The introduction of the continuous glucose monitor (CGM) has been a game-changer in the field of diabetes management. For patients, CGMs drastically reduce the number of annoying and painful finger sticks needed to monitor blood glucose. With readings as often as every five minutes (or on-demand), patients can see trends in their glucose levels throughout the day and program alarms that will allow them to more rapidly intervene.
Up until now, the primary beneficiaries of CGMs have been those patients diagnosed with type I or II diabetes, as they require constant monitoring to ensure that blood glucose does not reach dangerously low or high levels. But as the prevalence of diabetes has continually been increasing, much is being invested into preventing diabetes, particularly type II diabetes and its precursor, prediabetes.
Last year, Dexcom announced the G6 Pro, which significantly increases the number of potential users who can benefit from a CGM. The new system, which is now available for pre-order, removes many of the barriers that patients who have not been been diagnosed with diabetes may have in embracing this innovative technology. At its minimum, the G6 Pro is simply a sensor and transmitter unit; up to 10 days of glucose readings are stored on the transmitter which is read and analyzed retrospectively in-clinic. This “blinded mode” may be appropriate for some (but not all) potential users without diabetes who may be more technologically hesitant. For those who have diabetes or benefit from seeing their glucose measurements and trends with alerts, the “unblinded mode” enables these features through the user’s smartphone.
Medgadget recently received a demo of the G6 Pro in our mailbox, but unlike the non-functional, Personal G6 system we looked at previously, our G6 Pro came straight from the factory, ready to wear and see if this editor needed to cut back on the cookies and spend more time on the treadmill!
Our experience kicked off with a virtual “visit” to the Dexcom clinical team who guided me through the sensor application process. Other than the “Pro” marking on the transmitter, everything up to this point was identical to the Personal G6. Inserting the sensor/transmitter was painless (literally) with the entire process only taking about a minute.
From here, the experience diverges, as patients who have not been diagnosed with diabetes will simply wear the sensor for up to 10 days in the “blinded mode” with no intervention; the glucose readings are collected and stored on the transmitter and downloaded later. Our demo kit included a G6 Pro Reader, which was basically a modified Personal touchscreen reader that is used only by clinics to verify that the sensor is working properly and to download the data after patients return to the clinic.
Some without diabetes, like this editor, as well as all patients who have been diagnosed with diabetes, will instead use the Pro system in an “unblinded mode”. After sensor insertion, they’ll pair their sensor/transmitter with their Android or iOS smartphone to receive their glucose readings. This experience is very similar to the Personal system; these patients can use the Dexcom app view trends and set alerts. The only real differences with the Pro system is that the transmitter isn’t reusable, and the patient must have a smartphone.
Our week with the CGM went uneventfully, and we were able to constantly view glucose trends and even ask Siri for the most recent measurement. After seven days, we converted our data into detailed reports using the Dexcom Clarity app and reviewed it with Dr. Daniel Katselnik, a San Antonio based endocrinologist and paid Dexcom spokesman. He shared to our relief that our glucose levels had been within normal ranges, so our junk food consumption, as excessive as it may have sometimes appeared, hadn’t yet led to prediabetes! We also asked Dr. Katselnik about how the G6 Pro might change his practice, and he shared that it would enable him to utilize a CGM on a wider variety of patients and hopefully stop the progression of diabetes earlier.
We wanted to know more about CGM’s role in diabetes prevention, so we also reached out to our friend Dr. David Ahn, an endocrinologist and Program Director at the Mary & Dick Allen Diabetes Center of Hoag Hospital in Newport Beach, California.
“I think diabetes prevention is a really compelling potential market for CGM, and I think the use case for pre-diabetes is definitely there,” said Ahn. “It can be a very fascinating education tool to help people see first-hand how their body is being affected, because most people can’t otherwise tell when their blood sugar is 180 vs 100.”
But Ahn shared that when it comes to healthy people using a CGM to ward off any risk factors for diabetes, it might still be too early to jump to conclusions.
“The data sets are going to be so different for someone with Type 1 diabetes compared to someone without any diabetes,” he said. “Perhaps down the road once we start seeing what CGM tracings look like in the non-diabetes population, we might be able to identify which patterns indicate early risk, but we honestly just don’t have that data yet.”
Moreover, while those with Type I diabetes benefit from wearing a CGM continuously, is around-the-clock monitoring beneficial or even financially feasible for those without?
“These questions are still being answered, but something like the G6 Pro at least offers flexibility, convenience, and a price point that allows these questions to finally be discussed,” said Ahn.
Overall, we think Dexcom has developed a promising product in the G6 Pro. It will certainly continue to help patients who currently have diabetes better manage their glucose levels. It will benefit those with early-diabetes by allowing them to see how their bodies are affected throughout the day and what lifestyle changes can be made. And perhaps for the rest of us, it could someday reveal some insights into the inner workings of the disease and how we can prevent it.
Promo video for the Dexcom G6 Pro:
More information: Dexcom Professional CGM
Flashbacks: Dexcom G6 Pro with Blinded Mode FDA Cleared; A Brief Look at Dexcom G6 Continuous Glucose Monitoring System; Dexcom G6 Continous Glucometer Going on Sale in Europe; Dexcom G6 Continuous Glucometer Doesn’t Require Finger Pricks