twiist is a new tubed insulin pump from Sequel Med Tech, cleared for ages six and up. It runs the Tidepool Loop algorithm on iPhone and pairs with the Libre 3 Plus continuous glucose monitor (CGM) for automated insulin delivery.

What separates twiist is the user experience. From the iPhone app, you get a clean, detailed view of real-time data—insulin delivery, predicted glucose, insulin on board, and active carbs.

The bolus process is refreshingly simple: instead of simply setting carb entries, you pick a tag-along emoji which applies an absorption time. All foods affect us differently, so the ability to set absorption time based on glycemic index of a mean is a powerful tool. You can also fine-tune carb counts or absorption timing after the fact, which adds flexibility.

Apple Watch integration is another strong point. You can bolus, log meals, set an activity mode or pre-meal target, and check glucose trends directly from your wrist. The fact that I can discreetly log a meal and bolus without taking my phone out is a major win.

Accessibility is another big win here. twiist is available through pharmacy benefits — meaning if your insurance covers it, you can try twiist on a monthly basis and get the starter kit and future supplies sent to you from a pharmacy. No need to get locked into a 4-year contract with this system!

There are some tradeoffs. The system includes a lot of physical components needed for infusion set changes, which can make packing for travel a bit more involved. The Cleo infusion set comes with a steep learning curve and I found that about 3/10 sets would fall off right after I put it on. Alert customization is a bit limited right now, and the current alerts are louder than many users may prefer.

Overall, twiist feels like a meaningful step forward for looping systems, combining automation with a high degree of user customization. Watch our full twiist review at the top of this article. For more, we also spoke with early twiist users on the podcast, and have videos showcasing a twiist site change and app walkthrough.

Stay tuned for a full review write up, coming soon. Until then, what do you think of twiist? Let us know in the comments if you are using it or considering a try!

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