LifeAfterDx--Diabetes Uncensored

A internet journal from one of the first T1 Diabetics to use continuous glucose monitoring. Copyright 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014, 2015, 2016

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Location: New Mexico, United States

Hi! I’m William “Lee” Dubois (called either Wil or Lee, depending what part of the internet you’re on). I’m a diabetes columnist and the author of four books about diabetes that have collectively won 16 national and international book awards. (Hey, if you can’t brag about yourself on your own blog, where can you??) I have the great good fortune to pen the edgy Dear Abby-style advice column every Saturday at Diabetes Mine; write the Diabetes Simplified column for dLife; and am one of the ShareCare diabetes experts. My work also appears in Diabetic Living and Diabetes Self-Management magazines. In addition to writing, I’ve spent the last half-dozen years running the diabetes education program for a rural non-profit clinic in the mountains of New Mexico. Don’t worry, I’ll get some rest after the cure. LifeAfterDx is my personal home base, where I get to say what and how I feel about diabetes and… you know… life, free from the red pens of editors (all of whom I adore, of course!).

Saturday, January 29, 2011

The Saturday Share #11

Did you know that health topics are the number one internet search item, outstripping even porn? Uh… pardon the Freudian slip there...

So to do my part in trying to keep internet health information correct I’ve been two-timing my blog by writing over at
Sharecare were I am one of their “Experts” answering diabetes questions posted by readers.

I’m having a blast, and I’ve decided that every week I’m going to share one of my favorite questions with you here.

Sharecare Question: What does Sliding scale refers to in context of insulin?

My “Expert” answer: A sliding scale is a slightly old fashioned (but functional) approach to fixing high blood sugars. The scale has two columns, the first shows ranges of blood sugar; and the second shows units of insulin. So for instance—and I just pulled these numbers out of thin air so for Peat’s sake, don’t use them—the scale might look like this:

• For blood sugar of 151 to 200 take 2 units of insulin
• For blood sugar of 201 to 250 take 3 units of insulin
• For blood sugar of 251 to 300 take 4 units of insulin

It’s called a sliding scale because as the blood sugar numbers increase, so too do the units of insulin. The amount of insulin you need is variable—it slides—depending on your blood sugar.

Everyone needs a different, personalized scale that takes into account both their insulin sensitivity and insulin resistance. The bigger problem with sliding scale is that it is trying to close the gate after the horse has gotten out of the barn and the barn has burnt to the ground. It is a reactive therapy, trying to fix problems after they happen. More modern approaches focus on trying to calculate insulin needs beforehand. Key to this modern approach is “carb counting,” a method of estimating the blood sugar impact of a meal proactively and taking insulin to cover the meal before the first bite.

You can check out other Expert’s answers to this question, and my answers to many more questions by going here:

Then select the “Answers” tab near the top left.


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