Automated insulin delivery system shows strong real-world results across diabetes types

A smart insulin pump works for all diabetes types

Real-world data from 4,000 people with type 1 or type 2 diabetes using the twiist automated insulin delivery (AID) system show that most users achieved key glucose targets — and the results were nearly identical across both diabetes types. The findings, published in Diabetes Technology & Therapeutics, challenge the long-held assumption that AID systems primarily benefit people with type 1 diabetes.

Users spent 97.7% of their time in closed-loop mode, and the overall time in range (glucose 70–180 mg/dL) averaged 73.5%. Notably, people with higher baseline HbA1c levels saw the biggest gains. A companion 13-week clinical trial in Diabetes Care confirmed similar improvements in insulin-treated type 2 diabetes, with A1c dropping from 8.1% to 7.4% and no severe hypoglycemia events.

By the Numbers

• 64% of users achieved time in range ≥70%
• 86% kept time below range (glucose <70 mg/dL) under 4%
• A1c dropped by 0.7 percentage points in the clinical trial
• Patients with baseline A1c >8% saw a 46.2% increase in time in range

Why it matters: Millions of people with type 2 diabetes are managed in primary care settings where AID and CGM use remains very low. These results make a compelling case for broader adoption — and a call to action for clinicians to bring this technology to a much wider patient population.