insulin & pumps

Think Like a Pancreas

David Mendosa Health Guide August 01, 2012
  • To think like a pancreas is to come as close as possible to matching your insulin level to what your body actually needs. This is what your body would do automatically if you didn’t have diabetes. But with a little help from insulin injections or an insulin pump and a lot of guidance about how to use insulin you can do it.

    Guidance aplenty is what Gary Scheiner serves up in the completely revised and updated second edition of his most appropriately titled book, Think Like a Pancreas. When I reviewed the first edition in 2004 for my “Diabetes Update” newsletter, it was great, but this edition is both better and more comprehensive. It can guide its readers to learn how to match the amount, timing, and type of insulin that they take to their needs.




    The proper timing of insulin injections has always seemed to be to be one of the trickiest aspects of insulin use. That’s why in 2007 I asked Gary to write a little article about it for my website. His article, “Postprandial Hyperglycemia: It’s All in the Timing,” covers the basics of insulin timing. But Think Like a Pancreas covers it completely.

    Especially valuable is the table on page 41 of the book, “Insulin Action Profiles.” This table provides graphic pictures of the start time, peak, and duration of the five types of insulin, rapid-acting, short-acting, intermediate-acting, long-acting basal (detemir/Levemir), and long-acting basal (glargine/Lantus).

    Just as important to understand are insulin-to-carb ratios. Here again, Gary wrote an introduction to this concept for my website in his article “Insulin-to-Carb Ratios Made Easy.” But the book has a complete chapter on it.

    The book focuses solely on the use of insulin. It’s not just for type 1s, who have to use injections or a pump, but also for type 2s who are using -- or need to be using -- exogenous insulin, that is the insulin that we add to what our pancreas supplies.

    Gary is a great writer who also knows insulin as a user and as a teacher. Think Like a Pancreas is so readable that I found myself wanting to read every word of it when I picked it up with the intention of  just skimming through it.

    Gary has used insulin himself since 1985 and now uses both an insulin pump and a continuous glucose monitor. He teaches blood glucose balancing to people with diabetes through his private practice, Integrated Diabetes Services near Philadelphia. He is a Certified Diabetes Educator and serves on the advisory boards of several diabetes companies.

    A reservation that I have about recommending Think Like a Pancreas to everyone who uses insulin is that Gary doesn’t take low-carb eating into account. He assumes that his readers follow the more typical high-carb diet. I can only hope that when Gary writes another edition of this book that in it he will take the different considerations of low-carb eaters into account.

    Meanwhile, this is the best guidance anywhere for people using insulin or thinking about it. Think Like a Pancreas is available from Integrated Diabetes Services for $17.00. For that you get 306 pages focused on insulin use and a copy signed by Gary himself.