Livongo Health Files IPO: Diabetes Management Platform Backed by Over $140M in Funding Offers 90-Second Physician Guidance

Chronic diseases, such as heart disease, stroke, chronic respiratory diseases, and diabetes, have become the leading causes of death worldwide to date, accounting for 63% of all deaths. The treatment of these chronic conditions largely requires long-term adherence and management, which poses a significant challenge for ordinary patients.

There are already many successful examples of wearable devices working in tandem with smartphones to monitor vital signs. For instance, common running apps can track metrics such as running distance, real-time speed, heart rate, and calories burned, while also enabling long-term monitoring of one’s fitness progress. Therefore, similar management approaches appear feasible for chronic diseases.

U.S. healthcare startup Livongo provides more personalized services to patients suffering from diabetes, helping them monitor their condition, receive real-time guidance, and undergo early intervention.

According to VCBeat, Livongo Health was announced at TechCrunch DISRUPT in San Francisco in September 2014. Its founder and current CEO is , and its headquarters are currently located in Mountain View, California, USA.

Dedicated to improving the quality of life for patients with chronic conditions, Livongo initially focused on diabetes. In the United States, Medicare and other insurance programs spend $250 billion annually on diabetes care, representing a substantial healthcare cost. Regardless of whether you have type 1 or type 2 diabetes, you can access their services to help self-manage your condition while also reducing your personal expenses.

Livongo currently offers consumers a diabetes management system that integrates FDA-approved bidirectional interactive glucose meters, a mobile app, cloud-based analytics, and a real-time coaching team.. This innovative diabetes management system integrates mobile technology with implementation coaching, providing users with blood glucose data collection and tracking, as well as on-demand expert guidance. It empowers patients with diabetes and their families to gain a deeper understanding of the condition and identify treatment plans tailored to their individual needs.

Tullman stated that they are rethinking all current diabetes treatments, and their product will significantly improve the user experience for diabetes patients, enhance treatment outcomes, and reduce healthcare costs.

Glen Tullman is a distinguished entrepreneur and investor with business interests spanning multiple industries. He previously served as CEO of Allscripts, a large publicly traded company that provides digital health record services to clinics, hospitals, and other healthcare institutions. Notably, he is also the Managing Partner at 7wire Ventures, the firm that provided seed funding to Livongo.

Livongo Founder and CEO Glen Tullman

Tullman’s commitment to patients with diabetes did not begin with Livongo; in his early years, he was already a major donor to the Juvenile Diabetes Research Foundation (JDRF), the world’s largest charitable organization dedicated to type 1 diabetes, to which he has personally contributed millions of dollars.

Regarding the original intention behind founding Livongo, he stated, “Diabetes affects 29.1 million Americans, and my son is also a diabetic. The challenges arising from this condition emerge every minute of every day; as a parent, how could I not be anxious? Nearly everyone I know whose parents or partners have diabetes has experienced severe complications. What patients with diabetes need are better information and tools to manage their condition, more convenient channels to share health updates with family members or physicians, and coaching support when needed. The mission of Livongo is to keep disease at bay for our customers and create the healthiest possible lives for them.”

After six months of intensive efforts with investors at General Catalyst, Tullman finally launched Livongo, with General Catalyst injecting $10 million into its Series A financing round.

Livongo’s founding was aligned with clinical research conducted by industry-leading institutions such as the University of Massachusetts and the University of South Florida, forging strong ties within the diabetes care sector. The patient population keenly interested in its services has been steadily growing since its inception, and by 2015, Livongo had already built a database comprising 27,000 individuals with diabetes. Major healthcare provider HealthCare Partners established a partnership with Livongo at its launch, alongside other strategic partners such as Office Depot.

Although committed to becoming a treatment platform for various chronic diseases, Tullman believes that given the vast patient population and market size of diabetes, Livongo should start here.

Glucose meters are hardly new, but they can only provide your current blood glucose level. The glucose meter offered by Livongo, however, does far more than that.

Livongo's glucose meter features a color touchscreen and cellular connectivity,Moreover, in the 2016 product upgrade, the device was equipped with firmware over-the-air (OTA) update capabilities, much like the smartphones we use today, making it the world’s first blood glucose meter capable of online updates.. The new glucose meter also features a more streamlined user interface and a cleaner color scheme, facilitating nighttime use, while further simplifying the steps for blood glucose management. However, unlike the growing number of smartphone-connected hardware devices on the market, Livongo’s glucose meter operates independently, thereby avoiding many drawbacks associated with reliance on mobile devices, such as frequent disconnections. The main features of Livongo’s glucose meter include:

1. Internet-connected Glucometer

With Livongo’s glucose meter, users can easily read and upload their blood glucose data to generate blood glucose logs. These data are accessible online at any time, facilitating user follow-ups and tracking of their blood glucose status.

2. Real-Time Personalized Tips

Each time user blood glucose data is read, Livongo’s cloud-based system analyzes the information and the glucometer delivers real-time, personalized wellness tips tailored to the user’s specific condition, helping them manage their blood glucose more effectively and make informed decisions about their subsequent care plan.

3. Seamless Sharing

As founder Glen Tullman himself has a son with diabetes, Livongo understands the concerns of family members of patients with diabetes. Their glucose meters can be linked to relatives’ contact information, so that when blood glucose levels exceed alert thresholds, family members are notified via text message or email. The alert is also communicated to the user’s care team.

4. Lower Barrier to Entry

Users can add reading notes to indicate how they can better understand Livongo’s educational materials. Additionally, they can log their food intake to enable more comprehensive tracking. The longer users engage with the platform, the smarter and more personalized the guidance provided becomes.

In addition to advanced glucose meters, Livongo’s diabetes management system also includes a mobile app. Through the client application, users can view their blood glucose data, receive daily personalized health recommendations, and directly connect with a team of professional coaches.

If a user’s blood glucose level deviates slightly from the normal range, they will receive recommendations from Livongo, such as taking a walk or drinking a glass of juice.If a user’s blood glucose levels deviate significantly from the normal range, a health coach will call the user to provide guidance and alerts. This is one of Livongo’s key innovative selling points, with a target of connecting with users within 90 seconds.

Livongo’s team of guidance experts is composed of certified diabetes educators, and users can communicate with these experts at any time via phone, email, text message, or mobile app.

The guidance they provide is not only targeted at diabetes itself but also offers users advice on dietary nutrition and lifestyle changes.

Does uploading users’ blood glucose data to the cloud serve only for real-time analysis? Certainly not. Livongo’s secure website also provides users with more comprehensive data access services. On this platform, users can view their detailed blood glucose logs and obtainLivongoThe calculated key trends in disease management and predictive models provide users with a clear overview of the disease progression.

Unlimited Supply of Blood Glucose Test Strips

Additionally, the use of a glucose meter requires essential supplies such as test strips and lancets; if these are inadvertently depleted, blood glucose monitoring for the day becomes impossible. Livongo users need not worry about this, as the company provides lifetime free and unlimited test strips and lancets. When users’ supplies are running low, Livongo delivers new test strips and lancets directly to their doorsteps.

Livongo’s services are designed not only for individuals but also for large enterprises and health plans, helping them optimize healthcare spending. Currently, Livongo operates on a monthly subscription model, with individual users paying $75 per month. For its enterprise clients, employees can register using an activation code, and the subsequent membership fees are covered by their employers or health plans.

Livongo's Health Kit

Upon successful registration, members will receive a Livongo health kit, including a Livongo blood glucose meter, test strips, a lancing device, lancets, and detailed product instructions.

According to VCBeat, 88% of users expressed satisfaction with Livongo’s user experience, and 75% of diabetic patients reported feeling more optimistic about their condition after using the product.Tullman stated that there is already sufficient data to show that their product can save long-term customers up to $100 per month.

It has been nearly a century since healthcare professionals first developed effective treatments for diabetes. Therapies for both type 1 and type 2 diabetes have continued to improve alongside technological advancements. Globally, the number of people living with diabetes stands at 371 million, a figure projected to rise to 552 million by 2030. Faced with such a vast market, many innovative healthcare companies, in addition to Livongo, are pursuing ambitious goals.

AgaMatrix, a medical device company founded by Sonny Vu, launched the iBGStar blood glucose meter in 2012, the world’s first blood glucose meter capable of directly connecting to an iPhone. In 2015, AgaMatrix introduced cloud-based data services for iOS and Android users and released its second-generation device, the Jazz Wireless 2, which utilizes Bluetooth connectivity.

In September last year, the FDA approved the MiniMed 670G artificial pancreas device launched by Medtronic for use in patients with type 1 diabetes aged 14 years and older. This device frees patients from the burden of scheduled insulin injections by automatically administering insulin as needed based on blood glucose levels, mimicking the function of the body’s own pancreas.

Dario Health, a leader in the diabetes management industry, has gone public. Its model primarily relies on connecting external devices to smartphones. In contrast, Livongo’s newly launched glucose meter can operate independently, which will undoubtedly pose a challenge to companies like Dario.

VCBeat has learned that Livongo recently secured $52.5 million in Series D financing, co-led by General Catalyst and Kinnevik. Since its establishment over two years ago, the company has completed six funding rounds, raising a total of more than $140 million. With investors including Microsoft Ventures, Livongo has become a highly sought-after player in the market.

Since Livongo’s inception, General Catalyst has invested in the company multiple times. Hemant Taneja, Managing Director at General Catalyst, stated, “Livongo is one of the fastest-growing companies in our portfolio, and we are honored to continue making follow-on investments to help them establish a leading market position.”

Diabetes management is merely the starting point; the cash flow from continuous investment inflows will undoubtedly help Livongo expand its market, enter international markets, and develop into a multi-chronic disease management ecosystem, covering conditions such as depression and hypertension.

However, development bottlenecks still exist. Tullman stated that the refreshing experience delivered by their products is largely attributable to their ultimate, human-centric expert guidance services. This, in turn, places high demands on Livongo.They must allocate their limited pool of guidance coaches rationally among tens of thousands of users, a challenge that will intensify as the customer base continues to expand.Livongo is working to ensure that its health coaches can prioritize patients’ conditions. Tullman stated, “We only resort to phone consultations when a patient’s blood glucose levels are significantly above or below the normal range. Currently, the ratio of our health coaches to clients is approximately 1:2,500.”

This means that if the user base expands to 1 million, 400 health coaches will be required; and to serve the 30 million diabetes patients across the United States, the coaching team would need to scale up to 12,000 members. Ensuring a high-quality, high-quantity expansion of the coach workforce may well be one of the biggest challenges Livongo faces on its growth path.