
The Umbrella Effect
While long-acting or basal insulin delivery (insulin degludec [Tresiba], glargine [Lantus], detemir [Levemir], or the basal delivery rate of an insulin pump) is like having a long roof over your glycemic ‘head’. Injections or boluses of rapid acting insulin properties which are more "umbrella"-like. Consider this image: Properties of any insulin preparation include: 1) time to onset of sugar lowering effect; 2) duration of peak sugar lowering activity; 3) an effective duratio

CONVERSION THERAPY AND DIABETES
History and literature are overrun with examples of conversions: from Saul’s journey on the Road to Damascus in the New Testament, to the overnight transformation of the miserly Ebenezer Scrooge in “A Christmas Carol”. For the first 40 of my 50+ years living with type 1 diabetes I operated under the assumption that if I only had the right combination of insulin doses and carefully measured what I ate, then I would have the best diabetes control possible. I also told thousands

Shift Your Paradigm
To be successful at Sugar Surfing requires us to make a fundamental change in how we visualize or conceptualize blood sugar levels. Since the late-1970's, the concept of blood sugar measurement has been founded upon the collection of a single glucose value or 'level' from a sample of blood. Ironically, the term 'level' tends to promote a sense of stability. And this 'level' is collected at a single point in time, not over a period. Interestingly, prior to the days of self-mon

What is "Dynamic Diabetes Management"?
Dynamic Diabetes Management is better known as Sugar Surfing. The image below describes what this form of diabetes self care is all about. It's the result of 'glances' of the BG trend (done by the Surfer and which vary in their frequency) combined by choices made to 'act' or 'not act'. The power of omission is not to be underestimated. Sugar Surfing is diabetes management in the moment. It transcends static insulin dosing formulas which don't take your BG trending pattern int

Does Metabolic Syndrome damage teen brains?
I've followed many children with type 2 diabetes, and it's precursor: the metabolic syndrome. This recent publications raises very serious questions about an organ that we don't routinely think of as a target for complications: the brain. Conclusions: Metabolic syndrome was associated with impaired reading, working memory, and attention among adolescents. To read the full text manuscript as PDF including links: http://online.liebertpub.com/doi/pdfplus/10.1089/met.2016.0015