S11E3: Reversing Type 2 Diabetes using Tech and Nutrition with Sami Inkinen, Founder of Virta Health

2 things. Metabolic health or type 2 diabetes, obesity is not a personal choice. I haven't met a single person who would say, oh yeah, I decided to become obese. No, they have tried a dozen different diets and this and that and drugs, but they're still failing. But then number 2 was equally counterintuitive, which is you can actually reverse type 2 diabetes and it can happen very fast.

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Welcome back to The Room Podcast. We're thrilled to sit down with Sami Aikinen, the current CEO and founder of Vitra Health. Vitra is a company on a mission to reverse type 2 diabetes and tackle the global epidemic of metabolic health through telemedicine and nutritional science. But Sami is no stranger to building successful businesses. Before Vitra, he had co-founded Trulia, the real estate platform that changed the way people search for homes online. Launched in 2004 during a time of market disruption in the consumer internet space, Somi helped grow Trulia into a household name, ultimately leading the company to a successful IPO and its eventual acquisition by Zillow in 2014 for a $2.5 billion stock-in-stock transaction. Sami's journey is a remarkable example of the power of grit and entrepreneurship. From his early days growing up on a farm in Finland with not a ton of role models in tech, to moving to the US and building two industry-changing companies, Sami shares his insights on perseverance and seizing the right opportunities. In our conversation, we also explore how he identified key timing during moments of market disruption, first, of course, with the rise of vertical SaaS and now with the healthcare innovation that he's leveraging to revolutionize the treatment of chronic diseases. Let's open the door.

Sammy, thank you so much for being on The Room today. We're so excited to share this conversation with you.

Yeah, thanks for having me. Excited to have this chat.

Before we dig into all of the incredible stuff around Virta and your entrepreneurial journey with Trulia, We really love to start at the very beginning with our guests. Tell us, where did you grow up and how did that shape your view of the world?

As you might be able to tell from my accent, I did not grow up in Texas or Iowa. I, I, I grew up in Finland and actually spent the first 20+ years of my life there. So I grew up in southeastern part of Finland on a farm, and it was, I would say, wonderful. Humble beginnings in that my parents worked in a factory, so middle class, but we had a farm that we basically used to grow potatoes and chickens, chicken eggs, and pigs in the fall to basically provide food for the family. And I certainly did not have any role models of professional careers or starting companies. My parents did not even go to high school. So it was very kind of simple beginnings in that sense. And I had two sisters. So I'm the middle brother in between two sisters. But in terms of worldview or some of the foundational learnings that I had early, I feel like I've always had enough despite coming from very humble beginnings, which is to say that my expectations have always been low. I just make it happen with whatever I have. One path to happiness is low expectations. I would say that's one thing. The second one is I certainly know where food comes from. So growing up on a farm, picking potatoes every fall and feeding the chickens and getting the eggs and this and that and making bread from your own grains. It sounds very idyllic. I mean, it's a lot of hard work. So I say that's the second. And then the third one is I learned the value of manual labor very early. So literally every fall, every weekend, I would be in a forest with my dad. To get firewood to heat the house. Obviously Finland, four seasons in the wintertime. I just got to kind of love quote unquote hard work and manual labor and using it to actually make the family run. So lots of good learnings.

That's incredible. The themes of hard work obviously are so core to the founder journey, but I'm curious, back in Finland, did you think that you were going to become a founder?

No, let me answer that in two ways. I certainly wasn't thinking, oh, I want to start a company. And one of the big reasons was I didn't have role models for that kind of a path and career early in my life. However, I think whether nature or nurture, I've always had this desire to dream about what could be that's not here yet. And also this desire to create something for other people's benefits. I'll give you one example. So despite the fact that I was growing up in a farm, parents didn't go to high school, I got interested in computers by just seeing them on a magazine. It's like, hey, Commodore 64, Amiga, I want one of those. And I was able to convince my parents. So what I ended up doing, I guess I was like 15, I quote unquote built and started and ran one of the first BBS or bulletin board system. Which was the pre-internet. So you use a modem, kind of like, I guess, AOL in America. You dial up to this message boards and exchange files and this and that. So I ran one of those from my bedroom as a 15-year-old. I loved it. I loved the fact that people were dialing in and some people paid for the service. And I just got those kind of warms and fuzzies from the fact that I had created something from scratch and other people saw value in it. So to answer your question, It wasn't a premeditated plan to become an entrepreneur, but clearly something's wired in my brain to be very independent and try to create things. And then I realized that it was very rewarding to make something out of nothing and have people use it.

The early threads of entrepreneurship, which you later pulled. Fast forwarding a little bit, you went to Helsinki University of Technology for undergrad. And so definitely your love and early interest of computers became a consistent thread later in life. And then you went to Stanford for business school, which I assume is how you came to the US. Tell us a little bit more about what your 5-year plan looked like coming out of school.

There was no plan. And honestly, I feel like I've never even worked in my life. I've always been lucky to jump into something that I found exciting and rewarding and then went all in. So that's the answer. But just to highlight a little bit. I went all the way to master's. I did master's in physics and started my career in a nuclear power plant, which may sound like very unconventional to work in a nuclear power plant, but that's what I did in Finland. But in terms of the plan and even coming to America, I did not want to go to school. I was like, master's in physics, that's enough. I don't need that. But what happened to me was I had this entrepreneurial bug having toiled around with sponsor things back in Finland. And then through the pages of Fast Company and Business 2.0 magazines that more or less don't exist anymore, I got excited about Silicon Valley as the place for entrepreneurs to be. And a lot of my peers, Finnish kids, particularly boys who play hockey, where do you think hockey players want to go? It's NHL in America. And as an entrepreneur, to me, the NHL was Silicon Valley, where I had really never been and done anything. And so that pulled me to Stanford. I got very lucky that I got to Stanford Business School, but it was really kind of a means to an end. How do I get to America legally? And I was like, if I get to an American grad school, they're probably going to give me a visa. And so I only applied to one business school, which was Stanford, which is something that nobody does. If you want to go to business school, you apply to 5. So you're sure you get in. But yeah, that was my plan, if you will. And why I actually came to Stanford now, obviously it turned out to be amazing life experience. So it is a great school, but initially the idea was how do I get to America and Silicon Valley legally to make something out of nothing there?

Which is exactly what you did according to plan. While you were at GSB and while you were in America, you did in fact make something happen. You co-founded Trulia, a household name in the real estate search ecosystem. Tell us a little bit more about what experiences you went through at GSB that led you to meeting your co-founder and ultimately realizing that the time was now to start something.

The burning desire inside of me and the one of the reasons or main reason coming to America was that I want to build something, anything, as long as it's not illegal. I want to try my skills and luck in Silicon Valley. So that was the driving force for me. Even inside and at Stanford. The fact that I ended up co-founding Trulia, which is and was an online real estate marketplace, is accidental. I can talk about that in a second. But really the burning desire was like, I want to put myself into a position where I will perhaps find a co-founder and then start something useful here. And so what I ended up doing was a couple of things. First of all, I wanted to run the Entrepreneurship Club at Stanford. Stanford Business School specifically, and I knew it was one of the bigger clubs. And why did I want to do that? It wasn't about power or anything, but I knew that if I put myself into the center of the entrepreneurial talk and excitement, I'm probably likely to end up in a group or teaming up with the person to start a company. So that was one practical thing that I did. And I often tell people that, oh, what's better than being invited to a party? Being the host of the party. And so that was the idea in running the entrepreneurship club. And then my co-founder, funny enough, was another European and another physicist. So Pete Flint was my Stanford classmate. He studied physics at Oxford. And so two Europeans fresh off the boat ended up doing the monohouse real estate marketplace. I haven't usually shared this, but the actual real first bonding moment for two of us to get to know each other was in Mexico. And so first Thanksgiving, I first fall coming to America. Of course, all the Americans go and hang out with their families, right? And then there were a couple of orphans, mostly, uh, internationals and Europeans. And Pete was one of them. I was one of them. And we said, hey, let's do something luxurious and drive a car to Tijuana. And that's what we did. And we spent 5 days there. And without going into details what we did there, I got to know Pete very well in all kinds of settings. And he became a good kind of trusted friend and Those were the early steps how I met Pete. And then of course, about a year later, we both said, hey, let's see what we can do in online real estate because clearly there's a missing piece. We can talk about the founding thinking, but those were the foundational pieces and how I stumbled into Pete.

I'm smiling because I'm in my first year at business school right now and seeing these organic connections happen right in front of me and wondering, okay, who's going to go where with this person? I feel like There's sparks flying over here, like potentially for business opportunities, potentially for otherwise. You're just amidst all of these different moments and it's such an interesting time. And we've had the Cloudflare founders on who similarly had their first initial aha moments of meeting each other also behind the business school classroom. So it really is just like a season of extreme curiosity coupled with, this is around 2004, I believe, a really interesting time in the market of technology. And really just the development of consumer internet. You alluded to this a bit, but help us contextualize the timeframe where the world is your oyster of consumer online and how you and Pete felt uniquely positioned to have this aha moment of Trulia.

Yeah. First, I would say in terms of the macro environment for starting companies, it was frozen or negative. So this is year 2003, 2004, 2005. .com boom has crashed. So starting a company was not sexy, so to speak, the way that it was maybe for the last 5 years, for example, at Stanford and in that area. There are always people who are interested in entrepreneurship, but it was definitely not the thing to do at the time. So that's macro environment, which is a whole other topic, but I would say I personally think that's one of the best times to actually start something when not everybody's going in there. In terms of the specifics and consumer internet, while Pete had been a first, my co-founder Pete Flint had been a, I guess the very first employee of a consumer internet company in Europe called Athenee.com. So he had that DNA. I had been one of the very first employees of kind of an e-trade of Finland before coming to America. I had done software programming and paid my way through college doing that kind of stuff. So that was our DNA. To begin with coming into America. So I think we looked at the world and opportunities through that lens. And I guess internet and computers and software was the hammer in our back pocket. How did we end up starting an online real estate company? I honestly, I would say that for me personally, I could have started anything. So it certainly wasn't, oh, this is my passion. My parents were real estate brokers. No, no, no, no. I, I knew nothing about the residential real estate coming into. So in that sense, it was more opportunistic and I think the now very obvious aha that we had at the time was the world had gone from sort of portal-centric, Yahoo-centric world online to search-centric world. And Google was already becoming pretty dominant. Then this sort of vertical search emerged. You could find a job online, you could get airline tickets from Expedia or Hotels.com. You could find your spouse maybe from Match.com. So all this classified segment, there was like a narrow We called it vertical search at the time, and it was clear to us that Google isn't going to dominate everything. And in these big categories like finding a car, finding a spouse, finding airline tickets, hotels, and finding a home, it was very clear that a consumer-centric, consumer-driven online destination, service, platform, marketplace, brand, whatever you want to call it, will emerge. And that did not exist. In residential real estate. There were websites, but they were owned by the real estate industry. So like Century 21 or Coldwell Banker. So it's like in cars, if you only have ford.com, it's pretty clear that there has to be something that's consumer-centric. So that was our thinking and we said, could be us and let's go for it. And that's what happened.

Why not you? And thank you for helping us put ourselves back in the brain of this time period 20 years ago where vertical search was emerging and becoming quite novel and new. And it does remind me a bit today where we're having such a search shakeup again with the advent of GPT and how that's changed how we think about search. So I'm curious for the entrepreneurs out there who are thinking about this paradigm shift of today, like what are some learnings from this time that you were in and around and building?

First, I have to say, you said 20 years ago vertical search, and I go, whoa.

Yeah, sorry about that.

Literally is when I I came to America and here I am. And also it dates myself, obviously, but it sounds very MBA techie jerk, but any kind of the platform change. So disruption is super, super exciting, whether that was just the internet coming to begin with or the browser, the portal-centric world to search-centric world to, I guess the social networks came next. And then we had the mobile, the smartphones. And by the way, I worked for Nokia way, way back from the days, 1999. Because that was going to be exciting to see. And then Apple, they launched big time and Android, unfortunately. So I guess one thing I would say that whenever there's a sort of technological platform change or fundamental distribution change, it is a huge opportunity. Now, what will AI and these chat interfaces change? Everyone has their opinion. Nobody can know for sure. But the consensus, for example, is that the search box model for finding information that Google has dominated, more or less has a monopoly, my company, so I can say monopoly, will be challenged for sure. And so I generally, it's just an exciting opportunity when these platforms change. And I remember we were in the middle of building Trulia when Apple iPhone launched first. The reason I'm telling this story is it's easy to dismiss these changes, but if you're early, then you might really be able to capitalize. So iPhone launches, and of course we were like, oh, this is very exciting. But would you really buy a home on a phone? Not really. It's a kind of a computer or desktop kind of experience. And then you go on to open houses. Luckily, one of our relatively junior software engineers did not listen to us and whipped up our first iOS app over the course of a weekend. In something like 12 to 18 months, less than 2 years, more than half of our business as a pre-IPO company was through mobile. And so that just goes to show how quickly things changed. And we were techies, few founders. So long story short, any platform disruption is very exciting time. And you want to be at the cutting edge to find this sort of unfair opportunity for yourself.

And shout out to this engineer who had the gall to say to the awesome founders, I'm going to just build this over nights and weekends and hope you move forward with it. Cool to see that happen within your own company and the culture you created.

It's actually a good point. I've— now obviously you can't have complete anarchy, meaning my current company, Burdock, is about 500 employees now. Obviously you need some process and prioritization and product roadmaps and so forth. To get things done. That said, I always try to cultivate this mindset of if you have something that you truly think we should do, go make it happen. And one recent example, there was somebody in our content team for our patients, an internal thing, was talking about podcasts and oh, it's going to be hard and this and that and which approval and that approval. And I said, just go do it. Don't even ask anyone. Just go do it. Here we are, by the way, doing a podcast. It is not that difficult. It's not that expensive. Just go do it. It may sound like a simple thing, but as company scales and you have hundreds of employees, oftentimes they go, oh, I need to ask permission from 5 people. And even if it's just $100, I need to budget. So I try to fight against that by empowering people to just go do it. Because this iOS mobile engineers example in the Trulia days was a good example. And I'm glad he did it.

Awesome culture to cultivate writ large. And we are absolutely gonna talk about Virta Health and where you've gone from being a founder with Trulia all the way through to today. And before we touch on your current business that you built, we just wanted to just speak to the exit experience with Trulia, which is a really unique one, both incredibly successful, of course, as well as something that not every founder gets to experience. And just for those who are listening, you served as COO and president and board member through until IPO at Trulia to their eventual sale to Zillow Group. Interestingly, we actually have also had Spencer Raskoff on the podcast too, and we didn't touch on the Trulia acquisition, but we did touch on also scaling a real estate platform in this decade. Tell us a bit more about what that experience was like as a founder through exit acquisition, and then we'll talk about how you're crazy enough to do this whole thing again with Virta.

I often have gotten this question of what's your exit strategy? And I roll my eyes and, and say there is none. To me as a founder, particularly when you start a company, it's like getting married. And I am married, I have a wonderful wife, 14 years or so. And so if you ask me, what's your exit strategy after I get married? It's ridiculous, isn't it? It's like, give me a break. No, my exit strategy hopefully is death. Like statistically, maybe not, but I'm not thinking about how do I get out of this. I truly mean that. And why do I mention that? A, because it's true, but B, it also relates to this sort of IPO and, you know, who are acquiring us in that IPO. So going public and having new investors, it's yet another tool in a toolkit that allows you to build a company and hopefully succeed on your mission. And it truly is that. Now, the mindset, of course, is that if you've never done it before, it is glorified as a badge of honor and maybe the moment where you make a lot of money, which even that isn't exactly true. It is glorified. And certainly there are these kind of emotions like, oh my God, company's gonna go public.

Yeah.

Now I can tell my mom that something came out of this playing around on a computer and in a farmhouse when I was a kid. But so I, I would say the main thing is that the IPO for sure for a company can be a very useful tool. In fact, it can be a necessary tool, but it certainly isn't an exit. In fact, it is a new beginning with more expectations, new investors, and way more scrutiny. It's a very useful goal when applied to the right company at the right time. But that certainly is, is not an exit. Similar to, I guess in some ways there was a true exit when Zillow and Trulia merged, or Zillow acquired us 2014. And that's obviously different because one company buys the other and the other board disappears and the other company disappears. But I would say generally, first of all, companies are bought, not sold. If you're desperate trying to sell your company, You're probably doing something wrong unless you just have to find a new home and everything's gone sideways. But generally companies are bought, not sold, if there's a good outcome. And it just, it's natural in our economy, in our for-profit ecosystem that the bigger fish oftentimes eats the slightly smaller fish, scale economies and those kinds of things. So in many ways it was a natural evolution of the online real estate market. And marketplace, what ended up happening and the fancy MBA term industrial logic made sense for those two companies to be together. So you can still go to Trulia.com and I think, I don't know, 50 million plus Americans go every month, but it is now owned by Zillow Corp. So yeah, they are amazing experiences as a founder, but they also, I would say, overly glorified. And my thinking always is that the exit is not the goal. And in fact, if you think about an exit, It's kind of like running and staring at your toes, which means you're very likely to stumble.

That's definitely wise advice for founders that are in this journey and might get discouraged at times when things get hard. But clearly building businesses is something that is so core to your identity. In 2014, you started your new entrepreneurial chapter in founding Virta Health. Tell us what Virta Health does. And what the core product is.

After Trulia, I somehow ended up starting yet another company, and here I am building Virta Health. Yeah, maybe I'll give you a little bit context because we talk about tech and real estate, like now we're in healthcare. So a little bit painting the picture. We are basically solving the biggest health epidemic of our generation, which is metabolic health led by type 2 diabetes and obesity. So type 2 diabetes, obesity, several billion people now suffering from them globally, and more than half of American adults, like it is ridiculous. And the numbers are only going up. So more than half of American adults either have type 2 diabetes or suffering from obesity. So that's what we're solving. Unfortunately, before Virta, the best that humanity has had to offer for these conditions has been handful of Pharmaceutical companies selling drugs to treat the symptoms of these diseases, type 2 diabetes and obesity, for example, to treat high blood sugar. But managing the disease by treating the high blood sugar doesn't make the disease go away. So what we are doing at Virta is fundamentally reversing type 2 diabetes and obesity, reversing these chronic diseases through a combination of provider-led telemedicine, so technology and You guessed it, nutrition and food. And so that is our solution, how we have reversed type 2 diabetes and help people lose, lose weight sustainably. And I'm happy to talk about how this came about because it's equally unlikely as Trulia or coming from farm in Finland to America.

That was precisely my next question. So tell us, why is this problem something that you are so passionate about solving? I know Virta's mission is to reverse type 2 diabetes in 100 million people by 2025, which is a big mission. Tell us more about this.

Yeah, indeed. Our mission is to reverse diabetes in 100 million people. And generally, I would say this is my advice to a wannabe founder. How do you find the business idea? I always say you have to unexplainably fall in love with what you want to do, because if you don't, you will give up. It is so hard. It can be incredibly rewarding, but it's also mentally and physically so hard. And I unexplainably fell in love with the idea that we could solve diabetes and obesity and how we could solve it. But it was so accidental. It was literally like bumping into my future spouse accidentally in some way thing. And I, this is what happened. So if you had asked me around the time Truly, I went public and then Zillow started quoting us. If you had asked me then, how about solving diabetes and obesity? Like I would have Laughed you out of the room and rolled my eyes 100%. And the reason is I always saw these diseases as most healthy people still see, which is it's your own fault. You eat too much. You're just unhealthy. Blame yourself. One reason I think was I was, and to some extent still am, pretty high-performing endurance athlete. I had won the world championships in triathlon the year before TrueNorth went public. And I was like, I've got the willpower. Obesity, diabetes, not my problem. And then soon after all my triathlon accomplishments, I discovered that I was on my way to type 2 diabetes myself, and I was already pre-diabetic. I fell on the floor, so to speak, thinking, seriously, I've got the willpower. Wait a second, what's going on here? And that's just got me very interested. I went down the rabbit hole on meeting with Panzer Scientist and understanding like, what the heck is going on? If a fit triathlete becomes pre-diabetic, nobody has any hope, which is kind of the situation because half of Americans are either obese or type 2 diabetes. So long story short, I met two scientists who then became my Virta co-founders, but I basically discovered two things. One, metabolic health or type 2 diabetes obesity is not a personal choice. And by the way, we've now helped more than 100,000 Americans. I haven't met a single person who would say, oh yeah, I decided to become obese. Oh yeah, I decided to have type 2 diabetes. No, they have tried a dozen different diets and this and that and drugs, but they're still failing. So number one, I was wrong. It is not a personal choice. It's a metabolic disease. But then number two was equally counterintuitive, which is you can actually nutritionally reverse this quote unquote mistakenly chronic and progressive type 2 diabetes. You can nutritionally do that. With no hunger, no cravings, and it can happen very fast. And so when I became convinced that those two things are true, I said, this is insane. Literally like 1,000 people plus minus die every day in America from type 2 diabetes. First you lose some limbs, then they become blind, then you have a heart attack, then you die. Type 2 diabetes is not a pretty disease. And just thinking about it, that these people needlessly suffer and die. And obviously it's costing a huge amount of money. I was like, this is effing ridiculous. This is so ridiculous. If we can systematically reverse this disease and find an economic model that makes money in the process for everyone as well, this is like a Nobel Prize winning kind of adventure. Whether my Sanofi co-founders are going to win that or not, I don't know, but they should. There is a way to solve this problem and nobody has done it. It became very clear to me soon that, hey, let's go. And here we are, I guess, 9 years later now.

Thank you so much for sharing just that personal look into the journey and learnings you've had along the way for why diabetes is maybe something that we don't choose, and it's something that many people really fundamentally need help with. I think 2023, 2024 has been an interesting time. As it's been the year of GLP-1 medications becoming mainstream, from Ozempic to Wegovy. Tell us a little bit more about this shift in the landscape and how has treatment changed with these new innovations and what is Virta's take on that?

What I often say, somewhat jokingly, that what ChatGPT is for tech, Ozempic is for healthcare. Everyone has heard of probably by now Ozempic and the GLP-1s. And so I often say now these days that people ask, what does Virta do? What are the outcomes? Legitimately, we deliver Ozempic-like results without the cost and side effects and without the drug. First of all, these GLP-1 drugs such as Ozempic, they were actually approved for treating type 2 diabetes 2005. That's 19 years ago by FDA. So these are not new drugs, but what is new is that the same molecule was approved for treating obesity about 2 years ago first. And now there's like multiple brands, more or less the same molecule. So that is new. So the GLP-1s have been FDA approved for treating obesity. So that's new. So what's our view? I would say this, any innovation and anything new that's in the toolkit to address metabolic health and obesity in this case is positive progress. But the message that now being pushed to the world more or less is, oh, we have a magic pill, this is gonna solve obesity, is absolutely, completely, utterly wrong. It's not true. This is not materializing in the real world. And we have 9 years of experience actually managing, individualizing, and deprescribing GLP-1s through telemedicine with our patients because it was approved for type 2 diabetes. So we have almost 10 years of data dealing with these drugs with people with type 2 diabetes. I guess to summarize, these drugs have been a huge tailwind for our business for obesity because now there's attention on obesity. And given the cost of them, $1,000 or more per patient per month, isn't that insane? Like $10,000 a year or more. The desire by payers, insurance companies, and employers to invest into solving obesity with something more sustainable. Something much cheaper, such as a lifestyle-based treatment like Virta, has just gone absolutely through the roof. And the last thing I would mention and, and say is while these drugs can be a useful tool for some period of time, for some people, the key thing that payers and, and what we are implementing is that one, there is a lifestyle-based alternative always offered to people and Always is the first option. And then secondly, there has to be an off-ramp or strategy that works to get people off of these GLP-1 drugs because people can't tolerate it a long time. They're ridiculously expensive. It's all kinds of side effects. And what we've been able to show and publish now, peer-reviewed data, is that we have taken people completely off of Ozempic and other GLP-1 drugs and maintain that weight loss. For more than a year. And I don't think anyone else has this kind of dataset or published it. And we just actually came out early 2024. So kind of an exciting time to be in the space of addressing obesity. And these GLP-1 drugs, again, I would summarize it's a useful tool in the toolkit, but in no way are they going to be the magic bullet that's going to solve obesity. That is not true.

Thank you for helping us understand the nuance behind the scientific and behavioral approach that you all are doing, and you're leveraging the platform of telemedicine to be able to deliver this. To your patients and your customers. If I'm thinking about new ways or innovative ways of addressing my type 2 diabetes, how do I find Virta? Is it through my provider? Is it through peer-to-peer referral? Like, how do you approach this go-to-market, which is something that is in between an art and a science?

Yeah, well, first I should say we are a provider, so we employ medical doctors full-time. And so if you want to get access to Virta, and you are able and willing to pay out of pocket, you can literally go to our clinic, which is virtahealth.com, and then you apply, you have a telemedicine visit, and then the treatment starts. So anyone in America can access Virta today by going to virtahealth.com. That said, the go-to-market approach that we've taken and how most people have found Virta and get free access to it is through their employer health plan. And so using, again, business jargon, B2B2C, So we sell to businesses. We serve now, we had about 20 clients when COVID hit. Now we have 530 different organizations that benefit from Virta. So there's 400+ employers like U-Haul and Papa John's and UPS and big Fortune 500 companies, as well as health plans like Humana, Blue Cross Blue Shield of California, a number of others, and then some government entities like Veterans Administration. So these organizations cover Virta because it makes obviously human and ethical sense, but they also make money because reversing type 2 diabetes, getting people off of insulin and these GLP-1 drugs saves a lot of money. It makes economic sense for these payers to cover. So they cover Virta, and then in collaboration with them through email and mailers and benefits communication, we quote unquote market to these individuals who are eligible for revert, and then they find us, and then we start the treatment. So that's the model. And I'll just add one more thing. Very few things in American healthcare are such that you actually make someone better and you also save money. Even the GLP-1s, or like wonderful cancer treatment, it's a million dollars, it's going to extend life by 2 months, and then it's a tough decision. Should we cover or not? When we reverse type 2 diabetes, you don't have that trade-off. We save you money. And we make someone healthy. What is there not to like?

Definitely sounds like the definition of a win. And that explains how you've been incredibly successful both in scaling this company over the past 9 years, as well as going into the venture market to raise capital to continue furthering this unique and powerful mission. You've collectively raised over $300 million in funding from incredible funds such as Caffeinated, Obvious Ventures, and Venrock. First of all, congratulations. And we're curious, who was the first person to say yes to investing in Virta?

Very good question. And first, I should say, I don't take the capital lightly. I don't take the trust of our investors lightly. And I certainly don't celebrate the amount of money we've raised. And I say internally that while there's a lot of pressure with this company, several, oh, we raised this much money. I always say it's like a mortgage. Except that it's not an 8% interest, it's 100% year-over-year interest that investors have. So I don't take it lightly and we wanna make sure we deliver amazing return to our investors. And I'd also add that healthcare is expensive. It takes a lot of capital to build something. Trulia, again, we talked about Trulia. We went from zero to public with $33 million of equity finance, 33. And now for Virta, we raised more than $300 million. Luckily, more than 100 million of that is, is still in the bank. So we haven't burned it all. So that's just for like context. Now you asked who was the first one to invest. This is probably the non-answer, but it was me. I put my money and I was in a fortunate position that I had some leftovers from food and rent. So I was able to, after Trumia, do that. But in terms of investors, I would say I need to give credit to a lot of people, but Obvious Ventures was backing very early. So I need to give credit to them. Caffeinated Capital and Ray Tan Singh took a risk very early. And then the lead for our Series A, and they are still on our board and we would absolutely be nowhere without them, was Venrock and a very high quality healthcare and healthcare tech investor. And for someone like me coming from outside of healthcare, it's been— people laugh about VC value add, but it does exist if you work with the right folks. So there's some credit for lots of people. Who have supported us.

We're so excited to keep tabs on the future growth of Virta, but I think it's really such a personal problem you're solving. You're really transforming people's lives, and we're excited for more millions to become Virta Health patients. But could you share a story from one of your members and how Virta has helped them take back their life?

We exist to reverse type 2 diabetes and improve. That is why we exist. And I actually try to keep it very front and center. For example, every Monday we have our all-company all-hands and 100% of the time that meeting starts with a Virta patient joining and explaining their experience so that whether you're working on a spreadsheet or coding software and you may not be seeing patients like got providers and coaches, that it is at the front and center. So I would have so many stories, but let me try to illustrate how the human impact of reversing type 2 diabetes goes way beyond lab result improved, or we saved money to an insurance company. It goes way beyond. One is you, those of you on a video, I have this Virta t-shirt. It says Virta. This is our logo. We have a number of patients who have permanently tattooed that logo in their bodies after we reversed their type 2 diabetes. And it still gives me chills. To say it because it's insane. But it tells me that the experience that they've had is just so transformative. So that's one thing everyone, and by the way, I would challenge anyone in healthcare, find another healthcare company who's used those customers, Cigna, maybe do they have anyone with Cigna Local? Sorry to call them out, a wonderful insurance company. But anyway, so that's one. In terms of individuals or patients, I want to be careful because obviously we are provider and what I can say. But of those who've already publicly shared their name somewhere, the one person that comes to mind is, is a gentleman called Michael Collins from Alabama. And I think he joined Virta as a patient like 2 or 3 years ago now. And while his story is a little bit of extreme, this is still a reflective of where his life was. He wasn't that old as to begin with, had type 2 diabetes and north of 400 pounds of weight, which You know, he would tell you that it was massively overweight. He was on diabetes medications, and this is going to shock you. He was on 5 different diabetes medications. And this may sound like insane, but it is very common that people are on 3 to 5 or 6 diabetes medications. It's insane. People are just so medicated. But again, it does not make the disease go away. This is the old paradigm of managing the disease or one of its symptoms. So he became a Brita patient. I think one of the things he has shared, and I remember he said, how was my life? I didn't have a life. Like I couldn't play with my kids and now he has grandchildren. I couldn't play with my grandchildren. I didn't even want to leave my house because A, it was difficult and it's like honestly embarrassing to go anywhere. And I guess now 2, 3 years later, he has lost more than 200 pounds. On Virta, his blood sugars were at the A1C measure, 11%. It's basically like maple syrup running in your veins. It's now 5 point something. So it's below the diabetes limit. He's off of all diabetes medications, which is insane. And that's the definition of diabetes reversal. Blood sugar is normal, you're off the medications. So that's an example. But again, when you listen to him and think about these logo tattoos people have, the stories that people tell is less about, oh, what happened to my A1C? It's like I had I had no life. Now I have life. Like Michael, he used to ride an ATV to play with his grandkids because he couldn't walk. And now we can have a running competition with the kid. You just can't put a value to that. He would use terms, I had no life. Now I have life. And so anyways, is that, there's one story we have, obviously countless. That is the reality of type 2 diabetes and not having it. And I don't think this story is told enough because we sort of gloss over this big number. 35 million people have diabetes. Yeah, maybe you eat too much, take insulin. No, that's going to kill you over time. It's a reversible disease. I get very passionate about this topic because to me, it's almost unethical the way we talk about type 2 diabetes today and the kind of treatments that we're pushing primarily, which is managing with pharmaceuticals. There's a better way.

I'm just struck by the empathy, both in your tone and the disposition of the company itself to really make a change through this disruptive innovation on all sides of both the science and the delivery. And I think when we're talking to entrepreneurs, we often know that there's a big idea and a big vision behind it, but sometimes it doesn't necessarily meet the end consumer's experience and feelings in such a visceral, emotional, and physical way as your platform and product does. And so it's really unique to hear that story come to life. I just had one more high-level question to bring us back up before we ask our closing question. Which is you're bringing a lot of different parts of the innovation economy together, right? Platform delivery, scientific measures, as well as healthcare and partner innovation on the sides of the payers. All of these individually are very challenging businesses, and you're able to bring it together to provide this care. What would you say for the entrepreneurs out there who are thinking of tackling all or three or more of these things at once? What's been the uniquely hardest part? Of the journey for you in this unique space?

Specifically in healthcare?

Yeah. And the innovation meets manifestation of this solution.

Yeah. Oh, many. And if the cliché is that entrepreneurs who are many years into their journey, they say, if I had known all these things, I would never have started. I said it with Chewy and I can say it now after 9 years. Few buckets of things that are incredibly hard in America. Can help. Number one, when you operate in the organized healthcare system with the health plans and employers and PBMs and consultants, the go-to-market and the business model and making that work is incredibly complex. It's like a spider web. And when you're inside a spider web, you feel like you're prey to the spider. The incentives are so backwards. It is very fragmented. Yeah, we spend $4 or $5 trillion on healthcare, but It's more 100,000 different pockets. So that would be one. So go-to-market and figuring out how do you make your business work. Second one is more internal, which is, it's one thing to build a tech company. It's very hard. Then when you combine that with operational care delivery and you combine that with, say, medical doctors, and you combine that with the fact that you have human lives in your fingertips, marrying all those together, building a product, and then delivering seamless, high outcome, high safety experience is very hard. Culturally, internally, practically. For example, for a software engineer, a rapid pace might be pushing code once a week. For a medical doctor, a fast pace might be that care guidelines change once a year. And so now all these folks are in the same company and you as a leader or CEO, you're like, okay, we need to iterate and learn fast and to improve fast. So one person say, okay, let's one week cycles. The other one says one year cycles. Managing all these different things, which I did not have to do at Truvia, been incredibly hard.

Thank you so much for peeling back the curtain of the experience, both on the patient side as well as inside of your company and business. Congratulations on all you've accomplished, and, and we really look forward to keeping along on this journey. But this is our favorite last question to close us with, which is, who is a woman in your life that has had a profound impact on you and your career?

First of all, I live with a minimum of 3 women all the time, every day. That is, I'm married to a woman and I have 2 daughters. And I love it. It is genuinely the best and luckiest thing that happened in my life. It's amazing. So I will actually say my wife. I have started one company as co-founders with her, which we didn't talk about and we don't have to. And then she was one of the very, very first employees and became an executive inside Virta Health as well. So I had actually worked and observed and learned a ton from her. And I would say what's very inspirational about how she operates, and I've learned a ton from, is she's a very unique combination of very fast execution and attention to detail, and then also being very creative and disruptive. And very few people have those both. They're either like step back, they have big ideas and how to do things differently. Or they're in the details executing like a machine. But to have both those two and having them in a balanced way has been very inspirational. So I'll say my wife.

Yeah. And having that all in a life partner sounds pretty special. So thank you so much for both sharing that tidbit as well as your journey moving to the States, becoming a founder of both Trulia, Virta, and it sounds like some businesses in between. Sami, it's been a real pleasure to have you here with us in the room today. Thank you so much.

Thank you.

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