Basal Rate Adjustments in Omnipod Automated Insulin Delivery Systems
When you adjust the basal rate settings on an Omnipod automated insulin delivery (AID) system, these changes apply only to manual mode operation; the automated algorithm in AID mode independently modulates insulin delivery based on continuous glucose monitoring feedback and does not directly use your programmed basal rates. 1
How Omnipod 5 AID Mode Works
The Omnipod 5 algorithm replaces traditional basal rates with automated microboluses or microdoses of insulin delivered every 5 minutes, adjusting delivery by increasing, decreasing, or pausing insulin based on CGM feedback and predicted glucose direction. 1
The system modulates insulin delivery independently of your programmed basal rate settings when operating in automated mode, using its own predictive algorithm to determine insulin needs. 1
The algorithm does not "relearn" from manual basal rate changes—it operates based on real-time CGM data, predicted glucose levels (typically 30-60 minutes ahead), and adjustable glucose targets (generally 110-150 mg/dL). 1, 2
When Manual Basal Rates Matter
Your programmed basal rates only apply when the system reverts to manual mode, which can occur automatically under certain conditions or when you manually switch modes. 1
It is critical to periodically update your manual mode settings even while primarily using AID, as overall insulin needs may change over time, particularly in pediatric populations, and outdated manual settings could be dangerous if the system reverts unexpectedly. 1
Manual mode settings should be reassessed every 1-2 weeks based on continuous glucose data, as insulin requirements change with weight, activity level, and insulin sensitivity. 3
Adjustable Parameters in AID Mode
The parameters you can adjust to optimize Omnipod 5 automated insulin delivery include: 1
Glucose targets (typically 110-150 mg/dL in 10 mg/dL increments, with real-world data showing median time-in-range of 68.8% at 110 mg/dL target versus 53.6% at 130-150 mg/dL targets) 2
Insulin-to-carbohydrate ratios for meal boluses (all current AID systems allow ICR adjustment) 1
Correction factors/insulin sensitivity factors 1
Activity/exercise modes (which typically raise glucose targets and reduce insulin delivery conservatively, though some systems may still give autocorrection boluses above certain thresholds) 1, 4
Common Pitfalls to Avoid
Do not assume that changing basal rates will affect AID mode performance—the algorithm operates independently and you must adjust the parameters listed above (glucose targets, ICR, correction factors) to optimize automated delivery. 1
Never neglect manual mode settings thinking you'll always be in AID mode—system failures, illness requiring increased insulin, steroid use, or pregnancy may necessitate reverting to manual mode, and outdated settings could lead to dangerous hypo- or hyperglycemia. 1
Verify whether low-glucose suspend features remain active in manual mode, as this varies by system and could affect hypoglycemia risk if the system reverts unexpectedly. 1
Understand that temporary basal rate reductions (such as 50% reduction started 90 minutes before exercise) can be effective strategies in manual mode but work differently than the automated exercise mode adjustments in AID. 4