'twiist': the Apple Watch-controlled insulin pump
Sequel’s twiist, the first automated pump that can bolus from an Apple Watch, began a limited US launch in July 2025 for ages 6 and up.
Twiist is a new insulin pump in the United States that you can dose from an iPhone or an Apple Watch. It began a limited US launch in July 2025. Two things make it stand out: it is the first automated pump you can bolus from a watch, and it is the first approved product built on Loop, a closed-loop system that people in the diabetes community first built themselves. It is not available in the UK. Think of this as a sign of where phone and watch control is heading, not something to act on now.
- An automated insulin pump (also called a closed loop) reads a glucose sensor and adjusts your background insulin for you.
- Twiist lets you give a bolus (the dose of insulin for a meal or to bring a high down) from an Apple Watch, which no approved pump had allowed before.
- It runs the Loop algorithm: the software brain grew out of a community of people with type 1 who built and shared it long before any company sold it.
- The limited launch is for ages 6 and over and uses the FreeStyle Libre 3 Plus sensor.
- It is US only, on a small early launch, with no UK availability, so there is nothing to sign up for here.
Why this one is being talked about
Twiist, made by a company called Sequel, started shipping to a limited number of US users in July 2025. What has people interested is not that it is another pump, but two firsts. It is the first automated insulin delivery system you can control from an Apple Watch, so a mealtime dose can start from your wrist rather than a separate handset. And it is the first approved product built on Loop.
Loop is worth a sentence on its own. For years, people with type 1 and their families built their own closed-loop setups from open software, sharing the code freely, because official systems were slow to arrive. Twiist is a regulated, approved version of that community idea, which is a real milestone for a movement that started around kitchen tables rather than in a boardroom.
What it means for you in the UK
For now, honestly, not much day to day. Twiist is not available in the UK, and even in the US it is on a small early launch rather than a wide release. So there is nothing to join or ask to switch to.
Why it is still worth knowing is the direction of travel. Watch and phone control, and community-built ideas becoming approved products, are both signs of where diabetes tech is going. It is also worth keeping expectations realistic: a limited US launch is a long way from a system the NHS offers, and there is no UK timeline attached to this. If watch or phone control appeals to you, the useful question is what is offered here now, not what might arrive.