Most twiist Users Reach Target Glucose Levels
In a real-world analysis of 4,000 people with diabetes, most users kept blood sugar within their target range.
Updated on Nov. 4, 2026 in Diabetes
Live Poll
If you have diabetes and use insulin, would you consider an automated insulin delivery system?
An analysis of real-world data from 4,000 people with type 1 or type 2 diabetes using the twiist automated insulin delivery system found that most users achieved target glucose metrics. Users were tracked for at least two weeks between April 29, 2025, and April 29, 2026, so the findings are relevant to people managing diabetes with automated insulin delivery across the United States.
Why it matters
Automated insulin delivery systems are designed to adjust insulin dosing based on glucose readings, and real-world data helps show how these tools perform outside controlled trials. The results suggest that many users with either type of diabetes are reaching glucose goals in everyday life, which informs how patients and clinicians weigh these technologies.
This analysis drew on real-world data from 4,000 people with type 1 or type 2 diabetes using twiist, tracked for at least two weeks between April 29, 2025, and April 29, 2026. Overall time in range was 73.5%, and time in range was similar between people with type 1 and type 2 diabetes.
The players
Indiana University Center for Diabetes and Metabolic Diseases
A research center at Indiana University focused on diabetes care and metabolic disease research, affiliated with lead researcher Viral Shah.
Viral Shah
A diabetes researcher at the Indiana University Center for Diabetes and Metabolic Diseases who led the analysis of twiist user data.
The details
Automated insulin delivery systems use glucose readings to adjust insulin delivery continuously, reducing the need for manual dosing decisions. In this analysis, users spent 97.7% of their time in closed-loop mode, meaning the system was actively adjusting insulin. Mean overnight time in range reached 77.9%, and mean glucose averaged 150.2 mg/dL, with a mean coefficient of variation of 34%.
Timeline
April 29, 2025: Start of the twiist user data collection period.
April 29, 2026: End of the twiist user data collection period.
November 4, 2026: Analysis published on Healio.
Health Landscape
Automated insulin delivery systems represent a shift from manual insulin dosing toward technology that adjusts delivery continuously based on glucose readings. Real-world data from large user groups, such as this 4,000-person analysis of the twiist system, add population-level evidence to the technology's track record.
If you or a family member uses an automated insulin delivery system, these findings suggest many users reach their glucose targets, though individual results vary. It is worth discussing with your doctor whether the time-in-range and time-below-range measures in this analysis are useful benchmarks for your own care.
The takeaway
Most twiist users in this real-world analysis reached target glucose metrics, with a majority spending over 70% of time in range. If you use diabetes technology, consider reviewing your time-in-range data with your care team at your next appointment.
Further reading
For broader context on managing blood sugar with technology, explore our Diabetes coverage.
Source note: This article includes information reported by Healio.
Live Poll
If you have diabetes and use insulin, would you consider an automated insulin delivery system?
