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Enhance-d: Empowering Everybody Living with Diabetes to Reach Their Exercise Goals · StartUp Health NOW Podcast

• 0:00
  [chimes] Welcome. My name is Unity Stoakes, co-founder at Startup Health, and today I get to speak with health transformer extraordinaire Sam Scott from Enhance D.
• 0:15
  We're going to be learning about everything that Enhance D is doing and all the amazing work they're doing with the Diabetes Moonshot.
• 0:35
  Hey. Hey, Sam. How are you, sir? Hey, Unity. Yeah, I'm good. Thanks. It's nice to meet you. Nice to meet you. I'm so excited to connect with you and have a conversation about all things Enhance D. Where are you today?
• 0:51
  I'm in Switzerland, so the Italian-speaking region, just between Milan and Zurich. Okay. I once had the best skiing moment of my life in a small town called Courmayeur.
• 1:04
  It's kind of between France, Italy, and Switzerland. How far is that from where you are? I think pretty much exact- [laughs] It is, when you look at American distances versus European distances- Yeah. Yeah...
• 1:16
  I'd say, like, right in the middle. So I can see the mountains from outside my window. We're that close. Cool. I wish I was with you right now. Beautiful, beautiful part of the world. So tell me about you.
• 1:31
  Tell me about your background. Tell me about what got you into what you're doing today, and kinda the genesis that kind of led you to Enhance D. I'm, I'm very curious about your background. Okay. Yeah, sure.
• 1:47
  I mean, so I'm an academic by training, so I did a PhD in the UK. That's where I'm from originally. So my PhD was all around blood glucose management during exercise.
• 2:01
  So how do we do clinical interventions which involve different behaviors, nutritions, different forms of technology to help people to exercise safely and effectively? And after my PhD, I went to Toronto.
• 2:17
  I did a postdoc there. And then after Toronto, I was offered a position which was leading a clinical lab in Bern, in the hospital. So again, it was these interventions in a hospital set- setting.
• 2:35
  And then in parallel, I was working with a professional cycling team where all of the athletes had Type 1 diabetes.
• 2:42
  So I was in this really unique and privileged situation where I was working in a hospital, seeing what's happening in terms of getting research from, like, the lab to the clinic, and then working with pro athletes.
• 2:57
  And my goal and the, the role there was to set up a means of finding out how these athletes were doing what they were doing,
• 3:08
  and then communicating this with the general public and also with Novo Nordisk, who were the sponsors, and essentially trying to come up with a means to help the riders themselves.
• 3:23
  I did these two things in parallel for around five years, and then with my team, we recognized that there was an opportunity here. There was also a real need to create
• 3:36
  a digital platform that was taking advantage of the fact that almost everyone in Europe, North America living with diabetes has access to glucose monitoring.
• 3:49
  But the challenge of really understanding how to use that around exercise was lacking.
• 3:55
  So the need for a solution which was on the medical front but had more of a consumer-facing focus with sports was just not existing. So we all left our positions to focus on this 100%.
• 4:14
  Is that the point where you created Enhance D, or was Enhance D already set up? Where, where-- Tell me about that, that moment when Enhance D came to life.
• 4:29
  W- We all left our respective positions and then formed it independently. So, like, my co-founders and I, we recognized that we had very complementary skillsets in the technical point of view to create the platform.
• 4:46
  Myself, with my research background, the network I'd built with athletes, et cetera, and then my other co-founder, who had worked in sales for a different company that was involved in selling continuous glucose monitors,
• 5:02
  that was where we felt like all the elements came together. No one was doing this.
• 5:07
  No one was recognizing that if you create something that is very lean digital, it's something-- So you could think of it like Strava, but rather than taking advantage of the power meter, you're taking advantage of the CGM- Yeah...
• 5:22
  and you're directly meeting that need, which is helping people with diabetes. I love it. So I wanna dig into Enhance D, and I wanna learn more about this kind of transition from academia to working with these,
• 5:39
  uh, amazing athletes. And you were kind of doing this at a time where the continuous glucose monitor's revolution's kind of coming into existence.
• 5:51
  I mean, if we were talking 10 years ago, it would be a totally different scenario probably when you were starting your academic career to where we are today.
• 6:01
  There's these other forces at play where now almost anyone can have access to a continuous glucose monitor and, and thankfully there's-- athletes can, and people with, with T1D or other health needs can-Easily and affordably get access to these really powerful tools.
• 6:22
  So there are all these things kind of converging at once. Mm-hmm. I'm curious, uh, I'm so intrigued by this group of cyclists all with T1D and what your kind of initial insights were there, and- Mm-hmm...
• 6:38
  the magic that must have, must have sparked so many kind of, I guess, thoughts and insights. What did you notice first by working with- Yeah... athletes, I guess? Yeah.
• 6:51
  I mean, so when I, when I first started working in academia, which is not that long ago, maybe sort of 10 years ago when I was doing my PhD, there was, at the time, I think we were using Dexcom G4.
• 7:05
  Not many people had access to a CGM. We were using it in the context of the research, but it was something that was relatively new.
• 7:13
  Since then, there's been all kinds of initiatives where if you take countries such as the UK, there's now 100% sort of access with Type 1 diabetes on this, and just the sort of market penetration of CGM from the companies such as Dexcom, Abbott, they've been transitioning across Type 1 diabetes, now it's looking towards Type 2 diabetes.
• 7:38
  We now just saw the over-the-counter sensors. We're seeing these other startups which are focusing on non-invasive glucose monitoring.
• 7:47
  And so while everybody's focused on the hardware, there's the real opportunity to focus on the software. This is what we want to do. Okay. And then when it comes to the athletes, the take-home from there,
• 7:59
  and this didn't only apply to the athletes, this applies to what I was seeing in the clinic as well, is that it's very much down to the individual's trial and error, self-experimentation, and their ability to take on their past experiences to translate this into living a healthy, like, active lifestyle.
• 8:23
  So when we was working with the athletes, we didn't implement anything for a long time. What I wanted to find out, first of all, is what are you currently doing? What is your level of your...
• 8:38
  How comfortable are you with technology? Who do you ask for help? Where are you getting this advice? Who's making the decisions?
• 8:46
  And with type- Were people just having to hack it together on their own or figure it out on their own? What were you noticing? It's, it's largely individual.
• 8:55
  So you come across these people who reach really the pinnacle of sports. So there are examples. I've worked with rugby players.
• 9:03
  You see that there's professional tennis players, there's cyclists, but there's not a single way by which they're doing it.
• 9:11
  It's largely one person doing it and then another person independently doing it, and they're having to sort of...
• 9:20
  They are increasingly being able to see examples of other people doing it, but there's not a way to access really the guidance from the technology.
• 9:28
  There's not many clinicians who understand this or are really able to support. And if there are, there's just one-on-one support. There's nothing that's scaling at the moment.
• 9:39
  So in the same way that cycle coaches now are using standardized approaches whereby pretty much all cycle coaches for non-diabetes athletes are using a platform such as TrainingPeaks to prescribe training based on power meter data.
• 9:59
  They're looking at the information, and they've got very much standardized ways. It just doesn't exist within Type 1 diabetes. And this applies to regular people who just want to start exercising.
• 10:14
  The interpretation from their glucose monitors is down to doing a lot of work, doing a lot of individual time to really sit down, work out what works for you.
• 10:26
  And this is where I feel that this needs to be accelerated- Right... and, and sort of- Well, you're, you're changing everything here, Sam. You're part of the, the T1D Moonshot, and you're creating Enhance D.
• 10:40
  Tell us what Enhance D is and the vision for it. And we've got some of the backstory now kind of leading into this, but I just think it's a really compelling perspective on what you're creating and a really positive one.
• 10:56
  How do you describe the vision? So we want Enhance to be the number one diabetes coaching platform, uh, in terms of exercise, so assisting everybody living with diabetes to reach their exercise goals.
• 11:12
  Um- And is this Type 1 and Type 2? Yes. So initially, we're starting with Type 1 diabetes, and we've split this into, uh, s- further kind of our sort of target audience to start with.
• 11:29
  So really the initial audience are those who have a Strava account, are comfortable exercising. They're people who are willing to sort of figure stuff out on their own, and they're really ready for a solution like this.
• 11:43
  So we- Kind of the early adopter crowd. Yeah, the early adopters. So
• 11:49
  I mean, so much of what we're doing is, is sort of in the med tech space, but it, there's also things that I think that are unique to take from the learnings of a company such as Strava or Runna that have scaled so quickly in the, um, consumer sports tech space.
• 12:05
  So Strava, what they did was they started with what they call mammals, which was middle-aged male athlete in Lycra. So this was the person who was-Willing to play around with a power meter.
• 12:22
  At the time, it was not connected through Bluetooth. It was the person who was willing to connect that into their computer, et cetera. And this is a bit reflective of who we're starting with.
• 12:34
  That person living with Type 1 diabetes who's willing to sort of play around with the data themselves is particularly focused on reaching those goals. But
• 12:48
  we're going to very quickly make this more accessible to more and more people, whether you're just starting exercising, whether you're newly diagnosed, because we can really personalize the solution.
• 13:01
  And then the other element to this is that the doctor is like your coach. So s- most people living with Type 1 diabetes, they see their endocrinologist.
• 13:12
  The endocrinologist is limited in what they can see and what help they can provide in terms of physical activity, sports, and the major platforms that they have access to do not provide that information. So if we think
• 13:30
  food, insulin, stress, physical activity, maybe they're the four things. So far, physical activity is just missing from their toolkit to be able to provide that s- support.
• 13:42
  So reaching the doctors, helping them to support the patients, reaching the patients to help them meet their exercise goals.
• 13:51
  I, I love this lens on it because it's such a positive, proactive solution you're bringing to the world here. Starting with Type 1 diabetes, people with Type 1 diabetes, but then, as you know,
• 14:05
  so many millions of people with diabetes and cardiometabolic issues in general, this ties into just such a growing need. Mm-hmm. But you're coming at this, I think, from a very...
• 14:19
  There's this gap around exercise, and I think you saw that early and are coming in. And I think some of the influences you're describing with Strava and Runnr
• 14:29
  are just great models to bring forward because there's elements of these that are easy to use, great design, intuitive, provide real value for the, you know, the athletes or the people using them, and they've really consumerized, if you will, the approach, and it seems like that's what you're doing.
• 14:52
  How-- what's the model? So who is your target ideal user or customer today? So to- today, the ideal customer would be- Is it that MAMAL user, or do you have a different acronym for who want to use it?
• 15:10
  I think we're gonna be able to move quite a bit faster towards making this more available to everybody living with Type 1 diabetes who's interested in incorporating exercise, physical activity within their life.
• 15:26
  And the reason that I think we can move faster now is because, firstly, people are more familiar with platforms such as this, whereas Strava had the fact that this was quite new, the concept of this.
• 15:41
  Also, in-- this is also really interesting is that with Type 1 diabetes, there are preexisting communities that exist, sports communities, there are preexisting meetup groups, and we can leverage these to sort of bring together people through sport and exercise.
• 16:04
  So we've also created elements in the platform to connect different sports teams, and we actually have our own team. It's called the Enhanced Club. Yeah. So some of us in this team- I saw that on your website.
• 16:15
  It's a club- Yeah... that's real community-based. I wanna hear more about that. Yeah. So this is a, a community-run club. It started in the UK. We have around 300 active members. So they have regular meetups, do 5Ks.
• 16:32
  They do online events, and it's a way in which they can support each other, both digitally, but also just in general in life.
• 16:41
  And going back to your question about who's the target audience, we want it to be anyone with Type 1 diabetes who's interested in being more physically active. And that's around the product as well, creating a product
• 16:56
  that doesn't really exist in Type 1 diabetes, meaning that it's something that helps you to be healthy and manage your diabetes, but it's something that you actually want to use- Mm... not something that you have to use.
• 17:11
  Something that you might actually choose to opt into because you have that community element that you're really wanting. But you're also having a, an app that can be a bit more fun and engaging. Yeah.
• 17:24
  Along the lines of, we talk about the examples, Runnr, Strava. Nobody's forcing people to use those products, they actively want to, and this is what we want to incorporate here.
• 17:35
  And then, yeah, so with the Enhanced Club, we, we had the UK a- arm, and then very quickly we opened up a chapter in the Netherlands, and we've had interest in various places in the US, in, in Australia, in Romania.
• 17:50
  Can individuals open a chapter? And if so, where do they go to do that? Do they contact you at Enhance D? And by the way, we should say Enhance D, it's enhance-d.com, correct? Yeah. That's right. Yeah.
• 18:06
  Um- So tell them, like, I mean, I'm assuming it'd be wonderful if there's clubs all over the world. Yeah. Is this kind of a, a grounds up where, where you're looking for leaders in communities all over?Yeah.
• 18:20
  Yeah, exactly. So these are separate, so they're not part of the company itself. We're just the sponsor. Yeah. So in the UK, this is run by the team themselves. They're volunteers.
• 18:34
  But we're the sponsor, and we offer additional things in that we're able to support their growth. We're able to support a digital platform by which it facilitates some of the activities that they have.
• 18:47
  And with the Netherlands, there was a group of people who were really enthusiastic to start their own chapter, and so we're conscious that we don't want it to grow too quickly so that the quality dissipates.
• 19:01
  But if people are really motivated, we, we had some of the really early adopters on the app have been in, in Romania, also Belgium, who've got these pre-existing Type 1 diabetes cycling teams, and they're interested to sort of engage in this way.
• 19:18
  Yeah, this is what we want to do, and then in, in the future, we will start doing things like training camps or perhaps additional sort of meetings where we, we have these community elements built up. I love it.
• 19:31
  Yeah, I, I think I could see how powerful it would be to be in your local community with fellow runners or cyclists or athletes or people that just like to exercise together who understand the real needs and issues and opportunities by having T1D and then transforming this into a positive community experience together, I think is really- Mm-hmm...
• 19:58
  really powerful. So let us know how we can get the word out on that because I'd love to see these clubs form in cities all over the world. Mm-hmm.
• 20:07
  And I love your global approach here because this really is a global need. So tell us about where everyday people can get access to this. Do they go to the App Store? Do they go to the website? What's...
• 20:24
  Where are you today? Where's the organization? Where's the... Where is it today, and can people start using this today? Mm-hmm.
• 20:34
  Yes, so the app is available now on, on the App Store, on both Google Play, iOS, on, on Apple, Android. And the clinical dashboard, we've just started rolling out the first clinics in the UK and also Switzerland.
• 20:52
  So one of the things-- So that's where you can find us, websites, app stores. And, yeah, with the, in, in the UK, we've just started to do some pilots in collaboration with Dexcom, who are one of, our partner.
• 21:08
  So they are doing these pilots on behalf of us, and they've selected two clinics in the northwest of the UK.
• 21:15
  So all being well, that will work out well, and then we will look to sort of replicate that in additional parts of the country there. And they've been really supportive.
• 21:26
  And then we will start expanding that to further places, both in Europe and then also in, in the US. Wave a magic wand. Who would you love to reach?
• 21:37
  What types of organizations do you think should know about what you're doing at Enhance D? And it could be as broad as you wanna, you, you wanna take that question or as focused as you wanna take that question. Mm-hmm.
• 21:51
  Yeah. So I guess this is something- I mean, you're already working with- Yeah... you're already working with Dexcom. Mm-hmm. Uh, obviously, there's other companies that do CGM.
• 22:02
  There's other-- There's foundations, there's associations that have broad reach within T1D. There's, I think, just an extraordinary base of consumer companies- Mm... that should be getting behind this. Yeah.
• 22:19
  The Nikes and Adidas of the world. You're exactly right.
• 22:22
  Um, I think these amazing brands who care about all types of athletes, and I think these, yours is the type of innovation and company and team that these types of companies should be supporting and really showing the world about because you're, you're expanding the market of, you know, exercise.
• 22:47
  I even think about the, a lot of the work being done with some of the food companies that are thinking more about nutrition, and there could be some really cool integrations there. Mm-hmm.
• 23:00
  I'm just curious how you're thinking about the future of Enhance D. And if you were to wave a magic wand, where you see this in the future? Yeah. You're absolutely right.
• 23:12
  We're doing something that's very unique in that we have
• 23:16
  the possibility to connect on the more medical side with the device manufacturers such as Dexcom, also with diabetes associations, American Diabetes Association, Beyond Type 1, which is great because they have their massive community.
• 23:31
  And our app is made to really facilitate any messaging that they have because it's got the social parts of it. It's a way in which any, if you do a sponsored marathon, et cetera, can be sort of amplified digitally.
• 23:48
  But also on the more consumer-facing, we're in conversations with the likes of Adidas already. Exactly what you say, like, they are interested in helping to reach others.
• 24:00
  We are reaching a target audience that they can, they can reach this specifically with certain ways that we can build certain campaigns. So we're speaking with Adidas. We're speaking with Garmin, for example.
• 24:14
  These groups where we're interestingly both sports tech and med tech, and I can't really think of other examples- Yeah... which are in this space.
• 24:24
  Well, I think we need more of this and, you know, there's a lot of leaders, a lot of CEOs a- across the world that listen to this.
• 24:30
  We care deeply about-The Type 1 Diabetes Moonshot and the Diabetes and Cardiometabolic Moonshots, and the Food is Medicine Moonshots, and you cross over all of those. Mm.
• 24:42
  And we're so grateful to have you part of our community and ecosystem and be part of the Type 1 Diabetes Moonshot. Specifically, we want to get the word out.
• 24:52
  We need more shining examples like you're bringing into the world that I think are quite proactive and positive, and I, I just think it's a really exciting example. And I think there's creative collaborations.
• 25:10
  I think we need more creative collaborations in the marketplace
• 25:15
  between tech companies and companies like yours, consumer companies, apparel companies, food companies, big brands, et cetera, because I think it can make a tremendous impact, and I think there's a lot of strategic alignment.
• 25:32
  So I think it makes smart business as well. Last question. You're, you know, part of the StartUp Health family, StartUp Health community of Health Transformers.
• 25:43
  I'm just curious what your initial insights and feedback and what it's like to be part of a community of other Health Transformers that are aligned by purpose and mission, and what your thoughts have been so far.
• 26:00
  Yeah, it's, it's really good also with the differences between what people are focused on. There is such a big variety. I think where we are as a company, we've been part of the Moonshot since pretty much the beginning.
• 26:14
  Yep. But I'm really
• 26:17
  thinking that when we get to this next stage, which we're so close to doing, closing this fundraising round, it will just give us the capital to be able to engage more physically, especially on the US.
• 26:31
  So our aim with the next chapter of where we are in the company is that we need to be engaging more in likes of, like in San Francisco sort of thing.
• 26:44
  We have scientific partners we're working with who are at San- Stanford.
• 26:48
  We know that what we're building, which is digital, which is using the data that's coming together, which is using AI to provide these personalized suggestions, is something that lends itself so well to that ecosystem, and also with the StartUp Health community.
• 27:07
  And while it's been good, I think I'm looking forward to being able to engage with that so much more physically, in person. Also in New York as well. Yeah. Having the freedom as well to be able to engage more in person.
• 27:21
  And I know as well, like, the Helmsley
• 27:24
  are and have been so interested in exercise specifically, and I want us to be able to find ways in which we can match up what we're doing with what they also supported with those other projects. Yeah.
• 27:38
  No, that's absolutely right. And yeah- Um, yeah... Helmsley Charitable Trust has been, they were the first champions behind the T1D Moonshot, and we're so grateful- Mm... for them, and we're grateful for you.
• 27:48
  And I hope you'll come visit me. I'm out in Bay Area, San Francisco, Berkeley. Yes. Steve's in New York, so very, very much looking forward to spending more time with you in person. And so grateful for what you're doing.
• 28:03
  If you can't tell, and if the listeners can't tell, we are huge fans of the vision of Enhance-D.
• 28:09
  We want more partners, customers, and investors to, to check them out, because it's a really inspiring team and really great vision and technology for what they're doing. So any last words, Sam, before we log out here?
• 28:27
  Yeah, I think if you're interested, just don't be shy to get in touch. We've tried to be a team which is very accessible to take on feedback for the actual product.
• 28:38
  I think this is the other thing that's fantastic about the space that we're building something, which is Type 1 diabetes.
• 28:45
  The, um, willingness to give the technology a try and then also give the feedback, and we've been able to really leverage that, and we're really open to that. So, uh, if anybody hears it, we want to have that.
• 28:59
  We're also interested to have these different partnerships. Maybe there's things we didn't even consider. As you say, we're between these different worlds, which is unique. So, yeah.
• 29:09
  Well, congratulations on all your success to date, and I know there's a lot of good things to come and things you'll be announcing soon. So Sam, thank you so much, and thanks to everyone at the Enhance-D team.
• 29:22
  That's enhance-d.com. Check, check them out in the App Store, and we will see you soon. [upbeat music] And finally, an invitation to all of the extraordinary Health Transformers.
• 29:38
  Whether you are a startup, someone building the future of health, or whether you are an investor, funder, or buyer of the solutions out there in the marketplace, this is an invitation to you to join the StartUp Health member community.
• 29:53
  Learn more at startuphealth.com. Look forward to hopefully seeing you soon.