Optimizing the Omnipod® 5 Activity Feature for Your Patients

Guest Blogger
Category: Tips & Guidelines
 

“One of my patients always says, ‘ah, I pulled the tube out from other devices.’ And for this one, she’s so free, she can go anywhere and doesn’t feel like it’s bothering her life, so it makes it much easier. … she knows there is an ease of mind.” —Karen Lau, CDCES about one of her patients

People living with type 1 diabetes can face various challenges related to glucose management and activity. One of the salient benefits of the Omnipod 5 Automated Insulin Delivery (AID) System is its tubeless form factor. It enables patients to keep wearing the Pod whether they’re performing activities of everyday living, going swimming1 or playing rugby, without the need to disconnect. Because insulin needs vary throughout the day, Omnipod 5 has the Activity feature as an additional tool to help users manage their glucose when they need less insulin, such as during illness or exercise. Below are tips and reminders to help you and your patients get the most out of the Activity feature.

 

How Does the Activity Feature Work?

The Activity feature can only be used if the Omnipod 5 is in Automated Mode. Once enabled, the Activity feature sets the Target Glucose to 150 mg/dL and reduces automated insulin delivery. A few reminders to keep in mind:

  • After the Activity feature is enabled, patients can step away from their Omnipod 5 App (on the patient’s compatible smartphone or Insulet-provided Controller) when needed. For example, an athlete can play on a field while the Omnipod 5 App stays on the sideline and the Activity feature will function as intended. This is because the Omnipod 5 algorithm, called SmartAdjust technology, is embedded within the Pod itself, not in the Omnipod 5 App. Please note that it is important to monitor for alarms and alerts. Both the Pod and the Omnipod 5 App will make an audible alert if the patient is at or below 55 mg/dL.
  • The duration of the feature can be set for up to 24 hours in one-hour increments. Once the desired time is up, Omnipod 5 automatically switches back into full automated insulin delivery and returns to using the Target Glucose defined in the settings.
  • It can be cancelled at any time before the set time period expires.
  • If the System enters Automated: Limited due to a loss of communication between the Pod and Sensor, Activity feature would remain enabled.

  • For a reminder on how to enable or cancel the Activity feature, watch this brief video: 
     

     

Understanding Correction Boluses During Activity Feature

While the Activity feature is on, the Target Glucose of Omnipod 5 is 150 mg/dL. However, if a user initiates a correction bolus while the Activity feature is enabled, Omnipod 5 will use the programmed Target Glucose and Correct Above setting, not the Activity feature’s target of 150 mg/dL.

For example, if Sally’s programmed Target Glucose is 110 mg/dL and the Activity feature is on when Sally initiates a bolus, the SmartBolus Calculator will use the Target Glucose of 110 mg/dL when suggesting a bolus amount.

 

Considerations for Timing

In general, for the Activity feature to be optimally effective, it is recommended to enable it prior to the activity.2 If delayed hypoglycemia is a concern post-exercise, you may consider extending the duration.2

However, different activities may have different lead times and durations to achieve the best results. Factors like insulin on board (IOB), starting glucose, time of day, exercise intensity, and type and duration of exercise, as well as a person’s individual biology, all contribute to the decision around when to turn on the Activity feature and how long to have it enabled.

To help your patients find their individual windows for the best timing, consult their data management reports with them.

Additionally, if your patient could benefit from education regarding which activities are likely to put them at higher risk of hypoglycemia, you can suggest they read our patient-facing article on the Activity feature. This piece was written by two of our clinical customer support team members living with type 1 diabetes and is full of insightful, easy-to-digest information about managing diabetes with the help of Omnipod 5.

 

Considerations for Activity Feature vs. Setting a Higher Target

If scheduled activities are consistent day-to-day you can determine with your patients whether the Activity feature or a customized Target Glucose might be a better fit for them.

For example, in cases of recess, practice, or daily mall walks, consideration could be given to using the customized Target Glucose setting to program a higher Target Glucose for that segment of the day. Omnipod 5 allows users to preset up to eight Target Glucose segments a day—customizable from 110-150 in 10 mg/dL increments. The advantage of this approach is that the patient won’t have to remember to enable the Activity feature for scheduled day-to-day activities.

Please remember that the higher Target Glucose does not create any changes in the algorithm as described in the “How Does the Activity Feature Work?” section.

 

Considerations for Pediatrics and Recess

Recess, gym, and other active times at school take special consideration on behalf of school nurses. Parents may consider working with their school nurse to demonstrate how to enable the Activity feature for these scenarios based on their school plan. This can be easily done remotely with the Omnipod 5 App by just standing near the child. School nurses may refer to the “Caregiver Guide” that can be downloaded here.

Some school protocols may require a child to be removed from class to enable the Activity feature. If this creates too much disruption for the child, consideration could be given to the customizable Target Glucose as noted in the previous section.

 

What If My Patient is Still Experiencing Hypoglycemia?

If your patient is using the Activity feature as intended, but is still experiencing hypoglycemia related to vigorous or prolonged activity, you may consider working with your patient to examine bolus strategies for meals and snacks prior to exercise based on pre-exercise glucose values.

Per the 2023 AID Consensus Guidelines "consideration can be applied to the amount of IOB from user-initiated boluses prior to exercise. Additionally, if pre-exercise glucose is <120 mg/dL, consider 15 g fast-acting carbohydrate at the start of moderate intensity exercise, without a bolus."3

 

Helpful Resources

 

1. The Pod has an IP28 rating for up to 25 feet for 60 minutes. The Controller is not waterproof.

2.Berget C, Sherr JL, DeSalvo DJ, et al. Clinical Implementation of the Omnipod 5 Automated Insulin Delivery System: Key Considerations for Training and Onboarding People With Diabetes. Clin Diabetes. 2022;40(2):168-184. doi:10.2337/cd21-0083                         
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9160549/

3. Moshe Phillip, Revital Nimri, Richard M Bergenstal, et al. Consensus Recommendations for the Use of Automated Insulin Delivery Technologies in Clinical Practice, Endocrine Reviews, Volume 44, Issue 2, April 2023, Pages 254–280, https://doi.org/10.1210/endrev/bnac022

INS-OHS-02-2024-00006V1.0

 

“One of my patients always says, ‘ah, I pulled the tube out from other devices.’ And for this one, she’s so free, she can go anywhere and doesn’t feel like it’s bothering her life, so it makes it much easier. … she knows there is an ease of mind.” —Karen Lau, CDCES about one of her patients

People living with type 1 diabetes can face various challenges related to glucose management and activity. One of the salient benefits of the Omnipod 5 Automated Insulin Delivery (AID) System is its tubeless form factor. It enables patients to keep wearing the Pod whether they’re performing activities of everyday living, going swimming1 or playing rugby, without the need to disconnect. Because insulin needs vary throughout the day, Omnipod 5 has the Activity feature as an additional tool to help users manage their glucose when they need less insulin, such as during illness or exercise. Below are tips and reminders to help you and your patients get the most out of the Activity feature.

 

How Does the Activity Feature Work?

The Activity feature can only be used if the Omnipod 5 is in Automated Mode. Once enabled, the Activity feature sets the Target Glucose to 150 mg/dL and reduces automated insulin delivery. A few reminders to keep in mind:

  • After the Activity feature is enabled, patients can step away from their Omnipod 5 App (on the patient’s compatible smartphone or Insulet-provided Controller) when needed. For example, an athlete can play on a field while the Omnipod 5 App stays on the sideline and the Activity feature will function as intended. This is because the Omnipod 5 algorithm, called SmartAdjust technology, is embedded within the Pod itself, not in the Omnipod 5 App. Please note that it is important to monitor for alarms and alerts. Both the Pod and the Omnipod 5 App will make an audible alert if the patient is at or below 55 mg/dL.
  • The duration of the feature can be set for up to 24 hours in one-hour increments. Once the desired time is up, Omnipod 5 automatically switches back into full automated insulin delivery and returns to using the Target Glucose defined in the settings.
  • It can be cancelled at any time before the set time period expires.
  • If the System enters Automated: Limited due to a loss of communication between the Pod and Sensor, Activity feature would remain enabled.

  • For a reminder on how to enable or cancel the Activity feature, watch this brief video:     

     

     

     

Understanding Correction Boluses During Activity Feature

While the Activity feature is on, the Target Glucose of Omnipod 5 is 150 mg/dL. However, if a user initiates a correction bolus while the Activity feature is enabled, Omnipod 5 will use the programmed Target Glucose and Correct Above setting, not the Activity feature’s target of 150 mg/dL.

For example, if Sally’s programmed Target Glucose is 110 mg/dL and the Activity feature is on when Sally initiates a bolus, the SmartBolus Calculator will use the Target Glucose of 110 mg/dL when suggesting a bolus amount.

 

Considerations for Timing

In general, for the Activity feature to be optimally effective, it is recommended to enable it prior to the activity.2 If delayed hypoglycemia is a concern post-exercise, you may consider extending the duration.2

However, different activities may have different lead times and durations to achieve the best results. Factors like insulin on board (IOB), starting glucose, time of day, exercise intensity, and type and duration of exercise, as well as a person’s individual biology, all contribute to the decision around when to turn on the Activity feature and how long to have it enabled.

To help your patients find their individual windows for the best timing, consult their data management reports with them.

Additionally, if your patient could benefit from education regarding which activities are likely to put them at higher risk of hypoglycemia, you can suggest they read our patient-facing article on the Activity feature. This piece was written by two of our clinical customer support team members living with type 1 diabetes and is full of insightful, easy-to-digest information about managing diabetes with the help of Omnipod 5.

 

Considerations for Activity Feature vs. Setting a Higher Target

If scheduled activities are consistent day-to-day you can determine with your patients whether the Activity feature or a customized Target Glucose might be a better fit for them.

For example, in cases of recess, practice, or daily mall walks, consideration could be given to using the customized Target Glucose setting to program a higher Target Glucose for that segment of the day. Omnipod 5 allows users to preset up to eight Target Glucose segments a day—customizable from 110-150 in 10 mg/dL increments. The advantage of this approach is that the patient won’t have to remember to enable the Activity feature for scheduled day-to-day activities.

Please remember that the higher Target Glucose does not create any changes in the algorithm as described in the “How Does the Activity Feature Work?” section.

 

Considerations for Pediatrics and Recess

Recess, gym, and other active times at school take special consideration on behalf of school nurses. Parents may consider working with their school nurse to demonstrate how to enable the Activity feature for these scenarios based on their school plan. This can be easily done remotely with the Omnipod 5 App by just standing near the child. School nurses may refer to the “Caregiver Guide” that can be downloaded here.

Some school protocols may require a child to be removed from class to enable the Activity feature. If this creates too much disruption for the child, consideration could be given to the customizable Target Glucose as noted in the previous section.

 

What If My Patient is Still Experiencing Hypoglycemia?

If your patient is using the Activity feature as intended, but is still experiencing hypoglycemia related to vigorous or prolonged activity, you may consider working with your patient to examine bolus strategies for meals and snacks prior to exercise based on pre-exercise glucose values.

Per the 2023 AID Consensus Guidelines "consideration can be applied to the amount of IOB from user-initiated boluses prior to exercise. Additionally, if pre-exercise glucose is <120 mg/dL, consider 15 g fast-acting carbohydrate at the start of moderate intensity exercise, without a bolus."3

 

Helpful Resources

 

1. The Pod has an IP28 rating for up to 25 feet for 60 minutes. The Controller is not waterproof.

2.Berget C, Sherr JL, DeSalvo DJ, et al. Clinical Implementation of the Omnipod 5 Automated Insulin Delivery System: Key Considerations for Training and Onboarding People With Diabetes. Clin Diabetes. 2022;40(2):168-184. doi:10.2337/cd21-0083                          
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9160549/

3. Moshe Phillip, Revital Nimri, Richard M Bergenstal, et al. Consensus Recommendations for the Use of Automated Insulin Delivery Technologies in Clinical Practice, Endocrine Reviews, Volume 44, Issue 2, April 2023, Pages 254–280, https://doi.org/10.1210/endrev/bnac022

INS-OHS-02-2024-00006V1.0