Tuesday, December 29, 2015

Sugar Surfing For Good Blood Sugar Control

I'm not a huge fan of carb counting and never have been.  Many years ago, when I was newly diagnosed with Type1, like all good diabetics do, I began weighing and measuring my food, figuring out the carbohydrate amount, and then dosing my insulin injections based on that. But at best, my carb counting has always felt like a guessing game. I can eat the exact same thing and have the exact same amount of insulin with great results one day, and repeat it on a different day with either high or low post meal blood sugars- Neither of which feels good at all.

Obviously, when I have low blood sugar, I have to react and treat it.  So although it feels awful, and is often embarrassing and a burden, it never stays low for an indefinite period of time.

But with high blood sugars... Well, I USE to just wait until my next meal to take a shot. In the past, I'd been told by my doctors to not stack insulin doses, and I was also told to only take insulin before eating a meal. I held on to those rules for many years.

Which means... I would have hours of high blood sugars when my insulin coverage wasn't enough.  But over the past year or so, I've learned by trial and error how to avoid staying in a high range for more than just a short amount of time.  On my best days, when I'm really on my A game, I can avoid those high blood sugars all together.

I still obviously sort of count carbs (I "eye-ball" things, but I don't weigh and measure), but I don't worry too much about being spot on with my calculations- I can make adjustments when I see my Dexcom CGM trend graph start to head in the wrong direction. Sometimes, like after eating a high protein meal, my blood sugar is fine the first few hours. But around 3-5 hours post meal, I get a little rise.  When I see that upward trend begin, I just take a little insulin to cover it.  And that line on my Dexcom that was rising, dips back down and straightens- right where I want it.

One day, I received an email from JDRF about an author coming to Dallas to talk about Sugar Surfing.  I had heard the term "Sugar Surfing" mentioned on a few Type 1 Facebook groups that I belong to.  I knew very little of what it was all about, but I knew it sounded like something I was interested in.  So I signed up for the event.

It was a very motivating presentation.  Dr. Ponder, who is an endocrinologist that has Type 1 himself, went over many graphs that explain how he uses his CGM to maintain tight blood sugar control.  He makes it easy to understand and also interesting.
Dr. Stephen W. Ponder at a "Sugar Surfing" talk in Dallas
He definitely motivated me to do a better job keeping track of what I do. Since attending his event, I've started using the Dexcom 5 app as a spot to quickly and easily record how much insulin I take and when I take it.  That way, if I've forgotten the amount or exactly when I last took a dose, it's all right there so I can easily take a look.

So the myth that stacking insulin, or taking insulin between meals is a bad thing is officially dispelled. Instead, it turns out to be a huge reason why my A1C is currently under 6%. And I plan on keeping it there, by the way!

And yes... I do run into low blood sugars a fair amount of time, but nothing overly dramatic.  In fact, often, I can just eat about 5-10 grams of carbs and I'm right back up in the 80s.

There's a Facebook group for Sugar Surfing you can check out.  Dr. Ponder posts tips, his CGM graphs, and mentions when he'll be out speaking about his Sugar Surfing book.  The talks he gives, by the way, are free of charge.  When I went to the one in Dallas, I intended to buy his book, but the line was pretty long and I had another meeting to get to. So instead, I went home and ordered it online from Amazon.
Sugar Surfing by Dr. Stephen W. Ponder

I haven't actually finished the book- but it's a great reference tool for how to use your CGM to tighten your blood sugar control.

Anytime I make changes in my plan for managing my blood sugar, I do it gradually.  That way, I'm not taking any big risks. I've learned that when I make drastic changes, it never seems to go over very well.  So, please...be safe! 

Now that many of us are lucky enough to have a CGM, we can manage our blood sugars so much more effectively.


  1. Interesting article indeed! I've recently started using an app: Diabetes:M by Rossen Varbanov, which is helpful because I don't have a CGM and it tells me how much active insulin is still in my system.

    1. How cool- I've never heard of that but will definitely check into it. I'm currently using an Accu-Chek that offers that capability but on the phone app would be easier. Thank you so much for the info @ahealthymouse

    2. as far as apps go, i really love "rapid calc" when i am on MDI. it is basically the calculator portion of a pump and it even will decrease bolus amount for you depending on exercise. definitely worth the money!

    3. i am so glad you added this info- i couldn't find the other app someone else had mentioned, so i will check out rapid calc for sure. thanks for adding to the discussion!

  2. It really happens to me !!!! So many years thinking that extra dosis is a sign of bad control....
    However, try the App FoodMeter to count carbs, even it is in spanish it is so visual... It helps a lot!

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