← The Peter Attia Drive

#54 – Kevin Sayer, CEO of Dexcom: Continuous glucose monitors – impact of food, sleep, and stress on glucose, the unmatched power of CGM to drive behavioral change, and the exciting future of CGM

May 20, 2019 1h 44m 15 insights
<p>In this episode, Kevin Sayer, CEO of Dexcom, discusses the remarkable benefits of a continuous glucose monitor for the diabetes population. Peter shares his own invaluable insights he's learned from wearing a CGM including the impact of sleep and stress on glucose as well as the unmatched power of a CGM to drive behavioral change. Kevin also reveals some of the exciting partnerships and future advancements of their products benefiting not only those with type 1 and 2 diabetes, but also for the growing community of people interested in optimizing health and wellness.</p> <h2><strong>We discuss:</strong></h2> <ul> <li>How they met, and Kevin's path to becoming CEO of Dexcom [7:00];</li> <li>How CGM technology works, and what makes Dexcom's G6 the best model yet [15:15];</li> <li>Challenges of working in the US healthcare system and getting CGM insured [21:45];</li> <li>Developing an even smaller, more user-friendly, and less costly product while maintaining performance and accuracy [33:15];</li> <li>Next thing on the horizon for type 1 diabetes patients [43:30];</li> <li>The incredible accuracy of the G6, recommended over-the-counter glucose meters, and the unmatched power of CGM to drive behavioral change [48:15];</li> <li>Software improvements for type 2 diabetics, and the remarkable benefits of real-time feedback for driving behavioral change [58:15];</li> <li>Dexcom vs. the competitors, the less invasive options, and the fundamental problems needing to be solved with CGM technologies [1:07:00];</li> <li>The cost of CGM, why you need a prescription, and when might there be a OTC option? [1:12:00];</li> <li>Smartwatch integration, bluetooth technology, and exciting collaborations and partnerships [1:22:00];</li> <li>Future places for CGM: Hospitals, nutrition apps, general health and wellness, and more [1:27:15];</li> <li>Dexcom's unique company culture [1:34:15];</li> <li>Parenting advice from Kevin [1:37:30];</li> <li>Lessons learned through failures and success [1:38:45]; and</li> <li>More.</li> </ul> <p><span style="white-space: pre-wrap;">Learn more at <a href="http://www.peterattiamd.com/">www.PeterAttiaMD.com</a><br /> Connect with Peter on <a href="Facebook.com/PeterAttiaMD">Facebook</a> | <a href="Twitter.com/PeterAttiaMD">Twitter</a> | <a href="Instagram.com/PeterAttiaMD">Instagram</a>.<br /></span></p>
Actionable Insights

1. Use CGM for Behavioral Change

Utilize continuous glucose monitoring (CGM) for real-time feedback on how activities, especially food, impact your glucose levels. This immediate data can drive significant behavioral changes, helping you avoid choices that lead to undesirable glucose spikes, as demonstrated by the host’s experience with trail mix.

2. Optimize Type 1 Diabetes Management

For individuals with Type 1 diabetes, using a CGM can lead to significantly better glycemic control, with reported average A1C drops of 0.5 to 1.0 percentage points and a reduction in hypoglycemic events. This enables tighter management, moving from a ’normal’ A1C of 7.5% to 5.6% without hypos, as seen in pediatric patients.

3. Leverage CGM for Hypoglycemia Unawareness

If you experience hypoglycemia unawareness, use a CGM with alert and alarm features to be notified of low blood sugar. The system’s ‘share’ feature can also alert caregivers, potentially preventing hospitalizations that can cost $10,000 to $30,000.

4. Manage Evening Cortisol for Glucose

Pay attention to the role of evening cortisol levels on your nighttime glucose, as high cortisol can raise glucose levels even after a normal dinner. Tracking this correlation can help you understand and mitigate unexpected morning glucose elevations.

5. Identify Food-Specific Glucose Spikes

Use CGM to discover how specific foods, even seemingly healthy ones like grapes or trail mix, can cause unexpected and significant glucose spikes. This real-time information allows you to make informed dietary adjustments to avoid such reactions.

6. Understand Exercise Impact on Glucose

Observe how exercise transiently raises your blood glucose (e.g., a 30-point spike during a workout) but subsequently lowers your average glucose for the rest of the day (e.g., 10 points lower). This insight helps in understanding the overall benefits of physical activity on glycemic control.

7. Monitor Stress and Sleep for Glucose

Recognize the significant impact of stress and poor sleep on your glucose levels. High stress and crappy sleep can lead to higher glucose readings, highlighting the importance of managing these lifestyle factors for better metabolic health.

8. Calibrate G6 Daily for Accuracy

Even though the Dexcom G6 doesn’t require daily calibration, consider calibrating it once a day to potentially achieve even greater accuracy. The host notes this practice often results in readings that are within 3% of fingerstick measurements.

9. Wash Hands for Accurate Blood Glucose

Always wash your hands thoroughly before performing a fingerstick glucose test. Food residue on your hands can cause false elevations in your glucose readings, leading to inaccurate measurements.

10. Allow Children to Experience Failure

As a parent, don’t be afraid to let your children fail, as learning from failures can be as valuable, if not more so, than successes. This approach helps them develop resilience and motivation to achieve great things.

11. Improve Strategic Communication

In professional settings, ensure you are better prepared and more thoughtful in delivering your messages, especially when presenting strategic ideas to decision-makers. This increases the likelihood of your proposals being accepted and avoids ‘beating your head against the wall’ in futile efforts.

12. Recognize When to Disengage

Learn to identify situations where your efforts are not yielding results and be willing to disengage if the situation isn’t going to work out. This can prevent prolonged misery and open doors to better opportunities.

13. Build an Engaged Team

Recognize that your success is highly dependent on the people around you. Cultivate a team that is committed, works hard, and is deeply engaged in their work, as this collective dedication is crucial for achieving company goals.

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