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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.
NovoPen 6 & NovoPen Echo Plus provides the smart addition of a personal injection log. Both pens are compatible with Novo Nordisk insulins in Penfill 3 ml cartridges and work with NovoFine single-use disposable needles. You can transfer your insulin dosing information from your smart pen to your device using the app.
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.
NovoPen 6/NovoPen Echo : Sensor
Sensor uses a thin, flexible filament inserted just under the skin to measure glucose levels every 5 minutes. Push-button applicator allows sensor to be placed on the body in one step.
NovoPen 6/NovoPen Echo : Controller
Smart pen records daily injections and sends them to the compatible app by tapping the device with a compatible smartphone.
NovoPen 6/NovoPen Echo : Receiver
Smart pen and sensor readings displays dosage information directly on smart mobile device.
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.
Discreet and modern option for people using multiple daily injections.
Affordability and Access
$$$$
No insurance coverage data. Anticipated to be provided through Pharmacy.
$$$$
Sometimes covered. NovoPens are covered by some commercial insurance companies; typically, users pay $21 out-of-pocket copays for the eight-month device. Prices range from $0- $78. For those without any insurance coverage, a single pen price is $78.
Data Monitoring Options
Yes
Compatible with Tidepool - a web-based diabetes data management system.
Yes
Hold the dose memory of the pen straight against the Near Field Communication (NFC) spot on your device. Wait while your injection details are automatically transferred to a compatible app on your device. Compatible with multiple data monitoring platforms, including Glooko, MySugr, and Dose Check.
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
Dose-related data can be viewed on the NovoPen 6 & NovoPen Echo apps.
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.
28-day pen (Compatible with 10-day or 14-day sensor)
Sensor lasts for 10-14 days depending on the brand, insulin pen lasts for up to 28 days. Pen has 800-injection dose memory and a five-year battery life. Sensor works between 50ºF - 113ºF and pens can be kept at room temperature for up to 28 days.
Vision / Auditory / Dexterity
YES text to speech
YES vibration alerts
A LOT of dexterity needed
NO text to speech
NO 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.
Light on body. Pens are easy to use and do not remain attached to the body, senor is light on the body.
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.
Limited customizability. System integrates the Dexcom G6/G7 or Libre CGM for high or low alerts but requires manual dose adjustment and limits the ability to adjust insulin levels throughout the day.
Comfort
Low-profile. Low profile with an adhesive design that prevents the pump from catching on other objects.
Many components. Have to carry pens and pen needles. CGM is attached to the body.
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
NovoPen 6: The maximum dose is 60 units, and doses increase in 1-unit increments. NovoPen Echo Plus: The maximum dose is 30 units, and doses increase in 0.5-unit increments
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.
Simple design. Replaces regular insulin pen. No additional devices to add on.
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)
Hideable. Pens are portable but visible when in use. Frequent injections are unavoidable. View recommendations and data on a smartphone.