freestyle libre 2 device image
twiist AID systempng

Summary

The FreeStyle Libre 2 is the thinnest, all-in-one glucose sensor/transmitter and requires scanning using a handheld reader or compatible smartphone with an app. This sensor lasts for 14 days and only needs fingersticks as backup. Optional low and high blood sugar notifications are available for this system. 

FDA approved for insertion on the back of the upper arm (ages 4 years and older).

 

MARD of 9.3%

The twiist AID system was cleared by the FDA for use with CGMs that have received FDA designation as integrated continuous glucose monitors (iCGMs). As the twiist AID system gets closer to commercial availability, Sequel Med Tech will publicize the list of compatible CGM

*Recently FDA approved for people with type 1 diabetes ages 6 and up.

Components

Freestyle Libre 2 : Sensor

Freestyle Libre 2 : Sensor

Sensor uses a thin, flexible filament inserted just under the skin to measure glucose levels every minute. Push-button applicator allows sensor to be placed on the body in one step.

Freestyle Libre 2 : Receiver

Freestyle Libre 2 : Receiver

Conveniently access glucose readings using a reader, smartphone, or both. Available for both iOS and Android devices.

twiist  : Pump

twiist : Pump

Pump can be worn with a pump clip, adhesive patch or in a pocket.

twiist  : Controller

twiist : Controller

Pump is controlled by the twiist app on an iPhone. Data from both the pump and CGM are viewable on the twiist app Home Screen.

Twiist  : Infusion Set

Twiist : Infusion Set

An infusion set contains the thin plastic tubing that delivers insulin from the pump to the body.

Device Details

Overview

All-in-one glucose sensor/transmitter with low and high blood glucose alarms can be worn on the upper arm.

This system automatically adjusts insulin delivery according to continuous glucose monitor (CGM) readings and predicted blood sugar levels. It is the first FDA-approved AID system with Apple Watch compatibility.

Affordability and Access

$$$$
Widely covered. Provided by pharmacies. Price range; $0-$100/month. Often the cheapest and easier to access sensor. 

$$$$
No insurance coverage data. Anticipated to be provided through Pharmacy.  

Data Monitoring Options

Yes
After each sensor scan with the mobile app or reader, data is automatically sent to the user’s LibreView account which enables sharing with HCPs and caregivers via the LibreLinkUp app. Data upload is possible with Glooko and Tidepool data-management systems.

Yes
Compatible with Tidepool - a web-based diabetes data management system. 

Data View Options

Yes
Freestyle Libre 2 app provides glucose readings and alarms, multiple data views, the ability to share glucose data and real-time alarms with LibreLinkUp, and the ability to connect to a clinician's practice through LibreView. 

Yes
Data is stored and can be viewed directly from the twiist app on the mobile device (iPhone), and can be linked to an Apple Watch for viewing data as well.

 

Duration and Storage

14 Days
Sensors last 14 days and work between 50ºF - 113ºF. They are shipped in orders of 1-3 months at a time - which is 2-6 boxes at a time.

3-day pump 10-day sensor
Sensors last 10 days, and transmitters last 90 and work at 50ºF – 108ºF. The reservoir holds 300 units and is disposable, and the pump can be used for up to 3 years.

Vision / Auditory / Dexterity

YES text to speech
YES vibration alerts
3 sound sources
A LOT of dexterity needed

YES text to speech
YES vibration alerts
A LOT of dexterity needed

Patient Considerations

Active Lifestyle

Water-resistant for up to 3 feet deep for 30 minutes and light on the body, does not get in the way of activity. The reader must be within 1.5 inches of the sensor to scan it. 

Waterproof. The pump, when connected to the cassette, has a rating of IP28, indicating protection from continuous immersion in water. The pump can tolerate immersion to depths of up to 12 feet (3.7 m) for 1 hour.

Avoiding Highs and Lows

Optional glucose alerts for low and high glucose levels. Trend arrows show the direction glucose is heading, with the rate of change. 

Automatically adjusts insulin delivery. Increases or decreases insulin delivery to meet glucose targets. Insulin delivery settings can be aggressive or conservative.

Comfort

Low profile sensor and small adhesive.

Low-profile. Low profile with an adhesive design that prevents the pump from catching on other objects. 

Easy Insulin Dosing

Scanned sensor trends can be used for dose adjustment.

Customizable. Can bolus from phone, smartwatch, or directly from the device without needing to be attached to your phone. The device also directly measures the volume (amount) and flow (speed) of insulin delivered with every micro-dose

Easy to Use

Requires scanning. Self-application and manual scanning are required. Easy self-application.

Watch compatible. The twiist AID system is the first FDA-approved AID system that can be directly controlled from an Apple Watch.

Fewer Fingersticks

Factory-calibrated sensor. Finger-sticks needed for backup only. 

Factory-calibrated sensor. Fingersticks needed for backup only.

Privacy

Hypoglycemia safety alarm. Discreet size but built-in hypoglycemia safety alarm alerts users when glucose is below 55 mg/dl and is always on. 

Discreet. The pump is in two pieces - the top (algorithm and battery) and the bottom (insulin chamber and AVS technology)