In line with ATTD expectations, Dexcom has updated its Clarity data mobile app (Apple iOS, Google Play) to add three excellent CGM analysis features: (i) the ability to set daily time-in-range goals and be notified when they are reached; (ii) calling out a user’s “best day” within a specified time period; and (iii) bringing back “estimated A1c” under the newly-agreed-on term, “GMI” – Glucose Management Indicator (Diabetes Care 2018). These are all included on the Clarity mobile home screen. The default time-in-range goal is 70%, aligning with the ATTD consensus.
We are big fans of the Daily Time-in-Range Goal and “Best Day” notifications, which should help users identify Bright Spots – “When things go well, what did I do?” CGM has historically focused on mistake detection – “When are my highs and lows occurring and what did I mess up?” – but reinforcing what is working will also be key for improvement, engagement, and preventing burnout.
This is the biggest update to Clarity mobile since weekly notifications launched last year. It also continues a shift to a new paradigm of engaging with retrospective diabetes data – pushing relevant insights to users, rather than asking people to pull them from a web dashboard. Most importantly, Dexcom’s retrospective CGM data and patterns are generated with zero user burden – all G5/G6 mobile CGM data is uploaded automatically, Clarity crunches the patterns (the app does not need to be open), and the key stats are pushed to the user as they come up. Nice! Medtronic has also moved in this direction with Sugar.IQ, and we think it’s a great way to go – it’s far too much to ask people to log in to a dashboard and crunch their own data.
We’re also glad to see Dexcom is still thinking carefully about notification burnout: users must opt-in to these new notifications, and the “Best Day” notification will be generated for the most in-range day over the last seven days.
“GMI approximates the laboratory A1C level expected based on average glucose measured using continuous glucose monitoring (CGM) values derived from at least 14 days of CGM data.” Dexcom is presumably using the new equation shared in Diabetes Care and now posted on the Jaeb website. This equation was also recently validated for Medtronic and Abbott systems (Diabetes Care 2019), and we’d expect those data management platforms to soon add GMI (if they already haven’t). Tidepool Web added GMI in its recent (excellent) redesign.
--by Adam Brown and Kelly Close