Insulin pumps bring a welcome relief to people living with diabetes and tired of constant injections. They closely imitate the functions of the pancreas, releasing insulin in response to the changes in the blood sugar. 

Omnipod and t:slim are the biggest names in the diabetic management industry. With the recent release of the Omnipod 5 and the t:slim X2 Control-IQ, an Omnipod vs t:slim comparison is in order. 

We’ll discuss everything you need to know about these two devices, including their features, performance, average cost, and pros and cons. By the end of this article, you’ll be able to choose which insulin pump is best suited for your needs.  

Insulet Omnipod 5: A Brief Overview

Developed by Massachusetts-based medical device company Insulet, the Omnipod 5 is the world’s first tubeless insulin pump with an integrated CGM (Continuous Glucose Monitor). Its tubeless function eliminates the discomfort of inserting a needle under the skin and the inconvenience of disconnecting when exercising or doing sports.

The Insulet Omnipod 5 is the fourth commercially available AID (Auxin-inducible Degron) system, after the MiniMed 670G System, the MiniMed 770G System, and the Tandem Control-IQ system. It was sent off for approval with the FDA on December 23, 2020, and received full clearance on January 28, 2022. 

Upon its release, the Omnipod 5 broke Insulet’s newly set record. The company raked in over $1.3 billion in revenue for the Omnipod 5 alone, which is an 18% increase from the year prior. To top it off, the CES (Consumer Electronics Show) named the Omnipod 5 as an Innovation Award Honoree due to its outstanding design and engineering. 

Unlike previous Omnipod variants that come with separate controllers, the Omnipod 5 works with a smartphone app. The app is compatible with Android and Apple products, but Insult will send handheld controllers for users that don’t have a compatible smartphone. 

By allowing full customization, the Omnipod 5 gives you greater control of your glucose range. You won’t have to worry about losing or damaging the remote control, as the app can be downloaded on most phones. 

It also allows you to set up up to eight different programs to be used at varying times a day, further increasing its flexibility. 

Tandem t:slim X2 Control-IQ

Omnipod Vs Tslim - Tslimp Pump

The Tandem t:slim X2 has seen multiple advancements since its 2016 launch. It started off as a traditional insulin pump but has now evolved to work in tandem with Dexcom G6 CGM, which doesn’t require a fingerstick for diabetes treatment decisions or calibration.  

While the Omnipod 5 is the first tubeless insulin pump, the t:slim X2 is the first insulin pump that uses a fully automated insulin dosing software. Tandem named this technology Control-IQ.  

Control-IQ is connected to an integrated CGM and an ACE pump to predict glucose levels and adjust delivery accordingly. 

If glucose values are above 160 mg/dL, basal insulin delivery is increased. If the values are below 112.5 mg/dL, basal insulin delivery is reduced. Below 70 mg/dL, it stops. The target level can’t be customized to prevent underdosing or overdosing. 

The t:slim X2 uses a traditional insulin pump setup (pump mechanism, an insulin reservoir, and a cannula tube) and features optional settings for sleep and exercise. These settings change the treatment values to appropriately match the physiologic needs during these activities. 

Like the Omnipod 5, the t:slim X2 comes with a free t:simulator app to control the insulin pump using a mobile device. The app displays alarms and pump alerts, as well as insulin therapy data, basal and bolus deliveries, glucose trends, and pump status changes. It uploads all relevant information into the cloud-based t:connect web application automatically. 

Omnipod 5 vs t:slim X2: Similarities and Differences

The Omnipod 5 vs t:slim X2 are top-tier insulin dosing solutions for people with diabetes. They’re two of the world’s most advanced commercially available dosing systems, so choosing between one over the other is like choosing between Samsung and iPhone. Here’s how they compare to each other: 

Notable Features 

The Omnipod 5’s most defining feature is its tubeless functionality. With it, you’ll simply need to stick the pod on your skin and let the Dexcom G6 CGM sensor do its thing. This makes it an excellent option for children, physically active individuals, and those with trypanophobia (fear of needles).  

The Activity feature, when turned on, increases the target glucose level to 150 mg/dL within a set period. The pump goes back to the old target range when the designated period passes, which is added by the user. 

Another noteworthy feature is the Omnipod 5 SmartAdjust, an algorithm-based software that recalibrates insulin rates based on your glucose levels every five minutes. You can adjust the levels manually or put them in automatic mode with recommended values. 

On the other hand, the t:slim X2 takes pride in its Control-IQ technology. The pump realigns with the Dexcom G6 CGM every five minutes and predicts what your blood sugar will be 30 minutes ahead of time, looking back on its previous measurements. The pump will increase, decrease, or suspend  basal insulin delivery based on the numbers presented. 

Like the Omnipod, the t:slim X2 has an Activity feature. The Sleep function keeps your blood sugars between 112.5 and 120 mg/dL so you can get a full night’s sleep without being woken up due to low blood sugar. The Exercise function adjusts sugar levels between 140 and 160 mg/dL and stops when it’s predicted to be less than or equal to 80 mg/dL. 

When the t:slim X2 detects an abnormal increase in glucose levels (180 mg/dL or more), it releases a bolus shot automatically. It does so with a maximum of once per hour.

The t:slim X2 is compatible with children six and older, whereas the Omnipod can be used for children two and older. 

Ease of Use 

The Omnipod 5 doesn’t rely on plastic tubing or cannula, giving it a fair advantage over the t:slim X2 in terms of comfort and ease of use. The fact that it’s fully operated through the phone makes it all the more convenient. 

The Omnipod 5 measures 1.53 x 2.05 x 0.57 inches, making it one of the smallest insulin pods available on the market. It’s controlled through the Omnipod app called Omnipod View, which allows you to monitor your blood glucose in real time. 

In comparison, the t:slim X2 relies on a plastic cannula to deliver insulin to the body. The cartridge is designed a bit differently from other insulin pump brands. Rather than using a piston to push the insulin up, it uses pressure to draw insulin up into the tubing. This feature allows for a smaller, slimmer pump. 

The t:slim is about an inch bigger than the Omnipod at 3.1 x 2.0 x 0.6 inches, though still small enough to hide under clothes without issues.  

As for the touchscreen, it’s intuitive and not over-complicated. It eliminates much of the button-pressing and scrolling required to operate a non-touch-screen insulin pump. It includes features such as insulin sensitivity factors, customizable basal rates, and insulin-to-carbohydrate ratios. 

Both the Ominipod and the t:slim are fully rechargeable. The Ominipod lasts up to three days without charge, while the t:slim battery lasts up to seven days without charge (five if CGM is used).  

Units of Insulin 

The Omnipod 5 can hold up to 200 units of insulin, which is more than enough for general use. Depending on the usage, you may need to change the pods once every two or so days. It needs about 85 to 100 units to work. 

As for the t:slim, it can hold up to 300 units of fast-acting insulin. It should be changed every two to three days to prevent skin infections. 

Delivery and Accuracy 

The Omnipod 5 and the t:slim X2 are relatively new products, so there’s no clear consensus as to which insulin pump delivers better accuracy. Though tests are available, there are limited clinical data to support the claims of each. 

For the most part, both provide consistent insulin delivery with rare instances of pod failures (less than 90%). However, the t:slim X2 is believed to control glucose levels better than Omipod. It has demonstrated superiority to sensor-augmented therapy in a randomized control trial

Cost and Insurance

The Omnipod 5 and the t:slim XS are covered under private insurance companies, Medicare, and select Managed Medicaid Programs and State Medicaid. 

A box of 5 Omnipod DASH pods costs anywhere between $150 to $400 at retail pharmacies and stores, while a box of 10 can cost up to $800 (though some retailers sell them for far less). The pod lasts between two to three days, determined by how many units you use per day. 

The Dexcom G6 system needed to operate the Omnipod retails at $350 to $400. Each box comes with three sensors, which last 10 days each. Therefore, you’ll pay between $500 to $1,200 a month to use the Omnipod 5 insulin pump. 

The out-of-pocket cost of the t:slim X2 ranges between $3,000 to $4,000. This price covers all the supplies, including the Dexcom G6 system. Some plans cover more than 50% of this cost, so it’s worth looking into your insurance options before buying it at this price.  

Pros and Cons of Omnipod 5

Here are the biggest pros and cons of using Omnipod 5: 

Pros 

  • Seamless integration with Dexcom G6, one of the most accurate CGM available with a MARD (Mean Absolute Relative Difference) rating of 9%
  • Wireless, tubeless application
  • Comes with a waterproof rating of IP28, allowing you to dip in 25 feet of water for up to 60 minutes without damaging the pod
  • Adapts to a user’s needs after the first two or three pods, with the algorithm making self-adjustments based on the results over nine days  
  • Customizable targets in 10 mg/dL increments, allowing you to shoot small doses of insulin (from 0.0.5).
  • Lets you add up to eight different glucose targets throughout the day

Cons 

  • Max reservoir volume of only 200 units, with a minimum fill amount of 85 units
  • Accompanying Personal Diabetes Manager isn’t waterproof
  • Pod creates a bulging appearance on the skin
  • Doesn’t allow you to refuel or restart the hearth

Pros and Cons of t:slim X2

These are the advantages and disadvantages of using the t:slim over the Omnipod 5: 

Pros 

  • Automatically corrects boluses with a target of 110 mg/dL, delivering 60% of that value
  • Doesn’t require fingersticks for calibration or mealtime dosing
  • The two-way Bluetooth function allows you to integrate the pump into multiple devices, including smartphones and CGM
  • Available in up to five different types of infusion sets to meet your unique needs. Some come with an automatic inserter, while others feature a customizable insertion angle with various cannula lengths

Cons 

  • When the Control-IQ is on, you won’t be able to set your own target blood sugar. This can be an issue for pregnant women, where the target blood sugar needs to be lower than 110 mg/dL
  • Isn’t waterproof, so you’ll need to take it off when swimming or showering 
  • A clip or waist slip belt is required to place the pump, making it slightly more noticeable than the Omnipod 5

Conclusion

We hope our Omnipod vs t:slim guide helped you choose the insulin pump best suited for you! 

There’s no definitive winner in this comparison; it’s ultimately up to you to decide which device matches your preference the best. They’re both top-of-the-line insulin pumps with near-perfect accuracy and reliability. 

If you value convenience over anything else, we’d say that the Omnipod 5 is worth looking at for its tubeless functionality. If you don't mind using a cannula, the t:slim is a good choice for its high-level accuracy and automatic calibration.

Sources

At Diabetic Me, we are committed to delivering information that is precise, accurate, and pertinent. Our articles are supported by verified data from research papers, prestigious organizations, academic institutions, and medical associations to guarantee the integrity and relevance of the information we provide. You can learn more about our process and team on the about us page.

  1. Medical Device Network US FDA approves Insulet’s Omnipod 5 Automated Insulin Delivery System
  2. Consumer Technolog Association Omnipod 5 - tubeless, automated insulin delivery system
  3. Business Wire Tandem Diabetes Care Announces FDA Clearance of the t:slim X2 Insulin Pump with Control-IQ Advanced Hybrid Closed-Loop Technology
  4. Taylor & Francis Online A clinical review of the t:slim X2 insulin pump
  5. Tandem Diabetes Care Insulin Infusion Sets to Meet Your Unique Needs

About the Author

Ely Fornoville

Hi, I'm Ely Fornoville, and I am the founder of Diabetic Me. Being a type 1 diabetic since 1996, I developed a passion to help people learn more about diabetes. I write about diabetes and share stories from other diabetics around the world. I currently use a Medtronic Guardian 4 CGM and a MiniMed 780G insulin pump with Humalog insulin.

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