Lifestyle Predictors of Glycemic Outcomes with the Omnipod 5 Automated Insulin Delivery System in Pediatric Type 1 Diabetes
Amir Babiker, Sultan Alhammad, Raseel Alsubaie, Sara Alfakeeh, Rana Al Rasheed, Tamam Alshammari, Adel F. Almutairi, Bijesh Yadav, Nouf Alanazi, Eman Alshamari, Haifa AlFaraidi, Mohsen Al AtawiBackground
Hybrid closed-loop systems improve glycemic outcomes in children with type 1 diabetes, but the contribution of lifestyle factors to individual responses remains unclear. This study evaluated 19 lifestyle variables across seven domains as correlates and predictors of glycemic control after Omnipod 5 initiation.
Methods
Single-center cross-sectional study of 46 pediatric patients with type 1 diabetes using Omnipod 5. Ambulatory glucose profile reports provided time in range (TIR), coefficient of variation, average glucose, and A1C/glucose management indicator (GMI) for 14-, 30-, 60-, and 90-day trailing windows; 34 patients had pre-transition data. Nineteen lifestyle and six demographic/clinical variables were assessed via structured parent/patient report. Univariate screening and multivariable models adjusted for baseline severity identified predictors of glycemic control and improvement.
Results
Transition to Omnipod 5 was associated with a sustained TIR increase of 21–22 percentage points from baseline, along with parallel reductions in average glucose and A1C/GMI. No lifestyle or demographic variable robustly predicted glycemic control. In the paired subgroup, baseline TIR was the strongest predictor of improvement magnitude. After adjustment for baseline severity, sleep quality was the only independent predictor of ΔTIR (β = 8.64,
Conclusions
Omnipod 5 use was associated with substantial glycemic improvement in real-world practice. Among lifestyle factors, sleep quality showed the strongest independent association with improvement, supporting prospective studies integrating sleep and behavioral support with diabetes technology.