With the upcoming watchOS 4 update for Apple Watch slated to bring new features for diabetes management devices, we took some time to speak with Dexcom’s CEO Kevin Sayer this week about what it means for users. When Apple revealed watchOS 4 at its Worldwide Developers Conference this month, it featured Dexcom, makers of the G5 Continuous Glucose Monitor (CGM) popular among iPhone users, on stage as an example of an Apple Watch app that will benefit from new features in the release.

Sayer shared details on how exactly Dexcom devices will improve from these new features in watchOS 4, and more specifically why CoreBluetooth support will be a “game changer” for Apple Watch users with diabetes.

We also learned from Sayer about the next-generation of the company’s popular G5 CGM coming soon. And we had to ask about the chatter prior to WWDC that Apple is reportedly developing its own glucose monitoring technology, to find out his thoughts on the possibility of such features being built directly into future Apple Watch models.

Dexcom’s G5 CGM already works with both the iPhone and Apple Watch, but currently the G5’s signal has to go to the iPhone first before syncing data to Apple Watch. That means the data on Apple Watch is a bit delayed, and it also means you must have your iPhone around if you’re on the go and want to continue syncing data. With new support for CoreBluetooth in watchOS 4, the G5 CGM will make a direct connection:

The way we architected our transmitter to transmit this glucose data many years ago is there is two Bluetooth channels…so it could communicate with two devices at the same time… because our sensor talks to Android phones as well, it also speaks with certain models of insulin pumps … an Apple patient now with this Watch direct connectivity can have a direct Watch connection and a direct connection with another device… what that means for our patients, I think it’s a game changer for them. People who work out who have diabetes right now always have these fanny packs and if they have a Dexcom system they’re carrying their phone so the data’s there… If they have an Apple Watch [with CoreBluetooth support], they can leave that phone home, and track their workout real-time. Or if you’re in your office… if I had a meeting in the boardroom and had diabetes and was tracking my glucose…. I could leave my phone in my office so it wouldn’t bother my meeting… there’s a number of places where this direct connection will be useful… I think it’s part of a much longer term strategy to make that wearable more useful in the lives of people who use it.

Our ultimate goal is to make the on body component, the wearable, the size of about a penny… to wear it like a bandaid.

Sayer also confirmed that the current-generation G5 CGM will get the CoreBluetooth support for a direct connection with watchOS 4, although the iPhone will still likely be required for some setup and data entry:

Hardware-wise it’s ready to go… what we will have to do is once the new OS for the Watch comes out, we’ll have to fine tune our app and get it ready and make sure it works… Then we’ll submit our app to the FDA for review… We absolutely will support the feature.. We will give patients the ability to see their data directly on the Watch… for the current G5 system and systems after that… I believe we will continue to have set up with the phone app… a patient doesn’t have to enter data that often… they have to enter a couple calibrations a day… Those things are to be worked out during our human factors testing and our discussions with the FDA, in addition to our discussions with Apple.

One report from CNBC back in April, prior to the unveiling of new features for diabetes management with watchOS 4, claimed Apple had a secret team working on optical sensors to allow for noninvasive measuring of glucose levels (and Tim Cook was reportedly spotted wearing a sensor of some kind connected to Apple Watch). That’s something no one else has been able to do, so we asked Sayer his thoughts on the reports and the possibility of integrating the technology directly into a device like a smartwatch:

Right now the way our sensor works is there’s a small wire literally about the width of a human hair that’s inserted in the subcutaneous tissue, and that wire is coated with several membranes. And that’s how glucose is measured is through that sensor that’s inserted under the skin… for years people have tried to come up with solutions that don’t involve any thing under the skin, similar to what the Apple Watch would be with some type of light technology bouncing through the skin and back up… people who intensively manage their diabetes really require extremely accurate information, because insulin is a life saving and a life threatening drug. If somebody could solve that problem it would be a boon for diabetes, but we haven’t seen anything that’s better than what we have and we know how hard it is to do what we do…

He also told us about the company’s ultimate goal to make “the on body component, the wearable, the size of about a penny,” which in theory could enable a device the size of a bandaid that could be worn underneath or attached directly to a device like Apple Watch:

We experiment with a number of new form factors… Our ultimate goal is to make the on body component, the wearable, the size of about a penny, and have you be able to wear it like a bandaid. What our patients want today more than anything else, is to not have that [the CGM] seen… if it’s the size of a penny and like a bandaid sitting on your arm, if it can communicate directly to an Apple Watch… that’s a wonderful solution for a patient, they’ll be thrilled… If Apple asked for a collaboration, we’d certainly talk about it.

Currently under development and scheduled for a release as soon as next year following watchOS 4, Sayer told us about the next-generation of the company’s G5 CGM, which will feature a lower profile design, a new automated insertion system, and other new features:

Gen 6 is the name of the next platform… that is a different hardware configuration that will be lower profile and the insertion system will be automated and very, very user-friendly and easy for patients to use, with the same connectivity that we have in our current G5 system. So it will give the patients a much better on body experience, and the sensor we believe is really the next step in our technology evolution as far as making these things more accurate and more consistent…there’s a bunch of great features… Apple users have that to look forward to next year sometime, we hope to file it with the FDA in September…

For more on new health features coming in iOS 11 and watchOS 4, check out our roundup of what’s new.

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