Tips and Tricks: Omnipod 5

Dear Dani Grace and Jude,

Note: This page is advice for Grace, Jude and John. For any other reader, it’s information only. No therapeutic relationship is formed – read this.

If you select the Omnipod 5, here are the essentials:

  • How the algorithm works
  • Starting settings
  • Tips & tricks
  • Preventing and treating hypos
  • High-fat meals
  • Exercise

How the algorithm works

The Omnipod 5 has four components:

  • The Omnipod 5 Controller
  • Dexcom G6 sensor
  • A Dexcom G6 compatible phone
  • The Omnipod Pod (the algorithm is inside the pod) that does not have tubing

Take homes:

  • The algorithm works from an automatically calculated basal rate, called the Adaptive Basal Rate
  • Basal increases when the glucose is rising and reduced or stopped when it’s dropping every 5 minutes

Starting settings

The SmartAdjust just needs one basal rate and a 24-hour total basal amount to get going, so it’s very simple, The first Pod will work at its half potential, and it goes full steam ahead from the second pod.

Starting an AID system can be broken down into two parts. First, SURVIVE, then, THRIVE. You can download a guide on how to do this.

How to Survive and Thrive – (Omnipod 5). If you want a more comprehensive onboarding resource (Omnipod 5)

Tips & tricks

If you want to get 70% or more time in range, do not forget the basics:

Other things to be aware of:

  • You need a phone to operate the Dexcom G6. No phone, no work!
  • It only holds 200 units, so the Pods will not last three days if more than 65 units per day.

Preventing and treating hypos

It would be awesome if hypos were a thing of the past. But this will not be the case.

The algorithm will be able to stop hypos overnight!

However, if you give too much bolus insulin for a meal or exercise without planning, hypos will still happen.

You will likely need less hypo treatment than normal because the algorithm will have already slowed or stopped the insulin at least 30 minutes prior.

You may also want to prevent hypos if the glucose is 4.0-6.0mmol/L (70-110mg/dL) and trending down.

This is a guide I use based on weight. This example is for a 30kg person and the weight can be changed. The Survive and Thrive – (Omnipod 5) will provide a personalised chart upon entering your weight at the top

If you want this hypos guide, download it here.

High-fat meals

We know from the Mealtime Insulin Guide that high-fat meals with carbs, such as pizza and takeaways, require additional insulin.

In theory, if you enter 100% of the carbs eaten, SmartAdjust will take care of the rest. But some trial and error might be needed. Some people need to dial in 25-50% extra carbs (fake carbs) 90 minutes after eating to combat insulin resistance from high-fat meals. For example, if the meal is 100g carbs, then, 100g goes in upfront, followed by 25-50g in 90 minutes time.


There is the quick and dirty way and the more comprehensive planned method.

The quick and dirty method 

This involves putting on the activity mode before starting the exercise, ideally 90 minutes before. Then, supplement with small amounts of carbohydrates every 20 minutes as required.

Do not shovel loads of carbs in at once as the glucose might shoot high and the algorithm will increase the insulin and hypo risk.

How many carbs every 20 minutes?

Good question.

It depends on how much you weigh. Here is an example for a 50kg person. The Survive and Thrive – (Omnipod 5) will provide a personalised chart upon entering your weight at the top.

You can download the mmol/L and mg/dL versions if you want to give them a try?

Comprehensive planned method 

To be able to use this method, you will need to work your way through the Exercise Guide. You need to understand exercise types, bolus reductions, and how to change a plan after a trial.

Read it?

Great, you are up to speed with exercise management.

This table should now make complete sense!

Go forth and conquer Omnipod 5