Surfing the Blood Sugar Wave
New approaches to dynamic diabetes management
When it comes to type 1 diabetes surely few can claim to understand more about living with the condition than Dr Stephen Ponder, author of the new blood sugar bible Sugar Surfing.
Pediatric Endocrinologist Stephen W. Ponder MD FAAP CDE, himself living with insulin-treated diabetes, has spent over 30 years working with adults, adolescents and children with diabetes, 25 of them as a certified diabetes educator. But it wasn’t until recent years when he started wearing a Continuous Glucose Monitoring (CGM) device, that Ponder started thinking differently about diabetes self-management.
Like most specialists and healthcare professionals, he had been trained to use a set of static rules and metrics to achieve blood sugar control – a philosophy that says a management action, whether it’s food or insulin, should always yield similar blood sugar trends.
However, it soon became clear to Ponder that the blood sugar alert system on his CGM would produce variable outcomes from the same inputs, depending on what else was going on in his life – whether, for example, he’d exercised more, slept less or been under pressure.
This realisation started him on a journey to try and better understand, and ultimately predict, the factors that influenced the effect food and insulin were having on his blood glucose levels and ultimately quality of life.
For Ponder that meant looking at his CGM device in a whole new way. Instead of using it solely as a reactive tool, he started to work out ways to make it more predictive. By repeatedly checking his data stream – sometimes upwards of 50 times a day – and triangulating the readings with memories of recent actions such as his last insulin dose, most recent bout of exercise and what fuel he’d taken on board. Ponder was able to start to build a wave-like picture of how his blood sugar levels ebbed and flowed according to different circumstances.
His next trick was to set parameters on his CGM for the crests and the troughs of the waves, create an imaginary pivot point through the middle and then experiment with a range of different mini-interventions depending on the direction of the deviation from that central trend line.
Sometimes it was a snack, a juice or a gel, a low-carb meal or a meal high in carbohydrates; sometimes it was slowing or suspending his insulin pump. But whatever the intervention, Ponder was also keeping careful track of the other environmental factors going on around him that might affect the outcome of what he was doing.
Ponder’s bespoke form of dynamic diabetes management – or Sugar Surfing – was born.
As he’s quick to point out in the book, however, the comparisons between this type of blood sugar management and the sport of surfing go further than just studying a wave.
Sugar surfing takes time to perfect and anyone trying it for the first time is almost certain to experience his or her fair share of ‘wipeouts’. But with practice, Ponder argues, users of this technique can eventually learn to move and shape the trend line running down their blood glucose ‘wave’ to suit their individual circumstances. Sugar Surfing is based on the concept of frequent pattern management. Common blood glucose trend line patterns are characterized by a small number of recognisable geometric shapes e.g. delta wave, drop, etc.
The more experienced a sugar surfer becomes, the more they can challenge themselves with narrower wave ranges and even specific situational pivot points, such as when they know you’re about to embark on a particularly strenuous activity.
Sugar surfing, both for Ponder and for those who have since adopted his techniques, leads to a very individual form of blood glucose control that lets users respond to the things they have control over and also begin to predict and pre-empt situations coming down the track.
It’s this predictive, super-personalised kind of diabetes care that underpins the thinking behind the NowPatient mobile app. Like, Ponder, we want to make self-care decision-making as quick and reliable as possible for people who take insulin.
But where NowPatient differs is that rather than relying on real-time read-outs from a CGM, we’re employing the latest in machine learning and mobile technology to provide users with an iPhone tool that’s capable of analysing past self-care decisions and using the information to predict what’s likely to happen in the future.
We believe it’s the ‘second brain’ that will take the principles of Sugar Surfing to the next level and revolutionise the management of diabetes for millions of people around the world. For more surfing lessons on sugar surfing go to sugarsurfing.com.
Medical Disclaimer
NowPatient has taken all reasonable steps to ensure that all material is factually accurate, complete, and current. However, the knowledge and experience of a qualified healthcare professional should always be sought after instead of using the information on this page. Before taking any drug, you should always speak to your doctor or another qualified healthcare provider.
The information provided here about medications is subject to change and is not meant to include all uses, precautions, warnings, directions, drug interactions, allergic reactions, or negative effects. The absence of warnings or other information for a particular medication does not imply that the medication or medication combination is appropriate for all patients or for all possible purposes.
Related Articles
Can I Trust NowPatient
Our product and services are certified to international healthcare, medical device and data security standards
Medicines Experts
Meet our medical team
We are a broad skilled and passionate group of clinicians with experience of operating in health systems in the United Kingdom & United States. Providing excellent care and advice is at the heart of everything we do. You can read more about our medical team by visiting the medical team page or learn more about how we curate content by visiting our editorial process
WHY WE BUILT NOWPATIENT
We are committed to helping everyone, everywhere live healthier lives
The NowPatient virtual care platform provides you with access to trusted health information, affordable treatments, management of chronic health conditions and continuous monitoring for health risks. NowPatient can be accessed by downloading the App or using your web browser.
Download our app today
Your Questions Answered
For your peace of mind, we can answer your questions quickly
What does NowPatient do?
NowPatient is a digital health-technology platform functioning as both an online pharmacy and telehealth service. Packaged as a Class I software medical device, it’s accessible via web browser or mobile app (iOS and Android), and offers users worldwide on-demand access to virtual consultations, prescription services, and AI-powered health tools.
Ownership
The service is owned and operated by Infohealth Ltd, a licensed online pharmacy registered in England and Wales (company no. 04004930) with its registered office at Lynwood House, 373–375 Station Road, Harrow, England, HA1 2AW. Infohealth Ltd holds the necessary MHRA approvals for its pharmacy and telehealth offerings.
What It Does
- NHS Online Pharmacy: Order NHS-approved prescriptions (UK)
- Drug Savings: Access major US drug-savings programs (coupons, savings cards, manufacturer assistance, Canadian drug savings).
- Virtual Consultations: Get treated for a wide range of medical conditions by expert clinicians using a secure telehealth link.
- Medication Management: Set up refill & dose reminders, view private treatment plans, and track chronic conditions like diabetes or hypertension.
- Health-Monitoring Tools: Use AI-driven assessments for genetic risk tests, home test kits and blood-pressure monitoring.
- Wellness Insights: Access real-time pollen counts, air-quality data, BMI and type 2 diabetes risk scores, plus comprehensive health-condition information.
Get started today and benefit from Medication Reminders, Get Treated Privately, NHS Online Pharmacy, GP Appointment Booking, Rx Savings Card, Drug Coupons, US Drug Savings Programs, Health Conditions Information, Genetic Testing, Home Test Kits, BMI Risks, Type 2 Diabetes Risks, Pollen Meter, Air Quality Monitor, and lots more!
Our service is operated by experienced medical professionals in the United States and the United Kingdom.
You can view the online services we provide by clicking the link below:
Where is NowPatient located?
NowPatient has offices in the United Kingdom and United States.
In the UK, we are located at:
NowPatient
28 Chipstead Valley Road
Coulsdon
Surrey
CR52RA
In the US, we are located at:
NowPatient
8911 North Capital of Texas Highway
Suite 4200 #1263
78759
Austin, TX
How can I contact NowPatient?
To contact NowPatient, please use the contact form available on the Contact Us page.
Alternatively, if you need to speak to us, you can reach us on the following numbers:
UK telephone number – 020 388 51 500
US telephone number – 1-866-967-1977
Who owns NowPatient?
NowPatient is owned and operated by Infohealth Ltd, a licensed online pharmacy with services spanning the UK, US and Rest of the World. Infohealth Ltd is registered in England and Wales under company number 04004930 and our registered office is at Lynwood House, 373 – 375 Station Road, Harrow, England, HA1 2AW.
Our website is www.nowpatient.com. Our App is called “NowPatient” and can be downloaded from the App Store (for Apple devices) or Google Play (for Android devices).
Can you tell me more about your NHS online pharmacy?
NowPatient’s Pharmaceutical services in the UK are provided by Infohealth Limited trading as ‘Infohealth Pharmacy’.
Our dispensing pharmacy is regulated and authorized for internet sales by the General Pharmaceutical Council (GPhC), registration number 1036487. You can view our license credentials on the General Pharmaceutical Council website. Our superintendent pharmacist who is responsible for the safe and effective oversight of medicines supplies is Mr Amish Patel (Registration Number 2042705).
Medicines are not ordinary items of commerce. All medicines or healthcare product sales are made under the supervision of a registered pharmacist who is licensed by the GPhC. At all times, we endeavour to provide a professional and transparent service whose primary goal is to ensure that the best interests of the patient are served.
How do I make a complaint?
From time to time, we accept that our service levels may not be up to your expectations. NowPatient welcomes concerns, compliments and complaints as valuable feedback that will help us learn from your experiences and make improvements. Feedback can be provided via our clear and transparent Complaints Procedures.
Can you tell me more about NowPatient’s prescribing services for treatments offered?
Our prescribing services are regulated by the General Pharmaceutical Council (GPhC). We provide the following regulated activity:
• treatment of disease, disorder, or injury
• transport services, triage, and medical advice are provided remotely
• caring for adults over 65 years old
• caring for adults under 65 years old
NowPatient prescribing services are run by Infohealth Limited. The Clinical Safety Officer and nominated individual is Mr Navin Khosla.
Can you tell me more about NowPatient’s US services?
Our head of US services is Dr. Jamie Winn.
You can lower the cost of your prescription medications using our various savings programs which include drug coupons, savings card and manufacturer-sponsored patient assistance programs.
We do not provide any prescribing services or dispensing services in the United States.
Is NowPatient legit and can I trust information from NowPatient?
Yes. NowPatient provides trustworthy and accessible clinical, health education and prescription services. We are also trusted by the NHS to deliver clinical and NHS repeat prescription dispensing across the whole of England. In the United States, we work with over 65,000 pharmacies to deliver considerable costs savings for our users.
NowPatient is operated by experienced licensed medical professionals in the United Kingdom and United States. Our Medical Team can be found here.
Our service is trusted by thousands of patients worldwide. You can read their reviews on our Trustpilot:
What are NowPatient’s opening hours?
Our office hours are:
UK – Monday-Friday 9am-6pm GMT
US – Monday-Friday 8am-5pm EST
Please note that we are closed at weekends.
In the event of a medical life-threatening emergency please call:
UK – 999
US – 911
In the event of a medical emergency which is not life-threatening please call:
UK – 111