Big news, times two. twiist is now indicated for type 2 and works with more phone options. Know a patient that can benefit? Refer them now!
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Individualized Care, Made Easy.
See how twiist™ can help all of your insulin requiring patients better manage their diabetes with greater personalized control, advanced technology, and simplified access.
Sequel is working on adhesive options for on-body wear. Alternative adhesive options are available through third-party providers.
twiist is an automated insulin delivery (AID) system designed to adapt to your patients - helping simplify daily decisions with personalized control and smart features.
Looks and works like no other AID
system around
Greater personalized control. Advanced technology. Simplified access. The twiist AID System brings every component together in a seamless, intelligent experience designed to adapt to each patient's day.
The twiist Pump contains the twiist Loop algorithm, enabling the system to automatically adjust basal insulin delivery based on CGM readings, your personalized settings, and predicted glucose levels.
15-day CGM sensor delivering glucose readings every minute. More CGM sensor compatibility options are on the way!
Connect your iPhone and Apple Watch for discreet, app-based control. The twiist AID System is the only AID system that can be controlled from an Apple Watch.¹,³–⁷
Empower your patients with the twiist AID system
twiist personalizes diabetes care by offering your patients advanced technology with precision and flexibility to adapt to their day. Patients can start twiist for $0 for the first month and they’ll pay no more than $50 a month thereafter.*
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Simplified Access
Support for your patients and your team
- Most patients will pay $0 for the first month and no more than $50 per month thereafter*
- Patients can start using twiist even if they are still under contract with their previous pump
- Extensive product and patient support
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Greater Personalized Control
Adapts to patients' needs
- Auto Adjust fine-tunes insulin delivery every 5 minutes to help meet user-specified correction target
- Carb absorption time lets patients specify if they've eaten slow-, medium-, and fast-absorbing carbs
Designed for flexibility
- The smallest size pump to hold 300 units of insulin, weighing just 2 oz1,3-7
- Multiple wear options (fits in pocket, clips to belt, or uses an adhesive patch)
- Choice of compatible continuous glucose monitor
- Three ways to bolus: directly from the pump or with a compatible smartphone or smartwatch
Sequel is working on adhesive options for on-body wear. Alternative adhesive options are available through third-party providers.
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Advanced Technology
Breakthrough confidence features
- Unique iiSure technology can detect occlusions up to 9x faster than other AID systems2, potentially reducing the risk of prolonged hyperglycemia11.
Sequel is working on adhesive options for on-body wear. Alternative adhesive options are available through third-party providers.
Real-life outcomes that help patients thrive
Explore twiist™ AID System outcomes in type 1 and type 2 diabetes.
Nearly 77% Time in Range in Real-World Use12
Early twiist users; 8,598 user-days, Apr–Aug 2025.
See Type 1 data →Improved TIR Seen as Early as Day 114
twiist-T2D Pivotal Trial, 13 weeks, N=284.
See Type 2 data →RESOURCES
Get started with twiist
Everything you need to prescribe, initiate, and manage patients on twiist, all in one place.
EDUCATION
How to Prescribe twiist
Walk through the Rx process, from EMR ordering to pharmacy pickup.
WEBINAR
Clinical Insights On Demand
Watch expert-led sessions on initiation, adjustment, and real-world outcomes.
GETTING STARTED
Initiation & Settings Guide
Calculate starting settings and get your first patient up and running.
EDUCATION
Carb Amount and Absorption Time
Absorption time tells twiist how long carbs are estimated to affect your glucose levels.
Frequently Asked Questions
Find answers to common questions about iiSure™ sound wave technology and the twiist™ AID System.
It is called twiist™ because you twist it to open the device (kind of like an Oreo cookie).
The ii in twiist stands for intelligent insulin.
The twiist™ Pump is proudly manufactured in the United States.
Tidepool is a non-profit organization focused on diabetes. This technology is community-driven, designed by and for people living with diabetes, and offers extensive customizable options to truly personalize diabetes management. Sequel partnered with Tidepool because of their commitment to empowering the diabetes community. For further details about Tidepool, please visitwww.tidepool.org.
We tried capitalizing the ‘T’ in twiist, but it just didn’t feel right—like wearing socks with sandals. Plus, lowercase ‘t’ keeps things small, sleek, and stylish… just like our pump!
Transform Diabetes Management with the twiist AID System
$0 for the first month and no more than $50 a month thereafter.*
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MAT-1044 Ver 3.0 10/26
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Personalized Diabetes Control
INDICATIONS FOR USE
The twiist™ Automated Insulin Delivery (AID) System is for people with type 1 diabetes, ages 6 years and older, and type 2 diabetes, ages 18 years and older. It is available with a prescription, only in the U.S. Visit twiist.com/safety for important safety information.
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 automated insulin delivery system is not intended for anyone unable or unwilling to:
- Test blood glucose (BG) levels as recommended by their healthcare provider.
- Maintain sufficient diabetes selfcare skills.
- See their healthcare provider regularly.
- Demonstrate adequate carbohydrate-counting skills (preferred, not required).
Product not yet available outside of the U.S.
- Sequel Med Tech - twiist Automated Insulin Delivery (AID) System Powered by Tidepool User Guide.
- 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.
- lnsulet - Omnipod 5 Automated Insulin Delivery System User Guide.
- Medtronic - MiniMed 780G system User Guide.
- Beta Bionics - iLet Bionic Pancreas System User Guide.
- Tandem Diabetes Care - t:slim X2 Insulin Pump User Guide.
- Tandem Diabetes Care - Tandem Mobi System User Guide.
- 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.
- Wong JJ, et al. Psychosocial Effects of the Loop Open-Source Automated Insulin Delivery System. J Diabetes Sci Technol. 2023;17(6):1440-1447.
- 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.
- Klonoff DC, et al. Time to Moderate and Severe Hyperglycemia and Ketonemia Following an Insulin Pump Occlusion. J Diabetes Sci Technol 2024.
- Snow K, Aleppo G, Mitri J. (2026, March). Early Clinical Performance in the twiist™ AID System. [Poster Presentation] ATTD, Barcelona, Spain.
- Study Design: Approved by the Institutional Review Board of the JAEB Center for Health Research (ClinicalTrials.gov Identifier: NCT03838900), Wong et al conducted a prospective, observational, real-world study including a subset of 239 adults with T1D to evaluate the psychosocial and quality of life outcomes of using DIY Loop. Patients initiated the DIY Loop either on their own, or with community-developed resources, and used the DIY Loop algorithm with a non-twiist insulin pump over 3 months.
- Levy et al; A Multicenter 13-Week Evaluation of the twiist Automated Insulin Delivery in Insulin-Treated Type 2 Diabetes: The twiist-T2D Pivotal Trial. Diabetes Care 2026; dc261270.
*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.
For full FreeStyle Libre 3 Plus sensor safety information, please visit https://www.freestyle.abbott/us-en/safety-information.html. 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.