What are the recommendations for using the Omnipod (insulin pump system) in patients with type 1 or insulin-requiring type 2 diabetes?

Recommendations for Omnipod Insulin Pump System in Diabetes Management

Automated insulin delivery (AID) systems like Omnipod 5 should be the preferred insulin delivery method for patients with type 1 diabetes and insulin-deficient diabetes who can safely use the device (either themselves or with a caregiver), as they improve glycemic outcomes and reduce hypoglycemia. 1

Patient Selection and Benefits

Type 1 Diabetes

• Insulin pump therapy, particularly AID systems like Omnipod, provides significant benefits for patients with type 1 diabetes:
  • Reduces rates of severe hypoglycemia compared to multiple daily injections (MDI) 1
  • Decreases risk of diabetic ketoacidosis (DKA) 1
  • Reduces diabetes complications, particularly retinopathy and peripheral neuropathy in youth 1
  • Improves treatment satisfaction and quality-of-life measures 1
  • Increases time in range (TIR) with minimal time in hypoglycemia 2

Type 2 Diabetes

• Traditional insulin pumps, including tubeless systems like Omnipod, can be considered for patients with type 2 diabetes who are on MDI 1
• Recent evidence shows Omnipod 5 AID system in adults with type 2 diabetes:
  • Decreases HbA1c by approximately 1.3% 3
  • Increases time in range by 21.9% 3
  • Reduces time with glucose ≥250 mg/dL without increasing hypoglycemia 3

Specific Omnipod System Advantages

1. Tubeless Design:

   • Overcomes physical inconveniences of conventional tubed insulin pumps 4
   • 56% of users report that Omnipod fits better into their lifestyle than conventional CSII 5
   • 76% prefer the automated cannula insertion system 5

2. Automated Insulin Delivery (Omnipod 5):

   • Real-world evidence from nearly 70,000 users shows effective glycemic management 2
   • Median time in range of 68.8% for users with average glucose target of 110 mg/dL 2
   • Improvements in glycemic control occur rapidly (within 9 days) and are sustained 6
   • Benefits observed across diverse populations, including Medicaid/Medicare users 2

Implementation Considerations

Target Setting

• Multiple glucose targets are available (110-150 mg/dL in 10 mg/dL increments) 2
• Lower targets (110 mg/dL) achieve higher time in range (median 68.8%) 2
• Higher targets are more commonly used in younger age groups 2

Transitioning to Omnipod

• For patients transitioning from MDI to Omnipod 5 with type 2 diabetes, a 2-week manual mode period before starting AID may be beneficial 3
• Significant improvements in treatment satisfaction occur within 12 weeks of transitioning to Omnipod from either MDI or tubed insulin pumps 4

Special Populations

• Children and adolescents: Pump therapy may be the preferred mode of insulin delivery for children under 7 years of age 1
• Older adults: Access to insulin pump therapy, including AID systems, should be allowed or continued in older adults as it is in younger people 1
• Perioperative management: Hospitals should develop clear protocols for inpatient management of people on insulin pump therapy, with education for all healthcare professionals 1

Potential Barriers and Considerations

• Visual or cognitive impairment
• Loss of manual dexterity
• Infusion site reactions
• Psychological burden of device attachment
• Financial considerations and insurance coverage

Monitoring and Follow-up

• Regular assessment of glycemic metrics (TIR, time below range, HbA1c)
• Evaluation of quality of life and treatment satisfaction
• Adjustment of target glucose settings as needed

Insulin pump therapy, particularly AID systems like Omnipod 5, represents a significant advancement in diabetes management that can improve clinical outcomes and quality of life for patients with both type 1 and insulin-requiring type 2 diabetes when patients are capable of safely using the device.