The tech that powers twiist

Get to know the technology that's seamlessly integrated into the twiist™ AID System

The twiist AID System is the first automated insulin delivery system powered by Tidepool. twiist Loop is based on Tidepool Loop, an intuitive, smart technology that was originally designed by people with diabetes and their caregivers for people with diabetes!

Apps are available for both twiist AID System users and their care circle.

twiist App twiist insiight™ App

Predictive power

Every 5 minutes, twiist Loop makes glucose predictions to create a six-hour glucose forecast based on therapy settings, recent history of insulin delivery, recent history of carb entries and recent CGM readings.¹

Man wearing twiist device and carrying briefcase walking down the street while talking on the phone.

Dynamic adjustments

Basal delivery
Automatically adjusts insulin delivery every 5 minutes to meet your personal Correction Target.

Bolus recommendations 
Uses the six-hour glucose forecast and your Correction Target to calculate precise bolus amounts for carbohydrate and glucose corrections.

Adhesive options for on-body wear are currently being developed

Continuous optimization

The smart technology recalculates its six-hour forecast every five minutes, integrating the latest insulin dosing, carbohydrate, and sensor data to ensure the most up-to-date and accurate diabetes management.

The twiist App with twiist Loop is your diabetes management companion

Your all-in-one diabetes dashboard

No more juggling multiple devices or apps. The twiist home screen gives you a clear view of all your essential data in one place, including your insulin pump status, continuous glucose monitor (CGM) readings, and 6 hour glucose prediction. Get the full picture of your diabetes management at a glance, anytime, anywhere.¹

User-friendly design for a smooth experience

The twiist App includes an intuitive interface that's easy to navigate, fun food emojis to simplify carbohydrate logging, customizable pre-meal and activity presets, and built-in tutorials to help you get started quickly.¹

Next generation diabetes management features

The twiist App helps you log meals and exercise with ease. Change your mind about what you are going to eat after you enter the carbohydrate information? With the twiist App you can easily edit your meal entry and twiist Loop will adjust accordingly.¹

Seamless Apple Watch integration

The twiist AID System takes wearable tech to the next level. How? With most Apple Watch models, you can discreetly check your numbers without pulling out your phone. Best yet, enter carbs and deliver insulin right from your wrist. Manage type 1 diabetes on the go without missing a beat in your daily routine.

Feel more confident with insiight™ into your loved one’s diabetes care

With the twiist insiight App, you can:

View key diabetes management data, including glucose levels, active insulin, and carbohydrate information through your compatible smartphone and connected watch
Now receive notifications! You can get notifications for important glucose and pump events, so you can stay informed, even when you are not right there

Not every insulin delivery system keeps caregivers in the loop. twiist does. With twiist and the insiight App, you can be notified of insulin delivery blockages remotely.^§

The twiist AID System detects blockages up to 9x faster than other insulin pumps² (in as little as 19 minutes)^¶ and the twiist insiight App can notify you of insulin blockage events.

The insiight App is not intended to be a replacement for the information displayed by the twiist System App and should not inform dosing decisions. It is not intended to replace self-monitoring practices as advised by a physician. Data updates require WiFi or cellular connectivity and their frequency may vary depending on connection strength.

^§When comparing labelling of commercially available Caregiver Apps in the United States as of April 2026.

^¶Typical occlusion detection time for the twiist AID System is approximately 19 minutes at a basal rate of 1 unit per hour.

Redefining diabetes management

In other analyses of the Loop Observational Study, the Loop technology demonstrated clinically meaningful improvements across efficacy and psychosocial metrics.^8,10‡

6% Improvement in TIR⁸

Loop users spent more time within target glucose levels, reducing the risk of long-term complications.

90% Reduction in severe hypoglycemia⁸

Dramatically decreasing the occurrence of dangerous low blood sugar episodes.

20% Decrease in diabetes distress¹⁰

Alleviating the emotional and mental burden associated with diabetes management.

21% Improvement in sleep quality¹⁰

Promoting better rest and overall well-being for people with diabetes.

^‡Results obtained with the Loop algorithm using a non-twiist™ device.

INDICATIONS FOR USE

The twiist system is intended for the subcutaneous delivery of insulin, at set and variable rates, for the management of diabetes mellitus in persons requiring insulin, ages six and above. The pump is able to reliably and securely communicate with compatible, digitally connected devices, including automated insulin dosing software, to receive, execute, and confirm commands from these devices. The twiist system is intended for single patient, home use and requires a prescription.

The twiist Loop algorithm is intended for use with compatible integrated continuous glucose monitors (iCGM) and the twiist alternate controller enabled (ACE) insulin infusion pump to automatically increase, decrease, and suspend delivery of basal insulin based on iCGM readings and predicted glucose values. It can also recommend, and with the user’s confirmation, control the delivery of correction boluses when glucose values are predicted to exceed user configurable thresholds. The twiist Loop algorithm is intended for the management of type 1 diabetes mellitus in persons six years of age and greater. The twiist Loop algorithm is intended for single-patient use and requires a prescription.

The twiist Automated Insulin Delivery System includes a simple bolus calculator available when Loop is off. It is indicated for use for aiding the user in determining the bolus insulin dosage for management of diabetes mellitus based on consumed carbohydrates, operator entered blood glucose, insulin sensitivity, insulin to carbohydrate ratio, target glucose values, and current insulin on board.

CONTRAINDICATIONS

The twiist AID System is not intended for anyone unable or unwilling to:

Test blood glucose (BG) levels as recommended by their healthcare provider
Maintain sufficient diabetes self-care skills.
See their healthcare provider regularly
Demonstrate adequate carbohydrate-counting skills (preferred, not required).

The user must not:

Have difficulty seeing
Have difficulty hearing
Have deficient cognitive capabilities
Have physical impairments that would make operating the pump or iPhone difficult

Product not yet available outside of the U.S.

REFERENCES

1. Sequel Med Tech - twiist Automated Insulin Delivery (AID) System Powered by Tidepool User Guide.
2. Calculation based on a comparison of the following IFUs. The following reported 1 U/hr basal rate: Sequel Med Tech - twiist Automated Insulin Delivery (AID) System Powered by Tidepool User Guide; lnsulet - Omnipod 5 Automated Insulin Delivery System User Guide; Medtronic - MiniMed 780G system User Guide; Beta Bionics - iLet Bionic Pancreas System User Guide. The following reported 2 U/hr basal rate: Tandem Diabetes Care - t:slim X2 Insulin Pump User Guide; Tandem Diabetes Care - Tandem Mobi System User Guide.
3. lnsulet - Omnipod 5 Automated Insulin Delivery System User Guide.
4. Medtronic - MiniMed 780G system User Guide.
5. Beta Bionics - iLet Bionic Pancreas System User Guide.
6. Tandem Diabetes Care - t:slim X2 Insulin Pump User Guide.
7. Tandem Diabetes Care - Tandem Mobi System User Guide.
8. Lum JW, et al. A Real-World Prospective Study of the Safety and Effectiveness of the Loop Open Source Automated Insulin Delivery System. Diabetes Technol Ther. 2021;23(5):367-375.
9. Klonoff DC, et al. Time to Moderate and Severe Hyperglycemia and Ketonemia Following an Insulin Pump Occlusion. J Diabetes Sci Technol. 2024;18(6):1472-1479.
10. Wong JJ, et al. Psychosocial Effects of the Loop Open-Source Automated Insulin Delivery System. J Diabetes Sci Technol. 2023;17(6):1440-1447.
11. Butterfield RD, et al. Performance of a Continuous Subcutaneous Insulin Infusion (CSII) Pump With Acoustic Volume and Flow Sensing in Simulated High-Consequence Situations. IEEE Open J Eng Med Biol. 2024;5:593-599.

*The twiist™ Savings Program is available to individuals with a valid prescription and commercial insurance that covers twiist. Eligible participants can receive a Starter Kit for $0 and pay no more than $50 for Refill Kits. This offer is not valid for individuals enrolled in Medicare, Medicaid, or any other federal or state programs, or for cash-paying patients and non-covered claims. It is available only in the U.S. and is not valid in Puerto Rico, U.S. Territories, or where prohibited by law. While most commercially insured participants qualify for the $50 Refill Kit offer, those with high-deductible plans who haven't met their deductible may pay more than $50 per Refill Kit until their deductible is met. The maximum benefit is $200 per Refill Kit for covered claims. Terms are subject to change. Call us at 1-877-489-4478 or contact your insurance provider to confirm coverage.  

^†Sequel is working on adhesive options for on-body wear. Alternative adhesive options are available through third-party providers.

^‡Results obtained with the Loop algorithm using a non-twiist device.

Product for prescription only, for Important Safety Information please visit FreeStyleLibre.us
‍The sensor housing, FreeStyle, Libre, and related brand marks are marks of Abbott and used with permission.

The Eversense 365^® Continuous Glucose Monitoring (CGM) System is indicated for continually measuring glucose levels for up to one year in people (18 years and older) with diabetes. For important safety information, see bit.ly/eversensesafety.

“twiist,” “iiSure,” and the twiist logo are licensed trademarks of Sequel Med Tech, LLC. “Tidepool” and the Tidepool logo are trademarks of Tidepool Project, a fully-qualified 501(c)(3) nonprofit organization. © 2026 Sequel Med Tech, LLC. All rights reserved.