Metabolic Syndrome and its correlated diseases, such as diabetes, affect an estimated 20-25% percent of the global population. Most treatments apply a one-size-fits all approach to patient care that relies heavily on stop-gap interventions like expensive drugs and boilerplate lifestyle recommendations and does little to reverse the course of these conditions.
Helena has invested in and partnered with a pioneering new technology company to address the root cause of metabolic disease. Powered by artificial intelligence that gathers unique data from thousands of individual sensors, Twin Health’s treatment model is forging a new paradigm that drastically reduces healthcare costs while delivering personalized patient care aimed at disease reversal and prevention.
Twin’s Whole Body Digital Twin technology is capable of monitoring dynamic systems previously considered too complex to measure, such as a damaged metabolism. At present, Twin is using their technology to address Type 2 Diabetes. Their clinical results demonstrate first-in-kind health outcomes including 90%+ T2D reversal.
Helena is currently working to bring strategic partners to Twin and carve out a pathway for Twin Health’s adoption by employers and insurance companies. With profound implications for patient care across diagnoses, we believe the technology has the potential to create a radically different treatment landscape – one that prioritizes a whole-systems approach and compassionate, personalized care.
The impact of digital twin technology can be traced back to one of the most famous near-disasters in American history. On April 13th, 1970, some 200,000 miles above Earth, one of the oxygen tanks on board the Apollo 13 exploded. “Houston, we’ve had a problem here,” CMP Jack Swigert radioed down to mission control. The problems were many — failing electronics, sharply rising carbon dioxide levels, charting and following a reentry path. With the shuttle so far away and time running out, mission control had very few options.
What they did have was an exact physical replica of the Apollo 13 shuttle, dubbed a “mirrored system.” Within the spacecraft’s twin, mission control methodically recreated the Apollo 13’s conditions, finding and testing possible solutions in real time. Replicating and troubleshooting each complication as it arose, the ground team managed to guide the Apollo 13 crew to a safe landing in the South Pacific four days later.
Since then, the physical has become the virtual. The concept of a digital twin was formally introduced in 2002 by the University of Michigan’s Dr. Michael Grieves in the context of manufacturing. Describing what he called the “Mirrored Spaces Model,” Dr. Grieves outlined the structure for what became the modern technology: a virtual representation of a physical system that is dynamic, allowing the flow of data between the physical and the virtual for the entirety of the system’s lifecycle.
Advancements in technology have enabled digital twins to become more robust, precise, and ubiquitous. They have been used extensively in complex systems like supply chain management, equipment monitoring, and manufacturing.
Twin Health CEO Jahangir Mohammed was instrumental in ushering in a new era for the technology. An engineer and serial entrepreneur, Mohammed founded Jaspar – a company Inc. magazine called the “on switch” for the Internet of Things (IoT) – in 2004. Harvesting data from, and enabling communication between, an increasingly diverse array of objects, the IoT allowed twin technologies to proliferate and mature. Originally relegated to large scale implementations, digital twins could now be used for smaller, individual systems, as well. Tesla, for example, creates a digital twin for every car it produces.
In 2016, Mohammed found himself at a crossroads. He had just sold Jasper Technologies to Cisco Systems for $1.4 billion and was having lunch with his family in India. He saw his aunt struggling to read the menu due to blurred vision as a consequence of her type 2 diabetes (T2D). He looked around the rest of the table and did a quick calculation. Forty percent of his family was suffering from some form of chronic illness.
Mohammed wondered if he could apply the digital twin model to T2D treatment. Inspired, he devoted thousands of hours to research and consultations with scientists and physicians worldwide and discovered the world was merely treating symptoms of chronic metabolic disease, not solving the problem. Having experienced the increasing capabilities of digital twin firsthand, he believed the technology had the potential to transform the global metabolic disease treatment paradigm. Twin Health was founded in 2018.
Twin Health creates a “Whole Body Digital Twin” for each person it serves, using the most advanced biometric sensors and data to personalize treatment plans and address the root cause of an individual’s T2D.
According to the NIH, as of 2017, 462 million people worldwide are affected by T2D, and its incidence is on the rise globally: the number of people diagnosed with T2D has more than doubled since 1980, and it is projected to increase to 642 million by 2040. These statistics are especially troubling–or predictable–since onset of the disease is largely based on lifestyle.
Healthy, balanced meals and exercise are proven methods for delaying, or preventing, T2D, but these lifestyle choices are made particularly difficult with our increasingly abundant food, much of which is processed and calorie-dense, and our increasingly sedentary lifestyles. Of course, to have the option of making these lifestyle choices, one needs the time and space to exercise, as well as access to healthy, typically-expensive food options. It follows, then, that T2D disproportionately affects the more vulnerable members of society: low-income communities and ethnic minorities.
Its consequences are dire. It accounts for more than one million deaths per year, and its impact on quality of life are well-documented and grave: it has been tied to increased risk of everything from heart and kidney disease to Alzheimer’s and dementia, not to mention day-to-day effects like Mohammed’s aunt’s blurry vision.
It is also expensive. According to the CDC, in 2017, the total cost of medical care and lost productivity for people with diagnosed diabetes was $327B in the US alone, and the average annual medical expenses for a person with diabetes was almost 2.5 times the national average. (If you include all chronic diseases, the tally runs to over $3T.)
Those costs are reflective of T2D treatment plans that are impersonal, pharmaceutical, and entirely palliative. Patients with the same diagnosis receive the same general recommendations (the same general diet and exercise plans), and disease management relies heavily on medications–insulin and metformin, for example–that can run patients thousands of dollars per year, even with insurance. And none of these treatments address the root cause or reverse the disease’s progress; they merely control the disease’s spread and alleviate symptoms.
Twin Health is a new approach. The technology takes over 3,000 data points from both self-reported preferences and non-invasive sensors such as a continuous glucose monitor, a blood pressure meter, and a body composition scale, and combines them with machine learning models to create a person’s Whole Body Digital Twin: a dynamic, moment-by-moment digital representation of their individual metabolism, accessible through their app.
The platform collects and analyzes the data automatically and in real-time, giving the user a clear picture of their current metabolic health, both in specific areas and on the aggregate. The data is interpreted by their machine learning models – along with human health experts, called Twin Health Coaches – in order to identify individual causes of metabolic dysfunction, potentially leading to disease reversal. From there, Twin creates treatment plans and recommendations about nutrition, sleep, exercise, activity, and breathing that are highly individualized and minimally disruptive. They are designed to fit seamlessly into the user’s existing life, making them easier to adopt and maintain. And, since the Whole-Body Digital Twin is constantly evolving, it gets more detailed and more accurate over time.
Currently, Twin is focusing on type 2 diabetes, and the results have been promising. Twin’s clinical research team conducted the world’s first randomized controlled trial for reversing metabolic disease using digital twin technology. Per Twin, the data was published in the American Diabetes Association’s Diabetes journal: 90%+ achieved T2D reversal and 92% eliminated all diabetes medications, including insulin.
Helena Special Investments Fund I LP invested in Twin’s Series C funding round, which closed in August 2021 with ~$140M of capital injection. As Twin moves past its trials, it will initially roll out in India and the U.S. Its immediate target customers will be the risk-bearing employers and healthcare providers who are currently forced to bear the exorbitant costs associated with treating T2D.
From there, Twin intends to expand. Its Whole Body Digital Twin platform has the potential to transform the field of chronic disease diagnostics, prevention, and treatment, improving the lives of hundreds of millions of people around the world.
As it scales, the company will benefit from a seasoned and diverse Board of Directors that includes Toby Cosgrove (former president and CEO of the Cleveland Clinic), Mohat Bhatnagar (Managing Director of Sequoia India), Caroline Xie (General Partner at ICONIQ), and Bruce Dunlevie (Founder and General Partner at Benchmark Capital). At present, Helena and its partners have been helpful in bringing Twin at-risk employers and other medical networks to begin their own Twin trials, delivering near-term revenue and a path to long-term relationships.
In the first half of 2023, Twin Health announced partnerships with both Blackstone Inc. and GEICO. Blackstone trialed Twin in a small portion of its portfolio companies–14 of its 122 businesses–and it released some very encouraging preliminary results (reported by Bloomberg here) in April, the same time as Twin’s partnership with GEICO. For those people enrolled at least three months, medication costs fell by half. At one company, Medline Industries, more than a third of its employees who had been on the program at least two months were able to stop diabetes medications. Blackstone estimates that the companies trialing Twin will save hundreds of thousands of dollars per year just for the relatively small number of people who have signed up already.
At-risk entities are those that bear the brunt of the financial risk. In this case, in the treatment of T2D, insurance companies, employers, and health systems are all at-risk entities. They would see tremendous savings with healthier patients and a reduction in necessary treatments.
The Internet of Things (IoT) describes the network of physical objects that possess technologies that enable them to connect and exchange data with other devices and systems over the internet. (These “objects” can be practically anything with the ability to connect to the internet–a smart microwave, for example, or a person with a heart monitor.) The basic process is that the object creates data; a network transports the data to an application; and the application collects it. Jasper provides the software that enables those three nodes to function together.
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