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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
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.
The FreeStyle Libre 14-day is an all-in-one glucose sensor/transmitter that lasts for 14 days and only needs fingersticks as backup. . This sensor is a flash glucose monitor that requires scanning using a compatible smartphone app or a handheld reader.
FDA approved for insertion on the back of the upper arm (ages 4 years and older).
MARD of 9.4%
Components
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.
Freestyle Libre 14 Day : 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 14 Day : Receiver
Conveniently access glucose readings using a reader, smartphone, or both. Available for both iOS and Android devices.
Device Details
Overview
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.
All-in-one glucose sensor/transmitter can be worn on the upper arm.
Affordability and Access
$$$$
No insurance coverage data. Anticipated to be provided through Pharmacy.
$$$$
Widely covered. Provided by pharmacies. Price range; $0-$100/month. Often the cheapest and easier to access sensor.
Data Monitoring Options
Data View 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.
Yes
Freestyle LibreLink app displays glucose readings directly on the patient's compatible smart device.
Duration and Storage
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.
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.
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. 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.
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.
Avoiding Highs and Lows
Automatically adjusts insulin delivery. Increases or decreases insulin delivery to meet glucose targets. Insulin delivery settings can be aggressive or conservative.
Alerts are not available. High or low glucose alarms are not available. Trend arrows show the direction glucose is heading, with the rate of change.
Comfort
Low-profile. Low profile with an adhesive design that prevents the pump from catching on other objects.
Lowest profile sensor and smallest adhesive.
Easy Insulin Dosing
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
Scanned sensor readings can be used for dose adjustment.
Easy to Use
Watch compatible. The twiist AID system is the first FDA-approved AID system that can be directly controlled from an Apple Watch.
Requires scanning. Self-application and manual scanning every 8-hours are required. Easy self-application.
Fewer Fingersticks
Factory-calibrated sensor. Fingersticks needed for backup only.
Factory-calibrated sensor. Finger-sticks needed for backup only.
Privacy
Discreet. The pump is in two pieces - the top (algorithm and battery) and the bottom (insulin chamber and AVS technology)
Somewhat discreet. Scanning feature makes it easy to monitor blood glucose levels discreetly.