The New Omnipod 5 insulin pump: Algorithm updates and “Discover” - Dr. Jessica Lilly

The Omnipod 5 insulin pump, made by the company “insulet”, is currently the only tubeless insulin pump with automated insulin delivery capability and CGM connectivity on the market in the United States of America. The company released updates to its algorithm in June 2926, including a lower glucose target and improvements so that people can stay in automation for longer. It also connects now to the libre 3 plus sensor, giving patients more choice when it comes to choosing which brand CGM they want to use. What’s most exciting is the new platform called Discover. Listen in and learn more about how the Omnipod 5 is helping people with Diabetes stay in their target glucose range easier and for longer.

 

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Transcript

SPEAKER_00 0:01

Welcome to the Diabetes Diaries. I am your host, Rachel Seude. Today we are kicking off an incredible day of conversations with some of the brightest minds in diabetes care. Joining me first is Dr. Jessica Lilly, a pediatric endocrinologist and senior medical affairs lead at Insulette Corporation, the company behind the insulin pump omnipod. Dr. Lily has dedicated her career to improving diabetes technology for children and families. And today she is here to break down the biggest updates to Omnipod 5 since it launched, and why most people living with diabetes have absolutely no idea it even happened. Dr. Lily, welcome to the show.

SPEAKER_01 0:43

I'm so glad to be here, Rachel. Thank you so much.

SPEAKER_00 0:45

So, Dr. Jessica Lilly, they just made the biggest update to Omnipod 5 since it launched. And most people living with diabetes have no idea what makes this technology different, and how far have we come from where insulin pumps actually started?

SPEAKER_01 1:00

You know, I have family living with type one, and I think most people who work in diabetes have a story and a draw and something that brought them into the field. And so I remember watching my cousins grow up wearing insulin pumps, and you know, it took them a long time to come back to insulin pumps after some bad experiences, you know, some pump malfunction, some scar tissue, um, and you know, bulky devices. And so um they're um in their 30s now, and it took a little while to convince them to consider a new insulin delivery device after the AID era. I was in clinical practice for almost 15 years in the Southeast, um, in my hometown of Tipola, Mississippi, for the majority of it. Um, and it's been really amazing to see, even in that brief period of time, how quickly the technology has progressed. And so we um offer the only tubeless option. Um, and so I really love that form factor. People prefer not getting tangled with tubes. Um, and so um it's very wearable. You have a lot of options for sites, um especially if you're dealing with lipertrophy and needing different places for um your pump to go. Um and so um I really you know love seeing that not only in my patients, but also in my family members. And so we launched on the pod five in 2022, um, and so have seen wonderful results not only in clinical trials, but also in the real world. Um but we hear from patients and we hear from our healthcare professionals there are some changes that they wanted. And so the the first of these was a lower target, and so that's here, and we're over the moon for that. Um, and that launched on June 3rd. So this is very hot off the press. And so and then to me, and and I I'm sure that you as a um a practitioner, the most exciting part is uh the ability to stay in automated mode. And so previously, if people, you know, were high for too long, um, they would get a prompt to um to check their um their pump, wait five minutes, and then go back to automation after, you know, a troubleshooting. But now people will get that same alert, but they will remain automated because we know that when people stay in automated mode, they're able to um to have a higher time and range.

SPEAKER_00 2:59

Yeah, it's amazing technology. So the OmniPad 5 really does connect with so many different CGMs, and that connection it keeps people in a loop or a closed loop system, is what we say, to where the pump is actually giving or not giving insulin based on that glucose. And the glucose target can be set and customized, and now there is a lower glucose target of 100, whereas before it was 110. It doesn't seem like a big difference, but it really can be when you're living with diabetes and trying to manage just everyday life, trying to stay in range. So walk us through what insulin pump technology looked like when it first started. Like what were people dealing with at first?

SPEAKER_01 3:41

Well, we had a very different mindset to prescribing. And so um they it it was pretty complicated to you know put in an inset, um, to deal with all the um the supplies and and you know, making sure that you had everything that you needed to um to work the pump. You had to make you know changes on your own, you know, to all these different settings. Um, and then um there was no protection from hypoglycemia and there was no response to hyperglycemia. And so, in in a lot of ways, and for years and years we looked at longitudinal data for what we were able to achieve for A1C improvement, um time and range improvement, and we weren't really moving the needle, even with regular insulin pump technology, but AID has completely changed the game. And so some of the the previous thoughts that, you know, gosh, and when I'm considering a patient who is appropriate for an insulin pump, do I offer to someone who's struggling with literacy? Do I struggle with people who are having a lot of challenges in their lives? You know, that this may be too complicated, this may be too difficult for them. And now we're seeing a diabetes technology as a way to relieve burden. And so um in practicing in rural Mississippi, I saw just the tremendous um difference that we could make um in offering technology to children and their families and um and to be able to keep them in school, to keep parents from having to miss their work, to um have them feel better all the time, their time and range drastically improved, so many fewer lows, fewer hospitalizations, and fewer calls at night, which mattered a lot when you're on call 24-7, as you know very well. Um, and so um, and you know, and and what that translates to is all the children I cared for were sleeping through the night. Um they weren't having to be up and down because they were having to deal with lows. And so I really love you know the quality of life and um that we have been able to offer with AID and the reduction in diabetes distress. And we've we've shown that in our clinical studies. And so, you know, the you know, we we've come a very long way. And I think that we as prescribers need to catch up and to think about, you know, insulin pump therapy differently and not have to have a checklist or you know, to really, you know, have these these um pre-requirements for people that we consider AID for the ADA tells us that it's standard of care for everybody living with type 1 diabetes, and we have to consider it for people who are not meeting gulfs with type two.

SPEAKER_00 5:47

Yeah, your system is great connected with CGM because it really helps. It doesn't completely eliminate, but it reduces the incidence of low blood sugar. And I know that that can be a big problem for a lot of people that are on injections, so that's very convenient. What are the two biggest things you would say in the new updates from InsLET on OmniPod 5 that actually does something for someone living with diabetes day to day? Can you tell me about those new updates?

SPEAKER_01 6:16

So, one update that I haven't mentioned yet is the Freestyle Libre 3 Plus integration. And so, and that's also going to empower people who need to follow to use the Libre Link Up app to have a follow feature. And that's something that we have not had until now. That's really exciting, um, especially for people who are caring for an older relative who may have some dementia or cognitive challenges and want to be able to follow their blood sugars and see when boluses were given. Or of course, for my population, you know, we always want to know what's happening with our young ones. And so that that is a really fun update and and something new. And and we we believe strongly in sensor choice. And we we know that people out of my two cousins, I have one on one sensor and one on the other because of their personal preference. And I think that's really important. Um, and so I'm I'm excited about that. Um, and then the other thing that's coming cl soon, um, we're currently in a limited market release is omnipod Discover.

SPEAKER_00 7:09

How is that different from the current platform that is being used now? Right is this gonna help people and providers like guide maybe how much insulin should be needed, not needed. Yeah, tell me about Discover.

SPEAKER_01 7:21

And so we know that anything that improves engagement improves outcomes. And so, you know, I'm making sure that people are are really, you know, um invested in kind of what they're doing with their health. And so um we are presenting um data this weekend that looks at um people who engage with our Discover system who have been participants in that limited market release. And we saw that over a third of those who logged in even once in over six months of using Discover had an a clinically significant improvement in time and time and range, and so over 3%. And so that's almost an extra hour a day that you're giving people just by having that engagement. And so to be able to look and see their patterns, to be able to make those setting changes. Of course, our basal rate um auto updates, we we we have that constantly adjusting every five minutes and it response to blood sugars and adjusting that total daily insulin. But sometimes you need to take a step back and look at carb ratios or correction factors or other things, bolus frequency. Um, and so to have that visibility that we get and when we see patient patients in our clinic, when you have that hand that visibility to people living with diabetes so they can see on a daily basis and get those those prompts on the adjustments that they can make or reasons to call their healthcare um professionals, it's really going to be a game changer.

SPEAKER_00 8:33

Is there anything about the omnipod updates that actually surprised you as a clinician, something that you didn't expect to see in the data?

SPEAKER_01 8:42

One thing that's been really fun for me lately is looking at clinic level insights and looking at every individual clinic and to see, you know, what outcomes they're getting. And so we've been able to go into practices to show them here is your patient population, these are the targets they're using, here are the number of boluses, the time in automated mode, and different parameters like that. Here's your overall outcome. And every single clinic I've gone into has had just really outstanding results. And I think that we as clinicians kind of hang up on on that one or two patients who are really struggling and and and and the we tend to kind of cast uh aspersions on a system based on that one person's experience. But we've seen, you know, um the people are doing really, really well. And so um I've I've really, you know, the the protection from hypoglycemia in that whole cohort has been just astounding to me. And then to see that we are maintaining that protection from hypoglycemia even with a 100 target, um, and and to see that even in younger patients. And so, um, and in that that tighter glycemic range and that the the improvement in time and tight range, um, I think is something that we are all wanting to see. And so I'm just um help I I have become braver with target selection um by looking at this this evidence and this data. And I'm I'm really I'm hoping that people adopt that 100 target.

SPEAKER_00 9:57

Yeah, no, I think and I hope too that people will do the correction and the glucose target and just go ahead and start people on insulin pump therapy on an omnipod at that lower target. And the data is really showing that it protects patients. So, what does all of this mean for a parent managing a child's diabetes? Does this make their life easier, the parent?

SPEAKER_01 10:18

Oh, absolutely. I think so. And so, you know, I I remember, you know, growing up a a very frequent question that we got was did you bolus, did you dose, did you, you know, and you don't have to act like you you can know. You can look and see exactly what's happening when they're away from you, when they're at diabetes camp and in um when they're at school or with their with another parent or a non-custodial, you know, grandparent, somebody like that who is coming in. So just giving the village that it takes to uh to take care of our children, I think that it really gives you a lot more visibility into what's happening and then peace of mind and knowing that um the algorithm is going to adapt um to high blood sugars and to protect for low blood sugars. And so in reality, it gives people so much more freedom and then to not have to constantly worry about you know adjusting basal rates. And I mean, we're adjusting them every five minutes. And I found endocrinologists really love to adjust basal rates. Parents love to adjust basal rates. That's the first thing they like to do. But to be able to take their hands off of that and to let the system adapt to the changing needs, it's really great for growing children, for kids who are going through different, you know, through through puberty, coming out of honeymoon. We have so many different things where the insulin needs are changing rapidly. And to watch that system to be able to keep up has been just a real gift as a clinician, as somebody who loves people living with diabetes.

SPEAKER_00 11:30

Yeah. And I wanted to ask you something that I find very beneficial, especially for children, or really for all people, but I think parents would love this. There is a setting in the OmniPod 5 where you can put pre-selected foods and meals. And we know Yeah, tell me about that.

SPEAKER_01 11:46

Okay, so custom foods. And so I have to admit, when I heard about custom foods, I thought, well, this is just going to be like calorie king that people can, you know, go in and and and pick out their carbs and they're not going to do it. You know, I've I've gave out so many, you know, carb guides and things like that. And so many of my patients admitted not to actually not carb counting and a lot of guessing. And so you can go through in their visit, and I've done this where you can um, you know, go over their favorite foods and say, okay, like when you go to Chick-fil-A, what do you order? You know, because for most of us it's the same thing. When you um have a school lunch, when grandma cooks breakfast, you know, all these different, you know, uh discrete times in your life, and then put that in as your custom food. And so when you go in and put pizza night, you can just tap that and you know you typically typically get two slices of pepperoni done. And so, and you can put that carb count in, it pulls it in, it does the math, and you can even you know gamify it, you can put emojis, that's great for limited literacy. If you have someone for whom English is not a first language, you can customize uh customize it to their language. And so there are a lot of things that they can go in and pick something that's meaningful to them, tap, tap, tap, add it up, you know, oatmeal, apple, you know, cup of milk, you know, and then it all adds up together. And then you can hit use sensor, and that's going to pull in your glucose and the trend, and then adjust the correction dose that you get for that. And you see it all in front of you, what you're getting, and then you get to make that that um that dose. And it's so much easier. It takes the drama out of bolusing. And I think so many people want to bolus, you know, and they they they are but they're really afraid of what if I get it wrong. And so you give them this extra, you know, a way to make bolusing easier and to make it easy, and then they can do it right from their phone. And so, you know, just uh easily, you know, and it's it's so normative, especially for our teenagers to have their phone out, you know, pulling out a device, a little, you know, trickier. Um, but to be able to just act like they're texting, you know, a lot of them are a lot more willing to engage. And we we presented data at ADA last year that showed that people who used our app were engaging more, bolusing more, um and had better outcomes.

SPEAKER_00 13:37

Nice. Yeah, I think that meal calculator, the the pre-meals are just like something that's so underrated. And that's the one of the biggest features that I use. And I think it simplifies lives, especially for parents with children with diabetes, because it just helps predictability, especially if you don't know how many carbs are in something. You can just preset that in there and then roll. You know, that's right. So, what is the one thing you want every person living with diabetes who is watching this to do after seeing this? One one piece of advice.

SPEAKER_01 14:09

Give yourself a big hug. You know, that that's the first thing that like that comes to me is just to to give yourself a pat on the back. You are so brave. This disease can be so heavy. And just because you carry it well, that doesn't mean that it's not really burdensome. And so I'm just really proud of all of you and just know that that you know, as as a pediatric endocrinologist, like all of your healthcare team, we're rooting for you. And so um, you know, I know that that that's the big thing that we we want you to know is we we care about you, we're proud of you. Um, and so um, and then just be empowered to ask for what you need. The number one reason that people are not on an AID system is because their um health care team never offered it. And I know you see stories of day after day, Rachel, of people coming to you who have been kind of cast aside. And so it really matters to me that everybody living with diabetes feels empowered to use an AID system if they want to. And so, you know, we we try to make everything just as simple as we can. That's what we really focus on at InSLED is reducing burden, simplifying diabetes, and then just really um improving those clinical outcomes because you deserve to feel your best. You deserve to have diabetes not get in your way. And so don't be afraid to ask, just know how deeply we care.

SPEAKER_00 15:15

I want to say that this pump system, the OmniPad 5, offers the capability to connect with smartphones or has the capability of connecting with a PDM. So even if someone does not have access to internet, if they don't have a smartphone, we are still living in a time in 2026 where people do not have equitable access to things like iPhones and Androids. So people with even limited abilities or funding, they can still be on automated insulin delivery. Absolutely. They can still get an OmniPad 5, they can still use an insulin pump and they can use it with the PDM, which is almost like a little cell phone and it comes in the starter kit. So I think that's great that your company offers that so that everyone has access to a smart pump system.

SPEAKER_01 16:00

And I also love the accessibility of our pharmacy channel. You can pick it up where you um pick up your insulin, even if you don't have a stable address. You know, that that's another thing. You don't have to worry about dealing with durable medical equipment. Um, that the simplicity of being able to engage with pharmacy has just made this um management so much easier.

SPEAKER_00 16:16

Yeah. Well, thank you so much for all of these insights. I'm really excited about all of the new features with OmniPod 5, the low glucose target of 100. Now it is connecting with more CGMs. We're seeing the integration of the Libre 3 Plus, just offering increased access to technology for the people that need it most.

SPEAKER_01 16:34

Oh, so wonderful. I'm so glad that you asked me to be on today, Rachel. Yeah, thanks for having me. Thank you.