Sugar Surfing is a book written by Dr. Stephen Ponder and Kevin McMahon about type 1 diabetes. Dr. Ponder was diagnosed with type 1 diabetes in 1966. He is now pediatric endocrinologist, which gives care for children with diabetes and other endocrine system related issues. McMahon is co-author of this book and has a child with type 1 diabetes. This book gives detailed information about how to better manage diabetes. When Dr. Ponder was diagnosed, there weren’t many resources and accessories to help manage blood sugar. I believe what motivated these writers write this book is the journey they went through. In 1966, life expectancy was very short with diabetes, accessing insulin wasn’t easy, they had to manually check their blood sugar, in general, awareness of diabetes wasn’t much.
The target audiences are primarily people with type 1 diabetes however, this book is helpful for people following low carb diet, anyone that is using insulin pump or not, those who use a syringe to deliver insulin, families and friends of a diabetic patients, for diabetes educators and anyone that is interested in learning about type 1 diabetes. Dr. Ponder however suggests that the use of Continuous Glucose Monitor (CGM) in order to be able to make a quick decision and prevent highs and lows. CGM is a tool that diabetic person sticks on their body and can see their blood sugar number continuously. Diabetes affects the whole family, not just one person. when a person is diagnosed with type 1 diabetes, the whole family gets involved in the person's diabetes journey. When my child was diagnosed with type 1 diabetes, she was in the hospital for twelve days. Since I stayed with her, my husband had to take care of our son and the house. Even after coming home, we take turn to check on her each night. We didn’t know much about diabetes until her diagnosis, so it was and still is a learning process. We must communicate about her all-day activity and meal plan and the amount of insulin she needs without neglecting the other child. Diabetes is a journey and the patients need their loved once love and support. Therefore, it is helpful if everyone around the person gets educated about the sugar surfing.
The main goal of the work is help people and make them the best sugar surfer. In this book, Diabetes is considered as the wave and the surfers (diabetic patients) get on a surfboard (the CGM). Dr. Ponder shows in his book the comparison of a real-life surfing to a diabetic sugar surfing. The wave helps move the surfboard to go up and down. The surfer has to stay balanced on the board to enjoy the ride. The same is true for a diabetic person, their blood sugar has to stay in a certain range in order to have the best A1C. A1C is a test done every three months and it measures what percentage of their hemoglobin (a protein in red blood cells that carries oxygen) is coated with sugar. The higher the A1C level, the poorer the blood sugar control and the higher the risk of diabetes complications. Just like in real life surfing, if they don’t keep their balance and stay at a certain pace, they could possibly fall off the surfboard and drown. Therefore, it is important to become a good sugar surfer and be able to manage diabetes in order to avoid complications.
Some of the main points made by Dr. Pandora are
1. Knowing basic sugar surfing skills well and to use them all the time. This means, keeping the CGM properly calibrated, making sure the basal (background) insulin is doing its job, and learning how much insulin to give at each mealtime.
2. Developing the habit of frequent CGM display glances. It is important to keep an eye on the sensor (a little phone like machine that shows blood sugar reading every five minutes 24 hours). Viewing and managing blood glucose data is one the secrets of an ultimate success as a surfer. Knowing the blood sugar gives control over the diabetes.
3. Setting personal points (range where the blood sugar has to be). This is different for every individual and it is also different for different age groups. Children have a wide range and as they get older the range gets smaller. The better the range, the lesser A1C. For new surfers, it is easier to have a wide range (80 to 350) and manage it in that range. As they develop the surfing skill however, it is important to bring down the range (80 to 150).
4. Putting pieces together. Once a week, it is important to go back to look at the trend of the CGM and make changes accordingly. If there are too many highs, adjust the insulin pump to give more at those times to bring down the lows. Or if there are too many lows, adjust the pump to give less at those times to avoid those lows. Dr. Ponder says that “experienced surfers always study the waves before paddling out on the water to attack them.” page 51.
5. Repeat the steps and keep doing it. Surfing is learning how to manage the lows and highs with the help of CGM.
6. As the surfing abilities progress, it is important to lower targets for a better A1C.
I believe Dr. Ponder and McMahan have effectively accomplished their goal. They have shared their personal experience and explained about diabetes in detail. They have tried to compare diabetes experience to a real-life surfing experience in a way that everyone can understand.
I recommend that diabetes patients, families of diabetes patients, friends, healthcare providers, doctors, and anyone that is interested in learning about diabetes should read Sugar Surfing. There is on specific time to read this book, the sooner it is read, the better management of the blood sugar. My co-worker with type 1 diabetes suggested that I read this book so I can learn more about managing diabetes. However, when I read the book, not only that I learned to better manage, I also learned we are not the only ones that struggle with the situation. Therefore, this book is for anyone who is interested in better managing or helping a loved one to better manage their diabetes.