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Diabetes Connections | Type 1 Diabetes
Dexcom Stelo + Oura Ring: all about the new “Glucose” feature (Bonus episode!)
00:27:50
Dexom and Oura announced a partnership a few months ago and now they've announced a new integration. This is the Dexcom Stelo – the OTC biosensor (they don’t call it a CGM) for people who don’t use insulin and Oura a smart ring for fitness...
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Transcript38 lines
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Foreign.
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Hello and welcome to a bonus episode of Diabetes Connections. I'm your host Stacey Sims and you know, we aim to educate and inspire about diabetes with a focus on people who use insulin. However, this episode includes a lot of information for people who don't use insulin, people with type 2 or pre diabetes, but it also has implications for Those with type 1 and people with type 2 or other types of diabetes who do use insulin. Which is why I'm putting it out as a bonus episode. We are talking about the newly announced integration of Dexcom and Aura. This is the Dexcom Stelo, the over the counter biosensor. They don't call it a CGM for people who don't use insulin. And the aura this is a smart ring for fitness, stress, sleep and health. If you're new around here. And this is a type of an episode that brings in a lot of new people. Welcome. We're we have been doing this show for 10 years. This summer my son has type 1 diabetes. My husband lives with type 2. I don't have any kind of diabetes, but I do have a background in broadcasting and that is why I started the show back in 2015. I also host Mom's Night out events. We do four of those a year now and those are for moms of kids with diabetes and for Women with type 1. You can head on over to diabetes-connections.com or just click on the link in the show notes to find out more about that. This fall we will be in Minneapolis and Phoenix and we are going to announce our 2026 locations probably by the end of May. So excited about this event. It's been a lot of fun. I also have done many episodes of Diabetes Connections about Stello and about Dexcom and some information leading up to this integration which was just announced this week. So I will link those episodes up in the show notes as well. But again, if you're new you can always head over to the website diabetes-connections. Com. There is a very robust search. There's a little search box in the upper right corner. Just put in your keyword like Dexcom or Stello and you'll get all the episodes that we have done. I did a whole year of type 2 episodes so there's a lot of really good information there as well. All right, from the news release about this and I am quoting here this first to market Glucose Biosensor and Smart Ring integration will provide members with a personalized metabolic health experience that will allow users to better understand the link between activity, sleep, stress, nutrition and their Glucose. It will be available in the new Glucose feature within the OURA Ring app to all US members. Also, Dexcom and OURA are making this partnership as accessible as possible by allowing OURA members to purchase Stelo directly from Oura Ring.com end quote from the press release. My guest is endocrinologist Dr. Helen Barron, medical Director of Diabetes Education Services at Eisenhower Medical center in California. And a quick disclosure, Dexcom is a sponsor of the podcast and of Mom's Night out, but they don't tell me what to say or what questions to ask. I do think it's always important to disclose that. Okay, I would love to know what else you want to know about this integration, so please reach out after you listen, let me know. I do think this has implications down the road for people who use insulin. We do talk about that and you know, we're going to follow up and have more information down the road. All right, here is my chat with Dr. Helen Barron. Dr. Helen Barron, welcome to Diabetes Connections. I am excited to talk to you. How are you today? Thanks for being here.
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Well, thank you for having me, Stacy. I also am thrilled to be here and excited to talk about great things on the horizon for us.
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Before we jump in, would you mind just telling me a little bit about your background? I know as soon as you jump off this call, you're going to go see patients.
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That is correct. I am an endocrinologist. I did my medical training at USC in Southern California. I did my internship in residency and internal medicine at usc, my fellowship in endocrinology, diabetes and metabolism at usc, after which the brilliant minds at USC realized I wasn't going anywhere anytime soon. And I was made an assistant professor of medicine and endocrinology, diabetes and metabolism at usc. I stayed there in academic medicine for over a decade before I then made the switch to become the medical Director of Diabetes at Eisenhower Medical center in Rancho Mirage, California. I'm a full fledged clinical endocrinologist. You got a hormonal question? I got a hormonal answer. But diabetes is clearly my passion.
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Wonderful. Well, we have a lot to talk about today. Let's jump right in because the announcement came through that Dexcom and AURA are launching an integration. So let's talk about that from your perspective. And I, I, I can go through and read the press release here, but what does this mean for people with diabetes? Because aura is a sleep ring, right?
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That is correct. Aura. And I just happen to be an Aura wearer and member myself. And I've worn the OURA ring for a few years now. It is a delightful tool to provide insight into your metabolism. It gives information in a variety of parameters, not just limited to sleep does have a pedometer function and so it will tell you your activity levels and that in conjunction with other parameters. For instance, it can check your oxygen level in your blood, it can read the temperature of the body, and it detects your sleep patterns. So all of these features combined together can provide metabolic insights into how you are doing, how you are feeling, and how your body navigates the slings and arrows of daily life.
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And in terms of diabetes, I think we all know, I mean, I've seen in my son and certainly in my husband when they're not sleeping well, you know, when you're ill or other things are going on, your diabetes, your blood sugar fluctuates all over the place, more than normal. But is it proven? Is there a link between sleep and diabetes?
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Most certainly. So sleep is underrated. Sleep is such a wonderful health parameter, really, the trifecta of incredible biochemical health are good food intake, good exercise and good sleep. And if you are deficient in any one of those three major parameters, you're going to find that you try to make up for it in other entities. For instance, you don't have good sleep, you wake up tired, you wake up groggy, and if you don't have the opportunity to exercise, what are you going to reach for? For energy. Food. Yeah. However, a good night's sleep, you wake up feeling wonderful, you wake up feeling empowered, and then you can tackle the day in a more biochemically appropriate way.
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Boy, I have so many directions I want to go in. The first thing I want to do is just share and I think many of my long term listeners might know this. So I spent 13 years in morning television and radio, which meant I got up at 3 o' clock in the morning.
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Wow.
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Which we. Oh, not good. Also meant with. I had little kids and my husband owned a restaurant that I was going to bed way too late and I got sick. So as a mom of a Kid with Type 1, a community that is almost, I probably shouldn't say this, but I'll say it anyway. A community that's almost proud of the lack of sleep that they get. Like if I can get less sleep, my kid will be more healthy. And look at what a great mom I am. I'm always preaching like you're just going to hurt yourself. And I wound up in the hospital from lack of sleep. So I. I know, but it is really hard to get a good night's sleep, whether you live with diabetes or you care for someone with diabetes, a little bit separate. But I wanted to say all that to ask Oura Ring, how does it help your patients get a better night's sleep? How does it help you get a better night's sleep? Does it. Is it actionable?
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Not a problem. So, yes, although I'm not an official or a spokesperson, as I mentioned, I do wear the ring. I have done so for a few years. I. And in fact, it was recommended to me by a colleague in 2020, a fellow physician who said he knew that he had contracted Covid two days before first clinical symptoms. And the reason for that is that the Aura ring showed him his body temperature was increasing, his oxygen saturation was decreasing, and his sleep was becoming disturbed. And so with that information he had in the back of his mind, something is happening. And so Aura will tell you your sleep is not the same, and it'll ask you questions. What do you think is going on? What happened to change your sleep habits? And if it was something that you did, perhaps eating late at night or late caffeine, you acknowledge it. But if nothing else changes, you know to be on the lookout for something biochemically amiss. So within the Oura Ring, you can download an app to your smartphone or. And it provides a beautiful dashboard of these different metabolic functions, including sleep. And then you can tap onto the sleep for more information, and you can see your sleep latency. How long did it take you to fall asleep once you lay down, and then the different stages of sleep and whether or not you were awake or restless. And we in the medical community are so fond of the saying that knowledge is power, that we can assess and address an issue with baseline knowledge, because at the end of the day, without data, the chatter don't matter. You can feel unwell, but if you don't have data to back it up, there's nothing actionable there.
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Are you sure you're not going to be an official spokesman for anybody? That was. That was great. But to be clear, the OURA ring itself, when we're talking about Dexcom integration, it is not measuring glucose. It is taking the CGM readings from the Dexcom and integrating it into the platform. Tell me what the glucose reading in Aura will show people.
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Fantastic. So at this point, prior to the official launch of the Stella and the Aura integration, there's no glucose parameter on the app for the Oura ring. As soon as we have the integration May 6, we are going to be able to See additional features in the app for the aura, including glucose and meals. And that glucose will be an integration with the Dexcom STELO device, a biosensor that reads interstitial glucose. And so now that information will be integrated with the aura. So not only are we going to look at your exercise level from the pedometer function, not only are we going to look at blood oxygen saturation, not only are we going to look at temperature and sleep, but we're going to include glucose. Now, I'm very biased as an endocrinologist and a diabetologist, but I believe glucose runs the world. And to provide these insights in a meaningful, intangible way. So that when the OURA ring says, you didn't sleep well last night, what do we think is amiss? We can look at that glucose function and we can see, did we have a spike overnight or did you go low overnight? What happened? Was there an erratic nature to your glucose? Right now, with the aura, one of the things that it mentions if you don't have good sleep quality is did you eat too late? Which is an intriguing open question without anywhere to go except for food for thought, no pun intended. But with the integration with Stelo, we should be able to get meaningful, actionable evidence of, oh, I did eat late last night. Oh, look at my glucose. Oh, I can now see how the higher glucose affected lower sleep quality. And then that metabolic insight will provide, hopefully, actionable events for the individual and learn to make changes that will not only improve sleep hygiene, but downstream improve biochemical health.
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Yeah, I mean, knowing that Stello is approved for people with type 2 diabetes, and I want to talk about type 1 a little bit later on and the implications down there, how do you think, and speculation here, how do you think you're going to talk to your patients about using this together? That late night food is a really good example.
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Excellent. So, as you mentioned, the STELO is a BioSensor device, a CGM continuous glucose monitor that is approved for individuals that, that do not take insulin. So at this point, it is not for the type 1 cohort, nor is it for individuals with type 2 diabetes that take at least one injection of insulin a day. But for individuals with type 2 diabetes that are not on insulin, for individuals that have pre diabetes and may not be on medical therapy, for individuals that have a family history of diabetes, for individuals that are just glucose curious, so to speak, this is a device to open their third eye to their biochemical soul and understand where their glucose goes. And this can provide incredible information, admittedly Individuals who first start with a CGM will feel like there's an onslaught of data. Gone are the days of the intermittent finger sticks. Here you're getting data every so many minutes throughout the day, and it can cause paralysis by analysis, so to speak. But what we hope is that this data will be food for thought for the individual and will lead to open and direct communication with their healthcare team. My hope is when you see this data, you will think, how do I even begin? Great, engage me in a conversation. Let's talk, let's learn, let's move forward.
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Yeah, and I used the Stello briefly. I was a. I guess I was glucose curious, and I was. I'll tell you what surprised me the most. There was a robust encyclopedia type of information within the app. Because my concern, you know, as somebody who's done this podcast for a long time and been in the community a long time, is like, you can't put this on someone and then send them out in the world with no information. It is very scary and overwhelming. And I was impressed, frankly, with that. I hope people use it because a lot of us are just plug and play, and we. We just want to go through knowing that STELO is made for people who do not use insulin. What do you think? I mean, we're, we're. We're moving towards a little bit of speculation here, but I. I'd love to use your knowledge as an endocrinologist and a diabetologist about the use for a lot of these biomarkers for people with type 1 and people who do use insulin, because not only are we hearing, and again, we're speculating here, but not only am I hearing about more. I don't think acid is the right word, but more things that can be measured by interstitial fluid. Right. We hear maybe, oh, maybe down the road we'll hear ketones. Maybe down the road, alcohol. Maybe down the road, other things that we are just dreaming up. You know, where do you think all this is going to be able to measure so many of these things?
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Well, I am fond of the phrase dream it, believe it, achieve it. And I truly believe that science continues to march forward, but it marches forward incrementally. So right now we can talk about what we have at our fingertips, which is the Dexcom, stelo and AURA collaboration, where we add glucose readings into the metabolic health knowledge. Yes, we can definitely dream about additional entities that could be included and integrated in the future. And you mentioned some lovely entities, which I also want to see. But at this point, it is Glucose added to the baseline metabolic features of the OURA ring. But I am totally aligned with you, Stacey. You know we should always be happy with what we have. But yes, I'm very much a hey, what next, what next? What next individual. And what a beautiful stepping stone this is. We will enjoy it, we will utilize it and of course look to the future.
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One of the features that I did want to ask about, one of the features in this integration is time above range. Yeah, that I'm reading. We were familiar in this community with time in range. Time in tight range has become a conversation. Why time above range? Why is it important that that's noted?
- [16:11]
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Excellent question. So the Stelo device is going to be available for individuals 18 and older that do not have type 1 diabetes, do not have type 2 NR insulin. So if you are an insulin, there are other devices that may be utilized. If you are not on insulin and you have type 2 diabetes or pre diabetes or again are just glucose curious, so to speak. Or there's other parameters that for instance family history of diabetes, et cetera. This is a beautiful, insightful tool and one of the important things that we really need to remember is the prevalence of pre diabetes in this country, diagnosed and undiagnosed. And we all know where prediabetes goes when it grows up overt type 2 diabetes. And so this can be a beautiful tool in a meaningful day to day way that can capture individuals that are moving from normal glucose levels to elevated glucose levels. Now the converse hypoglycemia. If you have hypoglycemia that is known and that is documented, there are then other devices we can utilize as well for that. So the emphasis here is looking at that elevated or time above range glucose. And I think what Stello does is fantastic. Some of the parameters that you put into Stella when you first utilize it are do you have type 2 diabetes or pre diabetes or to the best of your knowledge, do you have normal blood glucose levels? And then the Stella will have different parameters. For instance, if you do have diabetes or prediabetes, you you will then have a range between 70 and 250 milligrams per deciliter as a blood glucose. If you indicate on the app that you do not have diabetes or prediabetes, Your range is 70 to 140 milligrams per deciliter. So I think that is very clever and very insightful as well. And the goals in the Stelo, if you indicate that you do not have pre diabetes or diabetes, is that your time in range is 96% or, or more. If you are outside of that time and range and that you're going higher than that, that is meaningful, actionable data that is giving to you in real time, not waiting until you go into a provider's office and getting maybe a hemoglobin A1C, which there are other biochemical values that interact with that. But here is meaningful, actionable data where we can do something about it. And in medicine, as in life and every big problem starts as a small problem and it is easier to intervene in the beginning. So I am just enthralled and excited about getting this device out there to individuals to gain biochemical insight into how their glycemic control progresses.
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So, you know, it's so interesting, Dr. Barron, because when I saw and I, you know, I come from a different perspective having a child with type one, when I saw time above range, my first reaction was like, oh no. Like, who needs to see that? We know how hard it is to spend time in range. We know how hard it is to manage type 1 diabetes. The idea that it's more, I can't call it a diagnostic tool because obviously Stella was not a diagnostic tool. But the idea that you could take that information and say, wait a minute, my device says I have time above range, I got to talk to my doctor, maybe I do have pre diabetes or diabetes did not occur to me. That's my own bias. But it sounds like this is something that, you know, that's the way you're looking at it. Not to put too fine a point on it, but that's the way you're looking at it.
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Stacey, I love the way you described it, that it's not a diagnostic tool. Exactly, but it is something. I would call it an insightful tool. Yeah. So as opposed to diagnosis, it's metabolic insight. It's giving that next level information and engaging in a discussion with the healthcare team to be able to intervene and have actionable, tangible results much sooner than otherwise would be. If you're just waiting for maybe a once yearly physical or waiting for symptoms here, we can nip it in the bud, address and assess and get on the right path.
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You know, everybody should have a doctor Baron. Right. But if they don't, many, many people, probably the vast majority of people with type 2 diabetes see a general practitioner. Are you hopeful that this will help the doctors better understand and maybe jump on things a little bit sooner? I mean, they're so great, but they're so overwhelmed.
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I completely agree. I completely agree. I think that this insightful tool, looking at individuals metabolism will engage an individual in discussions with their primary team at a much earlier rate where things are perhaps not as intense or not as distressful because we don't see these very, very, very elevated blood sugars. And so immediately there needs to be this medication and that medication we can focus on the foundation of type 2 diabetes, which is TLC. And I don't mean tender love and care, I mean therapeutic lifestyle changes. So that would be an increase in aerobic activity. That would be medical nutrition therapy. We don't use the D word diet. We talk about healthy fuel and we talk about weight loss if appropriate. And we talk about good sleep and good health hygiene. So see how it completes the circle and it all comes back to the beginning. This is what we want for our patients. We want not to wait so long until we have a process, a metabolic process that's difficult to control, but to be able to work to perhaps even reverse it to some extent or at least maintain that low level for as long as possible.
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So you mentioned that you've been wearing an OURA ring for a long time now. Have you learned anything that surprised you or any examples of ways that you've changed behavior?
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I have learned so many different things. So just a little bit of insight. I am a very good sleeper in general.
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Oh, congrats.
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A
Part of my medical school where I felt so sleep deprived for so long that now it's like my body says thank you. My sleep latency is very short. I actually fall asleep within 15 or 10 to 15 minutes of actually laying down. Go me, I didn't know that. And my stage four most deep and restful sleep comes in the first part of the night when I go to bed. And I found that so insightful. So we typically have these sleep cycles that last about 90 minutes and when you go through the different stages. But my deep sleep all happens very early on in the evening and I thought, oh, that is really interesting. So if there are some days where I have to wake up much earlier than usual, for instance, I have to travel or something else, you know. I know. Okay, well I'm going to move my sleep time up a little bit because I definitely want to make sure I get that core deep sleep in and I know I can front load it in the early part of the day, my sleep and then when I wake up early in the morning, I might be a little bit more tired, but I don't feel groggy and I don't feel unwell. So it was really insightful for me and I did make actionable changes because of it. I kind of have a little summary thing, if you don't mind. Oh yeah, yeah, yeah, for sure. Okay. So I've done a lot of thinking because I've worked with Dexcom in terms of utilization of their beautiful CGM products in my patient population as long as I can remember. I myself am a personal OURA ring wearer. So when I heard about this collaboration, it spoke to me not only professionally, but personally and this is what I think are some of the great things that we can do. So Dexcom and Aura are teaming up to change how we manage blood sugar and overall health. The Dexcom STELO biosensor tracks real time glucose. The OURA ring monitors sleep activity and recovery. Together they give individuals powerful personalized view of how lifestyle impacts blood sugar, turning daily choices into smarter health decisions. This is more than just a tech collaboration. This is a new era in proactive metabolic health management. This is where data meets daily life. This is where insight drives action. Welcome to the future of metabolic health.
- [24:38]
B
So having said that, let me ask you, you were just, you mentioned your lack of sleep when you were a medical student and you know, you've obviously, we all have over the last 20 years seen so many changes in the way diabetes is managed day to day, including cgm. When you think about it and you look back and you, you know you're going to go see patients in just a couple of minutes, right? I mean, any conclusions to draw just from the changes that we've already seen heading into that future that you mentioned, pulling into daily life? I mean, you've got to be very optimistic.
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I am, I am. I'm the eternal optimist. My glass is never half empty nor half full. It's always overflowing because I have to consider the air in the glass. I am a very positive person. I am so excited and thrilled for this collaboration because I think for those individuals that are in this field of metabolic health, we're aware of some of the tools and we utilize them. But to be able to take a step beyond the ultra techies and to be able to expose more individuals to their own biochemical insights of health, well, that'll help me so much as a physician, that will help my future patients so much. We are doing everything in our power to give individuals not only the length of life they want, but but the quality of life they deserve. And it starts with biochemical insights to be able to intervene earlier rather than later to preserve that excellent health and quality of life for our patients.
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Dr. Barron, thank you so much for joining me. I am just going to take your enthusiasm and it's going to carry me through the day. I hope I can sleep tonight, but thank you so much for sharing all the information.
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Well, I use my energy during the day.
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There you go. Perfect. Perfect.
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Stacey, thank you so much for this beautiful opportunity. It was an absolute delight speaking with you. Congratulations on everything you've achieved personally with your family and professionally and I would love to speak with you anytime. Again, thank you for this beautiful opportunity.
- [26:40]
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Fantastic. More information about the Aura Stello Partnership. You can just go to diabetes-connections.com and click on the episode homepage. Or if you're listening in a podcast app. There are pretty robust show notes wherever you're listening, but if you have any trouble finding them, just come on back to the homepage. If you're new and you like what you hear, please share the show and please subscribe to the show as well. It's always free, but if you're listening in a podcast app, just hit they're all different. Hit like follow or subscribe and that way you will automatically get the show wherever you are. Listening. Thanks as always to my editor, John Buchanis from Audio Editing Solutions, and thank you so much for being here. I'm Stacey Sims. I'll see you back here soon. Until then, be kind to yourself. Diabetes Connections is a production of Stacy Sims Media. All rights reserved.
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All wrongs avenged.
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Sam.