Q: We’ve been doing pretty well managing our son’s diabetes since he was diagnosed with type 1 a few years ago. But I’d like to get better at warding off big blood sugar swings. I’ve been hearing a lot about Sugar Surfing. Could it help?

A: Ever watch a surfer crest a huge wave and ride it to shore? Look closely, and you’ll see the surfer making frequent pivots and small adjustments to stay balanced. This isn’t guesswork. Experienced surfers understand wave patterns and know exactly which actions to take in the moment to respond to changing conditions.

Sugar Surfing applies this same principle to diabetes management. Through continuous glucose monitoring (CGM), Sugar Surfers learn how to use CGM trend lines to make pivots and adjustments in insulin amounts and carb intake to keep blood sugar within a tighter range.

I am a pediatric endocrinologist, and I am also a person with type 1 diabetes. Sugar Surfing developed from my own experiences with CGM. After using CGM for a few months, I could see that this new tool was letting me explore my diabetes in ways I never thought possible. I started asking “what if” questions. What if I took small amounts of carbs or insulin and observed the results on the BG trend line of my sensor? What does exercise really do to my blood sugar trends? What about stress? I could get answers to all these questions and more by simply glancing at my CGM and seeing how different actions and activities affected my blood sugar’s overall trend. Using this information, I began making decisions based on trend lines, rather than just reacting to a single number. I soon realized that I could help direct the ebb and flow of my blood sugar patterns — just like a surfer making adjustments so they can ride the ocean waves.

After beginning my own Sugar Surfing journey, my hemoglobin A1C fell to the 5 percent range and has remained there for years. Unexpected severe low blood sugars have faded away. Sugar Surfing is a useful technique to dynamically manage diabetes, and as CGM becomes a more common tool in diabetes management, it’s now possible for anyone to learn how to “manage the moment” in their type 1 care. Think of S.U.R.F. as an acronym:

  • See the patterns.
  • Understand the significance. (Are you starting to trend high or low?)
  • Respond appropriately. (What action should you take? Do you need a small amount of insulin or carb to redirect the trend?)
  • Follow up carefully. (Is your trend going in the direction you want?)

I have taught this process to both adults and children, as well as certified diabetes educators and fellow endocrinologists. If you want to learn more, you can ask your diabetes care team about it.

—Steven Ponder, M.D., F.A.A.P., C.D.E., is a board-certified pediatric endocrinologist with Baylor Scott and White Healthcare in Temple, Texas.

Disclaimer: The information in these articles is not intended as medical advice. Families should check with their healthcare professionals regarding individual care.

Sugar Surfing is a trademark of Dynamic Diabetes Management, Inc. All other trademarks are the property of their respective owners.

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People in the Know: Going Back to MDI
People in the Know: Transitioning to an Insulin Pump
What I Learned by Trying James’ CGM Device on Myself

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