Dexcom Explains the Benefits of G7 for People With Gestational Diabetes

Beyond Type 1 sat down with Dexcom Chief Operating Officer, Jacob Leach, to discuss the use of Dexcom G7 in people with gestational diabetes. 

Gestational diabetes is a form of diabetes developed during pregnancy in people who don’t already have diabetes. The American Diabetes Association (ADA) explains that the treatment of gestational diabetes aims to keep blood glucose levels equal to those of pregnant women without gestational diabetes. Treatment may include special meal plans, scheduled physical activity, blood glucose testing and insulin injections.

BT1: Can you explain why someone with gestational diabetes may decide to use the Dexcom G7? Is this a decision they’re making with their doctor?

Jacob Leach, Dexcom COO: The G7 is our first product that was approved for use in pregnancy in the United States. We’re really excited about the opportunity to bring continuous glucose monitors (CGMs) to more people to help. Since it’s a prescription device, this is a decision they’re making with their healthcare provider. 

It’s a beneficial tool in pregnancy. It’s a much better way to monitor glucose readings. With gestational diabetes, it impacts up to 10% of all pregnancies in the U.S. The prevalence is quite high. About half of all women who experience gestational diabetes end up being diagnosed with type 2 later in life.

The CGM helps provide feedback every five minutes every day. It helps the patient understand how their diet and food choices influence their blood sugar levels and inform the medication they have to take. People who wear the CGM, with all that feedback, are able to do a much better job of managing their blood glucose readings.

Can you speak to how people with gestational diabetes can use the Dexcom G7 with their doctor to visualize and understand daily variations in their blood glucose levels? What is the Dexcom G7 uniquely positioned to do in that capacity?

It’s the most accurate CGM available. One of the things that’s really important is getting those accurate and reliable readings because you’re making decisions off them—the system has alerts built into it so that when glucose goes out of range, it notifies the user. Basically, it is really helpful for the mother and the physician.

The expectant mother can get feedback around each meal, like how that particular meal impacted her glucose reading. What you can see is that different meals—different compositions of carbohydrates, proteins, all those things—impact glucose variability. It’s hard to understand that until you see it. 

It’s part of education. For the healthcare provider, it’s an important tool to tailor the therapy. If it’s the first time a person with gestational diabetes is doing insulin injections, it can be complicated. The CGM really helps simplify things. It helps understand how insulin is acting—is it reducing glucose values as expected? Do you need a little more? Do you need to adjust the dose? It’s helpful for the physician and mother.

It’s reported that the use of CGMs such as Dexcom G7 are associated with a lower risk of Preeclampsia is a complication of pregnancy. With preeclampsia, you might have high blood pressure, high levels of protein in urine that indicate kidney damage (proteinuria), or other signs of organ damage. Preeclampsia usually begins after 20 weeks of pregnancy in women whose blood pressure had previously been in the standard range. (Mayo Clinic)preeclampsia, a lower rate of C-sections, and lower gestational weight in patients with gestational diabetes. Can you explain to our audience what exactly that all means and why it’s important?

It [Dexcom G7] basically produces a much better overall outcome for the pregnancy. With gestational diabetes, there are higher risk factors for many of the items that you mentioned. When managing glucose, you manage those risk factors. That’s really what real-time data does.

How do you foresee standardized use of CGMs impacting people with diabetes—whether gestational, type 1 or type 2—in the short and long term?

With the Dexcom G7, we’ve proven, in multiple large randomized controlled trials, that there are positive outcomes associated with the use of the CGM—lower A1C and more time in range. These particular A1C reductions are associated with better outcomes. The idea is that, over time, if your glucose is better managed, you’re going to feel better and live a healthier life. You have less of the complications down the line.

That’s really what the CGM is about—giving people the information they need to make the best choices they can for their diabetes.

What does a person with gestational diabetes’s journey with Dexcom look like after they’ve given birth? What sort of ongoing support systems are advised or provided?

The prescription is written by their physician, and then the expected mother wears the product all the way through the pregnancy. After they’ve given birth, it’s up to the mother and physician to determine the ongoing utilization of the CGM. 

We’re really excited about Dexcom being the most connected CGM. What that means is we basically connect our data streams to multiple other applications that the user chooses. It’ll be exciting to see what else gets developed around information and data analysis in pregnancy. Particularly for women with gestational diabetes, potential solutions can be developed by Dexcom and by others who are trying to provide the user with optimum care.