Think Like a Pancreas Quotes

“Steroid medications such as prednisone and cortisone also cause insulin resistance. But the most widespread reason people become insulin resistant is weight gain. Too much body fat, particularly around the middle, limits insulin’s ability to function properly. In fact, gaining as little as ten pounds over a fifteen-year period can cause insulin resistance to double.”
― 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

“The beta cells constantly measure blood glucose levels and produce insulin, as needed, to keep blood sugar within a normal range. Beta cells also secrete amylin, a hormone that helps regulate the rate at which food digests.”
― 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

“going to be performed before or between meals, reducing the bolus at the previous meal would only drive the preworkout blood sugar very high. A better approach is to take the usual bolus at the previous meal and then snack prior to exercising.”
― Gary Scheiner, Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin

“Premeal Exercise In some cases, exercising before a meal will require a modest reduction in the bolus given for food or an elevated blood sugar after exercising. If you notice that your blood sugar drops low after the meal (or correction dose) that follows a workout, go ahead and reduce the bolus modestly (a 20–25 percent reduction is usually sufficient).”
― 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

“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

“To accomplish this, use an activity multiplier. Calculate your mealtime bolus as usual (based on the food, blood sugar level, direction, and IOB), and then multiply the bolus by a factor that results in a dosage reduction.”
― Gary Scheiner, Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin

“When exercise is going to be performed within two hours after a meal, the best approach is usually to reduce the mealtime bolus.”
― Gary Scheiner, Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin

“Most daily chores and aerobic exercises (performed at a submaximal level over a period of time) will cause blood sugar levels to drop as a result of enhanced insulin sensitivity and increased sugar metabolism. To prevent the blood sugar from dropping too low, you can reduce your insulin, increase your food intake, or both.”
― Gary Scheiner, Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin

“Some forms of physical activity, most notably high-intensity/short-duration exercises and competitive sports, can produce a short-term rise in blood sugar levels. This is due primarily to an adrenaline surge. But don’t forget that insulin sensitivity has still been increased.”
― 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

“A number of factors can affect our sensitivity to insulin, but the most significant is physical activity. Not just exercise, but any form of physical activity, including cleaning, shopping, playing, yardwork,”
― 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

“any boluses, whether they are being given to cover food, high blood sugar, or both.”
― Gary Scheiner, Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin

“prefer to deduct IOB from”
― Gary Scheiner, Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin

“trend graph on a continuous glucose monitor after giving a correction bolus.”
― Gary Scheiner, Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin

“A better way to measure how long it takes for your boluses to finish working is to watch the”
― Gary Scheiner, Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin

“Once the correction bolus is given, you should not eat, exercise, or give any more boluses until you reach the point at which the blood sugar flattens out. Here”
― 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

“Underestimating your duration of insulin action increases your risk for hypoglycemia. Overestimating increases your risk for high blood sugars.”
― Gary Scheiner, Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin

“an effort to prevent hypoglycemia), assume that the insulin takes five hours to finish and 20 percent is used up each hour.”
― Gary Scheiner, Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin

“For those who want to be more conservative with their dosing (in”
― Gary Scheiner, Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin

“A more traditional approach assumes that the bolus takes four hours to finish working and 25 percent is used up each hour. (See Table”
― Gary Scheiner, Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin

“Table 7-10.”
― Gary Scheiner, Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin

“insulin can finish working in less than three hours, and in others it can take as long as five or six hours. Inhaled Afrezza insulin is an exception, with an action curve lasting only two to three hours.”
― 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 2.5 units. Don’t freak out! If the math is more than you’re comfortable with, I’ve done it all for you in Appendix D”
― 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

“* 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