Anyone actually seen or looked into this new device? Looks promising. I’m less than thrilled with the 5!
UPDATE: I got into a survey group about the pump and while I still like it, like I love the occlusion detection, and being able to tell it you aren’t eating as much as planned, I still have some issues. Number one, I would have to find an infusion set that I could use again, and I hate tubing. No matter how short! I would miss the self-injecting feature of the Pods. Two, they didn’t say Humalog was the only approved insulin right now, but it is I think.
So it looks good, but loses a few things here and there. We’ll see how the new iPhone app feels with the 5. It may make me feel better about everything.
Never heard of it, but it looks very interesting. I’m in Canada so it probably won’t be here for another ten years.
Off-topic, but why aren’t you thrilled with the Omni 5 (which also isn’t released in Canada yet)?
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It’s been hard to figure out what it’s going to do. If you’re high it thinks sometimes you don’t need to treat it and sort of brings it down itself but slowly. Changes things so much that I cannot predict it’s behavior. I have tons of pods so I wont be able to switch anytime soon. I do not want a tubed pump every again so for now I’mstaying. It’s not terrible. The iPhone app is coming out soon so I can ditch the controller, which in and of itselfis a phone. Hopefully you get it there soon!
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Laura - I’m very interested in the Twiist pump. Its planned use of an algorithm derived from the DIY Loop makes it attractive to me. I’ve successfully used DIY Loop for eight years. There are a couple of open questions for me that cloud my hopes of potentially using this AID pump system.
The first is the insurance coverage it may receive. In an article posted by diaTribe, it offers this:
Although information is not yet available regarding the launch date of twiist, Sequel’s co-founder and CEO Dr. Alan Lotvin noted that the company plans to make the device available in pharmacies with a pay-as-you-go model for greater access and affordability.
According to Christopher Gilbert, VP of Marketing at Sequel, offering insulin delivery systems in pharmacies is often smoother for both patients and healthcare providers, and usually only involves a co-payment. Sequel’s goals are to remove cost as a barrier for people looking to start on an AID system and to allow people with diabetes to get started quickly, without making a long-term commitment, Gilbert said.
In contrast, commercial insulin pumps typically involve a four to five-year commitment and must be purchased through Durable Medical Equipment suppliers (i.e., Advanced Diabetes Supply, Byram Healthcare).
This looks like the path that Insulet chose for the Omnipod. It is available for pharmacy benefit only and does not qualify for DME (durable medical equipment) coverage. It would compare poorly with my Medicare DME coverage which covers 100% of my ongoing costs.
I have no problem with pharmacy benefit coverage, but elimination of the DME benefit is a deal breaker for me. Sequel’s webpage does not provide for any way to pose a question so I cannot ask them to clarify.
The second concern that I have is about the insulin formulations that may be used. I believe that Sequel only intends to use Humalog, but I’m not sure. I’ve used Apidra for over 15 years in my pumps and prefer not to switch. I know that I am allergic to Novolog; Humalog may work for me but why change something that has worked well long term?
The Tidepool AID contains many benefits not featured elsewhere. The targeted BG can be as low as 87 mg/dL. It displays and offers controls on my iPhone and Apple Watch.
Unfortunately companies avoid any specific consumer contact during its roll-out period and the company decisions that they make are often irreversible. We’ll just have to wait and see.
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Uh oh. I am allergic to Humalog. In fact I was put into the first US release program of Novolog due to that. If that’s true I’m out. I thought I heard that in the video I watched. Just no. That won’t work.
Now, I’m not paying for tubed Medicare pump rental, but do have extra help with Part D. I pay $60 a month for my part D plan. My husband only had to pay $21 for his for a year and he is on $10k a month chemo pills. Somehow I have to pay a premium for pods and he is done for the year. But I do get two day pod changes and three month supply for $11. So in a way I’m good, but only for now.
Yep. We’ll see I guess.
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Here’s the Humalog only reference from the same diaTribe article cited above:
The twiist AID system includes the following components:
- The Deka insulin pump, which is approved for use with the rapid-acting insulin Humalog. The reservoir holds 300 units and is disposable, while the rest of the pump can be reused for up to three years.
- The Tidepool Loop algorithm, which automatically adjusts insulin delivery based on CGM readings and includes several innovative features – more on this below.
- A compatible CGM sensor.
I understand that companies only list the insulin formulations that they have used to produce the FDA data that makes their system eligible for certification. In this case it looks like Sequel only used Humalog to produce its data.
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That diatribe article is a rewrite of a press release and fails to separate the marketing-speak from the facts. Its also from March, @Laura_S did you see anything newer? The pump uses infusion sets so its similar to the Mobi. I heard a rumor Tandem is working on a Mobi with a needle like the Omnipod called the Tobi.
Here’s what I found:
https://twiist.com/ a shell of a website
https://sequelmedtech.com/ seems to be a middleware company
https://dekaresearch.com/ the pump manufacturer
DEKA ACE Pump System FDA 510(k) Platform the Twiist is based on
DEKA Loop FDA 510(k) The algorithm and control electronics
DEKA ACE Pump integrated with Loop FDA 510(k)
DEKA ACE Pump added Novolog FDA 510(k)
None of the FDA docs say “Twiist” so nothing is ready for sale yet. I did find a reference to the Deka pump on JDRF, this really sounds like it’s the Tidepool pump. I’m not loving the lack of a clinical trial but its the same thing Tandem did with the Mobi. “Trust us, its equivalent”
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I just saw the convention piece. I thought the device had a patch option???
Can’t you use whichever insulin you want in your pump? After all, pumpers used Fiasp when it wasn’t initially approved for pump use, and use U200 even though it isn’t approved for pump use.
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You make a good point, @beacher. Although there are one or two pumps which use dedicated insulin vials of specific brand and size as the reservoirs, almost all pumps permit reservoir refilling from whatever vial you choose. And I suppose that the occasional doctor might object writing a script for insulin that is not indicated for the intended pump.
Although Sequel is a bit vague on some of the details, it most likely can be refilled from the vial of your choice.
Thanks for making that very valid point.
Edited to add: My memory is of the discontinued Snap pump. It has been the only pump to ever use a prefilled 3mL vial for the reservoir. It used Humalog insulin only. It was a great convenience and simplification that users like but limited users to one insulin formulation only. Snap was only on the market for about two years, 2013-2015.
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I was just saying that to someone yesterday. The Snap pump!
Didn’t the H-tron or D-tron offer pre-filled carts? I’m pretty sure it was planned, but I don’t recall if it ever came to be. I think it was (going to be) in addition to refilling.
Deka is Dean Kamen’s company. He made the first commercial insulin pump and started Auto Syringe.
There was also the Nordisk Infuser pump, which I used for a few years in the mid-1980s. It was advertised as being the only pump that used prefilled cartridges of undiluted insulin. This was expensive but a huge convenience over my previous pump (the Auto Syringe 6C, developed by Dean Kamen), where you had to dilute the insulin with saline when filling the syringe you then slotted into the side of the pump.
I’m not familiar with the particular features of these historical pump offerings. A google search revealed a Disetronic H-tron plus 2003 review on the Insulin Pumpers Forum that showed that it used a 315 unit capacity cartridge that does not specify that it was prefilled. It does show that the cartridge was either glass or plastic. A glass cartridge makes me wonder if it was a prefilled vial of insulin.
Please excuse my historical review, a chance to refresh my memory. I started on the Medtronic 504 model in 1987 and updated to later Med-T versions until I switched to the Animas Ping in 2008. I refreshed with a newer Ping in 2012 and finally switched to DIY Loop in 2016 using a MM 722, my current setup.
A little seach reminded me as well. 
I found a marketing blurb that claimed the D-tron Plus is the only pump to offer cartridges prefilled with Lily insulin. That may seem to conflict w/ Breacher’s post above, but maybe the Nordisk pump wasn’t using Lily insulin. Or maybe they weren’t in production at the same time. In any case, I recall that since I was using Novolog, the prefilled carts weren’t for me. I continued to fill my own, so prefilleds were not required.
Is the 6C the Blue Brick? My 2nd pump was the Auto Syringe Eugly. My first, I can’t recall the brand, had a small LCD, ~5 digits maybe, and everything was entered with up-down-enter buttons. The “big” screen and numeric pad on the Eugly was a game changer.
That’s actually my other concern, having experienced being orphaned when Assante went belly up. It’s a hella competitive market and while that can spur innovation it can also stomp on it. OTOH, I’m a huge fan of open source software development and there’s the example of Mac OSX being based on Unix/Linus to draw on, far back as that was. Be nice to see a successful commercial pump based on DIY Loop. It certainly is a better system than any of the other AIDs developed in-house by the big commercial makers.
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After Asante, who made the Snap pump, closed Lily wanted another Humalog only pump on the market and contracted with Deka to create one for them. That never came to market and Lily allowed the IP to revert to Deka in 2020 while Lily partnered with Ypsomed to either create or bring to the US a pump that uses Lily’s 1.6ml prefilled pumpcarts that are available in other countries.
I don’t know for sure that Twiist is the design Deka made for Lily but the dates are close.
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If I recall (it was a long time ago), the cartridges were branded Nordisk and possibly were filled with its proprietary insulin. Velosulin rings a bell. It was also, I think, the first pump to use a microprocessor.
The 6C came just after the Blue Brick. If the Blue Brick was a shoebox, the 6C was a paperback book. It had one basal setting, which you changed using a little screwdriver in the back. If you used more than one basal, you had to have a good memory! It had a tiny red LED screen, and loudly clicked and whirred whenever it delivered some insulin.
How far we’ve come, in so many ways!
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