twiist
Eversense
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.
This sensor lasts the longest - 365 days. It has to be placed under the skin by a healthcare provider. It has two parts, the implantable sensor and a transmitter that sends data to a mobile device.
MARD: 8.5-9.1%
*Recently FDA approved for use with insulin pumps.
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.
Receiver
Real-time glucose measurements sent to a compatible mobile-device or smart watch. No need for a separate receiver. Available for both iOS and Android devices.
Transmitter
Transmitter sits outside of the body and is held on by an adhesive. Sends data every 5 minutes to a connected mobile device.
Sensor
Professionally inserted by a physician during a medical visit. Minor procedure.
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.
Very small implantable sensor but large transmitter must be worn on top of the skin.
Affordability and Access
$$$$
No insurance coverage data. Anticipated to be provided through Pharmacy.
$$$$
Sometimes covered. Insertion and removal require a Health Care Provider. Insertion costs $100-$300, and removal costs $100-$400. Sensor and transmitter cost $800-$1400.
Data Monitoring Options
Yes
Compatible with Tidepool - a web-based diabetes data management system.
Yes
CGM data can upload automatically to the web-based Eversense data management system (EDMS) from the Eversense mobile app.
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
Eversense mobile app receives and displays data in easy-to-read charts and graphs that can be shared with family and friends through the Eversense NOW app.
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.
365 Days
Sensor lasts 365 days, but a physician must implant it. Transmitter must be charged daily.
Vision / Auditory / Dexterity
YES text to speech
YES vibration alerts
A LOT of dexterity needed
YES text to speech
YES vibration alerts
SOME 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 transmitter when submerged in 1 meter of water for up to 30 minutes and must be within 25 feet of the connected smart device.
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.
On-body vibration alerts when blood glucose levels are higher or lower than the set range. 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.
Longest-lasting sensor fits comfortably under the skin. Minor procedure is required. Least likely to have compression lows.
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
Predictive alerts make insulin dosing easier by tracking high and low trends.
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.
Minor procedure. Requires insertion by a physician during a medical visit.
Fewer Fingersticks
Factory-calibrated sensor. Fingersticks needed for backup only.
2 daily finger-sticks are needed to calibrate the sensor.
Privacy
Discreet. The pump is in two pieces - the top (algorithm and battery) and the bottom (insulin chamber and AVS technology)
Somewhat discreet. Tiny sensor is implanted under the skin, so the user can be discreet when needed. Ability to see sugar on watch or phone. Sensor not movable on body and requires regular meter use.