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 colorful labels like:

1. shelf

2. delta wave

3. lag time

4. pivot

5. drop

6. nudge

These are "first order" terms which Sugar Surfers quickly start to recognize on their trend lines, even during the course of a workshop.

A highly significant "second order" term is defined next: the inflection point. A pivot is an example of a single inflection point, whether it's an insulin or carb driven redirection of the BG trend line. But what can more than one inflection point help us define? What can we discover?

Here the two inflection points define the effective duration of insulin action for the insulin dose in the illustration. Keep in mind that duration of insulin action is not a constant, but a working "estimate" at best. The CGM trend line can best let you "see" your own duration of the blood glucose lowering effect of that recent dose.

In this example, there are no frequently changing pump basal rates running in the background. Just a single evening dose of long acting basal insulin (insulin degludec, Tresiba). Ensuring basal insulin "stability" or confidence is an essential Sugar Surfing tool that is well described in the book and at workshops.

Recognizing and properly interpreting inflection points is essential to Sugar Surfing and allows highly advanced (and at times aggressive) stacking maneuvers to be possible. A topic for future posts.

Start looking for your own inflections and reflect on what they might be telling you. By doing so, you pass through a portal and into the world of learning how to manage your diabetes at a level of proficiency far beyond what you ever thought possible.

Go to www.sugarsurfing.com for information about upcoming live workshops or to order the book.

Until then, Surf on dudes!