AN INTERVIEW WITH A GIANT IN THE DIABETES WORLD, DEXCOM’S CEO KEVIN SAYER

Years ago, I was friends with a man named Arthur Iger. He was more of a mentor, actually. Arthur was the father of Bob Iger who is the Chairman and CEO of the Walt Disney Company…..yes, THAT Walt Disney Company.

Through Arthur, I came to learn much about Bob, who many have credited for many saves in the Disney World especially that of making sure Pixar remained with the Disney Company. As I listened to Arthur over the years, and heard of Bob’s successes, I found none of it surprising. Bob seemed like his brilliance was only surpassed by his drive to make his company the best it could ever be. Status quo had no place in his business plan. The best way to stay good was to stay ahead.

Keeping your eye on benefitting the company, and not yourself, was a great way to appreciate humility as well. Confidence with feet planted. Bob Iger continued with great growth and became hugely successful as the world continued to learn from the company in so many areas. Food service, entertainment, crowd flow….quite honestly people learned that you can do things “right”, and you can do things “Disney-right”. When Arthur passed, I lost a good friend and there were a few times that I wanted to just pick up the phone and ask his son if he wanted to ‘grab a cup of coffee’ so I could find out what was new. I never found that relationship again………………………………until recently.

I had the complete honor of interviewing Kevin Sayer, CEO of Dexcom recently at the ADA Scientific Sessions in Boston, Massachusetts. Kevin is wonderful to talk to and there is no mistaking his handling of the reigns at Dexcom; to not only stay the leader they have been, but to make sure Dexcom devices are the absolute best that technology can possibly offer. His eyes focus sharply when he speaks of advancing all aspects of the Dexcom, and his face shows an incredible compassion when he speaks of seeing his product on little kids and how much more needs to be done. Here is my interview and see what all in the diabetes world should learn as well; that they can do ‘things right’ or they can do things “Dexcom-right”.   Many should follow Mr. Sayer’s lead. Enjoy the interview.
DiabetesDad (DD) You are heading your life and your career into becoming a CPA, how did it ever get you into this world?
Kevin Sayer (KS) That’s a great question, when I was in public accounting many of my client assignments were leading edge technology companies, health care, computer science, and disc drives. My clients were all emerging growth companies so some of them I would start with when they had nothing and would go all the way up to their public offering and their eventual sale to somebody else. So I had a lot of experiences that way and then when I became CFO of Minimed in 1994, my role evolved into much more than just being a CFO. I was……like……employee number 125 and when we sold that business to Medtronic, we had 2200 employees. So overtime when you have a small management team, you look at each other and ask who is going to be responsible for this, and who is going to be responsible for that, and you take more duties and you move on. I had some great mentors. In public accounting I had a wonderful mentor who I have had a 35 year relationship with; I worked alongside Terry Greg and Al Mann; I have been around a lot of great people over time.

DD And they influenced your direction…..
KS……a great deal.   And I grew up in the automobile industry with my dad watching him mange people all day long and learned an enormous amount there.

DD What’s so exciting about the Dexcom? What excites you about it and what is upcoming that excites you even more?
KS Do we have three hours?
(We both laughed at that notion)
KS The wonderful thing about Dexcom is what we do for people’s lives. Let me share a story with you. When we launched the Share System back in March we knew it would have a big impact. But we received an email from a patient in the Midwest and he said I have only had my Dexcom Share for three days but I feel compelled to write to you guys. He was a law school student and he stayed up all night studying for finals, took his final, got home and decided to mow his lawn, had a bottle of Gatorade and decided to go to sleep. Take a nap. Thinking everything would be okay, he checked his blood sugar before he went to sleep. In the middle of his nap, he went low and all of the alarms went off and he slept through them all but because of the Share System his brother; many, many hundreds of miles away was alerted that something was wrong. He called 9-1-1, the brother did, the paramedics, woke him up, pumped him full of glucagon—and in his own words he said “I would have died without your CGM, so with tears running down my face, I write you this letter. My cousin died not long ago because of this, he did not have to die if this was around.” The changes we can make in people’s lives and the lives we saved is what is exciting…..THAT IS WHAT is more exciting than any of the technology. Our next big step is in connectivity; that is our new next step. To share data properly. We’ve created an interesting dynamic between children and their parents. We freak some parents out because they now see each and every data point each and every day. A lot of these things psychologically have to be worked out. But that is our next big step, is the connectivity to the phone to eliminate the receiver so that people can carry one less thing. Data can be shared, and we can run analytics to make people’s lives EVEN better. From that point on, more accurate sensors, smaller sensors, smaller electronics. We listen to our patients.

DD How far away are we from seeing the phone from becoming the actual receiver; done and approved and ready to go?
KS We have filed that with the FDA for adults and for children it will go in very shortly. We would like to see both of them approved at the same time and on a track to do it by the end of this year.

DD THAT would be very exciting.
KS Yes, that would be fun.

DD Let’s say you are at a conference and you see an adult who is about 22-23 years of age and you see them checking their receiver, what goes through your head?
KS I go talk to them. I introduce myself and tell them my title. I ask them if they like it and take any feedback as to what, if anything, we can do better.

DD The same scenario occurs and there is a mom, but with a three-year old, and she is working with the child; what goes through your head knowing that ten years ago that was not happening and you have changed that whole dynamic?
KS Oh it’s breath taking. Who gets to go to work and do that?

DD Not a lot of people, not a lot of people at all…………………………..What would you suggest to the medical community when a patient is newly diagnosed and the inclination would be to say, ‘wait’?
KS I would say; “try it”.   I would also say that we need to do some work here as well. We need to build a body of proof to help change the minds of those in the medical profession who might be inclined to say, ‘wait’. We are not physicians and we need to continue to try to deliver our CGM first message and we need to provide better evidence for the physicians to say, “This really works. This leads to better outcomes.” We have a little more work to do there.

DD Can you address the idea of nonprofit giving to the private sector to accomplish a goal?
KS We have no problem with working with the nonprofit, within the guidelines of what the FDA outlines for us. If the non-profit group, for example, had a way to definitely make our product better, we would be more than happy to license that app and go through the proper FDA approvals and incorporate that into the product.

DD It’s a high pressure position, you are all around the country….what do you do when you want to get away from it all?
KS I have 5 sons, and inevitably somebody will be spending time with me. I have a 17-year-old left at home, and I have six grandchildren, so my spare time is spent with family. I have an amazing wife of 34 years this December; and I love to spend time with her as well.   I also love to golf and play sports of all kinds. I’m very active in my church and always have been. When I was younger I coached many of my sons’ teams. One of my favorite times in my life was working for my oldest son; he is a high school basketball coach and I was his assistant. It was awesome. Things like that, I love that.

DD As a leader in the diabetes industry, what are some of the biggest hurdles that are needed to be overcome in the furthering of a closed loop, bionic/artificial pancreas system?
KS Insulin is a big hurdle. Infusion sets are big hurdle; to consistently be able to deliver the exact amount of insulin every time insulin is delivered in a precise amount and know what is on there. When I started at Dexcom, everyone stated that glucose sensors had to be better. I think we’re getting pretty close but we’ll have to be better.

DD Are you referring to accuracy?
KS Yes, and accuracy is not just the number. Accuracy is the consistency of performance time, and time, and time and time again. When those sensors deliver the same results every single time, it is much better to run an algorithm with it. People being able to use it and work with it. The issue of the split community, one community saying we have to have glucagon with it and another community saying you don’t; I think those issues will all be worked out over time. Time being the key word.

DD Will you ever have a plastic-protective case like you did for the Dex Seven Plus?
KS I hope not…………….because I don’t want a receiver anymore.

DD What a great answer (both of us laughed).   Talk to your phone company?
KS I will tell you that we will sell a receiver for a back-up on a starter set and we are developing a more durable new receiver that will come out in the next 2-3 years. That would help. There are cases you can buy on other websites but we won’t build it.

DD Will you ever have receivers that have replaceable batteries?
KS Oh, yes, we are looking at that right now, but it will resemble more like disposable transmitters. We would rather make those and shrink the size of the transmitters. One of the things that gnaws at me more than anything is the size. I was at the CWD Friends for Life Conference in Florida last summer in Orlando and I see this army of children wearing CGM sensors and it looks bigger than the kid. The most dangerous thing in the world for our scientists is for me to go to a show like that for three days; because I come back and literally I tell them that I want it to be the size smaller than a bottle cap, and thinner than 2 quarters….and how do we do that? And battery technologies evolving, circuitries evolving and radios evolving; we have an advanced technology group looking at things like that and I would rather make the sensor like a band-aid. Wear it for a couple of weeks, peel it off, and put on another to simplify it rather than working on replacing batteries. However there is a catch—we DO NOT WANT IT TO BE MORE EXPENSIVE.   Performance has to come first, it has to be better than what is in present use, and it HAS TO BE less expensive. Making a product more expensive does not work.

DD Can you share how your team is involved with the Medicaid system and trying to get it covered?
KS We have picked up coverage in several Medicaid programs in the last year and we call on them all the time and we have a very strong effort going on…….but it is slower than we like. We keep pushing. It is an ongoing process. We have a very large group that is concentrated on strategic reimbursement that has many different levels. We’ve had a couple of big wins that should be announced over the next six months. CGM changes lives more than any technology that is available today…..this message must continue to get out there. There are fewer people on CGMs than on pumps and those on pumps is only about 30% of the population. Why would you drive your car at night without headlights or only turn them on for a few seconds every few hours. Patients who use this from the beginning have wonderful results than those trying to fly blind, and so my message is very simple; CGMs should be on the first line in diabetes treatment for everybody.

KS (Shows me his Apple Watch which is mimicking the receiver of his CGM. Note: Kevin does not have diabetes but he was wearing the device on this day.) We’ve just been looking at the secondary display of my data which is on my display of my Apple Watch. CNBC gave a list of the top 10 ‘must have’ apps for the Apple Watch and Dexcom App is one of those.   SO the design and architect is wonderful and I find that looking at the data on my watch much less invasive than even getting out my phone……looking at my watch is a very, very, simple task.

DD Right now your receiver communicates with your phone and your phone communicates with the Apple watch?
KS Correct

DD The goal, someday soon, will be to go directly from the…………..
KS Our Gen Five system, filed with the FDA, we designed the radio and the transmitter to talk to two devices at the same time so if a person had a watch and a phone, it could talk to both. If the person had a receiver and a watch-it could talk to both, and if the person had one device, it could talk to one device. We want to give as much flexibility as we possibly can.  We have also hired outside cyber-security experts to make it as safe as we can possibly make it

DD As I like to do; I like to close my interviews by stating a word, or phrase, and you telling me the first thing that comes into your mind. Diabetes?
KS Tough

DD If Kevin was not in a technology based company he would……..
KS ……(if I could do anything) I would run the Lakers. I really want to go run the Lakers…….and (while laughing) they truly need my help. BUT……..no one has approached me just yet.

DD A newly diagnosed child?
KS …needs a CGM immediately.

DD The word…..recall?
KS Catastrophic…….(thinks, smiles, and adds) won’t happen at Dexcom

DD Brigham Young University (His Alma Mater)?
KS I love my school….my school gave me wonderful opportunities

DD A world with no more T1 diabetes?
KS That would be fantastic and I would have to find a new place to hang out……and I could do that.

DD I always said if I had the chance to do this………..I would………and that is the chance to say thank you.  You have saved my children’s very lives. With that, this man of business, this man of genius……..this family man who also had tribulations in his own life with his children, as every family has; became just a dad……and this Diabetes Dad became pretty emotional; and we both teared up, shook hands, and gave each other a hug to end the interview.

I am a diabetes dad.
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