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Continuous Glucose Monitor

No pain, lots of gain

Dexcom is a leader in continuous glucose monitoring (CGM) systems for people with Type 1 diabetes.

Rather than the “snapshot in time” reading that a traditional glucose meter provides, CGM continuously tracks glucose levels so that users can see trends and patterns to help better manage their diabetes.

The Dexcom system is based on a tiny, flexible sensor placed just under the skin. The sensor takes a glucose reading every five minutes for up to 10 days at a time, providing dynamic glucose data that can be accessed and shared safely and conveniently through a smart device. The sensor is coupled with a small, reusable transmitter that shares the glucose readings wirelessly with an accompanying handheld reader or smartphone application.

While users of the Dexcom system greatly valued the enhanced ability to monitor and control their diabetes, applying the sensor to their bodies was an obvious pain point. Previous generations of the system required using a manual sensor applicator that resembled a large, plastic syringe. The user needed to push a plunger to drive a needle into the skin to insert the sensor and then pull up on a collar to pull the needle back out. This manual, two-motion process was painful, intimidating and error prone for many users, particularly for parents using the system with young children.

As Dexcom researched these user pain points they developed a concept for an “automatic” applicator that required only a simple press of a button. While the concept showed promise, early prototypes had high failure rates and were unreliable.

Unsure if the issues with the prototype were solvable or a completely new approach was needed, Dexcom partnered with Design Concepts to help move the next-gen development process forward.

Through a series of design sprints, we worked with Dexcom to rethink the experience by applying our process of designing options, creating prototypes, testing with users, and iterating on the applicator, seal and transmitter until we had a winner. This was an intensive process that went from concepting to manufacturing support.

Simple interaction takes complicated engineering

For Dexcom, one-touch, one-hand sensor application was a top priority. A positive user experience required a blink-of-the-eye insertion of the sensor to minimize any sensation or anticipation of pain. It also required achieving reliability to a nearly infinitesimal failure rate.

We developed several options and built prototypes that our human factors engineers tested with users to identify the best forms and safety features for easy, intuitive use. There were three rounds of testing before the desired form and functionality was achieved.

Taking what was a two-step manual process and making it into a simple, automatic process required a great deal of sophisticated engineering work that’s invisible to the user. Basically, our team had to design and engineer a fast, complicated motion in a disposable device that’s manufactured in high volume. Issues with jamming, material incompatibilities and friction were among the biggest challenges to overcome.

Beyond the engineering hurdles, the applicator was a challenge for our industrial designers. The new applicator is designed to be functional and friendly with a simple, clean form that’s easy to hold and intuitive to use.

During the design and testing process, we also identified areas for improvement in the wearable transmitter. The user wears the transmitter on the body continuously so making it smaller, stronger and more attractive was a considerable improvement to the experience. The redesigned wearable is smooth and sleek and transmitter insertion is easier, with nothing that can catch on clothing.

It also took many rounds of iteration to develop and refine a silicone seal for the sensor/transmitter that was reliable and easy to apply. Design Concepts did the research and development on the seals and Dexcom tested the many variants until we found a reliable option.

Out of several applicator concepts fully designed in CAD, the team down-selected to one design that was tooled and thousands of applicators were made in a pilot production line for testing. Then we did it again, rapidly, five times until we were sure we had a reliably functioning product. Our team built test fixtures and a pilot assembly line that informed the manufacturer of a simple automation pathway. A lot of the work for the pilot line made it into the final manufacturing process.

The Dexcom G6 represents a huge leap forward for CGM. That means healthier lives for the children and adults who rely upon it and continued market growth for Dexcom.

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