twiist
CeQur Simplicity Patch
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.
Cequr Simplicity is a thin and simple insulin delivery patch for mealtime and correction insulin. The 3-day wearable patch doses two units of insulin with every squeeze of the buttons on either side of the device. Users can fill their CeQur Simplicity patch with 100-200 units of rapid-acting insulin. This device is a hybrid between injections and an insulin pump to allow for discreet dosing without the need for programming or multiple injections.
FDA-approved for both type 1 and type 2 diabetes in people 21 years of age and older.
Components
Infusion Set
An infusion set contains the thin plastic tubing that delivers insulin from the pump to the body.
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.
Pump
Pump can be worn with a pump clip, adhesive patch or in a pocket.
Applicator
Patch uses a thin, flexible cannula inserted just under the skin to deliver insulin. Push-button applicator allows patch to be placed on the body in one step.
Reservoir
Fill reservoir is enclosed with the Patch and used to manually fill the Patch with insulin.
Patch
Wearable insulin patches come with reservoirs and directions for application. They can be applied on the abdomen.
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.
Convenient, discreet, and simple to use.
Affordability and Access
$$$$
No insurance coverage data. Anticipated to be provided through Pharmacy.
$$$$
Widely covered for insulin-dependent type 1 and 2. Supplies provided by DME or pharmacy. Price range; $0-$500/Month. When covered, most patients have a co-pay of $50 or less a month. Insurance plans and pharmacy benefits may vary.
Data Monitoring Options
Yes
Compatible with Tidepool - a web-based diabetes data management system.
No 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.
No Options
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.
3 Days
Patch can be worn for up to 72 hours and works in most temperatures (not for use in hot tubs, saunas, or freezing conditions). Does not require batteries or recharging.
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.
Limited Adjustability. No way to adjust long-acting insulin for higher activity on the fly, but the device is water resistant.
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 requires manual dose adjustment and limits the ability to adjust insulin levels throughout the day. If you need basal (background) insulin, you’ll still need to take it in addition to wearing the CeQur Simplicity.
Comfort
Low-profile. Low profile with an adhesive design that prevents the pump from catching on other objects.
Free of tubing. Patches do not have tubing and they're less bulky than traditional insulin pumps but it must be worn in areas that are easy to reach for insulin dosing.
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
Easy to Use. Squeezing the buttons on either side of the device delivers insulin in two-unit increments for dosing insulin for meals and correction.
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 with few steps. Patch is replaced every 3 days with insulin administered at the click of a button.
Fewer Fingersticks
Factory-calibrated sensor. Fingersticks needed for backup only.
Frequent finger-sticks are required.
Privacy
Discreet. The pump is in two pieces - the top (algorithm and battery) and the bottom (insulin chamber and AVS technology)
Hideable. Thinnest and lightest patch pump that's not as noticeable as injections.