Aug. 18, 2018

Early in my diabetes career, our publisher and my mentor, Steve Freed, had me live like I had diabetes for 2 weeks. I had to check my glucose before every meal, and count my carbs and calculate an insulin dose each time I ate. Although I didn’t have diabetes, he had an algorithm for me to use to give me high or low readings. I in turn had my interns do the same thing, and over the past 11 years we were actually able to identify a couple of students with diabetes, and six or seven who had prediabetes.

Over the years I have gotten into binge monitoring events, where I would check my glucose 6-8 times a day to see how I was doing. I am in the middle of one of those events now. Over the past four days, I have stuck my fingers 28 times, and on four after-meal occasions I have had a PPG high enough to have diabetes. I even had one morning reading that was over 130. Although my last A1c was 5.4, I still had some readings that could indicate diabetes.

Not many of our patients, or even you our readers, would be crazy enough to go on a monitoring binge like I did, but with the increased use and decreased cost of CGM, there may be an easier way. This week, Amanda Cortes, our PharmD intern, shares an article on Glucotyping and the use of CGM devices to help evaluate why these spikes happen, and how food choices can be individualized to delay or prevent the onset of diabetes.

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We can make a difference!

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Dave Joffe

Editor-in-chief***