Long-Term Use of Omnipod^® Insulin Management System Associated with Lower A1c in Adults with Established Diabetes and A1c =8%

Tubeless patch pumps may offer unique benefits enhancing long-term glycemic benefits seen in adults with diabetes starting continuous subcutaneous insulin infusion (CSII) therapy. We retrospectively evaluated adults with diabetes >6 months to assess changes in A1c and weight 1 year after initiating the Omnipod® Insulin Management System (Insulet Corp., Billerica, MA). Changes were assessed by baseline A1c category (<7.0%, 7.0-7.9%, 8.0-8.9%, and ≥9.0%) and then stratified by prior insulin regimen (MDI 65%, CSII 35%). At Omnipod initiation, 195 patients (39% male, 97% T1D) had (mean±SD) age 42±14 years and diabetes duration 21±14 years. Baseline A1c and weight were 7.9±1.3% and 175±36 lbs with no significant differences according to prior regimen. After 1 year, patients had 0.2% A1c reduction (p<.05) and non-significant weight change (+0.8 lb). Significant A1c reductions were noted in adults with baseline A1c ≥8% (A1c 8.0-8.9%: -0.3% (p<.05) and A1c ≥9.0%: -1.1% (p<.005). Modest to no increase in A1c was found in patients with baseline A1c <8% (A1c <7.0%: +0.2% (p<.05) and A1c 7.0-7.9% (p=NS). Weight did not change across all A1c categories. The Table shows changes in A1c by insulin regimen before Omnipod initiation. In adults with diabetes and A1c ≥8%, Omnipod initiation was associated with significantly lower A1c, most notably in those transitioning from MDI.