Optimizing the use of the Omnipod 5 system in adults with type 1 diabetes: an Italian expert Delphi consensus

Objective: Despite the growing body of evidence supporting the efficacy and safety of Omnipod 5, guidance on how to initiate the system and optimize its use in clinical practice remains limited. We aimed to develop expert-based recommendations for the clinical use of Omnipod 5 in people with type 1 diabetes. Study design: A panel of 18 Italian clinicians from different care settings and geographical areas, all with expertise in the management of adults with type 1 diabetes using AID systems, including Omnipod 5, participated in a three-phase Delphi-like consensus process. Agreement was rated on a 5-point Likert scale, and consensus was defined as ≥70% agreement or disagreement. Results: The final consensus output included 58 statements across five domains: initial settings, management of hyperglycemia, management of hypoglycemia, challenging meal scenarios, and physical activity. Consensus was ultimately achieved for 48 of 58 statements. Areas of agreement included duration of insulin action and Reverse Correction configuration, as well as the management of hyperglycemia, hypoglycemia, and physical activity. For high-fat/high-protein or multi-course meals, the panelists identified alternative strategies. Conclusions: This consensus provides a practical expert-based framework for initiating and optimizing Omnipod 5 in routine clinical practice while supporting individualized decision-making in complex scenarios.