yes, one of my doctors told me about his book and diet at my diagnosis- I don't know if my endo knows about him- i have to ask, but he didn't say he had not heard of him. my doctor told me to follow his diet- at first I didn't do it after my hospital stay but as soon as I did my bg came down and became more stable. I eat about 30-40 grams a day, I eat snacks and fruit and I dont follow a strict schedule.
Can I just say that I love your profile pic. I read Dr.B's book and found it very interesting. I stuck to its principles for a short while and did see results. My only problem is staying off the carbs
No, I doubt more have heard of him and if they have they are negative about his teachings. At least here in the U.S. the ADA rules supreme and they advise high carb/low fat diets. We don't all eat true Bernstein low but I think many of us restrict our carbs to some extent because it just makes sense. I am not a Bernstein low carber but I do really respect him and his "law of small numbers" makes a lot of sense to me: Less carbs = less insulin = less chance for error. I see you live in Israel where I think the diet is in general a lot healthier than the typical American diet which is high carb and junk food laden.
Here's my take on Bernstein. I own and have read his "Diabetes Solution" book cover to cover. You'll see that I disagree with many of the previous comments.
The Bernstein diet is an extreme diet. Contrary to some of the comments here, it stipulates that eating more than 30 grams of carb per day is not allowed. Reducing your intake to 30 grams of carb per day is difficult, and requires you to remove many foods from your diet. Have you have read the list of foods that Bernstein prohibits and are you comfortable that you can live with those restrictions? Besides the obvious refined sugars and desserts, the other foods that are prohibited (LINK HERE) include: all fruits, all grains, all bread, all crackers, all cereals, all rice, all pasta, all beans (legumes), many vegetables including tomatoes, carrots, peas, corn, onions, winter squash, potatoes and sweet potatoes, all milk and low or reduced fat dairy products, and any more than a few peanuts or tree nuts.
Maintaining such a diet, with so many restrictions, for the rest of my life, would be very, very difficult. Yet that is what truly embracing the Bernstein diet entails.
Note that most of the pro-Bernstein responses you've received in this T1 thread are actually from T2's or from recent-onset LADA T1's who still make some of their own insulin. Many of them use the Bernstein diet in order to avoid taking insulin. You've had T1 for more than 15 years, and if you're like me then you need to inject insulin every day and for every bit of food you eat. So I think the advice of the T2's is not necessarily suited to you. In my opinion, if you're injecting insulin for the food you eat, then you may as well eat the food you like and that you believe is healthy for you.
Note that a lot of the T2's who are pro-Bernstein are also using the Bernstein diet to deal with weight issues. If you have insulin resistance (common for those with T2 or those with excess weight), then the Bernstein diet can apparently be effective to lose weight. If this includes you, and if you've tried other ways to control BG and lose weight and have failed, then by all means go for it. But if you do not have insulin resistance, and do not want to lose weight, then it can be hard to maintain your weight eating a strict Bernstein diet, at least according to some anecdotal posts I've read on the DOC forums.
The Bernstein diet, like the Atkins diet, is an ultra-low carb, high protein, high fat diet. Because almost all vegetable protein sources contain a fair amount of carb, these diets are largely also high in animal protein and animal fat. And as already stated, you will never eat any more fruits, beans, or whole grains. Some people think this is healthy, but the American Heart association and many others do not. This is why most doctors do not support long-term maintenance on a Bernstein-like diet. Of couse many of the Bernstein proponents disregard this advice and argue that animal protein and animal fat are healthy, and that the AHA is wrong. What do you think? Some even argue that these organizations like the American Heart association have some evil motive to make us all unhealthy. You will have to decide how much of this you believe. In my opinion some of the low-carbers are a pretty paranoid lot.
The pro-Bernstein crowd often construct a false dichotomy, that you can either eat the Bernstein 30g carb per day, or you can eat unlimited amounts of sugar and carb and face a life of slow decline. Of course this is ridiculous. YOU get to decide how much carb you eat every day, and what foods you want to restrict or embrace. For many real-world T1 diabetics, eliminating refined sugar and flour while eating an amount of 100g to 200g of carb per day is the right amount that allows them to eat the foods they like, the foods that are healthy for them, and that can be well-managed with the insulin they inject with every meal.
Before trying Bernstein, you might want to try to tighten your control in a less radical way by accurately measuring your daily food intake, and shooting for a moderate carb intake while eating the foods you like. If you eat more than 100g carb per day you will avoid ketosis. While you are doing this, measure your BG a LOT to see the impact of the foods you eat, and eat similar foods at similar times every day to try to eliminate as many variables as you can. It took some time, but it worked for me. And I still eat what I consider to be a healthy diet, including all the foods in the "no-no" list above.
I have not read Bernstien so I can not argue your points, nor do I wish to. You make a solid case for exactly what I have done. I eat about 100 carbs per day. Give or take 20 or so depending on what I want and my activity level. I have found that a consistent schedule and careful food selections keep my BG very stable and me happy with my diet. This truly is about figuring out what works best for each of us. No CDE, doctor or book can truly do that for us. They can only offer advice.
Just so we are clear. Bernstein recommends a low carb, modest protein and high fat diet. And yes it is in direct conflict with the AHA recommendations which really never had any goal of helping blood sugar control or manage the outcomes for diabetics.
But the original poster wishes dearly to have a child and to do that she needs to get he blood sugar more tightly controlled. Nothing the AHA recommends will help her achieve that, and they make no claims it does.
Do you have any suggestions on an alternate diet that can help this young lady tighten up her blood sugar control?
I own and have read Dr. Bernstein's book. I think there are many useful things one can learn from it about managing diabetes....but the diet is too extreme for me right now. I have cut my daily carb intake to about 120-150 grams a day and can eat a quite varied diet.
I also have the sense that Dr. Bernstein is stuck in the past... he doesn't believe in CGM's, insulin pumps, or the new insulins. They can be quite useful adjuncts to diabetes care if one realizes the limitations each technology has. I can understand why he is comfortable with the approach that has worked so well for him for so many years...and he figures if it is good enough for him it is good enough for everyone.
Perhaps one day I will change my mind and adopt his diet and methods but at this time I am on an improving track that I think will get me under 6.0. If I get stuck I will try new things.
In the mean time, another new study has come out showing low carb diets can be useful for weight loss and result in improvements in cholesterol, fasting blood sugar, triglycerides, C-reactive protein, increases in HDL, etc, all of which would be good for heart disease/risk.
Detroit Free Press:
http://www.freep.com/article/20120831/FEATURES08/120831015/Low-carb-diet-gets-more-support-from-new-analysis
Link to the original article in Obesity Reviews:
http://onlinelibrary.wiley.com/doi/10.1111/j.1467-789X.2012.01021.x/abstract
When I read Lady Moon's question I don't see a request for a diet change, I see her asking for advice on getting her diabetes management in line. I don't think a radical diet change is the best way for most people to improve their diabetes management - in fact I think it is one of the worst ways because of the difficulty most people have in adhering to life-long radical changes in diet, especially a diet that prohibits as many foods and food groups as the Bernstein diet does.
What I recommended to her instead is to tighten control by testing BG often and using the results to adjust diet and insulin - in the way detailed by Walsh and Scheiner in their books and online.
And by the way, I don't think there is one doctor in a million who would recommend an ultra-low-carb diet of 15 to 30 grams of carb per day for an expectant mother.
Instead of attacking other people's replies and Bernstein's diet why don't you just give your own experiences and recommendations? Have you ever actually tried his diet or any low carb diet? What she asked at the end of her question for people who have tried Bernstein's diets/recommendations in any form to tell her what their experience was/is and that is what people have done.
I've read some of your other posts and it seems you are anti low carb for whatever reason, fine, if that is what works for you, a higher carb diet, that is great.
In Bernstein's book he says that he negotiates the diet with his patients, he doesn't expect people who have eaten a high carb diet their whole life to jump to 30 grams per day. Nor is he against cgm or new technologies as far as I know, why would he be? He also says he likes the new insulins: novolog and one other were mentioned in the latest edition of his book.
We are all our own people and we must experiment and see what works best for us.
I do think that both the ADA and AHA diet recommendations are terrible and that they have resulted in more obesity, more heart disease and more diabetes.
I'm recently diagnosed type 1/lada btw, and I need insulin. I'm not following a low carb diet to stop taking insulin. I need a basal and I need to bolus for nearly everything I eat. What low carb has done for me so far is to lower my overall bg range and to lower my insulin intake for bolus as well as to help to stabilize me a lot. I could never have done this on the 55% carbohydrate content recommended to me at the hospital which follows the ADA guidelines. That was spiking me up into the 200's even with a much larger bolus and we all know what those numbers can do to our bodies, I don't want to risk that. Btw, they also didn't want to give me any insulin bolus unless my bg was above 140!
The ADA has major problems, they recommend a diet that is harmful to diabetics and they accept endorsements and donations/deals from candy companies and the like who are not going to promote better health for anyone. As far as I know they put very little money towards research for finding a cure and for better treatment for us.
No one told her to do a 15 to 30 gram carb diet as far as I know, we told her what we did and what our experiences a la Bernstein are. She has to decide for herself what would be best for her and a possible baby- maybe the forum for expectant mom's would be a better place for her to ask for that advice.
The ADA has not recommended a high carb diet for ages... I wish people would stop repeating this nonsense. I get their magazine and they publish low-carb recipes and instruct people on how to lower their carb intake.
You can read their IRS submissions, which are public data, and see directly how much goes to research, education, fundraising, overhead etc. and where the funds come from. Same with JDRF.
Hree is what he says in his book about insulin pumps:
In our experience, insulin pumps do not provide better blood glucose control than multiple injections.
I think you would find quite a few people on here who have had the opposite experience. I simply cannot get the variation in basal rates I need through the day with MDI.
He also says:
The basal infusion rate (0.05 units per hour) is still too high for most people taking physiologic doses of basal insulin
First, some pumps can do 0.,025 units/hour. Second I defy anyone to get that kind of accuracy with a syringe, and Levemir , Lantus, or any other insulin. Measuring 1/2 unit to 1/4 unit is tricky , much less 0.025.
Additonally, the long acting insulins all have considerable variability in their release rates over time... the pump can be tuned quite finely, more finely than you can adjust a basal insulin.
About CGMs he says
CGMs have limited usefulness at the moment....the technology has been around for decades and manufacturers have made plenty of money by employing it shoddily.... I suspect it will pose the same problems as are found with insulin pumps and will not give the same accuracy and precision that we get with an injection and an accurate blood sugar meter
There is no doubt that CGMS are less accurate than fingersticks, however that does not mean that they are not a useful tool, nor that they have not saved lives by alerting people to an impending hypo.
I was wrong in my comment about modern insulins. He does support those.
There is plenty of good information in his book and I learned alot from it. I simply do not take it as the final word on diabetes control. I use all available sources, including the Scheiner, Walsh books, and the good people on this forum, as well as my diabetes team.
The ada recommends 1/4 plate grains/starchy veggies etc., 1 side of low fat milk/yogurt etc. and one of fruit, that would be a lot of carbs in one meal.
IMO that is too high carb a recommendation to make for us, although at their website they give no percentages- and that was exactly what the dietician who instructed me in the hospital told me I should eat, she stated that this was the ADA recommendation so this isn't nonsense I'm telling you- it didn't work for me and even with high doses of insulin it spiked me to 200-250's. She said specifically 45-55% carbs and not to count vegetables at all.
Why tell someone to eat so many carbs when their body can't process that and you need to overdose insulin to do it- that is dangerous. I'm telling you what I was told to do in a hospital which based everything on ADA recommendations according to them. They also gave me several meals that had nothing but carbohydrate in them and their diabetic dietary choices were a joke to say the least.
You're right about what he said about pumps/cgm, I remember reading that bit now. I don't know enough about pump technology to comment on that and I have no experience of a pump.
I could be wrong but I would guess the reason he doesn't like cgm is they aren't accurate enough- and I agree with that, from my own experiences I didn't feel I could ever rely on it to warn me about a low or even a trend. I think, I could be wrong, that he would be behind one that is accurate and more reliable. I also want one that is less painful! Actually I want one that is pain free, is that really asking too much??? lol or should we suffer pain constantly in order to feel safer, I found finger sticks less painful, something I never thought would occur...
You're right- many people do get better results with pumps, if there were one which wasn't painful and which doesn't have to be attached to me 24/7 with tubes/wires/needles and I NEVER had to worry about malfunctions possibly causing super high bg and or dka etc. I will definitely try it at some point. Who knows if things get really out of control for me I may try it anyway at some point, the pain factor and danger of dka are deal breakers for me. I think pendiq does have much smaller dosing which is accurate, I would like to try that first at some point too. I personally found recently that it was very hard to tell what I was dosing with a syringe, but everyone is different.
I guess he goes on what his own experience has been which was that he managed with injections and finger sticks and a very low carbohydrate diet to reverse longterm complications, but I don't think it's fair to say he wouldn't be behind better technology- he was a pioneer of using finger sticks.
I don't take anything as the final word either and I don't think anyone here would say that they do, although I could be wrong- however no one in my team, or in any of my care, except for my original doctor ever suggested a dietary change that helped me at all. They just told me to try to keep my bg between 100-200, that wasn't good enough imo. This diet in my own modified form works the best for me at the moment and I think most of us do find lower carb in some form does help us overall.
I seem to remember reading somewhere, maybe on his website, that he actually liked the idea of cgm but again he didn't feel the technology was good enough yet. I will try to find that.
Wow. What a great discussion. It is interesting to hear the wide variety of responses. A while back my doctor told me to eat whatever I wanted and he'd help me match my insulin to the food. Well my Hba1c skyrocketed, I felt awful and decided that this was not the way for me to go. At the same time, there are certain foods that I really enjoy - like fruit- which I love - so I get to figure out what are good fruits for me to eat, based on what my body can handle - and not feel deprived. In this respect I do think that diets need to be very individualized and pregnancy is surely a time when your body will have its own very special set of needs and cravings. Information here will be power to make wise decisions on the kind of diet you adapt. Maybe those who have gone through pregnancy with diabetes would have some special relevant words of advice! So I guess I would join the folks who say eating lower carbs has given them greater bg stability. Even with a low carb diet my blood sugars are way less than perfect. Then again I too am way less than perfect. What a drag that we have to surrender perfection if we are ever to live well with this disease. At least that's how it seems to me.
LC markedly improved my BG (been 30-40 carbs for 4 years) & also helped my emotional well-being by preventing wild swings. Perfect--nope. Surrender to & make myself nuts to attain perfection--nope.
Moderate amounts of berries & melon, which are my favorite fruits, don't have an adverse effect on me. I only eat fruit occasionally.
I started Dr. B's outline (mostly) on August 1st and my BGs are finding a new normal. They used to range everywhere from 40s to 400s, they now range from 80s to 180s most days. My insulin (via insulin pump) was averaging about 80-90 units a day and now ranging mostly 35-45 a day. I've lost about 6 lbs since August 1st. I can barely take a nap anymore because I have so much energy. I have done a hybrid/template of Dr. B, Paleo, Mark's Daily Apple. Basically trying to eat lower carbs (only meats and veggies mostly). NO refined carbs (sugar, sweets, breads, rice, pasta). Except allowing an occasional "experiment" as I like to call it which is a random splurge which every time I go "oh, that's why I don't eat that way any more...my BGs are crazy and I feel like crap". I'm T1, but in fairness I've gained like 60 lbs in the past 10 years (6 lbs a year) and probably have some T2 stuff with the weight gain. I have tried for the past 10 years to diet and would always fail when I ate anything with high carbs in it. Now that I eat low carb, I hardly even fall.
Hi everyone
This is my first post. I read his book when I started to gravitate to the Paleo lifestyle. I wish I had known sooner (32yrs) ago that I wasnt the only one who didnāt tolerate all that CHO so well. I just learned on my own what worked for me. Before insulin was discovered diabetes were prescribed an all fat diet. Anyway getting my CGM last spring was the best thing I ever did because I could see what my beloved high fat popcorn was doing to my sugars. Replacing popcorn with nuts and seeds helped me lose and keep off 7 lbs without effort. I still use skim milk in my tea and have a chocolate ice cream bar(s) every day (somethingās got to give) but my A1C dropped to 6.2 from high 7s to low 8s and I never feel deprived. Iāve always exercised but I have a son with autism so I tend to snack at night on bad days. I really think an all natural diet with lots of raw vegetables is best and especially during pregnancy. However as we all know some type 1s continue to produce insulin. I know Iām not one of them so I try to eat as little CHO as possible. With all this new information and gadgets itās getting easier for women to be pregnant. I maintained my A1cs in the low 5s but I passed out and felt like a zombie for 9 months. I hope all those who wish to have a baby enjoy a wonderful healthy pregnancy. Although I limited my artificial sweetener use during my pregnancy I regret I used it at all in case it was a factor in my sons autism. Thank you all for sharing!
I find that the closer to the Bernstein plan I am, the better my control and the lower my weight.
I think that there are many advantages in addition to blood sugar control in keeping one's insulin dose low.
As a researcher in this field (I studied carb restriction in my research years before I became a late-onset type 1), I can tell you that the cancer research world is suddenly paying more attention to the role of insulin in signaling pathways that lead to cancer.
The Bernstein plan has been hard for me to maintain in the long-term, but I still keep a goal to have my insulin (and hence my carbs) be as low as I can manage. I try to eat plenty of vegetables and reserve my carbs for dark chocolate.
My 2 cents.
Maria
Maria,
I too am fond of dark chocolate and would be curious how you handle this rather high fat item. Have you figured out how to dose for this lovely substance?
Thanks.
I found a great product - chocolate bars made from 100% chocolate - no carbs. Because I am on such a low-carb diet and have not had sugar in so long, the natural sweetness of the chocolate is enough - to me it tastes great! And its so concentrated that you don't need a lot to satisfy the chocolate cravings, so the fat issue is not a big deal.
Well, I have found that the most helpful thing for managing my diabetes is to be open. If my heart's desire is to get healthy, and if I'm open it will happen.
I have never felt better in my whole life eating 30 carbs a day. I found that I was a carb and sugar addict, and if I have a little I have to have a lot. In fact, it's much like a cigarette addiction for me. I really don't see any reason why carbohydrates in the form of sugar, bread, grain, pasta, or even fruit are necessary especially for an expectant mother.
Are we really alive if we don't make life-long radical changes sometimes?
Peace and Love.
1 Like
Hi Lady Moon,
I think I am a sugar/carb addict a bit too, I'm not sure what role that played in my D. I do feel a bit deprived at times even on 30-50 g a day which is what I'm doing now. It may be that the insulin is making me hungry a lot. But I know there is no other way to control my bg- Im too sensitive to carbs/sugar and to insulin. I think I will get this worked out for me at some point though. And lower carb is the way to go for me for sure. I have trouble absorbing fat and I don't like eating too much protein. I have ibs and it seems to affect that. But so far I'm doing ok with this.
I'm glad this is working for you and I wish you all the best with your health and with having a baby. Just ask your doc what he thinks about the lower carb and make sure it is ok for the baby- you may need to adjust your diet as you progress in a pregnancy. I think the main thing is for us to have good bg though, because the higher levels are bad for us... take care :)