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Omnipod 5 vs Tandem t:slim X2 with Control-IQ: Which is Best?

Omnipod 5 vs Tandem t:slim X2 with Control-IQ: Which is Best?

*Disclaimer: All content and information in this blog is for informational and educational purposes only. This article was medically reviewed by Amanda Ciprich, MS, RD. Last updated on 03/25/2024.

Insulin pumps have come a long way in recent years, offering users more automated insulin delivery features for managing their diabetes. Two of the most popular insulin pumps that are currently available are the Tandem t:slim X2 with Control-IQ and the Omnipod 5 System. Both of these insulin pumps have unique features that can make them appealing to different users. In this blog post, we are going to compare the overall user experience of Omnipod 5 and Control-IQ. Whether you are choosing your first insulin pump or looking to upgrade your current device, this blog post will provide a comprehensive comparison so you can make an informed decision about which system will be best suited for you.

Overview of Omnipod 5 Features

How does Omnipod 5 basal automation work?

Omnipod 5 uses an adaptive basal rate that takes the last pod’s average total daily insulin dose and applies 50% to the daily basal requirement. The basal rate uses this continuous baseline in addition to automatically adjusting basal rates every 5 minutes based on CGM values and 60-minute prediction.

When CGM values are predicted to be above or below the specified target ranges, the adaptive basal rate will increase or decrease accordingly. While in automated mode, the adaptive basal rate is updated with every Pod change as well as every 5 minutes based on CGM values. Omnipod 5 users cannot adjust basal rates while in automated mode, but can edit their target glucose that can influence automated insulin delivery.

What are the target glucose ranges for Omnipod 5?

A highlight of the Omnipod 5 insulin pump is that users can select their target ranges between 110-150 mg/dL, in 10 mg/dL increments. Omnipod 5 users also have the option to program up to 8 different targets throughout the day.

How does Omnipod 5 correct high blood sugars?

When CGM readings are above target range, Omnipod 5’s adaptive basal will increase in order to bring blood glucose back into target range. Currently, there is no automatic bolus feature with Omnipod 5.

What does Activity Mode do on Omnipod 5?

The activity feature in Omnipod 5 will automatically change the user’s target glucose to 150 mg/dL and begin decreasing insulin delivery at 150 mg/dL for a set period of time (1-24 hours) that the user selects. After the selected time expires, Omnipod 5 will go back to the user’s predetermined target glucose range. 

Which CGM systems can be used with Omnipod 5?

The Omnipod 5 system can be used with Dexcom G6, however, the Dexcom G6 receiver is not compatible. Users must use the Dexcom mobile app on their smartphone device as part of the Omnipod 5 system.

What are the special features of Omnipod 5?

Omnipod 5 is the first and only tubeless automated insulin delivery system that is integrated with a CGM. All of the other automated insulin delivery devices currently available on the market have tubing. This eliminates the need to disconnect during sports/exercise and water-based activities, which can be appealing for users. The Omnipod 5 system also allows users to set customizable glucose targets which differs from most automated insulin delivery devices that have fixed targets. This feature gives users the opportunity to alter their settings based on their schedule or daily activities when their blood sugar may run higher or lower.

What are the limitations of Omnipod 5?

There are several areas for improvement with the Omnipod 5 system. Users on Omnipod 5 cannot use an extended bolus or make temporary adjustments to basal delivery while in Automated mode. These features can be helpful for users in staying within their target glucose ranges especially when consuming high fat/high carbohydrate meals. Additionally, Insulet has provided healthcare providers with little-to-no information on the Omnipod 5 algorithm itself and knowing the exact inner workings of the automations within the algorithm seems to be a mystery.

Comparison of Omnipod 5 vs Tandem T:Slim

Overview of Tandem t:slim X2 Control-IQ

How does Tandem Control-IQ basal work?

Tandem Control-IQ technology will make adjustments by using the readings on a compatible CGM to predict glucose levels 30 minutes into the future and make insulin adjustments to the pre-programed basal rates as needed. Control-IQ will automatically increase basal insulin delivery when sensor glucose is predicted to be above 160 mg/dL, decrease basal insulin delivery if sensor glucose is predicted to be below 112.5 mg/dL, and will stop basal insulin delivery if sensor  glucose is predicted to be below 70 mg/dL.

What is the target glucose range for Tandem Control-IQ?

The target glucose for Control-IQ is set to 112.5 mg/dL for all users. The target glucose for Control-IQ can only be changed when users switch to Sleep Mode (112.5-120 mg/d) or Activity Mode (140-160 mg/dL), but will alter the settings for the automated basal and bolus features.

How does Control-IQ correct high blood sugars?

When Dexcom G6 sensor readings are predicted to be 180 mg/dL or more 30 minutes into the future, Control-IQ will automatically deliver a correction bolus. The automatic correction bolus will deliver only 60% of the calculated correction and a max of one correction bolus per hour.

What does the Activity Mode do on Control-IQ?

When activity mode is activated in Control-IQ, basal insulin delivery will decrease when the predicted value is less than or equal to 140 mg/dL compared to 112.5 mg/dL. Additionally, basal insulin delivery will be stopped when blood glucose values are less than or equal to 80 mg/dL. During activity, users will continue to receive increased basal delivery when blood glucose is greater than 160 mg/dL and correction boluses when blood glucose is over 180 mg/dL.

What CGM works with Tandem Insulin Pump?

The tandem t:slim X2 insulin pump with Control-IQ is currently the only automated insulin pump delivery system that is compatible with Dexcom G6, Dexcom G7, and Freestyle Libre 2 Plus.  

What are the Special Features of Tandem Control-IQ?

The most unique feature of the Tandem Control-IQ system is that it has exceptional personalization features for its users. When Control-IQ is activated, all of the user’s basal and bolus settings are applied. Users can adjust these as needed if their insulin requirements fluctuate throughout the day.  Additionally, Control-IQ automatically delivers correction boluses on the user’s behalf when blood sugar levels hit 180 mg/dL or above, enabling a faster return to target range.

What are the limitations of Tandem Control-IQ?

Control-IQ’s algorithm has many advanced features and personalization capabilities, but it also has limitations and drawbacks that users may encounter. Control-IQ has a default target range of 112.5 mg/dL, which may not meet users’ desired lower range preferences. The default insulin action time of 5 hours is unadjustable and may lead to overestimation of insulin on board as most people absorb insulin within 2-4 hours. The maximum duration for extended bolus is limited to just 2 hours, which may be insufficient during high carbohydrate/fat meals. While some users may become quickly accustomed to insulin pump tubing, others find it incredibly bothersome. The tubing replacement is complex and prone to air pockets, and the frequent disconnecting can impact blood sugar levels.

Which Insulin Pump is Best: Omnipod 5 or Tandem t:slim X2 with Control-IQ?

Both Omnipod 5 and Tandem Control-IQ have their own unique advantages and disadvantages. The best insulin pump will vary based on individual specific needs, lifestyle preferences, and health insurance coverage. Discuss the options with your healthcare provider to determine which pump is the best for you.


About Amanda Ciprich, MS, RD

Amanda Ciprich, a registered dietitian with a specialization in type 1 diabetes, was diagnosed with T1D herself at the age of 18. With her expertise and personal experience, she has authored two books, including "The Caregiver's Guide to Diabetes: Practical Advice for Caring for Your Loved One." As the founder of T1D Nutritionist, a virtual insurance-based private practice, Amanda provides counseling and guidance to individuals with T1D and their families, supporting them in effectively managing diabetes.