Years ago, I discussed a pump with an endo and stated that “I wouldn’t want to use it unless it is tubeless.” That time is here. Both have comparable performance, so it comes down to lifestyle factors, mobility, exercise, ease of use, waterproof-ness, etc. For now, I’ve asked my endo about the devices, stating a preference for the OmniPod, but looking for her opinion. She’s great about both technical details as well as talking, and getting feedback, from her patients.
GeminiAI Summary
Prompt: Are there any studies or user information to see which provides a better experience or control?
Response:
The consensus from these studies is that both systems provide exceptional, statistically comparable glycemic control.
Here is what the data and user experience reports indicate:
Time in Range (TIR): Multiple retrospective studies analyzing patients who switched from multiple daily injections or manual pumps to these automated systems show near-identical improvements. Both the Omnipod 5 and Tandem Control-IQ consistently increase a user’s Time in Range by 10 to 15 percentage points on average within the first 90 days of use, while drastically reducing the risk of severe hypoglycemia.
Algorithm Differences: While the end results are similar, the algorithms get there differently. Tandem’s Control-IQ uses a “treat-to-range” strategy, aggressively adjusting basal rates and giving automatic correction boluses to keep you between 112.5 and 160 mg/dL. Omnipod 5 uses a “treat-to-target” strategy, adjusting micro-boluses every 5 minutes to gently steer your glucose toward a customizable target (e.g., 110 mg/dL).
User Experience & Burden: Because the glycemic outcomes are so similar, studies note that patient satisfaction comes down to lifestyle and hardware preferences rather than algorithm superiority:
Waterproof vs. Water-Resistant: The Omnipod 5 pod is fully waterproof up to 25 feet for an hour, meaning users can swim and shower without interrupting their automated insulin delivery. The Tandem Mobi is water-resistant, but users are advised to physically disconnect the pump and tubing before swimming, which stops automated delivery during that time.
Wearability: Omnipod users report high satisfaction with the freedom of having no tubes, but sometimes report frustration with the bulkier profile on the skin and the fact that a pod cannot be temporarily removed (if you take it off, it must be thrown away). Tandem Mobi users appreciate the ultra-small footprint and the ability to temporarily unclip the pump to change clothes, but still have to manage the physical tubing.
Part of the experience of these systems are the apps. Not looking good for either. Both have an average review under 3 on Android, but slightly better scores on Apple.
There is not one of the 15 apps I have that deal with health metrics, equipment and other tracking that would get 5 stars out of 5 from me. They all lack something in various ways, and heaven help us if they redesign the app.
That said, I am fairly comfortable with the T:Slim app and both Dexcom and Dexcom Clarity. My big complaint is that both companies are too slow to allow iPhone ios upgrades. They use to at least send out a notification that a new version was approved.
My Tandem pump was replaced Dec 2025. The rep tried to steer me to MOBI. I am personally hesitant to put all my control in one device, a phone. I would like the Tandem T:Slim app to allow full control like the MOBI app, but I guess they didn’t want to do that.
My other issue is that I was having to load my cartridge with 2.5ml to last 3 days while the MOBI only allows 2ml. I am currently loading 1.9ml, but that has taken 4 months.
I was on a high dose of prednisone for months and for some reason even after tapering off it has taken months to regain a more usual insulin sensitivity. I still need to find someplace to deposit 12 pounds - any takers?
AI is probably right about that. I liked the Omni algorithm fine even though it’s less customizable than the mobi one. For me the problem was that there’s really only one kind of infusion set with Omnipod and if your site isn’t working you have to pull the whole thing off.
Possibly off topic, but I find it exasperating that no algorithm that I’m aware of acknowledges that it’s going to take more insulin to bring a BG from 260 to 220 than it will from 160 to 120 even though the change Is 40mg/dl in both cases.
My pump given override corrections when I am that high might as well infuse saline. I do something that raises my endo’s eyebrows to the back of his head, an IM shot into the deltoids of 6-10u. That works. In the muscle is quite a bit faster than SubQ.
But much more than 5u from my pump seems to be a waste of insulin. Not sure of the reason just know how it works in me.
In product design terms, I would always prefer single use tools (like an insulin pump - which is doing one big thing) vs. multi-use tools (like a phone, which now does many big things). It’s better to have both!
As for what I plan to do, I do intend to raise my blood sugar adequately before the workout, plus cut my hour Zone 2 into 2 30-minute sessions, at least for some exercise exercises. With my rowing workouts, I’m definitely going to need to break it in 2 since since it burns calories differently than my cross country and my spin workouts. For the latter, I’ll need to see. I’ll try full hour pieces, but if they start causing me problems, I’ll do the same kind of division into 2 halves with a short refueling.
I’ve also started a dialogue with my Endo and the hospital, so I’ll be seeing a PA soon to talk about moving to a pump. This is mostly driven by expected improvements to quality of life, hoping to sleep a little bit better. I’ve stated a preference for the OmniPod, since my activities usually have a lot of motion, and I sometimes shower twice a day. The cross-country ski machine is quite vigorous, as is the rowing, weight training, kettlebells, and plyometrics, where tubes might start to become a problem.
Personally I have no problems with tubes interfering with any of those physical activities you listed except cross country skiing as I don’t do that. The thing is most of my tubing is under clothes.
Now cats wanting to chew them can be an issue. I wear my pump clipped to my tee shirt neck when sleeping. That puts some tubing in reach of busybody cats
I agree with Carlos. I think the idea of tubes is more of a problem than the reality, especially if you wear pants with pockets.
As far as showering goes, it’s very easy to stop the pump delivering insulin and charge it while you’re in the shower. There’s no problem losing the basal during that short of an amount of time.
My cats were somewhat interested in chewing my tubing when they were kittens but have found other forms of mischief since then.
I am an enthusiastic user of the Tandem T7 which is a tubed pump. You get used to having the tube - but there are a few times I wish it weren’t there. It does catch on things if the tubing sticks out. Hasn’t been a major problem for me, but I could imagine if you were careless with the tubing it could catch on something and take out the insertion site.
For some of the different exercises you do @James.J.Igoe you might want to just leave the pump in the locker and turn it off. Or put it by your side if you’re doing reps for example.
e
@James.J.Igoe I play ice hockey a lot and used Omnipod for years. Last week I switched to Sequel twiist, my first tubed pump. I went into it worried about dealing with tubes but soon became comfortable with them. I wear the pump in a runners pouch around my torso 24/7 snd keep the pouch and tubes under all clothing. Disconnecting the pump, stowing everything in the pouch and hanging the pouch in your locker while you shower is easy and keeps the tubes out of harms way. Depending on the group I am skating with, I have gone back and forth over wearing the pump while skating or disconnecting.
One reason I gave up on Omnipod was a belief that I was not consistently absorbing all of the insulin pumped out of the angled cannula. I have no way of knowing if that belief was BS but with a tubed pump (and a more “straight in” infusion cannula) my TDD has been significantly reduced.
Any pump should provide you with an improved means of suspending or reducing basal for your workouts.
I don’t go for rides like you, but certainly appreciate the quote! I’m just now getting to the point where I can suspend basal in timely fashion or eat carbs to offset the “chore” of mowing the lawn! “Going stupid” is a classic symptom of me going low!
@CarlosLuis Interestingly, I note that the DIY Trio app (its an AID and works on an iPad). Note that I have NOT tried it, haven’t had to (thank goodness), but it provides yet another backup for my use of Trio. I currently have it on my phone, my wife’s phone, take the PDM with me on trips, and have the iPad with me on trips. Guess I should try it out and make sure it works!
@James.J.Igoe If you decide to try Omnipod, you may want to consider use of Dash pods, vice the O5, along with DIY Loop or Trio. Also works a few other pumps depending on where you are. Both require use of iPhone’s, one device for monitoring both CGM and pump.
I have seen quite a few people mention longer or steadier workouts feeling different for their numbers. Breaking things up or planning fuel seems to help some people, though everyone’s patterns can be a bit different.
