Gary Scheiner has lived with type 1 diabetes for more than 30 years, and he is the owner and clinical director of Integrated Diabetes Services, a practice specializing in coaching insulin users on glucose control and advanced self-management skills. Gary is the author of six books and countless articles on diabetes treatment and was named the 2014 Diabetes Educator of the Year by the American Association of Diabetes Educators. Please send any questions or comments to

When the first edition of my second book, Think Like a Pancreas: A Practical Guide to Managing Diabetes With Insulin, came out in 2004, it was an instant hit within the diabetes community. In the publishing world, they say that the only thing more appealing than a well-known author is a really catchy title. At the time, I wasn’t exactly a household name. But my original editor commented (after a few beers) that with a title like “Think Like a Pancreas,” the content could be total drek and it would still do pretty well.

Personally, I’m not into producing drek, or anything remotely close…especially when it comes to something I’m so passionate about. Having had type 1 diabetes for the past 30 years and working as a Certified Diabetes Educator for the past 20, I realize that there is a tremendous gap between what insulin users need from their healthcare providers and what they typically receive. Thus the reason for the book (now in its second edition) as well as my practice, Integrated Diabetes Services. I want to equip, train, and inspire people to manage their diabetes successfully. Let’s look at those topics one at a time.


Everyone needs the right tools to do the job. Zorro needed his sword. Bob the Builder needs his wrench. Even the Queen of England needs her crown and, on occasion, the cooperation of Parliament. And people who take insulin need the right tools as well:

1. An insulin program that matches their lifestyle
2. An effective insulin delivery device
3. A modern glucose monitoring system
4. (Potentially) additional medications to support the insulin
5. A supportive healthcare team


Even the best equipment is of little use in the wrong hands. Case in point: I gave my retired parents a very nice computer a few years ago, hoping they could communicate with their grandkids, balance their checkbook, and perhaps do a little writing. But they use it for little more than placing post-it notes to each other. To make optimal use of state-of-the-art equipment, there are certain skills that every insulin user must possess:

1. The know-how to use monitoring and insulin delivery tools properly
2. The ability to evaluate one’s own data and make necessary adjustments
3. Carb counting and a certain degree of dietary discipline
4. The capability to adjust insulin doses based on food intake, physical activity, and glucose levels


The right attitude makes all the difference in the world. It can enable anyone to overcome the odds and live a more satisfying, fulfilling, and successful life. In diabetes terms, the right attitude means the difference between having the right tools and skills and applying them for one’s benefit. Specifically:

1. Persistence and determination. Because past success means nothing if you don’t do the job today.
2. Flexibility, because life rarely follows the rules. You have to be willing to adapt and think creatively.
3. A true guiding principle. Nobody should manage their diabetes for the sake of nice-looking numbers.
4. Acceptance of the fact that not everything is within our control. There will be times when things don’t turn out as we hoped. All we can do is the best we can do.

There you have it. The right tools, implemented skillfully, by a driven individual… that’s Thinking Like a Pancreas.