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, a highly trafficked source of diabetes information and technology visited by 6,000 people a day, and 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.

The Super Bolus

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

The Incretins: GLP-1 Agonists and DPP-4 Inhibitors

by John Walsh, P.A, CDE

In 1902, Researchers first hypothesized that the gut might directly signal the pancreas. The term incretin was first used in 1930 to describe the enhanced glucose lowering effect that was seen when a gut extract was fed to dogs. In the 1960s, researchers discovered that almost twice as much insulin was released when they infused glucose directly into the gut rather than into the blood as an IV solution, renewing interest in a search for compounds produced by the gut that could lower blood glucose levels.


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