The Sequel Med Twiist Insulin Pump: A New Twist on Diabetes Management

Lindsay Cohen, RDN

Credit: Mama-Betes

For individuals living with Type 1 diabetes, automated insulin delivery (AID) systems have been a game changer for better blood sugar control and improved quality of life. The Sequel Med Twiist insulin pump is one of the newest innovations in this space. The Twiist insulin pump officially launched in the U.S. on July 7, 2025.

What Is the Sequel Med Twiist Insulin Pump?

The Sequel Med Twiist insulin pump is an AID system that is powered by the Tidepool Loop algorithm, which automatically adjusts insulin delivery based on real-time continuous glucose monitor (CGM) readings, carbohydrate intake data and other personalized settings. This “hybrid closed-loop” functionality means the system continuously monitors blood sugar levels and adjusts basal insulin delivery to help maintain stable blood sugar levels, minimizing the risk of high and low blood sugars.

What Sets the Twiist Apart From Other AID Systems?

The Twiist insulin pump uses sound waves to directly measure the volume and flow of each microdose of insulin delivered. This innovative iiSure™ Technology incorporates four checkpoints to ensure accurate insulin delivery.

This delivery precision not only ensures that users receive the exact amount of insulin they need but also allows for significantly faster occlusion detection. Twiist can detect blockages in the tubing or infusion set up to nine times faster than other AID systems, which helps ensure you are getting the insulin needed to prevent dangerously high blood sugar levels.

The Twiist pump is small and discreet — about the size of an Oreo cookie — and weighs around 2 ounces. It features a durable component that lasts for two years and a disposable cassette that contains the 300-unit insulin reservoir, which must be replaced every three days.

The system is currently approved for adults and children six years and older with Type 1 diabetes and is compatible with Abbott’s FreeStyle Libre 3 Plus sensor, with future integration planned for the Senseonics Eversense 365.

Other Key Features of the Sequel Med Twiist Insulin Pump

The Twiist insulin pump has quite a few additional features that distinguish it from other AID systems, including the following:

• Personalization and lower blood sugar targets: Twiist allows for customizable target blood sugar ranges as low as 87 milligrams per deciliter, which is one of the lowest available among commercial pumps.
• Intelligent meal absorption profiles: Twiist offers a meal absorption feature. Users can select from three absorption profiles (fast-acting, standard mixed meal or slow-digesting), represented by food emojis. This allows the algorithm to adjust insulin delivery based on how quickly the meal is expected to affect the blood sugar.
• Flexible control options: The Twiist system offers multiple ways to control insulin delivery. Users can bolus directly from a button on the pump itself, via a connected iPhone app or through an Apple Watch.
• Pharmacy access and reduced commitment: Sequel Med Tech plans to make the Twiist system available through retail pharmacies rather than solely through durable medical equipment channels. This makes it more accessible for those curious about new technology without a full four-year commitment.
• Predictive blood sugar forecasting: The Twiist AID system continuously updates a six-hour forecast every five minutes. Based on insulin delivery history, CGM readings, carbohydrate history and personalized settings, the system automatically adjusts basal insulin delivery to ensure blood sugar levels remain within the target range, helping to prevent both highs and lows.

In Summary

The Sequel Med Twiist insulin pump is an exciting step forward in automated insulin delivery technology. By combining a highly accurate pumping mechanism with patient-centered software, Twiist offers a state-of-the-art solution for individuals with Type 1 diabetes seeking more personalized, precise and convenient management. Its focus on faster occlusion detection, customizable targets and adaptable meal settings makes it a great option for those looking to get tighter blood sugar control.