Diabetes Unconference - Lows and Highs

Some of you may have heard of the Diabetes Unconference held in Las Vegas March 10-13, 2016. I was fortunate to attend again and I had a great time. I had a chance to see many of my friends who I met on-line. Some I had met face to face before, but others I was meeting for the first time. The thing about the Unconference is that it is like a four day support group meeting. The first part is about getting to know each other. This is really important because in order to really share we need to trust everyone. I think by the end of the first day we had really achieved that. And by Sunday everyone was comfortable enough to really share deep feelings.

As part of the ground rules for the Unconference we agreed that everything that was discussed would remain in the room, so you won’t be seeing anyone posting pictures from in the conference or quoting anyone. But I will share some of my personal lows and highs. First, I’ll start with a high. I was fortunate to attend a presentation by Dr. Stephen Ponder on his new book “Sugar Surfing.” I learned some new techniques that could really help me improve my diabetes management and I guess you really can teach an old dog new tricks. There is an active facebook page on Sugar Surfing. But that was not the best part. Everyone was asked to report how long they had diabetes and then guess on the total number of years present at the Unconference. I applied my best guesstimating skills and then used a “trick.” I guessed 2507.389 years. That 0.389 years may have seemed just funny, but it turns out to have been pivotal (notice Sugar Surfing “pun”). I came in second winning a signed Sugar Surfing book having beaten out the next best by 0.389 years. I felt a little guilty as the third prize was a very old “classic” glucose tab.

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I had worse control during my travel, too. I read other comments to the same effect. For me, the social distraction, as much as I enjoyed it, made me lose the normal focus. I missed several pre-bolus opportunities and there’s also the risk of pre-bolusing for an anticipated restaurant meal and running into a 45-minute time to be seated. Luckily I had understanding dinner companions for that!

It’s an unfortunate theme in my diabetes management. Alone, I can do real well. Add people to the equation and my skills quickly degrade. Some people can multi-task well, me, not so much.

Brian, now that you’re considering Ponder’s Sugar Surfing, maybe you’ll see your unwanted corrections simply as some savvy surfing moves.


Thanks @Terry4. My real challenge with Sugar Surfing is going to be frequent testing. I don’t have a CGM and it will be a challenge to get approval for more than 8 or so test strips a day. And I think you are right I will have to reconsider whether minimizing corrections is really what I should be doing. I did ask Dr. Ponder what he thought of Intramuscular (IM) injections since they work so much faster. He wasn’t really enthusiastic but he wasn’t critical. In fact he pretty much said he really believes that everyone needs to find their own way whether it is low carb, doing IM’s or whatever.

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This is the balance many struggle with. I could dig myself into a cave with an unlimited supply of insulin, test strips and cgm and absolutely maintain perfect blood sugar-- but that’s not really what I want out of life…

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Highly recommend truetest strips by nipro diagnostics ordered through Amazon, 300 = $45 cash price. Rated second only to freestyle in both accuracy and repeatability (the only two metrics evaluated) by consumer reports. Also only require a .5 microliter sample size… One of the best diabetes course changes I’ve ever made.

I get 8 test strips a day for 90 days for a co-pay of $40. Even with cheaper strips I would be looking at hundreds of dollars of added expense.

So if you supplemented an additional, say 4 strips per day… You’d be looking at 0.45 per day… Or an additional $40 “copay” for a 90 day supply… And since you can refill whenever you want instead of when the insurer allows it, there are additional advantages…

Actually, Dr. Ponder recommended something like 25 strips per day. In order to do Sugar Surfing you have to test in a way that identifies “trends.”

25/ day is well beyond what I’m actually willing to do in the real world… if my blood sugars were erratic enough to justify that level of monitoring I’d have a cgm no matter what the cost.

The whole point of Sugar Surfing is to do dynamic blood sugar management, testing for not only current readings but measuring trends and treating based on getting ahead of your blood sugars. You can’t really do that by just checking once 2 hours after a meal. That is the challenge.

Fair enough, but if ones blood sugars are stable enough that they can predict them to be in their target range w/o upward or downward trends at all times, except for predictable excursions such as major exercise or meals, then testing that frequently wouldn’t make sense…

That’s my primary goal. If I know my bg is between say, 75-100 and not rising or falling, there’s nothing to get ahead of, so why waste strips outside of once or twice after meals in order to determine necessary adjustments, head off trends etc?

I tend to think the same way when I see pictures of perfectly flat cgm lines… If that’s within ones abilities, why do they need the cgm?

17 tests/ day was the most I did. That was before I had a CGM and when I was getting ready for my black belt test. I was working out at lunch, running and lifting with some work buddies, and then at the dojang 5-6 nights/ week, and bicycling on Saturdays, to relax! LOL. I think 25 might be a stretch as I tended to test twice to sort of eyeball trends but didn’t do that much following up once I kind of new where I was headed and nudged things where I wanted them to be, if they were a bit off, if that makes sense.

I agree. But social interaction exists along a spectrum and I find I enjoy plenty of alone time. That works well for diabetes management. I enjoy being around people and I do need to refine my D-management skills in that setting. I will never be the guy that seeks out social settings for a very high percentage of my time. But I don’t want to be a hermit, either.

By the way, I fingerstick about 14x/day in addition to my CGM. I double stick for all CGM-calibrations and treatment decisions. When my endo said she didn’t think Medicare would pay for 14x testing per day, she still put in for it and Medicare went along.

Thanks for posting about the Unconference, Brian! Sounds like it was a great experience!

If I had T2D, I would ask for a CGM loaner. There is so much one can learn about own metabolism in just couple of weeks with CGM, with lasting benefits. In my opinion, this should be a standard practice for anyone with T2D.

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I have been referred to Dexcom by my endo for a loaner to see that I am not going low overnight. She is convinced that I must be having bad lows overnight. I really think the whole point of Sugar Surfing is to look at real time trend data to make tactical decisions, so you really need either a CGM or a whole boatload of strips.

Sure, Sugar Surfing is practical if one has access to CGM. My point is that even a loaner over couple of weeks can be extremely beneficial, and should be much easier to get approved for any PWD.

Now I’m even more sorry that I couldn’t make it to the Unconference - I really would like an opportunity to speak with Dr. Ponder. I read Sugar Surfing sometime ago, and found that it rather “systemizes” what I’ve been doing for some time. Of course, I do have the dvantage of a CGM, which helps tremendously.

@Brian_BSC, I wonder what Dr. Ponder’s opinion is of a person with T2D on insulin following his “surfing” techniques? I had a dialogue via email with his co-author, Kevin McMahon, some time back, which ended unpleasantly (oops :blush:) – he closed it out with me pointing out that the book is written for people with T1D and that I should “just find a different book to read.” I was rather displeased with that response - especially, as the system as presented works perfectly well for me - adjusted for my particular requirements, of course.

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I don’t know about others, but when I have fairly flat CGM lines it’s BECAUSE of responding to what the CGM is telling me throughout the day.

I actually found Dr. Ponder similar to Dr. Bernstein in that he is not into typing and very much encourages people to find their own way. He seemed rather explicit that his methods were appropriate to anyone on insulin that has either a CGM or high frequency testing.