Sugar Surfing

Updating my discussion to include using hybrid closed loop pumps for surfing and how to get the best results possible based on dynamic diabetes management principles. I’m honored to be returning.

⭐ Exciting News! The team at CWD is thrilled to announce that Dr. Stephen Ponder will join us in sharing his innovative sugar-surfing concepts with our community! 🏄‍♂️🌊 Don't miss this incredible opportunity to learn from a leading expert in the field of diabetes management. Join us and discover new ways to navigate the highs and lows of living with type 1 diabetes.

Register for FFL Anaheim at FFL.is/RegisterforAnaheim and get ready to ride the waves of better blood sugar control with Dr. Ponder at Friends for Life Anaheim!

Unpacking from 16 days at Texas Lions Camp. I came across one of my older name- necklaces from 15 years ago. Good times.

I departed Texas Lions Camp today after 44 years of associating with this magical place (out of the 75 years it has existed). The anticipation and excitement which accompanied my arrival 16 days ago was replaced with a slight feeling of sadness as I drove out today. It’s always an honor and a privilege to serve here. Blessings to all my fellow medstaff as they return to their homes, family and friends. I hope to return in 2025, God willing.

Why we are at Texas Lions Camp

I made a temporary tattoo for my patients earlier this year. Gave them all away and need to order more. These are the universal tasks which the majority of kids with diabetes can benefit from. This includes persons using insulin pumps or taking shots.

Math anxiety affects 20-25% of all kids and teens, plus many adults. Given the frequent calculations needed to manage daily insulin dosing, how do you approach this if your d-kid struggles with math?

Memories created at diabetes camp at Texas Lions Camp are unique to each person who attends. If you ever attended such a camp (or ours), what did it mean to you? Was the impact immediate, or did it take time to manifest? Please share your story. Thanks and blessings.

Thank you Paul Coker for the opportunity to participate today in your upcoming podcast. I had a fantastic time exploring the world of diabetes with you!

Off the wall question: what is the longest time period you (or your child) inadvertently left an expired sensor, infusion site, or Omnipod on the body?

Question to all my friends living with diabetes. What non-technology, non-medicine, non-dietary aspect of your diabetes self care do you consider your personal “superpower”?

My medical education over forty years ago emphasized cultivating a working understanding of metabolic mechanisms in health and disease. I am forever grateful to my mentors for this.

Thanks to Stacey Simms for talking with me about this. I embrace diabetes technology and try to raise awareness about the potential prices paid in their use which we all must be mindful about.

Listen here:

Diabetes Technology: Expectation vs Reality with Dr. Stephen Ponder Diabetes technology is getting better and better – automated insulin systems that link pumps and CGMs – smart insulin pens that have precise calculations and reminders – it’s been quite the evolution over the past few years. But outcomes – time in range, A1Cs, aren’t exactly where expert...

“Automated insulin delivery can be controlled by a neural network that learns using a saturated dataset.

A neural-network artificial pancreas performed similarly to a control algorithm in a small clinical trial.”

Interesting small study.

According to the lead author: “We are happy with both results because in hybrid mode, it got about 87% time in range, and in full closed-loop mode, it got 72%,” Kovatchev said. “Maybe that’s what we are going to expect in the future when we transition to fully automated closed-loop. Low-to-mid 70s [time in range] may be a benchmark to try and achieve.”

Neural-Net Artificial Pancreas: A Randomized Crossover Trial of a First-in-Class Automated Insulin Delivery Algorithm | Diabetes Technology & Therapeutics Background: Automated Insulin Delivery (AID) is now integral to the clinical practice of Type 1 diabetes (T1D). The objective of this pilot-feasibility study was to introduce a new regulatory and clinical paradigm – a Neural-Net Artificial Pancreas (NAP) – an encoding of an AID algorithm into a ...

Most of us don’t think much about how our brain anatomy is set up. But if you have diabetes and experience changes or shifts in blood sugar each day (which frankly means everyone), then here is some “food for thought”.

Deep inside the brain, the midbrain to be exact, is a tiny cluster of neurons with a very important role to play in how we sense physiological changes within our body, plus stresses from coming from outside our body.

It’s called the locus coeruleus (“blue spot”, or LC). As this overview diagram shows, it has direct lines of neural communication throughout the brain to important areas connected to thought and emotional well being.

I tend to simply its function when explaining how it plays a role in how we interpret blood sugar changes. The LC can be characterized as the “oh crap” signal generator in the brain. When dropping, anxiety or uneasy feeling can happen.

For example, the ‘sinking’ feeling we might experience with dropping blood sugars is driven by the LC sending signals to our forebrains. These LC nerves produce a chemical transmitter called norepinephrine.

As blood sugar falls (not only from just being hypoglycemic, but falling within the normal range), the norepinephrine levels in the LC rise and trigger signals to the conscious and subconscious areas of the brain. How they are interpreted consciously and acted upon by us is a learned action.

The purpose of the LC doing this is to make us aware that ‘something’ is happening, and likely not something necessarily positive. In other words it’s sensitive but not necessarily specific. So the twinge of anxiety we might experience in our thoughts as sugar levels are falling has a lot to do with the LC activity.

I have used this knowledge in my daily Sugar Surfing. When my inner “anxiety voice” grows louder, I will next glance at my CGM to see if it has anything to do with a downward drop or drifting of my blood sugar. It’s one of my greatest diabetes superpowers. I make it better by practicing as I wrote in my book Sugar Surfing.

I then take whatever action is needed to stop or reverse it.

I hope this little behind the scenes info helps you.

Although the Dexcom G7 CGM starts reporting data just 30 minutes after insertion, most of the time there is some significant variance with the outgoing readings as seen here. This has prompted me to wait almost 2 hours before activating a new sensor. So I guess I still use it like a G6. But the fundamental difference is I still have incoming readings during the new sensor warm up, by virtue of the 12 hour “grace period”. I don’t know if most others get steady and fairly accurate readings after only a 30 minute warm up after insertion, but I rarely do. What’s your experience?

Just approved for 18 and older with type 2 diabetes. Reads every 15 minutes. Will be sold over the counter and hopefully on shelves by this summer.

Stelo by Dexcom First Glucose Biosensor to be Cleared by FDA as Over-the-Counter Stelo will be the first glucose biosensor in the US cleared for use without a prescription Indicated for use for people 18 years and older who are not using insulin therapy A small, wearable sensor worn on the back of the upper arm, Stelo will provide glucose insights directly to a user’s smartpho...

It’s diaversary day! March 1, 1966. Starting my 59th year living well with type 1 diabetes.

Insulin pumps might be getting smarter, but some patients are compensating for that.

I truly had a fantastic time presenting to medical professionals on Friday and the members of the general public in Jackson Mississippi on Saturday, at the Diabetes Foundation of Mississippi’s “Zap Diabetes” superconference! Special thanks to Irena McClain and Mary Fortune of the DFM for the gracious invitation to attend and speak.