You don't have to be a math genius to try this test. This little bit of diabetes math offers great secrets about controlling your blood sugars, especially if you have Type 1 or Type 2 (on over 30 units of insulin a day) and are on an intensive management program.
John Walsh PA, CDE
John Walsh, PA is a Physician Assistant and Diabetes Clinical Specialist with Advanced Metabolic Care and Research. He has provided clinical care for patients with diabetes for more than 30 years, including thousands of people on insulin pumps. He is co-author of Pumping Insulin, now in its 5th edition, Using Insulin, STOP the Rollercoaster, and The Pocket Pancreas. President of the Diabetes Mall, he is also webmaster of diabetesnet.com, a highly trafficked source of diabetes information and technology visited by 6,000 people a day, and opensourcediabetes.org. John is a consultant and advisory board member for pharmaceutical and device corporations and a frequent speaker on diabetes, insulin pump therapy, bolus calculators, infusion set design, glucose management, and the future of smart pumps, meters and continuous monitors. His recent research, published in the Journal of Diabetes Science and Technology, explores the dosing and behaviors that lead to successful glucose outcomes by pump wearers. John has worn nearly every insulin pump and CGM available and is a sub-investigator on numerous research studies on diabetes drugs and devices.
John gives great presentations on various diabetes technologies to people with diabetes, health care professionals, diabetes educators, and students all over the country. The next presentation is May 10th, 2015 in Austin, Texas.
What is Hepatic Activation?
The theory behind the procedure is that diabetes is a complex metabolic process gone awry. Traditional diabetes therapy attempts to normalize blood sugar levels without considering the complexity of the problem. The simple strategy of most therapy is, "Give insulin when glucose is high and don't give insulin when glucose is low or normal." In contrast, Hepatic Activation attempts to reestablish the normal biochemical and physiological relationships between the gastrointestinal tract, liver and muscle.
The Dexcom STS and the Paradigm RT continuous monitors are currently available in the U.S. with a prescription. In this study, they are compared head to head while being worn by one person with Type 1 diabetes. Over 33 days, 262 simultaneous readings were compared between a One Touch meter and the two continuous monitors. The meter was used to calibrate both monitors and as the standard against which their accuracy was evaluated.
Current basal-bolus thinking says that 50% of the total daily dose of insulin works best as basal, and that a change in basal insulin delivery should occur several hours before a rise or fall in the blood sugar is desired. These ideas need to be rethought as newer, intelligent pumps begin to appear.
View the Super Bolus Presentation as a Slideshow