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Call sheet · Q4'25

DexCom (DXCM)

Q4'25 earnings call · held February 12, 2026 · compared with the Q3'25 call · management-credibility review
10/12
Disclosure score
8 low flags
Financial quality
Bottom line
The sleeper story is Ireland facility margin engineering: management is deliberately sacrificing Q4 2026 margins to build long-term capacity, but Street models don't reflect this one-time hit. The obvious headline is 13% revenue growth deceleration, but the real story is operational execution delivery - they fixed deployment issues, restored supply chain, and launched 15-day on schedule. The binding constraint isn't demand (20% patient growth) or supply (inventory rebuilt), it's coverage expansion timing for that 12 million Medicare lives. Jake Leach's most revealing quote: 'We are building to be ready for it as if it came tomorrow. That is how bullish we are on it coming.' My view changes if the RCT readout disappoints or gets delayed past mid-2026.

The 30-second version

  • Ireland facility opening will depress Q4 '26 gross margins by design - Street doesn't know this is coming
  • G7 15-day rollout is actually a stealth pricing reset - margins expand without raising prices
  • Type 2 non-insulin Medicare coverage timing just shifted from 'when' to 'early next year' - much faster than expected

What changed this quarter

MetricQ3'25Q4'25Change
Revenue$1.21B (+22% YoY)$1.26B (+13% YoY)900bp deceleration in growth
US Revenue$852M (+21% YoY)$892M (+11% YoY)1,000bp growth deceleration
International Revenue$357M (+22% YoY)$368M (+18% YoY)400bp deceleration but still strong
Gross Margin61.3%63.5%+220bp sequential recovery
Operating Income$273M (22.6%)$332M (26.3%)+370bp margin expansion
EPS$0.61$0.68Record quarterly EPS
Free Cash FlowNot specified>$1B annuallyFirst time surpassing $1B
Cash Position>$3.3B~$2.0B$1.3B decline after convert settlement
Stelo RevenueBuilding momentum$130M for 2025First full-year disclosure
Patient Base GrowthNot specifiedAlmost 20%Strong underlying volume

Accountability tracked

8 new promises made5 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.
Read the full DXCM Q4'25 report Subscribe
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This is a free preview. The full write-up and promise ledger are published to subscribers on Substack.
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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