"How does diabetes stand by you?"
I find metaphors useful in describing diabetes concepts and our approaches to self-care. One I often evoke with patients is "how do you walk with diabetes"?
In my experience as a person with diabetes for a half century, and as a Diabetologist, I can say that there are only three ways we "walk" with our condition.
We journey through our lives with diabetes always nearby. That is not a choice, but a fact. However, where we position oursel
“Are Doctors Really Necessary in Diabetes Care?” There is a principle in the computing world called Moore’s Law. Simply stated, computing power doubles every few months to years. At some point this will level off, but for now it’s still increasing. Medical knowledge also doubles every few years and has been expanding at a staggering pace. Yet with this knowledge explosion, the human capacity to absorb and apply it remains relatively static. We are already facing the conseque
One of my roles as an endocrinologist and certified diabetes educator (CDE) is to educate and support my patients' diabetes care skills in ways that help them understand how to best problem-solve and troubleshoot daily diabetes dilemmas. It's all about fulfilling my mission of empowering persons with diabetes. We all have a set of values and beliefs we use to interact with our world. There is a phrase (not necessarily a complementary one) called "living in a bubble". It means
In 1975, a famous endocrinologist published a very elegant experiment. He recruited 7 healthy adults with long standing type 1 diabetes. Using a chemical inhibitor called somatostatin, he blocked all glucagon production from their pancreases. Then he withheld their insulin doses to induce diabetic ketoacidosis (DKA). It took 18 hours for DKA to begin, compared to the 10 hours it took for the unblocked type 1 patients to develop DKA. His study was the first to affirm that insu
The key to managing diabetes is a willingness to frequently check blood sugar (including CGM), thinking about the situation (assuming you already have the knowledge), and taking action (sometimes not doing something is the right action). Just do two of three and you'll miss the mark. Sugar Surfing is our attempt to impart the knowledge and to encourage you to check, think and do... repeat. True, we now have mostly reliable CGM. But the key to it all is the appropriate applica
Air travel safety is a great American success story. This wonderful track record is driven not only by high tech avionics, but by a clear, focused and ongoing attention to maintaining the skills of the human element: the pilot. Ironically, our avionics can become a crutch of sorts. We’re now seeing calls by the FAA for pilots to get more involved with actually flying their planes since so much of the process has become so automated after take-off. There is apparently too much
It's the little things that can really foul us up in our day to day diabetes self-care. Case in point: simply cleaning hands before a BG check. I DID NOT clean my hands when I got the first value of 170 mg/dl [9.4 mmol/L]. I noticed a significant variance compared to my CGM device (lower). Of course I then washed my hands and rechecked. Voila, 102 mg/dl [5.7 mmol/L]. It was a much more "in range" value and consistent with my CGM device at that moment in time. Now think about