Sequel Med Tech and Senseonics expand US availability of twiist integration with Eversense 365  – February 20, 2026

National rollout follows January’s limited launch; first AID integration for year-long implantable CGM

Sequel Med Tech and Senseonics announced full US availability of the twiist AID system integration with the Eversense 365 CGM, following an initial limited launch of the integrated system last month. This marks the national rollout of the first AID system compatible with Senseonics’ one-year implantable CGM. This CGM integration, meanwhile, is the second for twiist, as the insulin pump first launched with Abbott FreeStyle Libre 3 Plus compatibility in July 2025.

Sequel’s twiist is the latest entrant into the US AID ecosystem

Sequel’s twiist is a relatively new entrant into the AID landscape. It first launched in the US in mid-2025 and was initially integrated with just Abbott’s FreeStyle Libre 3 Plus. The system is built on a Tidepool Loop-based algorithm embedded directly into the DEKA ACE pump platform and includes a semi-disposable circular pump, iOS controller, and Apple Watch connectivity. With this integration with Senseonics’s Eversense 365, twiist now supports two CGM options, expanding CGM choice within the platform.

The primary differentiator of twiist is its occlusion detection capability. Using Sequel’s iiSure technology, the system directly measures insulin delivery volume during each microdose, enabling identification of insulin flow interruptions. Sequel has previously reported an average occlusion alert time of ~19 minutes with twiist, faster than several other insulin pump systems that often require significant pressure to accumulate before an alarm is triggered.

The clinical relevance of faster occlusion detection is crucial. Published literature has shown that traditional pump occlusion alarms can take hours to trigger. In a comparative study conducted by Dr. David Klonoff (UCSF), Dr. Guido Freckmann (IFD, Germany), and Dr. Lutz Heinemann (Science & Co GmbH, Germany), time-to-alarm across five pumps ranged from 15 to 24 hours, with many in the two to four hour range. During this time, glucose may rise ~1 mg/dL per minute in the absence of insulin delivery, potentially leading to hyperglycemia and rising glucose trends before the problem is detected. Earlier identification could therefore reduce time spent in hyperglycemia and even reduce the risk of ketosis, in extreme circumstances. While data on twiist is still emerging, Sequel is positioning earlier occlusion detection as a key safety and reliability advantage, particularly for individuals concerned about prolonged, unnoticed delivery failures.

Senseonics’s Eversense 365 reaches over one year on the US market as a one-year implantable CGM

Senseonics’s Eversense 365 is the only long-term (in this case, one year) implantable CGM currently available on the market. The implantable device has been in development for over a decade, with earlier 90-day and 180-day versions preceding the current 365-day CGM.

Eversense 365’s core value proposition focuses on durability and wear reliability. Because the sensor is implanted, it does not require frequent replacement, which may appeal to individuals prioritizing fewer insertions and reduced daily device burden. However, the system requires an in-office insertion and removal procedure, which has historically limited uptake relative to fully disposable CGMs. The implantable sensor also cannot yet send data directly to a user’s phone – though the Freedom system remains in development – and consequently necessitates a removable on-body transmitter to see the real-time data.

For Senseonics, integration with Sequel’s twiist represents its first AID partnership and brings the implantable CGM into the AID ecosystem at last. AID remains one of the fastest growing areas of diabetes technology, with sales increasing approximately 21% in 2025, and entry into this market expands Eversense’s potential market beyond standalone CGM users. While we believe that Senseonics’ appeal is certainly not limited to those on insulin alone, it is an alternative for those seeking discretion in their diabetes management and for those who would like less “perceived or real” hassle, as well as for those who want to minimize the environmental effects of their diabetes care.

We are interested in seeing how clinicians are incorporating the combination into practice and how early real-world experiences have been so far.

Environmental and system-level considerations with Eversense 365

Beyond durability and discretion, the twiist-Eversense 365 integration introduces a potentially meaningful environmental consideration. Traditional disposable CGM systems require sensor replacement every seven to 15 days, resulting in roughly 24-52 sensors per year per user, in addition to applicators, packaging, and other components. By contrast, a single implanted Eversense 365 CGM is designed to last one full year, reducing the frequency of disposable components.

In a study quantifying environmental waste from diabetes devices in the US, average monthly waste for pumps was 2.7 pounds. While the exact environmental benefits of Eversense 365 have not been quantified yet, we imagine it has significantly reduced the environmental impact of weekly or bimonthly device changes and their associated packaging.

The combination of earlier occlusion detection via twiist and reduced sensor disposal via Eversense 365 positions this partnership around convenience and discretion, as well as around reliability and environmental footprint.

Commercialization transition and growth for Senseonics

The integration of Eversense 365 with twiist follows Senseonics’s assumption of full commercialization and distribution responsibilities for Eversense 365 from Ascensia on January 1, 2026. Presumably, the degree to which this transition increases revenue capture will be positive and it appears that the transition will enable more direct control over marketing and distribution strategy. As of the end of 2025, while Senseonics’ installed userbase was still estimated at <1% of the global CGM market with ~8,000 users, we imagine that the combination of a more discreet sensor and a pump that doesn’t have occlusion alarms might be very attractive. We look forward to hearing more about which customers Senseonics and Sequel will target together.

Senseonics 3Q25 results showed major progress, albeit from a low base, on the sensor insertion side, and we imagine that the combination of both “newer” technologies may prove compelling to many that understand the differentiation of both (CGM and pump) systems. On the CGM side, Senseonics showed meaningful progress at the end of 3Q25: (i) new patient starts increased more than 2.5x year-over-year; (ii) the company achieved sequential revenue growth of ~50%; and (iii) a 55% increase in active prescribers year-over-year. We look forward to Senseonics’s 4Q25 report on March 2, 2026.

Combination of Sequel and Senseonics is compelling

We are still in the early stages of AID. While there are clearly multiple right combinations of pumps and sensors, we imagine that this partnership is a compelling one. We are hearing that clinicians are presenting Sequel’s pump as a viable choice in more and more conversations – while this is anecdotal, we try to pay close attention to what many clinicians view as differentiated. It goes without saying, of course, that Senseonics also presents a different decision for patients.

Dr. Francine Kaufman, Senseonics CMO, shares her perspective on the integration

We were fortunate to speak to Dr. Kaufman about the integration. She said, “it is a very different user experience altogether with a sensor that lasts one year, including no interruptions that are unplanned, because the sensor cannot fall off. To date, AID users have had to figure out where the sensor is placed every ten to 15 days, and where the pump or pump catheter is placed every three to seven days. With Eversense and twiist there is only one device that needs replacing all throughout the year – not two. We are truly offering a differentiated experience with both twiist and Eversense 365.”

Dr. Alan Lotvin, Sequel Med Tech CEO, discusses goal of expanding choices for PWD

Close Concerns’ Questions

1. What benefits will be used in trying to persuade Senseonics’ Eversense 365 userbase to transition to Sequel’s twiist?
2. Among twiist users, how many are expected to adopt Eversense 365 versus FreeStyle Libre 3 Plus?
3. About which aspects of the AID integration with Sequel is Senseonics most responsible?
4. While we imagine that every sensor company is pursuing additional AID integrations, and while pump companies are expected to be “agnostic,” are Senseonics and Sequel doing any co-marketing? Ultimately, how does Senseonics compare marketing AID with Sequel to pursuing more AID combinations beyond twiist?
5. How are clinicians helping patients decide in the US on various pump/sensor combinations?

-- by Riya Chatterjee, Jeremy Alkire, Monica Oxenreiter, and Kelly Close