*Disclaimer: All content and information in this blog is for informational and educational purposes only.

The long-awaited announcement of FDA approval of Omnipod 5 finally came in January 2022. This system is the first automated insulin delivery system that is completely tubeless. Omnipod 5 is a hybrid closed-loop AID (automated insulin delivery device) that is comparable to the current Medtronic and Tandem systems. Here’s what you should know:

What is Looping?

The term “looping” comes from the full-term hybrid-closed loop system. These systems allow insulin pumps to do a lot of daily thinking, math, and worrying for you. For example, if you are dropping low, your CGM will inform your pump and utilize the algorithm your pump will either suspend or decrease your basal insulin to prevent the low. On the other end if your blood sugar levels are running higher, your pump will again utilize the data from your CGM and increase your basal rate or give you a partial correction dose. These devices can greatly improve blood glucose control and quality of life for people with diabetes by decreasing daily decision making required to manage blood sugars through automated protection against high and low blood sugar levels.

Pros of Looping:

• Users don’t have to micromanage their blood sugars 24/7 as the system is running without the user needing to manually input information.
• Improved overnight blood sugar levels from automatic insulin dosing which can reduce the number of overnight alarms decrease sleep disruptions.
• Low blood sugars are often less frequent and mild as the system will automatically decrease or suspend insulin delivery.
• The system can allow for carbohydrate counts to be slightly off as the system will automatically increase basal insulin or provide a correction.

Cons of Looping:

• Insurance coverage is poorly established for AID technology so there are often high-costs associated with the use of the systems.
• Troubleshooting issues from inaccurate CGM readings, faulty sites, or occlusions.
• Does not take away all of the daily decision making. The user will still be responsible for accurate carb counting for meals and prebolusing.
• There is a learning curve when starting with a hybrid-closed loop system as the user must be able to trust the system and technology. If the users do not trust the system, blood sugar levels have many high peaks and valleys as the system and user are trying to override each other.
• Limited research for children under 6 years of age.

Omnipod 5 Features:

• CGM integration with Dexcom G6 to protect against highs and lows.
• The system utilizes SmartAdjust Technology where it will automatically increase, decrease, or pause insulin delivery every 5 minutes based on your customized target range and 60-minute predicted glucose level.
• You can set your goal range to 110-150mg/dL (T:slim defaults this range to 110mg/dL and 160mg/dL and Medtronic defaults this range to 120mg/dL and 150mg/dL for exercise)
• When the activity feature is utilized, it will automatically set your target glucose to 150mg/dL.
• Omnipod 5 is compatible with Android with hopes for future compatibility with iPhone to be used as a controller.
• Users have the option of automated and manual mode.
• Approved for ages 6 years and older.
• Pods hold up to 200 units of insulin
• Dosing increments: 0.05 units per hour
• Basal Rate Delivery: 0.05 to 30 units per hour
• 5 year warranty

Automated insulin delivery systems like Omnipod 5 can be a great option for people with diabetes. However, it is still a medical device that may experience technical errors or malfunctions like kinked cannulas, occlusions, or failed adhesives. While looping can take some of the mental guesswork and burden from daily decision making, users are still needed to engage in their management and may still experience variability in their blood sugar levels. While no system is perfect and there are many barriers to care, research shows that Omnipod 5 can be of benefit to blood sugar management for people with diabetes.

Written By: Amanda Ciprich, MS, RD
Founder of T1D Nutritionist
Website: www.t1dnutritionist.com
Instagram: @t1d.nutritionist