Viome Nutritional Programs to Improve Clinical Outcomes for Metabolic Conditions

Inclusion Criteria:

• Resident of the United States

• Females and males ages 25-75 (inclusive)

• Able to speak and read English

• No unexplained weight loss, fevers, anemia, or blood in stool

• Willing and able to follow the trial instructions, as described in the recruitmentletter

• Signed and dated informed consent prior to any trial-specific procedures.

• Fasting insulin level >=15 uIU/mL or fasting glucose >= 100 mg/dL within the last 3months, verified from medical records

Exclusion Criteria:

• Unwilling to change current diet

• Unwilling to go to Quest

• Prior use of Viome products or services

• Antibiotic use in the previous 4 weeks

• Women who are pregnant (current or planned in the next 4 months), or breastfeeding

• < 90 days postpartum

• Active infection

• Unable or unwilling to use Viome's App on an iPhone or Android smartphone

• Significant diet or lifestyle changes in the previous 1 month

• IBD diagnosis

• Use of investigational drugs, products or devices within 1 month prior to and 4months after the start of the trial

• Cancer therapy within the previous 1 year

• Major surgery in the last 6 months or planned in the next 4 months

• Current (or previous) use of medications that increase insulin (sulfonylureas, suchas glimepiride, glipizide, glyburide, etc.)

• Current (or previous) use of exogenous insulin (such as Tresiba, Lantus, Toujeo,Levemir, Humalog, Novolog, Apidra, Fiasp, etc.)

• Prescribed any drug(s) that may interact with the supplement formulations

• Have any medical condition or allergy that may interact with, or prevents thehealthy consumption of the supplements such as:

Pregnancy Breastfeeding Minors GERD Gastric Ulcers Ulcerative Colitis Crohn's Disease Kidney Impairment (kidney cysts, kidney disease) Liver Condition (gallstones, cholecystitis, cirrhosis, hepatitis, hepatitis a, hepatitis b, hepatitis c, NAFLD/NASH, etc) HIV SIBO CuminAllergy GymnemaAllergy BacopaAllergy CitrusAIlergy LamiaceaeAllergy SageAllergy YeastAllergy MulberryAllergy ChicoryAllergy

• Allergies to any study-specific supplement ingredients

• Currently on a specific diet:

FODMAP KETO PALEO

• Gastrointestinal disease including:

• GI surgery except:

• Appendectomy and benign polypectomy

• Esophagitis

• Celiac disease

• GI malignancy or obstruction

• Peptic Ulcer Disease

• Duodenal or gastric ulcer disease