DexCom NASDAQ: DXCM reported first-quarter 2026 revenue growth of 15% year over year, citing continued demand for continuous glucose monitoring (CGM) products, expanded access, and new product launches. Management also highlighted improving profitability and cash generation, along with ongoing efforts to broaden reimbursement—particularly for people with type 2 diabetes who are not using insulin.
Quarterly results show higher revenue and margin expansion
Chief Financial Officer Jereme Sylvain said worldwide revenue in the first quarter was $1.19 billion, up from $1.04 billion in the first quarter of 2025. The company reported 15% growth on a reported basis and 12% organic growth.
In the U.S., revenue totaled $832 million, up 11% from $751 million a year earlier. International revenue rose 26% to $360 million, with international organic growth of 17%. Sylvain said international growth was “widespread across our core markets,” and cited “some of the largest increases” in areas where access has recently expanded, including France and Canada.
Profitability improved year over year. Sylvain said gross profit was $757.4 million, or 63.5% of revenue, compared with 57.5% of revenue in the prior-year quarter. He attributed the improvement to “strong execution across our operations and supply chain,” including manufacturing efficiencies, more normalized freight costs as inventory levels improved, and “initial benefit from the switchover to G7 15-Day.”
Operating expenses increased to $493.0 million from $453.1 million. Operating income rose to $264.4 million, or 22.2% of revenue, compared with $143.1 million, or 13.8% of revenue, a year earlier. Adjusted EBITDA was $364.5 million, or 30.6% of revenue, up from $230.4 million, or 22.2%, in the first quarter of 2025. Sylvain reported net income of $216.3 million, or $0.56 per share, representing 75% growth over the prior-year period.
Dexcom ended the quarter with approximately $2.4 billion in cash and cash equivalents, which Sylvain said was up more than $400 million from year-end 2025 due to “significant free cash flow performance in the first quarter.”
Type 2 non-insulin coverage remains a major focus
President and CEO Jake Leach said U.S. momentum was “especially pronounced” in type 2 diabetes, with strong first-quarter share gains “with the biggest increase coming from people with type 2 diabetes who are not on insulin.” He tied that to growing awareness of “the greater than 6 million non-insulin lives currently covered for Dexcom CGM across the three largest PBMs.”
Leach also announced a new commercial reimbursement win: “As of this summer, Prime Therapeutics will begin covering Dexcom CGM for all people with diabetes.” He said the addition puts Dexcom “on track to have commercial coverage for more than 7 million type 2 non-insulin lives by the end of this year.”
However, Leach emphasized that broader coverage—particularly through Medicare—is still a key objective. “The largest single driver towards that goal would be CMS coverage for the type 2 non-insulin population,” he said, adding that “around half of those with type 2 diabetes not using insulin sit within the Medicare population.” Leach reiterated Dexcom’s view that a CMS decision is “only a matter of time.” In the Q&A, Leach said the company’s conversations with CMS have suggested the agency understands CGM’s benefits in this category, and he noted that an RCT “may not be required” for CMS coverage.
Leach pointed to evidence generation efforts, including a full readout presented at ATTD of 12-month real-world registry data in the type 2 non-insulin population, which he said showed a “statistically significant A1C reduction over a 1-year period.” Dexcom is also completing a randomized controlled trial for people with type 2 diabetes who are not on insulin, which Leach said the company expects could become “the defining study” for this population. He said the full readout is planned for the ADA 2026 scientific sessions in a few weeks, and that results will not be published before the ADA presentation.
G7 15-Day rollout, patch upgrade, and software initiatives
Leach said Dexcom expanded the launch of its G7 15-Day system across all U.S. channels in the first quarter and described the broad rollout as “very well received,” with “excellent” feedback from customers and physicians. He said the response “goes well beyond the longer wear time,” highlighting feedback around a “new sensor algorithm” that delivers Dexcom’s “highest level of accuracy to date.”
During Q&A, Leach said the G7 15-Day is helping drive momentum and “is really driving new starts, as well as conversions over to it.” He added that Dexcom estimates “nearly 50%” of the base will be converted to the 15-day product by year-end.
Leach also said Dexcom recently began manufacturing with a new patch technology that received FDA clearance earlier this year. He said the upgraded adhesive is expected to improve “sensor survivability across our product portfolio” and reach the market “in the coming weeks.”
On software, Leach described a “complete redesign of Stelo” planned for the coming weeks, aimed at a more consumer-friendly experience with “more AI-driven personalized insights” and additional food logging capabilities, including detailed macronutrient information. He said Stelo is tracking to the company’s expectations and that users have asked for more context around real-time glucose data, prompting the redesign and a more personalized insights engine incorporating additional data sources such as activity trackers and sleep metrics.
Leach also discussed progress on Dexcom Smart Basal, a feature intended to help basal insulin management. He said Dexcom is expanding access within pilot key opinion leaders, and that the pilot is focused on workflow integration across different clinical settings. The company plans to broaden the launch “throughout the year,” once workflow issues are addressed.
Guidance reaffirmed as operating margin outlook increases
Sylvain reaffirmed full-year revenue guidance of $5.16 billion to $5.25 billion, representing 11% to 13% growth. Dexcom reiterated its full-year non-GAAP gross margin guidance of 63% to 64%, but increased its non-GAAP operating profit margin guidance to 23% to 23.5% and adjusted EBITDA margin guidance to 31% to 31.5%.
While first-quarter gross margin performance tracked well relative to guidance, Sylvain said the company kept gross margin guidance unchanged due to the “current geopolitical environment,” including uncertainty around fuel prices and shipping routes. In Q&A, he quantified potential risk from fuel and resins at roughly 50 to 100 basis points over the year and said that “absent that, we would be raising the gross margin guidance.”
On revenue cadence, Sylvain said the company does not guide quarterly, but noted that U.S. comparisons are “more difficult in the first part of the year and a little bit easier in the back half,” while international comparisons are “a little bit easier in the first half… and a little bit more difficult in the back half.” He reiterated Dexcom’s view that full-year organic growth should be “relatively split across U.S. and OUS,” and later said that while quarter-to-quarter performance can vary, the company continues to see strong opportunity in both geographies.
Capital allocation and Investor Day
Asked about cash usage, Sylvain pointed to the company’s ability to generate cash, noting that Dexcom paid down a convertible instrument in the prior quarter and completed $500 million of share buybacks in the back half of last year. He said additional cash provides flexibility for “tuck in M&A” tied to geographic expansion or new capabilities, as well as potential additional actions in capital markets, and added that Dexcom plans to discuss capital allocation further at its upcoming Investor Day.
In closing remarks, Leach thanked employees for execution and cited input from the company’s Customer Advisory Council as a contributor to strategy and customer experience improvements. Dexcom also reiterated plans to provide more detail on product launches and strategy at its May Investor Day, including a visit to its Mesa manufacturing facility for in-person attendees.
About DexCom NASDAQ: DXCM
DexCom, Inc is a medical device company that develops, manufactures and distributes continuous glucose monitoring (CGM) systems for people with diabetes. Its products are designed to provide near real-time glucose readings, trend information and alerts to help patients and clinicians manage insulin dosing and reduce hypoglycemia and hyperglycemia. The company's offerings combine wearable glucose sensors, wireless transmitters and software applications that deliver data to smartphones, dedicated receivers and cloud-based platforms for remote monitoring.
Founded in 1999 and headquartered in San Diego, California, DexCom has focused its business on advancing CGM technology and expanding clinical use beyond traditional insulin-dependent populations.
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