#463 Defining Diabetes: Crush it and Catch It

High Blood Sugar

Managing high blood sugar requires a nuanced approach, especially when unexpected spikes occur. Scott Benner and Jenny Smith emphasize the importance of understanding basal rates and pre-bolusing to prevent frequent highs 1. Jenny shares her personal strategy of being more conservative with corrections overnight, as she manages her own diabetes without external monitoring 1. Scott highlights the need for quick action to avoid prolonged high blood sugar, suggesting that aggressive correction can be beneficial if done carefully 2.

If you usually have high blood sugars all the time, your basal is wrong. You don't understand how to pre-bolus.

--- Scott Benner

Both agree that while rapid correction can be effective, it must be balanced to avoid the roller coaster effect of highs and lows 2.

   

Meal Timing

Timing meals and insulin doses is crucial for maintaining stable blood sugar levels. Scott shares a story of helping a child reduce their blood sugar from 400 to 70 by strategically timing insulin and meals 3. He stresses that insulin used now affects future blood sugar levels, and understanding this timeline is key to effective management 3. Jenny agrees, noting that experience helps in predicting when additional intervention is needed to stabilize blood sugar 3.

Insulin you use now is for later. But a better way to think of it is that insulin from before is affecting you now.

--- Scott Benner

Scott's "crush it, catch it, and start over" method is a practical approach for handling unexpected spikes, emphasizing the need for both immediate action and careful monitoring 4.