Rethinking the Treatment of Diabetes

Dr. Richard Bernstein has been banging on the doors of the castle for decades, but there has been little reply from the medical establishment or big pharma. Simply put ,most of his ideas will not make money, so they are all but ignored. The fact that his methods and nutritional emphasis on the restricting carbohydrates (he was the first to recognize that carbs, rather than than fats, were the culprits in raising blood sugars) could have saved much of the 218 billion dollars spent to treat type 1 and 2 diabetes in the United States in 2007 is apparently considered irrelevant.

The following is a new article by Dr. Bernstein, whom we are proud to claim as a board member of Diabetes Health. It is preceded by a rejection letter that Dr. Bernstein received in 1976 from the Contributing Editor of the Journal of the American Medical Association when he submitted an article suggesting that people with diabetes could finally achieve blood sugar control by blood sugar self-monitoring. Dr. Bernstein was not yet a doctor at that point, but as you'll see from his article below, he has been a type 1 for 62 years. His article was rejected, but today people with type 1 or type 2 are urged to test their blood glucose levels daily. Is it possible that, just as he was right then, he is also right now?

Diabetes Health believes he is.


Dear Mr. Bernstein,

Thank you for your October 20 [1976] letter.

I must say that, even though you cut your article to one-third, it would not do much good because hardly any physician or patient would take the time that you do to keep one's even keel. How any patients would use the electric device for measurement of glucose, insulin, urine, etc.

You are a spartan and a paragon, but, I fear, not common clay.

With kind regards,
Henry T. Ricketts, MD

Contributing Editor, American Medical Association

Here's a PDF of the original letter.


Dr, Bernstein writes, “Better treatment for diabetics is neither difficult nor risky, as some professionals advocate. Until we have a cure, normalizing blood sugars is the best solution we have, because that’s exactly what a cure will do. Why wait?”

Dec 8, 2008

The first time I presented medical research findings, I was not yet a physician. The year was about 1975. I was in my early forties and a mid-career engineer. The forum was a scientific symposium on diabetes. At the time, I felt that I had discovered the holy grail of diabetes care and was eager to share what I had learned.

By normalizing my blood sugars, I had nearly eliminated the hypoglycemic episodes that had been an almost daily occurrence for me, and slowly, with normal blood sugars, I had begun to reverse many of the complications I had accrued since my diagnosis as a type 1 in 1946.

Thanks to some fortunate circumstances, when the first three-pound blood sugar meters became available in 1969, I secured one. At the time they were a niche device, intended for emergency rooms, and only hospitals and physicians could acquire them. They were hardly envisioned as the multibillion dollar industry of today. My wife, a physician, helped me buy that first one, for the princely sum of $650.

I learned through trial and error that I could actually bring my blood sugars into a normal range and keep them there. I also learned that by controlling my diet-eliminating foods that caused considerable elevations in blood sugar, particularly simple carbohydrates such as starches and sugars-I could significantly reduce my dosage of insulin and thus reduce its unpredictability. By 1973, I had seen such important changes in my own health and the reversal of my complications that I attempted to persuade physicians specializing in diabetes to give my method (which also included basal/bolus insulin dosing) a try. 

By the time I gave my talk, I had persuaded two physicians doing diabetes research to study the effects of blood sugar normalization on diabetic complications. Both studies were really the first of their kind. And both showed reversal of early diabetic sequellaei,ii. Each also included a mental health aspect (because "the experts" were convinced that the studies were going to drive the participants crazy). In both studies, depression scores plummeted from severely depressed to normaliii,iv.

At that symposium, contrary to my naïve image of the world beating a path to my door because of my better mousetrap, my talk was met with indifference by the physicians there. (The few patients present, however, surrounded me afterward and bombarded me with questions.) Self-monitoring to help control blood sugars was a curiosity, nothing more. 

I struggled for opportunities to present my discoveries, but for the most part, there were no takers in the U.S. and a very few overseas. I tried to get medical journals to publish my findings, but the use of an "electrical device" to guide the treatment of diabetes was repeatedly ridiculedv. After a while, I realized that the only way I would get published would be with an MD after my name. 

In 1982, at age 48, I received my MD. A year later, I began my private practice. Because I was a type 1 diabetic and had developed my protocols on that model, I thought I was mainly going to be treating type 1 diabetics. It turned out, however, that there were many more type 2s who needed my help. 

At that time, there were about 6 million known diabetics in the U.S. I then had every reason to assume that because my first bookvi was already in print, my guidelines for treatment and prevention would be widely adopted. I may have been overly optimistic, but there was good reason for such hope. Evidence had accumulated that normal blood sugars not only reversed complications, but also prevented insulin-producing beta cells from burning out. 

The  current excuse that normal blood sugars cause severe hypoglycemia is borne of the common practice of treating diabetes with large amounts of carbohydrate covered by industrial doses of insulin or sulfonylureasvii,viii. The justification for this practice is the now disproved mythix that low carbohydrate/high protein diets cause dyslipidemia and nephropathy.

At about the time I started my practice, Gerald Reaven, author of Syndrome X, used the Biostator GCIIS, an "artificial pancreas," to normalize the blood sugar of 32 patients for two weeks. The cumbersome and expensive device constantly measured blood sugar and clamped it at 90 mg/dl. One outcome was that high A1c levels dropped dramatically. The study then followed the patients, half of them male, half female, and also found that it took two years of ordinary living [and likely inappropriate diet] for their A1c's to return to pre-study levels. To me this implied the most important finding-that beta cell burnout dysfunction could be halted or reversed by a combination of exogenous insulin and normal blood sugars. By giving overworked beta cells a rest, they could improve or regain function. A similar study by a Taiwanese group recently came to the same conclusionx.

It is usually easy to treat diabetics who make insulin, and the more insulin they make, the easier it is to treat them. The bulk of the type 2 patients I see make too little insulin to overcome their insulin resistance, so I may start them on at least a small amount of injected insulin. The problem with injected insulin is that large doses cannot be absorbed predictably. So the more insulin a patient must inject, the higher the likelihood of unpredictable blood sugars. This is typically the case when physicians prescribe high carbohydrate diets and then cover the carbohydrate with large doses of insulinxi.

Despite my own story and Reaven's important findings, the techniques I developed have been only superficially adopted, even all these years later. There are no "expert" guidelines for beta cell preservation, and sulfonylurea drugs, which hasten beta cell deterioration, are still widely prescribed. The same is true for high carbohydrate diets covered by industrial doses of insulin.

We now have an epidemic of diabetes, with some 20 million or more diabetics in the U.S., and the increase shows no signs of slowing. The epidemic is a multi-hundred billion dollar drag on our already overburdened healthcare system and fragile economy

Medical students, a recent study found, avoid specializing in diabetes care for a variety of reasons, mostly related to the hopelessness of current treatmentxii. That's probably because standard treatment these days doesn't work.

I read decades ago that blood sugar normalization might reverse diabetic complications for animals, but "the experts" claimed it would never be of value to humans. The new generation of experts still denigrates the practice. "People just won't be bothered," they say. If medical students feel hopeless about diabetes care, imagine how the diabetics themselves must feel.

With current guidelines, it's small wonder that people - diabetics and those who treat them - feel hopeless.

The current "wisdom" is that pre-prandial blood sugars should be as high as 130 mg/dl and postprandial blood sugars as high as 180 mg/dl -more than double normal. The only "complication" that those high blood sugars will prevent is hypoglycemia.  Patients are likewise instructed that an A1c is normal if less than 6.0 percentxiii (or the equivalent of an average blood sugar of 140mg/dlxiv) when studies of non-diabetics show that 6 percent applies only to people over the age of 70xv.

As dangerous as a severe hypoglycemic event can be, it's relatively easy to monitor for and correct. Complications that are vastly more serious and debilitating are inevitable with chronically elevated blood sugars. (I have found that my patients with normalized blood sugars rarely have severe hypoglycemic episodes, and far less frequently than I've seen in conventionally treated diabeticsvii,viii.) To those who guide the guidelines, the significant difference between a severe hypoglycemic episode and a stroke or heart attack is that while the latter are seen as natural consequences of diabetes, a physician can be sued if a patient dies from a hypoglycemic event. Thus current guidelines of care have been devised to protect the physician rather than the patient.

My position is this: people don't die from diabetes. They die from the complications of diabetes. I and others have shown that blood sugar normalization can prevent or reverse the complications of diabetes.

My blood sugars have been virtually normal for more than 40 years. Most of my patients' blood sugars and lipid profiles have dramatically improved and are usually normal. I have many patients on whom other specialists have given up who have come to me and learned how to easily normalize their blood sugars. 

If the medical community is going to make any headway against the epidemic of diabetes, then the experts are going to have to change their attitude toward blood sugar normalization. We must condemn the ready availability of cheap, simple carbohydrates and the official praise for their role in a "healthy diet," which is becoming more commonly recognized as the leading cause of the epidemic of diabetesxi.

I've learned from many of my patients that carbohydrate craving is almost like an addiction-once you get off "the stuff," you are less likely to crave it. It's also been shown repeatedly that a diet consisting mainly of protein plus minimal amounts of slow-acting carbohydrate or whole plant vegetables, leafy greens, and similar foods helps people achieve a sense of satiety that far outlasts that of simple sugars such as those found in starches (including whole grain breads)xi.

It's been a long time since that day when I first presented my findings, and my naïveté has been transformed to sadness. While there are many areas of diabetes care that could be drastically improved, here are a handful that can have a profound impact and are not difficult to implement.

Preventing unnecessary amputations is one. Over the past 26 years, in my capacity as director of the peripheral vascular disease clinic of a large metropolitan hospital and as a Fellow of the American College of Certified Wound Specialists, I've seen many diabetics post-amputation, and many more with ulcers of the feet.

Virtually all of the amputations have resulted from compliance with the current guideline that "a callus can be debrided with a scalpel by a foot care specialist or other health personnel."xvi That's just wrong. A callus is a symptom of pressure or shear forces and is protective rather than harmful. If it is aesthetically distasteful, the proper treatment-which requires little training-is the elimination of the pressure or shear forces that caused the callus. This is called "offloading" and is achieved by shoe modification or the use of orthotic shoe inserts. I cannot accept amputation as the solution for a callus.

Preservation of beta cell function is another. As noted above, the treatment of diabetes is much easier when a patient still has functioning beta cells. Every effort should be made to preserve beta cell function, if only to facilitate an eventual cure if the killer T cells responsible for beta cell destruction are ever isolated. 

I have repeatedly seen children in the "honeymoon" stage of type 1 diabetes whose parents have been told by their specialist that their children should not inject insulin until their beta cells have burned out. I likewise see type 2s who have received similar instructions. Maybe this is done to delay fears of "painful" injections. The fact is, injections need not be painful if a more benign injection technique is followedxvii. But the consequences of not having them when they're indicated certainly can lead to substantial pain over the long term. That kind of "care" will make patients much harder to treat in the future and likely lead to the usual consequences of chronic hyperglycemia. I'd rather see them live until there's a cure-which just might require some healthy beta cellsx.

To put it in the simplest possible terms, the complications of diabetes are caused by long-term hyperglycemia. Hyperglycemia is caused by the failure of the body to adequately maintain blood sugar at normal levels. Intervention through dietary restrictions of simple and total carbohydrates, regular blood sugar monitoring, medication, and, when appropriate, basal/bolus dosing of insulin can normalize blood sugars.  Overeating and excessive body weight can now usually be controlled by the use of self-injected synthetic Amylin and GLP-1xviii, a far more benign approach than the gastric banding/bypass surgery currently recommended. By blood sugar normalization, complications can be prevented or reversed and many deaths can be prevented. So common sense would dictate that if we, as a medical community, are considering the well-being of the patient, we should start at blood sugar normalization.

Better treatment for diabetics is neither difficult nor risky, as some professionals  advocate. Until we have a cure, normalizing blood sugars is the best solution we have, because that's exactly what a cure will do. Why wait?

Richard K Bernstein, MD, FACE, FACN, FACCWS

diabetes@scientist.com

Dr. Bernstein has written extensively for Diabetes Health. Search diabeteshealth.com for his name to read more articles.


  1. Bleicher S, Waltman SR, Santiago JR, Krupin T, Singer P, Becker B.  Vitreous Fluorophotometry and Blood Sugar Control in Diabetics.  Lancet 1979, Nov 1: 1068.
  2. Peterson CM, Jones RL, Dupuis A, Levine BS, Bernstein R, O'Shea M.  Feasibility of Improved Blood Glucose Control in Patients with Insulin-dependent Diabetes Mellitus.  Diabetes Care, 1979: 2: 329-35.
  3. Dupuis A, Jones RL, Peterson CM.  Psychological Effects of Blood Glucose Self-monitoring in Diabetic Patients.  Psychosomatics 1980: 21:7: 581-591.
  4. Bernstein RK.  Some New Considerations Regarding Psychodynamics in Insulin Dependent Diabetes of Longer than 5 Years' Duration.  Isr J Psychiatry Relat Sci: 1984: 27:4: 267-282.
  5. Copies of rejection letters are available upon request.
  6. Bernstein RK.  Diabetes, The Glucograf Method for Normalizing Blood Sugar.  1981: Crown Publishers, NYC.
  7. Bernstein RK.  Hypoglycemia in IDDM.  Diabetes Care: 1990: 13:7: 810-811.
  8. Bernstein RK.  Effects of Low Insulin and Low Carbohydrate on Frequency and Severity of Hypoglycemia.  Am Jnl Med: 1992: 92: 339-40.
  9. Accurso A et al. Dietary Carbohydrate Restriction in Type 2 Diabetes Mellitus and Metabolic Syndrome: Time for a Critical Appraisal.  Nutrition & Metabolism:  2008: 5:9: 1-8.
  10. Harn-Shen C, Tzu-En W, Tjin-Shing J, Li-Chuan H, Shen-Hung L, Hong Da L.  Beneficial Effects of Insulin on Glycemic Control and B-Cell Function in Newly Diagnosed Type 2 Diabetes...Diabetes Care: 2008: 31: 1927-1932.
  11. Bernstein RK.  Insulin Injections: Rotation of Anatomic Regions and Plasma Glucose.  JAMA: 1990: 264: 1535-36.
  12. Tucker ME.  Most Medical Students Reject Careers in Diabetes Care.  Clin Endocrinology News: Sept. 2008: 31.
  13. American Diabetes Association: Standards of Medical Care. Diabetes Care: 2008: 31:1: 518.
  14. Rohlfing CL, Wiedmeyer H, Little RR, England JD, Tennill A, Goldstein DE.  Defining the Relationship Between Plasma Glucose and HbA1c. Diabetes Care: 2002: 25: 275-78.
  15. Pani LN, Korenda L, Meigs JB, Driver C, Chamany S, Fox CS, Sullivan L, D'Agostinio RB, Nathan DM.  Effect of Aging on A1c Levels in Individuals Without Diabetes.  Diabetes Care: 2008: 31:10: 1991-96.
  16. American Diabetes Association. Foot Care.  Diabetes Care: 2008: 31:1: 533.
  17. Bernstein RK.  Diabetes Solution.  Little Brown, NYC http://manuscripts.jama.com: 2007: 249-60.
  18. ibid. 204-210.

Dr. Richard Bernstein is the author of two books your faithful Diabetes Health editor can highly recommend. I've read them both!

Dr. Bernstein's Diabetes Solution: A Complete Guide to Achieving Normal Blood Sugars (New 2007 Edition!)
Little, Brown and Company

The Diabetes Diet: Dr. Bernstein's 
Low-Carbohydrate Solution
Little, Brown and Company, 2007    

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Categories: A1c Test, Amputations & Amputee, Artificial Pancreas, Blood Glucose, Blood Sugar, Diabetes, Diabetes, Diets, Food, Foot Care, Insulin, Kidney Care (Nephropathy), Low Blood Sugar, Low Carb, Meters, The Cure, Type 1 Issues, Type 2 Issues


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Comments

Posted by Anonymous on 8 December 2008

A nice article, although short on recommendations for people to follow. That said, its been the conerstone of what i've known to be true for years. As a patient, I hate my endo's, because they just don't seem to "get" it. The cure for everything in their head is insulin. And thats just plain wrong. I do my best, not when I increase insulin dosages, but when I eat less carb, excersise more, and generally avoid "disturbing" the blood sugar balance. I try to convince the people around me of this, but they don't listen and think i'm being "too dramatic" and thus, the programme is hard to maintain. I wish doctors would print so guidlines so I could shut my critics up. (some of which are people like those I intend to marry)

I liken it to control theory. If you have massive forces pushing in opposition, and small % imbalance results in a large force imbalance, and throws the object in question, way out of position. With smaller forces, you have more time to react with the same % error.

Or said another way "aim small, miss small".

Posted by Anonymous on 8 December 2008

it doesnt matter if one cant exactly achieve dr bernsteins glucose control.not withstanding ,hes the benchmark when it comes to treatment.every diabetic should keeps his books next to their beds.
and every internist would do well to study them

Posted by Anonymous on 9 December 2008

Well, nothing changes, does it? Dr. Bernstein is still a spartan and a paragon. I admire his tenacity and encourage him to press on with his mission to improve care of people with diabetes. I agree that money would be better spent on researching the methods of low carb diets than the billions on pills as we do currently in this country.

Posted by Anonymous on 9 December 2008

Dr. Bernstein is a true hero.....in every sense of the word!

Posted by TerryKennedy on 9 December 2008

Dr. Bernstein, I enjoyed your article. As a pioneer myself I can relate to your hurdles. I remember Rodale ( Rodale Press ) and his Prevention Magazine and the heat he received from the FDA for telling it like it is. The Solutions were killing us and healthy living cornerstone with good nutrition was the answer. And of course the wellness industry is now plagued with many nutrition products that supplement and some that simple do not... Anyhow,I have been in the health/sport/management/competition business for close to 40years at a high level. And more importantly I prefer to be an encourage and lead those whom are struggling with health & nutrition. I am blessed to be working with a company that is positioned and engaged with truly active solutions with ADA, AHA, ICAA, AARP. yes establishments all looking for answers and partnerships of sorts. Regards, Terry D. Kennedy

Posted by Anonymous on 9 December 2008

Dr. Bernstein is just great. His book is super, full of useful information. I had to read it several times before I felt comfortable, but now I am approximately following his advice, and I am doing better than ever before. I am a 66 year old type 2 diagnosed in 2002 (but probably diabetic much earlier). Until I found books like Berstein's and Rosedale's, I felt lost. I started with A1C of 6.1 and now I am 5.2.

Thanks Dieabetes Health for this article! Big Pharma is shameful!

Posted by cde on 9 December 2008

An eloquent statement of the truths of DM care. Ultimately, it is not the physician or Certified Diabetes Educator who decides the "best" treatment. Rather, it is the person with DM. The ability to know, understand, and practice the treatment that best results in normoglycemia is acquired with time and the self-monitoring of blood glucose (BG). With BG monitoring results, it is not difficult to tell normal BG levels from hyperglycemia. Adjusting treatment and self-treatment to achieve normal BG levels is, as Dr. Bernstein writes, not rocket science. But one has to have the desire and decision to do so. Many more people with DM would have the desire and would make the decision if health care providers would more frequently inform them that it IS possible and worthwhile and not even that difficult to normalize BG. Sadly, many people with DM, reflecting the words of their health care providers, simply believe that 150, 180 mg/dL is fine "for a person with DM," as if our bodies were innately different from those bodies without DM. Chronic hyperglycemia is actually not fine, for anyone.

Dr. Stan De Loach
Certified Diabetes Educator
México, D. F.

Posted by Anonymous on 9 December 2008

I have just one question. For those who are intensely active with marathon type sports, how are we supposed to train with out adding extra carbs? I know when I'm low on carbs, I am miserable and exhausted during and after training sessions (not to mention fighting delayed lows). It's still a guessing game as to how many I need, and how to cover them.

Posted by cde on 9 December 2008

An eloquent statement of the truths of DM care. Ultimately, it is not the physician or Certified Diabetes Educator who decides the "best" treatment. Rather, it is the person with DM. The ability to know, understand, and practice the treatment that best results in normoglycemia is acquired with time and the self-monitoring of blood glucose (BG). With BG monitoring results, it is not difficult to tell normal BG levels from hyperglycemia. Adjusting treatment and self-treatment to achieve normal BG levels is, as Dr. Bernstein writes, not rocket science. But one has to have the desire and decision to do so. Many more people with DM would have the desire and would make the decision if health care providers would more frequently inform them that it IS possible and worthwhile and not even that difficult to normalize BG. Sadly, many people with DM, reflecting the words of their health care providers, simply believe that 150, 180 mg/dL is fine "for a person with DM," as if our bodies were innately different from those bodies without DM. Chronic hyperglycemia is actually not fine, for anyone.

Dr. Stan De Loach
Certified Diabetes Educator
México, D. F.

Posted by Anonymous on 9 December 2008

I have just one question. For those who are intensely active with marathon type sports, how are we supposed to train with out adding extra carbs? I know when I'm low on carbs, I am miserable and exhausted during and after training sessions (not to mention fighting delayed lows).

Read the books, law of small numbers, detailed records, trial and error. For energy you need to convert your body to using ketones. Dr B can run circles around you on 'em.

Posted by angivan on 10 December 2008

I am all for lower-carb diets to control BG's, but like most active and involved people who happen to have diabetes, I am unwilling to let my disease control my life. I wish Dr. Bernstein would discuss more ways for people who are athletic (I dance, for instance) and who have irregular schedules (I do theatre and volunteer work) to incorporate his teachings into a non-rigid lifestyle. His recommendations that we tote our own food and cook it ourselves when we travel and stay with a rigid and limited list of foods is not living, in my opinion. But I do keep my carbs under 120g most days, any less than that and all I want to do is sleep!

Posted by catman on 10 December 2008

Several posters have commented on a lack of energy on a low carb diet.

Steve Phinney PhD (U Davis) has done some excellent research on the shifts in sodium and potassium that take place when one first adopts a low carb diet. Specifically, one loses sodium when carbs fall below a certain threshold. Supplements can aid the adjustment by correcting the imbalance of electrolytes.

Phinney's research has demonstrated that endurance is superior on a low carb, high fat diet vs a high carb diet provided the electrolytes are balanced. This aside, there is an adaptive period that takes place before the body becomes fully functional on a low carb, high fat diet. Carbohydrate only offers an advantage in anaerobic activities. You can find some of Phinney's papers on the Nutrition and Metabolism Society web site.

I too embrace Dr. Bernstein as one of bright stars of diabetes management in an otherwise dark and hopeless void. But, with all due respect, I believe he has seriously erred in only giving minor attention to the role of magnesium in the management of diabetes.

Magnesium is one of the most important minerals in the body. It plays a major role in muscle function, especially of the heart muscle. Magnesium enhances insulin sensitivity and the transport of glucose into the cells. Numerous studies have shown that the majority of North American diets are deficient in terms of RDA levels of magnesium which many feel are far too low. Even more significant is that magnesium deficiency and diabetes are intertwined. Research has shown that the high insulin levels that accompany diabetes cause the body to lose or 'leak magnesium'. High insulin levels also prevent the body from retaining and storing magnesium. So if you are diabetic you are almost certain to be deficient in magnesium. If you have been chronically deficient for a long time it can take months or even years at high doses of magnesium to correct. And when a deficiency is corrected supplements usually need to be continued.

The uncontested research showing the existence of a widespread magnesium deficiency in the population and the evidence that diabetics appear to be universally deficient in magnesium whose deficiency has been tied to insulin resistance begs the question "Why isn't every diabetic professional putting their patients on magnesium supplements?" Could it be that magnesium supplements are inexpensive and that the symptoms of magnesium deficiency provide a fertile market for profitable medications which do nothing to correct the underlying cause?

Posted by catman on 11 December 2008

angivan
"I am all for lower-carb diets to control BG's, but like most active and involved people who happen to have diabetes, I am unwilling to let my disease control my life."

But it will unless you control diabetes (and you don't seem willing to do this) diabetes is controlling you. But hey, it's your choice.

"His recommendations that we tote our own food and cook it ourselves when we travel and stay with a rigid and limited list of foods is not living, in my opinion."

So you would prefer to succumb to diabetic complications instead?

"But I do keep my carbs under 120g most days, any less than that and all I want to do is sleep!"

At any one time you have less than 5 grams of glucose (i.e.

Posted by catman on 11 December 2008

angivan
"I am all for lower-carb diets to control BG's, but like most active and involved people who happen to have diabetes, I am unwilling to let my disease control my life."

But it will unless you control diabetes (and you don't seem willing to do this) diabetes is controlling you. But hey, it's your choice.

"His recommendations that we tote our own food and cook it ourselves when we travel and stay with a rigid and limited list of foods is not living, in my opinion."

So you would prefer to succumb to diabetic complications instead?

"But I do keep my carbs under 120g most days, any less than that and all I want to do is sleep!"

At any one time you have less than 5 grams of glucose (i.e.

Posted by catman on 11 December 2008

angivan continued

At any one time you have less than 5 grams of glucose (i.e.

Posted by Kathy on 12 December 2008

I am not familiar with Dr.Bernstein's earlier works, but what I have read here seems like common sense. I think that because diabetes is such a complicated disease that there are literally not two who are alike. It is frustrating to be treated "by the numbers" when most of the time, especially if you are on the pump and are manipulating it often, the numbers are meaningless.

As for diet, the only one that works 100% is the starvation diet. Not to be recommended, but considered as a baseline. Anything above it has to be countered with insulin or exercise. I have found that lower carbs helps, but I cant seem to get past the lack of energy either, especially in the morning. I have tried the liquid diet and the artificial eggs, but probably my best find is the high protein Special K cereal mixed with some regular cereal. Even that can be unpredictable.

Posted by Anonymous on 13 December 2008

Dr. B. Is my Hero!

About 7 months ago I was shooting insulin 4 times a day. I got his book and followed it to a T! I'm also a vegetarian. My first A1C after getting off of insulin was 4.7 yesterday was 4.8! I did my first 1/2 very hilly marathon last Sun, I'm 54, 1:45:09!
Depending on how far I'm going to run is how much oatmeal I have just before I run. Anybody who can't follow his simple plan is just plain LAZY and WEAK! I hate all you Cry Babies! Get serious or DIE! Use your imagination if you have one in the kitchen!

Posted by Anonymous on 4 March 2009

Dr. Bernstein,
Thank-you from the botom of my heart. My daughter was diagnosed at age 5 and had wildly fluctuating blood sugars for two years 54-500 prior to me researching alternatives and finding your book. I had followed my daughters endocrinologists instructions completely. After reading your book and following your advice, her blood sugars normalized immmediately and her daily insulin usage was cut in half from 20 units a day to around 10. Recently I have been listening to her new endo and her numbers are getting bad again so I'm going to go back to your way.
Preservation of her beta cells is of the utmost importance to me but both her endos have looked at me and said her beta cells are dead. This is despite her C-peptide test having the result of 1 and not being retested in years. I will always hold on to the hope that we can beat this thing. She is 8 years old now.

Posted by Anonymous on 2 June 2009

I believe the advice I have read here today to be sensible and I know it will work.
I know from experience that cereals of any kind will put my blood sugar too high even though a health professional told me to take no notice of this as it will go down again in a couple of hours. How can that be healthy?
Much better to eat proper dinners, meat and veg and an occasional fruit between meals.
I was told by my doctor not to follow this kind of diet as too much meat will lead to heart disease and that I should eat high a high carb diet.
I hope he is wrong but we all have to die of something and I just want to be as well as possible for as long as possible so thank you for this article which has encouraged me enormously.
PS I would say to any person taking strenuous exercise that they could carry some dried fruit and nuts and nibble on them if they felt the need.
G.

Posted by Anonymous on 23 November 2009

I just wish Dr. Atkins had not died from an unfortunate accident and could hear the change in opinions (science) regarding the low carb diet!

Posted by Anonymous on 29 December 2009

Dr. Bernstein is the best! My b/g's were normalized withing 24 hours of starting his diet, (w/o meds!) I was diagnosed with an a1c of 13!

Posted by funmoose on 12 February 2010

Dr. Bernstein like so many others must fight the establishment. Thank you Dr. Bernstein for persisting.


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