r/twiist

Hi I’m currently on Omnipod 5 and I’m just not satisfied with the algorithm. It’s not strong enough to bring my sugars down or keep them from falling too low, resulting in me having to be more hands on with my diabetes. O5 runs hybrid so it won’t bring my sugars down when it’s rising or high on its own is why I’m interested in the loop systems, my question is which one? Feeling very type A i want my numbers to be between 70-100. I do love the no tube though which is why I’m hesitant about tidepool having to switch to twist. But overall I’m focused on algorithms. Looking for insight on any information that will help me choose thanks :)

I take a medication 1-2 days a week and it makes me significantly insulin resistant. My settings work great from non medication days, but I sit high on the days I take the medication. My trainer suggested turning on the pre-meal setting, but no luck. He also seems confident the system can handle it, but it isn’t. Would you just manually Bolus to get it down? Or keep tinkering with settings on the pump?

The Cleo set is so frustrating. If I forget to press down on it (which I do often, I've got a one-track mind) it's basically useless and it's a miracle I even get it to stick when I get the applicator off. It also hurts really bad. Not the adhesive, but the cannula application is horrible, and it stays painful for pretty much my whole 3 days. Is this a privileged Omnipod user issue? Or is Cleo just really bad?

Also: WHEN are we getting a new infusion set

A little background, I am coming from Tandem Tslim 2 with Dexcom G7, A1C is 5.4 (avg bg around 110). I was noticing in the first few days of twiist that my average was closer to 135. This average is also likely higher in reality because I’ve noticed the Libre 3+ is about 20 points lower (I’m already looking into the Eversense).

I was trained on my twiist pump last Monday and wore it for 3 days before a mechanical failure on the pump which needed to be replaced. In those 3 days, I noticed a lot more prolonged highs after meals and simply not meeting the ”correction range.” I even noticed at times I would go in to add food and it would suggest 0 units for bolus.

What am I doing wrong here? The twiist rep suggested starting with one basal rate (much lower than my Tandem rates). I ended up just putting in my Tandem basal schedule because I felt pretty confident in it, but was running into the issues above. I have also lowered the Glucose Safety to the minimum and lowered the correction range.

Any help is appreciated! My partner and I are going to start TTC later this summer and I’m considering throwing in the towel and going back to my Tandem/G7 combo.

edit: “bolus schedule” -> “basal schedule”

Hi all! I am two weeks into my Twiist system and loving the system in general, but struggling while adjusting settings. I’m working alongside my Twiist trainer and I can see the light, but man it’s hard being patient and making slow changes.

My question(s): Dawn phenomenon has always been tough for me. Are people finding the algo can manage it without blousing for phantom carbs or just manually bolusing?

How long did it take to tweak your settings to find good time in range?

I am going sky high in the morning even with pre meal on, a generous max basal ( 4.7 ) and what we think is my correct insulin sensitivity factor ( we have been slowly making changes to it due to overnight lows ).

My insurance covers the Twiist but does not contract with either Byram or Alto, which are the only pharmacies with Twiist availability. Has anyone heard anything about a timeline for when the Twiist will be available at local pharmacy chains?

I use the insiight app on CarPlay to watch my levels while driving. Noticed that the app stopped providing info yesterday at 6:21pm. When I open the app, it’s not updating either. Software upgrade issue?

So as the title says, I’m going to be switching to the twiist in the next week or so and I’ve got some questions about prebolusing. Do you enter your meal then wait 15 minutes or so to eat still? Or do you use the pre-meal setting before you eat for however long (curious about how long before to use that too), then enter your meal and eat directly after? Just curious how everyone handles it. Any advice is greatly appreciated!

So I’ve been on a glp-1 (wegovy) and have lost just over 50 pounds.

I’ve also been going to the gym 6 days a week

6 days lifting, 4 of those days also doing cardio.

I’m currently in afrezza and tresiba. My tresiba does has gone from 27 units to 12.

I’m now so sensitive to the afrezza I’m having lows even when taking the smallest dose and a 4 unit which used to lower me 20 is lowering me 60+

Anyway, I had an endo appt yesterday and I was on a pump 8+ years ago. His suggestion was to maybe go back on one bc of the algorithm. I also start a new job Monday. (Eversense will be covered, and I’ve been on it before and loved it) and it connects with the twiist.

I’m just frustrated and concerned about giving up control to an algorithm. And nervous.

My last A1C was 6.1 but now the lows post exercise are longer and take more glucose to treat.

I’m just over it all, but I guess I can try a pump again. But I really like the afrezza.

I’m gonna try it in manual mode and work up to letting it do all the work.

Anyone else dealt with anything similar?

I’ve been on twiist for 3 weeks now, but have yet to achieve a good TIR like most people I’ve seen on here or what my trainer described.

Some background, diagnosed 5 years ago, still getting the hang of managing things. I had a horrific low a while back and still getting over the fear of pre-bolusing. It’s something I have gotten a lot better at on this system, but still not waiting 15min to eat most times. I switched from Novolog to Fiasp last year and the onset is noticeable.

With Twiist, I’m finding the algorithm is far too aggressive at the wrong times resulting in a rapid BG fall. I’m talking like 100+ mg/dL fall in <30min. For example, tonight I had a bowl of pasta, told the pump I was eating 45g carbs and use the longer absorption. I was already sitting at a BG of 200 from a small snack I didn’t bolus for accurately.

Pump gives me 3.5U. Sounds good. Now sitting on the couch, I suddenly feel my BG is dropping fast. Went from 200 to 120 in 25 min. All while I now have 5U of active insulin? (Pump gave me an extra 1.5U). Libre still showing down arrow and predicted to hit a BG of 50 in next 30 minutes.

Had no choice but to eat a large bowl of cereal after eating dinner to stop the fall. I did confirm it with finger sticks, only slightly off from Libre.

I’m not sure what to do. I have these dramatic spikes (in part from not prebolus) then huge crashes where I am symptomatic. My trainer has LOWERED my ISF to 1:30mg/dL and carb ratio. The logic is preventing a spike prevents a drop that can’t be predicted.

I plan on trying novolog again to see if the slower onset would work? But I’m truly at a loss of what I can do. I feel like I’m fighting against this pump everyday not to drop me low.

I’m considering switching from Dexcom G7 & Tandem T-slim to Libre & Twiist. I’ve used Libre. What should I know about Twiist that you won’t find in their marketing materials?