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Diabetes Connections | Type 1 Diabetes
Eversense 365: Pump Integration and Real-Life Use For the One-Year CGM
00:47:38
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A
Support for this episode comes from Omnipod.
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B
Did you hear the pod drop?
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Did you know all the sounds used to make that song come from a site change with the Omnipod 5 automated insulin delivery system. Pretty cool, huh? With Omnipod 5 pump, site changes are simple. The pod lasts up to 3 days, 72 hours, and to change it, you just fill up the pod with insulin, place it on your body, tap a few buttons in the Omnipod 5 app, and you're ready to go. There's no tubing to prime like with traditional insulin pumps, and it's virtually pain free, so you never have to see or handle the insertion needle. Want to try Omnipod 5 for yourself? Request a free Omnipod 5 starter kit today by visiting omnipod.com diabetesconnections Terms and conditions apply. Eligibility may vary. This week on Diabetes Connections, an update on Eversense, the CGM that sits just below the skin and lasts a year. This is the first time we're talking to the folks from Sensonics, the company that makes eversense, since they spun off from Essencia. So what does that separation mean? It's also the first time we're talking to somebody who uses Eversense with an insulin pump. It's now compatible with the twist. We're talking about the pump integration in real life. When will the next iterations of Eversense be out? Their success in the type 2 market? I am asking your questions and much more. 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. I think the allergy season here in North Carolina is coming to a close. Or if not, I'm ready to say this is the end of the beginning. I mean, oh, it's just, it's just green everywhere here, all that pollen. But I can't complain. I've mentioned here before, I started taking allergy shots a couple of years ago. I still have to take a little bit of like that over the counter allergy medication and I take it here. I kid you not. I started on Valentine's Day in February and I stopped taking it usually April 15th. We have such a gorgeous spring, but ugh, we pay for it. So I think my voice is doing okay today. It's been rough lately. Couple of quick things before we get to the interview though. If you are anywhere in the Carolinas, I want to let you know, breakthrough T1D summit coming up in Winston Salem, North Carolina, toward the end of the month, April 25th. I am not a speaker, but April Blackwell is. She works at NASA. She lives with Type one. She is absolutely amazing. She posted on her Instagram this week, you know, talking about Artemis and the moon and the mission. She's talking about how she has been spending time with colleagues designing the next lunar landers. So it's going to be a great, great talk in terms of Type one, but man, I'm going to try to go. I have so many questions for her about what's happening right now at NASA. And I will link up information about that in the show notes. Again, that is Winston Salem, North Carolina, on April 25th. And as you are listening, we have Club 1921 Atlanta. Tomorrow we have Club 1921 in Philadelphia. Next week, really King of Prussia, Pennsylvania, and then White Plains, New York. That's the first week of May, and that is open for registration. Club 1921 is a new event for us. We started it last year. And these are community dinners. Sometimes they are open only to healthcare providers and what I'm calling patient leaders, and sometimes they're open to the entire diabetes community. Those three events that I mentioned are for healthcare providers and patient leaders. Patient leaders, like if you work at a diabetes camp, if you, you know, don't have letters next to your name as a degree, but you work in some capacity in the diabetes field. If you're not sure, let me know. But all that information is on the website diabetes-connections.com under events. We may at this point have a wait list for Philadelphia, but join the wait list. We will let you know about cancellations about a week before the event actually happens. We keep them small on purpose. Their education, they're very meaningful and I really hope you can join us for one. All right. On the podcast this week, we are catching up with the folks at Sensonics, the makers of Eversense. That is the CGM that goes under the skin and can stay there for up to a year until you have to change it out. The transmitter does go on top of the skin, but it's not attached like a traditional cgm. And they are working to get the whole thing subdermal. Two big changes recently with Eversense, the company that makes it, took back full commercial control from its distribution partner, Essencia Diabetes Care. And the CGM itself now connects with an insulin pump. The twist, I am talking today to somebody who uses that system, Paris Hicks, as well as the Sensonic's Chief Commercial Officer, Brian Hanson. If you're new around here, we have been following this technology for a very long time. Going to link up our previous episodes in the show. Notes if you're interested in hearing about the evolution, hearing from people who were wearing it when it wasn't approved for up to a year use. Like I said, we've been covering this for a while. My conversation with Brian Hanson and Paris Hicks right after this. When it comes to managing diabetes, we all want less stress and more safety and accuracy. Benny has been working a ton and he's going to school and it's a lot to manage. I know diabetes will never be stress free, but we want tools that'll lighten the load. That's why I'm really excited about the Dexcom G7 15 day for people over 18. It's the longest lasting CGM sensor available with 15.5 days of wear including a 12 hour grace period. You get less hassle and less waste and it keeps everything we already love about dexcom. Real time numbers to your phone or watch, accurate readings and customizable alerts. If you want fewer interruptions in your diabetes routine and more consistency, check out Dexcom G7 15 day@dexcom.com Brian Hanson, Paris Hicks, welcome to Diabetes Connections. I am thrilled to talk to you both with some really new and interesting news. Welcome to the show.
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C
Thank you Stacey for having us today and congratulations as always on your continued success, or I guess better yet, your continued contributions to the field. You truly make a difference and so anytime we can spend some time with you, we certainly enjoy that.
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A
Paris, you have to understand. I forgot. I have to brace myself. Brian is wonderful and effusive, so I'm always taking it back when somebody starts.
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C
One of my favorites too. This will be fun, Paris. Trust me, this is good.
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B
Away with words. I like it.
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C
Stacy brings people together and that's the part that is really unique in our space and the part that I love so much in our space. And she is one of those energy gainers and so I just enjoy talking to her even away from these podcasts. You know that. Stacy, you're just a good person. Just a good person. I really appreciate that's a good thing.
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A
All right, Brian. And listeners, don't worry, we're still asking them all the tough questions. But Brian, thank you very much. I appreciate that. Paris, you are new to the show. Let me just ask you, tell me a little bit about yourself. You're living with type one now for about 10 years.
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B
Yes, ma', am. I was diagnosed when I was 18 years old back in 2016. So it's been about 10 years now. Started when I was about 18 years old. I was my first semester of college, just getting in right after my first semester, and my mom noticed all of the symptoms that I was having because her brother was living with type 1 diabetes. So she caught all the signs fairly quickly and immediately took me to the doctor and I started insulin that week. So nothing too dramatic, but I was, you know, newly diagnosed in college. But I always say I was thankful that I was old enough to understand. And so I had a great childhood and living with it now came second nature to be able to take care of myself.
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A
Wow. Well, dramatic enough to be diagnosed at any age.
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B
At any age. Right.
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A
And we're talking today because you use the Eversense as part of your system.
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B
Yes, ma'. Am. I actually started with Eversense back in a clinical trial when they were still the 90 day sensor. And ever since then, I finished the trial, I think, when it was still on the. When it was into the sixth month. And after that, you just couldn't get me off of it. So here we are on the 365 day sensor.
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A
Excellent. All right, so, Paris, stand by. I want to ask Brian a few business questions because things have changed since the last time we talked about Brian, I think this is the first time we're talking when Eversense is standalone. Can you give me a little bit of a sense of what's happened?
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C
Yeah, boy, we've got a lot going on. So at the end of the year, the Eversense product came from Essencia, which had been our worldwide distribution partner for the last four or five years, really back home to Senseonics. So now everything is vertically integrated in one company and we have a full team here in the US we're going through that same process with our European colleagues as well, and they'll be transferring over on May 1st with some transition service agreement to make sure that the business stays as is for a while through the year here. But everything has gone really well as planned. And yeah, we sit here today with 365 in the market for over a year with some great results. We've doubled our user base in that time. We just got CE marking for 365 in Europe. So that launch is just about ready to kick off. We've got Gemini in the. In the clinical trials or pivotal trials right now, and we're working on freedom right behind it. So there's a lot to talk about today and SQL, by the way, we've now integrated with a pump, which we talked about last time. So we've had a busy 2025 and now we're starting to really, you know, hit the ground running here in 26.
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A
Yeah, I don't do a ton on this show with like the stock market view or investor relations, but from a patient perspective, is there anything different people might notice from being independent from Asencia?
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C
Yeah, the goal was no, and I think we've succeeded on that. We had a standalone CGM group here in the us. We were using the BGM reps in Europe, so they'll be a little bit more noticeable in Europe when we transition. But here in the us, I don't think they're going to really see much difference. But certainly the team feels a difference coming under one roof and having a little bit more of an amplified voice within the senseonics organization. So we're pretty excited about it.
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A
Yeah. And let's talk a little bit about SQL, the first pump that you are working with. Listen, this is a newer pump, obviously, but we're seeing it more and more out in the community. I always want to ask about, like, the response you're hearing about, but it's so funny to say, how are people using it? I mean, a CGM at a pump is really not as new as a concept as it would have been just, you know, less than 10 years ago. But what's unique about how these two are working and how people are experiencing them?
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C
Yeah, we launched it with a limited launch in January, February. Ish. We launched it with general availability in mid February. The great news is several hundred folks paired almost immediately in the first couple of weeks. So some folks had gotten on the sensor with anticipation of the pump coming, some folks had got the pump with anticipation of being able to get the sensor. So we were really excited about the quick launch. And you and I have talked about before, the number one thing you want to offer is choice. Right. If you can offer choice for those that are using a pump and using a cgm, whether they use a traditional CGM or they use ours or whether they use other pumps, this has been a really unique pairing. It's the number one reason why people stopped using our sensor as well as they wanted to have pump connectivity. And it's the number one request. You know, ultimately we want to be connected to a pump. So from a commercial perspective, it was exciting for us and SQL, being new and many of their teammates were folks I knew before from my tandem days. Right. So we're seeing a lot of cooperation in the field and it kind of gets to amplify these products now with two salesforces out talking about it. And awareness is certainly important to us. But you know, some of the differences here is you've got the first year long sensor connected to a pump and so you don't have the startup times, the warmup times every 10 or 14 or 15 days. With their traditional CGM, you've got a year long continuous sensor now fueling the data into that pump. And so you get some time savings there and some more time connected to the pump by not having to do that. And right now the results are really good. The first 120 patients we took a quick snapshot of and Dr. Fran Kaufman presented that data at ATTD and the time and range was excellent. 77%. Time in hypo was below 3%. Everything the connectivity was exceptional. So early indications is pretty favorable so far and compares very favorable with any other system out there today. So so far so good.
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A
All right, connectivity is my number one question because when you put a 365 product on, you've got one side of the body to work with and a lot of CGMs will miss connectivity if the pump is worn elsewhere. Is this the same kind of issue with Eversense or do you see that it's not as much of an issue?
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C
It's a great question. I don't think it's that much of an issue because with our transmitter on the outside, that's a pretty decent transmitter sitting there, that also houses the battery that fuels a sensor right underneath the skin and that almost acts as a little bit of antenna sitting right there. So so far, wearing it on the arm, we haven't seen connectivity issues at all and it's been very favorable. But we've also talked in past lives, it typically helps to wear the pump on the same side that you have your cgm, right, because you've got that line of sight versus going through, you know, a body mass. But that has not been a complaint that we have had coming in. And I'd be curious, Paris, are you wearing it any differently than you would wear something before?
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B
I'm not, no. And from personal experience, I have had zero connectivity issues wherever I wear my CGM and my sensor. So it's been great.
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A
Paris, let me ask you this. Like a lot of people are still not that familiar. What does it feel like day to day? What does it look like day to day? Does it stick out? Is it bumpy? For you.
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B
Do you feel it without wearing my transmitter, I don't feel the sensor at all. I mean, you can touch my arm and maybe go find it, but you honestly forget that it's there. I personally always wear my transmitter. Unless I'm in the shower, I'll take it off. So, I mean, I'll knock it on doors, you know, I'll knock it with a book bag. I'll get my hair caught in it. But that's the beauty of it is I. I can just stick it right back on. You know, typically you hit a door and you're done for. You've lost a sensor. You know, that's 20 bucks right there. So now I can just stick it right back on. And it has just. It's so much easier from a day to day perspective.
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A
Yeah. And you don't, you don't feel the little sensor underneath your skin once it's in?
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B
No, ma'. Am. No. I mean, you can, like I said, you can go and find it, but it doesn't poke out. It just lays right underneath the skin.
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A
And have you had more than one inserted? Have you been wearing it long enough so that you'd have to go through that again?
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B
Yes, ma'. Am. I'm on my second 300, 365.
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A
What was it like the first time? And then. Because I have to remove it. Right. And put the new one in. Any issues?
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B
No, ma'. Am. My whole procedure personally takes five minutes for removal and reinsertion. So it's such a quick procedure. Getting to the doctor's office and sitting there and waiting takes twice as long as it does for the whole procedure.
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A
And Brian, more people are trained because this is an outpatient procedure. This isn't a surgeon. Right. Is it mostly endocrinologists doing this?
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C
Yeah. So mid level or a physician can do it. It's done in office, just with a sterile field. Takes roughly about 10 minutes. A little 3 millimeter incision and then there's a little tool that makes the cavity. And then you insert the sensor, you put a steri strips over the top of it, and 24 hours later, you put the transmitter over and you're off and running. So outside of a prick of a little lidocaine to, you know, give the site its proper treatment, you don't feel it at all. And so we did have to add some insertion sites and that was something we needed to do in 25 to make it more convenient for folks to have it close to them. And we've also stood up our own insertion network called Eon Care within Senseonics. And we have over 60 individuals that are like 1099s that work for us. They're like the pump trainers, as you think about the pump space, and they're doing it for us as well. So we're trying to make it as convenient as possible for someone to get the sensor if they want to, and hopefully close to them so they don't have to drive an hour or two to get it because there's only so much people are willing to do.
- [16:36]
A
Yeah. And, you know, you mentioned sites, and immediately I thought of where you actually insert the sight on the body. Is it only approved for arms? Is it approved for elsewhere?
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C
Yeah, in the upper arm is where it's approved for. So mine sits right there. There are folks that wear them in other parts of the body and stuff, and a physician can make that determination with the patient. But we do not indicate it for use anywhere else besides the upper arm.
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A
You're using the Twist pump. Let me see it. I love it. It's funny because I know and I've talked to the Twist folks. They're having a little trouble with the photographs because the scale. Right, right. It is the size basically of an Oreo.
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B
It really is. It's. I mean, I would say it's very comparable to like an Airpod case or something.
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A
Oh, yeah, There you go. So talk to us about it, starting with side of body. Knowing that everybody's different and what you experience. We're not expecting, you know, 100% of people who use the system. But in your personal experience, doesn't really matter where you put the pump.
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B
Right. I have had zero connectivity issues. I like to rotate my sights very well. I don't want any scar tissues, so I rotate well. And I've had zero connectivity issues.
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A
All right, I'm making notes to tell my son, move your pump. Listen, that ship has sailed. He is on his own. And I know we're talking about the cgm, but I also have to ask because you're one of the first people I've talked to on the program who used the Twist. I've seen it worn, kind of stuck to the body as well as just kind of as a traditional tubed pump, you'd wear clipped. How do you wear it?
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B
I'll clip it most of the time. But I have found there's off market, different holders that you can use that will allow you to, like, stick them to your body. And as a little personal, you can take an Eversense tape and stick it to the back and just stick it on your body as well. It works the same way. So ah, I, I've found little tricks around it.
- [18:25]
A
That's interesting. Again, you know we're talking about you personally using this but the Eversense tape. And either one of you can answer this question. The Eversense tape, if people aren't familiar is a little different than a usual adhesive is my understanding. Right. You can. You can kind of reuse it.
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C
Yeah. It's designed to be used once a day, taken off and thrown away and another one put on. But it's a very. It's a mild adhesive. It's a silicone based adhesive and it has tremendous sticky tendencies on the outside to hold the. The transmitter or in this case the pump on. But it can be worn for two, three, four days and as the edges kind of fray people take them off and throw them away or when they shower they just put a new one on. And we ship 390 with the year long sensor. So there's plenty to be had for someone to. You kind of use them how they want to use them. Stacy. But you can even take them off during the day and put that same adhesive right back on and it tends
- [19:18]
A
to adhere very well. Could help you spot type. You've used other insulin pumps insulin in the past. Your doctor about this is not your first foray into a pump in a sensor. The more you know the more.
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B
Or you can do several different visit
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A
screen for type one. I'm just trying to get a sense right. Of what really is different about this type 1 when you are using the sensor you still have to calibrate it and charge it. So talk to us about. I mean no system's perfect but talk to us about really kind of day to day how you go through and use it inconveniences and what you like about it as well.
- [19:49]
B
Yeah. So you only have to calibrate the Eversense 365 once a week after the initialization phase. So really I only. I do my calibrations every Wednesday morning. I'll just get up and that's my little routine and then I don't have to think about it for a whole nother week after that. So that's really been helpful. And the convenience factor of the ever since 365 has been probably reason why I have stayed on ever since 365 for so long. Just only having to have that sensor inserted once a year. It just gives me so much more time and freedom back into my life that you just get me off of it.
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A
How long is that initialization period?
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B
I want to say it's roughly 24 hours.
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C
Is it a little longer for the first two weeks? Stacy, when you get the first, when you get the product inserted, you don't put the transmitter on for 24 hours. And then at the 24 hour period you can put the transmitter on and it starts generating the glucose values. But for that first two week period, you'll be doing daily finger sticks to calibrate the product. And then once you move past that initialization phase, day 13 I believe it is, then you go into your weekly calibrations. You can do it more often that if you so choose and once you do it a little sooner, if you decide to, then it starts the next seven day window, you know, over so or it starts a seven day window so you don't have to do multiples. So it's pretty convenient from that perspective. And it has a 24 hour grace period if you don't do it right at seven days. So it's not like you have to sit right there on your sensor at that period to do the, you know, to do the calibration at that time.
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A
What if you miss it?
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C
Then it kicks you into having to do four over another eight hour period or so to get it kicked back in again. I'm just going to say I have mine in and I learned that once and I won't do that again.
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A
I imagine that with the year long sensor, that two week or 13 day daily calibration you were talking about is a lot less painful for people.
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C
It is versus doing it every day that we had to do with the 180 day or 90 day product. It certainly is an improvement to go to weekly calibrations, but we're still seeing the same sensitivity and superior accuracy. So we're pretty comfortable with that today.
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A
Yep. And Paris, how, how do you find the sensor and the pump working together? Had you used other aid systems? Is it pretty much like the same way, working in the background?
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B
So starting off, I started back in January on the Twist pump and I was terrified to start with another aid system because I have tried an aid system in the past and my biggest complaint was I could never get it to stay in the auto mode that it was supposed to be in. So in my head I was nervous that this would not keep me in auto mode. But I have had again, no issues with staying in the loop loop mode. So it's been a whirlwind of a change for that. So I'M excited about that for sure. So I've had no problems.
- [22:43]
A
And Brian, going back to that study that was presented at attd, you mentioned, you know, really good results. Did people stay on the system through the study? Right. Sometimes we have, we get a percentage of people who are like, I don't want to use it, I'm leaving the study. And it can kind of show you like when aid system first started, there were people who were like, I don't want to give it up. Can I buy it? I'm curious what the, what the stay in the study rate was, if there's such a thing.
- [23:09]
C
Yeah. So Stacy, good question. So a couple thoughts here. One is because we have an ICGM and they have an integrated pump as well, we didn't have to go through too much of a study from that perspective. There's really validation and verification work. This information that Dr. Kaufman presented was actually 120 users of the newly integrated system. So this was real world data and connectivity was well in the high 90s and again, time and range, 77% hypo below 2.7 actually. So the early data is really good. But let's just say it what it is. It was only two, three weeks of early data because we had just connected by the time we got to Barcelona for attd. So we'll have a much more robust set of data to share at probably ADA in New Orleans here coming up in early June. But you know, suffice it to say, we're excited about what we're seeing from the data and the feedback to date has been very positive as well. So more to come.
- [24:03]
A
Yeah, I think it's funny to talk about these studies now because, you know, back in 2015 and 2016 in you were tandem, you know, all this, it was like eye popping and amazing. Right. We're gonna have a CGM that talks to the pump. And now Paris, I don't wanna say like we take it for granted. Right. It's still an amazing thing, but at the same time we expect these things to work, we expect them to work together, but the difference is in the under the skin. Which leads me to. You've already mentioned this. Gemini and Freedom, this is next. Brian, talk us through this. What's the difference? And tell us a little bit about each of those.
- [24:39]
C
Yeah, Let me just start by saying that now that this Eversense365 product is done, the optical sensor, the actual sensor itself, it's done. We've added two more testing regions to it. So it has four testing regions. The data that Fran also presented, around 5,000 patients of the existing product showed that the first six months were equal to the second six months or vice versa. So we see no degradation in performance in the second half. We see no fall off. As far as early sensor retirements, one of the things we wanted to make sure is that the product truly performed and lasted for a full year. And it has done that in the data that FRAN presented. So, okay, great. The sensor's done today. The battery and the Bluetooth are in the transmitter that's worn on top of the skin. Right. The product is just underneath the sensors, just underneath the skin, and it's looking for fluorescence in the interstitial fluid. That transmitter is grabbing the values and sending it to a watch, a phone or a pump. So there's two versions coming next. The next one is Gemini, where we'll now take the battery and we'll attach it to the sensor and you'll say, okay, what's the advantage of that? Well, it actually takes the 365 product and it gives you some choices. Now, one with the battery underneath the skin, it's constantly powering the sensor because if you're not wearing the transmitter today, it's not powering the sensor and we're not getting any glucose readings. It's not storing any up. With the battery attached to the sensor, it will grab glucose readings and store up to eight hours of glucose readings. If you choose not to wear the transmitter, you can grab your phone and you can scan it. Very similar to what the Libre one was, near field communication. For someone, maybe a type 2, who really doesn't need every five minute continuous glucose readings, that might be a wonderful way to just interrogate the sensor by wanding your phone over it and getting it whenever you want it. If you do want continuous readings every five minutes to your phone, to your watch or to a pump, then you simply would wear the transmitter that would still have the Bluetooth in it. So that's Gemini, that's in clinical trials today and we hope to have that in the first half of 2027, give or take. Okay, so all positive, but what everybody is talking about, what everybody really wants, let's get rid of the transmitter and let's go ahead and take the Bluetooth that's in the transmitter and let's put it into the sensor itself. And so we'll replace the antenna that's in there today that has a near field communication with one that's a Bluetooth. And now you have a sensor underneath the Skin without any need for wearing anything on outside of the body. And that would be transmitting every five minutes like it is today. Again, battery powered for a full year, sending it to a watch, a phone or a pump. And that is what everybody quite frankly wants is nothing on body.
- [27:21]
A
Yeah. All right, so my first dumb question is why bother with Gemini? Is this a proof of concept? Is this something you have to do? Do you owe the battery people money? Like, why do you have to go step by step?
- [27:33]
C
Well, first off, I think you're right. The proof of concept makes a lot of sense. And we're using a company called Integer that makes batteries for several implantable dev devices, Cardiac and others. So they're very well known and thankfully Stacy, the FDA knows them very well. So there is a good predicate device that uses these batteries and they last for a long time. But it's a darn good question. If we believe freedom can come quickly thereafter, wouldn't you want to skip right to freedom? But there's something to be said about testing the battery and taking it through this pivotal trial process and submitting it to the FDA again under an icgm. This should be a relatively, I'd like to say easy and quick, but nothing is easy and quick. But we're just adding a battery. Stacey, how hard can it be?
- [28:14]
A
Oh, I'm going to knock the wood for you.
- [28:19]
C
I say that all the time. It's just a battery and a Bluetooth. How hard can this be? But so I think you're right. We're submitting it for the very simple reason that it helps us with the next phase, which is putting the Bluetooth in and getting to our Freedom product. If for some reason they really come close to each other, then maybe we don't launch the Gemini product. But I think there's going to be a year gap between them. Freedom will be a fast follower, probably something we launch in 2028 which is not that far away. And then here we're off to the races. And now we've eliminated the on body component, which is the number one request we get when it comes to what someone really would be looking for. A year long sensor underneath the skin, nothing on body. Let me have that.
- [28:59]
A
Yeah, that's exactly what my son wants. And he's waiting. Cause. And Paris, I wanna talk to you about this in a moment. And I think most listeners will know Benny wrestled in high school and it's a tough sport for any device. He got so much from his aid system that we really debated. He just felt the trade off at the time wasn't worth not being connected to a pump. But, boy, that. I mean, wrestlers, there's a lot of sports that the equipment just slides off of you. In Paris, I know you were a gymnast and you talk about CrossFit and you're very active. Talk to me a little bit about wearing devices and kind of how you manage with the ever since. But also just in general, like, how tough was it for you?
- [29:36]
B
Yeah, back whenever I was diagnosed, I was still. I was competing gymnastics for NC State University. So my biggest complaint with not starting on an insulin pump right away or a CGM was because they kept flying off. I mean, I'm flying, swinging around bars or I'm flipping in the air. Everything just kept flying off. So I went through a lot of tape and coban to try to keep everything. But. So that kind of brings me into a point about a Gemini or a freedom that would have been a game changer for someone like me or like your son who is a wrestler. Those devices not having to be on would really just make a huge difference in an athlete's life who's dealing with type 1 diabetes.
- [30:21]
A
Doing CrossFit now, how do you stay active?
- [30:23]
B
Yes, I do CrossFit, and I'm a big runner. Um, so I just finished a marathon. Oh, wow. And I'm big into CrossFit now. So wearing it ever since 365 has really helped me with that because I can take the tape on and off as I need to. So.
- [30:42]
A
And just to be clear, so. And we talked about this a little bit, but, like, you take the transmitter off and kind of like, just put it to the side, go about your business and then put the transmitter back
- [30:51]
B
on so I can. That's an option for me. I mostly like to keep it on when I can. But say I'm in the middle of a workout and it's starting to get a little sweaty and I can just take off that transmitter and I don't have to waste a sensor. So I just can take some tape when I'm done and just stick it right back on. And that's what I really love about ever since 365.
- [31:12]
A
I'm curious, and I know you haven't been on sequel for all that long, but it's based on loop. I know a lot of my listeners are very familiar with that. How does it work for you for exercise? Are you happy with the way that works out? Any. I don't want to say tips or tricks because, again, everybody's different. But anything you've noticed.
- [31:27]
B
Yeah, I've enjoyed the. There's a workout mode on the Twist app that you can use. So I try to turn that on about. I was told by my educator about an hour or two beforehand and it'll start working my blood sugar up just a little bit. So that way whenever I am exercising, it'll keep me a little bit higher in that range. So it's worked out really well for me. I've had, you know, you still go low every now and then, especially if it's a longer workout. But I really have had some good success with it, so I'm excited about that future.
- [32:00]
A
Yeah. Brian, number one question I got from my listeners was other pumps. Are you working with other pump systems? I know conversations are always ongoing. Anything you can tell us?
- [32:10]
C
Yeah, I think that's the best way. And just being at attd, those conversations continue. But I would say for this year, it's pretty likely that we'll be really leaning into our SQL partnership and, you know, amplifying that connectivity there. But we'd like to offer choice and we'd like to be able to have, you know, some further connected options. So stay tuned on that. As soon as I get a little bit more, you'll be the first to know.
- [32:31]
A
You know, you also mentioned people with Type 2 and it's been incredible over the last five years to see more and more diabetes technology being adopted by people with type 2 who use insulin and, you know, who don't. My, my father was diagnosed with type 2 about two years ago, doesn't need to use insulin. But it was wild to watch his journey wearing a CGM and what he learned from it. You know, he was obsessed with the numbers for the first couple weeks. It was wild. But it, it is interesting to see that. And you've already mentioned that. Is that a market and forgive me, Brian, do you have approval for type 2?
- [33:03]
C
We do, we do. 80% of our patients right now are type 2 patients. So not having pump connectivity really did limit us a little bit in the type 1 space. And you're calling on the endocrinology offices and they're like, all my patients are on pumps. And like, well, that's not statist. True. But we were seeing a much greater growth in that type 2 space. And now that we have the pump connectivity, I think you'll see that sway back a little bit towards type 1s. But insulin dependent type 2s and basal only, type 2 has been a very popular cohort for our, for our products. So, yeah, really good.
- [33:37]
A
I would imagine, with Gemini, too, as you mentioned, just being able to swipe is going to be big for that group.
- [33:41]
C
It is. And the optionality, I think, is key to that. Right. Because you wear it with a pump or you can wear it more of a type 2 product. And our CEO likes to really refer to it as more of a type 2 product. But I see it as 365 with advantages. Right. It really has a hybrid kind of approach to it, which I think excites me as much as anything.
- [33:57]
A
Have you learned anything that surprised you about how people with type 2 use the system? I know it's a weird question. So for a couple of years, I kept hearing that, well, there's no need to give people with type 2 diabetes A CGM. They don't have the swings. They don't need to check it every five minutes. And now, of course, we've seen how useful it is. I mean, I'll be honest with you, Brian. I think it would be a hard sell to tell somebody with type 2 that they need to go in and get this implanted because they're already. A lot of people with type 2 are like, I don't want to think about it that much. I've got it under control. Leave me alone. Is it a bit much to ask somebody with type 2 to do something like this, or you're finding that they're just as happy as somebody who uses a Dexcom or a Libre?
- [34:36]
C
Yeah, Stacey, I think it's a great question. First, let me just. I have it implanted. I do not have diabetes. I've worn the OTC versions of the traditional CGMs as well. I personally find it fascinating to watch my blood sugars. I have changed some of my diets and some of my habits just based on wearing a cgm. Now, that's not advocating for us to be in that performance or leisure category. Right. But it's an opportunity for everyone to kind of connect a little bit more with what. What they're eating and what they're doing and what exercise does to their body. The type 2 community, first off, we're seeing more in the Medicare side as well. So our demographics have been really skewing towards Medicare and really skewing towards type 2. And I think the convenience of having it and the simplicity of having it for the full year is why health care providers for certain patients that have struggled on a traditional CGM, have recommended our product. 80, 85% of our products or our users have used a traditional CGM before. So, again, offering choice and just having another option in the event that something hasn't gone as well for them in their prior connectivity to technology, I think is part of the reason why we're seeing some of the favorability in type 2. We're not really marketing towards that. We do a lot of direct consumer advertising. But again, it seems to be very popular in that insulin intensive type 2. Not as much in basal only, but in that insulin intensive type 2.
- [36:01]
A
Yeah, that's really, it's just so interesting to me as we see, you know, the technology adopted by more and more people, type 1, type 2, and as you said, even people without diabetes who are not this product, like you said, I think that makes a lot of sense.
- [36:14]
C
The other thing, Stacey, that you might have heard before is that type 2s don't have the same adherence or persistency or compliance. But we're seeing fairly close numbers, naturally, type 1s. And now that we see type 1s with a pump, you get the highest usage. But even with Fran's numbers of all comers, type 1s, type 2s, the amount of usage is incredibly high. And the type of type twos on the Medicare side, we're wearing it 95 plus percent of the time. And so I think those are really strong numbers to talk about. Where you hear others say that they're just using it intermittently. We're seeing, again, you're kind of pot committed when you have it under the skin, you might as well take advantage of it.
- [36:53]
A
Well, and when you're saying wearing it, you mean the external transmitter is connected.
- [36:56]
C
You are. You have to wear the external transmitter. So they're transmitting values over 90% of the time in almost every cohort, even adolescents that are using it, we're wearing it 90% of the time. And as you know from your son, that's a pretty high number.
- [37:10]
A
Yeah, definitely. And I forgot, Brian, pediatric approval, it's
- [37:15]
C
18 or above right now. We had started some pediatric work on the 180 and then the 365 came along. So we need to kick that back off. But we'd like to take that down to, you know, that 12 range or somewhere in that neighborhood. But you can imagine most of our resources right now are working hard to get Gemini out.
- [37:31]
A
No doubt. Another listener question I got was about accessibility. And I think this is fascinating. She's asking particularly for people who are blind or cannot see anything. You're working on for that?
- [37:43]
C
Yeah, I mean, the one thing that we have a little bit different is we have the on body vibratory alerts. Right. It vibrates in different cadences based on different things that the sensor wants to tell you. So from an impairment perspective, there certainly is an opportunity there to lean into ours a little bit different. If you can't hear the beeping or you can't read something on a phone that the buzzing or the vibratory alerts that are happening via the transmitter are something that someone like, that might enjoy with our product.
- [38:13]
A
Yeah. That's really interesting, Paris. Do you use that in any way? I mean, I know it can vibrate. Is that something that you experience? Can you talk a little bit about it?
- [38:21]
B
Yeah. I'm actually pretty appreciative of the on body vibe alerts because, say I leave my phone just sitting down and I'm moving around the house, or either I'm working out and my phone's maybe a little bit further away from me, I can tell whether my blood sugar is going to or is going high or going low based off the type of vibration that it gives me. So you really just learn which vibration is which, and that just kind of lets you know, like, hey, I need to go check my phone, or I need to check my watch to find out my blood sugar.
- [38:49]
A
Yeah. And we've talked about this, but it's been a long time, so forgive me. Paris, can you tell us, like, is it like. Like, what does it feel like? Is it two and then, you know, you're low? Is it three? Is it. What is it like?
- [39:01]
B
You know, I would exactly know what the vibratory alert was whenever it's going on, but to sit here and try to explain, it just feels weird.
- [39:12]
A
Yeah. No, I get it.
- [39:13]
B
You know, it's. It's like a beep, beep, beep, or like a buzz, buzz, buzz for low, and then it's like maybe four or so for high. It's just a different. It's a feeling almost.
- [39:23]
A
It's like, close.
- [39:25]
B
Pretty violent.
- [39:26]
A
You're pretty close.
- [39:27]
C
If you're out of range, it'll give you a different buzz, and you can actually customize it, Stacy, in the app itself. But most people just leave it the way it is. And again, I don't wear mine all the time, but I get used to it as well. I know exactly what that little buzz, buzz, buzz is. And so. And it's almost audible enough. Right. It's a fairly strong little vibrations, so it's definitely something we hear a lot from our users that they love. It's a question we get on freedom when we don't have the transmitter anymore. What are you going to do about it? We're really thinking about having some type of little patch or some type of little device or something that could grab that and mimic that. So it's definitely a user favorite with our product.
- [40:09]
A
Isn't that interesting that you'd have something that's potentially going away when you get the product that everybody has been asking for and you realize you've created a feature that people do not want to lose?
- [40:20]
C
Fair enough.
- [40:20]
A
Yeah, it's really interesting, Brian. I'll be honest. I didn't get too many questions because again, I don't think as many people have experienced it. And we're kind of waiting to see the improvements. We're kind of waiting to see the changes. Right. That are going to come with Gemini and Freedom. But one of the questions that did come up was about customer service. And interestingly, the question was, is customer service going to get better? But it wasn't from a user of the device because I pressed her on this, like, what are you asking about? And she said, well, I've been reading in some Facebook groups and I'm worried about their customer service. So my question is this for you. Do you think that being part of another company might have created extra layers, and do you think that it might be easier to get local reps? Right. Customer service, things like that? I'm not sure it's a fair question to ask because again, the way I set it up was it's kind of a secondhand question without a specific example. But I put it to you, it's
- [41:14]
C
a good business question. So we did revamp a little bit of what we were doing in 2025. So I certainly don't want to put that on Asencia, that Asensia wasn't investing properly. I led the entire business that was on me. And so we had to scale and change some things. And we did that as we got into the probably last semester of the year. We added about 15 agents and we enhanced our tech support or customer service group as well. And we have a new leader for that group. So I feel better about that going into 2026 here than maybe I did going into 2025. On a business side, Stacy, you can't please everybody. But, man, we're going to try, and we're all available here to do so as best we can. But I'm hoping that that part of the scaling. You and I, when we spoke last time, we talked a little about having a volume issue, right? When you just don't have enough, you just can't hire and invest enough. Doubling our user base in a really odd way helps you invest in your business and bringing on more folks to add more scale. And so our departments, both on the inside, sales front end as well as the tech support, customer service on the back end, those teams have grown quite a bit. And that scale helps you meet the needs of your users just at a better pace. And so I think we're better today than we might have been a year ago, and hopefully we're better a year from now than we are today. How's that?
- [42:32]
A
That's great. I appreciate it. This is a question I'm asking all of my folks in 2026, but I didn't tell you in advance so you could take a second. This year I'm trying to remember to ask all of my guests this question and it is, is there an organization in diabetes that has made a difference to you? Is there a group? Is there a person? I'm trying to see. It'll be interesting to see at the as the year goes on if there are any themes, if we can give shout outs or learn about new organizations. Doesn't have to be a charity. Can be a charity. Could be. I mean, Paris, you didn't go to diabetes camp, I'm sure, but stuff like that. Paris, let me start with you. Is there an organization that's made a difference?
- [43:08]
B
You know, I don't, right off the top of my head, I don't know if there's a specific organization that I can think of, but what I will say is a couple of people who, my generation is very much social media forward. So all of my friends that I have found on social media, those people have really gotten me through some hard times and I would attribute some of my diabetes success to them. Is like, it's a comparison mindset. I know, but it's wanting and striving to be better. So my friend Chris Rudin, who's also a fellow ever since ambassador, he's been one of the guys that I really look up to just in the space alone and also just several other people that I follow on Instagram, you know, just watching their daily life. Ariana Frayer, she's been a great success and she's been awesome. I know she doesn't use never since 365, but just watching her day to day life has been so helpful and inspiring to me. I contribute a couple people.
- [44:07]
A
Yeah, that's wonderful. Those are wonderful folks too. You know, great positive attitudes, but keep it real. So I appreciate that. Brian, how about you?
- [44:16]
C
Oh, gosh, My answer could be long. And I'm going to give you four really quick. You know, first and foremost, my first meeting at Tandem in 2016, that really moved me was children with diabetes or Friends for Life. Jeff Hitchcock and the team. You know, being down in Orlando that summer and just seeing the children interacting with each other, the educational opportunities for them, making them feel safe and being able to live a normal life really moved me. And I love the advocacy and the. The community that goes on this space. And you're a big part of that. Right? You're the connecting people all the time. This is the part that I just so love of the diabetes space. Getting to know JDRF very well. And I know they changed their name, but I still say jdrf. Aaron Kowalski and I have become good friends over the years. And again, what he does for diabetes, you know, he lives with it, his brother lives with it. Just what they do to give back and what that means to the world as far as advocacy in the space. Helmsley. Right. David Panzer. And just the business side of it and the brash nature of all the things that happen there. I thoroughly enjoy that business aspect and that, that fund that giving back. The piece there to help steer things and push. And then I'm also very close with Howard. Look. And Brandon Arbiter. You've probably talked to Brandon at Tidepool. There's very few people that. Especially Howard. Right. And hope it continues to get well again here. Just leaning into the space has really energized me and I spend a lot of time with Brandon and enjoy seeing their success, but also what they have done when they don't have to. Right. Howard didn't have to. And so anytime you decide that that's a mission, you don't have to. Right. And you lean back in. It's moving to me. And I've been doing this now for over 10 years, and that's why I keep doing it, because this community is pretty special, even for someone who doesn't have diabetes in the family. It makes me lean in because of the things you guys do.
- [46:10]
A
Paris Hicks, Brian Hanson, thank you so much for joining me. Thanks for keeping us updated. I look forward to more studies at ADA and the other conferences this summer. We'll keep everybody posted and more updates to come. Thanks so much for being here.
- [46:23]
B
Thanks for having us. We appreciate it.
- [46:24]
C
Thank you, Stacy. All the best.
- [46:31]
A
More information about everything we talked about in the show notes over@diabetes-connections.com I hope to see some of you tomorrow in Atlanta for Club 1921 and I hope to see many more of you at our events throughout the year. We do have two Moms Night out events coming up this fall, Detroit and Seattle. And of course, you will be hearing more about that in the weeks and months to come. Let me know what events you've got. Don't forget, you can always promote them with our community commercials. We still have openings for that, and I'd love to feature your event, your product, whatever you are working on in the diabetes community. And you can find out much more about that over on the website. All right, thanks to my editor, John Buchenis, from Audio Editing Solutions. Thank you so much for listening. I'm Stacey Sims. I'll see you back here soon. Until then, be kind to yourself.
- [47:24]
B
Diabetes Connection is a production of Stacey Sims Media. All rights reserved. All wrongs avenged.