New Year, New Beginnings: Using Omnipod® to Manage Exercise & Other Activities

The writers of this blog, Evan Deane RN, CDCES & Christine O’Neil RN, CDCES, are employees of Insulet Corporation. The authors’ opinions are their own.
This article is informational only and is not a substitute for medical advice and/or services from a healthcare provider (HCP). This article may not be relied upon in any way in connection with your personal healthcare related decisions and treatment. All such decisions and treatment should be discussed with a healthcare provider who is familiar with your individual needs.

With 2024 upon us, ’tis the season for a new year, new beginnings mindset. For many, this may mean fresh starts, goal setting, and steps toward a healthier lifestyle. Setting a New Year’s resolution will look different for everyone, whether it be hitting a daily step goal, starting a yoga class, embracing community in a group fitness class, or taking on the thrill of a new skill or hobby like rock climbing or dance. Whatever your plans are, exercising with diabetes can introduce new challenges when it comes to managing your blood glucose. Luckily, Omnipod is equipped with features that can help make this balancing act a little bit easier.

Evan Deane and Christine O'Neil are both Registered Nurses (RNs) and Certified Diabetes Care and Education Specialists (CDCES) living with diabetes. As members of our Clinical Product Support team, Christine and Evan bring a wealth of knowledge, experience, and passion to help Podders thrive with Omnipod. In this post, they’ll cover some of the most common topics they hear from customers about blood glucose management during exercise or an increase in activity.

Omnipod 5 Automated Insulin Delivery System's unique Activity feature can be particularly helpful in preparing for when you may need less insulin, such as before, during, and after exercise. When activated, SmartAdjust™ technology temporarily reduces insulin delivery and sets your Target Glucose to 150 milligrams per deciliter (mg/dL) for the amount of time you choose, up to 24 hours. Activity feature works best when it's set ahead of time, to reduce the total amount of insulin in your body (or insulin on board). Since everyone's diabetes is different, you should discuss appropriate timing and duration of use of the Activity feature with your healthcare provider (HCP).

Omnipod DASH® can also simplify managing diabetes around exercise with the ability to set a Temp Basal Rate. Temp Basal Rates allow you to make changes to the amount of basal (or continuous background) insulin your Pod is delivering for a set period of time. Like Omnipod 5's Activity feature, Temp Basal Rates may work best when set ahead of time to reduce the total amount of insulin on board (IOB) before exercising. Talk to your HCP about how to best configure the rate and duration of a Temp Basal Rate, before using the feature.

Temp Basal Rates can be set in one of two ways:

  • Percentage (%): Percentage allows for a change to be made by increasing your programmed basal rate by the percentage entered. For example, a down arrow of 20% would indicate a 20% decrease from your programmed basal rate.
  • Flat Rate (Units per hour or U/hr): A Flat Rate allows you to specify the exact basal rate you would like to deliver and replaces your programmed basal rate for the duration of time selected. For example, a flat rate of 1 U/hr will deliver exactly 1 U/hr for the length of time selected.


Factors to Consider Around Activity


For those that would like to use it, Temp Basal Rates are also accessible in Omnipod 5 in Manual Mode. When using Temp Basal Rates in Manual Mode, insulin delivery will not be automatically adjusted in response to predicted rising or falling glucose like it would in Automated Mode, so speak with your HCP to see if using Temp Basal Rates in Manual Mode is right for you. 

In addition to Activity feature and Temp Basal Rates, there are more factors to consider when preparing for exercise that may impact the way you choose to manage your diabetes.

Activity Type

Just as your glucose can respond differently to foods, it can do the same with varying forms of exercise, which may result in high (hyperglycemia) or low (hypoglycemia) glucose levels.

With aerobic exercise, like the examples below, the body utilizes oxygen to fuel the activity. Aerobic exercise can increase insulin sensitivity and can decrease your body’s stored glucose reserves, which may increase the risk of low glucose even hours after the activity is complete. Explore options for lessening the risk of hypoglycemia with your HCP such as reducing a mealtime bolus before the activity or utilizing Activity feature or a Temp Basal.

  • Running, jogging or walking 
  • Swimming 
  • Skiing or snowboarding
  • Elliptical 
  • Rowing 
  • Cycling 
  • Stair Climbing 
  • Step Aerobics 
  • Dancing 
  • Hiking

Anaerobic activity, like the examples below, involves short bursts of energy. Anaerobic activity does not rely on oxygen for fuel and instead uses energy stored in your muscles. During these types of exercise, your body releases hormones that cause your liver to release extra glucose into your body. If you experience exercise-induced hyperglycemia, discuss the possibility of incorporating a pre-activity bolus with your HCP.

  • High-Intensity Interval Training (HIIT)
  • Weightlifting 
  • Sprinting 
  • Dancing
  • Gymnastics
  • Figure skating  
  • Jumping rope 
  • Wrestling 

Recent Meals or Insulin on Board (IOB)

One consideration that may be overlooked when getting ready to break a sweat is the impact that recent meals or IOB may have on glucose levels. IOB refers to the insulin delivered by your Pod that remains active in your body and continues to reduce your blood glucose. Exercise has the potential to increase your sensitivity to insulin and, as a result, your glucose may drop quicker during or after exercise if you have a considerable amount of IOB from a recent meal or correction bolus. Be mindful of this when you're planning to exercise. For example, if you're eating lunch, but planning to go on a jog shortly after, your HCP may suggest reducing your meal bolus in order to prevent hypoglycemia.

Time of Day

Are you an early morning weightlifter, or a late-night yogi? Depending on your answer, you may find you need to adjust for exercise differently. One consideration is something called Dawn Phenomenon where people with diabetes may see increased glucose levels in the early morning due to hormones released during sleep, which cause the liver to produce more glucose.

If you frequently experience Dawn Phenomenon, you may consider scheduling activity in the morning to combat the rise in your glucose levels. Additionally, exercising before breakfast will mean less IOB from previous boluses, which may make avoiding hypoglycemia easier.

Alternatively, if you prefer to work out in the afternoon or evening, you may have more IOB prior to exercising. In this case, you may need to adjust your insulin delivery for a longer length of time before any activity to reduce the total amount of IOB before exercising.

Unplanned Activity

Another factor to consider is unplanned movement like tidying up around the house, yard work, or grocery shopping. You may find that your glucose drops during these activities. Take note of these and consider talking to your HCP about some of the tips discussed in this article.

If preparing for or managing diabetes around exercise sounds like a workout in and of itself, we get it! Sometimes, life doesn't allow you time to adjust your insulin delivery before a spontaneous opportunity arises. If you aren't able to plan or adjust your insulin for exercise, consider the other route and talk to your HCP about pretreating with fast-acting carbohydrates to allow your glucose to rise before exercise. Depending on the length, intensity, or type of exercise, you’ll want to adjust your carbs accordingly. Additionally, Activity feature and Temp Basal Rates may still be useful here to minimize the risk of low glucose during and after exercise. 

Real World Scenarios


Let’s take a look at the following Podder® stories to see how what we’ve covered can apply to everyday life.


Christopher started Omnipod DASH a month ago. He enjoys the freedom from multiple daily insulin injections (MDI) and the ease of use. Christopher has been shopping for his grandchildren for the holidays the past few weeks and has visited the local mall for a few hours daily in search of the perfect gifts.   

Unfortunately, he's been experiencing hypoglycemia after getting home from his shopping trips and is unsure why this is happening. Especially because he eats a sandwich at the food court before shopping, which he thinks would prevent his glucose from dropping. He wonders what the cause is.

Recommendation: Christopher should discuss options for reducing hypoglycemia with his HCP, such as reduction of his mealtime bolus before shopping or utilizing the Temp Basal feature.


Emily is on the Omnipod 5 Automated Insulin Delivery System and recently started training for a marathon. Unfortunately, she's been experiencing hypoglycemia during her runs. Emily is unsure why this is happening since she eats a large muffin before beginning her run and she's frustrated because she often has to stop in the middle of her run to treat a low.   

Recommendation: Large carbohydrate snacks can result in glucose spikes, which increase insulin delivery in Automated Mode, putting Emily at risk for hypoglycemia during the run. Emily should consider eating smaller quantities of carbohydrates during the run (as needed) and should talk to her HCP about utilizing Activity feature.


Liam is on the Omnipod 5 Automated Insulin Delivery System and recently qualified for the finals in wrestling. He does high-intensity interval training as part of his conditioning and he doesn't understand why his glucose spikes during HIIT and that it elevates even more on wrestling competition days. He always thought exercise would help lower his glucose.   

Recommendation: While anaerobic exercise has long-term benefits on glucose control, it may result in exercise-induced hyperglycemia during the activity. During these types of exercise, the body releases hormones such as adrenaline, that cause the liver to release extra glucose into the body. Liam should talk to his HCP about his exercise-induced hyperglycemia and the possibility of incorporating a pre-activity bolus. 

Whether you use these tips to bring your New Year’s resolutions to new heights or you incorporate them into new goals months from now, we want to see you put what you’ve learned into motion. Share pictures of you being active with Omnipod on social media and don’t forget to tag @Omnipod!

© 2024 Insulet Corporation. Omnipod, Omnipod DASH, the Omnipod logo, SmartAdjust, Simplify Life, Podder, and Podder Talk, are trademarks or registered trademarks of Insulet Corporation. All rights reserved. All other trademarks are the property of their respective owners. The use of third-party trademarks does not constitute an endorsement or imply a relationship or other affiliation.