For those in the “We Are Not Waiting” camp, the Sequel twiist pump was supposed to be the commercial homecoming for Tidepool Loop. It promised the soul of a DIY algorithm with the support of a medical device giant. But as of their recent announcement today, the narrative has shifted.
Sequel Med Tech and Diabeloop have announced a major partnership to integrate the DBLG2 algorithm into the twiist system. This isn’t just another integration; it’s a strategic pivot that suggests Sequel is looking for a more “hands-off” lead for their hardware as they eye both the home market and global scale.
Where Does twiist Stand?
While Sequel keeps its cards close to its chest, we can triangulate their current footprint as they head into 2026:
-
User Estimate: Industry analysts suggest that as of December 2025, the twiist system has roughly 2,000 to 5,000 active users (Source: Diabetotech Winter 2025 Update).
-
Launch Velocity: Having only launched in July 2025, with an initial waitlist of 4,000 people, Sequel spent the latter part of the year getting them onboarded.
-
Sensor Synergy: A significant chunk of growth comes from their partnership with Senseonics, as the first commercial patients recently went live using the twiist pump with the Eversense 365-day CGM (Source: Senseonics Q4 2025 Report).
All together, whilst these are speculative numbers, this would suggest that Sequel is still a small player in the insulin pump market compared to even Ypsomed, who were estimated to have approximately 70,000 users in the March 2025 based on data from their Investor Presentations (Source: Ypsomed Financial Presentations).
Why DBLG2? Moving Toward the “Full” Closed Loop?
If Tidepool Loop is the “manual transmission” for power users, Diabeloop’s DBLG2—which received FDA 510(k) clearance on December 18, 2025—is the high-performance automatic (Source: Diabeloop FDA Clearance Announcement).
Why would Sequel lead with this over Tidepool for the mass market?
-
The “Unannounced Meal” Factor: In their January 8, 2026 announcement, Diabeloop noted that DBLG2 is “one step closer to full closed loop.” The DBLG2 algorithm manages glucose automatically even if a user chooses not to declare a meal—a feature Tidepool Loop lacks by design (Source: Diabeloop News – January 2026).
-
Ease of Use: While Tidepool Loop requires significant human involvement in the setup and tuning of the system (PMID: 33226840), all of Diabeloop’s algorithms simply request weight and Total Daily Dose (TDD), then learn and adjust from there. Far less for the human user to do.
-
iiSure Synergy: Sequel’s iiSure™ technology (measuring insulin via sound waves) gives the algorithm a perfect feedback loop. Because the pump knows exactly how much was delivered, the DBLG2 algorithm could be more aggressive in its corrections. Compared to Loop, Diabeloop algorithms already have lower time below range (a little over 1%), and this hardware precision could enhance that even further (Source: Diabeloop CE MDR Announcement).
Shortcuts: Changing Places
By partnering with Sequel, Diabeloop gains instant access to the U.S. market—one of the biggest healthcare markets on the planet—with a path to get their system in the hands of users via a local sales team and support infrastructure.
Sequel gets two wins here:
-
Geographical Acceleration: DBLG2 received its CE marking under MDR on August 4, 2025. By partnering with Diabeloop, Sequel gains an immediate “plug-and-play” pathway into Europe. Diabeloop already has over 12,000 users across France, Germany, and the Netherlands. Instead of spending years navigating individual regulatory hurdles for the AID component in the EU, Sequel can eventually “drop” their twiist pump into the existing, trusted Diabeloop ecosystem.
-
Wider Appeal: They gain an algorithm that’s much more likely to work for a broader user base than Loop, which remains a necessity for scaling their business.
The Verdict
Sequel isn’t “dumping” Tidepool Loop, but it looks like they may be realizing that Tidepool potentially has a smaller audience amongst high-engagement users. Whilst they needed something to get started with, the Diabeloop/twiist integration is a mass-market product for the person who wants to stop counting carbs and is still happy with a time in range around 65%-70% (though clinical data often shows DBLG2 hitting closer to 80%).
What’s perhaps most noteworthy is that with this news, Sequel’s twiist becomes the first true commercial “interoperable” pump system, capable of working with multiple algorithms and sensors, giving users true choice. And if you start with one algorithm and you don’t like it? Then it’s much easier to change!
With the companies anticipating product readiness by the end of 2026 and a full U.S. launch in 2027, the era of choice in AID is officially here. Sequel is no longer just a pump company; they become a platform for the best brains in diabetes.
Leave a Reply