Switching Patients from Other Automated Insulin Delivery (AID) Systems to Omnipod® 5

“She was struggling with a tubed pump … she would forget to put it back on … so I put her on the [Omnipod] 5. … At her two-week follow-up I saw the most remarkable difference in her Time in Range and her graph was so impressive. Everyone was crying. And she said this is so much better.” —Dr. Anita Swamy about one of her patients

Many patients have had experiences similar to the one Dr. Swamy describes. In this patient’s case, she attributed her success to the on-body experience, but the tubeless design isn’t the only factor that distinguishes the Omnipod 5 AID system from other pumps. To help set your patients up for success with the Omnipod 5 AID system, it’s important to first understand a few key aspects of the Omnipod 5 algorithm, especially if you’re used to prescribing and optimizing other pumps. For a reminder of training resources available to you, visit our Provider Resources page.

The Omnipod 5 algorithm—called SmartAdjust™ technology—takes into account the patient’s total daily insulin (TDI). This is one of its key underlying bases for insulin delivery decisions. When Omnipod 5 is first initiated, the patient’s TDI is estimated off the basal program entered in Manual Mode. SmartAdjust technology assumes that this basal program accounts for 40-50% of the TDI while bolusing accounts for 50-60%.¹

Why does this matter? If the factors going into the TDI calculation are not based on the 50/50 split, then it may take longer for the system to adapt to the user’s insulin needs. The success of SmartAdjust technology hinges on accurate TDI.

For example, if you enter in a basal program intended to cover 30% of the patient’s insulin needs or if your patient chronically misses boluses, this will underestimate the user’s true TDI and may affect the adaptive basal rate.

Suggestions for Improving Success:

• Ensure that the initial basal rate entered when activating the first Pod accounts for 40-50% of the patient’s TDI¹
• Encourage the patient to pre-bolus for meals
• Prior to starting the patient on Omnipod 5, review their personalized bolus settings to optimize glycemia around meals and correction boluses. These settings include insulin to carb ratio, correction factor, and duration of insulin action.

One of the key features of the Omnipod 5 system is the adaptive basal rate. That adaptive basal rate is calculated with every Pod change. The system uses a decaying weighted average of TDI and more heavily weights the last 4 to 5 Pods when calculating the new adaptive basal rate.

Why does this matter? Some AID systems let you adjust the basal rate as a setting. With Omnipod 5, because the basal rate and TDI are adaptive based on the patient’s insulin needs, they cannot be adjusted as a setting. Instead, Target Glucose and bolus settings are the adjustable variables you can focus on in order to directly impact TDI. This ultimately impacts the adaptive basal rate set by the system, and with it, insulin delivery.

Suggestions for Improving Success:

• Aim for your patients to have 40-50% of their TDI as basal insulin and 50-60% as bolus insulin¹
• Remember that Target Glucose is the only adjustable setting that can directly impact automated insulin delivery, but indirectly bolus settings may
• The Omnipod 5 System Overview video gives further optimization and monitoring suggestions for the adaptive basal rate

The Omnipod 5 delivers micro boluses every 5 minutes based on:

• Sensor values
• Insulin on Board (IOB)
• Target Glucose (Adjustable from 110-150 in 10 mg/L increments)
• Adaptive Basal Rate

The SmartAdjust technology algorithm looks 60 minutes ahead, predicts where your patient’s blood glucose will be then and increases, decreases, or pauses insulin delivery every 5 minutes based on that prediction.

Why does this matter? Depending on your or your patient’s previous pump experience, you may be looking for automated correction boluses in cases of hyperglycemia. Omnipod 5 does not automatically administer a separate bolus for hyperglycemia. Instead, it automatically course corrects blood glucose with micro boluses every 5 minutes based off the factors noted above, while in Automated Mode. The system can deliver up to four times the adaptive basal rate in order to address hyperglycemia.

Suggestions for Improving Success:

• When administering a correction bolus for hyperglycemia, your patient should use the SmartBolus calculator which includes the CGM trend in its bolus calculation. In this way, the system can add up to 30% more insulin to a suggested bolus to address hyperglycemia by tapping “Use Sensor” within the bolus calculator.
• If your patient is struggling with TIR due to hyperglycemia, we invite you to create an Omnipod Connect account [link to Omnipod connect] and review the eLearning module on Omnipod 5 AID System: Management and Optimization

The Omnipod 5 AID system currently requires a Dexcom G6 to be used in Automated Mode. A separate prescription is needed for the Dexcom G6.

Our goal is to offer patients sensor of choice with operating system of choice, but currently the Dexcom G6 is the only compatible sensor for Omnipod 5. Please visit our innovation page and sign up for our newsletter to stay up to date on upcoming innovations and releases.

Meanwhile, if your patient uses a different sensor and would prefer not switching, we recommend considering the Omnipod DASH® system.

• System Overview Video
• Initiation, Everyday Use, and Expectation Setting Video
• A Comparison Chart of AIDs
• Omnipod Connect is a healthcare provider platform that gives you access to eLearning when you create a free account. For an in-depth review of Omnipod 5, we recommend viewing the Omnipod 5 eLearning modules.
• Contact Us: If you need additional guidance for the Pump Therapy Order Form, you can reach out to your local clinical rep.

1.Berget C, Sherr JL, DeSalvo DJ, et al. Clinical Implementation of the Omnipod 5 Automated Insulin Delivery System: Key Considerations for Training and Onboarding People With Diabetes. Clin Diabetes. 2022;40(2):168-184. doi:10.2337/cd21-0083 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9160549/