After being warned off 15g of carbs on Twitter once, I considered that a middle ground is not always such a bad thing. If you’re after a middle ground between Bright Spots And Landmines’ tips and Diabetes For Dummies’ everything-you-need-to-know styles, then this book might just be for you.

About The Author

Gary Scheiner is the owner of Integrated Diabetes Services – a Phildelphia based company offering diabetes education. He is a certified diabetes educator, and won the award of Diabetes Educator of The Year in 2014. As a type 1 diabetic himself, Scheiner is heavily invested in the world of diabetes management.

I thought my diagnosis story sounded unlikely – being diagnosed 6 days before my son was born. But the author easily tops that. He was diagnosed in a Texas suburb called Sugarland.


The first chapter is what you’d expect from a book written about diabetes management – at least one that is written by a person with type 1 diabetes. Gary Scheiner tells us about his diagnosis. He talks about how technology has progressed over the time he has lived with type 1, and how its advances have benefited him personally. CGM is cited as being his personal game-changer. He then spells out what he feels is the next biggest key to success.

“Technology aside, the thing that has made the greatest difference in my life with diabetes is learning how to match my insulin to my needs.

Gary Scheiner, Think Like a Pancreas

Chapter 2 is also mercifully short and sweet (no pun intended), and talks about the benefits of good diabetes management in the short and long term. I’m glad it doesn’t list every possible complication. If you’ve read the aforementioned Diabetes For Dummies you’ll probably be grateful too.

The rest of the book is full of useful information and actionable advice. Topics covers include types of insulin, pumps, and ways to manage your blood sugars.

Think Like A Pancreas refrains from slapping you across the face with a metaphorical stalk of broccoli. Rather, you will be exposed to some detailed advice on how to really nail down your insulin program. This is a good thing. As important as diet and exercise are, there is a reason your doctor prescribes you insulin instead.

Key Lessons

What on Earth my insulin is doing. I thought I knew, but in reality I was pretty clueless. Scheiner explains how different types of insulin work in a very detailed, but easy to understand way. (I’m sure my ex students all feel the same way about my quadratic equation lessons). Graphs of insulin’s effects on blood sugars are not everyone’s cup of tea I guess, but they are bloody useful.

Reading this book coincided with me starting to get evening spikes. Reading about the length of time lantus lasts for helped me to try something that helped. A little dose of basal insulin at noon has solved the issue – so far.

Keeping notes? Give yourself a pat on the back. Seeing the data that people can get on their devices, I do sometimes feel a little envious. I record all my blood sugar readings in teeny-tiny log books, and make the best notes I can in my terrible handwriting. Think Like A Pancreas however makes me feel good about how I keep my data, no matter how primitive.

“At this point, there is no good replacement for an organised written record-keeping system.

Gary Scheiner, Think Like a Pancreas

While things do just happen, they can be mostly planned for. As an example, the issue of alcohol first raising, then later lowering blood sugars is raised. Scheiner suggests bolusing for the drinks to avoid initial spikes, and then lowering the later basal dose to avoid an overly large drop. Its a great way of thinking, and is helpful to hear given my attempts to cultivate a positive mindset around diabetes.

The importance on focusing on the positive impact of good diabetes control. The question What’s In It For Me Now? is answered in a positive fashion. Answers such as increased energy, more restful sleep and personal safety are less depressing then the route most sources of information seems to go. It seems more motivating to list things this way, than in the manner I’m used to seeing: Control your blood sugars or you’ll be tired all the time, an insomniac and a danger to yourself.

Guideline amounts of carbs needed for different types of exercise. Among several items in the appendices (such as example log books, GI information for various food items and useful websites) a list of the amount of carbs required for various forms of exercise is listed. This table takes account your weight, so is not one-size-fits-all as other sources advice on this issue seems to be.


This book has opened my eyes to the importance of insulin. While I still want to look after my diet and exercise (and it’d be wrong for me to infer that this book does not go into detail on the importance of those), I am now very aware that almost any issue can be solved by how I use my insulin.

Of all the books I have reviewed so far, this one is closest to a must read.

Published by Marcus Pezzaioli

I started in September 2018 to document my attempts to get fit after a diagnosis of Type 1 Diabetes in April the same year. I believe sharing my story can help anyone who is afraid to exercise with type 1 diabetes, and show that it is not as complicated as it may appear from other sources of information out there. If I can do it, with no CGM and on MDI, starting out as somebody who does not fit the athletic profile whatseover; then anybody can.

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