Dexcom Stelo: Can Over-the-Counter Monitoring Finally Win the Diabetes Battle?

The Rise of the Glucose Monitor: Putting a Dexcom Stelo to the Test

For years, the daily ritual of checking my sleep stats was a familiar one, a quick scroll through my phone in the morning before my feet hit the floor. But the last 14 days have been different. Instead of sleep data, my attention has been drawn to my glucose levels. This shift is thanks to a tiny device residing on my left arm: the Dexcom Stelo continuous glucose monitor (CGM).

The Stelo is a notable player in the recent surge of over-the-counter (OTC) CGMs, joining the ranks of Abbott’s offerings. This accessibility marks a significant change, as CGMs have historically been the domain of Type 1 diabetics, who require constant monitoring and insulin management. The Stelo, however, is aimed at Type 2 diabetics, specifically those who don’t rely on insulin. While Type 1 diabetes is an autoimmune condition with insulin deficiency at its core, Type 2 develops over time as the body becomes resistant to insulin’s effects.

The promise of OTC CGMs like Stelo is alluring: the potential to help people with Type 2 diabetes achieve manageable blood sugar levels, potentially even eliminating the need for medication altogether. For prediabetics, it could offer a lifeline, enabling them to reverse their condition. Ultimately, the CGM acts as a valuable tool for understanding the intricate dance between food, exercise, and glucose levels.

While the potential is enormous, the price tag remains a barrier for most. CGMs typically fall outside health insurance coverage for individuals not on insulin, creating an exorbitant barrier for the general population. Dexcom recognized this and set out to make the Stelo more accessible, though the cost remains a consideration: $99 for a 30-day supply or a $89 monthly subscription. However, the device is HSA and FSA eligible, offering a glimmer of hope for those seeking affordable monitoring.

The Stelo’s functionality shares similarities with platforms like Nutrisense, a CGM-based platform I tested previously for non-diabetic individuals focused on optimizing their metabolic health. The user experience is intuitive, with a clear app interface that guides you through sensor insertion (a surprisingly painless process, despite the needle). Target glucose ranges are tailored based on your individual status – Type 2 diabetic, prediabetic, or non-diabetic – providing a personalized framework. After a brief calibration period, the app delivers real-time glucose levels. Integration with iOS and Android health APIs allows access to exercise and sleep data, enhancing the holistic picture. Meal logging is offered, though it requires manual input.

The most anticipated feature is the glucose spike alerts, sent directly to your phone. However, I found these alerts lagged behind the actual spike by 20-60 minutes. While not a critical flaw for those not actively managing insulin, it’s a drawback. Furthermore, the manual meal logging system could benefit from a more streamlined approach, particularly for those using other macro-tracking apps.

My biggest concern lies in the lack of data interpretation. While the streamlined data presentation is aesthetically pleasing, it lacks context. There’s no long-term view of daily historical data, meaning insights into patterns are limited to manual screenshot captures. As a result, it becomes challenging to decipher whether my glucose levels are within an acceptable range, especially without a medical professional’s guidance.

This lack of insight ultimately led me to schedule a doctor’s appointment for a blood sugar test. The Stelo, in its own way, highlighted a potential issue I might have been overlooking. This personal experience underscores the potential of these devices: identifying patterns and concerns, prompting proactive engagement with medical professionals.

Despite the app’s current limitations, it’s crucial to remember that this is a nascent technology. Speed bumps and learning curves are expected, and I plan to continue testing the Stelo. However, even in its early stages, the Stelo’s impact on people with prediabetes and Type 2 diabetes is undeniable. The ability to track glucose levels and work in tandem with a doctor offers a unique opportunity for informed health management.

The broader implications of this burgeoning technology are yet to be fully realized. There’s a growing interest in CGM-driven wellness, with influencers and startups promoting their use for weight loss and metabolic "fixes." While these claims are compelling, scientific evidence supporting their validity is still scarce.

Dexcom’s focus on those who stand to gain the most from accessible CGM technology is a commendable approach. The Stelo represents a step towards closing the gap in access, empowering individuals to take control of their health. As the technology evolves, it’s crucial to prioritize scientific evidence and navigate the potential for misuse, ensuring that the true beneficiaries of this groundbreaking innovation are those who truly need it most.

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