Behind the Term Sheet: How DayTwo is Revolutionizing Diabetes Care and Beyond with Microbiome Precision Nutrition

octobre 21, 2021

Diabetes is a global epidemic with over 420 million people (that’s 6% of the world’s population) who live with either type 1 or type 2 diabetes. The World Health Organization (WHO) recently launched the Global Diabetes Compact with Director-General Dr. Tedros Adhanom Ghebreyesus saying:

“The need to take urgent action on diabetes is clearer than ever. The number of people with diabetes has quadrupled in the last 40 years. It is the only major noncommunicable disease for which the risk of dying early is going up, rather than down.”

As metabolic diseases continue to rise, many are increasing their focus on diet — which is complicated by the fact that people respond differently to the same food. This highlights the growing need for personalized nutrition, not only for diabetes, but to promote healthier diets for all individuals. Meanwhile, the recent acceleration in microbiome research (studies on the trillions of bacteria and microorganisms that live in our bodies) is pointing towards a revolution.

At the forefront of innovation in precision nutrition, using gut microbiome profiling and AI, is DayTwo. Founded out of scientific research at Weizmann Institute and Mayo Clinic, and with the largest microbiome database in the world, DayTwo is the only precision nutrition solution using microbiome profiling and AI that enables a path to remission for metabolic disease, including type 2 diabetes, prediabetes, clinical obesity and non-alcoholic fatty liver disease (NAFLD). Using IDA™ (Integrated Dietary Algorithm) to predict individual blood sugar responses to food, DayTwo’s solution delivers sustainable outcomes: lower A1C, higher Time In Range, lower weight and BMI, improved energy, better sleep and reduced stress.

With the potential to impact millions of people with metabolic disease, we at Cathay Innovation are honored to co-lead DayTwo’s latest $37M financing round alongside aMoon. Since our original 2019 investment, we’ve been continuously impressed with DayTwo’s progress, in terms of research, product, market traction, sustained outcomes, and ability to attract key talent across the industry. We look forward to helping the company further scale its solution with employers, hospitals, health systems, and health plans to reach a greater number of people suffering from metabolic disease and potentially other therapeutic areas.

“We are grateful for Cathay Innovation’s continued support of DayTwo and for co-leading this round of financing. We are excited about DayTwo’s momentum and the outstanding clinical outcomes we have delivered for employers and health plans. Our innovative solution, which uses gut microbiome profiling, AI and virtual care, has captured the industry’s attention. We look forward to accelerating our growth in the coming year.”

David Henderson, CEO, DayTwo

The Human Microbiome: The Huge Market Potential of Trusting your Gut

How big is the microbiome market? Huge — both in terms of affected population and current spend with microbiome being linked to diseases with over $7 trillion in healthcare costs. Sometimes referred to as “the last organ,” the human microbiome plays a crucial role in human health with around 100 trillion microbes in the gut alone that train the immune system and help our bodies recognize friend from foe.

Just in the past 2 years, microbiome has emerged as a key factor in multiple disease areas, including cancers, chronic diseases, depression and obesity with research showing possible revolutionary cures (rather than just mitigating the effects). Over the past decade, more than $1.7B has been spent on human microbiome research with the total potential skyrocketing to a multi trillion-dollar market today. Yet, while there have been several emerging startups in the microbiome space across North America, Europe and Asia, there is yet to be a clear market leader.

Zeroing in on diabetes — the problem is staggering with 100M people in the US, and 1.5M new Americans being diagnosed each year, along with approximately 500M in China. This has huge consequences on quality of life, life expectancy and monetary burden on patients, insurers, employers and the government. In fact, patients with diabetes have 4x the healthcare costs and rising — ranging between $15K to $23K a year compared to $6K for the average patient.

This translates into a massive opportunity for companies that are working on diabetes interventions. Currently, all healthcare insurance programs have to provide a diabetes management solution by law but they are usually legacy methods that aren’t based on the latest technology or scientific development, often centered around tele-coaching. There is a growing appetite for evidence-based solutions exemplified by the early success of diabetes program companies such as Livongo, which was acquired by Teladoc for $19BYet, while these companies are helpful in monitoring and suggesting behavioral changes through connected devices and digital coaching, they don’t tackle the root cause of the illness, they are not proactive, and some use drastic diet recommendations that are simply not sustainable.

Enter DayTwo: Taking Personalized Gut Microbiome Health Solutions Mainstream

Based on years of research out of the Weizmann Institute (via Professors Eran Segal and Eran Elinav), DayTwo is the only company in the microbiome and diabetes space that tackles the root cause of the illness by using both gut microbiome profiling and AI to generate a Food Prescription™ for each individual member. Since the bacteria that lives in the gut differs widely from person to person, understanding what specifically spikes blood sugar for each member allows for minor adjustments to dietary preferences rather than cutting out entire food categories (like traditional diabetes programs).

This is one of the most unique aspects of the DayTwo program — enabling people to eat the foods they love (and maintain their family food culture and eating preferences) by matching food to the person. The company’s focus on blood glucose response makes the program highly actionable with high, sustained engagement rates.

Here’s how it works:

The Science — DayTwo collects full shotgun metagenomic sequencing of the gut microbiome and has created the largest proprietary microbiome database in the world (75,000+ members), deriving numerous causal and correlative associations between bacteria and human traits. This includes contextualized data including food and glycemia, etc., making applications beyond blood glucose response possible. The company maintains close ties to a number of prominent research institutes and pharma companies around the world (e.g., Mayo Clinic, Weizmann Institute, and Roche — DayTwo won the 2020 Roche Diabetes Innovation award) and its research has been published in numerous scientific papers and top journals (e.g., Cell, Cell Metabolism, Nature, JAMA and the American Journal of Clinical Nutrition).

The Product — The company uses gut microbiome profiling and AI to accurately predict blood glucose response and how an individual will react to specificfoods and food combinations. Members provide a gut microbiome (stool) sample which is analyzed using the highest resolution analysis available. Using AI and machine learning, these results are then scored against a database of over 1 million foods, grocery and restaurant items giving each member a food prescription. In addition, members are supported 1:1 with dietitians via telehealth who use both behavioral science and dietetics to deliver outcomes, DayTwo supports existing primary care doctors for each member to coordinate care, and employer and health plan partners receive quarterly outcome reports on progress.

The Results — DayTwo’s precision nutrition solution has been clinically proven to be more effective than ADA Guidelines and the Diabetes Prevention Program in lowering A1C and improving blood sugar Time in Range along with vast improvements in sleep and energy along with reductions in stress and hunger.

Parting Thoughts: Commercial Traction, Consumer Satisfaction and Future Opportunities

DayTwo is bringing much needed value to the healthcare market. By establishing critical commercial relationships with providers, large employers, and health plans, the company’s program is showing sustained engagement results that are remarkable. One-year outcomes include more than a 1.4 point reduction in A1C, a 69% improvement in Time in Range, 18 pounds of weight loss, a 3.3 point reduction in BMI, and significant reduction or elimination of medications. These are the sustainable and life-changing results that DayTwo is bringing to market.

Lastly, DayTwo has proven its ability to deliver and to continue to innovate an impactful product, scale operations and consistently meet (and exceed) expectations. At Cathay Innovation, we are beyond excited for the future of DayTwo — not only in improving the health of millions of people with diabetes but using its world leading microbiome platform to further research and find potential interventions for other chronic diseases.

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