Why Sugar Surf?
Lost in the haze of college rock, winging it, and not logging, it turns out that I began developing my own version of a dynamic approach to managing diabetes back in the late 1980’s. Sometimes this instinctual approach worked. I had varying degrees of success along with some gnarly wipeouts. For example, waking up naked in a pool of cranberry juice spilt all over the bathroom. Oops!
Diabetes is widely known to be hard and dealing with it all the time, well, sucks. A lot. Maybe more?
My main point of writing here is to to help people answer the question “Why Sugar Surf?”. As a non-medical professional, I feel I’m just like you. I have lived successfully with Type One diabetes since 1984 while raising a brilliant daughter. While managing my condition has been challenging, raising her is the thing I am proud of most!
It’s a great feeling when my actions lead to better than average results. However, changes in my routine as simple as losing weight proved challenging. In the past, wacky numbers or sharing about passing out would bring judgemental looks or admonishments from doctors and other practitioners. I found these experiences neither welcome nor helpful.
In 2009, my friend Kristie Hayes was great enough to eat Mexican food with me and explained how much she liked her insulin pump. More importantly, she shared how using her pump offered greater flexibility and finesse vs. my militaristic approach which involved full scale bombardment of large quantities of Regular or NPH insulin when encountering these occasional carb laden fiestas.
Since then, I developed new skills along with the help of an insulin pump to attain average blood sugars (A1c’s) at levels below what are typical for most people with T1 Diabetes. Even more controversial, my blood sugar levels are lower than recommended by the diabetes industrial complex.
I first encountered Dr. Ponder online a few years later and immediately felt a kinship to someone just like me. A person with a similar approach and excellent results but more importantly, he was able to articulate this method to others. Finally, a person with medical credentials and a mind towards clinical research whose message backed up my rebellious homemade approach. This validation is perhaps what I needed most. I was right!
Sugar Surfing is a methodology for managing diabetes developed and promoted by Dr. Stephen Ponder and Kevin McMahon. It is designed as a set of tools for teaching a new way of thinking about blood sugar management for people with type 1 diabetes and also for those in the medical profession. By breaking down the acts of frequent management into many tiny steps, their method teaches people how to identify situations and to apply these techniques safely. By combining some of these steps, people with diabetes can self-experiment and learn new skills, reinforce skills we already have, and build confidence in our ability to problem solve the many facets of managing blood sugars.
This manner of approaching blood sugar control (aka ‘Surfing’) differs greatly from what might be referred to as a static way of thinking. These static prescriptions for managing blood sugar, with a heavy emphasis on fixed targets and infrequent corrective actions, are developed not by the patient but by a practical stranger. In the world of medical dogma, these formulas create a rigid structure which attempt to dictate how patients are to approach diabetes. Doctors and diabetes educators are wise about diabetes in general but an equally smart person with diabetes can develop amazing insights into how their own body responds. Personalization leads to optimization. Only through the individual’s intimate knowledge is it possible to develop the skills and confidence needed to be more successful. In this way, only the person with diabetes is positioned to develop their own personalized approach to optimally manage their own diabetes.
Sugar Surfing outlines an approach to diabetes in which patients, devotees or, as Dr. Ponder calls them, “Surfers” frequently engage with their diabetes to achieve the results that they want. Diabetes can be a numbers game but the numbers are constantly in flux as moving targets. Stephen explains in his many lessons and updates, based on his own experiences as well as those shared by others, that anyone can learn to guide their numbers rather than being a slave to them. Managing in the moment allows him to adjust to the changing diabetes landscape.
Dr. Ponder also shares updates including scientific evidence explaining that diabetes rates, ratios, responses and well, everything else vary all the time. Most things vary all the time, all of the freaking time, 24-7-365. He annotates many of his own and his patients’ CGM lines and teaches how to interpret and attack various diabetes dilemmas that everyone with type one diabetes faces. He shares in his workshops and online updates and lessons how managing chaos is an important tenet of both diabetes science and living with diabetes.
“Flow”, a psychology text by Mikhail Csikszentmihalyi has nothing to do with diabetes. However, it lays out a theory that peak human experience can be achieved through engagement and improvement and that we are, in fact, programmed that way. Upon reading it, I was faced with a foundational motivation; that I should try harder if for no other reason than to see if I could get a better result.
One of my favorite sections of Flow lays out a scenario involving a worker tasked with producing 7 radios per day. Csikszentmihalyi proposes that repeating the process of building radios would lead anyone in such a scenario to conceive “hmm, I built 7 but maybe I can build 8, how do I build 8?” and to contrive to execute their plan and achieve their goal.
People with diabetes practicing static management are likely given a plan and targets by a medical provider who, in a best case scenario, might be equipped with provider tools with which to calculate dosages and set ranges with which both patient and provider might hope to succeed.
As people with diabetes quickly learn, hitting moving targets with general purpose tools is never easy.
People with diabetes also learn that getting supplies with which to treat diabetes itself, a total no-brainer according to many studies cited in the ADA Standard of Care document, which repeatedly shows, and has links to many scientifically-proven studies showing more intensive diabetes management to lead to clinically improved results for people with type one diabetes. Putting supplies into action, Dr. Ponder cites many examples, both his own and examples from his practice, about how people with diabetes can benefit from aiming at more normalized BG targets, adjusting parameters, rates, ratios and other numbers we all can all manipulate to our advantage.
Sugar Surfing shows people with T1 Diabetes how to turn diabetes from a hit or miss, somewhat randomized task, driven by infrequent provider contacts into an opportunity to use your extant knowledge and skills to build a sense of Flow that can lead to maybe not happiness, because diabetes still sucks, but satisfaction that you are doing well. We can then take these small successes and measure increases in the frequency and duration of these successes (e.g. - “time in range”, A1C and many other numbers we can use to measure success).
When we engage with our diabetes and build Flow, we can create a mindset beyond the dogma of “follow doctor’s instructions and go to clinic in 3 months…”.
The first step in turning diabetes into a game you can win is to turn it into a game. We will all keep practicing diabetes until the end of our days. But, we can win more often when we decide to learn and apply the shortcuts of Sugar Surfing into our day.
Pick up a copy or read the updates at SugarSurfing.com!