Real-World Data from U.S. Commercial Users of the 365-Day Implantable Eversense Continuous Glucose Monitoring System, Including with the Twiist Automated Insulin Delivery System Integration

Abstract

Background: The Eversense 365 Continuous Glucose Monitoring (CGM) System is the first implantable, 1-year CGM approved in the United States and Europe. In February 2026, Eversense 365 became available in the United States with the twiist automated insulin delivery (AID) pump and twiist loop algorithm. While clinical trial performance has been reported, this article describes the real-world experience with the Eversense 365 CGM system using open-loop therapies and with the twiist AID system. Methods: Deidentified sensor glucose (SG) data from the Eversense Data Management System were analyzed for the first 12,360 sensors used with open-loop therapies. Analysis included mean SG, glucose management indicator (GMI), percent in glycemic ranges and achieving hypoglycemia targets, and median transmitter wear time. Performance across the full 365-day duration and between the first and second 180-day periods was evaluated. For the twiist AID system, analysis included 153 sensors with >30 days following twiist pairing. Results: For the 365 CGM system in open-loop, the mean age was 57 years. A mean of 43,225 (±32,394) CGM readings per sensor were available. Mean SG was 161 mg/dL, and GMI was 7.16%. Mean percent time < 54 mg/dL was 0.6%, <70 mg/dL 2.7%, 70–180 mg/dL (time in range, TIR) 66.2%, >180 mg/dL 31.2%, and >250 mg/dL 9.8%. Median transmitter wear time was 93%. Glycemic outcomes remained stable across the first and second 180-day periods. For users of the twiist + Eversense 365 AID system, mean SG was 145 mg/dL, GMI 6.78%, and TIR 76.1%, with 2.3% <70 mg/dL and 0.5% <54 mg/dL, and 99% median transmitter wear time. Conclusion: In this large real-world dataset, the 365-day CGM system demonstrated high adherence and favorable glucometrics sustained over extended wear. Early data from the twiist + Eversense 365 system support integration of the implantable CGM within an AID system to support consistent and reliable insulin delivery.