I Switched From DIY To Omnipod 5 - Here’s How It Went

Three months ago, I was invited to the Limited Market Release of the Omnipod 5 iPhone app, so I decided to put my DIY insulin management on hold and try out the FDA-cleared system.  

I’ve used Omnipod for three years and for most of that time I either controlled it using open source apps like DIY Loop or Trio to automate insulin delivery. This experiment would be the first time I’d ever tried an FDA-cleared algorithm and I was excited to understand the pros and cons.

Why I like wearing the Omnipod tubeless pump

The Omnipod patch pump is forgettable in the best possible way. Its small and discrete form factor lets me wear the pod in a ton of places without factoring in where to attach it at bedtime or wondering if it will work with an outfit. Whether I’m showing it off with a crop top, or hiding it on the top of my butt under a swimsuit, Omnipod always feels like a natural extension of my body. Well, except for those times when I knock it off on a car door-frame – door frames are my true enemy!

The Omnipod 5 app is simple and intuitive

I felt comfortable starting my Omnipod 5 journey because I could use my iPhone as the controller. This was a huge upgrade over the previously required Personal Diabetes Manager (PDM). Now with the app, users can simply use an iPhone for dosing, pod changes, and all other controls and settings. 

The app’s sleek home screen displays glucose levels, insulin on board (IOB), and glucose trends in real-time. I love how I could easily toggle between different time ranges on the main graph between 3-24 hours, and distinguish whether I was in Automated or Manual mode based on the font color - purple for automated and blue for manual. 

My favorite feature of the app has got to be dark mode. As my phone switches over to the darker setting, my Omnipod 5 app switches to a black backdrop, and it’s much easier on the eyes for a nighttime correction.

Quick tech tip: I just got an iPhone 16 Pro and it’s my first iPhone with an Action button. This button lives above the volume buttons and can be programmed to open tools and apps. I programmed the Action button to be my “Pancreas button,” so when I press it, it instantly launches the Omnipod 5 app. The app requires Face-ID to unlock its controls. I would love Omnipod to remove the Face-ID requirement when you open the app and only require for treatment decisions, like boluses and setting changes.

@diabe_tech

You can use the Action button on iPhone to launch apps! #diabetes #tech #techtip

Currently, Dexcom G6 is the only continuous glucose monitor (CGM) supported by the Omnipod 5 iPhone app. According to Omnipod’s website, Dexcom G7 support is expected to roll out in early 2025. Omnipod has also mentioned upcoming support for the Freestyle Libre 2 CGM, but there has been no word on when that would arrive on the system. The app is only available in the U.S. for iPhone users and there have been no announcements for release in other locations. When I hear more, I’ll let you know!

Omnipod 5 alerts can feel excessive

The Omnipod 5 is forgettable - until it’s very much not. If there’s one area where the Omnipod 5 could improve, it would be with the alerts. On DIY systems, I could fine-tune alerts, but with Omnipod 5, both the pod and phone (or PDM) sound alerts simultaneously, making for an overwhelming experience. These alerts include low blood glucose alarms as well as pod expiration notifications which you can’t customize or turn off. I would love to see Omnipod introduce the ability to turn off on-pod alerts or silence them when in range of a controller. 

Getting used to a "new normal" glucose target

DIY systems allowed me to set a target glucose as low as 87 mg/dL, so when I switched to Omnipod 5, I didn’t know what to expect with its lowest target of 110 mg/dl. For three years, I was used to seeing my blood glucose hover overnight between 80-100 mg/dl. Waking up to my Omnipod 5 glucose readings, the new normal was between 110-130 mg/dl. Is this bad; I don’t know. According to the ADA Standards of Care guidelines, people with type 1 diabetes should aim to be in range 70% or more, but there is no guidance on what time in tighter range (70-140 mg/dl) should be. That said, I feel healthier when my glucose levels hover at a lower level and I’m not sure if it’s physical or just mental.

DIY vs. Omnipod 5: I miss custom overrides!

After using DIY systems for so long, I’ve become spoiled by the granular control I had over my insulin delivery—especially when it comes to insulin dosage and glucose target adjustments. 

With DIY Loop, I could create Overrides to temporarily adjust insulin treatment for various scenarios. Overrides let you initiate a temporary basal-rate and target glucose range for a set time-period while remaining in closed-loop mode, where the system automates insulin. So for example, when I went on a run, I would use my Running Override which reduced my basal insulin by 60% and raised my target glucose to 140-160 mg/dl. When I turned this on one hour before intense cardio, I practically never went low. Trio, another open source app I’ve used, has a similar function called Profiles and these worked just as well as DIY Loop.

On Omnipod 5 you can’t create custom profiles, besides a temporary target with Activity feature, which I’ll get into shortly. The only way to temporarily adjust basal rates is by leaving Automated mode and using Manual mode with a temp basal. 

The major upside of switching to Omnipod 5 was that the algorithm runs on the insulin pump which connects directly to the CGM. On DIY, a phone is required to receive CGM readings andrun the algorithm, and send treatment instructions to the pump. The freedom of walking away from my phone had a huge impact on my day-to-day. I could walk along the beach without my phone knowing it was still looping…I went out dancing on a vacation and left my phone in my room for hours, knowing I wouldn’t eat and I would receive on-board alerts if I went low. My “time in happiness” went up, and if I go back to DIY, I’ll sorely miss this aspect of Omnipod 5.

Navigating workouts with Omnipod 5

Working out with type 1 diabetes can feel scary because cardio can cause glucose levels to plummet. Overrides are a powerful tool on DIY Loop, so when I switched to Omnipod 5 I was worried about cardio using the new system.

Omnipod 5’s answer to physical activity is its Activity feature, which I’ve found helpful but not perfect. It bumps the target range to 150 mg/dL to prevent lows during exercise, but this doesn’t always prevent drops, especially during intense cardio. My Diabetes Educator recommended I do the following for intense cardio: I go into manual mode and set a temp basal of 60% lower insulin delivery for one hour before and during the exercise. While this worked most of the time, it was quite unnerving to leave Automated mode – I missed the ability to adjust my target and basal quickly while keeping the communication between my insulin pump and CGM going.

Omnipod is working on a fully-closed loop algorithm

Omnipod’s next version of its algorithm is called Evolution and promises to be a fully closed-loop system, where users no longer need to make treatment decisions. Results from early trials with type 1 patients have shown significant improvements over the current algorithm. Time-in-range for users who did not bolus on the new system hit 57%, a notable increase from 37% on the current algorithm.

Omnipod 5 or DIY - which will I use? 

So the big question is will I stay on Omnipod 5 or go back to open source? First of all, it comes down to the supplies I have and the devices that are supported. I felt comfortable switching to Omnipod 5 because I could use my phone as the controller, but the app doesn’t support Dexcom G7, and support isn’t expected until early 2025. I have a lot of Dexcom G7 sensors waiting to be used and my Dexcom G6 transmitter has officially died, so I can’t use the Omnipod app. Dexcom G7 is less expensive than the G6 because it’s an all-in-one sensor, whereas the G6’s separate transmitter comes at an additional cost. So, my only choice is to pay for more Dexcom G6s (no thank you) or use the G7s with DIY.

That said, even when the Omnipod 5 iPhone app supports the Dexcom G7, the main reason I will probably stick with DIY is the ability to set customized overrides for workouts. I work out a lot–I love to run– and I feel much more comfortable using customizable overrides in auto-mode during cardio.

Omnipod 5 is an incredibly strong system that kept my levels at a near 80% time-in-range over the 90 days I used it. For anyone who wants an FDA cleared system and a pump with lots of wearable flexibility, this system is a great option. If you prefer more control and tinkering with your settings, DIY may still be the better fit. If you’d like to hear more about how DIY Loop’s algorithm compares to Omnipod 5, and how one user prefers the latter, check out my podcast interview below.

Next up, I plan to try out a Tandem Mobi demo pump. Although the Mobi is a tubed system, the pump itself is about the size of the Omnipod 5 and can be adhered to the body, like Omnipod, but with a short tube. Stay tuned for my experience wearing that system!

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*DISCLAIMER: This article is not medical advice and is for educational purposes only. Always consult with your doctor before making changes to your health care. I work on sponsored content for Insulet, but in no means was this article, or my coverage on Omnipod, impacted by the relationship. All thoughts and opinions are my own.