Podcast Summary: Eversense 365 + twiist – Exploring the Newest CGM/Pump Combo

Podcast: Diabetes Connections | Type 1 Diabetes
Host: Stacey Simms
Guest: Brian Hanson, President of CGM, Ascensia
Episode Date: May 13, 2025

Overview

This episode dives into the innovative partnership between Eversense—the only implantable CGM (Continuous Glucose Monitor), now lasting up to 365 days—and its first automated insulin pump partner, the new twiist pump from SQL MedTech. Host Stacey Simms interviews Brian Hanson of Ascensia about the journey to this integration, the advantages and challenges of implantable sensors, new calibration and user features, and what the future holds for both the Eversense platform and the broader diabetes technology landscape.

Key Discussion Points & Insights

1. The Partnership: Eversense + twiist

• History & Context
  • Eversense started as a 90-day sensor in 2018, progressed to 180 days, and was FDA-approved for 365-day wear in 2024.
  • Eversense 365 is now classified as an ICGM, making it eligible for automated insulin delivery integration.
  • The twiist pump, developed by DEKA (founded by Dean Kamen, a pivotal pump industry leader), is the first pump to integrate with Eversense.
• Personal Connections
  • Brian shares stories from his two decades in diabetes tech, including ties to Dean Kamen and many leaders at SQL/DEKA, making this partnership a natural fit.
  • “It was just a natural fit…so we’re pretty excited and happy to be able to partner with them.” (08:11)

2. Eversense 365: What’s New?

• Features & User Experience
  • Sensor Size: Slightly bigger than a grain of rice and inserted under the skin of the upper arm via a minor procedure.
  • Wear Duration: Full year without replacement.
  • Calibration: Once daily for 13 days, then only weekly. This is seen as a major improvement.
    • “Our cancellations because of calibrations are down 91%. How’s that for a good fact?” (13:20, Brian)
    • If calibration is missed, the system disables readings until calibration is completed to ensure accuracy.
• Transmitter & Adhesive
  • New transmitter uses easy USB charging; no cradle required.
  • Gentle, proprietary adhesive suitable for users sensitive to standard adhesives; transmitter can be removed and reapplied easily.
• Advantages Compared to Traditional CGMs
  • No external patch changing, no adhesive rash, reduced risk of false/compression lows, and nearly invisible wear.
  • Only one yearly insertion, "a game changer" for many.
• Challenges & Patient Experience
  • Small number of “silent quitters”—users who stop wearing the transmitter even with a sensor in place. Ascensia follows up proactively.

3. The twiist Pump: Form and Function

• Unique Design Features
  • Form Factor: Small, round, “puck” shape, with short (on-body) or traditional infusion set options; discrete and flexible wearing.
  • Insulin Capacity: 300 units; accommodates higher-use patients.
  • Control: Full phone (and Apple Watch) control, customizable targets and settings, bolus via phone, watch, or device button.
  • Loop algorithm (developed in partnership with Tidepool, open-source heritage).
  • “You can bowl from your phone…it’s a full phone control pump now.” (22:08, Brian)
• Reliability & Accuracy
  • Designed for superior dosing accuracy and reliable occlusion detection, improving trust for patients and providers.

4. Data: Privacy, Access, Integration

• Ownership & Use
  • Data is anonymized and shared only with consent; no personal identifiers are accessible by Ascensia or third parties.
  • Eversense supports interoperability, making data available to repositories like Tidepool and for academic research.
  • “That data is not yours, right? Everybody should have that data. It should be actionable.” (Recalling Howard Look’s philosophy, 22:08)
• Protecting Patient Privacy
  • Reluctance to share granular data for “nefarious reasons” or out-of-context benchmarking, but open to scientific partnerships.

5. Real-World Use: User Feedback, Longevity, Troubleshooting

• Longevity Data
  • High user satisfaction among multi-year users; renewal rates increase as users move through second and third cycles.
  • Clinical trial data: 90% survival at 365 days, >95% in real-world settings.
• Problems & “Early Retirement”
  • Early failures addressed by free replacement; very low incidence.
  • Very few users request early extraction after initiation.
• Silent Quitters
  • Users who stop using the transmitter but leave the sensor in; Ascensia is working to identify and re-engage these users for maximal benefit.

6. Market Access, International Expansion & Regulatory Updates

• Pediatric Use
  • Currently approved for ages 18+; expansion to age 12 planned.
• International Approvals
  • Actively seeking CE mark for EU relaunch (starting with Germany), plans for Canada more complicated due to higher regulatory bar.
• US Rollout
  • Fall 2025 targeted for Eversense-twiist launch.

7. The Future: Roadmap for CGM Development

• Next Products Teased
  • Gemini: Implantable sensor with an internal battery, scan with phone or use transmitter (expected by end of 2026).
  • Freedom: Fully implantable with Bluetooth; no transmitter needed, ongoing data stream for a full year (end of 2027 planned).
    • “Freedom is exactly what you’re talking about…Now it’s under the skin, nothing on the outside…and it will do so for a year.” (37:57, Brian)

Notable Quotes & Memorable Moments

• On Patient Choice:
  “Choice is important, right? When you have more choices, you make better decisions... Big advocate for choice and we’re going to jump on this one.” (09:10, Brian)
• On Device Integration:
  “The feedback we’ve had is one procedure a year is fantastic. But I think the thing we were surprised about is the once-a-week calibration…has quite frankly been a game changer.” (10:23, Brian)
• On Troubleshooting & Real-World Behavior:
  “Even in a very structured format, the best laid plans don’t always come through…” (15:06, Brian)
• On Partnerships & Industry Relationships:
  “It was just a natural fit...I know several of their senior folks...” (09:10, Brian)
• On Industry Progress:
  “I was so impressed with the fact they could take a 180 sensor, turn it into a full-year sensor and still maintain the robust performance characteristics.” (36:51, Brian)
• On The Future of CGM:
  “Freedom is exactly what you’re talking about. Now…nothing on the outside of the skin. It’ll still maintain it for a year…” (37:57, Brian)

Timestamps for Major Segments

• 00:05 – Episode introduction, show history, Eversense overview
• 05:11 – Brian Hanson joins, discusses podcast and industry background
• 06:41 – Origin story of partnership with twiist (SQL MedTech, DEKA, Dean Kamen)
• 10:09 – Eversense 365 ICGM features and user perspective
• 12:41 – Calibration process explained
• 13:20 – User adaption, real world data on calibration and adherence
• 15:47 – Transmitter, charging, and adhesive details
• 17:56 – Connectivity questions, expectations for Eversense-twiist integration
• 18:23 – Bluetooth/placement concerns for pump/sensor
• 19:38 – Pediatric and international (Canada, Europe) access updates
• 22:08 – twiist pump features and user interface; Tidepool partnership
• 25:55 – Data ownership/sharing, privacy principles
• 28:20 – Potential Eversense partnership with Luna overnight system
• 31:21 – Real-world user feedback; reinsertion and long-term adherence
• 33:32 – Non-adherence (“silent quitters”), early failures, troubleshooting
• 37:57 – Future technology: Gemini and Freedom product roadmap
• 39:37 – Closing thoughts, gratitude, future community engagement

Tone and Style

The episode is approachable, candid, and occasionally humorous, grounded by Stacey's experience as a diabetes parent and Brian's friendly, open industry veteran style. Technical details are explained accessibly, with a focus on real-world user experiences as much as regulatory or engineering milestones.

Summary prepared for listeners seeking to understand the latest advances in CGM/pump integration, the user experience, and what’s next for implantable diabetes technology.