I received and was able to read my copy of Dr. Stephen Ponder’s new book “Sugar Surfing” last weekend. He is Pediatric Endocrinologist from Texas and has had T1 himself since 1966. I have followed him on FB for a while and enjoy his interesting and informative posts in which he shares his approaches to various tactical situations and shows how his results unfold with helpful annotations. Thankfully, the b the results and sharing his thought process which helps managing his BG very effectively, achieving near-normalized A1Cs in the low to mid 5s. He uses annotated CGM lines, showing dosing, when various events “appear” and then how things play out. They are not always flat and he points out in both his posts and his books that people without diabetes don’t ever have straight lines! Thankfully, this self-published book features lots of examples of these helpful and informative examples to illustrate the text.
The book itself lays out what Dr. Ponder describes as dynamic diabetes management. He explains that change and variation and, well, numbers being off, are part of the game but, instead of giving up, he lays out his approach which is similar to what I’ve been able to do, but his book lays out a methodology that we can use to take control of our BG and feel successful about it. He contrasts this dynamic approach with a more static approach, where you have a plan and measure yourself against your success in meeting a rigid plan. Here, Dr. Ponder lays out that diabetes itself has considerable dynamism that, to many experienced people with diabetes, makes following a rigid plan a questionable approach. Given his own lengthy experience with diabetes management dating from the dark ages of color coding, Dr. Ponder speaks credibly at the same time he’s being very informative.
Dr. Ponder uses a “surfing” metaphor and successfully throughout the book, adding an amusing spirit to the serious topics under discussion. The motif fits well with the waves in the pictures of annotated CGM lines that he uses to illustrate his excellent and apparently very well-founded tactical approach to managing diabetes. He suggests treating diabetes with respect, rather than fear, but lays out an approach to diabetes management that will allow us to put diabetes in it’s place successfully and take our management to a new level. We know how to use the tools we have but using them a bit differently has produced great results for Dr. Ponder. I’ve done many of the same things for years without the framework, or credibility to get people to try them out.
I’d say that the main drawback I noticed in the book might be that the approach seems to benefit CGM users… There are several sections where he touches that the method can work with frequent BG testing but doesn’t “coach” non-CGMers through it. This would be difficult in a manageable book but is certainly something to hope to see more of in the future.
Some PWD might object that Dr. Ponder’s methodology as presented here could be considered to be labor intensive. The proposition of looking at your CGM more doesn’t seem odd to me as I am a big fan of glancing at mine but someone who is used to maybe checking in on their CGM 10-20x/ day might find 40-50 to be intrusive. Some of this might be a simply that checking a lot isn’t comfortable but, diabetes is rarely comfortable. But it can be successfully managed and Dr. Ponder’s method shows a path not just to “OK” but to excellent, repeatable results that can improve the quality and, from an actuarial perspective, the duration of our lives.