Dexcom G8

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With the release of the new Dexcom G8 sensor, I think, according to this article, it will be necessary to add two additional options to the xDrip menu - to measure ketones and potassium:

Dexcom G8: Key Features
Jake Leach, CEO of Dexcom, told us about the main features of the new sensor:

The sensor is about 50 percent smaller than the G7, which itself was significantly smaller than the G6's.
Dexcom sensors will now have a 15-day lifespan. Previous generations were mostly limited to 10 days, although a new 15-day G7 recently became available.
The new self-adapting technology promises to increase accuracy over the entire life of the sensor.

Adaptive accuracy
Every CGM manufacturer is constantly working to improve the accuracy of their sensors.
"The number one reason patients stop using CGM — as an industry, not just Dexcom — is reliability. They say, 'It doesn't quite meet my needs.' That's where our focus is. Let's address that need, because that's the most important request of all."
Dexcom's big move is to use adaptive accuracy: the G8 sensor will analyze itself and adjust its readings over its 15-day lifespan
"We've been working on this for a long time. The electronics are quite complex. They not only measure the glucose signal from the sensor, but they also measure another signal that we receive from that sensor continuously, which allows us to understand the state of the sensor and adapt it to make it more accurate over time."
What is the alternative signal? Dexcom wouldn't say. "It's very proprietary; It's a trade secret; It's patented."
These adjustments are important because even Leach admits that the sensor occasionally acts “a little weird,” leading to unreliable measurements. Some users choose to recalibrate such sensors with a finger stick, and calibration remains an option on the G8. But he says this problem should be much less common with the G8 because the sensor can analyze and adapt its own performance in a new way.
Even when your sensor isn’t acting strangely, accuracy can fluctuate over the life of the sensor as your body reacts to the thread that sits under your skin. The body inevitably treats the puncture as a wound, says Leach, which can raise local glucose levels and lead to temporarily misleading readings. This is the main reason for inaccuracy in the first 24 hours, one of several common causes of tech stress in diabetes, as described in an article on our Everyday Health network.
Towards the end of the sensor's life, Leach says, the body can build up a "fibrous capsule" around the sensor, blocking glucose and even causing the sensor to fail. While a self-adapting sensor can't solve all of these problems, it would be the first time a CGM can sense and adapt to a user's unique and changing physiognomy.
Dexcom's CGMs already meet federal accuracy standards, of course, but there's still a lot of room for improvement, as CGMs have a fairly large margin of error.
Track ketones, potassium, and more
The G8 sensors may eventually track more than just glucose. “Our G8 platform has multi-analyte capabilities, so it can sense multiple [substances],” says Leach.
Ketones
One option is to monitor ketones. If you use insulin to treat diabetes, you may have been taught to check for ketones during illness or when your blood sugar levels are severely elevated. Ketones are acids that the body produces to provide energy when it can’t use glucose as its primary fuel. Without enough insulin, ketone production can get out of control, poisoning the blood. 1
Ketone monitoring is “definitely on our roadmap,” says Leach. “I think it’s going to be a useful tool over time.” He says there’s still work to be done to determine who the ideal user is and how exactly it’s going to work. The challenge is to improve results without adding weight. “The last thing you want is to be carrying something that’s going to create more anxiety.”
Although most people with diabetes do not have a serious need for continuous ketone monitoring, the technology can save the lives of people at increased risk of diabetic ketoacidosis (DKA).
Potassium
Potassium is another substance they're looking at. "We think it's a really exciting analyte to focus on," says Leach.
Although most people with diabetes don't have to think much about their potassium levels, it can be an important factor for people with chronic kidney disease. In advanced cases of kidney disease, it may become necessary to monitor your potassium intake and even limit your consumption of otherwise healthy ingredients like fruits and legumes, according to an article in Everyday Health. Many people with diabetes take medications that put them at risk for high potassium (hyperkalemia), including common medications for blood pressure and heart disease. 2
Today, measuring potassium isn't easy. "You have to take a large blood sample and have it analyzed with lab instruments. That's almost always done in a lab or hospital," says Leach.
Dexcom has also filed patents for a huge number of other substances. In the future, these devices could detect all sorts of biomarkers: "It's still a long way off, but in 10 years, multi-analyzers will be a big part of that."
A more stable learning platform
Dexcom plans to significantly contribute to the feedback and advice its app gives users.
Recently, Dexcom has added a number of features to some of its platforms, including intelligent food logging, macronutrient tracking, and AI-powered nutrition coaching. 3 Businesses will continue to make these features increasingly central to their CGM experience.
In this regard, the company recently acquired a platform called Nutrisense, which combines CGM and personalized coaching for people without diabetes who are interested in tracking and improving their metabolic health. Nutrisense offers personalized nutrition and stress management training, as well as an AI interface that helps identify trends and look for opportunities for improvement. 4
"They offer very advanced and personalized metabolic nutrition coaching," says Leach. "The engagement they create with users in the first 90 days of wearing a CGM is really significant. They not only engage with the real-time feedback from the CGM, but also with the nutritionists and their guidance."
"I think it's a powerful tool and we want to integrate it into all of our products, not just Stelo. I think all users can benefit."
What's happening with G7 and Stelo?
"The G8 will be the platform for all of our products going forward," says Leach. The Dexcom G7 will eventually be discontinued, though that will be years away, and the cheaper over-the-counter Dexcom Stelo will be built on the G8's hardware.
If you're still using a G6 — some members of the Diabetes Daily Forums claim the G6 is more reliable than the newer G7 — that means your beloved CGM's days are probably numbered. "The G6 is becoming obsolete for a lot of different reasons," says Leach.
When will the Dexcom G8 be available?
"Our goal right now is to launch it in late 2027," although it could be early 2028, says Leach.
There's still a lot of work to do. Dexcom has yet to begin the clinical trials needed for approval by the U.S. Food and Drug Administration, and "sometimes products take longer to get approved," Leach said.