Outcomes after 1 year in adults using Omnipod 5: Real‐world data from a UK diabetes centre

Despite substantial advances in diabetes care over the previous decade, only a minority of people with type 1 diabetes achieve an HbA1c 30 kg/m2. Fifty-nine per cent were predominantly using the lowest glucose target (6.1 mM) at the end of follow-up and median time in auto mode was 94% (91–99). In those with paired HbA1c data, median baseline HbA1c was 70 mmol/mol (63–76) and fell to 58 mmol/mol (52–63) during Omnipod 5 use (p < 0.001). Data summarising CGM changes are presented in the figure (Figure 1), including a change in TIR from 42% (33–58) to 60% (53–68, p < 0.001). GMI fell from 66 mmol/mol (57–70) to 58 mmol/mol (54–62, p < 0.001) and coefficient of variation for glucose fell from 37% (34–42) to 34% (32–38, p = 0.009). Change in TIR at 1 year was strongly negatively correlated with baseline TIR (R −0.581, p < 0.001). Percentage of insulin delivered as bolus was negatively correlated with increase in TIR (R −0.518, p < 0.001). Age, sex and socio-economic deprivation were not associated with TIR response to Omnipod 5. Median weight change was +2.3 kg (−1.3 to 3.8) or + 3.0% of baseline weight (−1.6 to 5.2). Weight change was not associated with change in HbA1c (R 0.115, p = 0.560) or TIR (R −0.101, p = 0.607). We have shown that Omnipod 5 is associated with clinically important improvement in TIR with no increase in TBR. Our cohort differs from other evaluations of Omnipod 54, 5 as the baseline HbA1c of participants was relatively high. Those with lowest TIR (highest HbA1c) are most likely to experience substantial increases in TIR when converting from standalone CSII to Omnipod 5. Individuals where bolus insulin was lowest (in relation to basal insulin) experienced the largest improvements in TIR; suggesting the system is effective in those who have historically delivered insufficient insulin doses at mealtimes. Reassuringly, weight gain was typically modest and not associated with improvements in HbA1c or TIR. This is the first real-world assessment of 1-year outcomes with Omnipod 5 in the United Kingdom and attests to the durability of improvements observed shortly after commencement. No funding source to report. FWG has received speaker fees from Abbott, Dexcom and Insulet. ARD has received speaker fees from Abbott. The data that support the findings of this study are available from the corresponding author upon reasonable request.