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Diabetes Connections | Type 1 Diabetes
Dexcom's 15-Day G7 Is Here: What's Changing, What's Next, and What You Need to Know
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- [00:05]
A
This week on Diabetes Connections. It's been a big month for announcements from Dexcom. So what does it all mean for you? The commercial launch of the 15 day sensor, a smart basal feature, and the announced phase out of the G6. I'm talking with Jessica Castle, vice president of Global Medical affairs for dexcom. We're covering all of this news and she is answering your questions. This podcast is not intended as medical advice. If you have those kinds of questions, please contact your healthcare provider. Welcome to another week of Diabetes Connections. I'm your host, Stacey Sims. You know, we aim to educate and inspire about diabetes with a focus on people who use insulin. If you're new around here, my son was diagnosed right before he turned 2 back in 2006. He's now about 21. I have a background in broadcasting. I spent my career in local television and radio news and that's how you get the podcast. Quick programming note, as we are barreling into 2026 here, we are making some changes to how the podcast and when the podcast is released next year. After ten and a half years of doing this show weekly and then adding an in the news episode, additionally twice a month, going to be changing that to an every other week schedule. In other words, the first week of January, you'll get an interview episode and then the second week in the news, the following week back to the interview, the next week in the news, and so on, rotating every other week with the formats. Of course, we'll probably wind up throwing some bonus episodes in there if something, you know, timely happens that I don't want to wait on. But as many of you know, we've added a lot of events and I'm speaking more and I'm writing more and I want to make sure the quality of this show does not change. I'm really excited to see what you think of it and how this goes. Just as an example of travel, in January, I'm going to be at the Breakthrough T1D Bethesda Summit. That is January 24th. It is in Rockville, Maryland. I'm doing what Breakthrough calls the author corner. So I'll be there with my books, the world's worst diabetes mom book series, and. And then I'll be back in that area. We'll be in Silver Spring, Maryland in February for Mom's Night Out. A lot more stuff going on for 2026, but we'll get to that. I know you're here to talk about Dexcom, so let's get to it. You know, Dexcom seems to like to throw US a curveball at the end of the year. I can't tell you how many times we get to December and there's Dexcom news. You know, usually it's an FDA approval like we got with the 15 day. Sometimes it's a big announcement like we saw with the G6 being discontinued. Either way, it's always of high interest. And so I'm very excited to be talking to them about this and giving them your questions. Most of these questions come directly from the Facebook group Diabetes Connections. The group and my guest is Jessica Castle. She is the Vice President of Global Medical affairs at dexcom. She is also an adult endocrinologist with vast experience in clinical trials. She has worked extensively in trials with automated insulin delivery systems. Finally, one quick disclosure. Dexcom is a sponsor of this podcast and is also a sponsor of our Mom's Night out events. They do not tell me what to say or what to ask. All right, my conversation with Jessica Castle right after this. Hey everybody. I know this is a busy time of year, but a quick reminder that registration is already open for three of our four 2026 Mom's Night out events. This is a unique event for moms of children with diabetes and Women with type one. Join us in the Washington, D.C. suburbs. Nashville, Detroit and Seattle for education, technology, community and cocktails. Use the promo code podcast to save 15% off. And that promo code is on top of our early bird specials, so do not miss out. All of the Moms Night out information is over@diabetes-connections.com Dr. Jessica Castle, welcome to Diabetes Connections. It's great to talk to you. How are you doing today?
- [04:04]
B
I am doing great. Good morning. Thanks so much for having me on your podcast. It's great to chat with you today.
- [04:10]
A
Well, I'm glad to have you here and it's always a busy time of year. It seems Dexcom likes these end of the year announcements. I was looking back in my notes and I feel like I do a December Dexcom episode almost every year. We've got a lot to talk about. But before we jump in, this is our first time talking for the podcast. Would you mind telling me a little bit about what you do at dexcom? You're an endocrinologist. Tell me a little bit about yourself.
- [04:31]
B
Yes, happy to. So I'm the Vice President of Medical affairs at Dexcom. I joined DexCom about two years ago and prior to that I was at Oregon Health and Science University in Portland, Oregon, so an academic medical center where I went to medical school and stayed on and did My training in endocrinology and then stayed at the Harold Schinter Diabetes Health center and was eventually the associate director at the diabetes center and had the great opportunity to be a healthcare provider for many patients living with type 1 or type 2 diabetes. I did a lot of work in clinical trials, including with dexcom, and worked in journal publications, including Diabetes Care.
- [05:12]
A
I have so many questions. Jessica, let's start with what I think is most on people's minds, because it is the most recent and that is the news that the G6 will be phased out. Can you give me the particulars of that? Let's start with just the nuts and bolts. Dates, times, all that kind of stuff for sure.
- [05:28]
B
So G6 is being phased out globally. In the US we can guarantee supply up until July 1st, and after that time, we won't guarantee the supply. We know that G6 is near and dear to many people's hearts, and so we want to make sure people have time to switch over to G7 or G7 15 day, which I think we'll talk more about later in the podcast. And it's important for us as a company to continue to innovate. Right. That's how we best serve our customers. Obsoleting G6 gives us an opportunity to focus on our next stage of innovation.
- [06:04]
A
It's funny, you know, my son started on the Dexcom G4 pediatric platinum, which was one of the early editions, obviously, of Dexcom, and it was pediatric only in that when you had the receiver, you had another page to scroll through. I don't think there was much of a difference, but we've been through a lot of different iterations. The G6 has been around for eight years. Am I right in that?
- [06:25]
B
That's right, yes. Many, many years of great use for so many patients. I'm excited for people to have the opportunity to transition to G7 or G7 15 day, but understand that it will be a period of time of transition for people.
- [06:40]
A
Yeah. And this may be an obvious question, but just to make sure to mention it, G6 is compatible with a lot of pumps. Is G7 compatible with all of the pumps that G6 is currently working with? There's not going to be an issue, in other words, with that kind of transition.
- [06:55]
B
Yes, that is correct.
- [06:56]
A
I think there may be some confusion because. And again, we'll talk about the G7 15 day, because that is not, as you and I are talking, that's not compatible with all of the pumps that partner with the G7 plane.
- [07:08]
B
That's right. Although maybe I could start with just saying a few words about G715 day because that might be a lot of people. And then I can talk a little bit about the pumps. But it is our latest and greatest product, so it's something we just recently launched. It's for adults living with diabetes and it lasts up to 15 and a half days, whereas our original G7 lasts for up to 10 and a half days. And as you mentioned, it will be integrated with multiple aid systems or automated insulin delivery systems. So that includes Beta Bionics, Islet Bionic, Pancreas, as well as the Omnipod five. And we're working very closely with Tandem. So we will be excited to announce later next year around our integration with Tandem.
- [07:52]
A
Okay, so how does it work? You know, we are a family that uses G7 and have not looked yet that deeply, frankly into the 15 day. Will Benny need a new prescription? Can I get it at the pharmacy? Take me through the process here.
- [08:07]
B
Because it is a new device, it does require a new prescription. So you need to go to your healthcare provider to get a prescription for GS7 15 day. It is currently available through DME suppliers and will be available very soon next year in pharmacies.
- [08:23]
A
You know, when we're talking about this here, we're seeing Dexcom G7. Dexcom G7 15 day. How long is this G7 original recipe really going to stick around for? And are you going to. Or are you going to wind up calling them different things?
- [08:35]
B
So great question. I would say, you know, we have no plans at this moment in time to phase out the original G7 or the G7 10 day and it will continue to be called G7 and then our newest product will be called G7 15 day.
- [08:50]
A
I'm sorry, this is a long running. I've done this podcast for more than 10 years and my long running comment is always like, can we give these things names instead of numbers? But I know that that's how it works and I know eventually we'll go to G8. You know, I can't imagine that it'll be called something different, but staying on the 15 day sensor for just a minute. Are there differences in the 15 day sensor other than the longer wear? Are there other improvements?
- [09:15]
B
Yes. So we recently got FDA clearance for Smart Basal. So that will be a feature soon to be launched on G7 15 day. And smart basal is an algorithm that helps adjust basal insulin for people with type 2 diabetes. So it is initiated by a healthcare provider and that healthcare provider puts in some settings, like for example Maximum insulin dose. And then Smart Basal uses the CGM data to minimize lows and highs and gives the the patient a new recommendation every day on how much long acting or basal insulin to take.
- [09:55]
A
I love this feature and I know that this is a primarily type 1 diabetes podcast, but as you listen, please understand there's a lot of people more and more all the time with type 2 who use insulin who are listening to this show. So I promise we're gonna get back to the. The other issues you have in just a moment. We have a ton of listener questions, but staying on Smart Basil, I think this is fantastic. Tell me a little bit more about how people with type 2 might use this. Because Basil dosing is. It's tough to get it right.
- [10:21]
B
It is incredibly tough to get it right. Having done this for many years, and. And I think sometimes people feel alone when they start insulin. And Smart Basil really is an opportunity to have to support people on an ongoing basis. And also you have the support of your healthcare provider because they've put in settings, but you don't have to call up the healthcare provider every day to get new doses. So I think that's a fantastic improvement, both for the person with diabetes, but also for the healthcare provider in terms of workflows. Smart Basal is both for people that are starting on insulin, which is fantastic, and that even from the time that you start insulin, you can get that level of support. So every day, having a recommendation on how much insulin to take can really ease the burden on the person with diabetes, because they then they don't feel like they're having to guess at how much insulin to take. I know as a healthcare provider, I've given people sheets of paper where they were asked to, you know, average their morning glucose values for the last three days and then use a scale to figure out how much insulin to take. And that can be really complicated, and especially when you're talking about something that has a risk of causing low blood sugars. And so it's been a great tool for people with type 2 diabetes starting insulin, and then also can be used to optimize. So if someone's already on insulin, but say they're. They're having problems with low blood sugars, or they're having problems with high blood sugars or both, then the Smart Basal feature can help adjust and really help minimize those lows and highs.
- [12:01]
A
Back to my question about other improvements. One of the biggest questions I got to ask you was about connectivity. I know, you know, this people who wear a Dexcom and use an automated insulin pump often struggle with keeping those devices connected depending on what side of the body they're wearing on. And there's lots of tips and tricks to make this better. Are there improvements coming in the G715 day? Is that something that you all have addressed?
- [12:24]
B
It is something that we are always evaluating and we're always making improvements. So that is Both on the G7 10 day and the G7 15 day. And I really encourage, if people are having issues, to call technical support, because it really depends on the situation. Right. And in, you know, what pump are they on? Is the smartphone involved? And so there are a lot of nuances there. So it's important to call and get personalized advice. But I want people to know that feedback has been heard. We know how incredibly important this is. Having been a healthcare provider for more than 20 years, I intimately know, and you for your son, how incredibly important this is. And so it's something that we're always evaluating and always improving.
- [13:07]
A
I don't know if you can answer this question, but Benny wanted me to make sure to mention that he gets frustrated because he says his dexcom stays connected to his phone. It's like, you know, he said, I mean, he's joking, but he's like, I could be half a mile away and, you know, my Dexcom stays connected to the phone, but. But it will more often disconnect from his pump. And he was wondering, is this perhaps a pump issue to talk to the pump manufacturers about? I said I would ask you. It doesn't sound like you're passing the buck, but I am curious because it does stay pretty well connected to the phone.
- [13:39]
B
Yeah. And I think also a great question. I think what I will say is that it is very much a collaboration and partnership with our pump partners. Right. And so we have to do work on our side. Pump partners do work on their side, and we work together to make the connectivity better. And it's something, again, we're always evaluating. We know it's incredibly important. We've made improvements, and we continue to. To assess and. And make additional improvements.
- [14:05]
A
One of the questions that I talked to Jake Leach about last year and a bunch of people asked me to mention today was the repl issue. And I heard Jake on the fabulous T C O Y D podcast shout out to them recently. And he basically said, I want to be clear, if somebody needs a replacement, we're giving you a replacement. I'm not going to talk about capping and numbers and things like that. Can you talk more about this policy Happy to.
- [14:30]
B
So for one, I'd love to point people to our website for the nitty gritty details. But what I, I think the high level takeaway message which echoes Jake's sentiments is that if there's a confirmed sensor failure, we will always replace that without limit and we want to, you know, it's incredibly important for our customers to have access to cgm. We know that these devices can be life saving and so we really want to make sure people are not without cgm.
- [14:58]
A
And we will link up more information from Dexcom in the show. Notes to your point about the nitty gritty details there. I do want to ask as well about ketone monitoring because there were a bunch of announcements this year, you know, about another company about Abbott doing this and I know that Dexcom has the capability and has talked about measuring what I learned are called analytes, ketones and alcohol and other things. Where are we in the process for that? From Dexcom?
- [15:22]
B
It is something definitely that we're evaluating and working on. I think we want to be very thoughtful about this. I think there is some opportunity here for ketones, but I also think there's some potential challenges. So I worry about giving people ketone information without the right context might provoke anxiety and undue burden. So I think it's something that. Do we think there's an opportunity here? Yes, we want to continue to support our users in the best ways that we can, but it's something that needs to be done really thoughtfully.
- [15:58]
A
A little bit of pushback and then a follow up question on that. You know, that's kind of what we heard from some physicians 15 years ago when they said, oh, CGM is too much data for patients, they're going to get overloaded, we don't want them to have it, it should be blinded and physician only. I'm going to assume that's not really what you mean, but that you're, are you doing research in how people might best see this and use this? I mean you come from that field, you come from all that analytics of those trials.
- [16:23]
B
I totally agree and I think it's a matter of making sure we frame up the information rather than saying, hey, you have high ketones, now you go figure out what to do with that information. Right. I think it's on manufacturers to make sure we provide the correct context of this is the right next steps based on your ketone levels and then potentially put that in context of other information like symptoms, for example. I can understand the very much the potential value, but I think as Manufacturers, we need to really make sure that we're doing this in a thoughtful way.
- [16:58]
A
Yeah. And I can tell you just from our experience, I vividly remember Benny in diapers squeezing cotton balls that we had stuck in the diapers to check for ketones. And my husband and I then saying, what are we supposed to do if he has them? Like, what is this? We had no idea what we were doing and we didn't. I mean, thankfully we were able to call our endocrinologist and get good guidance, but we realized at that time we had no idea why we were checking. So I appreciate your answer. One thing I did forget to ask, and I wanted to make sure to get in about the Dexcom 15 day. Can you talk about pediatrics at all? A bunch of parents were asking me to see, like, oh, when is this gonna be available for kids? Cause it's not on launch.
- [17:35]
B
So the current G715 day is for adults only. So 18 and older pediatric users have unique needs. Right. As, you know, as a mother, you know, whose son was diagnosed at a very young age. And so we really wanna assess G7 15 day and make sure that it is the best product for pediatric users who have unique needs before we launch a pediatric product.
- [17:59]
A
Yeah. I mean, that's a long time to keep something on a little body.
- [18:02]
B
Yes, indeed.
- [18:03]
A
And I'm sure there are other concerns as well. Okay, let me talk about my listener questions. And I've brought in some of them already, but really one that came up is, was about accuracy and reliability. As you mentioned, near the beginning. G6 is near and dear to a lot of people. We have been very lucky. I don't say this because Dexcom is a sponsor. I say it because it works really, really well for Benny. And knock on wood, it always has. He just is one of these people that it stays on, it works well. Very thankful for that. But a few people said they really felt that there was a discrepancy between the G7 and the G6. The G6 was better for them for accuracy and reliability. The question is, have you improved that for the 15 day? Will they see improvement?
- [18:44]
B
So, great question. And one thing I want to make sure people know is that feedback has been heard right. And this is. It's incredibly important for us to. To understand what people are experiencing in the field. We've heard that feedback. We've taken that very seriously. We have made improvements and it's something that we're continuing to monitor and approve. And the G715 day is our most accurate sensor and so I'm excited to say that, you know, the accuracy in G7 15 day is, you know, highly accurate. And also the G7 10 day, we've made improvements there as well. And it's something that we continue monitoring and making improvements.
- [19:27]
A
I don't know if you can answer this question or if you want to answer this question, but your answer there kind of makes me say, okay. When I see people saying, well, it's not. It's not as accurate as the G6, I always wonder, like, well, how do we know?
- [19:40]
B
Right?
- [19:40]
A
How do we know? But it sounds like Dexcom knows. It sounds like there's, you know, making these improvements shows that there were improvements to be made, if that makes sense. So can you talk a little bit? Is the G6 empirically more accurate than the original recipe G7?
- [19:55]
B
No. Short answer would be no, that G7 is just as accurate as G6. That being said, we have had feedback, as you mentioned, and it's something that we take very seriously. And so there's. And I would say there's always an opportunity to make improvements right across all devices. And it's something that we take very seriously around the quality of our products. And again, you know, having been a healthcare provider for so many years, I know how much people rely on these products, including for automated insulin delivery and to make treatment decisions for injections or other medications or treating lows. And so quality and accuracy is incredibly important. And so I just want to make sure that your listeners know that their feedback has been heard. We've made improvements. I would not say that G7 is not as accurate as G6. And I really encourage people to transition over to G7. If you haven't tried G7 or if you've tried it and you went back to G6, then now is a great opportunity to go to G7. And I anticipate people are going to have a great experience with G7.
- [21:02]
A
I really appreciate that answer, and I appreciate you letting me call it original recipe G7. I promise I won't always do that. Are there changes coming to the adhesive? This was another listener question. Do you anticipate people still needing to use the over patch? Have they changed the adhesive in any way?
- [21:17]
B
Yeah. So G715 days still has the overpatch. The adhesive is something also that we're always working on. So we launched a new adhesive this year, and I anticipate people have noticed that it might be a little bit stickier, and it's something that we will continue to iterate on, it's always a balance of making sure it's sticky enough so the sensor doesn't come off, but doesn't cause skin irritation. And so we're always finding that right balance and, you know, using new adhesives to, to be able to provide that longer wear without skin irritation.
- [21:52]
A
Another person asked me, is an Android direct to watch in the works? Also, will we be able to connect it with our car system like iPhone users?
- [22:02]
B
Great question. Something that we continue to look at. So I don't have any specific dates to give you today, but it's definitely. We understand people are interested in that and something that we're always evaluating.
- [22:13]
A
What's it like at Dexcom when you make these major changes and announcements? I mean, it's exciting, but it's also got to be a little stressful with all the questions and comments that you get.
- [22:23]
B
You know, I would say it's very exciting because I love the fact that Dexcom's always at the edge of innovation and continuing to drive to provide quality, easy to use, accurate products for our users. And, you know, I essentially grew up with diabetes technology. So in my fellowships or as a part of my training, CGM first became available. And I was able to see over my career how it evolved from having to do finger sticks to then being able to use it to make treatment decisions and then going on and using it for automated insulin delivery. And Dexcom led that innovation at each of those steps. And so it's incredibly exciting to be able to announce our G7 15 day product. And, you know, I love being able to talk about all the great things Dexcom is doing. So I think it's a great, great opportunity to come and chat with you today.
- [23:14]
A
Are you, you're still not, you're not still in practice as an endocrinologist, are you?
- [23:18]
B
I am not, no. I stopped seeing patients about two years ago at Oregon Health and Science University. But I keep very close to those colleagues as well as healthcare providers across the globe because it's really important for us to understand people's experience and we want to make our products easy to use for our users, but also we want to help support our healthcare providers.
- [23:41]
A
You were still seeing patients two years ago? It really hasn't been that long. I'm curious what you told them about CGM in terms of starting, you know, adults. I was looking at some statistics and the, the amount of children with diabetes who are on CGM is absolutely incredible. It's something like 15% 10 years ago, and now 85% and adult adoption is not quite as drastic, but very close behind. What do you tell your patients back then when they were starting cgm?
- [24:08]
B
I was excited to share how much value they could get out of the cgm. Right. And you know, I've heard it phrased as making the invisible visible for people. Right. And so being able to see how diet impacts their glucose values. Right. The timing of insulin impacts those glucose values. It was a great safety net for people to be able to alert them when they were low or when they were high. And I unfortunately had a patient that died from severe hypoglycemia during my practice who didn't have the benefit of cgm. And so just incredibly thankful that people now have that option to avoid having severe lows. Wow.
- [24:51]
A
I wanted to ask you. I haven't had a chance to ask Dexcom about this smart food log. Can we talk about that for a minute? You take a picture, you put it in. How does this work and is it for everybody or is it just on Stello?
- [25:04]
B
Yes, it is for everybody. It is a way to log food by snapping a photo and then the AI in the background generates the description and then the user can edit the description. And it works incredibly well. I have used it many a times myself just to test it out. And so then it helps make food logging much easier for people.
- [25:25]
A
When I first heard about this, I thought, okay, this is the first step in Dexcom allowing people eventually to just take a picture and get the carb count and it be more accurate in terms of like the depth of the food because, you know, if you have a bowl, it could be hard for the photo to be accurate and things like that. Do you foresee this down the line? I mean, gosh, I'm just trying to think like when Benny was four, you know, hey, Mac and cheese, how much is that? Click. I'm at a restaurant. Click. Is that where we're going or hope to go?
- [25:51]
B
I think there's huge opportunity here. We know how difficult it is for people to count carbohydrates. And so definitely something that we're evaluating and more to come on that in the future.
- [26:02]
A
And then I gotta ask you. G6, going away. G7, original recipe. G7, 15 day. G8. Right. G8 is on. We can we talk? Anything?
- [26:13]
B
G8. What I can say is that, you know, at Dexcom, we're always looking to innovate. And so what you can expect from future generations is smaller, more accurate and easier to use.
- [26:27]
A
You know, one of the things that does concern me with the 15 day. And I feel a little bit better about what you all have been saying about sensor replacement is not so much dexcom, but it is insurance companies. And that is if they're paying for a certain amount of sensors right now per month. Right. I would get three G6s or I'd get three G7s. Now I'm going to get two G7 15 day. And if it falls off, especially with, you know, really active kids who are bunking into things and, you know, Benny was a wrestler. He's been working as an emt, he's lugging stuff, he's running around. I'd be very concerned that insurers would kind of, you know, leave us holding the short end of the stick here. Is this a thought over at dexcom, or do you feel like the replacement policy is going to be enough to reassure people that this will work?
- [27:09]
B
I do think the replacement policy will be enough to reassure people and know that anytime we have a sensor failure, we will replace that sensor without limit.
- [27:21]
A
Very reassuring and great to hear, so thank you for that. All right, so before I let you go, you've been at dexcom two years. Are you still excited to get there every day? Assuming you go or not, but to get to work every day, yes.
- [27:34]
B
So I work virtually, but I am incredibly excited to get to work to every day. I get to do so many different things throughout the day. So anywhere from engaging with world experts on CGM to product development and thinking through the next innovation from dexcom, to working on an article that'll be published in a journal, to working on a slide deck that will be presented at a symposium. So, you know, I have lots of great opportunities throughout the day. And so it has been such a great transition for me. I really miss seeing patients. That's one thing that I'm sad about. Leaving Oregon Health and Science University. I have always respected dexcom and this is why when my predecessor, David Price, retired, I joined dexcom. And it's been such a great move for me. And I work with a lot of incredibly smart people and I feel like we do good things and it makes me excited to go to work every day.
- [28:40]
A
Awesome. Well, thank you so much for joining me. It's the first time we talked to the podcast. I hope it's not the last. Thanks for jumping on. Jessica, thank you so much for joining me.
- [28:48]
B
You know, I really appreciate you taking the time to bring me onto your podcast. Super excited about G7.15 day for our users and the great advances. To have something that, you know, lasts longer and less waste for our environment and improved accuracy. So lots of great features there and just excited to be able to chat with you about it. Foreign.
- [29:16]
A
More information about everything we talked about over@diabetes-connections.com as always, if you're listening on a podcast app, you know, like Apple Podcasts or Spotify or something, sometimes it can be kind of hard to get into the show. Notes if you ever have a problem, head on over to diabetes-connections.com and every episode has its own homepage. Go to the Episodes tab. And if you're new around here, we have a very robust search engine on the website because we have done more than 750 episodes. If you just go to the box on the upper right corner, put a keyword in, you know, dexcom or travel or holiday, whatever you need, and episodes should pop up. All right, the plan here is two more episodes before the end of the year. We've got some fun stuff planned. And then it is full steam ahead to 2026. Thanks to my editor, J. John Buchanas from Audio Editing Solutions, and thank you so much for listening. 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.
- [30:21]
B
All wrongs avenged.