2026 Eastern States Conference

Title: Pumping Up a Patient's Time in Range 

Authors: Nikki Polivka, PharmD, Marissa Chiumento, PharmD, Christina Brady, PharmD, BC-ADM, Rachel Wesolowski, PharmD, BCACP 
Learning Objective: Identify the difference in time in range (TIR) for patients who transition from a closed loop or open loop tubed insulin pump system to the closed loop Omnipod 5 tubeless system. 

Learning Objective: Identify the difference in Time in Range (TIR) seen when patients with type 1 diabetes transition from a closed loop or open loop tubed insulin pump system to the closed loop Omnipod 5 tubeless pump system

Background/Objective: Insulin pump systems (both tubed and tubeless) that communicate with continuous glucose monitors (CGMs) are considered “closed-loop” as they can automatically adjust insulin based on blood glucose readings whereas pump systems that do not communicate with CGMs are considered “open-loop.” Closed-loop systems have previously shown improvements in TIR as well as A1c measurements in comparison to open-loop systems, and in practice patients tend to prefer a tubeless system in order to avoid the bulkiness of a tubed system. This research will provide further insight on the difference in TIR seen when patients with type 1 diabetes transition from a closed loop or open loop tubed insulin pump system to the closed loop Omnipod 5 tubeless pump system. 

Methods: This is a retrospective cohort study using electronic health records of adult patients with type 1 diabetes who transitioned from a closed or open loop tubed insulin pump to the closed loop tubeless Omnipod 5 insulin pump system managed by Geisinger providers from 2/1/2022-8/1/2025. Patients were excluded from the study if they had used an Omnipod 5 system for less than three months, used a tubed pump system for less than three months, had a pregnancy throughout any duration of the study period, and if they were less than 18 years of age. Data review involved the use of CGM/pump websites (Dexcom Clarity, Libreview, Glooko, Medtronic Carelink, Tandem Source) in order to find exact TIR reports. A paired t-test was used to compare changes in TIR and hemoglobin A1c readings between time spent on the tubed pump vs the tubeless system. An unpaired t-test was used to compare the amount of hospital admissions due to hypoglycemia and diabetic ketoacidosis for those on tubed pump therapy versus those on the Omnipod 5. 

Results: There was a total of 44 patients included in this study. Prior to pump system switch, there were a total of 22 patients who had their pump in automated mode while 22 patients had their pump in manual mode. Upon analysis, there was a statistically non-significant increase in TIR for patients who transitioned from tubed pump therapy to the Omnipod 5 (mean change +4.21%; p = 0.064). There was a statistically significant decrease in A1c for patients who transitioned from tubed pump therapy to the Omnipod 5 (mean change (mean change -0.41; p = 0.005). Finally, there was a statistically non-significant difference in the number of admissions for hypoglycemia (1 for tubed pump system, 1 for Omnipod 5; p = 1), and a statistically non-significant difference in the number of admissions for diabetic ketoacidosis (0 for tubed pump system, 0 for Omnipod 5; p = 1). 

Conclusion: There is a statistically non-significant increase in TIR for patients who transition from an open or closed loop tubed pump system to the tubeless closed loop Omnipod 5. 

Self-Assessment Question: T/F: It can be concluded that there is a true increase in time in range for patients who transition from a tubed pump system to the tubeless Omnipod 5.