Jake Leach - President and COO of Dexcom

[00:00:01] Rob Howe: Welcome to Diabetes Innovators, a special series from Diabetics Doing Things covering the 85th Scientific Sessions. We're held in June 2025 in Chicago, Illinois. You're going to hear interviews from leaders of tech companies, people with diabetes, diabetes creators, researchers, and more on this podcast. If you want to learn more or hear more from this series, visit DiabeticsDoingThings.com slash Diabetes Innovators. Enjoy the episode. episode. Okay, let's talk about our partners who help support this podcast. Today, I'm going to talk about Type Zero, which is typezerohealth.com. It is a business run and founded by a person with type 1 diabetes, John Jensen, who's been on this podcast a couple of times. I've been using this product since 2018. I started training for a half marathon, which I ran in Dallas in December 2018. I was looking for a workout supplement, a pre-workout that I could trust not to spike my blood sugar. And so that's what I've got here in my hand is the clean pre-workout. I use the stim-free version, which doesn't have caffeine. And I trust it. And I've used it now. So 2018, it'll be almost seven years for me using this pre-workout. It really works for me because I can drink it late in the day. And most of my basketball leagues that I'm playing in now are late at night. So I might have a game from 7pm, 8pm, 9pm. And I can make sure that I'm able to get up and play and also be able to fall asleep later that night so I can wake up in the morning, go to work and meet the demands of my life. Type Zero has gone a step further this year in our partnership, and they've launched the Rob Howe stack, which also includes a couple of my other favorite products, creatine monohydrate, which I've been taking the past two years. 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There's a ton of zinc, selenium, chromium, all of the good electrolytes in this supplement. You mix the stick pack with, you know, 16 to 20 ounces of water, helps you get hydrated. I've been doing mine in the beginning of the day to start my day and make sure that I'm hydrated. And it helps with your insulin sensitivity. It helps me have some clarity and make sure that, I'm not a very disciplined hydrator when I'm sitting at my computer all day. It's good to be reminded to make sure that you're getting your hydration in. And it's a little bit more interesting to drink than just water. So you can get these as part of the Rob Howe pack, or you can get them on your own. You can get them on Amazon or directly from typezerohealth.com. And when you order from typezerohealth.com, if you use code Rob Howe, that'll save you 20%. So they've got some great sales going on really regularly. So if you can't save more with a promo that they're running, use code ROBHOW and you'll always get that 20% off and your support helps them support the podcast. So if you are a person with diabetes who's looking for a reliable supplements company, that's not going to spike your blood sugar, it's going to get you into the mode to be the higher performer that you are, I recommend and I take type zero. I wouldn't recommend a product that I don't use myself. So please support typezerohealth.com, code ROBHOW and search the ROBHOW stack to see which supplements I take and get a good deal on those as well. Okay, let's get to the episode. I also want to take this opportunity to promote Diabetes Legends Basketball Clinics. As you guys know, the last couple of years, we've started to do basketball clinics all throughout the country under our Diabetes Legends Basketball Clinics name. We've gotten to introduce over 100 campers with type 1 diabetes to diabetes legends like Lauren Cox and Gary Forbes and more. We've got three clinics coming up this year, June 7th in Dallas, a very special event at Friends for Life Conference on July 11th, and then later in September, we're going to be returning to Denver. If you're looking for more information on the events themselves, you can visit diabeticsdoingthings.com slash events. And if you're interested in learning more about the Diabetes Legends Foundation, which we formed in 2025, to better support our ongoing initiatives and creating opportunities for kids with diabetes to have a great day with diabetes via one of our clinics, please connect with us and fill out a form on our website, diabeticsdoingthings.com. Hi, my name is Jake Leach. I'm the president and Chief Operating Officer at Dexcom. Jake, welcome to the show. And we mentioned this before we started recording, but I've heard you many times over the years on Stacey Simms' podcast, Diabetes Connections. So thanks for being here today. I really appreciate your time. Absolutely, it's a pleasure. Okay, so coming into the 85th Scientific Sessions, which is this upcoming weekend, there's a lot of news coming out of Dexcom. And I kind of want to start with the evolution of Dexcom as more of like a consumer wearable. Learnings from Stelo, the over-the-counter CGM. and sort of the integration as well with Oura Ring and some of the findings and energy that that's brought to the company.

[00:05:13] Jake Leach: Awesome, yeah, a lot of great stuff in there. As you mentioned, we're preparing for ADA coming up this weekend. And we've got at ADA lots of clinical evidence that we've been generating. Some of the newest evidence is from Stelo, as you mentioned, our over-the-counter continuous glucose monitor, first approved by the FDA. Very excited last year to launch, get that approval and then launch the product. We've been really focused on generating evidence in places where evidence hasn't existed strongly in the past, and that's really in type 2 diabetes, those who don't use insulin, which is the majority of people who have diabetes type 2, as well as in prediabetes and those in general health and wellness that's interested in glucose. And we're seeing the impact even in the first 30 days. One of the things we're publishing at the conference is a paper that shows just in the first 30 days, people with type 2 diabetes significantly increased their time in the normal glucose range. And that's really based on using the product, seeing the feedback, and then making changes to their activities, levels, diet, all kinds of personal choices that really helped them manage diabetes better. I think, you know, it's early days, but that just in the first 30 days, I think the study was about 20,000 people that started using Stelo. And so lots more to come, but that was one of our goals was to get this product out there and start generating that evidence.

[00:06:33] Rob Howe: And you mentioned that, you know, most people with diabetes live with type 2. And so, you know, a study, even though, like you said, it's early days, 20,000 people. I mean, that's a pretty good sample size for, you know, showing that impact. And we're going to dig into a little bit of the type 2 diabetes attitudes and experiences report that you guys have published, which I got to dig into a little bit this morning prior to our conversation. And yeah, I mean, I think it's really interesting. Like now, my father-in-law, for example, was diagnosed with type 2 diabetes. And hi, Bill. I know you listen to the podcast. And he was able to, you know, have the discussion with us about over-the-counter CGM before he was able to get a prescription. And that, you know, was able to learn a little bit about what was out there. So that was pretty exciting for me personally as well.

[00:07:13] Jake Leach: Yeah, having the product over the counter now really enhanced access to CGM to a much broader population. You know, over the history, you know, the last couple of decades of CGM development and, you know, availability, it's really progressed from the type 1 users and where it was originally kind of focused replacing finger sticks for that group. It's just continued to expand because the benefits of having real time personalized glucose information can be so impactful to somebody's health because they can make the choices based on information they've never had before. It's really interesting. Most of the people who are using Stelo today have never seen their glucose readings continuously, right? So it's just this unbelievable unlock of information that wasn't available before. And now that it's over the counter and you can just get it so easily. It's wonderful to see the uptake. We still have lots to do, though. There's still a lot of awareness that needs to be driven. And that's really one of the things that comes out of the type 2 diabetes report you mentioned that we just are publishing here. Going into ADA, it's about the attitudes around CGM for both users and physicians. And one of the key learnings is that we need to continue to drive access and awareness of this technology because the doctors and the patients all believe in the benefits.

[00:08:24] Rob Howe: Yeah, we can go ahead and talk about that right now if you like. One of the things that I thought was really interesting was 100% of U.S.-based HCPs recommend using a CGM with a GLP-1 or an SGLT-2 inhibitor. So, you know, if you're already on a type 2 diabetes medication, to get 100% across the board recommendations from doctors to use a CGM in tandem with that was really not surprising necessarily for somebody like me living with diabetes in the space. But I think broader for general awareness is like, oh, this is something that I need.

[00:08:55] Jake Leach: Yeah, it is highly encouraging that, you know, the attitudes over time have certainly changed. I remember back when we were originally talking about CGM use in type 2 basal users, right? Those that take insulin once a day, the long-acting type. And that's one of the medications they're taking to treat their type 2 diabetes. We were having discussions around with physicians and payers and everybody around the appropriateness of CGM in that population. We ran a large control trial and showed the significant improvements in outcomes that you can get when people with type 2 on basal insulin use CGM. Now we're in this new category. You've got GLP-1s now in the mainstream, and you've also got SGLT-2s, other drugs. And I think that the recognition that the drugs are very beneficial in outcomes, but there's a really important place for CGM to play in helping people with adherence to taking their medications, helping physicians titrate medications, as well as the lifestyle component of managing diabetes, which is so important.

[00:09:54] Rob Howe: Talking with that lifestyle piece of it, somebody like myself who loves nerding out over not just their glucose data, but their health data in general, the integration with Oura Ring I thought was really exciting. I've always wanted to be able to see what kind of impact my glucose had on the rest of my, whether it's metabolic or recovery metrics or what have you. What has the first few months since that has gone live been like for you guys?

[00:10:16] Jake Leach: It's been fantastic. We've seen a lot of uptake of Stelo in Oura users that weren't aware of the technology. So Oura's brought a lot of great awareness of what Stellar is and what it can do for people. And so that integration has been fantastic. Two very innovative companies working together. We've really enjoyed working with them as well as the integration through products. I think we've done together done a really nice job of enhancing the user experience of both the products together, particularly when you use them, you know, in combination. And so I think in terms of the data analysis, we're still kind of early days on that. We've got the integration flowing. We have data going back and forth. Oura has got their interpretation of the glucose curves by day that they're reporting out. But I think there's a lot we're going to learn as people continue to use the products and we continue to, you know, provide the data and research around the links between sleep and stress and activity and glucose. And particularly in folks that with and particularly those that don't have diabetes. Right. I think there's still opportunities really to show the benefits in that population and that partnership is one of those ways to do it.

[00:11:26] Rob Howe: Yeah. You know, we often talk about diabetes as the disease with too many inputs. Right. There's so many different things that affect your glucose. And one of the things that I think I talked about a lot more last year as I was learning this, but I think as people with type 1 diabetes, we sometimes judge our glucose numbers. If we don't get a good night of sleep or we're stressed out for one reason or another, we think it's the diabetes, but really it's just the lack of sleep and its impact on insulin sensitivity or stress and its impact on what's going on behind the scenes and the diabetes is just part of that, kind of gives us that lens of what to look through. So very interesting.

[00:12:00] Jake Leach: It really does. I mean, even I wear a lot of CGMs. I don't have diabetes, but I certainly can see the impact of stress on my glucose levels as well as, you know, when I'm more active and I'm working out and on a better schedule, I can definitely see better glucose control just in myself. So it is a kind of an applicable thing for many, many people.

[00:12:20] Rob Howe: Yeah, it's all connected. Yeah. So speaking of connected, wow, that was a really good transition. There's been some other excitement with some of you guys as partners coming out for an in advance of ADA scientific sessions. So what's some of the excitement on the Dexcom side on the Omnipod 5 G7 iPhone launch?

[00:12:38] Jake Leach: Yeah, it's super exciting. So, yes, Omnipod, as you mentioned, Rob, just launched the iOS compatible app with their Omnipod 5 system in G7. So now users can run their G7 app on their iPhone as well as the Omnipod 5 app and not have to carry around a separate controller or device to control their system. So that is something that many of our users were still using our G6 platform, waiting for that upgrade to come because they really liked the Omnipod 5 system, but didn't want to have to carry around multiple devices. So now that Omnipod launched that, Insulet launched the iOS compatible app for G7, super excited. I think a lot of those folks that were waiting to upgrade to G7 will now be able to do so. So that's exciting. Our partner, Tandem, is starting to launch into the Type 2 space. So they've got the approval there for Type 2 with integration with our sensor, G7, the Control IQ algorithm. So that's exciting. Then we've got on the connectivity front, we're starting to see a lot more connectivity with insulin pens. So these smart pens that log your insulin doses. Novo throughout Europe has a connected pen, the Novo Pen 6 that we've connected with. And we're seeing a lot of uptake of that, which is great because what it does is it puts all your insulin data in the G7 app automatically. So it's not this idea of how much insulin data you take. You have to manually log it. It's all automatically logged. And then it also flows through clarity so that both the user and their healthcare provider can see CGM concurrent with insulin dose and delivery, just like they can in the AID systems. You know, a lot of excitement around the different connectivity, and we're going to continue to, you know, push that forward across multiple partners.

[00:14:18] Rob Howe: That's really exciting to have it all in one report, too, and just automatically get into your clarity reports with, like you said, those critical metrics that those of us who use pumps, we get automatically. That's always the stress of a person on multiple-day injections. Did I give myself the right dose and how much insulin is still on board? Now I don't have to really guess those things.

[00:14:36] Jake Leach: It is. And it's really helpful for folks that are new to insulin therapy, particularly type 2, whether they're on multiple injections a day or the single injection day. It really helps them and their physician work through the initial onboarding of insulin. Because CGM is very helpful to titrate the insulin, make sure you don't have hypo, don't take too much insulin or you can match it up. But also having the actual insulin doses, you know, that's one of the things when I talk to physicians, particularly primary health care providers, they're like, man, I wish I could see what, you know, I could see the patient's CGM. I wish I knew what insulin, how much they were taking and when they were taking it. And then the other thing they've asked for is, man, it'd be nice to know what they're eating. And so we do have a really exciting new feature coming out on G7, which is intelligent photo meal logging. So you literally take a picture of your meal and then it basically uses AI to determine what the food is and then logs that into both the G7 app but also into Clarity so they can see easily the types of meals people are eating. And I think that's really helpful in both the education component of diabetes but also in the treatment.

[00:15:40] Rob Howe: I think AI is going to be a very, very popular topic at this year's scientific sessions. That's really exciting that you guys are integrating that into the app experience as well. What gets measured gets managed, right? The more access that we can give to our care teams, the better we can figure out what's kind of going on behind the scenes. That's right. Any response from the 15-day approval for G7 that you'd like to discuss today?

[00:16:05] Jake Leach: Sure, sure, yeah. So as you mentioned, Rob, G7 was just earlier this year approved the 15-day version of it. A couple of the exciting things about that product is that it's a culmination of all the learnings we've had over the last couple of years to have a G7 in the market. We updated the glucose algorithm that's inside the product to be the most accurate sensor we've ever produced. So not only did we extend the duration of it, but we also enhanced the accuracy based on learning to sensor behavior in people. It's typically the way we do it. We launch a product, we learn a bunch, and then we continually make enhancements to it. We did that with many of our different generations, and now it's time for G7 to receive that same update. And so the 15-day, we're intending to launch it later this year. Right now, we're working through a couple of really important components for users. First is compatibility with all of our pump partners. So we want to be able to launch and rapidly have that compatibility so there's no confusion. The last thing we want is someone to upgrade to G7 15-day and then realize it doesn't work with their AID system. So that's super important for our users to work with our partners to get that done. And then we're also working through the insurance coverage. So it's kind of seamless when someone upgrades. It doesn't change anything for them on the insurance coverage side.

[00:17:18] Rob Howe: Yeah, I did see some questions in the community. Is that going to change the number of sensors that the insurance covers? And it sounds like you guys are working through that.

[00:17:25] Jake Leach: Yeah, yeah, yeah. It's basically two sensors per month, but with plenty of those replacements of something, you know, falls off, doesn't last. We want to ensure that users always have the sensors they need. So it's a big part of CGM technology is that sensors don't always last the full duration. The vast majority do. But when there is an issue, we want to be able to make sure that folks get those sensors and we can ship them those replacements. And they can keep going because it's so important in their therapy. We fully understand that.

[00:17:53] Rob Howe: Yeah, and I think this is a good segue into some of the recent G7 product quality issues that you guys are addressing. And I think most recently, the product recall and the options that patients have to sort of return sensors in certain batches that have been recalled. I want to know a couple of things, like obviously like what you can share with us about that, but also how Dexcom behind the scenes like is listening to that feedback and getting back to patients and what we should know about what's going on behind the scenes with you guys.

[00:18:21] Jake Leach: Yeah, sure. Well, first thing, one thing to make sure is clear is no sensors have been recalled. We did have a receive, the receiver that folks, some people use that. We do want users to check their serial number. We have a number of devices that have a component, the speaker component in there that, you know, alerts and alarms are such a critical part of what CGM does. And there's this extremely low probability for a certain batch of receivers that that speaker may stop functioning after a period of time. And we've seen a very low occurrence rate of that, well below 1%. But we want folks to really check that. So on our website, you can go to our website and type in the serial number. And if it's impacted, we'll arrange for you to get you a new one. If it's not impacted, then you can keep going. That's for users that use that product. So, you know, although it's a really low probability of something happening, we want to make sure that those folks get the alerts and alarms they need. That's related to the receiver for G6, G7. On the sensor side, yeah, we're always, you know, striving to continue to enhance the product reliability. When issues pop up, we address them quickly. We monitor both in the factory but also in the field the performance of our sensors. We also talk to customers quite frequently about their experiences and we monitor all the channels out there in the traffic and different discussions. And we've been growing and growing and scaling our business and issues do happen and we basically jump on them and fix them rapidly. And so it's kind of like a never ending part of getting CGM to millions of people around the globe is making sure that we're always improving the technology.

[00:20:00] Rob Howe: Yeah, thank you. I think I want to just make sure that I ask that. Otherwise, my audience, I don't think, would be very happy with me.

[00:20:06] Jake Leach: Yeah, I think the main thing that we want users to know is, one, we know issues happen. Two, we want to be able to replace sensors if an issue does happen without a limit. There's been a lot of discussion around limits on sensors. If you have a sensor failure, we're going to replace that with no limit. There's no limit on that. And so we really want to make sure that users know we're listening, we're continuing to improve the product, and we want to make sure you always have the sensors you need.

[00:20:29] Rob Howe: Yeah, thank you. And as we kind of wrap the interview up, like as you are getting ready to go to Chicago and, you know, join up with the team, like what, you know, what should we be excited about seeing from from Dexcom? You know, maybe even something we haven't covered yet in the type 2 diabetes attitudes and experiences report. You know, as you guys are gathering together for this, like what's what's top of mind for you?

[00:20:49] Jake Leach: It's really, it's the largest, you know, ADA is the largest diabetes conference in the United States. And for us, it's one of the biggest conferences of the year where we get to see many of those healthcare providers and the key opinion leaders that are out there driving awareness and creating the evidence that's needed so people can get more and more access to CGM and coverage. And it's a global meeting, so we see a lot of our, you know, different folks from around the globe. And so we're really excited about the evidence. This year in particular, we've got a really significant number of abstracts and presentations in the scientific sessions around CGM and the impact it makes across the spectrum of diabetes, pre-diabetes, and even health and wellness. So really excited about that and really spreading awareness around CGM technology and the benefit it can have.

[00:21:36] Rob Howe: Jake, thank you so much for your time and have a great conference. And I appreciate you making this contribution to Diabetes Innovations and Diabetes Doing Things podcast.

[00:21:45] Jake Leach: Yeah, it was a pleasure, Rob. Really, really enjoyed speaking with you and look forward to chatting again soon.