Omnipod Insulin Pump for Diabetes Management
Automated insulin delivery (AID) systems like Omnipod should be the preferred insulin delivery method for people with type 1 diabetes and other insulin-deficient diabetes who can safely use the device, as they improve glycemic outcomes and reduce hypoglycemia. 1
Suitability for Different Types of Diabetes
Type 1 Diabetes
- AID systems like Omnipod are strongly recommended for youth and adults with type 1 diabetes who can safely use the device (either independently or with caregiver assistance) 1
- The Omnipod 5 System has demonstrated favorable glycemic outcomes in real-world conditions across nearly 70,000 children and adults with type 1 diabetes 2
- Insulin pump therapy has modest advantages for lowering A1C (0.30% reduction) and reducing severe hypoglycemia rates in children and adults with type 1 diabetes 1
Type 2 Diabetes
- Insulin pump therapy can be offered to people with type 2 diabetes on multiple daily injections who can safely use the device 1
- The choice should be based on individual circumstances, preferences, and needs 1
- Recently, one AID system was approved for use by people with type 2 diabetes 1
Other Types of Diabetes
- Insulin pumps are suitable for other types of insulin-deficient diabetes (e.g., post-pancreatectomy, cystic fibrosis-related diabetes) 1
- For insulin-requiring patients with any type of diabetes, pumps may improve satisfaction and simplify therapy 1
Benefits of Omnipod System
Clinical Outcomes
- The Omnipod 5 System has shown improvements in time in range (70-180 mg/dL) with minimal time below 70 mg/dL in real-world use 2
- Long-term studies (up to 2 years) in very young children show maintained improvements in glycemic outcomes with the Omnipod 5 AID System 3
- The tubeless AID system has demonstrated improved HbA1c levels and increased time in range for both adults and children with type 1 diabetes 4
Design Advantages
- Omnipod is the first commercially available "patch pump" - a fully integrated wearable pump controlled wirelessly through a handheld device with a built-in blood glucose meter 5
- Most insulin pumps use tubing to deliver insulin through a cannula, while Omnipod attaches directly to the skin without tubing 1
Cost-Effectiveness
- The tubeless AID system (Omnipod 5) has been found to be cost-effective compared to standard of care in people with type 1 diabetes from a US payer's perspective 4
- For children with type 1 diabetes, the incremental cost-effectiveness ratio was $9,927 per QALY gained 4
- For adults with type 1 diabetes, the incremental cost-effectiveness ratio was $10,310 per QALY gained 4
Important Considerations
Patient Selection
- The choice of device should be based on individual circumstances, preferences, and needs 1
- Patients must be capable of using the device safely (either independently or with caregiver assistance) 1
- DiabetesWise (diabeteswise.org) and DiabetesWise Pro (pro.diabeteswise.org) can help healthcare professionals and patients choose appropriate diabetes devices 1
Exercise Management
- The Omnipod personalized model predictive control algorithm has shown good performance during moderate intensity exercise in adults with type 1 diabetes 6
- Options for exercise management include temporarily raising glucose set points or reducing basal rates before exercise 6
Access and Disparities
- Adoption of pump therapy shows geographical variations related to healthcare professional preference and socioeconomic status 1
- Pump therapy is more common in individuals of higher socioeconomic status as reflected by race/ethnicity, private health insurance, family income, and education 1
- Addressing differences in access to insulin pumps may contribute to reducing health disparities 1
- Individuals who have been using continuous subcutaneous insulin infusion should have continued access across third-party payers 1
Implementation Considerations
Initiation Process
- Practical aspects of pump therapy initiation include:
- Assessment of readiness of the person with diabetes and their family 1
- Selection of pump type and initial pump settings 1
- Education on potential pump complications (e.g., DKA with infusion set failure) 1
- Transition from multiple daily injections 1
- Introduction of advanced pump settings (e.g., temporary basal rates, extended/dual wave bolus) 1
Special Populations
- Older individuals with type 1 diabetes benefit from ongoing insulin pump therapy 1
- Pump therapy can be successfully started at the time of diagnosis 1
- For very young children (2-5.9 years), the Omnipod 5 AID System has demonstrated safety and effectiveness with up to 2 years of use 3
Inpatient Considerations
- Patients who can safely use diabetes devices should be allowed to continue using them in inpatient settings or during outpatient procedures when proper supervision is available 1