Sugar Surfing Lesson #11: It's not a meal plan

More people have been reading and hearing about Sugar Surfing. Doctors and diabetes educators have been starting to discuss Dynamic Diabetes methodology in their offices. With this rapid growth in awareness, wrong assumptions might be made about what Sugar Surfing is and what it is not. Because the word “Sugar” is used to describe this decision-making process, some may assume it endorses eating sugar, and seem put off. This is false.

Sugar Surfing is a metaphor. Those who have mastered its principles or who have read the book know this. It’s a reference to our ever shifting blood sugar levels, not sucrose (table sugar) or even carbohydrates in general. Sugar Surfing is a dynamic approach to decision making. It considers more than just a blood sugar level and a measured amount of food. Sugar Surfing does not prescribe what a person or child with diabetes should eat or drink. Those choices are very personal.

What's eaten is important to know and understand in Sugar Surfing. Food is one of several pieces of highly valuable information used to make ‘in the moment’ self-care choices. Surfers profile the effects of a food or meals using the blood sugar trendline of a CGM device as shown here.

Sugar Surfers learn how to interpret these sugar trending patterns. They use these data to determine the significance of a sugar trend. Armed with these data, they can then make smarter choices in the moment to steer the glucose trend in a direction of their choosing. Those choices could involve activity, stress management, food or insulin. Sugar Surfing is empowering.

Persons who use low carb, high protein meal strategies can Sugar Surf. Many are employing many of its concepts and may not be realizing that they do. Stress, insulin pump malfunctions, use of blood sugar altering medicines, and illness can happen to anyone with diabetes using any meal plan. And almost everyone engages in some form of strenuous physical activity from time to time, maybe daily. These situations can be benefitted by knowing how to Sugar Surf.

I know many people who practice the art of what I call “Omnicarbing”. Some days they will carefully practice very low carbohydrate meal plans for stretches of time (days or weeks). They then take a day or two to eat more carbohydrates than the low carb philosophy might approve of. They often need smaller amounts of insulin than on carb heavier days, but in both cases can maintain sub 140 mg/dL (7.8 mmol/L) blood sugars either way thanks to Sugar Surfing.

I don’t think these people are seeking approval from any group or individual. They simply have embraced a modified version of the low carbohydrate style of nutrition which is used successfully by so many. I am not in any position to judge any method of nutrition which has been thoughtfully considered and can yield positive results with training and experience. That includes the low carbohydrate approach. It would be wise for those who do fervently believe and embrace it to respect the choices others make and not condemn them. That’s my opinion.

I know persons who are highly successful low carb practitioners who still dabble in extra carbs from time to time. They just don’t share. They fear being judged. I will not “out” anyone on this and never will.

For the record, I am an Omnicarber too. I can take small doses of insulin and have ultra-low carb days. But I can also eat carbs. I’ve done that for years. I agree with proponents of the low carbohydrate movement about the advantages of limiting carbs and processed foods to improve our metabolic measures of control. But since I have found methods to manage carbs (of all kinds) better than before using Dynamic Management skills, I choose not to live in fear of an occasional hamburger and onion rings or tell myself I’m harming a loved one by letting them attend a friend’s birthday party and have a slice of cake.

I might get bombarded with PowerPoint slides about proper low carb eating and the inherent evils of carbs. Please refrain. I’ve heard it for years. Remember we are all on the same side. I advocate mutual respect between people who apply low carb approaches and those who do not. Both are good people with nothing but the best of intentions. I have been caring for low carb families of children with diabetes for years in my medical practice. I’ve even heard the criticism of fellow endos and CDE’s about this.

A few years ago, it was advocated that all diabetes care should be individualized. Sugar Surfing is based on this bedrock principle. That means what we choose to eat should be part of this thinking.

At the start of my journey with diabetes, I was given a piece of paper with all the foods I was supposed to eat (and many I was to avoid). If I didn’t follow those rules, I was made to feel like a “cheater”. It took decades to break that grip of guilt. Sugar Surfing helped.

Eating recklessly and taking more insulin for it is not a wise choice, I agree. Sugar Surfing does not advocate reckless eating or anything else reckless for that matter. It’s simply a method for making insightful self-care choices “in the moment”. How you choose to eat is entirely up to you. Personally, I believe in moderation. It's worked well for me the last 52 years with diabetes. To each his own.

To quote one of my cultural icons, “Forrest Gump”:

“That’s all I have to say about that”