What is Sugar Surfing?
Sugar Surfing is a metaphor for Dynamic Diabetes Management, also known as “managing the moment”. It’s based on an awareness of one’s blood sugar trends using a continuous glucose monitoring system or by use of frequent blood glucose checks with a handheld meter. By viewing blood glucose trending, a person can make self-care choices earlier and at times more aggressively than with old-style single point in time blood sugar information. Sugar Surfing represents a paradigm shift in how type 1 diabetes can be managed by individuals or involved families.
Why should I Surf?
Sugar Surfing is a choice. Empowered Surfers can enjoy a greater command over their blood sugar trends since surfing balances proactive (forward-looking) and reactive (backward-looking) elements. This allows an empowered and experienced Sugar Surfer to steer or direct the flow of the trend line. The flux and drift of blood sugar trending becomes easier to manage with time. A major benefit of mastering Sugar Surfing is the sense of empowerment felt by the surfer, who may have lived for years under the belief that blood sugar levels could never be directed.
What tools do I need to do this?
Frequent blood sugar data points are the currency of the Sugar Surfer. Under most circumstances, these data are collected from a continuous glucose monitoring system (CGMS). These can also be collected using “flash monitoring” glucose measurement systems if the data is collected with sufficient frequency. In rare cases, frequent self-monitoring of blood glucose using a standard handheld meter can provide sufficient data points to make effective Sugar Surfing self-care choices.
How long does it take to learn?
Like any skill, Sugar Surfing improves with time, attention to detail, and practice. This ability is not dispensed by a health care provider or spreadsheet. Rather, it’s a collection of well-rehearsed methods based on an understanding of one’s own unique responses to insulin, food, exercise and stress.
What is the goal of Surfing?
The goal of Sugar Surfing is personal empowerment. The Sugar Surfer chooses his/her personal goals.
Do I have to Surf all the time?
Sugar Surfing occurs when one chooses to do it. Therefore, Surfers choose when they Surf and when they don’t.
Can others help me Surf?
An empowered Sugar Surfer relies on others when needed. These are usually people who know the Surfer and have a basic working understanding of type 1 diabetes.
Why has my diabetes doctor not heard or know about Sugar Surfing?
Sugar Surfing is a new construct. Therefore, it’s not unusual that established endocrinologists are not aware of this new approach to diabetes self-care.
Is Sugar Surfing dangerous?
Risk is always present in the management of type 1 diabetes. Sugar Surfing is based on choices. Not all choices will result in desirable outcomes. It is incumbent on the Sugar Surfer to be prepared for unexpected outcomes from self-care choices they make.
Do I need an insulin pump to Sugar Surf?
Sugar Surfing does not rely on the choice of how one’s insulin is administered. Therefore, persons using injected insulin can Sugar Surf as can those who choose insulin pump therapy.
How do I get started?
Information on Sugar Surfing can be found several ways. On line, go to www.sugarsurfing.com or like the Facebook page Sugar Surfing for years of publicly posted information about Dynamic Diabetes Management, aka Sugar Surfing. The book “Sugar Surfing” can be purchases as an e-book or softcover at the same website. After reading the book, the individual can make their own choice as to whether Sugar Surfing is desirable to learn and practice.
Is Sugar Surfing costly?
Access to CGM devices varies based on location and insurance. This is the major financial cost. The other costs are only one’s time and attention, for which there is no way to assign a monetary value.
Do I need a CGM to Sugar Surf?
Ideally, yes. However, flash glucose monitoring devices are now available in many locations. These devices can provide sufficient blood glucose data to allow effective Dynamic Diabetes self-care decisions to be made. Standard hand-held blood sugar meters, if used often enough, can also provide useful and actionable information to make some Sugar Surfing maneuvers.
Can children Sugar Surf?
Absolutely. Children and their parents can work together to perform many routine Sugar Surfing maneuvers. With young children, this becomes a team effort with family. AS children grow and mature, more Surfing skills can be transferred to the adolescent.
What are the benefits of Sugar Surfing?
There are two broad categories to the benefits of Sugar Surfing. First, the level of glycemic control can improve over time with consistent application of Sugar Surfing methodology. Second, the sense of empowerment created by Sugar Surfing is a psychological benefit unto itself.
How do I keep Sugar Surfing from taking too much of my time?
Since Sugar Surfing occurs as often or as little as you choose, you can control how much of your time which it takes. As experience grows, most Surfers have no problem conducting everyday life activities at the same time they are vigorously Surfing.
Can an artificial pancreas Sugar Surf?
The artificial pancreas automatically applies many of the methods used by Sugar Surfers. But what a human being can do, and a machine cannot, is make choices. The AP can at best react to the choices made by the person wearing the device. The power of being proactive and the ability to anticipate change is something a machine cannot do for a human being.
How well do I need to count carbs to Sugar Surf?
Counting carbohydrates has been a cornerstone of managing type 1 diabetes for years. Sugar Surfers use carb counting skills as a starting point. Therefore, a basic knowledge of carb, fats and proteins are important. But as Surfing is “holistic” in how it views food, the preferred approach is to look at meals themselves with as much attention as the carbohydrates which make up the meal. Empowered Sugar Surfers take the “top 10” approach. That is, they take time to master the blood sugar raising effect of their “top 10” meals at breakfast, lunch and dinner. Such an approach respects the unique blood sugar raising effect of different foods/meals based on their entire energy content, not just the carb count. The carb count therefore serves as a “starting point” for consideration of insulin dosing.
How do sports and Sugar Surfing mix?
Sugar Surfing is very helpful for many sports. Contact sports can be challenging since it may make wearing a sensor difficult to do. But since sports participation can create significant, sudden changes in blood glucose levels, the ability to Surf can be a powerful skill to add a competitive edge.
Can pregnant women Sugar Surf?
Yes, pregnant women can Sugar Surf. Since improved blood sugar control is the expected outcome, this is beneficial to any woman’s pregnancy. But her doctor should be aware that she is using Dynamic Diabetes Management methods.
How can I tell I'm a good candidate to learn how to Sugar Surf?
Sugar Surfers tend to be internally motivated. They care about managing their diabetes not because they are told to, but because they want to. This is huge distinction. No one can be compelled to Sugar Surf. As has been said, it is a CHOICE.
If I choose not to Sugar Surf, is that a problem?
Not at all, a person can get on and off the Sugar Surfboard as often as they wish. They can also choose to manage their type 1 diabetes based on traditional static formulas and sliding scales like millions of others. These static approaches have worked reasonably well for many people and still do, but generally with less flexibility and fewer feelings of personal empowerment against diabetes. Rarely do they attain the level of diabetes self-control reached by an empowered Sugar Surfer however.
When is the best time to learn how to Sugar Surf?
Surfing can be learned at any time. It might be best to learn it first, since unlearning static methods of self-care can make it harder. Patients who embrace Sugar Surfing from diagnosis have a unique view and tend to be more serene about their management, less judgmental and general more satisfied than persons with a physician prescribed set of dosing algorithms and sliding scales.
If I learn to Sugar Surf, how will it make my life with type 1 diabetes different?
Most Sugar Surfers will attest that Dynamic Diabetes Management is empowering. This creates a sense of satisfaction that static self-care often lacks. If practiced long enough, the opportunity to achieve tighter levels of blood sugar control can translate to better health and wellbeing.
My teen shows no interest in wearing a CGM or Sugar Surfing. What should I do?
First, don’t force the issue. You will not win. Teen Sugar Surfers choose when they are ready to take on this responsibility. That choice cannot be made for them. One way to increase the likelihood of a teen embracing this skill is to avoid use of judgmental terms or beliefs about diabetes control, especially blood sugar numbers. A blood sugar carries no moralistic value. Hence, it’s crucial to avoid the use of the words “good” or ‘bad” when discussing blood sugar values. People internalize these comments as attacks on their autonomy. Working with the teen as they try to chart a course learning how to manipulate their trend line can be made easier by parents who can embrace a sense of mystery and exploration in learning the core Sugar Surfing skills described in the book or at live workshops.
My spouse has type 1 diabetes and is struggling with having the condition. Will Sugar Surfing help him/her?
It could be a huge benefit to your loved ones, especially your spouse.
Are there any places where I can't Sugar Surf?
Probably underwater. Otherwise there are no places where basic Sugar Surfing methods can’t be applied.
How can I help my child Sugar Surf at school?
School personnel can make or break the ability to Sugar Surf in the school. Parents need to be negotiators and not demanders regarding working hand in hand with school teachers and school nurses. Setting up meetings to discuss what can and can’t be done effectively in a school setting is the best first step. In the US, the creation of a 504 plan might make it easier to get the necessary support to perform core Sugar Surfing methodology.
Has Sugar Surfing been scientifically studied?
The basis of Sugar Surfing is called frequent pattern management. Results of a randomized clinical trial on FPM was published in 2012 in the peer reviewed journal Diabetes Care.
If I wait too long, will I be unable to learn how to Sugar Surf?
No, Sugar Surfing is not age-dependent.
Is Sugar Surfing a one size fits all approach to type 1 diabetes self-care?
No. Sugar Surfing represents the most individualized approach to diabetes self-care known. No two Sugar Surfers are alike.
Will Sugar Surfing help me live longer?
Unknown. But while you still reside on this Earth, you might just find yourself happier and more empowered about how you manage your diabetes than any time in your life.