FUDiabetes

Is Dexcom imploding?


#1

You would never know it from their stock price, which is soaring, but as far as the actual performance of their product (overall, this is person-to-person, I know), and their customer service, it seems that Dexcom has taken a nosedive as a company over the past year, and that is frightening as it is a company so dear to many of us here and one upon which so many of us rely.

It is a real shame. When we started a few years ago, Dexcom was incredible. Their product really WORKED and worked well, and their customer service was fantastic. Their staff seemed to understand how difficult this disease is for those dealing with it and worked to make things right. I felt a great sense of loyalty to this brand… as if this company “got it”, was in it with us, and delivered an excellent product that could be counted on and service that made me comfortable that they would always be there if something went wrong with their product and help was needed. Dexcom was a rock.

Now their product (the G6) is no longer reliable for a not-insignificant percentage of users and their service is not nearly as good for any of us as it once was. It is like the bottom has dropped out in the past year or so. It is very frustrating to go BACKWARD in tech and service… three years ago I had a sensor system with the G4 Platinum with share that gave my family:

  1. A long range to the receiver, provided by RF

  2. Ultra stable readings with no dropouts - again, a byproduct of the superior RF technology

  3. 2 weeks or so sensor wear

  4. The ability to see raw data during warmup - something we did not trust to dose from but which was very helpful to see if things were flying up or down and needed checking, rather than just waiting for 2 hours in the dark.

  5. A transmitter with a small profile.

  6. A transmitter with a life of six months to a year.

All of that disappeared with the next model, the G5, as Dexcom went from ultra-stable and long-range RF, which never dropped out, to finicky and much-shorter range Bluetooth, which has many more data dropouts, including, distressingly at night (we had a G5 for a few months). This bluetooth-only product also has to be kept much closer to our child, which is far more inconvenient. The higher-profile transmitters (due to Bluetooth) now only lasted three months, and raw data was all of a sudden hidden on warmup.

So the “new” generation tech gave us less information, less range, less stability and less usability and convenience. The only positive tradeoff was the ability to go straight to a phone without a receiver, but that feature really was not meaningful for the way our family uses this device, so it was not a draw.

Now, with the G6, it is apparently even worse by the accounts I have been seeing. The only thing to return from my original list is the low-profile transmitter. Everything else is still at that frustrating step back technologically. But even worse, there are now massive backorders, very high sensor failure rates for many people, and larger data dropouts, especially at night, etc. Obviously, this is person to person. The G6 apparently works great for many, including for my brother’s family, who has no complaints. But I have also seen far more online about failures and other issues for people using the G6 than I did about the G5, and Dexcom’s CEO has acknowledged these issues.

The large failure rates have combined with the new markets now opening up to these sensors to create a situation where there are constant backorders for the G6, with many people having large gaps in their CGM coverage as a result, which is just unacceptable. This did not happen on the G4 or G5. It is a step back. And now customer service has suffered as a result of all of this, with long wait times being the norm, callbacks to customers not happening, people getting hung up on, orders not getting shipped out, etc.

Basically, the G6 seems to be, overall, a catastrophe for Dexcom. I realize it has not been a catastrophe for their stock, but this collapse in their product quality and service could be the beginning of doom for the company, particularly the moment a viable competitor appears.

We should not be going backward in service and tech. The product should get better, not worse. T1Ds who have come to rely on this product should not be, all of a sudden, getting gaps in their coverage due to failing sensors which no longer last, backorders, and bad customer service. Dexcom has a near-monopoly due to the insane and costly FDA approval system in this country, which so massively slows innovation and competition. But they will not have that forever, and they do not need to act like they have it. The stakes are too high for too many families.

How frustrating to go from something we as a family started on THREE YEARS AGO, the G4 Platinum with Share, which was fantastic, to each new generation since getting worse technologically and presenting, at best, tradeoffs rather than straight improvements (from our point of view - I’m sure some of the improvements are better for other people’s situations), and with Dexcom’s service getting worse to match.

But the decline in quality is not limited to the new tech - even the old tech is now taking a hit at Dexcom. I have seen here that many people getting the G4/G5 sensors have noticed them all of a sudden take a nosedive in how long they normally last when worn. We have seen the same thing. The sensors used to last around two weeks. All the newer ones are not even lasting a week. This has gone on for months now. Dex rep told me that if it a sensor gets to the 6th day that is now considered a week, so they will not replace those anymore. That is a new policy, and not a good policy, because it could create unfair gaps in coverage for patients. If one’s insurance covers a month worth of sensors and they all happened to crap out at the start of the 6th day then one could, at absolutely no fault of their own, be 8 or so days shy of the month with no sensors available and no way to get more until the month rolls over. This is not right, and it would not have happened at this company two years ago. More going backward.

The CEO of Dexcom, Kevin Sayer, recently said on a diabetes podcast that G6 failure rates were due to the new algorithm - the FDA’s accuracy standard across the low and high ranges required a new algorithm that was more exacting than the older models, he said, and thus sensors fail when they can no longer meet the standard. These sensors would not have failed under the older G4/G5 algorithm.

This may be true, but I cannot imagine it is the whole explanation, because if that were all that were going on then the G4/G5 sensors would not also be failing sooner. But they are, and without any new algorithm. Clearly, there was a manufacturing change that caused this. My suspicion is they began putting less enzyme on the sensors to stop people from wearing them beyond the allotted time (7 or 10 days). This could have been an economic decision or something to do with the FDA not liking people wearing them beyond the “approved” time. But whatever it is, it is a huge pain for the user, more going backward with the product and now service, and it is clear that the algorithm alone cannot be the cause of all these failures as the G4/G5 sensors are also being affected .

I wish they would just go back to the old manufacturing standard. With the G6, the high failure rate combined with expansion into new markets has caused constant backorders and delays. That is not cool, considering these devices are used to keep people from going into comas and for staving off long-term complications. Patient and caregivers should not be faced with days or weeks without CGM coverage because of a manufacturing change which has made the product worse. Dexcom should change manufacturing back to what it was and give people some padding again with their time. It is no fun to be without a CGM once one is used to using it.

For that matter I really wish they would reincorporate RF for those who want to use it. It is just a way better technology than bluetooth - it goes further and is far more stable. I know bringing that back is incredibly unlikely, so I will not hold my breath, but its loss is unfortunate.

At any rate, this post was just a bit of venting, as my frustration with what has been going on with Dexcom has been mounting. And I know I am not alone, based on what I have been hearing from others. I have gone from being an enormously loyal booster of Dexcom to all who would listen to now being frightened at what is going on with the company and worried about what it means for future care. The product getting worse and the service going backward is not something we want to see.

This turnaround feels like being adrift at sea in a lifeboat, and for a few shining minutes sighting a large vessel coming in for the rescue, only to see that vessel now turning the other way, and maybe disappearing forever beyond the fog bank. It is disheartening.

I have loved Dexcom, and still do. I cannot imagine life as a diabetic caregiver without it. Those who work at this company are not only providing jobs and making money for shareholders, they are truly making the world a better place and immeasurably helping the lives of many who have a very difficult disease. I would be proud to work there, and I know all who do are doing their best. But I find myself more and more hopeful that competitors, foreign and domestic, will arise and offer some real competition so things may get back on track.

I was not thinking that way a year ago. Now I do almost daily. What a shame.


#2

I can only speak for myself but I love Dexcom. It works great, customer service is responsive to issues, and we have peace of mind and are able to sleep during the nights.

I’m not at all disappointed with the company. The only think that is even slightly annoying to me are the shorter sensor lives but they’ve always been 7 day products anyway.


#3

I love them, too, but right now I love them the way I might love a friend who I see in danger of becoming an alcoholic. I note the changes, am distressed by the slide in performance and demeanor, and really hope they get will back on track with their lives.

I am very glad you have not noticed any of the issues except for the shorter sensor life. Even there, though, I would say that having sensors all of a sudden work for half of what they used to is a clear step back. And tech should get better, not worse, especially for patients or caregivers managing a disease. This is certainly just my own opinion. I do not, however, think it is an isolated one, given what I have been seeing from others in the community of late. Talk has gone from universal Dexcom love to, with many, frustration (mostly G6 users) and concern.

I was annoyed by the changes away from the G4… again, I really believe tech should get better, not worse - once a technology is demonstrated for a patient it is cruel to go backward in future iterations when we know from experience that we could, and did, have it better before. But it was just annoyance and resignation that I would have to live with those changes. Now, there are many negative reports on the G6, and people like you and I and many others are waiting and hoping that these things get ironed out before we move up. But will it get better? Or just keep getting worse? Combine that with the customer service issues which so many of late have seemed to feel,and that annoyance turns to real concern for the future.

I love my friend and hope they do not continue this slide!


#4

I use G6 and I am happy with it’s accuracy and reliability. No concerns on my end. Started with 7+,g4,g5 and now g6.


#5

@DDunn Dexcom is not sliding, they are experiencing some growing pains, but are not sliding. I have used a Dexcom every day since a couple of weeks before they released the STS3, so I speak through the lens of experience.

The switch to Bluetooth has actually opened up a lot of opportunities to share the signal with alternate devices. To also include an RF radio would be a huge power drain and would also increase the physical profile of the transmitter. So it is not a step backwards, it is a large step forward.

Mr. Sayer has widely acknowledged the problems with the G6 release. I think they learn from this situation and I don’t think it will happen again.

With Medcare coverage approved, G5 production had to be ramped up immediately. Inevitably, some error was introduced, and is currently being addressed.

At the same time, Dexcom has to continue to develop ground breaking development to remain competitive. Their market strength says they are doing just that, and not resting on their laurels.

In 14 or so years I have never had a problem with Dexcom Support. I too have some trepidation with their outsourcing, but so far it has been fine. They are outsourcing to locations around the world where they have Dexcom facilities currently, so their support staff will have some knowledge of the product.

You would be better served by growing your protocol than complaining that the system has bypassed your methods. I use xDrip+, and the G6, after a rough start that Dexcom Support rapidly ameliorated, is giving me near dead on accuracy.

From the STS3, to the Seven, Seven Plus, G4, and G5, the G6 is by far a big step forward.


#6

I totally understand where you are coming from on this, any many have begun to feel frustrated with Dexcom.

I have been on the G6 for a full 4 months now and feel very fortunate that it’s gone well for me. No sensor failures, incredible accuracy, I extended all but 1 sensor (which got ripped off on day 7) to at least 2 weeks with good accuracy, and insertion is a breeze… similar to @jim26 I’ve used the Seven, Seven+, G4, G5 and now G6 and (for me) the G6 is the best product they’ve made by a wide margin. It’s unfortunate that other people (and a lot of young ones apparently) are having issues with the system though, absolutely.

I’ve not had to call Dexcom for any reason (I order through a supplier) so I can’t speak to the decline in customer service :slightly_smiling_face:


#7

@DDunn, I understand your frustration. Fortunately, we have not had any of the tech issues with the G6. It is better for us in almost every way as the G5, with the exception of being able to get a sensor to last 21+ days every time. With that said, the insertion is better, the profile is better, the communication integration with our pump (Tandem) is better. Lots to be excited about.

The growing pains the company is experiencing, both in the manufacturing process, the decision to do a wide launch before they had enough inventory (stupid decision), and the desire to start cutting costs (offshoring support) is typical big company behavior. So what started as a small growth company with plenty of investor funding was achieved, and they now need to lock in their profitability because the market won’t be kind when their top line growth slows down, and they now have about as broad an indication as you are going to get and have captured the ability to sell to Medicare patients. So they must improve the bottom line now to keep their stock price going in the right direction.

Sorry about the ramblings, but seeing the gaps frustrates me, but to my thinking they are predictable, and I don’t think they are going anywhere. The competitor (Abbott) is doing a good job of pushing them, but clearly isn’t in a position to wipe Dexcom out at this point.


#8

This is mostly true for me. I really like the low profile of the G6! I love my Dexcom, but I definitely have some complaints about bleeders and their customer service when ordering supplies.

I’m hoping the customer service doesn’t get worse after they make all these changes.


#9

I definitely found that Dexcom was less reliable the longer I used it. I started on the G4 and usually got around 2 weeks, sometimes more, out of a sensor. This is very important for me as I don’t have private insurance coverage for it. When I switched to the G5 I would often get ??? all of the time after a week. I had better luck with xDrip, but still wonky readings for extended periods of time. People bash the Libre’s accuracy, but I actually find the sensors last for 2 weeks consistently and give me accurate readings when I scan. I much prefer the profile of the sensor and the insertion process, at least compared to the G4/G5. If cost was no object, I’d probably stick with the Dexcom, but I do think they are making choices that make the system more expensive and less reliable if using sensors longer than a week.


#10

I am sorry to hear this. It is so interesting to see how different our experiences are. I could not be happier with Dexcom.


#11

On my second G6 sensor right now, having upgraded after five yrs on G5. Had some trepidation about making the change, but so far… I LOVE it. Just way more accurate than G5, to the extent that I really feel ok relying on it for boluses, which I never quite 100% did with G5. And I’m getting far fewer Bt dropouts, as in basically none, whereas I was getting them every couple of days with G5. Doing the roll-over thing is more complicated and my first attempt didn’t work. But I got a solid ten days, which is fine by me. The transmitter life thing has been an issue since the G5, but I’ve been using xDrip to keep running when that comes up. Presumably it works with the G6, though I haven’t had to cross that bridge yet.

I am concerned about the news that they’re laying off their domestic TS & CS staff and offshoring support to the Philippines. I’ve gone through that in the tech world and it’s always marked a major decrement in quality. So there are things that make me nervous. But as for the device itself, I couldn’t be happier. Well, I could, but only by a little bit.


#12

I’ve only used the G4 and G5. We never did get the G4 Share in Canada, so to me having the Bluetooth ability to send readings to my phone is great. I haven’t noticed any changes between the G4 and G5 in terms of dropouts, adn in fact the ability for the G5 to store some data when out of range means I have almost no breaks in data compared to the G4.

I pay totally out of pocket for my supplies, so the idea that sensors may last for less time is disappointing, but not surprising (they did the same with the transmitters). From a company standpoint, it makes sense to use less enzyme (or whatever they may have done) if it’s cheaper and still performs as advertised. The sensors were never advertised to work for weeks on end, although I myself do stretch sensors out as long as they will last. So from Dexcom’s perspective, I understand that. I’m on week five of my current sensor and it’s still accurate. But I am not using the latest sensors, either.

Ultimately, though, I will use whichever system is cheapest as long as it has decent reliability. So if Dexcom does continue to make sensors/transmitters that can’t be extended (which seems to be their trend), I’ll switch to Libre with few qualms if it’s significantly cheaper. And especially if Dexcom is no longer replacing sensors that fail prior to a full seven days. If I pay $85 for a sensor that doesn’t last the full seven days, they better give me a new one or a refund.

As far as I know, the US is the only country that has widespread CGM coverage. In most other countries (Canada, UK, Australia) users have to pay out of pocket for their supplies. So it will be really interesting to see what happens if Dexcom continues on their trend of restricting extension of supplies when other, cheaper options come along. Is the US market alone enough to sustain them? Because my guess is that most people in other countries are going to go for the cheapest option when they are self-funding these systems. Dexcom has been the cheapest option up until now because of the ability to extend sensors/transmitters. But if that’s no longer an option, it ceases to be the cheapest option.


#13

I generally really like Dexcom’s product. However, I’ve had so many issues with their customer service (sales, not tech support, which I don’t tend to need) over the past two years, that I have mixed feelings re: the outsourcing to the Philippines. In my mind, what they have been doing has been so abysmal that some sort of drastic, system-wide change is needed. Who knows if this will be it or not.

For me (and I’m guessing many folks), the bluetooth is a big deal and a huge convenience. I would hate to go back to carrying my receiver (haven’t used one ever since the day I upgraded to G5). I found it one too many devices to keep track of and would sometimes forget it before heading out of the house only to be without my Dex all day as a result, whereas I never forget my phone. Plus, now I can get away with being out and about with only my phone, one insulin pen, and a couple of rolls of smarties for diabetes supplies, which is pretty awesome.


#14

It works very well with xDrip+. No worries.


#15

I expect (guess) Abbott will be receiving the FDA designation of iCGM in the very near future. Although this is US, it may impact the Libre world-wide but that is only a wild guess. The FDA special controls for iCGM specifically address extension:

(5) The device must include appropriate measures to ensure that disposable sensors cannot be used beyond its claimed sensor wear period.

Actually surprising that the FDA has not required Dexcom to close the obvious gaps which allow trivial extension of the G6. A minor update in the G6 transmitter could easily close the current process used for extension.


#16

Thank you all for your perspective. It has actually made me feel better and less wary about what is going on. I realized there was a sample issue of some kind about the things I’ve been hearing when one is only hearing the complaints and not the good stuff. Also, you brought up some good points and I forgot about the new insertion as another benefit of the G6.

Still, I AM hearing quite a bit more grumbling about G6 issues than I did about the G5 in terms of failures, long wait times for backorders and other issues. And some of us have held off on moving up to the G6 because of those concerns. I know the FDA has only approved the G6 for use without calibration, but we have honestly used the lower models for years now without calibrating for days at a time usually, and it still almost always lines up well. It has worked so well I am afraid of moving up to some new thing and getting the bad results I’ve been hearing about. It would be a huge backward step in quality of life to go from a sensor that works very well with very little calibration, that never drops out and goes for two weeks, to one that all of a sudden does not work as well. But I suppose eventually we will have to move up, and some of the good testimony here makes that prospect less scary. Hoping the G7 comes out before we do, however, and that it is a home run.

One question I have - what is the Xdrip extension of the G5 transmitter you guys are talking about? I have not heard that one.


#17

I’ve read similar grumblings about Dexcom sensor life and customer service but have not given up on them yet. That is despite the fact that I had a few G5 sensors (in a row) in February that did not last as long as I have experienced in the past. One of the sensors gave up after a few days, and my experience with customer service was very positive…they looked at my Clarity data while I was on the line and immediately agreed to send me a replacement, and were professional about getting it delivered to my hotel in Kauai where I was staying when I had all the sensor issues. I doubt that any competitor will be as good as Dexcom on the customer service side, and hope that Dexcom can maintain that level of service. The good news is my current sensor is on day 10 and going strong.

My strategy for hedging my bets is to try out the alternative CGMs and make sure I have options in case I decide to give up on Dexcom at some point in the future. I tried the 10 day Libre last year and plan to try the updated version some time if they run special pricing. Initially I was pretty happy with the Libre performance, but then again I never had to deal with their customer service. I tried an expired Libre sensor last month and got terrible results compared to finger sticks. I am also scheduled to try the Eversense starting in late March for 6 months (they have a good discount for cash payers) and will see how that goes.


#18

It would be quite interesting to get a play-by-play report.
If you are in the mind to do so.
The good, the bad, and the ugly. And everything in between.


#19

I suspect insurance companies and possibly provincial programs will choose to fund the Libre. I think Manulife already pays for the Libre and other companies may have started to as well. Of course, when looping goes mainstream maybe this will change, but I think the introduction of the Libre in Canada is a serious blow for Dexcom trying to get insurance company support.


#20

If you run Xdrip+ instead of the official Dexcom Apps you can ignore the end of life trigger and keep running the transmitter until its battery dies. Here is one of the threads that docslotnick tracked how long a transmitter actually lasts based on battery life.