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 is based on the patient’s total daily insulin (TDI). When Omnipod 5 is first initiated, the patient’s TDI is estimated off the basal program entered in Manual Mode. Omnipod 5 assumes that this basal program accounts for approximately 50% of the TDI while bolusing accounts for approximately 50%.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:

• Review the individuals actual insulin delivery compared to the programmed settings in the current pump to assess bolus overrides, temporary basal rate use and missed boluses and ensure an accurate assessment of the current TDI.¹
• Ensure that the initial basal rate entered when activating the first Pod accounts for approximately 50% of the patient’s expected TDI¹
• Prior to starting the patient on Omnipod 5, review their personalized bolus settings to optimize glycemia related to boluses for meals and corrections. These settings include insulin to carb ratio, correction factor, and duration of insulin action.
• Encourage the patient to pre-bolus for meals, ideally 10-20 minutes before eating¹ 

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 adjust basal rates to impact their algorithm.  With Omnipod 5, basal rates are only used in Manual Mode and not used by the algorithm in Automated Mode except to calculate the first Pod’s initial TDI.  Changing basal rates after initiation will not impact the algorithm. Instead, Target Glucose is the only setting that directly impacts the insulin delivery from the algorithm.  In general, a lower target usually equates to more TIR and lower mean glucose, whereas a higher target equates to less TIR, higher mean glucose, and reduced hypoglycemia risk. The TDI is updated with each Pod change, allowing the algorithm to adapt to changing insulin needs. Real-world insights have shown TIR can be maximized with optimized settings of Target Glucose 110 mg/dL, Insulin to Carb Ratio ≤350/TDI and a Correction Factor ≤1500/TDI ⁴.

Suggestions for Improving Success:

• Aim for your patients to have approximately 50% of their TDI as basal insulin 
• Target Glucose is the only adjustable setting that can directly impact automated insulin delivery.
• Real world users increased time in range by 10-12% by switching to the lowest Target Glucose setting with no clinically meaningful impact on time below range.³
• Real-world insights have shown TIR can be maximized with optimized settings.³  Consider strengthening bolus settings at follow-up appointments
• The Omnipod 5 System Overview video gives further optimization and monitoring suggestions for the adaptive basal rate

The Omnipod 5 delivers microboluses every 5 minutes based on:

• Sensor values and trends
• Insulin on Board (IOB)
• Target Glucose (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 adjusts insulin delivery every 5 minutes for up to 12 autocorrections per hour. The system can deliver up to four times the adaptive rate to help protect against and correct highs.   

Suggestions for Improving Success:

• When administering a correction bolus for hyperglycemia, your patient should use the SmartBolus calculator, which can include the sensor trend in its bolus calculation. Tap  
  “Use Sensor” so the system can add up to 30% more insulin to a suggested bolus to address hyperglycemia
• Consider stronger bolus settings, like Correction Factor of ≤ 1500/TDI to help maximize TIR⁴

Our goal is to offer patients the ability to start on Omnipod 5 using their preferred sensor brand. The Omnipod 5 AID System is integrated with the following CGM sensors: Dexcom G7 Series, Dexcom G6, and the FreeStyle Libre 2 Plus Sensor.  A separate prescription is needed for the CGM sensors.  

Please visit our innovation page and sign up for our newsletter to stay up to date on upcoming innovations and releases.

• 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, Annan SF, Biester T et al. Practical considerations for using the Omnipod® 5 Automated Insulin Delivery System: Clinical experience from the United States and Europe. Diabetes Obes Metab. 2025;1-11 doi:10.1111/dom.16321
2. 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/
3. Forlenza G, et al. Presented at: ATTD; March 19-22, 2025; Amsterdam, NL. Real-world data from 403 people with T1D aged 2+, and 58 people with T2D aged 18+ using the Omnipod 5 System who transitioned from the 150 mg/dL to 110 mg/dL Target Glucose. Each Target Glucose was used for a consecutive period of 14-90 days. Median time in Range (70-180 mg/dL) improved +11.8% (p<0.05), and median time <70 mg/dL +0.23% (p<0.05) for people with T1D. Median time in Range (70-180 mg/dL) improved +10.4% (p<0.05), and median time < 70 mg/dL +0.04% (non-significant) for people with T2D. Omnipod 5 results based on users with ≥75% of days with ≥220 readings available. Data on File. 05.15.25. RF-042025-00013
4. Retrospective RWE data on file.  2025.  Results shown for users with optimized settings including sufficient CG data (≥  75% of days with ≥ 220 readihngs), ≥ 90% time in Automated Mode, ≥5 bolus/day and an average Target Glucose of 110-115mg/dL.  Optimized settings: ISF x TDI ≤ 1500, IC Ratio x TDI ≤ 350.  RF-062025-00014 

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