DexCom Expands Access and Innovation While Balancing Headwinds

DexCom, Inc. DXCM reported second-quarter 2025 results that highlighted robust top-line growth, continued progress in expanding access and meaningful product innovation. Revenues grew 15% year over year to $1.16 billion, with broad-based contributions from both the U.S. and international markets. Management raised full-year revenue guidance to $4.6-$4.625 billion, reflecting confidence in ongoing momentum, particularly in the type 2 non-insulin segment.

At the same time, the company faces competitive pressures, regulatory uncertainties and operational hurdles, all of which affect the near-term risk-reward balance. With a leadership transition ahead, DexCom remains positioned for long-term expansion.

DexCom share have gained 4% so far this year against the industry's decline of 7%. The S&P 500 Index increased 8.8% in that period.

Short-Term Growth Drivers

U.S. Expansion in Type 2 Non-Insulin Coverage: The most immediate growth catalyst is the rapid expansion of coverage for type 2 non-insulin patients. As of the second quarter, DexCom secured reimbursement with all three major U.S. PBMs, providing access to nearly 6 million covered lives. This development is already translating into strong new patient starts, reinforcing management’s confidence in raising guidance. Importantly, clinicians are increasingly integrating CGM into earlier stages of care, accelerating adoption within primary care channels.

Stelo Momentum and Consumer Adoption: DexCom’s over-the-counter biosensor, Stelo, continues to gain traction. The app surpassed 400,000 downloads this summer, with rising adoption among wellness users and prediabetic populations. Partnerships with platforms like Oura and Amazon are broadening distribution and enhancing digital integration. While Stelo currently represents just 2-3% of revenues, it demonstrates the potential for DexCom to diversify beyond traditional diabetes management into broader metabolic health.

15-Day G7 Sensor Launch: FDA clearance for the 15-day G7 sensor marks another short-term catalyst. A potential launch in the rest of 2025 should support utilization and potentially improve gross margin dynamics as reimbursement negotiations shift toward monthly coverage models. This longer-wear sensor enhances convenience and strengthens DexCom’s competitive positioning.

Operational Improvements in Supply Chain: After supply constraints earlier in the year, DexCom restored inventory levels by executing record production months and leveraging expedited shipping. The company also rolled out a nationwide warranty program for pharmacy customers, bolstering service reliability. These operational stabilizations should mitigate near-term disruption risk and support smoother growth in the second half.

Long-Term Growth Drivers

Expanding International Coverage: International revenues grew 16% in the second quarter, led by DexCom ONE+ adoption. Coverage wins in regions such as Ontario, Canada, and France underscore growing global recognition of CGM’s clinical and economic value. In markets like Japan and Germany, low penetration of basal insulin users presents a substantial long-term opportunity. Management expects further international expansion across both established and emerging markets to remain a durable growth pillar.

Next-Generation G8 Platform and Multi-Analyte Sensing: Looking further, DexCom’s G8 sensor platform represents the next major leap in CGM technology. Designed to be 50% smaller, with multi-analyte sensing capabilities, G8 could expand the addressable market by addressing broader metabolic monitoring needs, including ketone detection. While timelines depend on clinical and regulatory milestones, G8 is expected to reinforce DexCom’s innovation leadership and strengthen competitive differentiation.

Broader Clinical Applications: DexCom is also advancing evidence generation to expand CGM usage beyond diabetes. Recent clinical trials demonstrated benefits for gestational diabetes and type 2 non-insulin users, while early studies suggested positive outcomes in chronic kidney disease. As real-world evidence accumulates, these findings could pave the way for new reimbursement approvals and expanded adoption across metabolic health conditions.

Software and AI Integration: DexCom continues to operate with a “consumer technology mindset,” rolling out 17 app updates in the first half of 2025 alone. Innovations such as AI-enabled smart food logging, seamless integration with wearables like Oura, and enhanced data visualization enrich user experience and increase retention. These digital enhancements help transform CGM from a monitoring device into a comprehensive health platform, reinforcing customer loyalty and utilization.

DXCM's Sales & EPS Estimates

Challenges

Margin Pressures and Inventory Costs: Despite revenue growth, gross margin contracted to 60.1% from 63.5% a year ago, largely due to higher logistics costs and expedited shipping. While management expects sequential improvement as supply-chain normalization continues, sustained investment in distribution and warranty programs may weigh on profitability in the near term.

Competitive and Regulatory Uncertainty: DexCom faces intensifying competition, particularly from Abbott ABT, which is strengthening its integration with insulin pumps and advancing new sensor platforms. In addition, the CMS proposal for competitive bidding in CGM and pumps, while still preliminary, poses a medium-term risk. Medicare represents roughly 15% of DexCom’s business, and any pricing compression could affect margins starting as early as 2027.

Leadership Transition: CEO Kevin Sayer will step down in early 2026, handing leadership to current president Jake Leach. While Leach has been with DexCom since its inception and is well regarded, transitions of this magnitude always carry execution risk. Ensuring continuity of strategic focus, particularly across innovation and global expansion, will be critical.

Conservative Guidance and Execution Risk: Although management raised revenue guidance, it remains cautious about the back half, citing the need to meet commitments despite outperformance in the first half. This conservatism reflects execution challenges around scaling new coverage wins, driving sustained utilization and balancing global expansion with profitability.

Competition Update

Abbott continues to assert dominant momentum, driven largely by its FreeStyle Libre portfolio. The company reported a strong 18.3 % increase in continuous glucose monitor sales in first-quarter 2025, boosting medical device revenues by 9.9 % — beating EPS forecasts for the 21st consecutive quarter. Underpinning its success, Abbott projects Libre franchise annual sales could reach $10 billion by 2028, fueling investor optimism around expanded CGM adoption.

Roche RHHBY has maintained steady growth across its Diagnostics arm, achieving 6% sales growth in first quarter of 2025 on a constant-exchange-rate basis. Roche is advancing CGM technology, showcasing an AI-enabled SmartGuide system that predicts glucose trends and hypoglycemia up to two hours ahead. These innovations reinforce Roche’s potential to integrate predictive analytics into diabetes care and expand its CGM footprint.

Medtronic MDT is gaining traction with its Smart MDI and MiniMed 780G systems. Real-world data show that users of Medtronic’s Smart MDI system achieved Time-in-Range averages of 67% to 71% when acting on insulin-alert prompts. Separately, use of the Medtronic’s MiniMed 780G with SmartGuard improved HbA1C by 0.6% and increased Time-in-Range by nearly 10% versus manual insulin delivery.

DexCom, Inc. Price

DexCom, Inc. price | DexCom, Inc. Quote

Conclusion

DexCom delivered another quarter of strong double-digit growth, underpinned by expanded access, international traction and product innovation. The company’s leadership in CGM technology, coupled with growing evidence supporting broader use cases, provides a compelling long-term narrative. However, margin pressures, regulatory uncertainty, competitive threats and the looming CEO transition temper near-term enthusiasm. At current levels, the stock reflects both opportunity and risk in equal measure. Investors should continue to hold the stock and wait for greater clarity on execution in type 2 non-insulin adoption, international scale-up, and margin recovery before revisiting a more bullish outlook. DexCom currently carries a Zacks Rank #3 (Hold). You can see the complete list of today’s Zacks #1 Rank (Strong Buy) stocks here.

Want the latest recommendations from Zacks Investment Research? Today, you can download 7 Best Stocks for the Next 30 Days. Click to get this free report

This article originally published on Zacks Investment Research (zacks.com).

Zacks Investment Research