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Managing in the moment
Here is a quote from a d-parent I know: "Our daughter has had type 1 diabetes for 6 years, her A1C runs as high as 8%. We've recently been using the insulin pump but can't seem to control or balance the blood sugars during activities or after changing the infusion site. Can you advise us on how to adjust the pump?" Ok, reasonable and common concerns I've heard for years. And I certainly understand the intent. But the focus might better be placed somewhere else besides primari
Quick Tips for Type 1 Diabetes
Installment #10 What follows is a quick and dirty list of my top of mind quick tips. A gram of alcohol has 7 calories. Foods with carbohydrates and lots of protein and fat are broken down into sugar more slowly. The glycemic index of a food indicates how quickly it turns into blood sugar. The glycemic index of a donut is 76 The glycemic index of white bread is 70 The glycemic index of whole milk is 22 The glycemic index of skim milk is 32 The glycemic index of low fat ice cre
Quick Tips for Type 1 Diabetes
Installment #9 What follows is a quick and dirty list of my top of mind quick tips. Children with diabetes are more likely to miss days at school than non-diabetics. Glucagon should only be given if someone with hypoglycemia is unable to take food by mouth. People with significant diabetic retinopathy can have 20/20 vision. Get regular eye exams. Levemir and Novolog can be mixed together in the same syringe, but the Novolog works slower. Injecting insulin at room temperature
Quick Tips for Type 1 Diabetes
Installment #8 What follows is a quick and dirty list of my top of mind quick tips. Basal rates are best changed at least 2 hours before desired effect. An extended insulin pump bolus for pizza may require up to 8 hours. When you see a pattern of both high and low blood sugars, fix the lows first. Fasting blood sugar patterns are the last to change when coming out of the honeymoon. Some insulin pumpers need a more aggressive insulin to carb ratio in the mornings. Anti-GAD65 a


Second Order Sugar Surfing Essentials
The glycemic trend line on a continuous glucose monitor (CGM) is always telling a story. It's the story of your blood sugar control. So much is revealed by the trend line if you only know how to look for it and interpret it. Sugar Surfing is the Rosetta Stone to deciphering the mysteries of your or your child's blood sugar control challenges. Graduates of my Sugar Surfing Workshops and students of the book can quickly identify "structures" on the trend line. These include col
Quick Tips for Type 1 Diabetes
Installment #7 What follows is a quick and dirty list of my top of mind quick tips. During any illness, check blood sugars more often. The dawn phenomenon is high morning blood sugars caused by overnight growth hormone. Most persons with type 1 diabetes will have over 5000 episodes of low blood sugar in a lifetime. The three macronutrients in our diet are carbohydrates, fats and protein. A meal plan for a person with diabetes should be individualized to their unique needs. A


γνῶθι σεαυτόν (Know thyself)
“Know thyself” Greek philosophy and Sugar Surfing have something in common. Never in the past would I have imagined requiring a total of 10 units of insulin for an avocado steak salad with balsamic vinaigrette dressing on the side, plus a small appetizer of fried avocado topped with crab meat and a light remoulade topping. I’m not here to be a nutritional role model, just to explain how I managed this situation using Sugar Surfing methodology. The first dose was for the meal