Dexcom G6: Available to Who? A Post by Tracy Ramey

This post was originally published on the T1International blog on February 17, 2021. I wanted to post it here on Hugging the Cactus because it was incredibly well-written and eye-opening. Thank you to Tracy Ramey for sharing her perspective and prompting me to really think about diabetes technology and who it is available to you. I couldn’t agree more with your closing thoughts. Read on to learn about Tracy’s thoughts on the Dexcom G6, its availability, and the problems with the commercial that aired during Super Bowl LV.

Celebrity. Celebrity in a filter. Technology. Sleek. Celebrity showcasing a device that many people with diabetes can’t afford and telling said people with diabetes that they should get with the times. That’s it. That’s the entire commercial for Dexcom G6, a continuous glucose monitor (CGM), that aired during Super Bowl LV Sunday. To the world outside of the diabetes community, it presents an easy solution to the problem of diabetes management, a quick aside they can tell that person with diabetes they know in the office on Monday.

“Hey I saw Nick Jonas in that commercial. He said you don’t have to prick your finger anymore! Ya know, he doesn’t even look like he has diabetes.”

As a mother of a child that has type 1 diabetes, managing this condition is always on my mind. I am my child’s “pancreas momager,” if you will. For the past three years I have endured well meaning people giving advice, offering empty platitudes, and not understanding the tightrope we walk as a family attempting to raise a well rounded human that is growing physically and emotionally while course correcting a disease that is never the same day to day. I hear often how diabetes is manageable, an understanding that is as true as it is nuanced. Managing diabetes is not a one size fits all leather jacket. Said person with diabetes will assuredly be giving Diabetes Splainin’ Danny an immense amount of side eye.

With this ad, Dexcom and Nick Jonas had an immense opportunity to truly advocate for all insulin dependent people on the world’s stage. Instead of dispelling hurtful myths such as diabetes being caused by eating too much sugar, or insulin being “so cheap, it’s like water”, they created new ones like people with diabetes do not need to prick their fingers. The ad conveyed that there is an easy solution to diabetes management, which is a huge blow to everyone that has been fighting with insurance companies, pharmaceutical companies and device companies just to get basic insulin and other vital supplies covered, including glucose monitors.

Dexcom’s ad conveyed that there is an easy solution to diabetes management, which is a huge blow to everyone that has been fighting with insurance companies, pharmaceutical companies and device companies just to get basic insulin and other vital supplies covered, including glucose monitors.

Most people with diabetes know about Dexcom and the other major continuous CGM company, FreeStyle Libre by Abbott. Assuredly, if they don’t have one of these devices, in most cases it’s not for lack of understanding – it’s due to high cost. For many uninsured or underinsured insulin dependent people who are already struggling to afford their insulin, the Dexcom (with an initial out-of-pocket price tag for receiver, transmitter, and pack of 3 sensors that exceeds $1,000) is technology that remains out of reach. The ad boldly proclaimed “It looks like the future, but it’s available now.” Available to who? I know people that have had to plead with their insurer to keep their Dexcom if coverage changes occur. Many can’t get it covered in the first place, even though being able to have CGM technology is a gamechanger in the life of people living with diabetes. IT affords a level of control that is hard to think of giving up once you experience it.

But again, we must ask: who is this available to? This technology requires a prescription, and we know that Black and Brown communities are being offered access at much lower rates than their white peers. I am a Black woman with a family history of type 2 that puts me at greater risk of developing it. Interestingly, despite having several family members with type 2 diabetes, my child with type 1 is the first person that has CGM technology, and that was because I pushed for it.

You know what I’m getting at. The elephant in the room is medical racism and implicit bias. When cries for justice rang out for Ahmaud Arbery, George Floyd, and Breonna Taylor, many companies found themselves scrambling to make sure they appeared to sympathize with Black people and the systemic disregard for our lives. But here we are, almost a year into the pandemic, with a January 8th, 2021 headline from Endocrine.org that reads “Black people with type 1 diabetes, COVID-19 are four times more likely to be hospitalized for diabetic ketoacidosis.”

Companies that make a profit off of medical devices as life altering as Dexcom owe it to their consumers to look at the data and adjust to get their technology onto the bodies that need it most. Instead of addressing how they are going to provide a solution to inequities that black, Indigenous and people of color (BIPOC) face – especially Black patients – in comparison to their white peers, Dexcom paid $5 million plus for a Super Bowl ad that ignores barriers to access completely. This is chump change when, according to Yahoo!Finance, they earned $1.93 billion in 2020.

Dexcom offers a life saving product that I am fortunate enough to be able to use for my child because of my health insurance. I am acutely aware that many who look like us and need it the most don’t have access to CGMs like Dexcom’s G6. The Black and Brown people that are experiencing medical systemic racism deserve better. All insulin dependent people deserve better than a 30 second ad that wags it’s finger at all of us silly Billy gumdrops that are still pricking our fingers. Don’t spit on me and tell me it’s raining.

My Thoughts on Nick Jonas and His Dexcom Super Bowl Commercial

On February 2nd, Dexcom announced some major news: Nick Jonas – yes, the famous guy from that band – is starring in a Dexcom commercial that will be airing in a coveted Super Bowl Sunday advertisement slot.

This is pretty big for a couple of reasons, one being that Nick Jonas is now an official paid Dexcom spokesperson. In addition, this represents the first time that a diabetes company like Dexcom will be airing an ad that will be delivered to millions of Americans at the same time, which is definitely a big deal.

Upon hearing this news, the diabetes online community and I had some intense and justified reactions.

Nick Jonas is officially a Dexcom spokesperson, which generated some strong reactions from the diabetes community.

A lot of people expressed frustration that a superstar like Nick Jonas only ever seems to talk about his type 1 diabetes when he’s being paid to do so.

And listen, that frustration is warranted. It’s like the guy is trying to monetize his diabetes and it’s a little gross. There’s collective annoyance that Nick Jonas doesn’t use his (massive) platform and following on a more regular basis to advocate for diabetes. That’s a hard pill to swallow for a lot of us who have created blogs, podcasts, social media profiles, and more in order to help the diabetes community and beyond by doing things like raising awareness and talking about real issues regarding access to necessary diabetes care and medication (and so much more). So when Nick Jonas finally opens up about it, apparently it’s to advertise an expensive piece of technology that isn’t available to all people with diabetes. (And here’s my disclaimer: Yes, I use a Dexcom G6 CGM and I love it. But I’m very aware that I’m fortunate to be able to afford it because others cannot.)

It’s a little difficult for me to sympathize much with Nick Jonas here. Of course, I don’t know him (though I’m sure he’s a lovely guy and obviously he’s quite talented). I have no idea what it’s like to be a celebrity. He’s been in the limelight since he was a teenager. Many of us grew up with him. I can’t imagine what kinds of pressure he’s faced, so something like diabetes (a deeply personal condition) might be tough for him to talk about in a candid manner in front of the mass media. Or maybe he simply doesn’t know how to frame discussions around it. Who knows, but his acceptance of this sponsorship deal warrants the conversations that it has generated. Moreover, I can’t ignore his involvement with a non-profit that’s become infamous for accepting money from big pharma, which is massively problematic in the fight to make insulin affordable for all.

Let me end that line of thought by pointing out that he’s not the only person with diabetes featured in this commercial. There are two other “real-life”, non-celebrities living with diabetes who got this incredible opportunity to be featured in a freakin’ Super Bowl commercial. As someone who has participated in Dexcom ads in the past*, I can understand how exciting this time must be for these two people, and I hope that it isn’t diminished by the diabetes online community’s reaction to Nick Jonas’s appearance and sponsorship deal.

Now let’s pivot to the fact that Dexcom has dropped (probably) millions of dollars to appear in this Super Bowl ad slot…and signing a high-profile celeb like Nick Jonas as a company spokesperson likely wasn’t cheap, either.

It definitely leaves me feeling unsettled. Why did the company feel it was necessary to spend so much on this new advertising campaign? As my friend Stacey put it, Dexcom is putting corporate and celebrity money before patient needs. The reality here is that not everyone can afford insulin, let alone a “gratuitous” piece of diabetes technology like a Dexcom continuous glucose monitor. Elevating diabetes to the national spotlight only does good when it can do something about insulin access and affordability, or to raise awareness about it, or to explain how to recognize the symptoms of diabetes.

To sum it all up, I’ll share a thought from another person I’ve come to know from the diabetes online community: @miss__diabetes. The day that Dexcom announced the commercial, she tweeted:

Nick Jonas is the advocate of a privileged life with #type1diabetes. Doing super bowl ads tells the rest of the world that diabetics are living their best life with diabetes technology when the reality is diabetics are dying because they can’t afford insulin. #Insulin4all

@miss__diabetes

A nicely phrased sentiment as well as a reminder that we’ve got a long way to go in the fight for affordable insulin, don’t you think?

*When I appeared in Dexcom advertisements, I was not compensated beyond the company paying for my transportation, on-set meals, and hotel. If you want to learn more about the experience, I wrote this blog post about it, and I am always open to answering questions.