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Randomized Controlled Trial
. 2025 Sep 1;48(9):1598-1606.
doi: 10.2337/dc25-0141.

Use of the Omnipod 5 Automated Insulin Delivery System Activity Feature Reduces Insulin Delivery and Attenuates the Drop in Glycemia Associated With Exercise in a Randomized Controlled Trial

Lauren V Turner  1 , Jennifer L Sherr  2 , Dessi P Zaharieva  3 , Jesica Baran  4 , Irl B Hirsch  4 , Bruce W Bode  5 , Sue A Brown  6 , Suzan Bzdick  7 , Mei Mei Church  8 , David W Hansen  7 , Ryan Kingman  3 , Lori M Laffel  9 , Viral N Shah  10 , Sheri Stone  7 , Todd E Vienneau  11 , Lauren M Huyett  11 , Bonnie Dumais  11 , Trang T Ly  11 , Michael C Riddell  11 ; Omnipod 5 Exercise Research Group
Collaborators, Affiliations
Randomized Controlled Trial

Use of the Omnipod 5 Automated Insulin Delivery System Activity Feature Reduces Insulin Delivery and Attenuates the Drop in Glycemia Associated With Exercise in a Randomized Controlled Trial

Lauren V Turner et al. Diabetes Care. .

Erratum in

Abstract

Objective: To compare the efficacy of enabling Activity feature 60 (AF-60) or 30 min (AF-30) before prolonged exercise versus the automated mode (Auto) in adults and adolescents with type 1 diabetes wearing the Omnipod 5 System.

Research design and methods: In this three-way crossover study, 38 participants (age 30 ± 15 years; BMI 24.7 ± 4.1 kg/m2; HbA1c 7.5% ± 0.9% [58 ± 11 mmol/mol]) from the extension phase of the pivotal trial of the Omnipod 5 System completed a 70-min treadmill session at 64-76% maximum heart rate in a postabsorptive state under each of the three conditions. Auto was resumed after exercise, and glycemia and insulin delivery metrics were examined in the 4-h postexercise period.

Results: The percentage of participants who developed hypoglycemia during exercise did not differ significantly between Auto (42%) and AF-60 (29%; P = 0.34) or AF-30 (24%; P = 0.14). However, AF-60 and AF-30 reduced insulin delivery compared with Auto in the hour before (P < 0.001) and during exercise (P < 0.001). There was also a favorable attenuation in glucose drop during exercise when comparing Auto (-57 ± -35 mg/dL) with AF-60 (-44 ± -33 mg/dL; P = 0.02) and AF-30 (-36 ± -34 mg/dL; P = 0.01). In the postexercise period, glycemia and insulin delivery were comparable.

Conclusions: Enabling the Activity feature either 60 or 30 min before exercise reduced insulin delivery and attenuated glucose drops relative to Auto, but hypoglycemia incidence was not different across the three conditions. These findings support the use of the Omnipod 5 System for exercise but highlight the importance of using additional strategies, such as earlier use of Activity feature and/or carbohydrate intake to further reduce hypoglycemia risk.

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Conflict of interest statement

Duality of Interest. L.V.T. has received in kind research support from Dexcom, Inc. J.L.S. has served as a consultant for Medtronic; served on advisory boards for Medtronic, Insulet Corporation, Vertex Pharmaceuticals, Inc., MannKind Corporation, StartUp Health T1D Moonshot, Bigfoot Biomedical, Inc., and Cecelia Health; and received speaking fees from Insulet Corporation and Zealand Pharma A/S. D.P.Z. reports research support from Insulet Corporation and speaking and/or advisory fees from Dexcom, Inc. I.B.H. reports serving as an advisory board member for Abbott Diabetes Care, Roche, Bigfoot, and GWave and receives research grant support from Dexcom. B.W.B. reports research support from Insulet Corporation and Medtronic, has served on an advisory panel for Medtronic, and declares speaking fees from Insulet Corporation. S.A.B. reports research support from Dexcom, Inc., Tandem Diabetes Care, Inc., Insulet Corporation, Tolerion, and Roche Diagnostics and has served on the data safety board for MannKind Corporation. D.W.H. reports research support from Sanofi, Eli Lily, Insulet Corporation, Boehringer Ingelheim, and Medtronic. L.M.L. reports consultant fees from Dexcom, Inc., and Novo Nordisk and serves on advisory panels for Janssen Pharmaceuticals, Inc., MannKind Corporation, Medscape, Medtronic, Vertex Pharmaceuticals, Inc., Lilly Diabetes, Provention Bio, Inc., and Sanofi U.S. V.N.S. reports research support from Insulet Corporation and Novo Nordisk and has received consulting fees from Dexcom, Inc., Insulet Corporation, embecta, and Tandem Diabetes Care, Inc., and advisory fees from Novo Nordisk, Sanofi, and Medscape. T.E.V. was a full-time employee of and owned stock in Insulet Corportation at the time of the study. L.M.H., B.D., and T.T.L. are full-time employees of and own stock in Insulet Corporation. M.C.R. reports speaker fees from Novo Nordisk, Sanofi, and Dexcom, Inc.; receives consultant fees from Insulet Corporation, Eli Lilly, and Dexcom, Inc.; and is a stock- and shareholder of Zucara Therapeutics. No other potential conflicts of interest relevant to this article were reported.

Figures

None
Graphical abstract
Figure 1
Figure 1
CGM measurements from 1 h before to 4 h after three exercise sessions, including AF-60 (purple), AF-30 (teal), and Auto (yellow). Solid lines are the medians, and shaded regions denote the IQRs. Target glucose range (70–180 mg/dL) is indicated in black dashed horizontal lines. Exercise period is denoted between dotted vertical lines from t 0 to 70 min (although exercise could have been prolonged if a hypoglycemic event <70 mg/dL occurred). Shaded vertical regions denote 5-min exercise breaks.
Figure 2
Figure 2
Percentage of participants with a hypoglycemic event (<70 mg/dL) over the exercise session time course in the three exercise sessions, including AF-60 (purple), AF-30 (teal), and Auto (yellow).
Figure 3
Figure 3
Box plots demonstrating the relationship between session and insulin delivery before (hashed lines) and during (solid color) exercise. Three exercise sessions include AF-60 (purple), AF-30 (teal), and Auto (yellow). Box plots extend from the 25th to 75th percentile; whiskers extend from the 10th to 90th percentile; horizontal lines within the boxes depict the medians, with the plus signs indicating the means. *P < 0.05 by two-way repeated-measures ANOVA.
See this image and copyright information in PMC

References

    1. Bohn B, Herbst A, Pfeifer M, et al. ; DPV Initiative. Impact of physical activity on glycemic control and prevalence of cardiovascular risk factors in adults with type 1 diabetes: a cross-sectional multicenter study of 18,028 patients. Diabetes Care 2015;38:1536–1543 - PubMed
    1. Colberg SR, Kannane J, Diawara N.. Physical activity, dietary patterns, and glycemic management in active individuals with type 1 diabetes: an online survey. IJERPH 2021;18:9332. - PMC - PubMed
    1. Johansen RF, Caunt S, Heller S, et al. Factors influencing physical activity level in adults with type 1 diabetes: a cross-sectional study. Can J Diabetes 2024;48:431–438.e1 - PubMed
    1. McCarthy MM, Whittemore R, Grey M.. Physical activity in adults with type 1 diabetes. Diabetes Educ 2016;42:108–115 - PMC - PubMed
    1. American Diabetes Association Professional Practice Committee . 7. Diabetes technology: standards of care in diabetes—2024. Diabetes Care 2024;47(Suppl. 1):S126–S144 - PMC - PubMed

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