The new revisions contains a lot of important new information, particularly covering the newer drugs like Byetta, Smylin and Victoza.
Thank you Dr. Bernstein--when I see results like this (including a postprandial after breakfast) it reaffirms how good the system works. I am exercising a lot these days so I am eating about 2-3 times the 30g / day number of carbs. I bolus for both carbs and protein using the TAG method described in that forum.
I was diagnosed T1 2.5 years ago now, and I immediately found Dr. Bernstein's book and gained control of my blood sugars, with improved A1C results, etc. However, after a really strong first year, I am slipping....due to burnout, stress, etc. I've just lost my motivation to stick to the short list of foods to eat on the diet. It's not just the baby carrots that are sneaking in (among a ton of other things that are "nos" on the diet), but I've reintroduced really hoppy beer (I have a weakness for good IPA)and I "cheat" all the time now with my kids' food and also at parties. I'm dejected, I was feeling so great about Dr. B's lifestyle and figured I could do it forever, and I made it one year and let it slip. Just wondered if anyone has had similar experiences, and if so, if you have any advice on how to get back into it with the same enthusiasm as when you first started the diet. The burnout is just making me want to forget it all, forget eating how I should, forget testing all the time, to ignore highs, etc. Any advice would be appreciated.
T1VY,
I am not suffering burnout, but I can understand how it can happen. Carbs are addictive. If you hae a taste, you want some more. I have to be sure I have alternatives. BTW, Dr. Bernstein's WOE can be modified a little. I have a sliver thin almond cookie, or a piece of sugar free chocolate after dinner. Lite beers aren't carby and clear alcohol(a martini, or a gin and tonic with sugar free tonic) is carb free.
I think burnout is a real issue. I'm not clear it is just carb addiction, but a mental thing. And while Dr. appreciates it, I don't think his teachings really address it. He is basically totally focused and expects all his patients to be just like that. But we are human. And the strict diet, the constant blood sugar checks, waking up in the middle of the night, it takes a toll. I don't have any answer, but I would recommend that you consider reading William Polonsky's book "Diabetes Burnout." And you might also consider making a special effort to "treat" yourself like amanda02 suggests. I cook up great stuff. An ice cream made from full cream or sugar free margaritas. Try to turn testing and all that into a "habit" and try to make eating a "treat" not a burden.
I slip sometimes, but it seldom lasts more than a day. The one thing I never do is stop testing, and my meter has always been able to issue a loud enough wakeup call to get me back in the groove.
I also eat slightly more carbs than Bernstein prescribes -- usually around 40 a day. I exercise regularly and that works for me. My latest A1c was the best it's ever been.
Brian's suggestion about treating yourself is dead on. I do allow myself the occasional treat -- fruit, ice cream cone, whatever it happens to be -- and bolus appropriately to suppress the spike. The key word is "occasional". That's usually sufficient to take the mental pressure off and leave me free to do what I know I should do. We are not robots, and the mental aspect of management is just as critical to success as the physical aspect.
I think burnout applies to anything that requires a person to do certain things and not do other things. I think it's one of the reasons that diets do not work -- something like 95% of people regain the weight, and I don't think it's because they've gorged. Instead, a little slip here, an I don't care there, and after a while, they're back to where they started. So what can you do about it?
In our case, I think we have some magic. Called our meters. If you slip, then your meter will remind you that your BG is not really where you want it to be. So you treat it. And resolve to do the next right thing, whatever that may be. Which is not to say that a treat every once in a while is not permissible, but you have to be careful not to let it get too common. You could "schedule" treats, knowing full well that you are going to have to treat for them, and then not have another one until your next "appointment". How often that should be is up to you, but the more often, the more likely that your BGs will slip. If it was me, I'd do once a month.
The other thing I wanted to mention is that the people who seem to be the most successful on Bernstein are the ones who like a lot of foods, and are creative with their cooking. On the one hand, the same old meat and veggies can taste very different with different sauces and different cooking methods. Secondly, some people have gotten very clever at making "pastries" with substitute flours and sweeteners, so it feels like a treat, but is not high carb. There are a zillion low-carb recipes on the web, if you're into that kind of thing.
So, good luck, and hang in there!
Type1VT, diabetes is a relentless foe, so in many ways burnout is to be expected. Although I find sticking to the diet relatively easy my problem is sticking with my exercise program day after day week after week year after year. What I use to motivate me is keeping in the habit of frequent testing, if I miss even a few days of exercise it starts to show up on my meter and I know I have to get out there and walk even if I've had a long exhausting day at work.
Diets that depend on will power tend to fail, so you need to find treats that are really treats, that way you won't feel deprived. My go to is a couple of squares of dark chocolate with some nuts and maybe a few strawberries. Perhaps you can keep something on hand to eat that you really like, instead of sneaking something off your kids plate.
Re parties: I often eat something before the party. This makes it easier to stay on the straight and narrow if there is nothing to eat. Your friends will be very impressed at the tiny portions on your plate as well as your iron will power:) When all else fails I break out the one bite rule, which says I can have one bite of anything, but only one. I can make a single spoonful of a particularly nice desert last several minutes by taking very tiny bites and savoring each one to the fullest.
I don't drink so I can't help you with the beer. You might get some ideas if you posted a question in the main forum. acidrock23 for one seems to be able to enjoy beer and still maintain an H1C in the fives. I had to Google IPA as I'd never heard of it, sounds like something I would have enjoyed in my beer drinking days.
Finally perhaps you need to loosen up a little on the diet. If you can't maintain 30g long term, perhaps you can stay with 50g long term. Dr. B in his book speaks of negotiating a diet with his patients, so perhaps he is not quite as dogmatic as many assume. 30g may be optimal but there is a vast middle ground between that and the carb laden diet many of us ate pre D.
You guys are awesome, thanks for the support and the inspiration. I like the idea that I can have treats now and then instead of punishing myself and not allowing anything. I found I was getting into that same diet mode of "restrict....binge....restrict" and it's just not working. So restricting 100% is what I need to cut out. I also am supercharged about reading Dr. B's book (the newest edition I can find) in its entirety. It's been since I first got diagnosed that I read it an it "changed my life" (at last for awhile) and it'd be good to get that reaffirmation.
Bsc, thanks for the recommendation of Diabetes Burnout. I'm ordering it ASAP. So glad there is this forum, I seriously was writing that last message at 3am this morning, sick with worry and frustration, but it was so nice to have "someone" to talk to. I feel better now, thanks y'all. :)
Sometimes talking it out can really help. This is a great place to do that since we're all in the same boat.
I find that monitoring my BG and my weight, gives me the feedback to keep on track. I've only rarely fallen off the wagon in the last 8 years or so. I do allow myself a TINY portion of treats every now and then, but keep them within my daily carb allowance.
Dr.Bernstein rocks! I went to my opthmalogist appointment today to have my second laser treatment to my left eye. There is scarring from lipids that have fallen into the macula but no additional damage. My retina specialist told me everything looks good, greatly improved. The most important tnings are keeping my BGs, BPs, lipid down. I am NOT taking BP meds or statins, and just 1000MG MetEr. The real help is from Dr. Bernstein's WOE. My DME is healing. The edema has disappeared.
Happpy for your wonderful news, Amanda!
I've been eating 25 - 30 gr carbs for the past 4 months. My readings are great (85 to 120). I've had several heart attacks and am concerned about the fat levels I'm taking in. Anyone have any experience with CAD?
Rick N. Read up on anything you can about Ketogenic Diet. The idea that it debunks the myth that fats are bad. You just have to make sure you are eating the right fats. Look around on the internet. We became a fat phobic society. I see a lot of new info that states that it is any starch that lines the artery walls. Acidic waste. Lot's to read up on and rethink.
RickN, this question has generated a lot of strong opinions on both sides. Research I've seen says the bad combo is high fat high carbs , AKA the typical American diet. Cutting either fat or carbs results in improvements in the lipid profile. How to interpret blood lipid profiles is another contentious topic. Here is a blog post from the Low Carb dietician website concerning these issues.
In the end you will have to read up on both sides of the argument and make an informed decision. Personally I eat 30 to 50g of carbs/day and don't limit saturated fat. However I try not to eat any Omega 6 oils or hydrogenated fats.
Got my A1C back today 5.5 down from 6.7 :)
RickN, Congradulations!
Great job Rick!
I've got to share/brag a little bit. My fasting BGs have been as low as 103 this month. That is certainly a contrast to what it was in January when the lowest was 145. I don't count carbs, but I'm not eating as many as I was. I've also added 1000 UIs of vitamin E. Can't say what is working, just that it is. ;)