Jake Leach never set out to run a major healthcare company. His first exposure to the medical device industry came in the 1990s, when he took a $10-an-hour job washing lab equipment at MiniMed, an insulin pump maker in California. His high school sweetheart had spent the summer interning there and passed the position to him before returning to school. The work was not glamorous, but it gave Leach something he needed at the time: a paycheck that could help cover community college.

A lesson in earning what you want

Leach grew up in California’s San Fernando Valley, where money was tight. His father worked in groundskeeping at a Catholic school and his mother later became a teacher’s aide. From an early age, Leach understood that if he wanted something, he would have to earn it himself.

That lesson crystallized when he wanted a $350 bicycle as a child. For his family, the price was steep. Rather than give up, Leach spent the summer washing cars for $2 each and used layaway to slowly pay for the bike. The experience shaped his outlook.

“Hard work gets you what you want, and you know you may not always succeed, but you can control it. You can control that outcome,” Leach said.

Engineering curiosity ran in the family

Leach also developed a fascination with how things worked. His maternal grandfather was a handyman who took him along on household projects, from plumbing to electrical repairs. By the time Leach was 10, he was learning how light switches were wired and how electrical panels functioned. That curiosity eventually led him to tinker with old VCRs and build homemade rockets.

The connection to diabetes would become personal. After his grandfather’s gallbladder ruptured, the family learned the emergency was related to diabetes. His grandfather would take insulin for the rest of his life. Leach did not know it then, but those experiences would help steer his future toward glucose monitoring technology.

From community college to corner office

Leach started at Glendale Community College before transferring to UCLA, where he studied electrical and biomedical engineering. He became the first person in his family to earn a four-year college degree. The lab dishwasher job at MiniMed turned into a full-time role, and he stayed for seven years until the company was acquired by Medtronic in 2001.

In 2004, a startup called Dexcom offered him a different path. The company had roughly 30 employees and wanted to challenge established players in diabetes technology. The opportunity also came with a practical benefit: Leach’s salary would more than double, from $45,000 to $95,000. He joined.

Two decades without asking for a promotion

Now, more than 20 years later, Dexcom has become a healthcare giant. The company went public in 2005 and by 2025 reported $4.6 billion in annual revenue, about 3.5 million users worldwide, and roughly 11,000 full-time employees. The broader rise of GLP-1 drugs for type 2 diabetes has also brought fresh attention to glucose monitoring.

Leach rose through the ranks without ever requesting a promotion. He became chief technology officer in 2018, chief operating officer in 2022, and president and chief executive in January. His annual base salary is now $1.15 million, a long way from $10 an hour.

"It's always been: keep doing a really good job, keep solving big problems, keep fostering leaders, teaching people, learning from other people," he said.

Career advice for the next generation

Leach's advice to young workers is straightforward. He believes the people who advance are the ones willing to step outside their immediate responsibilities and take on work others avoid. He describes it as getting outside your swim lane.

"Everyone kind of has their functional swim lane. You got to get out of that, and I think that's when you become a more valuable leader for an organization," he said.

He also emphasizes that there is no shortcut. "It's all about hard work," Leach said. "There's no shortcut."