Startup Spotlight: UAE-Born Meta[bolic] Is Redefining Healthcare

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In the evolving landscape of healthtech, innovative startups are reshaping the way wellbeing is approached. A trailblazer in this field is a company born in the UAE, co-founded by Ali Hashemi and Ihsan Almarzooqi: meta[bolic]. In the five years since its inception, the startup has grown beyond its initial remit, and has made its impact felt in the burgeoning wearables industry as well.

The company’s evolution began with the creation of GluCare.Health in 2019 as a diabetes management platform, following which Zone.Health, a weight management platform, was launched. Both were then absorbed under the meta[bolic] umbrella– which essentially builds the tech that powers both these platforms. Both of them were created with the belief that hybrid healthcare -marrying traditional care with digital health and virtual care- was the future. “This thesis gelled into a vision to build a continuous model of care that delivered superior outcomes by giving agency back to our patients– where we define agency as the ability to turn data into knowledge, into insight, into action, into measurable outcomes,” Hashemi, who is also the CEO of meta[bolic], says. “What that meant in a practical sense was harnessing the full potential of all the continuous forms of data we’re already capable of producing, from wearables and connected devices, with a hyper-personalized physical footprint that served to translate data correlations into actionable insights for our patients. An engagement platform, if you will, around best-in-class clinical care, powered by data driven insights.”

Successful startups need to identify a gap in the market, and the co-founders of meta[bolic] were able to do just that. Believing that first-generation digital health companies already tackled metabolic health, but did not manage care provision and had also misaligned incentives at the grassroots level, the meta[bolic] team set out to create a way to deal with this issue- and that’s how GluCare.Health came into being. “We felt that was an important gap, and set out to build a platform that would take the best of both worlds and deliver a care model that was both comprehensive and continuous,” Hashemi says.

However, Hashemi admits doing so was a risk. “Of course, we were going against the grain, and when one of the ‘OG’ virtual care startups, Livongo, was acquired by Teladoc for over US$18 billion, consensus would have been that we were on the wrong track with our less obviously scalable hybrid model,” Hashemi recalls. “But that didn’t discourage us.”

In addition, being self-funded allowed meta[bolic] to take risks and execute decisions swiftly, Hashemi says. “We were self-funded, and willing to take the risk on our bet that hybrid healthcare would ultimately earn the right to win,” he notes. “We deconstructed every aspect of the patient journey, both physical and virtual, and re-assembled it into something that was both seamless and magical for our patients, but also something that within the first year was delivering among the best outcomes in the world. Livongo’s best published results were a 1% reduction in HbA1c (one’s average blood glucose levels for the past two to three months) in 180 days, whereas GluCare delivered 2.1% reduction in half the time- a hugely unprecedented improvement.”

Since the launch of GluCare and the subsequent establishment of Zone and meta[bolic], it’s been a period of non-stop execution for the company, and the last 12 months have been busier than ever, says Hashemi. “Having demonstrated the clinical superiority of the model itself, we spent much of 2023 institutionalizing what we’d learned, and templating what we had built for replication and growth, both on the physical footprint, as well as in the cloud,” the CEO says. “We embarked on a complete rebuild of our tech stack to incorporate the valuable insights our patients shared with us about their journeys. We continued to publish in the world’s leading scientific journals, and push the envelope on the introduc- tion of hybrid care into the mainstream.”

Here, Hashemi reiterates the advantage of being self-funded, and not having to raise capital in what could have otherwise been a challenging year. “Candidly, the fact that we were self-funded afforded us a degree of intellectual and execution freedom to take risks that we otherwise may not have been able to take had we been custodians of outside investor capital,” he reveals. “That freedom to think, ideate, test, fail, and iterate was something we did to an extreme, and, while conceptually that should underpin every disruptive startup’s ethos, there’s always a cloud of investor sentiment that might guide or guardrail a startup in a certain way– and that might not be ideal.”

Perhaps it’s this freedom to take risks is what governed meta[bolic]’s collaboration with ŌURA, the company behind Oura Ring, the smart ring that delivers accurate, personalized health data, insights, and daily guidance into sleep, activity, readiness, and recovery, which was announced in January this year. While historically, merging wearables with clinical care has been a struggle -mostly due to technology not being at the right place- the process is now more or less straightforward. ŌURA data -which includes detailed sleep analysis and daytime stress scores- will be integrated into the GluCare.Health platform, providing a holistic view of individual metabolic health. This data will be directly accessible to healthcare professionals, enabling them to make informed decisions and personalize treatment plans. Commenting on how this partnership came to be, Hashemi says it was a “serendipitous” occurrence. “I’d met ŌURA’s chief scientist through a friend and colleague at Harvard Medical School with whom I am engaged on clinical trials for another portfolio company,” he shares. “In parallel, our friends over at Jazz Ventures (early investors in ŌURA) thought what we were working on was interesting, and connected us with Tom Hale, ŌURA’s CEO. There was immediate alignment on mission and vision, and the partnership was cemented.”

The collaboration with ŌURA is expected to deepen the understanding of digital biomarkers related to sleep and stress, contributing significantly to metabolic dysfunction. “As far as clientele goes, we’re very excited about the prospect of our patients discovering the power of the ŌURA Ring as part of their clinical journey,” Hashemi says. “We’re also equally excited about the opportunity to serve ŌURA’s existing clientele more broadly as we expand into new markets. This collaboration also serves to push further the consolidation of what was siloed into ‘medical/clinical’ with what has historically considered ‘wellness/ lifestyle’ into a single multifaceted and comprehensive service to consumers.”

Collaborating with ŌURA, the company behind the Oura Ring, has let meta[bolic] make its mark in the wearables industry. Image courtesy: meta[bolic]

Meanwhile, in addition to the company’s work over the last year, Hashemi reveals that there are plans to shift towards a business model with GluCare where the focus is on being rewarded for the results delivered. For instance, GluCare’s current business model for the care of diabetics, Hashemi says, is the typical insurer-driven model of reimbursement. “In other words, we are reimbursed for the time that we spend and the things we do for our patients,” he explains. “This, however, is a flawed model- we want to move away from getting paid for the things that we do, and rather move toward a model where we are rewarded for the results we deliver. That’s a long-term disruptive goal that we’ll need to keep chipping away at together with partners. Our target here will be primarily employers, as they ultimately own the risk pool that we’re able to effectively mitigate.”

Meanwhile, for the weight loss program, the company makes use of a different revenue model altogether, and it is expected to stay the same for the foreseeable future. In terms of the future, while meta[bolic] has been self-funded so far, Hashemi admits that this may change soon. “As we expand our network of clinics, we’ll endeavor to fund that growth via non-dilutive capital,” he says. “We may, at some point, raise strategic or venture capital to fuel expansion of the core platform, so we’re having early conversations with selected investors on that front in preparation.”

The enterprise has also growth in its sights for the next 12 months. “Expansion into new markets is a priority for this year, as well as an expansion of our service offering to include more for members who are interested in staying ahead of any changes in their metabolic functions,” Hashemi says. “We are enhancing our healthspan and longevity offerings as well, with curated peptide protocols and regularized testing programs. But there is still much for us to learn, and many ways for us to improve our core value proposition, which we will continue to do.”

Image courtesy: meta[bolic]

Talking about his own career trajectory, Hashemi views entrepreneurship in healthcare as “a great privilege, as you’re able to do well and do good simultaneously. As a second-time founder (well, third time, if we count my first failed startup right out of university), the objective this time around was to tackle a problem of scale and consequence.” Of course, the entrepreneurial path is not without its challenges, and Hashemi’s journey with meta[bolic] has been no different. “I’ve faced quite a number of existential challenges throughout my life and career, from getting expelled from medical school three times, to having an unscrupulous competitor in a past startup life attempt to bankrupt and destroy our fledgling company,” he reveals. “While some of these challenges did feel like they changed my DNA at a molecular level, what I ultimately learned is to have gratitude for adversity. Only with that mindset can one maintain the grit and persistence to work through the inevitable seemingly insurmountable challenges that face entrepreneurs, and power through -and ultimately surpass- them. On each occasion, I came out stronger on the other side.”

‘TREP TALK: Meta[bolic] Co-Founder Ali Hashemi Shares His Tips For Entrepreneurs
Earn the right to win
“This is my go-to phrase, and it fits the startup mentality perfectly. Getting to the finish line is about demonstrating a maniacal determination to be the best at what you do, and earning the right to serve your customers and stakeholders.”
Get to first principles
“This one has been circulating for quite a while, made famous by Elon Musk’s repetitive ‘ask why’ approach to problem-solving, but it’s worth resurfacing in the context of healthcare. Focus on what matters most in driving superior outcomes, stay accountable to that outcome, and clear away the clutter that interferes with that.”
Be your own biggest critic
“Wake up each morning, look in the mirror, and tell yourself that there’s likely someone out there with more experience, a better network, and more money than you looking at solving the same problem you’re looking at. Do this not with a defeatist or nihilistic lens, but rather as an exercise of humility that forces you to focus on #1 and #2.”

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