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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 Medtronic MiniMed™ 780G system is designed with SmartGuard™ technology, which can help with the occasionally missed meal or inexact carb counts. It provides automatic basal adjustments to manage glucose levels to a prespecified target (100 mg/dL [5.5 mmol/L], 110 mg/dL [6.1 mmol/L], or 120 mg/dL [6.7 mmol/L]) and auto correction bolus, every 5 minutes. The advanced hybrid closed-loop system uses current and past glucose trends from the Guardian™ 4 sensor to detect a rapid rise (e.g., a missed meal) in sensor glucose. No fingersticks required when the SmartGuard™ feature is active.
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.
Medtronic 780G : Pump
Pump connects tubing to a small patch called an infusion set that attaches to the body.
Medtronic 780G : Sensor
Sensor is inserted underneath the skin, either on the abdomen or arm.
Medtronic 780G : Controller
Pump receives CGM readings and automatically adjusts insulin delivery. Data from the pump and CGM viewable on compatible smartphones.
Medtronic 780G : Infusion Set
An infusion set contains the thin plastic tubing that delivers insulin from the pump to the body.
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.
This system is integrated and has a customizable settings. Many providers are familiar with Medtronic products.
Affordability and Access
$$$$
No insurance coverage data. Anticipated to be provided through Pharmacy.
$$$$
Coverage information is not yet available. Price range; $0-10,769 to start and $0-$300/Month. Price range varies depending on insurance coverage.
Data Monitoring Options
Yes
Compatible with Tidepool - a web-based diabetes data management system.
Yes
CareLink connect is available for care partners with up to five people who can follow a pump user and receive high and low notifications to help keep everyone in the loop.
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
Data is viewed on compatible smart devices through the MiniMed Mobile App. You can download and view pump or CGM data on CareLink.
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.
7-day pump 7-day sensor
Sensors last 7 days, transmitter needs weekly charging, store between 36 °F - 86 °F. Pump can be used for up to 7 days with the extended infusion set and works between 40ºF - 104ºF.
Vision / Auditory / Dexterity
YES text to speech
YES vibration alerts
A LOT of dexterity needed
NO 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.
Temp Target. Manually increase blood sugar target range to 150 mg/dl during activity. Temp target can run 30 minutes to 24 hours in 30-minute increments. Auto corrections are disabled. The pump is not waterproof.
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.
Customizable auto-bolus. Auto-correct bolus corrects highs if carb counts are miscalculated or bolus is occasionally missed. The system aims to maintain a target blood glucose level between 100 mg/dL and 120 mg/dL depending on personalized target glucose settings. Auto-bolus is available every 5 minutes to correct blood sugar between 100 mg/dL and 120 mg/dL (12 corrections per hour). Automatic insulin delivery settings are adjustable.
Comfort
Low-profile. Low profile with an adhesive design that prevents the pump from catching on other objects.
Somewhat comfortable. Medtronic sensors need more tape than other sensors. Largest pump option.
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
Automatically adjusts settings. Automatically adjusts insulin to reach personalized target between 100 mg/dL and 120 mg/dL. Will automatically revert to manual mode in certain situations. Basal and bolus in 0.025 increments. Extended bolus unavailable when using automated insulin delivery mode.
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.
Easy software. Software makes many dosing decisions. Can be difficult to keep automatic insulin dosing features working. Requires fewer parts than do-it-yourself systems.
Fewer Fingersticks
Factory-calibrated sensor. Fingersticks needed for backup only.
Factory-calibrated sensor. Fingersticks 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 discrete. Ability to check blood sugar on phone or watch. Pump has tubing but can be clipped to clothing or placed in a pocket to be discreet when needed.