medtronic receiver v2
twiist AID systempng

Summary

The Medtronic Guardian Connect is a continuous glucose monitoring (CGM) system that provides real-time glucose data on a compatible smartphone. The system offers optional low and high blood sugar notifications and can be inserted on the abdomen or back of the upper arm.

 

MARD of 9.6%

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

Guardian Connect : Sensor

Guardian Connect : Sensor

Sensor is inserted underneath the skin, either on the abdomen or arm. Push buttons applicator allows sensor to be placed on the body in one step.

Guardian Connect : Transmitter

Guardian Connect : Transmitter

Seashell-shaped with built-in Bluetooth capability that allows it to send glucose data directly to a smartphone every 5 minutes.

Guardian Connect : Receiver

Guardian Connect : Receiver

Trends and alerts are viewed directly on a mobile device. 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

One of the larger sensors, may be cumbersome to wear on some parts of the body under clothes.

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

$$$$
Sometimes covered. The costs vary depending on individual insurance coverage and how insurance classifies CGMs. Price range $0-$600/month.

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

Data Monitoring Options

Yes
CGM data can be linked to a CareLink account and shared with the user's health care team. 

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

Data View Options

Yes
The Guardian Connect mobile app allows users to view glucose levels, trends, create customizable alerts, and share blood glucose data with family and friends. 

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

7 Days
Sensors last 7 days, and transmitter battery needs weekly charging and replacement once a year. Both can be stored between 36°F - 86°F.

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
A LOT
of dexterity needed

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

Patient Considerations

Active Lifestyle

Waterproof transmitter when submerged in up to 2.5 meters of water for 30 minutes and must be within 20 feet of a connected mobile device.  

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

Measures sensor glucose 24/7 and sends alerts when a high or low is detected. 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

More tape is needed for Medtronic sensors.

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

Easy Insulin Dosing

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

Rechargeable sensor transmitter but has the most steps to change sensor.

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

Fewer Fingersticks

2 daily finger-sticks are needed to calibrate the sensor.

Factory-calibrated sensor. Fingersticks needed for backup only.

Privacy

Somewhat discreet. Ability to see sugar on watch or phone. Sensor requires regular meter use.

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