In Which I Review a Book That Changed the Way I Look At Diabetes Management

Disclaimer: I purchased this book myself. I have not been compensated in any way for this review, and all the opinions herein are my own.

A lot of people are given seemingly inconsistent information when they are diagnosed with type 1 diabetes. They are told that they can eat a normal diet as long as they cover the carbohydrates with insulin. However, they are also told that they should keep their blood sugars within range as much as possible.

Unfortunately, with the static diabetes management style that is still most often taught by well-meaning endocrinologists and diabetes educators, it is impossible to avoid a large spike in blood sugar after consuming a typical carbohydrate loaded meal. If the insulin ratios are correct your blood sugar will eventually come back down into range, but it will inevitably be high for at least a couple of hours.

A combination of a static management style and a desire to keep people from having frequent low blood sugars leads to the current A1C recommendations of 7.5 for children and 7.0 for adults. These are well above the A1C for a nondiabetic, and they aren't even achieved by about 80% of people with diabetes.

Some have chosen to address this crisis by eating low carbohydrate diets. That is absolutely a viable solution that works well, and I'll review two books later this month that speak to that option and have provided relief and renewed health to many people with diabetes.

However, the choice is not between a normal diet with roller coaster blood sugars and a low carb diet with mostly in range blood sugars. There's a third way, proposed and used by an endocrinologist who is a long time type 1 diabetic himself: Dr. Stephen Ponder. Dr. Ponder calls his dynamic diabetes management style Sugar Surfing, and it has allowed many people to have lower and sometimes even nondiabetic range A1Cs and mostly in range blood sugars while eating whatever they want to eat, within reason.

The one essential tool for sugar surfers is a continuous glucose monitor (CGM). Some people find an insulin pump a useful tool as well because sugar surfing often involves giving more doses of insulin than you would give on a standard static management plan. However, that is a personal choice. Many people, including Dr. Ponder himself, have successfully surfed their blood sugar waves using multiple daily injections.

Dr. Ponder challenges type 1 diabetics and their caregivers to use their CGM graph as a tool to understand how food, insulin, and activity affect their blood glucose trends and then to act on that knowledge.

His writing style is conversational and easy to understand, despite the fact that he uses some medical terms and introduces all new terms (such as delta wave and shelf) related to sugar surfing. It's easy to read this book over a day or two (I read it for the first time over two mornings while Kittygirl was at VBS the summer after she was diagnosed), but you'll want to keep coming back to it to gain a deeper understanding of sugar surfing as  you continue your journey with diabetes.

I won't give away all the secrets of sugar surfing in this review. Get yourself a copy of the book (a free e-book is available for new diagnosed type 1 diabetics at the sugar surfing website). However, I will say that Kittygirl would not have an A1C and time in range that consistently impress her endo and blow away her pediatrician if we had not found this book and applied its methods. Dr. Ponder also gives seminars all over the country in which he teaches the methods in his book. You can find upcoming dates on the website.

All that, and we're actually pretty mediocre sugar surfers. We don't apply all the techniques consistently and we almost never takes notes about either successes or failures. However, even if you're not ready to apply everything in this book, just changing one or two things could make a huge difference in your or your child's diabetes management.

Think Like a Pancreas, which I reviewed last week, is my #1 recommendation for people to understand what having diabetes means. Sugar Surfing is my #1 recommendation for people who want to take the next step and take control of their diabetes instead of letting it control them. Sugar surfing well is not easy, and you will inevitably fall off  your surfboard on occasion. However, the results are well worth learning the techniques and putting in the effort.