Recommended Settings for Omnipod 5 in Automatic Mode
For optimal morbidity, mortality, and quality of life outcomes, the Omnipod 5 automated insulin delivery system should be set with glucose targets between 110-120 mg/dL for most patients, with the system maintained in automated mode at least 95% of the time. 1
Key Setting Parameters for Omnipod 5 in Automatic Mode
Glucose Target Settings
- Primary glucose target: 110-120 mg/dL provides the best balance of glycemic control while minimizing hypoglycemia risk 2
- Target adjustment timing: Set up for 24 hours but can be adjusted with up to eight segments per day 1
Exercise and Activity Adjustments
- For planned exercise: Increase glucose target from 130 to 150 mg/dL starting 90 minutes before exercise 3
- Alternative approach: Use temporary 50% basal rate reduction 90 minutes pre-exercise 3
- Activity mode: Enable activity/exercise mode for periods of increased physical activity 1
- This raises the glucose target to reduce hypoglycemia risk
- Note that some systems may still deliver autocorrection boluses if glucose rises above threshold even in activity mode 1
Meal Management
- Carbohydrate announcements: Manual entry of carbohydrates remains necessary for meal boluses 1
- Insulin-to-carbohydrate ratio: This parameter can be adjusted to optimize insulin delivery 1
Insulin Delivery Parameters
- Maintain automated mode: Aim for >95% time in automated mode for optimal outcomes 4
- Adjustable parameters:
- Insulin-to-carbohydrate ratios
- Insulin sensitivity/correction factors
- Active insulin time 1
Special Considerations
When to Revert to Manual Mode
- During illness: When experiencing temporarily increased insulin resistance or reduced oral intake with ketosis 1
- With steroid treatment: AID systems may not respond rapidly enough to increased insulin requirements 1
- During pregnancy: Lower targets needed may not be achievable on AID systems 1
Safety Considerations
- Manual mode settings: Update manual mode settings periodically as insulin needs change, particularly in pediatric populations 1
- Low glucose suspend features: Understand whether these remain active when reverting to manual mode 1
- Hypoglycemia correction: With AID systems, fewer carbohydrates are needed to correct hypoglycemia as basal insulin will be suspended 1
- Avoid overcorrection which can lead to rebound hyperglycemia
Monitoring and Optimization
- Regular data review: Ensure data is available for providers to view for dose optimization 1
- Time-in-range goal: Aim for >70% time in range (70-180 mg/dL) 2, 4
- Hypoglycemia minimization: Expect <1% time below 70 mg/dL 2, 4
Contingency Planning
- Always maintain backup supplies including:
- Batteries/charging cables
- Insulin infusion sets
- Reservoirs
- Vial of insulin and syringes/pens
- Glucose meter and test strips
- Glucagon
- Ketone test strips
- Backup glucose sensor and transmitter 1
By following these recommended settings and considerations, patients can maximize the benefits of the Omnipod 5 automated insulin delivery system while minimizing risks of hypo- and hyperglycemia, ultimately improving clinical outcomes and quality of life.