Sequel
Sequel Med Tech is a privately held medical technology company that develops the twiist Automated Insulin Delivery System — an FDA-cleared insulin pump using proprietary iiSure sound wave microdose measurement — for people with type 1 diabetes in the United States.
- Company typePrivate
- Founded2023
- HeadquartersManchester, United States
- Headcount251–500
- GTM typeB2C
- OfferingHardware or Manufacturing
What Sequel does
Sequel Med Tech, LLC is a privately held medical technology company headquartered at 50 Commercial Street, Manchester, New Hampshire. The company develops the twiist Automated Insulin Delivery (AID) System, which it positions as the first drug-delivery system that directly measures the volume of insulin delivered with every microdose using its proprietary iiSure sound wave technology, paired with the Tidepool Loop algorithm. The twiist system received FDA 510(k) clearance in March 2024 for people ages 6 and up with type 1 diabetes, and a 307-adult pivotal trial in insulin-treated type 2 diabetes reported a 0.7 percentage point HbA1c reduction and a Time in Range improvement from 57% to 73%. Sequel has expanded the twiist ecosystem through CGM integrations with Abbott's FreeStyle Libre 3 Plus (March 2025) and Senseonics' Eversense 365 one-year implantable CGM (February 2026, the first AID compatible with Eversense 365), and a January 2026 agreement to integrate Diabeloop's DBLG2 algorithm with U.S. launch targeted for 2027.
Sequel generates revenue primarily through hardware sales of the twiist pump system and recurring consumables (refill kits), distributed nationwide through U.S. pharmacy channels rather than traditional DME. Eligible commercially insured patients can obtain a starter kit for $0 and capped refill kits at $50 per kit through the twiist Savings Program. The company pursues a hybrid go-to-market combining direct-to-consumer activity through twiist.com, healthcare-provider engagement, and a B2B2C benefits platform called SequelConnect that targets employers and health plans. Customer segments center on people with type 1 diabetes (primary), insulin-treated type 2 diabetes (investigational), prescribers (endocrinologists, primary care), employers and health plans, and pharmaceutical partners — exemplified by a September 2025 co-development agreement with Arecor Therapeutics to pair a 500 U/mL ultra-concentrated insulin (AT278) with twiist. Co-founders include Dean Kamen (inventor of the AutoSyringe), Pablo Legorreta (Founder/CEO of Royalty Pharma), William Doyle, Maureen Toohey, and CEO Alan Lotvin.
Sequel firmographics
Firmographics- Name
- Sequel
- Legal name
- Sequel Med Tech, LLC
- Website
- https://sequelmedtech.com
- Company type
- Private
- Founded year
- 2023
- Operating status
- Operating
- Headcount range
- 251–500 employees
- Short description
- Sequel Med Tech is a privately held medical technology company that develops the twiist Automated Insulin Delivery System — an FDA-cleared insulin pump using proprietary iiSure sound wave microdose measurement — for people with type 1 diabetes in the United States.
- Ownership category
- akta.pro rank
Sequel industry classification
Industry- Product category
- Automated Insulin Delivery
- NAICS
- Electromedical and Electrotherapeutic Apparatus Manufacturing (334510), Totalizing Fluid Meter and Counting Device Manufacturing (334514)
- SIC
- Surgical & Medical Instruments & Apparatus (3841), Electromedical & Electrotherapeutic Apparatus (3845)
- akta.pro primary industry
- Automated Insulin Delivery (AID) / Closed-Loop Systems (HLAHAHAF)
- akta.pro secondary industries
- Insulin Pumps & Patch Pumps (HLAHAIAG), Connected Therapeutics & Smart Drug Delivery Monitoring (HLACAFAL), Insulin Pumps (Tubed) (HLAHAHAB)
Keywords
Where Sequel is headquartered
LocationHeadquarters
- HQ city
- Manchester
- HQ country
- United States
- HQ region
- North America
Offices2 records
Markets served
Sequel business model
Business model- GTM type
- B2C
- Offering type
- Hardware or Manufacturing
- Cost components
- Technology or R&D, Supply Chain, Marketing or Sales, Personnel, Operations
Revenue model
- twiist AID System Sales: Sequel generates revenue through the sale of its twiist Automated Insulin Delivery System hardware and associated consumables. The system is available nationwide through pharmacy channels with a flexible access model, suggesting recurring consumable revenue from refill kits.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Other | Pay-as-you-go | Starter Kit at $0 for eligible commercially insured patients |
| Other | Monthly | Refill Kits at $50 per kit for eligible patients |
Go-to-market motion2 records
Distribution channels3 records
Marketing channels6 records
Sequel product offering
Product offeringCore offering
Sequel Med Tech develops and sells the twiist Automated Insulin Delivery (AID) System, a FDA-cleared insulin pump for people ages 6 and up with type 1 diabetes that uses proprietary iiSure sound wave technology to directly measure insulin volume with every microdose. The system is powered by the Tidepool Loop algorithm and integrates with leading CGMs (Abbott FreeStyle Libre 3 Plus, Senseonics Eversense 365). The company also offers SequelConnect, a benefits platform that helps employers and health plans improve member access to insulin therapy.
Product overview
Sequel is a medical technology company offering the twiist Automated Insulin Delivery (AID) System as its core product. The twiist system is the first AID system that directly measures insulin volume with every microdose using proprietary iiSure sound wave technology, powered by the Tidepool Loop algorithm. The company provides CGM integrations with Abbott FreeStyle Libre 3 Plus and Senseonics Eversense 365. Sequel also offers SequelConnect, a platform for employer and health plan benefits management. The portfolio centers on making automated insulin delivery more accessible through pharmacy channels for people with type 1 diabetes, with clinical development underway for type 2 diabetes indication.
Differentiator
Problem solved
Functional benefit
Brands
- twiist: Automated Insulin Delivery (AID) system that directly measures insulin volume with every microdose using proprietary iiSure sound wave technology. FDA-cleared for people ages 6 and up with type 1 diabetes.
- SequelConnect
Products and services
- twiist Automated Insulin Delivery (AID) System First drug delivery system that directly measures the volume of insulin delivered with every microdose using proprietary iiSure sound wave technology. FDA-cleared for people ages 6 and up with type 1 diabetes, automatically adjusts basal insulin delivery based on CGM readings and the Tidepool Loop algorithm. Available by prescription via pharmacy channels with a $0 Starter Kit savings program for eligible commercially insured patients.
- SequelConnect Employer and health plan benefits platform that transforms how members access insulin therapy through a next-generation approach, leveraging Sequel's pharmacy-channel AID distribution model to deliver diabetes therapy benefits.
Quantifiable outcome
- HbA1c improved by 0.7 percentage points (from 8.1% baseline) in type 2 diabetes pivotal trial
- +2 more outcomes
Companies that use Sequel
Customer profileNamed customers3 records
Segments5 records
Ideal customer profiles4 records
Sequel technology and API
TechnologyTechnology focussed Yes
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
Integration3 records
AI capability2 records
Feature3 records
Sequel partnerships and signals
Strategic signalPartnerships
Six partnerships are on record, tiered core.
- Senseonics HoldingscoreIntegration partnership to combine the twiist AID system with Eversense 365 one-year continuous glucose monitoring system. This is the first AID system compatible with Eversense 365. Full U.S. availability announced February 2026. The integration pairs Senseonics' implantable CGM technology with twiist's iiSure technology for improved insulin delivery accuracy and occlusion detection. Senseonics also hosts analyst events at ADA featuring integration updates.
- DiabeloopcoreCollaboration to integrate Diabeloop's FDA-cleared DBLG2 automated insulin delivery algorithm into the twiist insulin pump. This marks the first integration of Diabeloop's algorithm into a commercial insulin pump in the U.S. market. The companies expect product readiness by end of 2026 with initial U.S. launch in 2027, potentially followed by global expansion.
- Arecor TherapeuticscoreCo-development agreement signed September 2025 to combine Arecor's 500U/mL ultra-rapid-acting insulin AT278 with Sequel's twiist AID system. Each company committed up to $1.3 million in development funding ahead of a pivotal Phase 2 trial targeting H2 2026. The partnership aims to develop ultra-concentrated insulin formulation specifically designed for the twiist system.
- Abbott (FreeStyle Libre 3 Plus)coreIntegration partnership making twiist compatible with Abbott's FreeStyle Libre 3 Plus CGM sensor. This was announced as the first CGM integration for the twiist AID system in March 2025. The integration enables patients to use Abbott's widely-adopted CGM with the twiist system.
- TidepoolcorePowered by the Tidepool Loop algorithm, which automatically adjusts basal insulin delivery based on CGM readings and predicted glucose values. The twiist system uses Tidepool's open-source algorithm platform for automated insulin delivery functionality.
- DEKA Research & Development Corp.coreDEKA, led by co-founder Dean Kamen, has partnered with Sequel to advance AID technology for people with diabetes by leveraging advancements in CGM and intuitive algorithms. DEKA brings 40+ years of insulin delivery innovation heritage.
Scale indicators3 records
Recent moves6 records
Expansion highlights7 records
Sequel competitors and assessment
Company assessmentDirect peers
- Insulet Corporation: Insulet's Omnipod 5 is a leading tubeless AID system serving Type 1 diabetes patients in the U.S. It is the most direct competitor to Sequel's twiist in target customer (insulin-dependent diabetes), category (automated insulin delivery), and go-to-market motion (consumer/patient-direct). Several Sequel executives (Chris Gilbert, Debby Norton) previously held diabetes-care roles at Insulet.
- Tandem Diabetes Care: Tandem's t:slim X2 with Control-IQ is an established tubed AID system integrated with Dexcom CGMs and serving a similar Type 1 diabetes patient population. It directly competes with Sequel's twiist on automated insulin delivery, CGM integration, and clinician-driven prescribing workflows.
Broad incumbents
- Medtronic Diabetes: Medtronic's MiniMed 780G is the market-leading AID system with the largest global installed base, integrated with its own Guardian CGM. As the incumbent, Medtronic competes broadly with Sequel on automated insulin delivery while also leveraging a much broader diabetes and medtech portfolio.
Emerging players
- Beta Bionics: Beta Bionics markets the iLet bionic pancreas, an AID system targeting Type 1 diabetes. As a smaller, newer entrant with a similar focus on simplified automated insulin delivery, it overlaps with Sequel on target customer and category but with a differentiated glucagon-inclusive dosing approach.
- Bigfoot Biomedical: Bigfoot Biomedical develops connected insulin delivery solutions for people with diabetes. As an emerging AID-focused player, it shares Sequel's emphasis on simplifying AID access and integrating with CGMs, though its commercial footprint and product maturity are at earlier stages.
- Diabeloop: Diabeloop is a European AID algorithm developer whose DBLG2 algorithm is being integrated into Sequel's twiist pump. While primarily an algorithm partner, Diabeloop also commercializes AID solutions in Europe, making it a partial competitor in algorithm-driven automated insulin delivery.
Others
- Dexcom: Dexcom is the leading standalone continuous glucose monitor provider and a key CGM ecosystem participant. While not a direct AID competitor, Dexcom's CGMs (e.g., G7) are integrated by other AID systems and the company is expanding into insulin delivery adjacencies, making it strategically comparable as part of the automated insulin therapy stack.
- Abbott Diabetes Care: Abbott's FreeStyle Libre platform (including Libre 3 Plus) is integrated with Sequel's twiist AID system. Abbott is a CGM ecosystem enabler rather than a direct AID competitor, but it plays a central role in the closed-loop therapy stack Sequel depends on.
- Senseonics Holdings: Senseonics is the developer of the Eversense 365 one-year implantable CGM, which is integrated with Sequel's twiist AID system as its first such pairing. Senseonics is a CGM/connected-care peer rather than a direct AID competitor, but is a core integration partner.
Regional players
- Ypsomed: Ypsomed is a Swiss-based diabetes care company marketing its mylife Loop AID solution primarily in Europe. It competes in the same automated insulin delivery category as Sequel but with a distinctly different geographic focus, making it a regional rather than direct U.S. peer.
Market position
Strengths5 records
Weaknesses5 records
Competitive moat5 records
Key risks6 records
Key highlights7 records
Customer concentration
Sequel social profiles
Digital presenceSequel compliance and trust
Trust signalCompliance1 record
Sequel financial estimates
Financial estimateRevenue estimate
Valuation estimate
Sequel leadership team
Management profileNumber of profiles
Profiles18 records
Sequel funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
Sequel M&A and investment
M&A and investmentM&A
Investments1 record
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about Sequel
What does Sequel do?
Sequel Med Tech develops and sells the twiist Automated Insulin Delivery (AID) System, a FDA-cleared insulin pump for people ages 6 and up with type 1 diabetes that uses proprietary iiSure sound wave technology to directly measure insulin volume with every microdose. The system is powered by the Tidepool Loop algorithm and integrates with leading CGMs (Abbott FreeStyle Libre 3 Plus, Senseonics Eversense 365). The company also offers SequelConnect, a benefits platform that helps employers and health plans improve member access to insulin therapy.
Is Sequel a public or private company?
Sequel is a private company. It is classified as founder individual operated bootstrapped and is currently operating.
When was Sequel founded?
Sequel was founded in 2023. It employs 251 to 500 people.
Where is Sequel based?
Sequel is headquartered in Manchester, United States, in the North America region.
How does Sequel make money?
One revenue line is on record: twiist AID System Sales.
Who are Sequel's main competitors?
Direct peers on record are Insulet Corporation and Tandem Diabetes Care. Medtronic Diabetes is listed as a broad incumbent. Emerging players are Beta Bionics, Bigfoot Biomedical and Diabeloop. Others are Dexcom, Abbott Diabetes Care and Senseonics Holdings. Ypsomed is listed as a regional player.
Does Sequel have an API?
No public API is recorded for Sequel.
What industry is Sequel in?
Sequel's product category is Automated Insulin Delivery. Its primary akta.pro industry code is HLAHAHAF, Automated Insulin Delivery (AID) / Closed-Loop Systems, with a secondary code of HLAHAIAG, Insulin Pumps & Patch Pumps. Its NAICS code is 334510 and its SIC code is 3841.