leave a new person behind and then not understand their their alarms and other things I got. Okay, a couple quick I have kept you way longer. Are we okay? Yeah, we're talking. Let's see. Apple CarPlay Does that ever do you think that'll ever happen?

Jake Leach 54:36
It could we've we've prototyped with it actually, even a couple of years ago, when it first came out. We had we had CarPlay stereos there enabled stereos on engineers desks and we were playing with it. We, you know, haven't I don't think we kind of figured out how you would how we bring it to market yet. But I think it's an exciting option. So it's definitely something we've looked at and we're looking at

Scott Benner 54:59
web Access to follow. That's something simple like is a maybe like a little widget or something on my screen, something where I could see somebody's blood sugar without having to open up a phone or something like that. I know there are third, there's a third party option, which to be perfectly honest, I'm looking at right now my screen, it works great. So if you can, apparently they want your version of it. Oh, here's a small one. When I clear my alerts on my, my watch, can they Please clear my alerts on my phone too? So I don't have to clear them twice. Is that a limitation of iOS? Or do you

Jake Leach 55:32
just have to tell you it's not? It's not? No, it's it will it was a limitation of some of the earlier designs and also a little bit of the kind of regulatory approach, one of one of the unique aspects of is, if you can clear alerts on your watch. It's, it's not, it's no longer considered a secondary display, it's more of it's in control now as the system. So the regulatory kind of approval cycle for that in the past was different. Now that we're at the 510 K, we can fix that. And so it's in, it's on one of our higher items on the backlog of features to implement. So we do recognize that it would be much more convenient to be able to acknowledge it on your watch and not have to go back to your phone. So we will fix that. And it's not a limitation of the device. Okay,

Scott Benner 56:20
so two more questions, slightly bigger ideas, and then I'm going to ask you about pipelining. And then I'm gonna let you out. So one person asked, Are you guys happy with your mark value? Or is it something you're always working on?

Jake Leach 56:36
I would say we're happy with it. But we're also always working on improving it. The, you know, the sensors work, they're very reliable. But as everyone's experienced, at times, it can be inaccurate. And so I, there's always places for us to look. And so the team that's continually at Dexcom worked on, improving performance is going to continue to do that. So we're, we're really, my main focus is now not on, you know, the average metric, but it's, you know, the Amir de metric, I'm way more focused on anything, that's more than 20% off of a blood reference. It's kind of the outside of 2020, those, those metrics that we capture 30% off or 40% off, we have a very small number of readings that are in those areas. But those are the ones we're focused on. Because you know, we've hopped on system be as reliable as possible. So we'll never rest we're gonna keep keep where the performance later we intend to stay there. Excellent.

Scott Benner 57:39
Is there any, you know, I feel like people talk about waste, like recyclable waste with G six more than they did with G five. And I, it's funny, because when I hold the G five insert, I hold the G six inserter. They don't feel like one doesn't feel much heavier than the other, which in my mind means it's not that much more material one way or the other. But I think it just looks bigger. And so it bothers people more not that it shouldn't. But do you guys ever talk about recycling programs now? Or is that not we do, we,

Jake Leach 58:09
we talk we talk about recycling programs, we also talk about, you know, kind of next generation or next generation platform, you know, kind of making the applicator device even even smaller, with even less, less plastic involved. And I think the complexity of it is you're getting the sensor under the skin isn't as simple. There's a lot of important aspects to it isn't just like slipping into the scan. There's how the needle inserts the speed, the size before so all those things. And so the G sex was our first automated applicator with all that technology built in. And we do talk about recycling programs with it. But recycling medical waste is a bit challenging

Scott Benner 58:51
in the construction. Right, it has to be pulled and taken.

Jake Leach 58:53
Yeah. You know, and it's one of those things, there's a lot of cost involved in that for for you know, depending on who's paying for it and so just it wasn't we are we are very aware of it. And we think what g six you you do have less applicators per year they do a G five to the longer center life. And but yeah, we're aware of it and we want to continue to, you know, make the products you know, as environmentally friendly as possible. But the reality is, you know that it does take technology to get that sensor under the skin. Yeah. Hey,

Scott Benner 59:27
if someone sees a blood sugar, it's just off their testing and the CGM is not it's not saying anything close to what their their phone says even if she says you want them to calibrate then or no What are they supposed to be doing that?

Jake Leach 59:41
No, usually, most particularly, I mean with G six, my recommendation is if you take a finger stick and it doesn't match your readings, or if you're you know if if you're reading on the phone just seems way off, you know on your display it the CGM reading isn't what you expect. Take a finger stick, double check. I mean, don't don't ignore your symptoms or what you think things should work and trust it. Take a finger stick. And look. I think what I the way that I recommend folks use it is not to calibrate right away, because often, the errant signals in CGM resolve themselves. And so if you see like a persistent error, or a persistent difference between the finger stick and the CGM, then you don't think it's resolving then calibrate. But you know, give it some time. If you you know, if it's, you know, see Jim's not reading accurately don't don't immediately jump in calibrating, because what we've seen actually is that if you calibrate a CGM during a signal error, you can actually cause more damage than help. And so you want to kind of let it let it go for a little bit and then only really entered calibrations. If you're not seeing the sensor signal, go back to what you expect. Gotcha.

Scott Benner 1:01:00
Okay. There was a there's a lot of questions, and I don't think you're you because because your your r&d, but if you could pass on to anybody, you know, obviously always cost access. You know, people want to know if there's a coupon day stuff like that, you know, but it's, you know, I got a specific note from someone who listens in South Africa, and they're like, it's here, and it's available, but I can't afford it. And is there? Is there is Dexcom, helping to make that more affordable. Like, are they working with the entities that could help that be more affordable?

Unknown Speaker 1:01:31
You know, it's

Scott Benner 1:01:32
just, it is, is CGM, just something that's not affordable for everybody? Or is it something that we hope that one day it will be and behind the scenes you guys are working towards that we maybe just don't see that day to day?

Jake Leach 1:01:46
I think the the answer The answer to the axes of definitely, yes, we're working behind the scenes on a lot of things. Medicare was a big push for us, we have a number of folks internationally that are working across the different markets and the dynamics in those in those places. And I say, and so access is going to continue to get better as it has over the years, you know, more states are starting to cover Medicaid of different states are now covering, I think, with the movement of Medicare. So I think in the US reimbursement is it's always slow. But you know, access we've been we've got, you know, vast majority of folks with private plans or even public now, plans are covered into some capacity. And I think as we continue to improve the technology cost, you know, ultimately, the costs will come down as the technologies as we come out with, you know, future generations. Yeah. And so I think CGM is going to get to the point where it can replace finger sticks as the I think it already has in many places. But I think across the world, there's still some work to do to get CGM access better. I think a lot of it has to do with, you know, the, the amount of product in the country, the volume, the distribution, all of those, those aspects. So I just see CGM in the future being the lower lower cost over. But I think it takes time because we have to develop the systems that those have the level of performance that users need, as well as the cost. And in those, those are in a lot of the technology are competing requirements. And so there is a way to balance them. And we are continuing to make progress on both performance and cost.

Scott Benner 1:03:33
Let me ask you this. And I'm just gonna come right out and tell you like, if you can't say or you're uncomfortable, I get it. But there is a less expensive CGM available. Did they do in your opinion isn't? Is it not the same quality?

Jake Leach 1:03:48
Is it not something? Definitely, it's definitely not the same performance. I think, if anybody looks at the performance numbers, or even just talks to folks who have experience with the competitive product, I think it's they'll, they'll know that the system is not as reliable in the hypoglycemic ranges that it doesn't have today doesn't have, you know, kind of any kind of alerts or alarms that could signal us. So what you know, give me an example of what we've seen in Europe, is that the health care systems are willing to pay more for the Dexcom product because of the feature set, the alerts, the alarms, the performance, we even have some areas, health payers that call out the share feature is an important aspect of the system. And they're willing to reimburse it for a higher rate because of that. Yeah. So I think it's well recognized. I think patients recognize it as well as payers and physicians, they recognize that there's a pretty significant difference between the two products. But you know, the way I would look at a competition is good. I'd rather have a competitor than No, no competitors. So I think I think it makes us all better. And we all strive and push each other each other, so I like industries that have competition. And I like the fact that we do have some competition in a glucose monitoring space.

Scott Benner 1:05:08
Jake, I've sat in a car that you can buy for $10,000. I've sat in a car you can buy for 5470 and 120. I can't afford $120,000 car. But when I'm sitting in it, I get the idea of why it costs $220,000. And so I think there are levels of, there are levels of what you need to expect out of things. And it's easy to say, you know, I don't know. I mean, there's some Mercedes over there, I can't afford. But, you know, why can't it be as cheap as this Honda? And I think there's a reason you know what I mean, and I just didn't know what you would think of it. And it's a tough question for me, because, I mean, we're, you know, we've been with you guys for a really long time, I believe what you're saying, but I didn't want to, you know, I didn't know how comfortable you are talking about. So I appreciate that very much. I guess the last real question I have is then, is gees, you mentioned g seven. So g sevens next, but is G seven the last of that. That kind of, I don't know, I don't know, features like, like, form factor? Are we going to move to something smaller after that? Is that the goal? Or or could there be a g8? while you're still working on something else? I guess merrilees Next, right.

Jake Leach 1:06:20
Yeah, yeah, very rarely is next. We're working very closely with them on this next next generation platform. And yeah, there's, there will be G, G, H, and G nines and G 10. And then we're going to continue to innovate in all the areas we want to which is, you know, cost, convenience, performance and outcomes is a new one, right? I mean, trying to, you know, we've for a long time, we've provided reliable glucose readings. But now it's all about what do you do with that information? How do you get a better outcome for, for the user? With with no advice, connections that are excellent partners. So there's still a tremendous amount of opportunity to, you know, continue to evolve the system. And so yeah, there will be there's multiple platforms GG seven, as well, and development, which is how many, you know, in product development General, but also medical devices that where you have to run clinical studies, yet you you work on them for many years, before they become public.

Scott Benner 1:07:22
Yeah, there, hey, listen, there's a this is a little aside. But I hear anxiety from people a lot, because now used to be able to get a transmitter ahead. Like you used to know, if the transmitter when the transfer you had was done, the next one was sitting with you. But the insurance company's mind, I have pretty spectacular insurance. And I'm in that situation to where Arden sensors just arrived the other day, but I was not allowed to order another transmitter yet. And I don't I know, that's a very back room kind of thing. But if it could be impressed upon the the providers that there is a lot of just quality of life comfort, where it's not in the back of your head, oh my gosh, what do I do if this should happen? I mean, there's a lot of value in that for people. So I don't know if there's a way to pass that around and make any impact with anybody. But I know what it impacts a lot of people. So I just thought I thought that was worth mentioning here at the end.

Jake Leach 1:08:17
I can't, that's a great point. We, we recognize that. And we we will make sure that the the folks continue to communicate that but we we fully appreciate the amount of anxiety that can happen, you know, when managing diabetes and found the fact that, you know, if you can't, and if you don't have extra supplies, you don't have that transmitter. It's not a good, it's not a good feeling.

Scott Benner 1:08:42
Yeah, and I'm not looking for enough to, you know, stock up 10, you know, 10 people with diabetes for a year, I just want, I just want one, just enough to think that if something were to happen to this one, you know, that was outside of the parameters of expectation that I wouldn't then have to wait, I know, it seems kind of crazy, maybe to think but for some people having to wait two days is a long time, you know, having to wait, you know, and then some people fall into that. Well, my, you know, my distributor is two weeks out and above. And it's just it's a strange space for people to be in. So I appreciate you saying that. Jake, you stayed on way longer than we were supposed to. And I'm assuming I'm gonna get yelled out about that later.

Unknown Speaker 1:09:18
But I really appreciate

Scott Benner 1:09:18
that this was really fantastic. And you went through every one of these questions. So kudos to you for hanging on like this. And I really appreciate Hope you're nowhere near those fires out there.

Jake Leach 1:09:31
Now we're lucky. We're lucky in San Diego where we don't we're not near the fires, although Yeah, feel feel for everybody affected and really appreciate the time, Scott wonderful discussion. And yeah, don't worry, no one. No one's going to yell at you. This is great. I'm already married.

Scott Benner 1:09:48
I don't need to be yelled at by other people. Okay. appreciate that very much. Yeah, I really do. I you know, whenever you have stuff to talk about like this, I love having you on. So thank you very, very much.

Jake Leach 1:10:01
Okay, I look forward to the next day. Our next chat. Take care. Have a good day. Thanks, guys.

Scott Benner 1:10:09
Thanks so much to Jake leech for coming on the show. Thank you to Omni pod dancing for diabetes and Dexcom for sponsoring, please go to my Omni pod.com forward slash juicebox. good at dancing the number for diabetes.com or go to dexcom.com forward slash juice box. Of course you don't have to remember any of those because we go into the podcast app. There's links right there. There's also links at Juicebox podcast.com. If you enjoyed the episode, and you're looking for a way to share the podcast, go to Juicebox podcast.com. Go to the page specific to this episode, copy the link and take it out and share it in the world. I don't know where Facebook, Instagram wherever you talk to people. That would be wonderful if you could do that.

Let me end by saying thank you for all the new ratings and reviews on iTunes for everyone who shares the podcast and all the wonderful emails that I've been receiving. You all are far too kind.

Jake Leach 1:11:00
I'll be back next week.

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