O-28: Real world data with a new automated insulin delivery system in pediatric type 1 diabetes
R P Wadwa, E C Cobry, K Snow, J MitriAbstract
Introduction
Automated insulin delivery (AID), combining use of an insulin pump, continuous glucose monitor (CGM) and AID algorithm is considered the standard of care for pediatric type 1 diabetes (T1D) management where AID is available and feasible. In the United States, five systems are now approved for pediatric use. The twiist™ AID system (Sequel Med Tech) is the most recent system to became commercially available with an indication for use in T1D in the United States and released in 2025, integrating the twiist pump, Loop algorithm & phone app and Libre 3 plus or Eversense CGM. Real world data describing twiist use in youth with diabetes are presented here for the first time.
Objectives
To describe real-world data for the Sequel twiist AID system in youth with diabetes aged 6-17 years.
Methods
CGM data analyzed from 140 youth initiating the twiist AID system between July 2025 and March 2026 were stratified by age (6-12 years & 13-17 years) (table). Demographic data were gathered by self-report.
Results
Data in 140 youth aged 6-17 years (mean age 13 years) included 11,706 user-days from users with at least 14 days of CGM data (mean: 84 days; median: 72 days; range: 14-245 days). Mean time in range (TIR 70-180 mg/dl) was 67.7% overall with higher time in range in the 6-12 year olds (70.0% vs. 65.4% in 13-17 year olds). Time in tight range (46.8% overall) was also higher in 6-12 year olds (48.9 vs 44.7% in 13-17 year olds). Both age groups had low rates of hypoglycemia, with time <70 mg/dl at 1.8% and 2.1% and time <54 mg/dL at 0.13% and 0.23%. Overall, 35% had both TIR >70% and time below range (<70 mg/dl) <4%. Both groups had higher TIR overnight.
Conclusions
The first publicly available real-world pediatric data for the Sequel twiist AID system shows high TIR without excess hypoglycemia for many users. These findings highlight twiist as a promising new therapeutic option for youth with T1D.