I was incredibly lucky to be invited by Dexcom UK and Ireland to attend the 11th international conference on the Advanced Technologies and Treatments for Diabetes (ATTD) held in Vienna this year (Berlin next year – please invite me again, Dexcom!)
Bias aside, this was definitely the most attended talk of the conference that I went to, and I went to a lot of talks! The big reveal was the Dexcom G6, although pictures and some details have been available online for several months now. I will summarise the features below, but I would say that the big reveal is that it won’t require any calibrations. If you’ve had your Google News alert on for Dexcom, as I have, you’ll know that there was debate as to whether Dexcom would first bring out a one calibration device, followed later by a no calibration version. Rumour has it that the delay in announcement was due to Dexcom waiting for the no calibration to be be perfected – so this would technically make the G6 the G7. Either way, it’s an amazing advancement for parents of children with diabetes who have been put off by the twice daily recommendations on the G5. For those of you who use and value the ability to calibrate, worry not – you will still be able to calibrate the G6 should you wish to, although the party line is that because each sensor will be factory calibrated, there is no need for this feature. Still, I’m glad to see that it’s still an option as I’m prone to a calibration or four!
New features for the G6:
- The sensor will now last ten days, rather than seven for the G5.
- The sensor will be slimmer in profile – by 30% compared to the G5. If you don’t use Dexcom, you might think that the G5’s quite bulky, but it really isn’t, and the G6 will be even slimmer still.
- The new applicator looks much less like a torture device, and a lot more like the Libre inserter. In a clinical study, 98% of kids rated the new applicator as “very easy” or “somewhat easy” (vs. 59% for the G5), and 70% rated the pain as “didn’t feel anything” (vs. 30% for the G5).
- The sensor will have improved accuracy overall, but especially on day one – the MARD increased from 10.7% on the G5 to 11.2% on the G6. Without any calibrations, it maintained an overall accuracy of 9% MARD compared to the same accuracy of the two calibration per day G5.
- No interference from Paracetamol/Acetaminophen – I always use Ibuprofen anyway, but this means that I can have Lemsip again without my sensor giving up the ghost!
- There will also be a new feature called the ‘Urgent Low Soon Alert’ which is a predictive low alert that is more effective at predicting hypos that the current ‘Fall Rate Alert.’ It’s designed to give you a fifteen minute warning before you become hypo, so that you can hopefully treat it before you actually hit those low numbers.
- The G6 will allow you to set a second set of customisable alerts – so you could set different target BGs overnight, or for weekends, or for sport, etc.
- There will also be more compatibility with smart watches. So far, Dexcom have confirmed that they are working on direct to watch communication with the Apple Watch and the new generation FitBit watches. In a Q&A, I was informed that the plan is also to work with Android, but nothing has been confirmed yet.
- Dexcom G6 will be compatible with more devices – Insulet Omnipod pumps, Tandem pumps (not yet available in the UK as far as I am aware, but this is who Dexcom is testing their closed loop system with, so one to watch), and with Eli Lilly smart insulin pens.
- There was also confirmation of Dexcom’s partnership with Google Life Sciences department or Verily in making a much smaller CGM which will be factory calibrated; last for fourteen days; feature a disposable, single use transmitter – all with the aim of bringing CGM technology to more people for much less money.
CGM vs. FGM
One of the main debates at the conference seemed to be between the relatives merits of Flash Glucose Monitoring (Libre) and CGMs (Dexcom and Elite). The overall message was that Flash is a great stepping stone in taking control of your diabetes, but that CGM is a better tool overall. It’s hardly a surprising conclusion, but I was surprised by how this topic dominated the conference. It didn’t feel very innovative to make these suggestions, and I had hoped for something more in the way of second generation Flash. I know so many people for whom Flash is a perfect tool precisely because it doesn’t have alerts, and doesn’t require calibrations. Alert fatigue with Dexcom was mentioned more than a few times, and I agree that there should be an option to turn off all alerts. Whilst being alerted to an urgent low is useful the majority of the time, sometimes just having the option to turn off alerts (without having to turn off Bluetooth, which is the only current method to silence alerts) would be beneficial.
While at ATTD, I also had the pleasure of meeting the team behind my favourite ever diabetes charity – INPUT. Lesley and Melissa were just as lovely and knowledgeable in person as I had hoped. Please do check out their website if you live in the UK and are interested in pumps or CGMs. Without them, I am certain I wouldn’t have an NHS-funded Omnipod!
I did ask Eversense when they were coming to the UK, but I won’t even bother repeating the BS answer I got from them, but it involved the phrase “lots of happy NHS funded patients” if that helps clear up the kind of reality they’re living in.
Finally, on the last day, I ended up by chance chatting to Cyndi and Isabella from Ayuda Heuristics. I don’t find MySugr personally useful, so I didn’t have high hopes for a diabetes app, but I was actually pleasantly surprised to hear about such an innovative app. The team did a much better job of explaining how the app works, but I understood it to work like this: Through collecting data from multiple sources such as your Dexcom, location, calendar, etc. the app learns how your behaviours affect your blood sugars. For example, it may notice that during a regular meeting scheduled on your calendar, your blood sugar rises from stress. It can then suggest an increased temporary basal the next time your calendar shows that you have that meeting. Furthermore, it uses your individual diabetes data together with other app users’ data to identify people with similar patterns, and then uses that collective data to help you both. They are currently recruiting beta testers using iPhones and insulin, so please visit here if you’re interested.
Medtronic very graciously let me use their pumps to demonstrate how a tubed insulin pump works. Whilst there, I learned about their newest infusion set: the MiniMed Mio Advance, and I am happy to report that my friend was able to get her hands on it, and is very pleased with how painless and easy the insertion was. It’s their most advanced infusion set so far, so I would encourage you to try to get your hands on one if you’re not a fan of your current infusion set. I was also informed that it’s cheaper to prescribe than the Sure T, so if you’ve had issues with your clinic prescribing those, you might have better luck with the Advance set.
Stay tuned for a second blog post from ATTD all about the new Omnipod Dash and Horizon system, along with my first impressions of my Omnipod pump!
There are also lots more photos saved on my ATTD Instagram story if you’re into ‘hilarious’ captions and that sort of thing!
Also, please check out the babe that is Natalie Balmain’s brilliant ATTD vlog here – I am awkwardly answering questions throughout!
A note: I was invited by Dexcom as part of the #DexcomTribe for the Dexcom G5 Mobile. In the spirit of honesty, they paid for my flights, accommodation, and food, but I was not monetarily reimbursed for my time. I was not asked to create any specific content.