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Call sheet · Q1'26

DexCom (DXCM)

Q1'26 earnings call · held April 30, 2026 · compared with the Q4'25 call · management-credibility review
8/12
Disclosure score
1 medium, 5 low flags
Financial quality
Bottom line
The sleeper story is pure execution driving type 2 non-insulin share gains without waiting for major coverage wins - they're finally monetizing the 6M+ lives already covered instead of just talking about CMS. The obvious headline is solid Q1 beats, but the real constraint is new patient growth has plateaued at 'close to records' for four straight quarters while management pivots to retention and base conversion. Jake's most revealing quote: 'The low end would be not records globally' - that's your real guidance framework. My view changes if they start reporting actual new patient numbers again instead of hiding behind 'close to record' language, or if CMS coverage gets a firm timeline instead of perpetual 'matter of time' deflection.

The 30-second version

  • Type 2 non-insulin share gains accelerating despite no major coverage wins - this is pure execution
  • G7 15-day driving margin expansion AND customer satisfaction - the product actually works
  • They stopped giving new patient start numbers and pivoted to 'close to a record' - growth is decelerating

What changed this quarter

MetricQ4'25Q1'26Change
Total Revenue$1.26B (+13% YoY)$1.19B (+15% YoY)+200 bps acceleration
US Revenue$892M (+11% YoY)$832M (+11% YoY)Flat growth rate
International Revenue$368M (+18% YoY)$360M (+26% YoY)+800 bps acceleration
Gross Margin63.5%63.5%Flat Q/Q despite Q1 seasonality
Operating Income$331.5M (26.3%)$264.4M (22.2%)-410 bps margin compression
Adjusted EBITDA$422.2M (33.5%)$364.5M (36.0%)+250 bps margin expansion
Net Income$265.1M ($0.68/share)$216.3M ($0.56/share)+75% YoY growth
Free Cash Flow$1B+ for full yearNot disclosed for Q1Stopped reporting quarterly FCF
Cash Position$2.0B$2.4B+$400M increase
Type 2 Non-Insulin Coverage6M+ lives7M+ lives by year-end+1M lives added

Accountability tracked

8 new promises made4 narrative shifts flagged6 prior promises scored
Inside the full report
The complete write-up covers the full promise ledger with kept/missed calls, disclosure-quality scoring, the metrics-vanished check, verification items, and the questions to ask next quarter.
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Scores, kept-promise rates, and flags on this site reflect the author's opinion, applying a stated methodology to statements management made on public earnings calls. Informational and educational purposes only - not investment advice, a recommendation, or an offer to buy or sell any security. Sources believed reliable but not guaranteed; the author may hold positions in the securities discussed.

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