Your ‘Digital Twin’ Could Help Control Type 2 Diabetes

From verywellhealth.com

Key Takeaways

• An AI-driven system that collects sensor data, lab data, and patient feedback may be able to greatly improve the health of people with type 2 diabetes.
• Taken together, the data from the system allows healthcare coaches and providers to make specific recommendations for a patient.
• Preliminary results from an ongoing clinical trial found that some patients were able to come off anti-diabetes medications within four months of using the "digital twin" system.

Devlin Donaldson, 64, of Colorado Springs, Colorado, was diagnosed with type 2 diabetes in 2015. His employer’s insurance company contacted him in early 2020 about a new, personalized system that could help manage his condition, but he didn’t believe anything could help him get his diabetes under control.

“I was kind of losing hope,” Donaldson tells Verywell. “I had decided that I was never going to get my arms around this and figure out exactly what I needed to do or how to do it. Managing diabetes seems ongoing, never-ending, and without a lot of up-side.”

Still, he gave the system, called Whole Body Digital Twin, a try.

“I was told I had a chance to heal my body. There was a chance I could reverse this,” Donaldson says. “I was hooked.”

Digital twin technology, or software replicas of patients, is a relatively new concept in medicine. Using information ranging from age and weight to activity levels and smoking status, a digital twin can help predict a patient’s response to a new prescription, or map out what lifestyle changes would best control, reverse, or prevent chronic conditions.

Twin Health

Whole Body Digital Twin is specifically designed to create a representation of person’s metabolism via an app-based tool. Thanks to a combination of blood tests, biometric data, and patient-provided information, the app allows healthcare providers to recommend various adjustments to diabetic patients.

The level of precision seems to be able to control—and even reverse—type 2 diabetes.

When he started using the digital twin, Donaldson had an A1C level of 10.1%—well above the threshold needed to be considered diabetic. He was using several medications in an attempt to keep his diabetes under control. But at the 180-day mark of using the system, his A1C level was 6%, and he was taken off all his medications. He has lost about 50 pounds. The waist size on his pants has gone from 42 inches to 34, he says.

“It’s not a hard program for me to stick with because I’m seeing results,” Donaldson says.

He’s not the only one. An interim analysis of an ongoing control trial of Whole Body Digital Twin in 33 people found that 13 patients lowered their haemoglobin A1C levels to below 5.7%—a level considered normal—after four months using the system. Nineteen others lowered their A1C levels to below 6.4%—a level indicative of prediabetes rather than diabetes.

Twelve patients who had been using oral diabetes medication were able to stop using them. Two patients using insulin no longer need it after 90 days.

How Does It Work?

Thanks to five wearable sensors, the Whole Body Digital Twin system collects 3,000 data points per day on each person with a digital twin. Information is collected via:

• An activity monitor that tracks steps and sleep
• A continuous blood glucose monitor
• A blood pressure cuff
• A scale that measures body weight and body composition
• A ketone meter

The data are sent to an app where patients enter information and answer questions about their diet, lifestyle, and activity. A person’s lab results can also be included.

“By taking all of that data in we can build a replica of a person's metabolic state," Lisa Shah, MD, chief medical officer of Twin Health, the company behind Whole Body Digital Twin, tells Verywell. “We’re continuously monitoring their metabolism, and because we can continuously monitor it, we can see the changes that demonstrate the healing process.”

Based on the data collected, a coach provided by Whole Body Digital Twin is able to make recommendations and create interventions across five key areas: nutrition, medication, sleep, activity, and breathing.

“Our health coach is partnered with members and spends a lot of time just learning about what they love in life, what they enjoy, what makes them happy,” Shah says. “Because if we make recommendations that are going to make them miserable, they’re never going to do it.”

Shah says both her parents are using Whole Body Digital Twin after 32 years with diabetes. Both now have normal blood glucose levels and have controlled their high blood pressure.

For Donaldson, setting up the system was the most challenging part. He says that it took him a day or two to get used to using the app and the Bluetooth-enabled equipment. He logs in what he eats each day, how much water he drinks, and other information into the app, but the app also gives him feedback.

“I probably check it every hour or so,” he says. He credits the support from his coach with helping him believe he could reverse his diabetes.

Clinical Trials Underway

A four-centre clinical trial of the Whole Body Digital Twin is underway, Shah says. The study will run for several years and is the one that the interim paper is based on. Another clinical trial is about to begin at single medical centre, she adds.

Because the Whole Body Digital Twin system uses sensor technologies and devices like activity monitors and body weight scales that have already received approval, it does not need approval from the Food and Drug Administration (FDA), she says.

Twin Health is already working with two insurance companies to offer the system to patients with type 2 diabetes. They expect that insurance companies or employers will pay the costs of the system, rather than patients. About 5,000 people are now using the Whole Body Digital Twin.

https://www.verywellhealth.com/type-2-diabetes-digital-twin-5206096