Smart pump comparison

How each pump works

Omnipod 5

Uses your ISF and current glucose to adjust basal insulin only — no automatic correction boluses. Predicts glucose 60 minutes ahead to prevent overcorrection. Especially strong at nighttime hypoglycemia prevention due to conservative correction logic.

Tandem Control-IQ

Calculates hourly correction boluses using ISF and current glucose. Also considers short-term trend (30-minute prediction) to avoid stacking insulin.

• Sleep mode: targets 112.5–120 mg/dL.
• Exercise mode: targets 140–160 mg/dL.
• More aggressive overnight to reach tighter morning targets.

Medtronic 780G

Delivers frequent correction boluses (every 5 minutes) using ISF, current glucose, and adaptive trend analysis. Learns from past patterns and predicts future glucose to fine-tune dosing, using current and past data. Its meal detection feature automatically corrects missed or underestimated meal boluses.

Clinical tips for exercise

• Start mode early — activate exercise mode 30–90 minutes before activity so basal adjustments take effect.
• Hydration & carbs — hydrate and carry fast-acting carbs, especially for prolonged or intense workouts.
• Post-exercise monitoring — watch for delayed hypoglycemia, especially after evening workouts or endurance training.
• Sensor accuracy — CGM lag during rapid glucose changes can affect algorithm response; consider fingerstick confirmation if symptoms arise.
• Omnipod 5 — Activity Mode raises target and temp basal, but has no bolus suppression: less protective during anaerobic bursts.
• Tandem — Exercise Mode is well-designed for aerobic activity; suspends bolus corrections and adjusts basal proactively.
• Medtronic — Temp Target plus Suspend Before Low offers strong protection, especially for unpredictable glucose drops.

Pre-meal bolus adjustments based on activity

If exercise is planned within 1–2 hours after a meal

• Reduce pre-meal bolus by 25–50%.
• Especially for moderate aerobic activity (walking, swimming, yoga).
• Consider reducing even more if the patient has a history of post-exercise hypoglycemia.

If exercise is high-intensity or prolonged

• Reduce bolus by 50–75%.
• For activities like running, HIIT, or cycling over 60 minutes.
• May also need pre-exercise carbs depending on glucose level and insulin on board.

If glucose is borderline before exercise

• Consider delaying the bolus or taking a small snack first, especially if basal insulin is active.
• Timing matters — snacks should be taken 15–30 minutes before activity if glucose is borderline.