The Twiist automated insulin delivery (AID) system from Sequel Med Tech has been available for three months, and users are now sharing real-world experiences. Powered by Tidepool’s FDA-cleared Loop algorithm, Twiist connects with the Libre 3 Plus CGM to adjust insulin every five minutes based on continuous glucose data. The pump allows smartwatch bolusing, customizable workout targets, and even retroactive carb edits if your meal changes—bringing both automation and flexibility.

The system’s app gives users detailed glucose and insulin insights, with unique features like emoji-based meal bolusing to signal how quickly food absorbs. Its acoustic occlusion detection promises faster alerts if insulin flow is blocked. While the rechargeable battery system and Cleo infusion set have drawn mixed reactions, users say glucose control has improved, with fewer stubborn highs and smoother nights. Coverage is expanding but still varies by insurance (it’s not covered by my insurance yet!).

This week’s Diabetech podcast dives deep into real user experiences. I speak with Sean Wilkinson, who’s tried several AID systems including DIY Loop, and Jori Matushek, a nurse practitioner with T1D, about life with twiist and the system’s pros and cons. Listen to the full episode at the top of this page or watch the video below.

Disclaimer: Diabetech content is not medical advice—it’s for educational purposes only. Always consult with a physician before making changes to your healthcare.