Sequel

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.

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

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

• Automated insulin delivery
• Diabetes management devices
• Insulin pump systems
• Continuous glucose monitoring
• Type 1 diabetes care

Headquarters

HQ city

Manchester

HQ country

United States

HQ region

North America

Offices2 records

Markets served

GTM type

B2C

Offering type

Hardware or Manufacturing

Cost components

Technology or R&D, Supply Chain, Marketing or Sales, Personnel, Operations

Revenue model

1. 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

Go-to-market motion2 records

Distribution channels3 records

Marketing channels6 records

Core 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

Named customers3 records

Segments5 records

Ideal customer profiles4 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration3 records

AI capability2 records

Feature3 records

Partnerships

Six partnerships are on record, tiered core.

• Senseonics HoldingscoreTechnology or Integration · 19 February 2026Integration 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.
• DiabeloopcoreTechnology or Integration · 13 January 2026Collaboration 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 TherapeuticscoreStrategic or Co-development Partner · 25 September 2025Co-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)coreTechnology or Integration · 18 March 2025Integration 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.
• TidepoolcoreTechnology or IntegrationPowered 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.coreStrategic or Co-development PartnerDEKA, 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

Direct 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

• YouTubeyoutube.com/@twiist_diabetes
• Facebookfacebook.com/twiistdiabetes
• Instagraminstagram.com/twiistdiabetes
• TikToktiktok.com/@twiistdiabetes
• LinkedInlinkedin.com/company/sequel-med-tech

Compliance1 record

Revenue estimate

Valuation estimate

Number of profiles

Profiles18 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments1 record

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Sequel