Gary Scheiner > Quotes

“Dietary fat can also cause another blood sugar rise hours after a meal. This is because fat in the diet can create insulin resistance, which forces the liver to secrete more glucose than usual.”
― Gary Scheiner, Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin

“Remember, the point is not to see which I:C ratio produces a normal glucose level three to four hours later but to determine which ratio produces a result similar to the premeal value.”
― Gary Scheiner, Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin

“Formula 1: The 500 Rule The 500 rule is based on the assumption that the average person consumes (via meals and snacks) and produces (via the liver) approximately 500 grams of carbohydrate daily. Dividing 500 by the average number of units of insulin you take daily (basal plus bolus, also called “total daily dose”
― Gary Scheiner, Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin

“sex, and anything else that has us using our muscles and breathing more heavily than usual.”
― Gary Scheiner, Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin

“Now here’s where it gets interesting: people who lose the ability to produce insulin can sometimes develop insulin resistance, and those who have insulin resistance sometimes lose the ability to produce insulin.”
― Gary Scheiner, Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin

“* There are two ways to accomplish the adjustment. One option is to add (or subtract) from the blood sugar value that you use to calculate your bolus. For example, if your blood sugar is 180 (10) and rising fast, use 230 (12.8) to calculate your dose. If your blood sugar is 120 (6.7) and falling modestly, use 95 (5.3) to calculate your bolus dose.”
― Gary Scheiner, Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin

“The formula that I find works best for figuring the daytime sensitivity factor is called the 1,700 (94) rule. Take your total daily insulin, including basal and bolus insulin, and divide into 1,700 (94 if measuring blood sugar in mmol/l).”
― Gary Scheiner, Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin

“way is to check your blood sugar every thirty minutes after giving a correction bolus and see how long it takes for the blood sugar to stop dropping.”
― Gary Scheiner, Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin

“fuel and may require less of an insulin reduction.”
― Gary Scheiner, Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin

“TDD), should give you a reasonable approximation of your I:C ratio: 500/TDD.”
― Gary Scheiner, Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin

“Look for an exercise physiologist who is also a diabetes educator; many ADA- and AADE-recognized diabetes centers and programs offer the services of exercise physiologists.”
― Gary Scheiner, Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin

“Several professional groups, including the American Association of Clinical Endocrinologists, recommend adjusting insulin doses based on the rate of change that is taking place. Why? Consider the purpose of bolus insulin: to have the glucose level back into one’s target range by the time the bolus has finished working (typically three to four hours later). The usual bolus dosing formulas take the current glucose level into account and assume that the glucose is stable at the time the bolus is given. However, if the glucose is rising, the blood sugar is likely to be above target when that usual bolus has finished working. And if the glucose is falling, the blood sugar is likely to wind up below target.”
― Gary Scheiner, Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin

“Over time most of us experience a conditioning effect. This means that we tend to become more efficient at performing the same activity once we have had a chance to practice it. As a result, we burn less”
― Gary Scheiner, Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin

“is 171, she will need (171–120) / 25, or 2”
― Gary Scheiner, Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin

“Applying my daytime formula of (BS–100) / 40, I gave myself 2.6 units using my insulin pump. Several hours later, just before dinner, my blood sugar was down to 112. I dropped 93 points (205–112). Dividing by 2.6 units, I come up with a sensitivity factor of 36 points per unit—not exactly 40, but close enough.”
― Gary Scheiner, Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin

“Research has shown that large portions of protein (at least 60 g) will raise the blood sugar as much as about 20 g of carb, even when consuming the protein along with carbs.”
― Gary Scheiner, Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin

“One of the potential problems with the weight method is that it fails to consider body composition. An individual who weighs 250 pounds but is very muscular will be much more sensitive to insulin than a person of similar weight who has a great deal of body fat. Another problem is that this system fails to consider stages of growth and hormone production.”
― Gary Scheiner, Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin

“Fiber is a carbohydrate that is resistant to digestion and does not raise the blood sugar. When looking at the”
― Gary Scheiner, Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin

“If you already take rapid-acting insulin at your meals and your blood sugar levels are close to normal most”
― Gary Scheiner, Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin

“Sensitivity factors may also change over time. With weight gain, most people lose some sensitivity to insulin, so the sensitivity factor tends to decrease. Changes in physical activity levels can also affect insulin sensitivity. Prolonged periods of inactivity resulting from illness, injury, travel, or a sedentary occupation may lower insulin sensitivity and require a reduction in the sensitivity factor. In contrast, weight loss and increases in physical activity can produce an”
― Gary Scheiner, Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin

“Remember, a higher sensitivity factor means that less insulin will be given to fix a high reading.”
― Gary Scheiner, Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin

“Bolus dose = (food dose + correction dose + rate of change adjustment – insulin on board ) x activity adjustment”
― Gary Scheiner, Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin

“Your target blood sugar should be a single number near the midpoint of your acceptable target range.”
― Gary Scheiner, Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin

“Verifying Your Sensitivity Factor You can verify the accuracy of your sensitivity factor by doing the following: 1. Check your blood sugar at least four hours after your most recent bolus of rapid-acting insulin. 2. If the blood sugar is elevated, calculate and give the appropriate dose of insulin. Go about your usual activities, but do not eat or exercise for the next several hours. 3. Check your blood sugar four hours later. 4. Calculate how much your blood sugar came down, and then divide by the number of units you gave yourself.”
― Gary Scheiner, Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin

“Personally, I find that overlay reports, such as the one shown in Figure 7.2, are better for evaluating meal doses than summary or average reports like Figure 7.1, since the details are easier to see.”
― Gary Scheiner, Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin

“Rather, your sensitivity factor is how much each unit of insulin is expected to lower your blood sugar.”
― Gary Scheiner, Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin

“and 10 g of that amount is sugar alcohol, deduct 5 g from the 25 g, for a total of 20 g.”
― Gary Scheiner, Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin

“approach is that you may be entering blood sugar values into your pump or logging device that are not true readings, so the data will be inaccurate when downloading. The other option is to calculate your dose using your actual blood sugar, but add or subtract a specific amount of insulin based on your correction factor. The amount of the bolus adjustment depends on your sensitivity factor. For someone whose insulin sensitivity factor is 50 mg/dL (2.8 mmol/l) per unit of insulin, a gradual downward trend could be offset with a half-unit reduction in the usual bolus amount. For someone whose sensitivity factor is 20 mg/dL (1.1 mmol/l) per unit, a sharp rise could be offset with a bolus increase of”
― Gary Scheiner, Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin

“What causes insulin resistance? Typically, it is a combination of genetics (heredity) and lifestyle (the way we live). Having blood relatives (parents, siblings) with type 2 diabetes greatly increases the risk. Certain ethnic groups, including Native Americans and people of African, Hispanic, Asian, and Pacific Island descent, are also at high risk. The aging process plays a role as well. The older we get, the more insulin resistant we tend to become.”
― Gary Scheiner, Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin

“Your sensitivity factor (sometimes called a “correction factor”).”
― Gary Scheiner, Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin