Type 1 University

by adam brown

When it comes to diabetes, a little bit of knowledge can go a long way (and that’s one of the main reasons we write diaTribe!). A perfect example is the day I learned about the importance of pre-meal boluses. This was right around the time I had started on CGM, and it was quickly becoming apparent that I needed to improve my glucose control after meals. At a conference I was attending, someone said casually enough, “Pre-meal bolusing, as we all know, is one of the most important ways to control high blood sugar after meals.” I’d neither heard this before nor made the connection between peak insulin action (about 90 minutes) and peak blood glucose after meals (about 60 minutes). But I soon began putting those insights into practice, with the result of much improved control and A1c.

Sadly, most people with diabetes don’t get these useful bits of practical knowledge from infrequent doctor’s appointments and hard-to-find information on the web. Fortunately, a new online program called Type 1 University (T1U) may help those of us seeking more information. (Despite its name, T1U will offer many classes applicable for type 2 diabetes.)

I enrolled in Type 1 University for two live classes, “Getting the Most From Your Continuous Glucose Monitor” and “Weight Loss for Insulin Users.” Signing up for each live class required logging in on the website, entering my name and email address, and paying $29.95 (each pre-recorded class costs $19.95). On the day of the class, I received an email containing the link to the class and password. After a painless download of software, I was sitting in the comfort of my own home, earning credit at Type 1 University!

First, the software that powers Type 1 University is really cool. It features a large PowerPoint slide in the center of the screen, live video and audio of Gary speaking in the lower right corner, and text chat in the upper right. It’s effectively a one-on-one tutoring session with a true professional in diabetes management. Gary responds to questions in real time, making the session interactive and participatory.

My first class, “Getting the Most from Your Continuous Glucose Monitor,” focused on the information that CGM provides patients. Gary began with a bold declaration: forced to choose between using a CGM and using a pump, Gary would go with the CGM. This statement, capturing the importance of CGM, set the tone for the entire class.

Gary gave practical recommendations on how to look at immediate CGM information (real-time), intermediate information (past day), and retrospective information (downloaded data). He took time to address specific questions, such as, “How long should I wear my sensor?” (Answer: “As long as you possibly can!”), “What is an appropriate standard deviation?” (Answer: “Less than 1/3 of mean glucose.”), and “What are appropriate high/low alarm thresholds?” (Low: 80-100 mg/dl and High: 160-300 mg/dl, with further tightening over time). The thing I appreciated the most was Gary’s user-friendly, to-the-point recommendations and action steps. After the hour flew by, I walked away with knowledge I could put into practice, something diabetes education often struggles with.

Two days later, I attended my second class, “Weight Loss for Insulin Users.” Gary has a master’s degree in exercise physiology, so I had pretty high expectations, and he did not disappoint. He covered considerable information in one hour, addressing topics like basic principles of weight management and tips on reducing insulin requirements to achieve weight loss. Again, I picked up some useful guidelines, like exercising after meals to improve weight loss (reduces insulin intake), cutting back on high fat meals to reduce basal insulin requirements, and the important influence of hormones like ghrelin (stimulates appetite) and leptin (secreted while sleeping to suppress ghrelin; may help explain why getting more sleep can help with weight loss and why most people aren’t hungry in the morning).

I really appreciated the last 20 minutes of class, when Gary gave 16 simple tips for losing weight. They ranged from things we’ve all heard like getting more sleep and eating at home to less obvious tips like using spices to satisfy your taste buds. At appropriate points, Gary stopped to let us ask questions, and he was always quick to answer and make connections to class concepts.

A few tips if you plan on signing up for a class. First, because the classes are only an hour and Gary covers a lot of ground, you should plan to take lots of notes (buying access to a live class does not grant you access to the pre-recorded version of the same class). Second, you should go to class with questions in mind – consider it an opportunity to pick the brain of an expert in diabetes management. Finally, make sure you have an Internet connection than can handle video and audio, as connection problems would stymie everything.

When I think about education in diabetes, I must defer to Benjamin Franklin’s timeless words: “An investment in knowledge pays the best interest.” Indeed, I strongly believe that the small cost to invest in a class at Type 1 University will pay huge dividends in the long run, both in the management of your diabetes and in reducing the risk of long-term complications.

Adam’s Favorites

• Practical, useful information from a diabetes expert.

• Interactive feel and ability to ask questions.

• Convenient and hassle-free option for diabetes education.

Recommendations and Improvements

• Take notes!

• Go to class with questions in mind – there is no access to a recorded version of class for those who purchase live access.