Clean operational beat — but composition is the issue: margin-led with US growth decelerating, and a quiet revenue-guide trim at the high end. Q1'26 Revenue $1,191.9M (+15% YoY) beat ~$1,175M Street by +1.4%; Adj EBITDA $364.5M (+58% YoY) beat ~$314M by +16%; Adj EPS $0.56 +75% beat $0.47 by +19%; GAAP EPS $0.51 +89% YoY. Margin breakout: Non-GAAP GM 63.5% (+597 bps YoY, fully recovered) — flat sequentially vs typical seasonal step-down on G7 15-day rollout. Adj Op margin 22.2% (+839 bps); Adj EBITDA margin 30.6% (+836 bps). Top-line composition: US Revenue $832.3M +11% (decelerated from +21% Q3'25 peak; matched Q4'25); 2-yr stack ~13% CAGR. International $359.6M +26% reported / +17% organic (vs +7% Q1'25 — sharp acceleration on France/Canada wins, ~9 pts FX tailwind). New patient adds: Q1'26 was a global record; US "very close to a record" — fourth straight quarter of "near-record" US language (mgmt explicitly awaiting Prime Therapeutics summer turn-on +1M T2 NIT lives → 7M+ by YE26 + CMS T2 NIT NCD unlock). Channel: Distributor 85% (+14.8%) / Direct 15% (+16.4%) — DME-pharmacy mix stabilized; 2024 channel reset normalized. FCF inflection: $449M (+364% YoY); cash balance +$400M to ~$2.4B; ~$500M of $750M auth remaining (auth runs through 6/30/2026 — re-up + tuck-in M&A likely flagged at May Investor Day). FY26 guide: Revenue $5.16-5.20B (+11-13%) quietly trimmed from $5.16-5.25B — $50M off high end one quarter into the year despite record global new-patient Q1 (most under-appreciated negative). Op margin RAISED to 23.0-23.5% (+75 bps mid); Adj EBITDA RAISED to 31.0-31.5% (+75 bps). GM held at 63-64% only because of a 50-100 bps oil/resin/freight placeholder; absent that, mgmt said they would have raised. Tone shift: CMS T2 NIT NCD rhetoric strengthened — Leach now suggests RCT "may not be required"; Prime Therapeutics commercial win named; 15-day NPS strong. Softening: US growth algo (4 consecutive "close to a record" quarters; David Roman/JPM directly challenged whether US CGM market is slowing, echoing ABT). Slipped: Smart Basal broader launch — still in pilot, mgmt now committing only to "broaden throughout the year." One material contradiction across 4 transcripts: Q2'25 reaffirmed FY25 op margin ~21% / GM ~62% with "a couple hundred bps" GM improvement projected — Q3'25 cut GM to ~61% and op margin 20-21% citing scrap rates. Real walk-back. Stock at $60.91 near 52-wk low ($54.11) despite headline beat — buyside reading decel US growth + margin-only beat as pure-play CGM market maturation. Watch: (1) May 2026 Investor Day — LRP credibility test; (2) ADA RCT readout June 2026; (3) CMS T2 NIT NCD proposed rule (1H'26 expected); (4) G7 15-day base conversion (~50% by YE26); (5) Q4'26 sequential GM decline as Ireland facility turns on; (6) CEO succession overhang (Sayer not on Q1 call; medical leave Q3'25, no Q1'26 update). GLP-1 narrative effectively neutralized — T2 NIT RCT explicitly enrolls GLP-1 patients.

Key Metrics Trends

Metric	Q1 2024	Q2 2024	Q3 2024	Q4 2024	Q1 2025	Q2 2025	Q3 2025	Q4 2025	Q1 2026
US revenue ($M)	$653M	$732M	$702M	$803M	$750M	$841M	$852M	$892M	$832M
US revenue ($M) YoY %	-	-	-	-	+14.9%	+14.9%	+21.4%	+11.0%	+10.9%
International revenue ($M)	$268M	$272M	$292M	$311M	$286M	$316M	$357M	$368M	$360M
International revenue ($M) YoY %	-	-	-	-	+6.6%	+16.0%	+22.3%	+18.5%	+26.0%
Total Revenue ($M)	$921M	$1.0B	$994M	$1.1B	$1.0B	$1.2B	$1.2B	$1.3B	$1.2B
Total Revenue ($M) YoY %	-	-	-	-	+12.5%	+15.2%	+21.6%	+13.1%	+15.0%
Non-GAAP Gross Margin %	61.8%	63.5%	63.0%	59.4%	57.5%	60.1%	61.3%	63.5%	63.5%
Non-GAAP Gross Margin % YoY chg (bps)	-	-	-	-	-430	-340	-170	+410	+600
Adj Op Margin %	15.2%	19.5%	21.3%	18.8%	13.8%	19.2%	22.6%	26.3%	22.2%
Adj Op Margin % YoY chg (bps)	-	-	-	-	-140	-30	+130	+750	+840
Adj EBITDA ($M)	$221M	$284M	$300M	$300M	$230M	$328M	$368M	$422M	$364M
Adj EBITDA ($M) YoY %	-	-	-	-	+4.3%	+15.4%	+22.8%	+40.7%	+58.2%
Adj EBITDA Margin %	24.0%	28.3%	30.2%	27.0%	22.2%	28.3%	30.5%	33.5%	30.6%
Adj EBITDA Margin % YoY chg (bps)	-	-	-	-	-180	+0	+30	+650	+840
Non-GAAP EPS ($)	$0.32	$0.43	$0.45	$0.45	$0.32	$0.48	$0.61	$0.68	$0.56
Non-GAAP EPS ($) YoY %	-	-	-	-	+0.0%	+11.6%	+35.6%	+51.1%	+75.0%
GAAP Diluted EPS ($)	$0.36	$0.35	$0.34	$0.38	$0.27	$0.45	$0.70	$0.68	$0.51
GAAP Diluted EPS ($) YoY %	-	-	-	-	-25.0%	+28.6%	+105.9%	+78.9%	+88.9%

_Trajectory: clean V-shape — 2024Q3 trough → 8 quarters of recovery into 2025Q3 peak → optical decel as easy comps roll off. 2024Q3 was the actual bottom (US -2% YoY, total +2%) on the DTC channel reset. 2024Q2 destock miss was the trigger: total YoY decel -870 bps; US +24% → +19%; Intl +24% → +7%. 2025 recovery + Stelo ramp: US carried it (+15/+15/+21), then handed off to Intl in 26Q1 (+26%, best print in 12-quarter window). Margin breakout in 2025Q4/2026Q1: Adj op margin +750 bps and +840 bps YoY; GM fully recovered to 63.5%; EPS +51% then +75% YoY. Verdict: Top-line momentum maturing (US settling into low-double-digits), but margin/EPS story still has room. Bull case from here requires Stelo to scale + CMS NCD to unlock; otherwise DXCM is a 12-14% grower with margin recovery largely realized. New patient adds not disclosed as a structured Daloopa series — DXCM doesn't disclose as recurring KPI._

Beat/Miss

Guidance

Catalysts

Street Q&A

Contradictions

Read-Throughs

This Quarter vs Consensus

Metric	Consensus	Actual	Variance	Read
Revenue	~$1,175M	$1,191.9M	+$17M / +1.4%	Beat — +15% YoY
Adj EBITDA	~$314M	$364.5M	+$50M / +16%	Beat — margin 30.6% (+836 bps)
Adj EPS	$0.47	$0.56	+$0.09 / +19%	Beat — +75% YoY
GAAP EPS	—	$0.51	+89% YoY	Beat
US revenue	—	$832.3M	+11% YoY	Decel from Q3'25 +21% peak; matched Q4'25
Intl revenue	—	$359.6M	+26% / +17% organic	Acceleration — carried beat
Non-GAAP GM%	—	63.5%	+597 bps YoY	Record — flat sequentially vs typical step-down
Adj Op margin	—	22.2%	+839 bps YoY	Margin breakout
FCF	—	$449M	+364% YoY	Cash inflection
L8Q Revenue beat rate	—	75% (6/8)	—	Misses concentrated in 2024 trough
L8Q EPS beat rate	—	75% (6/8)	—	Pattern matches
L4Q Revenue beat rate	—	100% (4/4)	—	Consistent beater post-recovery
L4Q EPS beat rate	—	100% (4/4)	—	Surprises widening (+7/+7/+5/+19%)

Pattern: Consistent beater post-recovery with widening EPS surprises. L4Q 100% beat on both lines; L8Q 75% — misses concentrated in the 2024 trough (Q2'24 sales-force reorg blow-up; Q4'24/Q1'25 EPS misses on margin dis-leverage). Composition issue: Q1'26 beat was margin-driven; US revenue $832.3M +11% (decelerating, slightly soft vs whisper); Intl +26% reported / +17% organic carried the top line. Mgmt variance commentary: T2 non-insulin coverage wins (Prime Therapeutics announced; 7M lives by YE26), G7 15-day rollout, France/Canada Intl reimbursement, manufacturing/freight margin gains. DME-to-pharmacy narrative effectively closed (was a 2024-early-2025 story). Basal expansion still a 2026/27 setup (Smart Basal in pilot). Stelo ~1pp of guide; redesign launching; Intl launch this year but de minimis dollars. GLP-1 notably absent — neither tailwind nor headwind. The disconnect: stock at $60.91 (near 52-wk low $54.11) despite headline beat — buyside reading decelerating US growth + margin-only beat as pure-play CGM market maturation.

Guidance Deep Dive

Metric	Prior Guide (Feb'26)	New Guide (Q1'26)	vs Prior	Read
FY26 Revenue ($B)	$5.16-5.25B	$5.16-5.20B	-$50M off high end / -$25M mid	Most under-appreciated negative
FY26 Reported Rev Growth	+11-13%	+11-13%	Reaffirmed	Range tightened down
FY26 Non-GAAP GM	63-64%	63-64%	Maintained	50-100 bps oil/resin placeholder; absent — would have raised
FY26 Adj Op Margin	~22.5% mid	23.0-23.5% (mid 23.25%)	+75 bps mid	Margin upside is real
FY26 Adj EBITDA Margin	~30.5% mid	31.0-31.5% (mid 31.25%)	+75 bps mid	Margin breakout continues
FY26 Adj EPS	Implied raise	Raised on margin	Raised	Margin pass-through
Stelo trajectory	$130M / 1pt of growth	Same — app redesign + ex-US 2H launch	Maintained	Optionality intact
Prime Therapeutics	Not yet announced	Summer 2026 turn-on + 1M T2 NIT lives → 7M+ by YE26	Commercial win named	PBM coverage expanding
CMS T2 NIT NCD	Pending	Leach: "RCT may not be required" + direct CEO/CMS dialogue	Tone strengthened	Proposed rule expected 1H'26
G7 15-day conversion	Q1 rollout	~50% of US base by YE 2026	On track	Razor-and-blade intensifies
Smart Basal broader launch	Early access Feb'26	Still in pilot, broaden through year	Slipped	Watch
Q4'26 GM trajectory	Stable/up	Sequential decline as Ireland turns on	New	One-time step-down
Tariffs / supply chain	—	50-100 bps GM placeholder (oil/resin/freight)	New	Oil-driven, not tariff
Buyback ($750M auth)	—	~$500M remaining; runs through 6/30/2026	—	Re-up + M&A flagged at IDay
May 2026 Investor Day	—	LRP credibility test	Upcoming	Largest single catalyst

Tone: bifurcated — strengthening on coverage / margin; softening on US growth algo. Strengthening: CMS coverage rhetoric (Leach now suggests RCT may not be required); Prime Therapeutics commercial win (7M T2 NIT lives by YE26); 15-day NPS and conversion pace (~50% by YE26); margin breakout. Softening: US growth algorithm — 4th consecutive "close to a record" US starts quarter; David Roman/JPM directly challenged whether US CGM market is slowing (echoing ABT). US organic 11% vs OUS 17%. Slipped: Smart Basal broader launch — still in pilot, mgmt now committing only to "broaden throughout the year" vs Q4'25 framing of early-access in Feb'26. Risk flags: CEO succession overhang (Sayer medical leave Q3'25, no update Q1'26); Q4'26 sequential GM decline as Ireland turns on; competitive bidding earliest 2028. GLP-1 narrative neutralized — T2 NIT RCT explicitly enrolls GLP-1 patients. Net read: Margin upside real, but increasingly the only lever — top-line trajectory marginally weaker than Feb'26 framing implied. One material contradiction: Q2'25 reaffirmed FY25 op margin ~21% / GM ~62% with "a couple hundred bps" GM improvement projected vs Q3'25 cut GM to ~61% and op margin 20-21% citing scrap rates. Real walk-back.

Upcoming Catalysts

#	Catalyst	Timing	What to Watch	Read
1	CMS T2 NIT NCD	Proposed rule 1H'26	RCT may not be required (mgmt explicit); CEO direct CMS dialogue ("matter of time"); coverage criteria likely tied to drug-therapy evidence	Most asymmetric — could unlock ~12M Medicare cohort
2	May 2026 Investor Day	Mid-May 2026	LRP credibility test; CEO succession; capital allocation; G8 timeline; out-year growth ex-Stelo	Largest single sentiment catalyst
3	ADA RCT readout	June 2026	T2 NIT efficacy data; A1c bps target; supports CMS coverage	Coverage / payer wins downstream
4	G7 15-day base conversion	~50% by YE 2026	Razor-and-blade intensifies; gross margin lift	Margin tailwind
5	Prime Therapeutics turn-on	Summer 2026	+1M T2 NIT lives → 7M+ by YE26	Commercial win confirmed
6	International expansion (UK/France/Germany/Japan)	Through FY26	France/Canada wins; +17% organic in Q1; G7/Stelo ex-US rollout	Pillar of growth
7	Stelo OTC growth	Through FY26	App redesign + AI insights; ex-US launch in 2026; ~1pt of guide	Optionality lever, not core driver
8	Insulet/Tandem AID partnership volume	Ongoing	Pump volume on G7; Smart Basal pilot expansion	Modest contributor
9	Abbott Libre 4 competitive dynamics	FY26	No Libre 4 launch in 2026; ABT iterating Libre 2+/3+; Libre Assist AI meal-planning at CES; glucose-ketone sensor pivotals 2026 → launch end-26/27	Lighter competitive intensity than expected
10	GLP-1 patient enrollment trends	Ongoing	Mgmt has neutralized — T2 NIT RCT explicitly enrolls GLP-1 patients	Effectively neutralized
11	Tariffs / supply chain	FY26	50-100 bps GM placeholder (oil/resin/freight, not tariff)	Oil-driven optionality
12	Buyback ($750M auth, $500M remaining)	Through 6/30/2026	Re-up + tuck-in M&A likely at Investor Day; ~$2.4B cash + $400M+ Q1 build	Re-up imminent
13	M&A optionality (digital health, AI)	FY26-FY27	Investor Day potential reveal	Optionality
14	Q4'26 sequential GM decline	Q4 2026	Ireland facility turn-on	One-time step-down
15	CEO succession overhang	Ongoing	Sayer medical leave Q3'25, not on Q1'26 call; Leach as President & CEO	Watch
16	Competitive bidding round	Earliest 2028	Multi-year — not 2026 risk	Distant
17	Oura Ring integration	FY26	Stelo v2 partner — wearable ecosystem signal	Positive optionality
18	Pricing / payer contracting cycle	FY26	Bidding negotiations; net price stability	Stable

Street Q&A

#	Analyst (Firm)	Topic	Mgmt Response	Quality
1	Roman (JPM)	Is US CGM market slowing? (echoing ABT)	Leach: 11% US growth + record new patients; awaiting Prime Therapeutics turn-on + CMS T2 NIT NCD.	Well Answered — pushback on bear narrative
2	Multiple analysts	Stelo trajectory / TAM	Leach: ~1pt of FY26 guide; complete app redesign + AI insights; ex-US launch in 2026; de minimis ex-US revenue this year.	Well Answered
3	Multiple analysts	T2 NIT coverage / Prime Therapeutics	Leach: Prime announced; ~1M lives summer 2026 turn-on; 7M+ T2 NIT lives by YE26; CMS criteria likely tied to drug-therapy evidence.	Well Answered — quantified
4	Multiple analysts	CMS LRP / RCT requirement	Leach: RCT may not be required; direct CEO/CMS dialogue ("matter of time"); declined to put a date on coverage.	Partial deflection — punted to IDay
5	Multiple analysts	FY26 revenue guide trim at high end	Sylvain: range tightened down; not flagged as cut; mgmt framed as "reaffirmed."	Soft handling — quietly trimmed
6	Multiple analysts	Margin trajectory / 50-100 bps oil placeholder	Sylvain: GM held at 63-64% only because of 50-100 bps oil/resin/freight placeholder; absent that would have raised.	Well Answered — explicit hidden upside
7	Multiple analysts	G7 15-day base conversion	Leach: ~50% of US base by YE 2026; key driver of Q1 GM lift; majority on G7 already.	Well Answered — quantified
8	Multiple analysts	Smart Basal broader launch timing	Leach: still in pilot, will broaden throughout the year — slipped from Feb'26 early-access framing.	Soft slip
9	Multiple analysts	International growth trajectory	Leach: France/Canada wins; +17% organic; +9 pts FX tailwind; G7/Stelo ex-US rollout 2H'26.	Well Answered
10	Multiple analysts	Capital allocation / buyback	Sylvain: $500M remaining of $750M auth (runs through 6/30/2026); $2.4B cash; $400M+ Q1 cash build.	Partial — capital allocation specifics deferred to IDay
11	Multiple analysts	ABT Libre 4 / competitive landscape	Leach: no Libre 4 in 2026; ABT iterating Libre 2+/3+; AI meal-planning Libre Assist at CES; glucose-ketone pivotals starting 2026.	Well Answered — lighter competitive heat
12	Multiple analysts	Pricing / payer contracting	Sylvain: stable pricing; bidding negotiations on track.	Well Answered
13	Multiple analysts	CEO succession / Sayer status	Not directly addressed by Leach; Sayer medical leave Q3'25, no Q1'26 update.	Conspicuous absence
14	Multiple analysts	Out-year growth ex-Stelo	Leach: deferred to Investor Day; LRP framework expected.	Hard deflection — IDay
15	Multiple analysts	RCT A1c bps target	Leach: ADA June 2026 readout; declined to give specific bps target.	Deflection
16	Multiple analysts	Quarterly cadence (NIT impact)	Sylvain: declined to break out NIT margin mix impact quarterly; deferred to IDay.	Deflection
17	Multiple analysts	GLP-1 substitution risk	Not raised by analysts directly; mgmt has neutralized — T2 NIT RCT explicitly enrolls GLP-1 patients.	Notable absence
18	Multiple analysts	DME / pharmacy mix	Not raised; story effectively closed (was 2024-early-2025 issue).	Absent
19	Multiple analysts	Tariffs	Not raised directly; closest framing was 50-100 bps GM headwind on oil/resin/freight.	Absent
20	Multiple analysts	Oura Ring partnership	Leach: Stello v2 integration; positive ecosystem signal.	Well Answered

Contradictions

#	Topic	Severity	Statement A	Statement B	Why it's a tension
1	Adj operating margin / GM trajectory	Medium — within-quarter walk-back	Q2'25: reaffirmed FY25 op margin ~21% / GM ~62% with "a couple hundred bps" GM improvement projected for Q3	Q3'25: cut GM to ~61% and op margin to 20-21% citing scrap rates "higher than expected"	Real walk-back within one quarter on margin trajectory.
2	T2 NIT TAM framing	Medium — soft reframing	Q2'25: 6M covered as path to "25M person population"	Q3-Q4: 6M reframed as half of the ~12.5M commercial pool, with Medicare separate ~12M cohort	Soft incompatibility — TAM denominator changed.
3	DME → Pharmacy mix shift	Low — magnitude shift	Q3'25: mix "stabilizing"	Q4'25 / Q1'26: re-asserted as continuing (smaller) 2026 drag	Magnitude shift, not directional.
4	Competitive framing (AID/multi-analyte)	Low — soft tonal shift	Q2'25: dismissive on AID/multi-analyte threats	Q3'25: admitted "a bit of an impact on new starts"	Q4-Q1 reasserted stability; soft tonal shift.
5	Stelo trajectory	None — consistent	Multiple Q: 2-3% guide → $130M → 1pt of 2026 growth → de minimis OUS 2026	—	Consistent.
6	15-day G7 launch timing	None — consistent	H2'25 Warrior → "coming weeks" Q3 → all channels Jan 2026 → 50% conversion target	—	Coherent execution.
7	Tariff impact magnitude	Low — new condition	Pre-Q1'26: not addressed	Q1'26: 50-100bp fuel/resin GM risk introduced	New condition, not contradiction.
8	Capital allocation cadence	None — consistent	Convert paid in cash; ongoing repurchases; M&A optionality	—	Consistent.
9	GLP-1 substitution risk	Notable absence	Never engaged in any of 4 calls	—	Notable absence — strategic decision to not engage.
10	G8 timelines	Deferral, not contradiction	Repeatedly deferred to May 2026 Investor Day	—	Deferral pattern.

Indirect Read-Throughs

Name	Relationship	What DXCM signaled	Read-through
Abbott (ABT — Libre)	Direct CGM competitor	DXCM claims share gains in US T2 NIT and OUS tenders previously Libre-exclusive but now dual-formulary; no Libre 4 launch in 2026	NEGATIVE for ABT — DXCM gaining share
Oura Ring	Wearable / ecosystem partner	Stello v2 integration partner — positive ecosystem signal	POSITIVE
Prime Therapeutics	PBM (commercial customer)	New PBM win — ~1M T2 NIT lives summer 2026 go-live	POSITIVE — coverage expansion
CMS	Regulator / payer	RCT may not be required; CEO direct CMS dialogue ("matter of time")	POSITIVE for DXCM if T2 NIT NCD lands
GLP-1s (LLY / NVO)	Therapeutic peers	Not named explicitly; framed symbiotically — CMS criteria may require pharmacotherapy evidence	NEUTRAL — neutralized narrative
Insulet (PODD) / Tandem (TNDM)	Pump partners	Smart Basal in pilot positioned as basal-titration alternative; may overlap with AID value prop for basal-only patients	MIXED — pump partner + competitive overlap
Medtronic (MDT)	AID competitor	Q3'25 admitted "a bit of impact on new starts" from AID; Q4-Q1 reasserted stability	NEUTRAL
Senseonics (SENS)	Implantable CGM peer	Not directly mentioned	Neutral
CVS / Walgreens (WBA) / Amazon Pharmacy	Retail pharmacy	Distributor (DME-heavy) 85% / Direct 15% mix little changed; pharmacy-channel growth steady	NEUTRAL — mix stabilized
UnitedHealth (UNH) / Cigna (CI)	Insurance / PBM	Not directly named; payer contracting stable; bidding negotiations on track	NEUTRAL
Apple / Whoop / Google Fit	Wearable/consumer health	Not directly named; Stello opening to "activity trackers" generally	Optionality
FX (~9 pts OUS tailwind)	Macro KPI	Reported 26% OUS vs 17% organic; FX tailwind driving optical strength	NEUTRAL — but OUS organic +17% impressive
Oil / resin / freight	Macro KPI	50-100 bps GM placeholder; absent that GM guide would have been raised	Optional upside if oil normalizes
ABT Libre Assist (CES 2026)	AI competitor product	Abbott rolled out AI meal-planning feature at CES 2026	NEGATIVE — competitive AI build
ADA (American Diabetes Association)	Industry body	RCT readout June 2026 at ADA scientific sessions	POSITIVE

Data sourced from Daloopa. Document search is currently in beta; transcript and filing snippets may vary.