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Select Device Freestyle Lingo Freestyle Libre 3 Freestyle Libre 2 Freestyle Libre 14 Day Dexcom G7 Dexcom G6 Dexcom Stelo Guardian Connect Medtronic Simplera Eversense Meter Omnipod Omnipod Dash Medtronic 780G Medtronic 630G Tandem t:slim X2 Bigfoot Unity Medtronic InPen Tempo Pen NovoPen 6/NovoPen Echo Insulin Pen Afrezza CeQur Simplicity Patch V-Go Patch Omnipod GO Patch Syringe and Vial Beta Bionics iLet Pancreas Control IQ with Dexcom Control IQ with Freestyle Libre Medtronic 780G with Smart Guard Omnipod 5 Tandem Mobi Tidepool Loop twiist DIY Loop Apple Series 6/7/8/9/10/SE (2nd Generation) Garmin vívosmart 5™ Garmin Venu Sq 2 Garmin Venu 3 Garmin vivoactive 5 Garmin Fenix 8 Garmin vivofit jr 3 Garmin Forerunner 165/265/965 Garmin epix (Gen 2) Garmin Enduro 3 Fitbit Ace LTE Fitbit Charge 6 Fitbit Inspire 3 Fitbit Versa/Versa 2/4/Versa Lite Fitbit Sense 2 Fitbit Luxe Google Pixel 2/3 Samsung Galaxy 4/5 Xiaomi Mi Band 9 Oura Ring Whoop 4.0 Withings ScanWatch 2 Withings ScanWatch Lite Pedometer 3D Pedometer
Summary
Traditional syringe and needle. The most affordable insulin delivery option.
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
Syringe and Vial : Bolus Insulin
Bolus (fast-acting) insulin vial for meal time or high blood sugar correction.
Syringe and Vial : Basal Insulin
Basal (long-acting) insulin vial for steady release of insulin that helps control blood sugar between meals, and overnight.
Syringe and Vial : Needles
Classic syringes with plunger used to fill insulin for injection
twiist : Pump
Pump can be worn with a pump clip, adhesive patch or in a pocket.
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
An infusion set contains the thin plastic tubing that delivers insulin from the pump to the body.
Device Details
Overview
Nothing on the body when not in use but very visible when dosing.
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
$$$$
Syringes are available worldwide in pharmacies or DME without prescription. Price Range: $0-$300/month depending on insurance coverage.
$$$$
No insurance coverage data. Anticipated to be provided through Pharmacy.
Data Monitoring Options
No Options
Yes
Compatible with Tidepool - a web-based diabetes data management system.
Data View Options
No Options
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
28 Days
Open vials can be stored at room temperature (not above 80º F) for up to 28 days. Unopened vials should be stored in the refrigerator (36ºF - 86ºF.)
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
NO text to speech
NO vibration alerts
A LOT dexterity for insertion
YES text to speech
YES vibration alerts
A LOT of dexterity needed
Patient Considerations
Active Lifestyle
Limited Adjustability. No way to adjust long-acting insulin for higher activity on the fly.
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
Limited customizability. Requires a high level of engagement and effort to avoid highs and lows but can be paired with a CGM for improved blood sugar control.
Automatically adjusts insulin delivery. Increases or decreases insulin delivery to meet glucose targets. Insulin delivery settings can be aggressive or conservative.
Comfort
Many components. Must carry insulin vials and large syringes but nothing attached to the body.
Low-profile. Low profile with an adhesive design that prevents the pump from catching on other objects.
Easy Insulin Dosing
Requires attention. You have to do the math to figure out your dose. Unable to adjust basal in real-time.
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
Many steps. Requires effort to figure out doses and deliver insulin every single time you need it.
Watch compatible. The twiist AID system is the first FDA-approved AID system that can be directly controlled from an Apple Watch.
Fewer Fingersticks
Frequent finger-sticks are required.
Factory-calibrated sensor. Fingersticks needed for backup only.
Privacy
Hideable. Vials and syringes can be hidden when not in use but very visible when in use. Frequent injections are unavoidable.
Discreet. The pump is in two pieces - the top (algorithm and battery) and the bottom (insulin chamber and AVS technology)