Dexcom, the leading manufacturer of CGM (continuous glucose monitor) technology, recently released an API for app developers. “API” stands for application programming interface — essentially it grants third-party app developers the ability to integrate Dexcom CGM data into their apps. As a regular blogger who also happens to be a Dexcom CGM user (and a very happy one, I might add — the CGM has quite literally changed my diabetic life!), I was given the chance to interview Dexcom’s CEO, Mr. Kevin Sayer, to talk a little about what this means for Dexcom, what this means for diabetes care teams, and most importantly, what this will mean for the millions of people living with diabetes.
Better integration for better understanding
One of the key points Mr. Sayer stressed was that allowing the Dexcom platform to be integrated into the larger app ecosystem will provide people living with diabetes (and their care teams) a much better understanding of the multiple variables affecting diabetes management. This is particularly exciting for people living with Type 2 diabetes. As Mr. Sayer noted, management of Type 2 diabetes is influenced by a huge number of factors, including with diet, exercise, stress, sleep patterns, weight, and so much more. And because those with Type 2 aren’t necessarily on insulin (and therefore managing blood glucose by managing an array of choices rather than simply matching insulin to food), understanding the intersection of all these variables is crucial. However, folks with Type 2 use the CGM at a much lower frequency, something Mr. Sayer hopes to change. “By integrating the CGM data into a broader array of apps [such as nutrition apps, exercise apps, and so on], people with Type 2 can gain a very clear picture of how these activities and variable are affecting their blood glucose.” He also hopes this integration can make it easier for people to include CGM data in their diabetes care — after all, it’s easier to check one app and see all the data than it is to open three separate apps.
Another area where the integration of technology will be particularly useful is in medical records for diabetes care teams. The medical field is moving in this direction already — for instance, I have an app on my phone now that shares my test results with me, shows upcoming appointments, lists current prescriptions, and so forth. I simply log in and there it all is. And of course, on the other end, my care team has that same information and can respond to my requests (for say, prescription renewals). But imagine if my CGM data could be shared within that same platform! Rather than simply reviewing a printout of my CGM data every 3–4 months, this could allow my care team to track my data day-to-day. They could look for patterns, perhaps even receive alerts when particular patterns of high or low blood sugars emerged and communicate with me between appointments for more immediate corrections. According to Mr. Sayer, of the many inquiries from app developers so far, data management for health-care providers has been one of the most robust.
“This API allows our CGM data to be tailor-fit into what each individual patient needs in terms of HOW that data is filtered, analyzed, shown, and organized,” Mr. Sayer told me. As he noted, Dexcom has been a leader in the development of CGM technology for many years, and the company feels (deservedly) confident in the technology they have brought into the world — and again, as a longtime user of a Dexcom CGM, I can certainly attest to the reliability and immense benefit it as offered me. However, he said that doesn’t necessarily mean they always have the best answer for how that data should be organized for every patient, and the release of this API allows that data to be integrated into any number of apps that can organize that data in very useful new ways for users.
New possibilities, new challenges
When I asked Mr. Sayer about the challenges of building this new platform, he explained that Dexcom actually had to build up an entirely new division of staff to launch this API. As he noted, it wasn’t simply a matter of organizing and releasing a bunch of code for app developers, but rather reimagining how CGM data fits into the entire health-care and technological ecosystem. And of course, data security was also a priority. “A lot of energy went into making sure the data would be secure,” said Mr. Sayer. This, of course, is paramount in this day and age, and Dexcom has been working on the development of this API for a very long time now (think years, not months), taking great pains to ensure this data is kept absolutely safe.
Since I had Mr. Sayer on the phone, I couldn’t help but ask one final question. I asked him what he envisions for the future of the CGM, and what he thinks the landscape will look like 10–15 years from now. After jokingly asking if I had at least an hour to talk about all the possibilities, he said the primary goal for Dexcom currently is to get to a point where the CGM can completely replace finger-stick blood glucose testing. “We’re getting closer all the time,” said Mr. Sayer. As has been noted within the pages of this very site, in December of 2016 the Dexcom CGM became the first to be approved by the FDA for dosing — meaning the data was deemed accurate enough to be used to make decisions on how much insulin to take without needing to perform a finger-stick glucose test to verify the information. He noted the devices will continue to get smaller and easier to use (the next generation 6 sensor will be smaller, with a longer insertion life, automatic push-button insertion, and further increases in accuracy).
I was diagnosed with Type 1 diabetes 23 years ago. When I started out, I was taking the old “Regular” insulin and NPH. It meant every meal had to contain the same amount of carbs, the same amount of protein, and happen at the same time every day. It meant my life and my schedule had to revolve around my diabetes. Finger-stick testers were well established, of course, but pumps were still a future fantasy and nothing like the CGM was even imaginable. To look back to that time from where I sit today is rather astonishing. As I type these words, I have the ability to stop, grab my iPhone, and see my blood glucose in real time (120! Nice…). I still use shots, but I take short-acting insulin and a once daily long-acting that allows me to eat when I want to, and to match my insulin to the food instead of doing it the other way around. And my CGM allows me to see exactly how my body responds to the food and insulin I take. Seeing the further expansion of this technology promises many new possibilities in how we treat this disease. The CGM quite literally changed my life, and so in wrapping up, let me simply thank Mr. Sayer and the entire team at Dexcom for continuing to advance this technology. I can’t wait to see what happens next!
Want to learn more about continuous glucose monitoring? Read Sensing the Big Picture With Continuous Glucose Monitoring” or watch Continuous Glucose Monitoring.”